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

17 Citations (Scopus)
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Abstract

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
Volume6
Issue number1
DOIs
Publication statusPublished - 27 Jan 2022

Keywords

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

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