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European Radiology
Published in: European Radiology 4/2018

01-04-2018 | Breast

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

Authors: Jing Zhao, Jing Zhang, Qing-Li Zhu, Yu-Xin Jiang, Qiang Sun, Yi-Dong Zhou, Miao-Qian Wang, Zhi-Lan Meng, Xin-Xin Mao

Published in: European Radiology | Issue 4/2018

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Abstract

Objective

To explore the feasibility of sentinel lymph node (SLN) identification by contrast-enhanced ultrasound (CEUS) in pre-operative breast cancer patients and the value of enhancement patterns for diagnosing lymph node metastases and characterising axillary nodal burden.

Methods

110 consecutive breast cancer patients were enrolled. Before the surgery, microbubbles were injected intradermally. The lymphatic drainage pathway was detected to identify the SLNs. Blue dye and indocyanine green (ICG) fluorescence were used to trace SLNs during the operation. The enhancement patterns of SLNs were recorded and compared with the final pathological diagnosis.

Results

SLN detection rate was 96.4 % of 110 patients, 134 SLNs were detected in total. The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of predicting SLNs metastases by CEUS enhancement patterns were 100 %, 52.0 %, 43.4 %, 100 % and 64.9 %, respectively. No metastatic SLNs were presented as homogeneous enhancement. Low nodal burden with 0–2 SLN metastases in 92.5 % nodes presented as heterogeneous enhancement. No enhancement pattern was proved to be SLN metastases in 100 % patients.

Conclusions

CEUS is a feasible approach for SLN identification. CEUS enhancement patterns can be helpful in recognising metastatic SLNs and nodal burden.

Key Points

• 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.
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Metadata
Title
The value of contrast-enhanced ultrasound for sentinel lymph node identification and characterisation in pre-operative breast cancer patients: A prospective study
Authors
Jing Zhao
Jing Zhang
Qing-Li Zhu
Yu-Xin Jiang
Qiang Sun
Yi-Dong Zhou
Miao-Qian Wang
Zhi-Lan Meng
Xin-Xin Mao
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5089-0

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