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Preliminary study of real-time three-dimensional contrast-enhanced ultrasound of sentinel lymph nodes in breast cancer

  • Ziyue Hu
  • Xueqing Cheng
  • Juan Li
  • Jingzhen Jiang
  • Zirui Jiang
  • Hui Li
  • Tingting Li
  • Zhenqi Zhang
  • Bo Tan
  • Man LuEmail author
Breast
  • 24 Downloads

Abstract

Purpose

To investigate the clinical value of real-time three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the detection of sentinel lymph nodes (SLNs) and drainage lymphatics in breast cancer patients.

Method

The prospective study was performed in women with pathology-confirmed T1/2 breast cancer between June 2016 and December 2017 who underwent sentinel lymph node biopsy and 3D-CEUS. The number, size, location, enhancement pattern of SLNs, and the lymphatic drainage patterns were reviewed. The routes, location of SLNs, and lymph channels (LCs) on the surface were marked. All patients underwent blue dye–guided sentinel lymph node biopsy (SLNB) finally.

Results

According to the postoperative pathology findings and the blue dye staining of the lymphatic drainage routes, there are six patterns of lymphatic drainage routes and the coincidence rate of the 3D-CEUS was 97.4%; the sensitivity, specificity, positive predictive value, negative predictive value, the LN detection rate, and the correct diagnosis rate of the 3D-CEUS were 75%, 93.0%, 81.8%, 89.9%, 95.3%, and 87.7%, respectively.

Conclusion

3D-CEUS is a new feasible and useful approach to detect the SLNs and LCs. 3D-CEUS can accurately localize the LCs and SLNs and estimate the presence of metastatic lymph nodes.

Key Points

• The three-dimensional contrast-enhanced ultrasound can detect the sentinel lymph nodes.

• The three-dimensional contrast-enhanced ultrasound can show the stereo direction of sentinel lymph nodes and lymph drainage routes.

• The three-dimensional contrast-enhanced ultrasound can accurately localize the LCs and SLNs and estimate the presence of metastatic lymph nodes.

Keywords

Ultrasonography Contrast media Sentinel lymph node Breast cancer 

Abbreviations

2D-US

Two-dimensional ultrasound

3D-CEUS

Real-time three-dimensional contrast-enhanced ultrasound

3D-US

Three-dimensional ultrasound

ALN

Axillary lymph node

CEUS

Contrast-enhanced ultrasound

ICG

Indocyanine green fluorescence

LC

Lymph channel

LN

Lymph node

SLN

Sentinel lymph node

SLNB

Sentinel lymph node biopsy

Notes

Funding information

This study has received funding by the Department of Science and Technology of Sichuan Provincial.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Man Lu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Observational

• Performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
  2. 2.School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina
  3. 3.University of Wisconsin-MadisonMadisonUSA
  4. 4.Department of Breast surgery, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of MedicineUniversity of Electronic Science and Technology of ChinaChengduChina

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