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Open Access 01-12-2013 | Research article

Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control

Authors: Fernanda Philadelpho Arantes Pereira, Gabriela Martins, Maria Julia Gregorio Calas, Maria Veronica Fonseca Torres de Oliveira, Emerson Leandro Gasparetto, Lea Mirian Barbosa da Fonseca

Published in: BMC Medical Imaging | Issue 1/2013

Abstract

Background

Magnetic resonance imaging (MRI) guided wire localization presents several challenges apart from the technical difficulties. An alternative to this conventional localization method using a wire is the radio-guided occult lesion localization (ROLL), more related to safe surgical margins and reductions in excision volume. The purpose of this study was to establish a safe and reliable magnetic resonance imaging-radioguided occult lesion localization (MRI-ROLL) technique and to report our initial experience with the localization of nonpalpable breast lesions only observed on MRI.

Methods

Sixteen women (mean age 53.2 years) with 17 occult breast lesions underwent radio-guided localization in a 1.5-T MR system using a grid-localizing system. All patients had a diagnostic MRI performed prior to the procedure. An intralesional injection of Technetium-99m macro-aggregated albumin followed by distilled water was performed. After the procedure, scintigraphy was obtained. Surgical resection was performed with the help of a gamma detector probe. The lesion histopathology and imaging concordance; the procedure’s positive predictive value (PPV), duration time, complications, and accuracy; and the rate of exactly excised lesions evaluated with MRI six months after the surgery were assessed.

Results

One lesion in one patient had to be excluded because the radioactive substance came back after the injection, requiring a wire placement. Of the remaining cases, there were four malignant lesions, nine benign lesions, and three high-risk lesions. Surgical histopathology and imaging findings were considered concordant in all benign and high-risk cases. The PPV of MRI-ROLL was greater if the indication for the initial MR examination was active breast cancer. The median procedure duration time was 26 minutes, and all included procedures were defined as accurate. The exact and complete lesion removal was confirmed in all (100%) patients who underwent six-month postoperative MRI (50%).

Conclusions

MRI-ROLL offers a precise, technically feasible, safe, and rapid means for performing preoperative MRI localizations in the breast.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2342/13/33/prepub

Title: Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control
Authors: Fernanda Philadelpho Arantes Pereira
Gabriela Martins
Maria Julia Gregorio Calas
Maria Veronica Fonseca Torres de Oliveira
Emerson Leandro Gasparetto
Lea Mirian Barbosa da Fonseca
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Medical Imaging / Issue 1/2013
Electronic ISSN: 1471-2342
DOI: https://doi.org/10.1186/1471-2342-13-33

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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