Technical improvement of pO(2) measurements in breast cancer: investigation of the feasibility in patients and in vitro validation of the method.
OBJECTIVE
Investigating tumor oxygenation in breast cancer with the Eppendorf device is hampered by the deep location and inadequate fixation of the tumor within the breast. In order to ensure the correct site of pO(2) measurements, guiding aids were introduced and the reliability of the refined method was evaluated.


METHODS
For guidance of the needle electrode, a metal trocar was inserted up to the tumor rim. Its positioning and all transtumoral tracks of the needle electrode were monitored continuously by ultrasonography. Thus, 150 tumor measurements in 148 patients were evaluated. In a phantom, the possible influence of the metal trocar was assessed and the measurements of two histographs with five different needle electrodes were compared.


RESULTS
In 88% of measurements (132/150) complete or partial sonographic demarcation of the tumor was possible. 83.2% of the tracks (437/525) could be controlled by ultrasonography. Overall, in 60% of measurements (90/150) all values derived reliably from within the tumor. In vitro, an influence of the metal trocar on the measurements could be excluded. Differences between histographs were in accordance with tolerance limits.


CONCLUSIONS
From theoretical considerations and the phantom experiments a significant negative impact of the technical modifications could be excluded. Instead, the method described here showed to be beneficial in measuring tumor oxygenation in breast tumors. The authors strongly advise to consider exclusively intratumoral pO(2) values as proven by ultrasonography for oxygenation profiling, as in 40% of all measurements the origin of single pO(2) values or tracks was questionable.
Auer
Florian
F
Department of Radiotherapy and Radiation Oncology, Klinikum rechts der Isar, Technische Universität, Munich, Germany. Florian.Auer@lrz.tu-muenchen.de
Röper
Barbara
B
Scheich
Dieter
D
Molls
Michael
M
Eiermann
Wolfgang
W
Raab
Günther
G
D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D015687:Cell Hypoxia / Q000502:physiology*; D004566:Electrodes; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D009339:Needles; D010100:Oxygen / Q000032:analysis*; D011237:Predictive Value of Tests; D013525:Surgical Instruments; D016217:Ultrasonography, Mammary / Q000295:instrumentation*
D010100:Oxygen