Skip to main content

Advertisement

SpringerLink
Log in

High-resolution MR lymphography using ultrasmall superparamagnetic iron oxide (USPIO) in the evaluation of axillary lymph nodes in patients with early stage breast cancer: preliminary results

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to examine the utility of high-resolution magnetic resonance (MR) lymphography using ultrasmall superparamagnetic iron oxide (USPIO) in the evaluation of axillary lymph nodes in patients with early stage breast cancer.

Methods

Ten women with breast cancer without swollen axillary lymph nodes were enrolled in this study. High-resolution MR lymphography was performed 24 h after administration of USPIO. On the MR examination, a 3-inch surface coil was placed on the sentinel lymph node (SLN) parts as defined by a radioisotope (RI) scintigraphy method, and T2*-weighted (T2*W) and T1-weighted (T1W) images were obtained. Detected nodes were differentiated as normal or diseased nodes by the enhancement patterns. The day after MR examination, SLN biopsy (SNB) was performed. The imaging results were compared to the histopathologic findings.

Results

On MR images, the mean number of detectable nodes was 7.9 per patient. Eight patients who histopathologically had no metastatic lymph nodes were diagnosed as nonmetastatic and two patients who had 3- and 6-mm metastatic areas in the node, respectively, were diagnosed as metastatic preoperatively. No side effects were noted.

Conclusions

High-resolution MR lymphography using USPIO enabled us to obtain good axillary lymph node evaluation results. These results suggest that this method of imaging may contribute to better preoperative lymph node staging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Morrow M. Role of axillary dissection in breast cancer management. Ann Surg Oncol. 1996;3:233–4.

    Article  CAS  PubMed  Google Scholar 

  2. Michel SC, Keller TM, Frohlich JM, Fink D, Caduff R, Seifert B, et al. Preoperative breast cancer staging: MR imaging of the axilla with ultrasmall superparamagnetic iron oxide enhancement. Radiology. 2002;225:527–36.

    Article  PubMed  Google Scholar 

  3. Pressman PI. Surgical treatment and lymphedema. Cancer. 1998;83:2782–7.

    Article  CAS  PubMed  Google Scholar 

  4. Yeoh EK, Denham JW, Davies SA, Spittle MF. Primary breast cancer. Complications of axillary management. Acta Radiol Oncol. 1986;25:105–8.

    Article  CAS  PubMed  Google Scholar 

  5. Silverstein MJ, Skinner KA, Lomis TJ. Predicting axillary nodal positivity in 2282 patients with breast carcinoma. World J Surg. 2001;25:767–72.

    Article  CAS  PubMed  Google Scholar 

  6. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349:546–53.

    Article  PubMed  Google Scholar 

  7. Sachelarie I, Grossbard ML, Chadha M, Feldman S, Ghesani M, Blum RH. Primary systemic therapy of breast cancer. Oncologist. 2006;11:574–89.

    Article  CAS  PubMed  Google Scholar 

  8. Yoshimura G, Sakurai T, Oura S, Suzuma T, Tamaki T, Umemura T, et al. Evaluation of axillary lymph node status in breast cancer with MRI. Breast Cancer. 1999;6:249–58.

    Article  PubMed  Google Scholar 

  9. Mumtaz H, Hall-Craggs MA, Davidson T, Walmsley K, Thurell W, Kissin MW, et al. Staging of symptomatic primary breast cancer with MR imaging. Am J Roentgenol. 1997;169:417–24.

    CAS  Google Scholar 

  10. Bruneton JN, Caramella E, Hery M, Aubanel D, Manzino JJ, Picard JL. Axillary lymph node metastases in breast cancer: preoperative detection with US. Radiology. 1986;158:325–6.

    CAS  PubMed  Google Scholar 

  11. Harada T, Tanigawa N, Matsuki M, Nohara T, Narabayashi I. Evaluation of lymph node metastases of breast cancer using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging. Eur J Radiol. 2007;63:401–7.

    Article  PubMed  Google Scholar 

  12. Anzai Y, Blackwell KE, Hirschowitz SL, Rogers JW, Sato Y, Yuh WT, et al. Initial clinical experience with dextran-coated superparamagnetic iron oxide for detection of lymph node metastases in patients with head and neck cancer. Radiology. 1994;192:709–15.

    CAS  PubMed  Google Scholar 

  13. Bellin MF, Roy C, Kinkel K, Thoumas D, Zaim S, Vanel D, et al. Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles––initial clinical experience. Radiology. 1998;207:799–808.

    CAS  PubMed  Google Scholar 

  14. Anzai Y, Prince MR. Iron oxide-enhanced MR lymphography: the evaluation of cervical lymph node metastases in head and neck cancer. J Magn Reson Imaging. 1997;7:75–81.

    Article  CAS  PubMed  Google Scholar 

  15. Harisinghani MG, Saini S, Slater GJ, Schnall MD, Rifkin MD. MR imaging of pelvic lymph nodes in primary pelvic carcinoma with ultrasmall superparamagnetic iron oxide (Combidex): preliminary observations. J Magn Reson Imaging. 1997;7:161–3.

    Article  CAS  PubMed  Google Scholar 

  16. Tatsumi Y, Tanigawa N, Nishimura H, Nomura E, Mabuchi H, Matsuki M, et al. Preoperative diagnosis of lymph node metastases in gastric cancer by magnetic resonance imaging with ferumoxtran-10. Gastric Cancer. 2006;9:120–8.

    Article  PubMed  Google Scholar 

  17. Nishimura H, Tanigawa N, Hiramatsu M, Tatsumi Y, Matsuki M, Narabayashi I. Preoperative esophageal cancer staging: magnetic resonance imaging of lymph node with ferumoxtran-10, an ultrasmall superparamagnetic iron oxide. J Am Coll Surg. 2006;202:604–11.

    Article  PubMed  Google Scholar 

  18. Saksena MA, Saokar A, Harisinghani MG. Lymphotropic nanoparticle enhanced MR imaging (LNMRI) technique for lymph node imaging. Eur J Radiol. 2006;58:367–74.

    Article  PubMed  Google Scholar 

  19. Kanemaki Y, Kurihara Y, Itoh D, Kamijo K, Nakajima Y, Fukuda M, et al. MR mammary ductography using a microscopy coil for assessment of intraductal lesions. Am J Roentgenol. 2004;182:1340–2.

    Google Scholar 

  20. Stets C, Brandt S, Wallis F, Buchmann J, Gilbert FJ, Heywang-Kobrunner SH. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO. J Magn Reson Imaging. 2002;16:60–8.

    Article  PubMed  Google Scholar 

  21. Stadnik TW, Everaert H, Makkat S, Sacre R, Lamote J, Bourgain C. Breast imaging. Preoperative breast cancer staging: comparison of USPIO-enhanced MR imaging and 18F-fluorodeoxyglucose (FDC) positron emission tomography (PET) imaging for axillary lymph node staging––initial findings. Eur Radiol. 2006;16:2153–60.

    Article  PubMed  Google Scholar 

  22. Memarsadeghi M, Riedl CC, Kaneider A, Galid A, Rudas M, Matzek W, et al. Axillary lymph node metastases in patients with breast carcinomas: assessment with nonenhanced versus uspio-enhanced MR imaging. Radiology. 2006;241:367–77.

    Article  PubMed  Google Scholar 

  23. Tokuhara T, Tanigawa N, Matsuki M, Nomura E, Mabuchi H, Lee SW, et al. Evaluation of lymph node metastases in gastric cancer using magnetic resonance imaging with ultrasmall superparamagnetic iron oxide (USPIO): diagnostic performance in post-contrast images using new diagnostic criteria. Gastric Cancer. 2008;11:194–200.

    Article  PubMed  Google Scholar 

  24. Harisinghani MG, Barentsz J, Hahn PF, Deserno WM, Tabatabaei S, van de Kaa CH, et al. Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N Engl J Med. 2003;348:2491–249926.

    Article  PubMed  Google Scholar 

  25. Schwartz GF, Giuliano AE, Veronesi U. In: Proceedings of the consensus conference on the role of sentinel lymph node biopsy in carcinoma of the breast. 19–22 April 2001, Philadelphia, Pennsylvania. Cancer 2002;94:2542–51.

Download references

Author information

Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Kosei Kimura, Nobuhiko Tanigawa, Takehiro Nohara, Mitsuhiko Iwamoto, Kazuhiro Sumiyoshi, Satoru Tanaka & Yuko Takahashi

  2. Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan

    Mitsuru Matsuki & Yoshifumi Narumi

Authors
  1. Kosei Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nobuhiko Tanigawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mitsuru Matsuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takehiro Nohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mitsuhiko Iwamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuhiro Sumiyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Satoru Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yuko Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshifumi Narumi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nobuhiko Tanigawa.

About this article

Cite this article

Kimura, K., Tanigawa, N., Matsuki, M. et al. High-resolution MR lymphography using ultrasmall superparamagnetic iron oxide (USPIO) in the evaluation of axillary lymph nodes in patients with early stage breast cancer: preliminary results. Breast Cancer 17, 241–246 (2010). https://doi.org/10.1007/s12282-009-0143-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-009-0143-7

Keywords

Search

Navigation