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断层合成引导下的真空辅助乳腺活检:一项可行性研究。

Tomosynthesis-guided vacuum-assisted breast biopsy: A feasibility study.

作者信息

Waldherr Christian, Berclaz Gilles, Altermatt Hans Jörg, Cerny Peter, Keller Patrik, Dietz Uwe, Buser Katharina, Ciriolo Michele, Sonnenschein Martin Josef

机构信息

Breast Centre Bern (Brustzentrum Bern), Division of Radiology & Nuclear Medicine, Klinik Engeried, Lindenhofgruppe, Riedweg 15, 3012 Bern, Bern, Switzerland.

Breast Centre Bern (Brustzentrum Bern), Division of Gynaecology & Surgical Oncology, Klinik Engeried, Lindenhofgruppe, Bern, Switzerland.

出版信息

Eur Radiol. 2016 Jun;26(6):1582-9. doi: 10.1007/s00330-015-4009-4. Epub 2015 Sep 18.

Abstract

PURPOSE

Evaluation of feasibility and clinical performance of a tomosynthesis-guided vacuum-assisted breast biopsy (TVAB) system compared to Stereotaxy (SVAB).

MATERIALS AND METHODS

All biopsies were performed on consecutive patients: 148 TVAB biopsies and 86 biopsies on different patients using SVAB. Evaluation criteria for each biopsy were technical feasibility, histopathology, procedure time, and complications.

RESULTS

All 148 TVAB biopsies were technically successful, and gained the targeted groups of microcalcifications (100 %). In 1 of 86 SVAB procedures, it was not possible to gain the targeted microcalcifications (1 %), in 3 of 86 the needle had to be adjusted (4 %). All TVAB biopsies were performed without clinically relevant complications. Distortions were biopsied exclusively by TVAB, mean size 0.9 cm, p < 0.0001. Of the 24 distortions, 13 were cancer, 11 Radial Scars/ CSL. The mean procedure time for TVAB was 15.4 minutes (range 7-28 min), for SVAB 23 minutes (range 11-46 min), p < 0.0001.

CONCLUSIONS

TVAB is able to biopsy small architectural distortions with high accuracy. TVAB is easily feasible and appears to have the same degree of clinical performance for diagnosing microcalcifications. The increased number of biopsied distortions by TVAB is presumably due to increased use of tomosynthesis and its diagnostic potential.

KEY POINTS

• TVAB is easily feasible. • TVAB is able to target architectural distortions with high accuracy. • TVAB diagnoses microcalcifications with the same clinical performance as SVAB.

摘要

目的

与立体定位真空辅助乳腺活检(SVAB)相比,评估断层合成引导真空辅助乳腺活检(TVAB)系统的可行性和临床性能。

材料与方法

对连续的患者进行所有活检:148例TVAB活检以及对不同患者进行86例SVAB活检。每次活检的评估标准包括技术可行性、组织病理学、操作时间和并发症。

结果

148例TVAB活检在技术上均获成功,且获取了目标微钙化灶组(100%)。86例SVAB操作中有1例未能获取目标微钙化灶(1%),86例中有3例需要调整针的位置(4%)。所有TVAB活检均未出现临床相关并发症。仅通过TVAB对畸变进行活检,平均大小为0.9厘米,p<0.0001。在24例畸变中,13例为癌症,11例为放射状瘢痕/复杂性硬化性病变。TVAB的平均操作时间为15.4分钟(范围7 - 28分钟),SVAB为23分钟(范围11 - 46分钟),p<0.0001。

结论

TVAB能够高精度地对小的结构畸变进行活检。TVAB操作简便可行,在诊断微钙化方面似乎具有相同程度的临床性能。TVAB活检的畸变数量增加可能是由于断层合成的使用增加及其诊断潜力。

关键点

• TVAB操作简便可行。• TVAB能够高精度地靶向结构畸变。• TVAB在诊断微钙化方面与SVAB具有相同的临床性能。

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