Park Clara, Chevalier Frauke, Möbus Volker, Hoedl Petra, Engelmann Kerstin, Falk Stephan, Leithner Doris, Kaltenbach Benjamin, Vogl Thomas J, Müller-Schimpfle Markus
Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt am Main, Germany.
Department of Radiology, Municipal Clinics Frankfurt/Main-Hoechst, Frankfurt am Main, Germany.
Breast Care (Basel). 2020 Dec;15(6):628-634. doi: 10.1159/000506069. Epub 2020 Feb 21.
The aim of this study was to evaluate the feasibility and the accuracy of a secondary, metachronous ultrasound (US)-guided marking of the stereotactic vacuum-assisted breast biopsy (ST-VABB) area.
The institutional ethics committee approved the study. The retrospective study included 98 patients. In ST-VABB of 45 women, no tissue markers were deployed at the biopsy site, even if no residual calcifications remained. After histology proved the necessity for a subsequent operation, the biopsy site was marked under US guidance using a coil marker. All interventions were technically successful. No complications occurred. Mammography was done to visualize the coil deployment. The distances from the center of the lesion and the biopsy cavity to the coil location were measured in both planes to evaluate the accuracy of the marking procedure.
In 24 of the 46 cases, the whole lesion was biopsied without residual elements. The mean time between ST-VABB and sonographic marking of the lesion was 9.7 days (median 6.5). The biopsy cavity could be detected in 40 (87%) cases and thus marked exactly. The mean time of US-guided marking was 12.5 min. The mean distance between the coil and the target lesion was 0.6 ± 1.5 cm in the craniocaudal (cc) view and 0.5 ± 1.5 cm in the mediolateral (ml) view for all markings. The mean delta value from the distance nipple-original lesion and from the distance nipple-coil was 0.85 ± 1.2 cm (median 0.5) in the cc view and 0.88 ± 1.2 cm (median 0.6) in the ml view for all cases. Clip migration was not observed.
Our study demonstrates the feasibility and the technical success of secondary metachronous coil marking of the biopsy site under US guidance after receipt of histology. This approach seems to be a cost-effective alternative to the standard procedure of the primary coil marking especially in all completely removed lesions. It may offer advantages for allergic patients.
本研究旨在评估立体定向真空辅助乳腺活检（ST-VABB）区域的二次、异时超声（US）引导标记的可行性和准确性。
机构伦理委员会批准了本研究。这项回顾性研究纳入了98例患者。在45名女性的ST-VABB中，即使活检部位没有残留钙化，也未在活检部位放置组织标记物。在组织学证明有必要进行后续手术之后，使用线圈标记物在超声引导下对活检部位进行标记。所有干预操作在技术上均获成功，未发生并发症。进行乳房X线摄影以显示线圈的放置情况。在两个平面上测量病变中心和活检腔到线圈位置的距离，以评估标记程序的准确性。
46例中的24例，整个病变均被活检且无残留成分。ST-VABB与病变的超声标记之间的平均时间为9.7天（中位数为6.5天）。40例（87%）病例中可检测到活检腔，从而能准确标记。超声引导标记的平均时间为12.5分钟。所有标记中，在头尾位（cc）视图中线圈与目标病变之间的平均距离为0.6±1.5厘米，在内外侧（ml）视图中为0.5±1.5厘米。所有病例中，在cc视图中乳头至原病变距离与乳头至线圈距离的平均差值为0.85±1.2厘米（中位数为0.5），在ml视图中为0.88±1.2厘米（中位数为0.6）。未观察到夹子移位。
我们的研究证明了在获得组织学结果后，在超声引导下对活检部位进行二次异时线圈标记的可行性和技术成功性。这种方法似乎是原发性线圈标记标准程序的一种经济有效的替代方法，尤其是在所有病变完全切除的情况下。它可能对过敏患者具有优势。
