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Minareci Y, Sozen H, Altinkara Hacioglu B, Yuvanc HO, Topuz S, Salihoglu MY. Sentinel lymph node biopsy with carbon dye in endometrial cancer: a single center, prospective cohort study. Surg Endosc 2024; 38:1608-1616. [PMID: 38291161 PMCID: PMC10881722 DOI: 10.1007/s00464-023-10662-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Many agents have been used for the detection of sentinel lymph nodes in endometrial cancer. Carbon dye, which has a strong staining ability and high contrast due to its dark black color, identifies the lymph nodes efficiently. Our aim was to evaluate the safety and efficacy of carbon dye for the detection of sentinel lymph nodes in endometrial cancer. METHODS We conducted a single-center, prospective, cohort study in 89 patients with early-stage endometrial cancer between September 2021 and August 2022. The procedure was performed under laparoscopy. RESULTS The sensitivity and negative predictive value of the sentinel lymph node biopsy (SLNB) with carbon dye injection were 83.3% and 98.8%, respectively. Mapping identified at least one sentinel lymph node in 84 patients (94.4%) on one pelvic side and at least one sentinel lymph node in 73 patients (82.0%) on each pelvic side out of 89 patients. In addition, no carbon dye-associated allergic reaction was detected. CONCLUSION Carbon dye is a non-allergenic, inexpensive, and effective agent for SLNB with a satisfying sensitivity and a negative predictive value. In addition, both unilateral and bilateral detection rates were sufficient. Accordingly, carbon dye may be a promising tracer and a considerable option, particularly for low-income countries.
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Affiliation(s)
- Yagmur Minareci
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Faculty of Medicine, Istanbul Medical Faculty, Istanbul University, Turgut Ozal Millet Cd, Monoblok Binasi, No:118, Zemin Kat, Jinekolojik Onkoloji Poliklinigi, Capa, Fatih, 34093, Istanbul, Turkey.
| | - Hamdullah Sozen
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Faculty of Medicine, Istanbul Medical Faculty, Istanbul University, Turgut Ozal Millet Cd, Monoblok Binasi, No:118, Zemin Kat, Jinekolojik Onkoloji Poliklinigi, Capa, Fatih, 34093, Istanbul, Turkey
| | | | - Huseyin Oguz Yuvanc
- Department of Gynecology and Obstetrics, Eskisehir City Hospital, Eskisehir, Turkey
| | - Samet Topuz
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Faculty of Medicine, Istanbul Medical Faculty, Istanbul University, Turgut Ozal Millet Cd, Monoblok Binasi, No:118, Zemin Kat, Jinekolojik Onkoloji Poliklinigi, Capa, Fatih, 34093, Istanbul, Turkey
| | - Mehmet Yavuz Salihoglu
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Faculty of Medicine, Istanbul Medical Faculty, Istanbul University, Turgut Ozal Millet Cd, Monoblok Binasi, No:118, Zemin Kat, Jinekolojik Onkoloji Poliklinigi, Capa, Fatih, 34093, Istanbul, Turkey
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Lee CU, Piltin MA, Moldoveanu D, Urban MW, Hesley GK. Using US Twinkling Artifact to Identify Breast Biopsy Markers: Brief Report. Radiol Imaging Cancer 2023; 5:e220168. [PMID: 37326508 PMCID: PMC10413298 DOI: 10.1148/rycan.220168] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/08/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023]
Abstract
Breast biopsy markers play an essential role in the surgical management of patients with clinically node-positive breast cancer. Marking a pathology-proven lymph node ensures accurate imaging assessment of response to neoadjuvant systemic therapy and decreased false-negative rates in sentinel lymph node biopsy. There is a clinically unmet need to make breast biopsy markers, particularly in the axilla, more sonographically visible or identifiable for preoperative localization purposes. Previously described color Doppler US twinkling artifact of some breast biopsy markers in in vitro gel phantoms and in ex vivo cadaveric breasts suggests that twinkling of such markers can be leveraged for improved in vivo detection. In this retrospective case series of eight female patients (mean age, 58.6 years ± 12.3 [SD]), conventional B-mode US imaging failed to identify the biopsy marker associated with a surgical target in the breast or in an axillary lymph node. However, in each patient, the marker was successfully identified with the help of color Doppler US twinkling. Keywords: Breast, Ultrasound, Color Doppler US, Lymphatic, Artifacts, Biopsy Marker Published under a CC BY 4.0 license.
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Affiliation(s)
- Christine U. Lee
- From the Department of Radiology, Division of Breast Imaging and
Intervention (C.U.L., G.K.H.), Department of Surgery, Division of Breast and
Melanoma Surgical Oncology (M.A.P., D.M.), Department of Radiology, Division of
Radiology Research (M.W.U.), and Department of Physiology and Biomedical
Engineering (M.W.U.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Mara A. Piltin
- From the Department of Radiology, Division of Breast Imaging and
Intervention (C.U.L., G.K.H.), Department of Surgery, Division of Breast and
Melanoma Surgical Oncology (M.A.P., D.M.), Department of Radiology, Division of
Radiology Research (M.W.U.), and Department of Physiology and Biomedical
Engineering (M.W.U.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Dan Moldoveanu
- From the Department of Radiology, Division of Breast Imaging and
Intervention (C.U.L., G.K.H.), Department of Surgery, Division of Breast and
Melanoma Surgical Oncology (M.A.P., D.M.), Department of Radiology, Division of
Radiology Research (M.W.U.), and Department of Physiology and Biomedical
Engineering (M.W.U.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Matthew W. Urban
- From the Department of Radiology, Division of Breast Imaging and
Intervention (C.U.L., G.K.H.), Department of Surgery, Division of Breast and
Melanoma Surgical Oncology (M.A.P., D.M.), Department of Radiology, Division of
Radiology Research (M.W.U.), and Department of Physiology and Biomedical
Engineering (M.W.U.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
| | - Gina K. Hesley
- From the Department of Radiology, Division of Breast Imaging and
Intervention (C.U.L., G.K.H.), Department of Surgery, Division of Breast and
Melanoma Surgical Oncology (M.A.P., D.M.), Department of Radiology, Division of
Radiology Research (M.W.U.), and Department of Physiology and Biomedical
Engineering (M.W.U.), Mayo Clinic, 200 First St SW, Rochester, MN 55905
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