Evaluation of axillary status in patients with breast cancer using thin-section CT

Abstract

These findings suggest that CE-CT based on size criteria is useful for evaluating the preoperative axillary status of breast cancer patients, but that evaluation is more difficult and the sensitivity is reduced in patients who have received NAC.

Superparamagnetic iron oxide-enhanced MRI at 3 T for accurate axillary staging in breast cancer

“…On the other hand, CT‐LG itself may not be sufficient to diagnose sentinel node metastases using the size criterion of a short‐axis diameter of more than 5 mm for axillary staging. Shien and colleagues reported a sensitivity of 78 per cent, specificity of 75 per cent and accuracy of 76·5 per cent, whereas the sensitivity, specificity and accuracy were 79, 56 and 62 per cent respectively on a patient‐by‐patient basis in the present study. The sensitivity, specificity, accuracy, NPV and PPV of MRI were superior to those of CT‐LG on a node‐by‐node basis; particular difficulty in identifying micrometastases using CT‐LG was evident.…”

“…Sentinel node size was measured by using an electronic caliper on CT‐LG. A node larger than 5 mm in short‐axis diameter was considered metastatic.…”

Lymph node shape in computed tomography imaging as a predictor for axillary lymph node metastasis in patients with breast cancer

“…Computed tomography (CT) is one of the representative modalities that can be used to evaluate the lymph node status, and is commonly used in hospitals due to its noninvasive and inexpensive characteristics. However, the number of studies investigating the clinical usefulness of CT in determining the axillary lymph node status is limited (5). …”

Diffusion‐weighted magnetic resonance imaging in the characterization of axillary lymph nodes in patients with breast cancer

“…In particular, lymph nodes may be enlarged reactively and normal‐sized lymph nodes may be infiltrated by malignant cells (4), so that the diagnostic performance of US is far from optimal: sensitivity and specificity widely range (from 26.4%–92% and from 55.6%–98.1% respectively) and overall accuracy is around 78% (5–8). Little if any improvement on US results are obtained with computed tomography (CT: 46%–78% sensitivity, 75%–96.6% specificity) (9, 10) and magnetic resonance imaging (MRI: 83%–100% sensitivity, 56%–90% specificity) (11), despite the fact that these techniques can evaluate both the morphology and—through contrast media administration—the vascularization of the lymph nodes. The evaluation of metabolic glycolytic activity through positron‐emission tomography (PET), alone or associated with CT, does not yield more accurate diagnostic results (48.5%–66% sensitivity, 80%–96% specificity, 73.2%–79% accuracy) (5, 6, 9, 11).…”