Ultrasound visibility of select breast biopsy markers for targeted axillary node localization following neoadjuvant treatment: simulation using animal tissue models

Portnow, Leah H.; Kwak, Ellie; Senapati, Gunjan M.; Kwait, Dylan C.; Denison, Christine M.; Giess, Catherine S.

doi:10.1007/s10549-020-05840-x

Cited by 19 publications

(8 citation statements)

References 24 publications

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“…Portnow et al [ 15 ] reported the US visibility of four types of tissue markers—including UltraCor Twirl and UltraClip—in animal tissue models stimulating axillary echotexture, and UltraCor Twirl demonstrated the highest score on the grading system used by radiologists. Lim et al [ 14 ] reported that UltraCor Twirl showed the best US visibility and highest excision rate after NAC among the four different types of tissue markers, including UltraCor Twirl and UltraClip, in 14 patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, US-guided localization of axillary lymph nodes after a partial or complete radiologic response to neoadjuvant chemotherapy may often be challenging to radiologists [ 12 , 13 ]. A few studies have reported the US visibility of tissue markers for axillary lymph node localization in animal model phantoms or in a small number of patients with different types of tissue markers [ 14 , 15 ]. However, to the best of our knowledge, no study has evaluated the visibility of tissue markers in metastatic axillary lymph nodes after showing a pCR on US.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Ultrasound Visibility of Tissue Markers in Metastatic Lymph Nodes after Neoadjuvant Chemotherapy in Patients with Breast Cancer

Kim

Han

et al. 2022

Diagnostics

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This study aimed to investigate the differences in ultrasound (US) visibility for the localization of clipped metastatic lymph nodes after neoadjuvant chemotherapy (NAC), according to tissue marker type. This single-center retrospective study included 59 consecutive patients with breast cancer who underwent tissue marker insertion for histologically proven metastatic axillary lymph nodes before NAC, between March 2020 and August 2021. Two breast tissue markers were used: UltraClip™ (n = 29) and UltraCor™ Twirl™ (n = 30). The US visibility of tissue markers after NAC and the successful excision rate of the clipped lymph nodes were compared between the two types of tissue markers. UltraCor™ Twirl™ showed better overall US visibility than UltraClip™ after NAC (86.7% vs. 72.4%), but the difference was statistically insignificant. In the absence of residual metastatic lymph nodes on US after NAC (n = 32), UltraCor™ Twirl™ showed significantly better US visibility (83.3%, 15/18) than UltraClip™ (42.9%, 6/14; p = 0.027). The marker type was not associated with the successful excision of the clipped lymph node. UltraCor™ Twirl™ showed better US visibility than UltraClip™ in the metastatic axillary lymph nodes after NAC in the absence of residual suspicious lymph nodes on US.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the Ultrasound Visibility of Tissue Markers in Metastatic Lymph Nodes after Neoadjuvant Chemotherapy in Patients with Breast Cancer

Kim

Han

et al. 2022

Diagnostics

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“…On the other hand, few studies have reported the use of Twirl clips for TAD. Portnow et al [30,31] compared the US visibility of several clips in animal tissue models and reported that Twirl clips showed the highest visibility score, followed by the Tumark Q and Tumark Vision biopsy markers. Lim et al [32] reported that Twirl clips had the best US visibility in comparison with other clips such as the Hydromark clip, UltraClip Dual Trigger, and UltraClip.…”

Section: Discussionmentioning

confidence: 99%

Axillary Evaluation with Targeted Axillary Dissection using Ultrasound-visible Clips after Neoadjuvant Chemotherapy for Patients with Node-Positive Breast Cancer

2022

J Surg

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Background: Targeted Axillary Dissection (TAD) can decrease the False-Negative Rate (FNR) of sentinel lymph node biopsy after Neoadjuvant Chemotherapy (NAC). This study aimed to investigate the accuracy of TAD using ultrasound-visible clips for axillary staging, with the secondary aims of assessing the ultrasound identification rate and localization technique of the clipped node.Methods: This prospective study was conducted using patients with clinically T1-3, N1, 2, M0 breast cancer undergoing NAC followed by surgery. For targeted lymph node biopsy, a Hydromark or a UltraCore Twirl clip was placed in a biopsyproven node. During the surgery, the clipped node was removed with sentinel lymph nodes and palpable nodes.Results: A total of 26 patients were enrolled. The median number of lymph nodes removed with TAD was four (range, 2-10). The FNR of TAD was 0% (0/16). Ultrasound identified the clipped node marked with the UltraCore Twirl in 100% (12/12) and with the Hydromark in 92.9% (13/14, p = ns) of the respective cases. Wire localization combined with dye injection successfully removed the node marked with the UltraCore Twirl in 100% (12/12), whereas the node marked with the Hydromark was removed by localization with fluorescence technique, wire-and-fluorescence technique, and wire-and-dye injection in 50% (1/2), 100% (2/2), and 80% (8/10) of the cases, respectively (p = ns).Conclusions: TAD predicted post-NAC axillary nodal status with an FNR of 0%. Labelling the positive node with a USvisible clip and localizing it with a wire and dye allowed successful TAD.

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“… 6 , 7 However, US often falters in identifying the MC following NACT, especially in cases of total clinical response, prompting the need for mammography and incurring added radiation exposure. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Photoacoustic/ultrasound dual-modality imaging for marker clip localization in neoadjuvant chemotherapy of breast cancer

Deng,

Bai,

Xiang

et al. 2024

J. Biomed. Opt.

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. Significance To ensure precise tumor localization and subsequent pathological examination, a metal marker clip (MC) is placed within the tumor or lymph node prior to neoadjuvant chemotherapy for breast cancer. However, as tumors decrease in size following treatment, detecting the MC using ultrasound imaging becomes challenging in some patients. Consequently, a mammogram is often required to pinpoint the MC, resulting in additional radiation exposure, time expenditure, and increased costs. Dual-modality imaging, combining photoacoustic (PA) and ultrasound (US), offers a promising solution to this issue. Aim Our objective is to localize the MC without radiation exposure using PA/US dual-modality imaging. Approach A PA/US dual-modality imaging system was developed. Utilizing this system, both phantom and clinical experiments were conducted to demonstrate that PA/US dual-modality imaging can effectively localize the MC. Results The PA/US dual-modality imaging can identify and localize the MC. In clinical trials encompassing four patients and five MCs, the recognition rate was . Three experiments to verify the accuracy of marker position recognition were successful. Conclusions We effectively localized the MC in real time using PA/US dual-modality imaging. Unlike other techniques, the new method enables surgeons to pinpoint nodules both preoperatively and intraoperatively. In addition, it boasts non-radioactivity and is comparatively cost-effective.

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Ultrasound visibility of select breast biopsy markers for targeted axillary node localization following neoadjuvant treatment: simulation using animal tissue models

Cited by 19 publications

References 24 publications

Comparison of the Ultrasound Visibility of Tissue Markers in Metastatic Lymph Nodes after Neoadjuvant Chemotherapy in Patients with Breast Cancer

Comparison of the Ultrasound Visibility of Tissue Markers in Metastatic Lymph Nodes after Neoadjuvant Chemotherapy in Patients with Breast Cancer

Axillary Evaluation with Targeted Axillary Dissection using Ultrasound-visible Clips after Neoadjuvant Chemotherapy for Patients with Node-Positive Breast Cancer

Photoacoustic/ultrasound dual-modality imaging for marker clip localization in neoadjuvant chemotherapy of breast cancer

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