Mumtaz H, Hall-Craggs M A, Wotherspoon A, Paley M, Buonaccorsi G, Amin Z, Wilkinson I, Kissin M W, Davidson T I, Taylor I, Bown S G
National Medical Laser Centre, University College London Medical School, England.
Radiology. 1996 Sep;200(3):651-8. doi: 10.1148/radiology.200.3.8756910.
To investigate magnetic resonance (MR) imaging guidance of interstitial laser photocoagulation to treat primary breast cancer.
Twenty female patients with symptomatic breast cancers diagnosed at cytologic examination underwent interstitial laser photocoagulation by means of a single fiber prior to surgical excision. Gadolinium-enhanced T1-weighted three-dimensional fast low-angle shot (FLASH) MR imaging was performed before and after laser therapy (median, 48 hours; range, 24-96 hours). Following resection, tumors were mapped in detail histopathologically. The extent of disease, size of laser burn, and extent of residual tumor were correlated with MR findings.
Twenty-seven tumors were detected at histopathologic examination in the 20 patients. Five patients had more than one invasive mass. Twenty-five of the 27 tumors were identified as discrete enhancing masses at MR. The two missed invasive foci were obscured on MR images by diffuse patchy enhancement that correlated with the presence of an associated extensive intraductal component. Early (4-hour) follow-up images failed to depict the laser effect. Later (24-96 hours) follow-up images depicted the laser-induced necrosis as a zone of nonenhancement within the residual enhancing tumor. The correlation coefficients (MR vs histopathologic analysis) for the laser-burn diameter and residual tumor were 0.80 and 0.86, respectively.
Delayed gadolinium-enhanced MR images can help define the extent of laser-induced necrosis and residual tumor after interstitial laser photocoagulation therapy in breast cancer.
研究磁共振（MR）成像引导下间质激光光凝治疗原发性乳腺癌。
20例经细胞学检查确诊为有症状乳腺癌的女性患者，在手术切除前通过单根光纤进行间质激光光凝。在激光治疗前后（中位时间48小时；范围24 - 96小时）进行钆增强T1加权三维快速低角度激发（FLASH）MR成像。切除后，对肿瘤进行详细的组织病理学定位。将疾病范围、激光灼伤大小和残留肿瘤范围与MR表现进行相关性分析。
20例患者经组织病理学检查共发现27个肿瘤。5例患者有不止一个浸润性肿块。27个肿瘤中有25个在MR上表现为离散的强化肿块。2个漏诊的浸润性病灶在MR图像上被与广泛导管内成分相关的弥漫性斑片状强化所掩盖。早期（4小时）随访图像未能显示激光效应。后期（24 - 96小时）随访图像显示激光诱导的坏死为残留强化肿瘤内的无强化区域。激光灼伤直径和残留肿瘤的相关系数（MR与组织病理学分析）分别为0.80和0.86。
延迟钆增强MR图像有助于确定乳腺癌间质激光光凝治疗后激光诱导坏死和残留肿瘤的范围。
