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Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla

PURPOSE: Clip-marking of axillary lymph nodes with initial biopsy-confirmed metastasis is required for targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of the clipped targeted lymph node. There have been several studies w...

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Autores principales: Guergan, Selin, Hoopmann, Uta, Roehm, Carmen, Boeer, Bettina, Fugunt, Regina, Helms, Gisela, Seller, Anna, Marx, Mario, Oberlechner, Ernst, Hartkopf, Andreas, Preibsch, Heike, Brucker, Sara, Wallwiener, Diethelm, Hahn, Markus, Gruber, Ines Verena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325667/
https://www.ncbi.nlm.nih.gov/pubmed/34142225
http://dx.doi.org/10.1007/s00404-021-06085-9
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author Guergan, Selin
Hoopmann, Uta
Roehm, Carmen
Boeer, Bettina
Fugunt, Regina
Helms, Gisela
Seller, Anna
Marx, Mario
Oberlechner, Ernst
Hartkopf, Andreas
Preibsch, Heike
Brucker, Sara
Wallwiener, Diethelm
Hahn, Markus
Gruber, Ines Verena
author_facet Guergan, Selin
Hoopmann, Uta
Roehm, Carmen
Boeer, Bettina
Fugunt, Regina
Helms, Gisela
Seller, Anna
Marx, Mario
Oberlechner, Ernst
Hartkopf, Andreas
Preibsch, Heike
Brucker, Sara
Wallwiener, Diethelm
Hahn, Markus
Gruber, Ines Verena
author_sort Guergan, Selin
collection PubMed
description PURPOSE: Clip-marking of axillary lymph nodes with initial biopsy-confirmed metastasis is required for targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of the clipped targeted lymph node. There have been several studies which examined the feasibility of TAD in routine clinical use. In this context, the optimal clip visualisation was noted as one of the crucial limiting factors. We, therefore, evaluated the sonographic detectability of 10 different commercially available markers within an in vitro model simulating the anatomical composition of the axilla. METHODS: In this standardised model consisting of porcine fat with 30 mm thickness, the visibility of a total of ten markers was analysed in all 3 planes (parallel, diagonal, orthograde) with wire guidance and then classified into either “visibility good”, “visibility moderate” or “visibility poor” with regard to the alignment of the transducer. Additionally, “real-life conditions” were simulated, in which the markers were searched without any wires guidance. RESULTS: It was observed that, while not all markers are detectable in fatty tissue, markers with spherical shape (non-embedded Inconel or Nitinol) or rectangular-shaped Titanium markers with embedded material have a clear advantage. 3D-shaped markers can always be detected in all three axes, which is of particular importance in the axilla with its pyramid shape and fatty tissue. CONCLUSION: The shape and the embedding of the material play a crucial role for visibility and efficacy of the marker, as reliable marking of suspicious and pathological axillary lymph nodes is essential for TAD.
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spelling pubmed-83256672021-08-02 Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla Guergan, Selin Hoopmann, Uta Roehm, Carmen Boeer, Bettina Fugunt, Regina Helms, Gisela Seller, Anna Marx, Mario Oberlechner, Ernst Hartkopf, Andreas Preibsch, Heike Brucker, Sara Wallwiener, Diethelm Hahn, Markus Gruber, Ines Verena Arch Gynecol Obstet Images in Obstetrics and Gynecology PURPOSE: Clip-marking of axillary lymph nodes with initial biopsy-confirmed metastasis is required for targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of the clipped targeted lymph node. There have been several studies which examined the feasibility of TAD in routine clinical use. In this context, the optimal clip visualisation was noted as one of the crucial limiting factors. We, therefore, evaluated the sonographic detectability of 10 different commercially available markers within an in vitro model simulating the anatomical composition of the axilla. METHODS: In this standardised model consisting of porcine fat with 30 mm thickness, the visibility of a total of ten markers was analysed in all 3 planes (parallel, diagonal, orthograde) with wire guidance and then classified into either “visibility good”, “visibility moderate” or “visibility poor” with regard to the alignment of the transducer. Additionally, “real-life conditions” were simulated, in which the markers were searched without any wires guidance. RESULTS: It was observed that, while not all markers are detectable in fatty tissue, markers with spherical shape (non-embedded Inconel or Nitinol) or rectangular-shaped Titanium markers with embedded material have a clear advantage. 3D-shaped markers can always be detected in all three axes, which is of particular importance in the axilla with its pyramid shape and fatty tissue. CONCLUSION: The shape and the embedding of the material play a crucial role for visibility and efficacy of the marker, as reliable marking of suspicious and pathological axillary lymph nodes is essential for TAD. Springer Berlin Heidelberg 2021-06-17 2021 /pmc/articles/PMC8325667/ /pubmed/34142225 http://dx.doi.org/10.1007/s00404-021-06085-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Images in Obstetrics and Gynecology
Guergan, Selin
Hoopmann, Uta
Roehm, Carmen
Boeer, Bettina
Fugunt, Regina
Helms, Gisela
Seller, Anna
Marx, Mario
Oberlechner, Ernst
Hartkopf, Andreas
Preibsch, Heike
Brucker, Sara
Wallwiener, Diethelm
Hahn, Markus
Gruber, Ines Verena
Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
title Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
title_full Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
title_fullStr Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
title_full_unstemmed Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
title_short Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
title_sort evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
topic Images in Obstetrics and Gynecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325667/
https://www.ncbi.nlm.nih.gov/pubmed/34142225
http://dx.doi.org/10.1007/s00404-021-06085-9
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