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乳腺病变的磁共振定位:国家癌症研究所的大型欧洲评估。

Magnetic Localization of Breast Lesions: A Large-Scale European Evaluation in a National Cancer Institute.

机构信息

Breast Imaging Unit, Radiology Department, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy.

Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, Milan, Italy.

出版信息

Clin Breast Cancer. 2023 Dec;23(8):e491-e498. doi: 10.1016/j.clbc.2023.08.004. Epub 2023 Aug 22.

Abstract

INTRODUCTION

For decades the standard for preoperative breast lesions' localization has been wire localization. In recent years the options for nonwired localization have significantly expanded and include radioactive seeds, radar reflectors, radiofrequency identification tags and magnetic seeds. The aim of our study is to evaluate on a large scale the performance of preoperative magnetic seed localization of nonpalpable breast lesions.

MATERIAL AND METHODS

We prospectively collected data on all patients undergoing image-guided magnetic seed localization from September 2019 to December 2022. We analyzed imaging findings, histological results, and type of surgery. The primary outcome was the successful localization rate. Secondary outcomes were the successful placement rate, the ease of percutaneous positioning, the procedural complications, and the reintervention rate.

RESULTS

A total of 1123 magnetic seeds were placed in 1084 patients by 4 radiologists under ultrasound (1053) or stereotactic (70) guidance. All seeds were detectable transcutaneously in all breasts sizes and at all depths by 7 surgeons with a success rate of 100%. A total of 97.5% seeds were correctly placed into the target lesions (only 2.5% were dislocated). All radiologists have shown good compliance during the procedure, and there were no complications or safety issues. The reoperation rate was 5.1%.

CONCLUSIONS

Image-guided localization with magnetic seeds is an easy, safe, reliable, and effective method for localizing nonpalpable breast lesions. Both radiologists and surgeons agreed that the technology was intuitive to use and that it can be widely applied in preoperative localization in breast units.

摘要

简介

几十年来,术前乳房病变定位的标准一直是金属丝定位。近年来,非金属丝定位的选择显著增加,包括放射性种子、雷达反射器、射频识别标签和磁性种子。我们研究的目的是大规模评估术前不可触及性乳房病变的磁性种子定位性能。

材料与方法

我们前瞻性地收集了 2019 年 9 月至 2022 年 12 月期间所有接受影像引导磁性种子定位的患者的数据。我们分析了影像学表现、组织学结果和手术类型。主要结局是成功定位率。次要结局是成功放置率、经皮定位的难易程度、手术并发症和再干预率。

结果

4 名放射科医生在超声(1053 例)或立体定向(70 例)引导下为 1084 名患者共放置了 1123 个磁性种子。7 名外科医生在所有乳房大小和深度均能经皮检测到所有种子,成功率为 100%。共有 97.5%的种子正确放置在目标病变部位(仅 2.5%发生脱位)。所有放射科医生在手术过程中都表现出良好的依从性,没有并发症或安全问题。再手术率为 5.1%。

结论

磁性种子引导下的定位是一种简单、安全、可靠和有效的定位不可触及性乳房病变的方法。放射科医生和外科医生都认为该技术易于使用,可广泛应用于乳房单位的术前定位。

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