Department of Surgical Oncology, Sendai, Japan.
Eur Radiol. 2009 Apr;19(4):868-74. doi: 10.1007/s00330-008-1220-6. Epub 2008 Nov 15.
To investigate the usefulness of computed tomography (CT) with skin-marker placement in determining the excision area and decreasing the positive or close margin rates in breast-conserving surgery (BCS). Multidetector-row helical computed tomography (MDCT) mapping images were reconstructed in subjects (n = 117) diagnosed with primary breast cancer who had undergone MDCT using CT skin markers. Serial 5-mm-thick slices prepared from the surgical specimen were used for pathological analyses. A "positive margin" was defined as the presence of malignant cells at the surgical margin, and a "close margin" as a tumor within 5 mm of the surgical margin. The rates of positive and close margins were calculated. We identified the lesions in 111 of 117 cases (94.9%) on MDCT. Of these, 93 underwent BCS under the guidance of MDCT mapping and the remaining 18 underwent mastectomy. Among the 93 cases, 6 (6.5%) had positive or close margins and were diagnosed with ductal carcinoma in situ of low nuclear grade. MDCT mapping with a CT skin marker is feasible for simulating surgical positioning and determining the excision area. MDCT mapping could decrease the positive and close margin rates in BCS.
为了研究在保乳手术（BCS）中使用带皮肤标记物的计算机断层扫描（CT）确定切除范围和降低阳性或接近切缘率的有用性。对 117 名经 MDCT 皮肤标记物行 MDCT 检查诊断为原发性乳腺癌的患者进行 CT 定位图重建。从手术标本中制备的连续 5mm 厚切片用于病理分析。“阳性切缘”定义为手术切缘有恶性细胞，“接近切缘”定义为肿瘤距手术切缘 5mm 以内。计算阳性和接近切缘率。在 117 例患者中有 111 例（94.9%）在 MDCT 上识别出病变。其中，93 例行 MDCT 引导下 BCS，其余 18 例行乳房切除术。在 93 例患者中，有 6 例（6.5%）为阳性或接近切缘，诊断为低核级导管原位癌。带 CT 皮肤标记物的 MDCT 定位图是模拟手术定位和确定切除范围的可行方法。MDCT 定位图可降低 BCS 的阳性和接近切缘率。
