Accuracy of CEUS-guided sentinel lymph node biopsy in early-stage breast cancer: a study review and meta-analysis

Cui, Qiuxia; Li, Dai; Li, Jialu; Xue, Jialei

doi:10.1186/s12957-020-01890-z

Cited by 43 publications

(39 citation statements)

References 50 publications

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“…Regarding the number of observed lymph nodes, more lymph nodes were observed with MB than CEUS, which is consistent with the results of some previous studies [ 2 , 18 – 21 ]. Since MB has a small molecular weight and lymphatic vessels have good absorbency of MB, when it drains to the SLN after injection, there is partial drainage to subsequent lymph nodes other than the SLNs, causing some of the subsequent lymph nodes to be stained blue during the process of intraoperative detection.…”

Section: Discussionsupporting

confidence: 92%

“…MB is prone to allergic reactions, local skin flap and adipose tissue necrosis in previous study [ 21 ], and one patient developed localized skin necrosis in our study. No patients had adverse reaction to CEUS in this study.In addition, CEUS can display lymphatic vessels and lymph nodes visually.…”

Section: Discussionsupporting

confidence: 47%

“…Previous reports have shown that the identification rate of SLN by CEUS was 70 %~100 % [ 21 ]. The injection site and dose of UCA are inconsistent, and the SLN localization methods are diversified.…”

Section: Discussionmentioning

confidence: 99%

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The value of contrast‐enhanced ultrasound in determining the location of sentinel lymph nodes in breast cancer

et al. 2021

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Background This study aimed to explore the sentinel lymph node (SLN) identification rate in breast cancer by subcutaneous and intradermal injection of ultrasound contrast agent in the mammary areola region, compared to the results achieved with methylene blue (MB). Methods A total of 390 breast cancer patients with planned sentinel lymph node biopsy from our breast surgery department from July 2017 to February 2019 were enrolled. All patients were subjected to preoperative contrast-enhanced ultrasound (CEUS), that involved an intracutaneous injection of 1 mL ultrasonic contrast agent (UCA) at 3 and 6 o ‘clock, as well as a subcutaneous injection of 1 mL UCA at 9 and 12 o’clock. The enhanced lymph nodes along the enhanced lymphatic vessels from the mammary areola were traced. The number of enhanced lymph nodes were recorded, and an ultrasound-guided injection of 1:10 diluted carbon nanoparticles were used to mark all first site enhanced lymph nodes (i.e., SLNs). An intraoperative dye method (MB) was used to track the SLNs and the results were compared with the CEUS findings. Results Among the 390 cases of breast cancer, enhanced SLNs were observed in 373 patients after an injection of UCA with an identification rate of 95.64 % (373/390), compared to the identification rate of 92.05 % (359/390) using the intraoperative MB. The difference between the two methods was statistically significant (P = 0.016). And among the 390 patients, a total of 808 enhanced lymph nodes were traced by preoperative CEUS, with a median of 2 (1,3). A total of 971 blue-stained lymph nodes were traced using the intraoperative MB, with a median of 2 (2,3), indicating a statistically significant difference (p < 0.001). Conclusions Intradermal and subcutaneous injections of UCA in the mammary areola region may have clinical application value for the identification and localization of SLNs in breast cancer patients. The identification rate is higher than that of blue dye method, which can be used as a new tracer of sentinel lymph node biopsy and complement other staining methods to improve the success rate.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 47%

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The value of contrast‐enhanced ultrasound in determining the location of sentinel lymph nodes in breast cancer

et al. 2021

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“…SLN biopsy done by pCEUS, which has been a focus of research over recent years, especially for breast cancer, has shown a promising performance (29). However, only a few studies focused on percutaneous pCEUS in SLN in CMM.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous contrast-enhanced ultrasound for localization and qualitative diagnosis of sentinel lymph nodes in cutaneous malignant melanoma of lower extremities: a preliminary study

Guo¹,

Xiang²,

Wang³

et al. 2022

Quant Imaging Med Surg

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Background: To explore the feasibility of sentinel lymph node (SLN) tracing by percutaneous contrastenhanced ultrasound (pCEUS) in patients with cutaneous malignant melanoma (CMM) and the ability to enhance patterns of SLNs in diagnosing lymph nodes (LNs) metastases. Methods: Fifty-three patients with CMM of the lower extremities treated at our hospital were included in the study. All the participants received pCEUS preoperatively. The enhanced lymphatic channels (LCs) and associated SLNs were observed and tracked in real-time. The number of enhanced LCs and enhancing patterns of SLNs were recorded. Subsequently, SLNs localized by pCEUS were pathologically examined. Results: Of the 53 cases, SLNs were successfully localized by pCEUS in 48 cases. In total, there were 59 detected SLNs averaging 1.23±0.42 SLNs per case. The main lymphatic drainage patterns (LDPs)were the following: one enhanced LC pointed to one or more than one SLN, and multiple enhanced LCs pointed to one or multiple SLNs. There were four enhancing patterns of SLNs (uniform, annular, uneven, and no enhancement), among which the first two were considered benign nodes, while the latter two were considered metastatic nodes. With pathological results as the gold standard, the diagnostic sensitivity and specificity by pCEUS were 90.9% and 75.0%, respectively.Conclusions: Contrast-enhanced ultrasound (US) is a feasible approach for SLN identification in patients with CMM of the lower extremities. Enhancing patterns of SLNs may help predict metastasizing SLNs. This novel method may be a promising technique for clinical application.

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“…It's been reported that the combination of those 2 methods can significantly increase the success rate of SLN biopsy and reduce its false negative rate. [ 5 , 6 ] The blue dye method currently uses methylene blue more frequently in China, which is simple, economical, and easy to obtain, [ 7 ] but it's been reported to be connected with several adverse complications such as contrast agent extravasation. [ 8 ] The radionuclide method recommends the use of 99mTc-labeled sulfur colloid.…”

Section: Introductionmentioning

confidence: 99%

Preoperative evaluation and influencing factors of sentinel lymph node detection for early breast cancer with contrast-enhanced ultrasonography

Ling

2021

Medicine

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Sentinel lymph node (SLN) is important in the early diagnosis of breast cancer. We aimed to evaluate the role of contrast-enhanced ultrasonography (CEUS) in the preoperative evaluation for SLN and potentially influencing factors, to provide evidence to the management of breast cancer. Patients with breast cancer who treated in our hospital from May 2018 to May 2020 were selected. All patients underwent CEUS examination to find SLN and judged whether the lymph node had cancer metastasis. We evaluated the sensitivity, specificity, and accuracy of CEUS in predicting SLN, and its differences in pathological diagnosis results and related influencing factors were also analyzed. A total of 108 patients with breast cancer were included. And a total of 248 SLNs were detected. The sensitivity of CEUS to the preoperative evaluation of SLN was 84.67%, the specificity was 81.14%, the positive predictive value was 76.08%, and the negative predictive value was 89.27%, the positive likelihood ratio was 4.06, and the negative likelihood ratio was 0.14. The area under the curve of the preoperative evaluation of SLN in CEUS examination was 0.813 (95% confidence interval: 0.765–0.911), and there was significant difference in the size of SLNs between SLN-negative and SLN-positive groups ( P = .043). Preoperative CEUS has good predictive value for the SLN detection in patients with breast cancer, and it is worthy of clinical application.

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Accuracy of CEUS-guided sentinel lymph node biopsy in early-stage breast cancer: a study review and meta-analysis

Cited by 43 publications

References 50 publications

The value of contrast‐enhanced ultrasound in determining the location of sentinel lymph nodes in breast cancer

The value of contrast‐enhanced ultrasound in determining the location of sentinel lymph nodes in breast cancer

Percutaneous contrast-enhanced ultrasound for localization and qualitative diagnosis of sentinel lymph nodes in cutaneous malignant melanoma of lower extremities: a preliminary study

Preoperative evaluation and influencing factors of sentinel lymph node detection for early breast cancer with contrast-enhanced ultrasonography

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