Radiology Department, Vita-Salute University, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Radiol Med. 2011 Jun;116(4):564-74. doi: 10.1007/s11547-011-0654-0. Epub 2011 Mar 7.
This study evaluated the methods, technical aspects and impact of preoperative radiological guidance in radioguided occult lesion localisation (ROLL) for single nonpalpable breast lesions.
A total of 288 patients underwent ROLL before surgery. Human serum albumin macroaggregates labelled with 3.7-7.4 MBq of technetium(99) were injected into the lesion. In the case of ultrasonographic guidance (221/288 patients), inoculum positioning resulted in a change of echogenicity at the lesion site. In the case of mammographic guidance (67/288 patients), iodinated contrast medium was injected following the radiotracer for subsequent mammographic evaluation. Patients underwent surgery within 24 h from ROLL. A gamma-detecting probe was used to locate the lesion during surgery and guide its removal. After excision, the specimen was examined by either ultrasonography or mammography to verify complete lesion removal before histological evaluation.
The lesion was correctly localised in 281/288 patients (97.5%). One ROLL procedure failed because surgery could not be performed within 24 h and the radioactivity decayed. Of the six incorrect localisations, 2 were due to the radiological guidance and 4 to technetium(99) dispersion.
Radiological guidance in ROLL ensured the outcome of the procedure of localisation and removal of single, nonpalpable breast lesions in the majority of cases.
本研究评估了术前放射性引导在放射性示踪隐匿性病变定位（ROLL）中用于单个不可触及乳腺病变的方法、技术方面和影响。
共有 288 例患者在术前接受了 ROLL。将人血清白蛋白微球用 3.7-7.4MBq 的锝（99）标记后注入病变部位。在超声引导的情况下（221/288 例患者），接种物定位导致病变部位的回声发生变化。在乳腺 X 线摄影引导的情况下（67/288 例患者），在放射性示踪剂后注射碘化对比剂，以便随后进行乳腺 X 线摄影评估。患者在 ROLL 后 24 小时内进行手术。在手术过程中使用伽马探测探头定位病变并指导其切除。切除后，通过超声或乳腺 X 线摄影检查标本，在进行组织学评估之前确认病变完全切除。
288 例患者中有 281 例（97.5%）正确定位了病变。有 1 例 ROLL 程序失败，原因是无法在 24 小时内进行手术，放射性衰减。在 6 例不正确的定位中，2 例是由于放射学引导，4 例是由于锝（99）弥散。
在 ROLL 中进行放射学引导确保了大多数情况下单个不可触及乳腺病变的定位和切除程序的结果。
