Equivalent cross relaxation rate image for decreasing a false negative case of sentinel lymph node biopsy

Matsushima, Shigeru; Sasaki, Fumio; Sarumaru, Shuhei; Ohta, Daisuke; Era, Seiichi; Sogami, Masaru; Inaba, Tadashi; Yasutomi, Keita

doi:10.1016/s0730-725x(03)00208-x

Cited by 9 publications

(15 citation statements)

References 4 publications

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“…In this paper we demonstrate that ECRI is a feasible technique that does not require contrast injection to detect axillary lymph nodes in breast cancer. ECRI was able to quantitatively distinguish changes in the structural organization of the axillary lymph node, with lower ECR values for metastatic lymph nodes (10, 15, 18).…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported that ECRI was related to changes in the macroscopic image, and that it was possible to evaluate the presence or absence of axillary lymph node metastases (18). The aim of this study was to employ ECRI as a technique for assessing the metastatic status of the axillary lymph nodes in breast carcinoma patients, with the eventual goal of reducing the number of false negatives that can occur with SLNB.…”

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confidence: 99%

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Equivalent cross‐relaxation rate imaging for sentinel lymph node biopsy in breast carcinoma

Matsushima

Sasaki

Yamaura

et al. 2005

Magnetic Resonance in Med

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Sentinel lymph node biopsy (SLNB) is an important technique for detecting axillary lymph node metastasis in breast carcinoma patients. However, false-negative results are a problem. Equivalent cross-relaxation rate (ECR) imaging (ECRI) is a measurement method that can be used to quantitatively evaluate a change in the structural organization of lymph nodes by magnetic resonance imaging (MRI). We performed axillary ECRI in an attempt to decrease the false-negative results of SLNB. Regions without metastases showed a higher ECR value. On the other hand, regions with metastases showed a lower ECR value. The ECR images were compared with macroscopic histology images in which the presence or absence of axillary lymph node metastasis could be evaluated. ECRI is a potentially useful method for evaluating the efficacy of SLNB. Over the past few years, breast conservation surgery has become a standard procedure for the operative management of early breast cancer. The sentinel lymph node (SLN) biopsy (SLNB) is fast becoming the technique of choice to determine whether breast cancer has spread to the lymph ducts or nodes. The only time an SLNB is bypassed is when there is significant evidence of clinical involvement of one or more axillary nodes. However, involvement of the axillary nodes with metastatic carcinoma can lead to mechanical obstruction of the lymphatic sinuses and alterations in fluid transport, which in turn may lead to a false-negative result if a radio-tracer or dye approach is used (1).Magnetic resonance (MR) lymphography is used to localize SLNs in breast cancer, and some studies that used contrast agent have been reported (2-6). Off-resonance saturation imaging is an MRI technique that selectively alters the contrast on the basis of tissue macromolecular environments by magnetization transfer and spin lock (7,8), and the contrast obtained is highly dependent on the offset frequency (7-10). In saturation transfer ratio imaging (STRI), the contrast obtained in the breast cancer tissue at frequency offsets of 7 and 19 ppm from the water resonance frequency has been shown to correlate with the malignant potential of the cells and the extent of fibrosis, respectively (11). In an in vitro nuclear magnetic resonance (NMR) study, Callicot et al. (12) found that the cross-relaxation rate is a more sensitive parameter than the STR for characterizing human breast tissue. The crossrelaxation rate (1/T IS ) is defined as the magnetization transfer rate constant, i.e., [1/T IS ϭ 1/T 1 * -1/T 1 ], where T 1 and T 1 * are the longitudinal magnetizations of the observed water protons before and after irradiation of the saturation transfer pulse on polymer protons, respectively (13,14). We further refined this technique and showed that the cross-relaxation rate can be calculated using a simple equation (15,16). We named this technique "equivalent cross-relaxation rate imaging" (ECRI). We suggested that the equivalent cross-relaxation rate (ECR) at frequency offsets below 10 ppm depends not only on the rigidity of gels, bu...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Equivalent cross‐relaxation rate imaging for sentinel lymph node biopsy in breast carcinoma

Matsushima

Sasaki

Yamaura

et al. 2005

Magnetic Resonance in Med

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“…In ECRI, the contrast obtained in breast cancer tissue is correlated with the malignant potential of cells and the extent of fibrosis 2,12,13. It may be possible to evaluate the presence or absence of axillary lymph node metastases and to confirm the cellular density of axillary lymph nodes using the ECRI technique 3,4…”

Section: Discussionmentioning

confidence: 99%

Cellular Imaging Using Equivalent Cross-Relaxation Rate Technique in Rabbit VX-2 Tumor Model

et al. 2011

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Purpose:Equivalent cross-relaxation rate (ECR) imaging (ECRI) is a measurement technique that can be used to quantitatively evaluate changes in structural organization and cellular density by MRI. The aim of this study was to evaluate the correlation between the ECR value and cellular density in the rabbit VX2 tumor model.Materials and methods:Five rabbits implanted with 10 VX2 tumors in the femur muscles were included in this study. We adopted the off-resonance technique with a single saturation transfer pulse frequency of 7 ppm downfield from water resonance. The ECR value was defined as the percentage of signal loss between the unsaturated and saturated images. ECR images were constructed based on the percentage of the ECR value. Pathological specimens were divided into 34 areas and classified into two groups: the viable group and the necrotic group. ECR values were measured and compared between groups. The correlation between the ECR value and cellular density was then determined.Results:The mean ECR value was significantly higher in the viable group than in the necrotic group (61.2% vs. 35.8%). The area under the curve that calculated by receiver operating characteristic curve was 0.991 at 7 ppm. The regression graph showed a linear relationship between the ECR value and cellular density; the correlation coefficient (r) was 0.858.Conclusion:There is a strong association between the ECR value and cellular density in VX2 tumors and so ECRI could be a potentially useful technique for accurately depicting viable and necrotic areas.

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“…The ECRI technique is applied to quantitatively evaluate a change in the protein-water interaction; whereas, ECR is able to directly provide information regarding cell content when the offset frequency of the MT pulse is less than 10 ppm. Matsushima et al (7, 17, 18) used ECR to evaluate the degree of malignancy of the axial lymph node swelling in patients with breast cancer, and demonstrated that ECR values of normal lymph organization are more than 100% and that ECR provides useful results regarding the diagnosis of benign and malignant lesions. The ECR values of FL and DLBCL are less than 100%.…”

Section: Discussionmentioning

confidence: 99%

“…ECR values were ranked as normal lymph organization » fibrous ingredients (17, 18). The cellular density of DLBCL was lower than that of FL, and the photomicrograph of DLBCL demonstrated an increase in fibrous ingredients.…”

Section: Discussionmentioning

confidence: 99%

Cellular Density Evaluation for Malignant Lymphoma Using Equivalent Cross-Relaxation Rate Imaging - Initial Experience

et al. 2010

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ObjectiveEquivalent cross-relaxation rate (ECR) imaging is an MRI technique used to evaluate quantitatively a change in the protein-water interaction. We aimed to evaluate retrospectively the usefulness of ECR imaging for the histologic classification of malignant lymphoma (ML).Materials and MethodsInstitutional Review Board approval was obtained and all patients provided informed consent. The study subjects included 15 patients with untreated ML who were histologically diagnosed with follicular lymphoma (FL; n = 8) or diffuse large B-cell lymphoma (DLBCL; n = 7). All patients underwent ECR imaging and the offset frequency was set at 7 ppm.ResultsThe median ECR values were 71% (range; 60.7 to 75.5) in FL and 54% (50.8 to 59.4) in DLBCL (p = 0.001). The median cellular density was 1.5 ± 0.17 × 106 / mm2 in FL and 1.0 ± 0.70 × 106 / mm2 in DLBCL (p = 0.001). The correlation coefficient between the ECR values and cellular density in ML was 0.88 (p = 0.001). In FL and DLBCL, assuming ECR value cut-off points of 60%, both sensitivity and specificity were 100%.ConclusionA strong correlation between ECR and cellular density in ML is demonstrated and the ECR may be a useful technique to differentiate between FL and DLBCL.

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Equivalent cross relaxation rate image for decreasing a false negative case of sentinel lymph node biopsy

Cited by 9 publications

References 4 publications

Equivalent cross‐relaxation rate imaging for sentinel lymph node biopsy in breast carcinoma

Equivalent cross‐relaxation rate imaging for sentinel lymph node biopsy in breast carcinoma

Cellular Imaging Using Equivalent Cross-Relaxation Rate Technique in Rabbit VX-2 Tumor Model

Cellular Density Evaluation for Malignant Lymphoma Using Equivalent Cross-Relaxation Rate Imaging - Initial Experience

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