Kousaka Junko, Nakano Shogo, Ando Takahito, Tetsuka Rie, Fujii Kimihito, Yoshida Miwa, Shiomi-Mouri Yukako, Goto Manami, Imai Yuko, Imai Tsuneo, Fukutomi Takashi, Katsuda Eisuke, Ishiguchi Tsuneo, Arai Osamu
Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
Department of Breast Surgery, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minatoku, Tokyo, 108-0073, Japan.
Breast Cancer. 2016 Mar;23(2):301-9. doi: 10.1007/s12282-014-0574-7. Epub 2014 Nov 6.
With increasing use of computed tomography (CT), incidentally detected breast lesions are being encountered more frequently. The aim of our study was to verify the utility of targeted sonography using an image fusion technique, real-time virtual sonography (RVS) that coordinates real-time sonography images with previously obtained CT images using a magnetic position tracking system, for evaluation of incidentally detected breast lesions on chest CT.
Eleven lesions in 11 women with no history of breast cancer who were referred to our unit for assessment of breast lesions incidentally detected on CT were enrolled in this study. To assess the efficacy of targeted sonography using RVS, we analyzed the frequency of sonographic detection of incidentally detected breast lesions and the difference between sonography- and CT-determined diameters.
Using RVS guidance, all 11 lesions were sonographically detected. Ten (91 %) of 11 lesions underwent sonography-guided biopsy, yielding a success rate of 90 % (9/10). The remaining sonography-guided biopsy failure lesion required surgical biopsy for definitive diagnosis; this was performed after RVS was used to mark CT imaging information onto the breast surface. Four (36 %) lesions subsequently proved to be malignant. The mean diameters provided by RVS were 14.9 ± 6.7 mm for sonography and 16.8 ± 7.5 mm for CT (p = 0.538).
Using RVS, a sonographic probe was precisely guided to the lesions. Our results suggest that targeted sonography using RVS is a useful technique for identifying incidentally detected breast lesions on chest CT.
随着计算机断层扫描(CT)的使用日益增加,偶然发现的乳腺病变越来越常见。我们研究的目的是验证使用图像融合技术——实时虚拟超声(RVS)的靶向超声检查的效用,该技术使用磁定位跟踪系统将实时超声图像与先前获得的CT图像进行协调,用于评估胸部CT上偶然发现的乳腺病变。
本研究纳入了11名无乳腺癌病史的女性,她们因评估CT上偶然发现的乳腺病变而被转诊至我们科室。为了评估使用RVS的靶向超声检查的疗效,我们分析了偶然发现的乳腺病变的超声检测频率以及超声和CT测量的直径差异。
在RVS引导下,所有11个病变均通过超声检测到。11个病变中有10个(91%)接受了超声引导下活检,成功率为90%(9/10)。其余超声引导下活检失败的病变需要进行手术活检以明确诊断;在使用RVS将CT成像信息标记到乳房表面后进行了手术活检。其中4个(36%)病变后来被证实为恶性。RVS测量的超声平均直径为14.9±6.7mm,CT平均直径为16.8±7.5mm(p = 0.538)。
使用RVS,超声探头能精确地引导至病变部位。我们的结果表明,使用RVS的靶向超声检查是识别胸部CT上偶然发现的乳腺病变的一种有用技术。