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一项关于非放射性手术引导技术在切除不可触及乳腺病变时定位的前瞻性、单臂、多中心临床评估。

A Prospective, Single Arm, Multi-site, Clinical Evaluation of a Nonradioactive Surgical Guidance Technology for the Location of Nonpalpable Breast Lesions during Excision.

作者信息

Cox Charles E, Russell Scott, Prowler Vanessa, Carter Ebonie, Beard Abby, Mehindru Ankur, Blumencranz Peter, Allen Kathleen, Portillo Michael, Whitworth Pat, Funk Kristi, Barone Julie, Norton Denise, Schroeder Jerome, Police Alice, Lin Erin, Combs Freddie, Schnabel Freya, Toth Hildegard, Lee Jiyon, Anglin Beth, Nguyen Minh, Canavan Lynn, Laidley Alison, Warden Mary Jane, Prati Ronald, King Jeff, Shivers Steven C

机构信息

USF Breast Health Program, University of South Florida, Tampa, FL, USA.

Department of Surgery, University of South Florida, Tampa, FL, USA.

出版信息

Ann Surg Oncol. 2016 Oct;23(10):3168-74. doi: 10.1245/s10434-016-5405-y. Epub 2016 Jul 28.

Abstract

OBJECTIVES

This study was a multicenter evaluation of the SAVI SCOUT(®) breast localization and surgical guidance system using micro-impulse radar technology for the removal of nonpalpable breast lesions. The study was designed to validate the results of a recent 50-patient pilot study in a larger multi-institution trial. The primary endpoints were the rates of successful reflector placement, localization, and removal.

METHODS

This multicenter, prospective trial enrolled patients scheduled to have excisional biopsy or breast-conserving surgery of a nonpalpable breast lesion. From March to November 2015, 154 patients were consented and evaluated by 20 radiologists and 16 surgeons at 11 participating centers. Patients had SCOUT(®) reflectors placed up to 7 days before surgery, and placement was confirmed by mammography or ultrasonography. Implanted reflectors were detected by the SCOUT(®) handpiece and console. Presence of the reflector in the excised surgical specimen was confirmed radiographically, and specimens were sent for routine pathology.

RESULTS

SCOUT(®) reflectors were successfully placed in 153 of 154 patients. In one case, the reflector was placed at a distance from the target that required a wire to be placed. All 154 lesions and reflectors were successfully removed during surgery. For 101 patients with a preoperative diagnosis of cancer, 86 (85.1 %) had clear margins, and 17 (16.8 %) patients required margin reexcision.

CONCLUSIONS

SCOUT(®) provides a reliable and effective alternative method for the localization and surgical excision of nonpalpable breast lesions using no wires or radioactive materials, with excellent patient, radiologist, and surgeon acceptance.

摘要

目的

本研究是一项多中心评估,采用微脉冲雷达技术的SAVI SCOUT(®)乳腺定位与手术引导系统用于切除不可触及的乳腺病变。该研究旨在在一项更大规模的多机构试验中验证近期一项纳入50例患者的初步研究结果。主要终点是反射器成功放置、定位和切除的比率。

方法

这项多中心前瞻性试验纳入计划对不可触及的乳腺病变进行切除活检或保乳手术的患者。2015年3月至11月,11个参与中心的20名放射科医生和16名外科医生对154例患者进行了知情同意和评估。患者在手术前7天内放置SCOUT(®)反射器,通过乳腺X线摄影或超声检查确认放置情况。通过SCOUT(®)手持探头和控制台检测植入的反射器。通过影像学检查确认切除的手术标本中存在反射器,并将标本送去做常规病理检查。

结果

154例患者中有153例成功放置了SCOUT(®)反射器。有1例中,反射器放置位置距目标有一定距离,需要放置一根导丝。手术期间所有154个病变和反射器均成功切除。对于101例术前诊断为癌症的患者,86例(85.1%)切缘清晰,17例(16.8%)患者需要再次切除切缘。

结论

SCOUT(®)提供了一种可靠且有效的替代方法,用于不可触及乳腺病变的定位和手术切除,无需使用导丝或放射性物质,患者、放射科医生和外科医生的接受度良好。

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