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.
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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
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Funding
This study has received funding by the Department of Science and Technology of Sichuan Provincial.
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The scientific guarantor of this publication is Man Lu.
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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.
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Written informed consent was obtained from all subjects (patients) in this study.
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• Prospective
• Observational
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Ziyue Hu and Man Lu contributed to the work equally and should be regarded as co-first authors.
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Hu, Z., Cheng, X., Li, J. et al. Preliminary study of real-time three-dimensional contrast-enhanced ultrasound of sentinel lymph nodes in breast cancer. Eur Radiol 30, 1426–1435 (2020). https://doi.org/10.1007/s00330-019-06494-0
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DOI: https://doi.org/10.1007/s00330-019-06494-0