The value of contrast-enhanced ultrasound for sentinel lymph node identification and characterisation in pre-operative breast cancer patients: A prospective study

Zhao, Jing; Zhang, Jing; Zhu, Qingli; Jiang, Yuxin; Sun, Qiang; Zhou, Yidong; Wang, Miaoqian; Meng, Zhilan; Mao, Xinxin

doi:10.1007/s00330-017-5089-0

Cited by 68 publications

(62 citation statements)

References 33 publications

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“…: Chinese Medicine H20041829). Methylene blue was superior in SLN identification (Wang et al 2017;Xie et al 2017;Zhao et al 2018). We observed whether the number of LCs in double blue dye was identifiable from the body surface, as well as the consistency between the number and position of the SLNs in surgery compared with pre-surgery.…”

Section: Surgical Use Of Blue Dyementioning

confidence: 88%

How Pre-operative Sentinel Lymph Node Contrast-Enhanced Ultrasound Helps Intra-operative Sentinel Lymph Node Biopsy in Breast Cancer: Initial Experience

Cheng

et al. 2019

Ultrasound in Medicine & Biology

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We aimed to evaluate the value of sentinel lymph node contrast-enhanced ultrasound (SLN-CEUS) and surface tracing for the biopsy of intra-operative sentinel lymph nodes (SLNs). Between June 2015 and December 2017, a total of 453 patients with early invasive breast cancer were recruited. Patients received an intradermal injection of microbubble contrast agent around the areola on the day before surgery. The locations and sizes of lymphatic channels (LCs) and SLNs were marked on the body surface using gentian violet. Then, injection of double blue dye was performed half an hour before surgery. We compared the pathway of LCs and the location of SLNs obtained from SLN-CEUS and blue dye during surgery. Among the 453 patients, the mean numbers of LCs and SLNs detected by SLN-CEUS were 1.42 and 1.72, respectively, and the coincidence rate was 98.2% compared with blue dye during surgery. The median distance from the SLN to skin measured by preoperative CEUS and blue dye was 1.95 § 0.69 and 2.03 § 0.87 cm (p = 0.35). There were three SLN enhancement in our research, including homogeneous enhancement, inhomogeneous enhancement and no enhancement, with the sensitivity, specificity, positive predictive value and negative predictive value of SLN-CEUS for the diagnosis of SLNs being 96.82%, 91.91%, 87.54% and 98.01%, respectively. SLN-CEUS with skin marking can identify the pathway of LCs and the location of the SLN before surgery, measure the distance from the SLN to skin and determine if the SLN is metastatic. SLN-CEUS can be used as an effective complement to the blue dye method.

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Section: Surgical Use Of Blue Dyementioning

confidence: 88%

How Pre-operative Sentinel Lymph Node Contrast-Enhanced Ultrasound Helps Intra-operative Sentinel Lymph Node Biopsy in Breast Cancer: Initial Experience

Cheng

et al. 2019

Ultrasound in Medicine & Biology

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“…Of the 16 selected studies, 9 used SonoVue as CEUS material [26][27][28][39][40][41][42][43][44], 6 used Sonazoid [23][24][25][45][46][47], and 1 used DEFINITY [48]. The administration sites and methods of contrast agents mainly include intradermal [23-28, 39-44, 47] and subcutaneous [45,46] injection around areola or peritumoral parenchyma injection approaching the axilla [48].…”

Section: The Localization Detection Rate Of Ceus For Slnmentioning

confidence: 99%

“…The administration sites and methods of contrast agents mainly include intradermal [23-28, 39-44, 47] and subcutaneous [45,46] injection around areola or peritumoral parenchyma injection approaching the axilla [48]. SLN localization methods are diversified, including skin labeling [23,27,41,42,[44][45][46][47], guidewire localization [25,26,40,43,48], labeled peptide clip localization [28], iodine-125 seed implantation [39], and ultrasound-guided fluorescent dye injection [24]. Seven studies used the isotope-dye dual tracer method as a comparator [23,27,39,43,45,46,48], while another nine studies were compared with the simple dye method [24-26, 28, 40-42, 44, 47].…”

Section: The Localization Detection Rate Of Ceus For Slnmentioning

confidence: 99%

“…Seven studies used the isotope-dye dual tracer method as a comparator [23,27,39,43,45,46,48], while another nine studies were compared with the simple dye method [24-26, 28, 40-42, 44, 47]. Sixteen studies showed that the detection rate of SLN by CEUS method was 70~100% [23][24][25][26][27][28][39][40][41][42][43][44][45][46][47][48], as shown in Fig. 2.…”

Section: The Localization Detection Rate Of Ceus For Slnmentioning

confidence: 99%

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Accuracy of CEUS-guided sentinel lymph node biopsy in early-stage breast cancer: a study review and meta-analysis

Cui

et al. 2020

World J Surg Onc

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Objective: To investigate whether preoperative localization of sentinel lymph node (SLN) by contrast-enhanced ultrasound (CEUS) can further improve the accuracy of sentinel lymph node biopsy (SLNB). Method: Collect published literatures or conference reports by searching electronic databases. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) evaluation method is used to evaluate the quality of the screened literatures. The pooled risk ratio of cancer metastasis of SLN identified by CEUS (CE-SLN) compared with SLN not identified by CEUS (nonCE-SLN) is calculated, and the pooled diagnostic accuracy of CE-SLN for pathological status of all SLNs is also evaluated. Result: Through search and screening, a total of 16 studies were included, of which five and seven studies, respectively, entered the meta-analysis of metastatic risk ratio and diagnostic accuracy. The localization rate of preoperative CEUS for sentinel lymph nodes was 70 to 100%. The meta-analysis shows that the risk of metastasis of SLN identified by CEUS is significantly higher than that not identified by CEUS, 26.0% vs 4.6%, and risk ratio (RR) is 6.08 (95% CI 4.17-8.85). In early-stage breast cancer, the pathological status of CE-SLN is a good representative of all SLNs, with a pooled sensitivity of 98% (95% CI 0.94-1.00), pooled specificity of 100% (95% CI 0.99-1.00), diagnostic odds ratio (DOR) of 2153.18 (95% CI 476.53-9729.06), and area under the subject receiver operating characteristic (SROC) curve of 0.9968. Conclusion: In early-stage breast cancer, preoperative localization of SLN by CEUS is expected to further improve the accuracy of sentinel lymph node biopsy (SLNB).

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“…MRI has been widely used in breast examination because of its good soft tissue contrast, high sensitivity, and high negative predictive rate (2). Although this technique is superior to digital mammography and ultrasonography, its efficacy in identifying malignant nodes is unsatisfactory (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Radiomics Nomogram of DCE-MRI for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

et al. 2020

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This study aimed to establish and validate a radiomics nomogram based on dynamic contrast-enhanced (DCE)-MRI for predicting axillary lymph node (ALN) metastasis in breast cancer. Method: This retrospective study included 296 patients with breast cancer who underwent DCE-MRI examinations between July 2017 and June 2018. A total of 396 radiomics features were extracted from primary tumor. In addition, the least absolute shrinkage and selection operator (LASSO) algorithm was used to select the features. Radiomics signature and independent risk factors were incorporated to build a radiomics nomogram model. Calibration and receiver operator characteristic (ROC) curves were used to confirm the performance of the nomogram in the training and validation sets. The clinical usefulness of the nomogram was evaluated by decision curve analysis (DCA). Results: The radiomics signature consisted of three ALN-status-related features, and the nomogram model included the radiomics signature and the MR-reported lymph node (LN) status. The model showed good calibration and discrimination with areas under the ROC curve (AUC) of 0.92 [95% confidence interval (CI), 0.87-0.97] in the training set and 0.90 (95% CI, 0.85-0.95) in the validation set. In the MR-reported LN-negative (cN0) subgroup, the nomogram model also exhibited favorable discriminatory ability (AUC, 0.79; 95% CI, 0.70-0.87). DCA findings indicated that the nomogram model was clinically useful. Conclusions: The MRI-based radiomics nomogram model could be used to preoperatively predict the ALN metastasis of breast cancer.

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The value of contrast-enhanced ultrasound for sentinel lymph node identification and characterisation in pre-operative breast cancer patients: A prospective study

Abstract: • CEUS is a feasible approach for SLN identification and characterisation. • The enhancement patterns on CEUS can be helpful in recognising metastasised SLNs. • Homogeneous enhancement pattern has the highest negative-predictive value.

Cited by 68 publications

References 33 publications

How Pre-operative Sentinel Lymph Node Contrast-Enhanced Ultrasound Helps Intra-operative Sentinel Lymph Node Biopsy in Breast Cancer: Initial Experience

How Pre-operative Sentinel Lymph Node Contrast-Enhanced Ultrasound Helps Intra-operative Sentinel Lymph Node Biopsy in Breast Cancer: Initial Experience

Accuracy of CEUS-guided sentinel lymph node biopsy in early-stage breast cancer: a study review and meta-analysis

Radiomics Nomogram of DCE-MRI for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

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