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Ruffenach L, Heintz D, Villette C, Cosentino C, Funfschilling D, Bodin F, Bahlouli N, Chatelin S. Ultrasonic elastography for the prevention of breast implant rupture: Detection of an increase with stiffness over implantation time. J Biomech 2024; 163:111955. [PMID: 38266533 DOI: 10.1016/j.jbiomech.2024.111955] [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: 08/17/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
Breast implants are widely used after breast cancer resection and must be changed regularly to avoid a rupture. To date, there are no quantitative criteria to help this decision. The mechanical evolution of the gels and membranes of the implants is still underinvestigated, although it can lead to early rupture. In this study, 35 breast explants having been implanted in patients for up to 17 years were characterized by ex vivo measurements of their mechanical properties. Using Acoustic Radiation Force Impulse (ARFI) ultrasound elastography, an imaging method for non-destructive mechanical characterization, an increase in the stiffness of the explants has been observed. This increase was correlated with the implantation duration, primarily after 8 years of implantation. With an increase of the shear modulus of up to a factor of nearly 3, the loss of flexibility of the implants is likely to lead to a significant increase of their risk of rupture. A complementary analysis of the gel from the explants by mass spectrometry imaging (MSI) and liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS) confirms the presence of metabolites of cholesterol originating from the breast tissues, which most likely crossed the membrane of the implants and most likely degrades the gel. By observing the consequences of the physical-chemical mechanisms at work within patients, this study shows that ultrasound elastography could be used in vivoas a quantitative indicator of the risk of breast implant rupture and help diagnose their replacement.
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Affiliation(s)
- Laetitia Ruffenach
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France; Service de chirurgie plastique esthétique et reconstructrice, Hautepierre hospital, CHRU Strasbourg, HUS, Strasbourg, France
| | - Dimitri Heintz
- Plant Imaging & Mass Spectrometry (PIMS), IBMP, UPR 2357 CNRS, University of Strasbourg, Strasbourg, France
| | - Claire Villette
- Plant Imaging & Mass Spectrometry (PIMS), IBMP, UPR 2357 CNRS, University of Strasbourg, Strasbourg, France
| | | | | | - Frédéric Bodin
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France; Service de chirurgie plastique esthétique et reconstructrice, Hautepierre hospital, CHRU Strasbourg, HUS, Strasbourg, France
| | - Nadia Bahlouli
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France
| | - Simon Chatelin
- ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France
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Georgieva M, Kammerer S, Prantl L, Jung F, Stroszczynski C, Jung EM. Imaging of breast implant and implant-associated complications: Capsular contracture and intra- or extracapsular rupture. Clin Hemorheol Microcirc 2020; 76:221-231. [PMID: 32925022 DOI: 10.3233/ch-209218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In recent years, follow-up after breast reconstruction with silicone implants and the detection of complications have been relieved by the possibility of improved diagnostic methods. METHODS Between January 2015 and December 2019 a total of 40 patients (29-84 years) with silicone implants were included in this retrospective study. The implants were examined clinically and with modern imaging: general ultrasound imaging (US), magnetic resonance imaging (MRI), high resolution computed tomography (CT) and positron emission tomography -computed tomography (PET-CT). If necessary, a histological/cytological sample was taken. The breast implants were assessed by three radiologists specialized in breast imaging. The grade of capsular contracture was classified according to the Baker classification. RESULTS All 40 women obtained a clinical examination and an US diagnostic to identify early and more common complications such as implant folding and capsular fibrosis. Depending on the clinical examination and ultrasound findings additional MRI (n = 10), CT (n = 9) and/or PET-CT (n = 2) were performed. 16 patients had implants folding proven with US (n = 16), MRI (n = 6) and CT (n = 1). The grade of capsular fibrosis was determined according to the Baker classification. The following results were obtained in our study: 25 breast implants with Baker grade I and eleven breast implants with Baker grade II, both proven with US; one breast implants with Baker grade III and one breast implant with Baker grade IV, proven with US (n = 2), MRI (n = 1) and CT (n = 1). One patient had intracapsular rupture and one patient had extracapsular rupture, both detected on CT and surgically proven. No patient had a silicone accumulation in the lymph nodes. One patient had pathologically enlarged axillary lymph nodes, which were evaluated as inflammatory changes in PET-CT. Long-term complications such as the development of malignant breast tumors could not be observed. CONCLUSION To detect early complications after breast implant surgery, a regular clinical examination is indispensable. Imaging methods complement each other and if they are used multimodal, it is easier to identify early complications. Modern diagnostic modalities like ultrasound and magnetic resonance imaging expand the spectrum and improve diagnostic safety.
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Affiliation(s)
- M Georgieva
- Department of Radiology, University Hospital Regensburg, Germany
| | - S Kammerer
- Department of Radiology, University Hospital Regensburg, Germany
| | - L Prantl
- Department of Plastic, Hand, and Reconstructive Surgery, University Medical Center Regensburg, Germany
| | - F Jung
- Brandenburg University of Technology, Molecular Cell Biology, Senftenberg, Germany
| | - C Stroszczynski
- Department of Radiology, University Hospital Regensburg, Germany
| | - E M Jung
- Department of Radiology, University Hospital Regensburg, Germany
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Ma X, Li Q, Wang JL, Shao J, Zhu YC, Ding W, Zhang HS, Wang HY, Shen JK. Comparison of elastography based on transvaginal ultrasound and MRI in assessing parametrial invasion of cervical cancer. Clin Hemorheol Microcirc 2017; 66:27-35. [PMID: 28211804 DOI: 10.3233/ch-16235] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Xi Ma
- Department of Ultrasound Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Qi Li
- Department of Ultrasound Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Jian-liang Wang
- Department of Radiology Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Jun Shao
- Department of Ultrasound Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Yu-chun Zhu
- Department of Radiology Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Wei Ding
- Department of Ultrasound Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Hou-sheng Zhang
- Department of Ultrasound Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Hong-yan Wang
- Department of Radiology Diagnosis, Kunshan Hospital Affiliated to Jiangsu University, Kunshan, Jiangsu, China
| | - Jun-kang Shen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Institute of Radiotherapy & Oncology, Soochow University, Suzhou, China
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Yao MH, Wu R, Xu G, Zhao LX, Liu H, Pu H, Fang Y. A novel two-dimensional quantitative shear wave elastography to make differential diagnosis of breast lesions: Comprehensive evaluation and influencing factors. Clin Hemorheol Microcirc 2017; 64:223-233. [PMID: 27814283 DOI: 10.3233/ch-16188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Virtual touch imaging quantification (VTIQ), a form of shear wave elastography, may help in the diagnosis of breast lesions. OBJECTIVE We aimed to evaluate the diagnostic performance of combined VTIQ and conventional ultrasound (US), and assess the factors influencing VTIQ measurement. METHODS From September 2014 to December 2014, 162 patients with breast lesions were examined by US and VTIQ to assess shear wave speed (SWS) and morphological characteristics (lesion shape, orientation, margin and echo pattern). The sensitivity, specificity and accuracy of VTIQ, US and VTIQ+US for the diagnosis of breast lesions was evaluated in comparison to pathological results. Factors influencing deviations in SWS measurements were assessed by logistic regression. RESULTS The SWS cut-off between malignant and benign lesions was 3.73 m/s. The sensitivity, specificity and accuracy were: 98.07%, 55.96%, and 69.57% for US; 76.92%, 78.89% and 78.26% for VTIQ; and 98.07%, 84.40% and 88.82% for US+VTIQ. The two factors that influenced the SWS results were the lesion margin (odds ratio [OR], 16.363; 95% confidence interval [CI], 3.220-29.020) and vascularity (OR, 6.712; 95% CI, 1.358-9.072). CONCLUSIONS The lesion margin and vascularity could affect the measurement of SWS as well as the experience of examiner. However, VTIQ is still a reliable method that provides valuable information in the differential diagnosis of breast lesions, and may reduce unnecessary biopsies.
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Trottmann M, Rübenthaler J, Marcon J, Stief C, Reiser M, Clevert D. Differences of standard values of Supersonic shear imaging and ARFI technique – in vivo study of testicular tissue. Clin Hemorheol Microcirc 2017; 64:729-733. [DOI: 10.3233/ch-168039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M. Trottmann
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - J. Rübenthaler
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - J. Marcon
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - C.G. Stief
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M.F. Reiser
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - D.A. Clevert
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
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Trottmann M, Marcon J, D’Anastasi M, Bruce M, Stief C, Reiser M, Buchner A, Clevert D. Shear-wave elastography of the testis in the healthy man – determination of standard values. Clin Hemorheol Microcirc 2016; 62:273-81. [DOI: 10.3233/ch-162046] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M. Trottmann
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - J. Marcon
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M. D’Anastasi
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M.F. Bruce
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - C.G. Stief
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - M.F. Reiser
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - A. Buchner
- Department of Urology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
| | - D.A. Clevert
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Grosshadern Campus, Munich, Germany
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