Diagnosing sentinel lymph node metastasis of T1/T2 breast cancer with conventional ultrasound combined with double contrast-enhanced ultrasound: a preliminary study

Zheng, Yufeng; Sun, Jun; Zhu, Lin; Hu, Meng-Shang; Hou, Lingling; Liu, Jianxia; Dong, Fenglin

doi:10.21037/qims-22-1175

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Moreover, the SLN technique is highly valuable for improving the quality of life of patients, as it can help prevent unnecessary ALN dissection, thereby reducing the length of hospitalization, the risk of infection in the axillary fossa, and the risk of lymphedema ( 4 ). Hence, determination of preoperative SLN status is crucial for accurate clinical staging and individualized treatment in patients with BC ( 5 , 6 ). Currently, the assessment of SLNs primarily relies on intraoperative SLN biopsy ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Yang,

Lu,

Tan

et al. 2024

Quant Imaging Med Surg

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Background The noninvasive prediction of sentinel lymph node (SLN) metastasis using quantitative magnetic resonance imaging (MRI), particularly with synthetic MRI (syMRI), is an emerging field. This study aimed to explore the potential added benefits of syMRI over conventional MRI and diffusion-weighted imaging (DWI) in predicting metastases in SLNs. Methods This retrospective study consecutively enrolled 101 patients who were diagnosed with breast cancer (BC) and underwent SLN biopsy from December 2022 to October 2023 at the Affiliated Hospital of Jiangnan University. These patients underwent preoperative MRI including conventional MRI, DWI, and syMRI and were categorized into two groups according to the postoperative pathological results: those with and without metastatic SLNs. MRI morphological features, DWI, and syMRI-derived quantitative parameters of breast tumors were statistically compared between these two groups. Binary logistic regression was used to separately develop predictive models for determining the presence of SLN involvement, with variables that exhibited significant differences being incorporated. The performance of each model was evaluated through receiver operating characteristic (ROC) curve analysis, including the area under the curve (AUC), sensitivity, and specificity. Results Compared to the group of 54 patients with BC but no metastatic SLNs, the group of 47 patients with BC and metastatic SLNs had a significantly larger maximum axis diameter [metastatic SLNs: median 2.40 cm, interquartile range (IQR) 1.50–3.00 cm; no metastatic SLNs: median 1.80 cm, IQR 1.37–2.50 cm; P=0.03], a higher proton density (PD) (78.44±11.92 vs. 69.20±10.63 pu; P<0.001), and a lower apparent diffusion coefficient (ADC) (metastatic SLNs: median 0.91×10 −3 mm 2 /s, IQR 0.79–1.01 mm 2 /s; no metastatic SLNs: median 1.02×10 −3 mm 2 /s, IQR 0.92–1.12 mm 2 /s; P=0.001). Moreover, the prediction model with maximum axis diameter and ADC yielded an AUC of 0.71 [95% confidence interval (CI): 0.618–0.802], with a sensitivity of 78.72% and a specificity of 51.85%; After addition of syMRI-derived PD to the prediction model, the AUC increased significantly to 0.86 (AUC: 0.86 vs. 0.71; 95% CI: 0.778–0.922; P=0.002), with a sensitivity of 80.85% and a specificity of 81.50%. Conclusions Combined with conventional MRI and DWI, syMRI can offer additional value in enhancing the predictive performance of determining SLN status before surgery in patients with BC.

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Section: Introductionmentioning

confidence: 99%

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Yang,

Lu,

Tan

et al. 2024

Quant Imaging Med Surg

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Clinical Study of Double Contrast-Enhanced Ultrasound Combined with Dye Method and Marker Placement to Identify and Locate Sentinel Lymph Nodes in Patients with Breast Cancer

Yang,

Gao

2024

ABCR

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Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769; the diagnostic sensitivity *Dayan Yang and Lini Gao have contributed equally to this work.

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Diagnosing sentinel lymph node metastasis of T1/T2 breast cancer with conventional ultrasound combined with double contrast-enhanced ultrasound: a preliminary study

Cited by 2 publications

References 28 publications

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Evaluating the added value of synthetic magnetic resonance imaging in predicting sentinel lymph node status in breast cancer

Clinical Study of Double Contrast-Enhanced Ultrasound Combined with Dye Method and Marker Placement to Identify and Locate Sentinel Lymph Nodes in Patients with Breast Cancer

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