MR Imaging-guided Focused Ultrasound Surgery of Breast Cancer: Correlation of Dynamic Contrast-enhanced MRI with Histopathologic Findings

Gianfelice, David; Khiat, Abdesslem; Amara, Mourad; Belblidia, Assia; Boulanger, Yvan

doi:10.1023/b:brea.0000003956.11376.5b

Cited by 131 publications

(110 citation statements)

References 24 publications

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“…These methods include touch frozen section analysis (25), touch preparation cytology (26), specimen radiography (27,28), rf spectroscopy (29,30), Raman spectroscopy (31), radioguided occult lesion localization (32), near-IR fluorescence (33,34), and high-frequency ultrasound (35)(36)(37). The intraoperative application of MRI, which has been successfully applied in brain surgery (38)(39)(40)(41)(42), is limited in its application in BCS.…”

mentioning

confidence: 99%

Application of desorption electrospray ionization mass spectrometry imaging in breast cancer margin analysis

Calligaris

Caragacianu

Liu

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

217

202

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Distinguishing tumor from normal glandular breast tissue is an important step in breast-conserving surgery. Because this distinction can be challenging in the operative setting, up to 40% of patients require an additional operation when traditional approaches are used.Here, we present a proof-of-concept study to determine the feasibility of using desorption electrospray ionization mass spectrometry imaging (DESI-MSI) for identifying and differentiating tumor from normal breast tissue. We show that tumor margins can be identified using the spatial distributions and varying intensities of different lipids. Several fatty acids, including oleic acid, were more abundant in the cancerous tissue than in normal tissues. The cancer margins delineated by the molecular images from DESI-MSI were consistent with those margins obtained from histological staining. Our findings prove the feasibility of classifying cancerous and normal breast tissues using ambient ionization MSI. The results suggest that an MSbased method could be developed for the rapid intraoperative detection of residual cancer tissue during breast-conserving surgery.B reast cancer is the most commonly diagnosed carcinoma in women in the United States and Western countries. Breast conservation surgery (BCS) has become the preferred treatment option for many women with early-stage breast cancer (1). BCS entails resection of the tumor, with a clean margin of normal tissue around it. Surgery is usually followed by radiation therapy. Results from seven large randomized prospective studies, with the largest two having over 20 y of follow-up, have shown equal survival when comparing BCS coupled with whole-breast radiation and mastectomy (2, 3).Normally, breast surgeons aim to remove a patient's tumor, along with a rim of normal tissue that is free of cancer. Preoperative mammography, ultrasonography, or MRI may be used by the surgeon to guide adequate resection (4-6). Despite numerous improvements in imaging and surgical technique, the need for reexcision to achieve complete tumor resection in the United States typically ranges from 20-40% (7-15), and has been reported as being as high as 60% (16). The importance of reexcision is underscored by numerous studies, which have shown that incomplete resection of tumor and positive margins are associated with increased locoregional recurrence compared with negative margins (12,(17)(18)(19)(20). Furthermore, the landmark meta-analysis performed by the Early Breast Cancer Trialists' Collaborative Group (18, 21) directly linked local recurrence to survival, placing great emphasis on the surgeon's role in minimizing local recurrence by obtaining adequate margins.Breast tumor reexcisions are accompanied by a number of undesirable problems: The completion of therapy is delayed, infection rates are increased, cost is increased, there can be a negative psychological impact on the patient, and there can be diminished aesthetic outcomes (22-24). The development of an intraoperative technique that allows the fast and accurate ident...

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mentioning

confidence: 99%

Application of desorption electrospray ionization mass spectrometry imaging in breast cancer margin analysis

Calligaris

Caragacianu

Liu

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

217

202

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“…IN RECENT YEARS, the treatment of breast cancer has become less invasive: from radical mastectomy to breast-conserving surgery, to minimally-invasive thermal therapies such as radiofrequency ablation, laser ablation, and focused ultrasound (1)(2)(3). Accurate thermometry is a prerequisite for the safe and reliable application of minimally-invasive thermal therapy in a clinical setting.…”

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confidence: 99%

Do respiration and cardiac motion induce magnetic field fluctuations in the breast and are there implications for MR thermometry?

Peters

Bartels

Sprinkhuizen

et al. 2009

Magnetic Resonance Imaging

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Purpose:To assess the distribution of respiration and cardiac motion-induced field fluctuations in the breast and to evaluate the implications of such fluctuations for proton resonance frequency shift (PRFS) MR thermometry in the breast. Materials and Methods:Gradient echo MR field maps were made to study the effect of regular respiration, maximum capacity respiration, and cardiac motion on the stability of the local magnetic field in four healthy female volunteers. Field fluctuations (in parts-per-million [ppm]) were averaged over a region of interest covering both breasts. Results:The average field fluctuation due to regular respiration was 0.13 ppm, due to maximum capacity respiration 0.16 ppm and Ͻ0.03 ppm due to cardiac motion. These fluctuations can be misinterpreted as temperature changes of 13, 16, and 3°C when PRFS-based MR thermometry is used during thermal treatment of breast cancer. Conclusion:Respiration causes significant field fluctuations in the breast. If MR thermometry were to be safely used in clinical practice, these fluctuations should be taken into account and should probably be corrected for.

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“…The 63 articles included 16 feasibility studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], 12 phase I studies [29][30][31][32][33][34][35][36][37][38][39][40], nine phase II studies [41][42][43][44][45][46][47][48][49], three comparative studies [50][51][52], one retrospective study [53], and four randomised controlled trials [54][55][56]. In 18 studies the type of study was not reported [8,[57][58][59][60][61][62][63][64][65]<...>…”

Section: Selected Studiesmentioning

confidence: 99%

Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

Peek

Ahmed

Napoli

et al. 2016

International Journal of Hyperthermia

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Purpose: Breast conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer.Methods: A systematic search of the literature was performed using PubMed and Medline library databases to identify all studies published between 1994 and May 2016. Studies were considered eligible for inclusion if they evaluated the role of ablative techniques in the treatment of breast cancer and included ten patients or more. Studies that failed to fulfil the inclusion criteria were excluded. Results:We identified 63 studies including 1608 patients whose breast tumours were treated with radiofrequency (RFA), high intensity focused ultrasound (HIFU), cryo-, laser or microwave ablation. Fifty studies reported on the number of patients with complete ablation as found on histopathology and the highest rate of complete ablation was achieved with RFA (87.1%, 491/564) and microwave ablation (83.2%, 89/107). Short-term complications were most often reported with microwave ablation (14.6%, 21/144). Recurrence was reported in 24 patients (4.2%, 24/570) and most often with laser ablation (10.7%, 11/103). The shortest treatment times were observed with RFA (15.6±5.6 minutes) and the longest with HIFU (101.5±46.6 minutes).

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MR Imaging-guided Focused Ultrasound Surgery of Breast Cancer: Correlation of Dynamic Contrast-enhanced MRI with Histopathologic Findings

Abstract: These results suggest that parameters from DCE-MRI data could provide a reliable non-invasive method for assessing residual tumor following MRIgFUS treatment of breast tumors.

Cited by 131 publications

References 24 publications

Application of desorption electrospray ionization mass spectrometry imaging in breast cancer margin analysis

Application of desorption electrospray ionization mass spectrometry imaging in breast cancer margin analysis

Do respiration and cardiac motion induce magnetic field fluctuations in the breast and are there implications for MR thermometry?

Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

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