Takayuki Osanai

Magnetic Resonance Imaging of the Metal Clip in a Breast : Safety and Its Availability as a Negative Marker

PurposeThis study assesses magnetic resonance (MR) safely of the stainless-steel clip inserted after stereotactic-guided directional vacuum-assisted biopsy (DVAB) of the breast, and evaluates its imaging value.MethodsWe used a sausage as a substitute breast and inserted the clip into it. The MR images of the substitute were scanned using a breast coil, and it was then dissected. After the substitute experimentation, MR scanning of the breast was performed using a dynamic contrast enhanced technique, in which a clip was placed after DVAB for suspicion of ductal carcinoma was seen as grouped amorphous calcifications on mammography.ResultsOn every magnetic resonance image of the substitute, the clip was seen as a spotty signal void, with no surrounding artifact. There was no movement and no evidence of increased clip temperature on dissected of the substitute, confirming the safety of breast MR with a clip in place. There was no patient complaint of feeling heat or pain during the MRI examination and there were only biopsy scars on the surgically excised breast specimen material. On the breast MR images, a spreading region of the tumor adjoining the position of the signal void was identified as an early enhancing lesion.ConclusionsThe safety and reliability of breast MR examination using a mammotome clip was demonstrated by both the mock examination and the breast examination. It is possible to localize of tumor spread regions based on the marker position using the clip as a negative signal marker.

Endoscopic resection of benign breast tumors: retromammary space approach.

Endoscopic surgery is characterized by the creation of a working space. At our department, we have obtained good results with a retromammary space approach in which the tumor is resected after creation of a working space in the retromammary space. The special instruments used for this purpose comprise an endoscopic vein harvesting system to dissect the retromammary space, a dissecting balloon to compress the space to achieve hemostasis, and laparosonic coagulating shears to incise the tumor. This surgical technique provides a superior cosmetic result, and the level of patient satisfaction has been high.

Multiple 18F-FDG, PET-CT for Postoperative Monitoring of Breast Cancer Patients

Background: Positron emission tomography (PET)-computed tomography (CT) may be useful in the post-treatment follow-up of breast cancer patients. Purpose: To assess the usefulness of 18F-fluorodeoxyglucose (FDG) PET-CT (PET-CT) for postoperative monitoring of breast cancer patients. Material and Methods: One hundred twenty-nine PET-CT studies performed on 55 female postoperative breast cancer patients (median age 56 years, range 36–86 years) were analyzed. The median interval between the PET-CT studies was 6 months (range 1–15 months). In order to determine the usefulness of serial PET-CT examinations in the postoperative follow-up of breast cancer patients, the PET-CT findings were compared with the physical findings, findings obtained by other imaging modalities, and the 18F-FDG-PET (PET) findings. Results: The PET findings were negative in 4 metastatic bone lesions with a positive bone scan. The PET findings were also negative in 6 of 9 osteogenic bone metastases and one of 64 osteolytic bone lesions. There were 5 cases with false-positive of PET, which were determined to be areas of soft-tissue hyperactivity. All false-positive/-negative findings were corrected by the addition of CT. Conclusion: The results of this study lend support to the clinical role of PET-CT in the postoperative follow-up/monitoring of breast cancer patients.