The London Breast Institute, Princess Grace Hospital, London, U.K.
Department of General Surgery, Khyber Teaching Hospital, Peshawar, Pakistan.
In Vivo. 2020 Jan-Feb;34(1):233-238. doi: 10.21873/invivo.11765.
BACKGROUND/AIM: Wire-guided localisation (WGL) has been the mainstay for localisation of clinically occult breast lesions before excision. However, it has restrictive scheduling requirements, and causes patient discomfort. This has prompted the development of various wireless alternatives. In this prospective study we shall evaluate the role of radiation-free wireless localisation using a radiofrequency identification (RFID) tag and a hand-held reader (LOCalizer™) in the management of occult breast lesions.
This technique was evaluated in a prospective cohort of 10 patients. The evaluation focused on: i) successful deployment, ii) identification and retrieval, iii) the status of surgical margins and need for re-operation, iv) resected specimen weight, v) marker migration rates (>5mm), and vi) acceptance by patients, radiologists and surgeons.
RFID tags (n=11) were deployed under ultrasound guidance pre-operatively to localise occult breast lesions in 10 patients. The mean time for deployment of the RFID tag was 5.4 min (range=2-20). The mean distance from the lesion was 0.45 mm (range=0-3). The mean duration for retrieval was 10.2 min (range=6-20). Mean specimen weight was 19.6 g for malignant lesions (range=4.5-42). All tags were identified, and none had migrated. There were no positive margins, re-operations, nor complications. Patient feedback was highly positive. Both radiologists and surgeons rated the LOCalizer™ technique as better than WGL.
Our study demonstrates that wireless localisation using RFID is an effective and time-efficient alternative to WGL, with low margin positivity and re-operation rates, and high patient, radiologist and surgeon acceptance.
背景/目的：在切除前，导丝引导定位（WGL）一直是临床隐匿性乳腺病变定位的主要方法。然而，它的安排要求具有限制性，并且会引起患者不适。这促使了各种无线替代方法的发展。在这项前瞻性研究中，我们将评估使用射频识别（RFID）标签和手持读取器（LOCalizer™）进行无辐射无线定位在隐匿性乳腺病变管理中的作用。
这项技术在 10 名患者的前瞻性队列中进行了评估。评估重点为：i）成功部署，ii）识别和检索，iii）手术边缘状态和再次手术的需要，iv）切除标本的重量，v）标记物迁移率（>5mm），以及 vi）患者、放射科医生和外科医生的接受程度。
在 10 名患者中，术前在超声引导下部署了 RFID 标签（n=11）以定位隐匿性乳腺病变。部署 RFID 标签的平均时间为 5.4 分钟（范围=2-20）。病变的平均距离为 0.45 毫米（范围=0-3）。检索的平均持续时间为 10.2 分钟（范围=6-20）。恶性病变的平均标本重量为 19.6 克（范围=4.5-42）。所有标签均被识别，且无迁移。无阳性边缘、再次手术或并发症。患者反馈非常积极。放射科医生和外科医生都认为 LOCalizer™ 技术优于 WGL。
我们的研究表明，使用 RFID 的无线定位是 WGL 的有效且高效的替代方法，具有较低的边缘阳性率和再次手术率，以及患者、放射科医生和外科医生的高度接受程度。
