Ultrasound-guided radar reflector localization of axillary lymph nodes facilitates targeted axillary dissection
This study evaluated feasibility and patient outcomes for targeted axillary lymph node (LN) dissection (TAD) with SAVI SCOUT® ultrasound-guided radar reflector localization (RRL). In this IRB-approved retrospective study, 800 consecutive patients who underwent ultrasound-guided RRL between November...
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| Veröffentlicht in: | Clinical imaging 2022-10, Vol.90, p.19-25 |
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| creator | Weinfurtner, R. Jared Leon, Amie Calvert, Alexander Lee, M. Catherine |
| description | This study evaluated feasibility and patient outcomes for targeted axillary lymph node (LN) dissection (TAD) with SAVI SCOUT® ultrasound-guided radar reflector localization (RRL).
In this IRB-approved retrospective study, 800 consecutive patients who underwent ultrasound-guided RRL between November 2017 and June 2020 were reviewed. Of these patients, those with axillary LN RRL were included in this study. Reports in the electronic medical record were reviewed to determine RRL placement, retrieval, and surgical outcomes.
A total of 147 patients met inclusion criteria. Of these, axillary RRL was performed for biopsy-proven metastatic disease in 134 and inconclusive or benign biopsy in 13. RRL was successful in 146/151 lymph nodes (97%). Two patients had placement >10 mm from target and 3 had no post-placement signal. In all 5, the targets were successfully retrieved at surgery. Specimen radiographs were performed in 135 cases and confirmed the intended target in all 135 (100%). In 109 patients who underwent TAD + sentinel lymph node biopsy (SLNB), the RRL LN and the SLN(s) were different in 18 (17%). In 3 of these, the RRL LN was the only malignant LN (3%). In the 105 patients who underwent neoadjuvant chemotherapy, 43% (45/105) achieved nodal pCR and 85% (89/105) had |
| doi_str_mv | 10.1016/j.clinimag.2022.07.007 |
| format | Article |
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In this IRB-approved retrospective study, 800 consecutive patients who underwent ultrasound-guided RRL between November 2017 and June 2020 were reviewed. Of these patients, those with axillary LN RRL were included in this study. Reports in the electronic medical record were reviewed to determine RRL placement, retrieval, and surgical outcomes.
A total of 147 patients met inclusion criteria. Of these, axillary RRL was performed for biopsy-proven metastatic disease in 134 and inconclusive or benign biopsy in 13. RRL was successful in 146/151 lymph nodes (97%). Two patients had placement >10 mm from target and 3 had no post-placement signal. In all 5, the targets were successfully retrieved at surgery. Specimen radiographs were performed in 135 cases and confirmed the intended target in all 135 (100%). In 109 patients who underwent TAD + sentinel lymph node biopsy (SLNB), the RRL LN and the SLN(s) were different in 18 (17%). In 3 of these, the RRL LN was the only malignant LN (3%). In the 105 patients who underwent neoadjuvant chemotherapy, 43% (45/105) achieved nodal pCR and 85% (89/105) had <3 metastatic lymph nodes at surgery.
Ultrasound-guided RRL of axillary LNs is a feasible approach to facilitate TAD with high placement and retrieval success rates. This enables TAD as an alternative to complete axillary LN dissection (cALND), sparing some patients with low nodal tumor burden from cALND.
•US-guided SAVI SCOUT® radar reflector localization of axillary lymph nodes is highly successful (97% initial placement success rate, 100% surgery retrieval success rate)•This facilitates targeted axillary dissection + sentinel lymph node biopsy in patients with high likelihood of achieving low nodal burden•For ER/PR+ patients with only 1 suspicious lymph node on initial imaging, 95% had low nodal burden after neoadjuvant chemotherapy
Precis•US-guided SAVI SCOUT® radar reflector localization of axillary lymph nodes is highly successful and facilitates targeted axillary dissection in patients with a likelihood of low axillary nodal burden</description><identifier>ISSN: 0899-7071</identifier><identifier>EISSN: 1873-4499</identifier><identifier>DOI: 10.1016/j.clinimag.2022.07.007</identifier><language>eng</language><publisher>Philadelphia: Elsevier Inc</publisher><subject>Axillary lymph nodes ; Biopsy ; Breast cancer ; Cancer therapies ; Chemotherapy ; Dissection ; Documentation ; Electronic health records ; Electronic medical records ; Feasibility studies ; Localization ; Lymph nodes ; Lymphatic system ; Mammography ; Metastases ; Metastasis ; Pathology ; Patients ; Radar ; Radar reflector localization ; Radar reflectors ; Retrieval ; Surgeons ; Surgery ; Surgical outcomes ; Targeted axillary dissection ; Tumors ; Ultrasonic imaging ; Ultrasound</subject><ispartof>Clinical imaging, 2022-10, Vol.90, p.19-25</ispartof><rights>2022 Elsevier Inc.</rights><rights>2022. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c303t-76d7d4a4c29754b73d5eafc6f04df485cfa24ee771b299a25bbb1575b1db76cd3</citedby><cites>FETCH-LOGICAL-c303t-76d7d4a4c29754b73d5eafc6f04df485cfa24ee771b299a25bbb1575b1db76cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clinimag.2022.07.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids></links><search><creatorcontrib>Weinfurtner, R. Jared</creatorcontrib><creatorcontrib>Leon, Amie</creatorcontrib><creatorcontrib>Calvert, Alexander</creatorcontrib><creatorcontrib>Lee, M. Catherine</creatorcontrib><title>Ultrasound-guided radar reflector localization of axillary lymph nodes facilitates targeted axillary dissection</title><title>Clinical imaging</title><description>This study evaluated feasibility and patient outcomes for targeted axillary lymph node (LN) dissection (TAD) with SAVI SCOUT® ultrasound-guided radar reflector localization (RRL).
In this IRB-approved retrospective study, 800 consecutive patients who underwent ultrasound-guided RRL between November 2017 and June 2020 were reviewed. Of these patients, those with axillary LN RRL were included in this study. Reports in the electronic medical record were reviewed to determine RRL placement, retrieval, and surgical outcomes.
A total of 147 patients met inclusion criteria. Of these, axillary RRL was performed for biopsy-proven metastatic disease in 134 and inconclusive or benign biopsy in 13. RRL was successful in 146/151 lymph nodes (97%). Two patients had placement >10 mm from target and 3 had no post-placement signal. In all 5, the targets were successfully retrieved at surgery. Specimen radiographs were performed in 135 cases and confirmed the intended target in all 135 (100%). In 109 patients who underwent TAD + sentinel lymph node biopsy (SLNB), the RRL LN and the SLN(s) were different in 18 (17%). In 3 of these, the RRL LN was the only malignant LN (3%). In the 105 patients who underwent neoadjuvant chemotherapy, 43% (45/105) achieved nodal pCR and 85% (89/105) had <3 metastatic lymph nodes at surgery.
Ultrasound-guided RRL of axillary LNs is a feasible approach to facilitate TAD with high placement and retrieval success rates. This enables TAD as an alternative to complete axillary LN dissection (cALND), sparing some patients with low nodal tumor burden from cALND.
•US-guided SAVI SCOUT® radar reflector localization of axillary lymph nodes is highly successful (97% initial placement success rate, 100% surgery retrieval success rate)•This facilitates targeted axillary dissection + sentinel lymph node biopsy in patients with high likelihood of achieving low nodal burden•For ER/PR+ patients with only 1 suspicious lymph node on initial imaging, 95% had low nodal burden after neoadjuvant chemotherapy
Precis•US-guided SAVI SCOUT® radar reflector localization of axillary lymph nodes is highly successful and facilitates targeted axillary dissection in patients with a likelihood of low axillary nodal burden</description><subject>Axillary lymph nodes</subject><subject>Biopsy</subject><subject>Breast cancer</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Dissection</subject><subject>Documentation</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Feasibility studies</subject><subject>Localization</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Mammography</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Pathology</subject><subject>Patients</subject><subject>Radar</subject><subject>Radar reflector localization</subject><subject>Radar reflectors</subject><subject>Retrieval</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Targeted axillary dissection</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><subject>Ultrasound</subject><issn>0899-7071</issn><issn>1873-4499</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNqFkc1OxCAUhYnRxHH0FQyJGzetQGkpO83Ev8TEjbMmFOhIw5QRqHF8epmMunDj6t7Fd07uPQeAc4xKjHBzNZTK2dGu5aokiJASsRIhdgBmuGVVQSnnh2CGWs4Lhhg-BicxDigLOWUz4JcuBRn9NOpiNVltNAxSywCD6Z1RyQfovJLOfspk_Qh9D-WHdU6GLXTb9eYVjl6bCHuprLNJprwnGVYmZadfUtsYs1k2OAVHvXTRnH3POVje3b4sHoqn5_vHxc1ToSpUpYI1mmkqqSKc1bRjla6N7FXTI6p72taql4QawxjuCOeS1F3X4ZrVHdYda5Su5uBy77sJ_m0yMYm1jcrkc0bjpyhIwxnimDY0oxd_0MFPYczXCZITa5uK4jpTzZ5SwceY0xGbkDMPW4GR2PUgBvHTg9j1IBATuYcsvN4LTX733ZogorJmVEbbkDMR2tv_LL4Ajo2Xvg</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Weinfurtner, R. Jared</creator><creator>Leon, Amie</creator><creator>Calvert, Alexander</creator><creator>Lee, M. Catherine</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>202210</creationdate><title>Ultrasound-guided radar reflector localization of axillary lymph nodes facilitates targeted axillary dissection</title><author>Weinfurtner, R. Jared ; Leon, Amie ; Calvert, Alexander ; Lee, M. Catherine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-76d7d4a4c29754b73d5eafc6f04df485cfa24ee771b299a25bbb1575b1db76cd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Axillary lymph nodes</topic><topic>Biopsy</topic><topic>Breast cancer</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Dissection</topic><topic>Documentation</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Feasibility studies</topic><topic>Localization</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Mammography</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Pathology</topic><topic>Patients</topic><topic>Radar</topic><topic>Radar reflector localization</topic><topic>Radar reflectors</topic><topic>Retrieval</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Targeted axillary dissection</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weinfurtner, R. Jared</creatorcontrib><creatorcontrib>Leon, Amie</creatorcontrib><creatorcontrib>Calvert, Alexander</creatorcontrib><creatorcontrib>Lee, M. Catherine</creatorcontrib><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weinfurtner, R. Jared</au><au>Leon, Amie</au><au>Calvert, Alexander</au><au>Lee, M. Catherine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound-guided radar reflector localization of axillary lymph nodes facilitates targeted axillary dissection</atitle><jtitle>Clinical imaging</jtitle><date>2022-10</date><risdate>2022</risdate><volume>90</volume><spage>19</spage><epage>25</epage><pages>19-25</pages><issn>0899-7071</issn><eissn>1873-4499</eissn><abstract>This study evaluated feasibility and patient outcomes for targeted axillary lymph node (LN) dissection (TAD) with SAVI SCOUT® ultrasound-guided radar reflector localization (RRL).
In this IRB-approved retrospective study, 800 consecutive patients who underwent ultrasound-guided RRL between November 2017 and June 2020 were reviewed. Of these patients, those with axillary LN RRL were included in this study. Reports in the electronic medical record were reviewed to determine RRL placement, retrieval, and surgical outcomes.
A total of 147 patients met inclusion criteria. Of these, axillary RRL was performed for biopsy-proven metastatic disease in 134 and inconclusive or benign biopsy in 13. RRL was successful in 146/151 lymph nodes (97%). Two patients had placement >10 mm from target and 3 had no post-placement signal. In all 5, the targets were successfully retrieved at surgery. Specimen radiographs were performed in 135 cases and confirmed the intended target in all 135 (100%). In 109 patients who underwent TAD + sentinel lymph node biopsy (SLNB), the RRL LN and the SLN(s) were different in 18 (17%). In 3 of these, the RRL LN was the only malignant LN (3%). In the 105 patients who underwent neoadjuvant chemotherapy, 43% (45/105) achieved nodal pCR and 85% (89/105) had <3 metastatic lymph nodes at surgery.
Ultrasound-guided RRL of axillary LNs is a feasible approach to facilitate TAD with high placement and retrieval success rates. This enables TAD as an alternative to complete axillary LN dissection (cALND), sparing some patients with low nodal tumor burden from cALND.
•US-guided SAVI SCOUT® radar reflector localization of axillary lymph nodes is highly successful (97% initial placement success rate, 100% surgery retrieval success rate)•This facilitates targeted axillary dissection + sentinel lymph node biopsy in patients with high likelihood of achieving low nodal burden•For ER/PR+ patients with only 1 suspicious lymph node on initial imaging, 95% had low nodal burden after neoadjuvant chemotherapy
Precis•US-guided SAVI SCOUT® radar reflector localization of axillary lymph nodes is highly successful and facilitates targeted axillary dissection in patients with a likelihood of low axillary nodal burden</abstract><cop>Philadelphia</cop><pub>Elsevier Inc</pub><doi>10.1016/j.clinimag.2022.07.007</doi><tpages>7</tpages></addata></record> |
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| subjects | Axillary lymph nodes Biopsy Breast cancer Cancer therapies Chemotherapy Dissection Documentation Electronic health records Electronic medical records Feasibility studies Localization Lymph nodes Lymphatic system Mammography Metastases Metastasis Pathology Patients Radar Radar reflector localization Radar reflectors Retrieval Surgeons Surgery Surgical outcomes Targeted axillary dissection Tumors Ultrasonic imaging Ultrasound |
| title | Ultrasound-guided radar reflector localization of axillary lymph nodes facilitates targeted axillary dissection |
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