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Computerized evaluation scheme to detect metastasis in sentinel lymph nodes using contrast-enhanced computed tomography before breast cancer surgery

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Abstract

Sentinel lymph node (SLN) biopsy for evaluating lymph node metastasis during breast cancer surgery is associated with several problems, such as the consequent increase in operation time and the possibility of abrupt changes in the treatment plan during the operation. Although it is desirable to distinguish SLNs with and without cancer metastasis before surgery, there is no established examination for this purpose. This study aimed to develop a computerized scheme for evaluating metastasis in SLNs by analyzing computed tomography lymphography images and the three-dimensional versions of these images. Our database consisted of computed tomography lymphography images from 100 patients with breast cancer. Three subjective features of the nodes were assessed in the three-dimensional images: (1) the shape of the lymphoduct, (2) degree of signal enhancement in the nodes, and (3) shape of the nodes. Six objective features were also assessed in the computed tomography lymphography images: (4) the long axis, (5) area, (6) standard deviation of the signal values, (7) mean signal values, (8) maximum signal value, and (9) minimum signal value. Support vector machines were employed to evaluate cancer metastasis in SLNs. For the input, six of the nine features were selected in a stepwise method. The classification accuracy, sensitivity, and specificity were 98.0% (98/100), 97.8% (44/45), and 98.2% (54/55), respectively. The positive and negative predictive values were 97.8% (44/45) and 98.2% (54/55), respectively. This computerized method exhibited high classification accuracy and will be useful in determining the need for lymph node dissection before breast cancer surgery.

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Acknowledgements

The authors are grateful to the members of the Department of Radiology, Maruyama Memorial General Hospital, for supporting this work.

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Authors and Affiliations

  1. Department of Radiology, Maruyama Memorial General Hospital, 2-10-5 Hon-cho, Iwatsuki-ku, Saitama, 339-8521, Japan

    Hiroshi Ashiba

  2. Graduate School of Health Science, Suzuka University of Medical Science, 1000-1 Kishioka-cho, Suzuka, 510-0293, Japan

    Hiroshi Ashiba

  3. Department of Electronic and Computer Engineering, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan

    Ryohei Nakayama

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  1. Hiroshi Ashiba
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  2. Ryohei Nakayama
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Correspondence to Hiroshi Ashiba.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required at our Institution. This article does not contain any studies with animals performed.

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Ashiba, H., Nakayama, R. Computerized evaluation scheme to detect metastasis in sentinel lymph nodes using contrast-enhanced computed tomography before breast cancer surgery. Radiol Phys Technol 12, 55–60 (2019). https://doi.org/10.1007/s12194-018-00491-6

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  • DOI: https://doi.org/10.1007/s12194-018-00491-6

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