Feasibility of breast MRI after sentinel procedure for breast cancer with superparamagnetic tracers. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Krischer, Benedict; Forte, Serafino; Niemann, Tilo; Kubik-Huch, Rahel A.; Leo, Cornelia
• Is Part Of: European journal of surgical oncology. Volume 44:Issue 1(2018)
• Page Start: 74
• Page End: 79
• Publication Date: 2018-01
• Subjects: Sentinel node biopsy -- SNB -- Breast cancer -- MR imaging; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2017.11.016
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Rationale: The gold standard for detection of axillary sentinel lymph nodes uses injection of a radioisotope (99Tc Nanocoll). As an alternative to this method, a magnetometer detecting the superparamagnetic tracer Sienna+ ® can be applied for detection of sentinel lymph nodes. The goal of this study was to determine whether interpretation of breast MRI is impaired by Sienna+ ® tracer residues in the operated breast and axillary lymph nodes after a sentinel procedure using this tracer. Patients and methods: 34 patients who received the Sienna+ ® tracer for marking the sentinel node were invited to undergo a follow-up breast MRI. Native MR images were obtained from breast and axilla. The breast MRIs were evaluated by two independent breast radiologists for Sienna+ ® tracer related artefacts and for the degree of impairment of the MR imaging. Results: 24 of the 34 invited patients took part in this study. The mean time since injection of Sienna+ ® was 42 months (40.6–45.4 months). Two patients had bilateral surgery with injections in both breasts, leading to a total of 26 separate cases. One case had to be excluded due to breathing artefacts. In 10 cases (40%), impaired imaging was found. In three cases (12%), the MRI scan reading was impossible due to Sienna+ ® tracer residues, the other 12 cases (48%) showed no restriction. In the subgroup of patients treated with breast conserving surgery, tracer residue artefacts were found in 13 of 17 patients (76.5%). Conclusion: To our knowledge, in this study for the first time MR feasibility after Sienna injection was investigated. Sienna+ ® impaired breast MRI after a mean follow-up time of 42 months in half of the cases. Further research is needed to investigate time and field-strength dependency of tracer detectability as well as the diagnostic impact of these artifacts on contrast-enhanced imaging in a clinical setting.