Breast MRI in patients after breast conserving surgery with sentinel node procedure using a superparamagnetic tracer

Anke Christenhusz*, Joost J. Pouw, Frank F.J. Simonis, Michael Douek, Muneer Ahmed, Joost M. Klaase, Anneriet E. Dassen, Caroline A.H. Klazen, Margreet C. van der Schaaf, Bernard ten Haken, Lejla Alic

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
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Background: A procedure for sentinel lymph node biopsy (SLNB) using superparamagnetic iron-oxide (SPIO) nanoparticles and intraoperative sentinel lymph node (SLN) detection was developed to overcome drawbacks associated with the current standard-of-care SLNB. However, residual SPIO nanoparticles can result in void artefacts at follow-up magnetic resonance imaging (MRI) scans. We present a grading protocol to quantitatively assess the severity of these artefacts and offer an option to minimise the impact of SPIO nanoparticles on diagnostic imaging. Methods: Follow-up mammography and MRI of two patient groups after a magnetic SLNB were included in the study. They received a 2-mL subareolar dose of SPIO (high-dose, HD) or a 0.1-mL intratumoural dose of SPIO (low-dose, LD). Follow-up mammography and MRI after magnetic SLNB were acquired within 4 years after breast conserving surgery (BCS). Two radiologists with over 10-year experience in breast imaging assessed the images and analysed the void artefacts and their impact on diagnostic follow-up. Results: A total of 19 patients were included (HD, n = 13; LD, n = 6). In the HD group, 9/13 patients displayed an artefact on T1-weighted images up to 3.6 years after the procedure, while no impact of the SPIO remnants was observed in the LD group. Conclusions: SLNB using a 2-mL subareolar dose of magnetic tracer in patients undergoing BCS resulted in residual artefacts in the breast in the majority of patients, which may hamper follow-up MRI. This can be avoided by using a 0.1-mL intratumoural dose.

Original languageEnglish
Article number3
JournalEuropean radiology experimental
Issue number1
Publication statusPublished - 27 Jan 2022


  • Artefacts
  • Breast cancer
  • Magnetic resonance imaging
  • Sentinel lymph node biopsy
  • Superparamagnetic iron oxide nanoparticles
  • UT-Gold-D


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