Usefulness of lesion image mapping with multidetector-row helical computed tomography using a dedicated skin marker in breast-conserving surgery
Usefulness of lesion image mapping with multidetector-row helical computed tomography using a dedicated skin marker in breast-conserving surgery
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DOI：
10.1007/s00330-008-1220-6
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发表时间：
2009-04
影响因子：
5.9
通讯作者：
N. Harada-Shoji;Takayuki Yamada;T. Ishida;M. Amari;A. Suzuki;T. Moriya;N. Ohuchi
中科院分区：
文献类型：
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作者：
N. Harada-Shoji;Takayuki Yamada;T. Ishida;M. Amari;A. Suzuki;T. Moriya;N. Ohuchi
探讨计算机断层扫描（CT）结合皮肤标记物放置在确定切除区域和降低保乳手术（BCS）中切缘阳性或闭合率方面的有效性。对117例诊断为原发性乳腺癌的受试者进行了多排螺旋计算机断层扫描（MDCT）标测图像重建，这些受试者使用CT皮肤标记物进行了MDCT。从手术标本制备的连续5 mm厚切片用于病理学分析。“阳性边缘”定义为手术边缘存在恶性细胞，“闭合边缘”定义为手术边缘5 mm内的肿瘤。计算切缘阳性率和切缘闭合率。我们在117例病例中发现了111例（94.9%）MDCT病灶。其中，93例在MDCT标测指导下接受BCS，其余18例接受乳房切除术。93例中6例（6.5%）切缘阳性或接近，诊断为低核级别导管原位癌。使用CT皮肤标记物的MDCT映射对于模拟手术定位和确定切除区域是可行的。MDCT定位可降低BCS的阳性率和边缘闭合率。
To investigate the usefulness of computed tomography (CT) with skin-marker placement in determining the excision area and decreasing the positive or close margin rates in breast-conserving surgery (BCS). Multidetector-row helical computed tomography (MDCT) mapping images were reconstructed in subjects (n= 117) diagnosed with primary breast cancer who had undergone MDCT using CT skin markers. Serial 5-mm-thick slices prepared from the surgical specimen were used for pathological analyses. A “positive margin” was defined as the presence of malignant cells at the surgical margin, and a “close margin” as a tumor within 5 mm of the surgical margin. The rates of positive and close margins were calculated. We identified the lesions in 111 of 117 cases (94.9%) on MDCT. Of these, 93 underwent BCS under the guidance of MDCT mapping and the remaining 18 underwent mastectomy. Among the 93 cases, 6 (6.5%) had positive or close margins and were diagnosed with ductal carcinoma in situ of low nuclear grade. MDCT mapping with a CT skin marker is feasible for simulating surgical positioning and determining the excision area. MDCT mapping could decrease the positive and close margin rates in BCS.