Real-time ultrasound and freehand-SPECT

2014 ◽  
Vol 53 (06) ◽  
pp. 259-264 ◽  
Author(s):  
T. Winkens ◽  
T. Opfermann ◽  
P. Elsner ◽  
I. Runnebaum ◽  
A. Darr ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Malignant Melanoma ◽  
Region Of Interest ◽  
Fusion Imaging ◽  
Ultrasound Images ◽  
Registration Accuracy ◽  
Cross Sectional ◽  
Data Set ◽  
Freehand Spect

SummaryAim of this work is to report first experiences of the feasibility and applicability of a hybrid freehandSPECT/ultrasound (fh-SPECT/US) imaging concept, with regard to SLN imaging, in patients with breast cancer and malignant melanoma. Patients, methods: 18 patients with breast cancer or malignant melanoma received standard SLN scintigraphy. Following this, fh-SPECT using declipse®SPECT (SurgicEye, Munich, Germany) was performed, a handheld-gamma camera-based method to visualize activity distribution within a region of interest as a cross-sectional data set. These data were transferred to an ultrasound device and sensor-navigated ultrasound was performed combining fhSPECT data with ultrasound images, displaying superimposed images. Quality of fh- SPECT and co-registration accuracy was assigned to one of four categories and occurrence of artefacts was assessed. Results: In 4/18 examinations, there was a no deviation regarding co-registration of both data sets. For 9/18 patients, there was a deviation of <1 cm (mean 0.7±0.3 cm, range 0.3–1.0 cm). For 3/18 patients, a deviation >1 cm was present (mean 1.7±0.3 cm, range 1.5–2.0 cm). In 2/18 examinations no lymph node was found in the region of highest activity. Fh-SPECT reconstruction artifacts occurred in 6/18 examinations. Conclusion: The fusion imaging concept combining SLN information with ultrasound images presented here proves to be feasible and technically successful. However, significant technical limitations were shown in fh-SPECT quality and fusion precision. Subject to technical optimisation of SPECT quality and co-registration, a meaningful contribution to the preoperative planning of lymph node therapy is imaginable. Thus, fundamentally a preoperative histological examination by fh-SPECT/US-guided biopsy is possible.

scholarly journals Epidemiological and pathological characteristics of post-surgical cases of invasive breast cancer among ethnicities of Iran in 2018: A single center cross-sectional study

2020 ◽  
Vol 26 (1) ◽  
pp. 6-9
Author(s):  
Soheila Sayad ◽  
Seyyed Ahmadi ◽  
Reza Nekouian ◽  
Mahshid Panahi ◽  
Khatereh Anbari
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Invasive Breast Cancer ◽  
Triple Negative ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Single Center ◽  
Cross Sectional ◽  
Familial History ◽  
Number Of Patients

Background: Present study aimed to investigate immunohistochemical parameters in post-surgical cases of invasive breast cancer. Methods: In this single center cross-sectional study we investigated ethnicity, familial history, type of cancer, stage of cancer, lymph node positivity, bilateral involvement, metastasis and immunohistochemical parameters (estrogen and progesterone receptor, human epidermal growth factor receptor 2, as well as frequency of triple positive and triple negative patients merely based on immunohistochemical parameters). Results: Frequency of positive familial history was 27.42% (16.31-38.52%). Lymph node involvement was detected in 55.93% (43.26-68.60%) of the cases. Frequency of positive HER2 was 38.60% (25.96-51.23%). There were 17.54% (7.67-27.42%) of triple positive and 7.02% (0.39-13.65%) of triple negative cases. The most common stage at the time of diagnosis was stage 3 with 43.33% (30.79-55.87%) frequency. In Lur/Lak population higher frequency of positive HER2 cases was detected whereas in Mazani population frequency of positive HER2 cases was low (p=0.0291). Conclusions: These results could contribute to understanding of breast cancer patterns among different ethnicities. In order to draw clear conclusion future investigations have to be done in several health centers, for longer time periods and with larger number of patients.

scholarly journals Association between axillary lymph node involvement and clinicopathological features of breast cancer among Indonesian women

2020 ◽  
Vol 29 (1) ◽  
pp. 32-7
Author(s):  
Dody Novrial ◽  
Gita Nawangtantrini ◽  
Hidayat Sulistyo ◽  
Henida Dwi Sari ◽  
Wahyu Djatmiko
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Predictive Factors ◽  
Axillary Lymph Node ◽  
Menopausal Status ◽  
Growth Factor Receptor ◽  
Tumor Stage ◽  
Clinicopathological Features ◽  
Axillary Lymph ◽  
Cross Sectional

BACKGROUND Some clinicopathological features play roles in the spread of breast cancer to axillary lymph node (ALN). However, their roles as predictive factors are not well-established. This study was conducted to determine the correlation between the clinicopathological features of breast cancer and the risk of ALN involvement in Indonesian women. METHODS This cross-sectional study was conducted in Margono Soekarjo Hospital using archival data from January 2017 to June 2018. All subjects with breast cancer who had undergone modified radical mastectomies without any evidence of distant metastasis were included. Chi-square and Fisher’s exact tests were performed to assess the relationship between ALN involvement and age, menopausal status, laterality, tumor size, tumor stage, histological type, tumor grade, lymphovascular space invasion (LVSI), skin or nipple infiltration, perineural invasion, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status. The odds ratio of each variable was evaluated using ordinal regression analysis. RESULTS Stage 3 breast cancer had the worst status of ALN involvement compared with stage 1 (OR = 3.49; 95% CI = 1.51–8.08) and stage 2 (OR = 3.04; 95% CI = 1.32–6.98). Likewise, positive LVSI also had the worst status of ALN involvement compared with negative LVSI (OR = 8.68; 95% CI = 4.23–17.81). CONCLUSIONS Tumor stage and LVSI could be considered as independent predictive factors of ALN involvement in patients with breast cancer, especially among Indonesian women.

Changing the Intraoperative Nodal Status of a Breast Cancer Patient Using Freehand SPECT for Sentinel Lymph Node Biopsy

2014 ◽  
Vol 39 (5) ◽  
pp. e313-e314 ◽  
Author(s):  
Christina Bluemel ◽  
Andreas Schnelzer ◽  
Alexandra Ehlerding ◽  
Klemens Scheidhauer ◽  
Marion Kiechle
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Cancer Patient ◽  
Breast Cancer Patient ◽  
Lymph Node Biopsy ◽  
Nodal Status ◽  
Freehand Spect ◽  
Node Biopsy

Predicting nonsentinel node status in breast cancer preoperatively by molecular characterization of core needle biopsies with multiparametric protein analyses

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21068-21068 ◽  
Author(s):  
G. W. Sauer ◽  
N. Schneiderhahn-Marra ◽  
C. Kurzeder ◽  
K. Koretz ◽  
R. Kreienberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Molecular Markers ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Predictive Value ◽  
Significant Risk ◽  
Cancer Center ◽  
Axillary Lymph ◽  
Data Set ◽  
Core Needle

21068 Background: Axillary lymph node dissection (ALND) still remains the standard treatment for breast cancer patients with sentinel lymph node (SLN) metastases. However, since only 40% to 60% of patients show additional lymph involvement, complete ALND offers no additional benefit for almost 50% of patients but carries a significant risk of axillary morbidity. In an attempt to achieve a more precise prediction for the individual patient a multivariable logistic-regression analysis of a large data set of eight histopathological variables has been published by the Memorial Sloan-Kettering Cancer Center (MSKCC) that predicts the likelihood of metastases in Non-SLNs with a ROC of 0,71. To achieve a more precise estimation of additional lymph node involvement preoperatively we analysed molecular markers of potential predictive value. Methods: Beside histopathological variables, fifty proteins of potential prognostic and predictive value were preoperatively quantified in lysates from 120 core needle biopsies with multiplex sandwich immunoassays. Biopsies, taken at the Breast Cancer Center of the University of Ulm Medical School, were classified as invasive mammary carcinomas. Variables which could be used to improve the accuracy of prediction of non-sentinel lymph node (NSLN) involvement were defined. Results: We demonstrated appropriate sensitivity, reproducibility, and robustness for this protein microarray technology to characterize proteins in core needle biopsies and generate reliable data sets. In an initial univariate data analysis (Mann Whitney test) six of the analysed parameters (TIMP2, p= 0,027; FasR, p = 0,0025; MIF, p= 0,030; FGF-2, p= 0,0020, PDGF AA/BB p= 0,027; RANTES p= 0,024) correlated with NSLN involvement beside known histopathological variables (i.e. tumor size, p= 0,006; grading, p = 0,0009). Conclusions: We defined molecular markers of diagnostic value to predict NSLN involvement. This might be an acceptable substitute to the known histopathological variables by the MSKCC nomogram to predict potential NSLN involvement preoperatively. No significant financial relationships to disclose.

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