Contrast Enhanced Ultrasound (CEU) Using Microbubbles for Sentinel Lymph Node Biopsy in Breast Cancer: a Systematic Review

Gkegkes, Ioannis D.; Iavazzo, Christos

doi:10.1080/00015458.2015.11681099

Cited by 24 publications

(19 citation statements)

References 40 publications

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“…CEUS with microbubbles, based on the use of dispersion with sulphur hexafluoride gas injected intradermally around the areola, for sentinel node biopsy was first reported in 2013. In a subsequent meta‐analysis of five studies, this technique identified sentinel lymph nodes in 9·3–55·2 per cent of patients, with a sensitivity of 61–89 per cent and a false‐negative rate of 6·6–39 per cent. No comparative study of CEUS against the dual‐modality technique exists to validate this method.…”

Section: Discussionmentioning

confidence: 99%

Network meta‐analysis of novel and conventional sentinel lymph node biopsy techniques in breast cancer

et al. 2019

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Background The aim of this network meta‐analysis was to compare the performance of blue dye alone or in combination with radioisotope (technetium‐99m, Tc) with three novel techniques for sentinel lymph node detection in breast cancer: indocyanine green fluorescence (ICG), superparamagnetic iron oxide (SPIO) nanoparticles and contrast‐enhanced ultrasound imaging (CEUS). Methods PubMed, Embase, the Cochrane Library, China Knowledge Research Integrated Database, http://clinicaltrials.gov and OpenGrey databases were searched up to 31 November 2017, without language restriction. Studies that compared the detection performance of at least one of the novel methods (ICG, SPIO and CEUS) with that of traditional methods (blue dye and/or radioisotope) were included in network meta‐analysis. Results Thirty‐five studies were included. Pooled risk ratios (RRs) for Tc (1·09, 95 per cent c.i. 1·04 to 1·15), ICG (1·12, 1·07 to 1·16) and SPIO (1·09, 1·01 to 1·18) showed statistically better performance in detecting sentinel lymph nodes than blue dye alone. ICG had the lowest false‐negative rate, with a RR of 0·29 (0·16 to 0·54), followed by Tc (RR 0·44, 0·20 to 0·96) and SPIO (RR 0·45, 0·14 to 1·45), with blue dye alone as the reference group. Conclusion SPIO or ICG alone are superior to blue dye alone and comparable to the standard dual‐modality technique of blue dye with Tc.

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Section: Discussionmentioning

confidence: 99%

Network meta‐analysis of novel and conventional sentinel lymph node biopsy techniques in breast cancer

et al. 2019

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“…In our study, we followed the rationale of guiding the CNB to the lymph node cortex, where early metastatic tumor deposits develop . However, the CEUS technique justifies and enables percutaneous CNB of small benign‐appearing lymph nodes with a very thin cortex . Limiting the 14‐gauge needle's trajectory to a thin cortex is not possible.…”

Section: Discussionmentioning

confidence: 99%

“…Such lymph nodes are more prone to substantial structural damage and disruption of the hilar blood flow after a 14‐gauge CNB, which may induce the development of perinodal fibrosis. On the other hand, it is unlikely that the contrast agent itself could cause perinodal fibrosis because microbubble destruction occurs within a short time frame . Moreover, there has been no report of clinical, sonographic, or pathologic evidence of fibrosis or scarring at the site of CEUS intradermal injection in previous CEUS + CNB studies …”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22][23][24][25][26][27][28][29][30] However, the CEUS technique justifies and enables percutaneous CNB of small benign-appearing lymph nodes with a very thin cortex. [31][32][33][34]41,42 Limiting the 14-gauge needle's trajectory to a thin cortex is not possible. Such lymph nodes are more prone to substantial structural damage and disruption of the hilar blood flow after a 14-gauge CNB, which may induce the development of perinodal fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, it is unlikely that the contrast agent itself could cause perinodal fibrosis because microbubble destruction occurs within a short time frame. [31][32][33][34]41,42 Moreover, there has been no report of clinical, sonographic, or pathologic evidence of fibrosis or scarring at the site of CEUS intradermal injection in previous CEUS + CNB studies. [31][32][33][34]41,42 Finally, it is possible that the inflammatory reaction responsible for perinodal fibrosis may be transitory because the mean time F I G U R E 5 CEUS (A) and grayscale (B) images show a contrasted afferent lymphatic vessel (arrow) and a contrasted sentinel lymph node (white arrowhead).…”

Section: Discussionmentioning

confidence: 99%

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Perinodal fibrosis developed after ultrasonography‐guided core‐needle biopsy of a contrast‐enhanced ultrasound‐detected sentinel axillary node interferes with subsequent surgical sentinel node dissection

Serquiz

Moro

Menossi

et al. 2019

J of Clinical Ultrasound

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Objective To evaluate perinodal fibrosis after 14‐gauge staging core‐needle biopsy (CNB) of the axillary sentinel lymph node (SLN) identified using contrast‐enhanced ultrasonography (CEUS) and its interference with subsequent surgical SLN dissection in breast cancer patients. Methods Frequencies or means of main clinical, sonographic, pathological, and surgical characteristics were calculated. We also compared patient groups with and without perinodal pathological fibrosis. Results Forty‐eight patients who underwent CEUS + CNB and axillary surgery were eligible for this cross‐sectional study. Axillary surgical specimens showed perinodal fibrosis in 9/48 (18.7%) patients. Interference with SLN dissection was reported in 4/48 (8.3%) patients (two hematomas, three abnormal palpation findings, and four difficult dissections). The overall surgical detection rate of SLN was 43/48 (89.6%). In the majority of cases, perinodal fibrosis was described as moderate (4/9 [44.4%]) or severe (4/9 [44.4%]). The mean time elapsed between CEUS + CNB and axillary dissection was shorter in patients with perinodal fibrosis (P = .04). Interference with SLN dissection was only reported in patients with perinodal fibrosis (P < .001). Surgical SLN detection was successful in all nine cases in which perinodal pathological fibrosis or interference with SLN dissection was reported. Conclusion Perinodal fibrosis may impair the surgical SLN dissection in early stage breast cancer patients who were staged using CEUS + CNB using a14‐gauge needle.

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Sentinel Lymph Node Biopsy in Breast Cancer-Techniques

Chintamani,

Rastogi

2023

Sentinel Node Biopsy in Breast Cancer

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Contrast Enhanced Ultrasound (CEU) Using Microbubbles for Sentinel Lymph Node Biopsy in Breast Cancer: a Systematic Review

Cited by 24 publications

References 40 publications

Network meta‐analysis of novel and conventional sentinel lymph node biopsy techniques in breast cancer

Network meta‐analysis of novel and conventional sentinel lymph node biopsy techniques in breast cancer

Perinodal fibrosis developed after ultrasonography‐guided core‐needle biopsy of a contrast‐enhanced ultrasound‐detected sentinel axillary node interferes with subsequent surgical sentinel node dissection

Sentinel Lymph Node Biopsy in Breast Cancer-Techniques

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