title: Ex vivo MRI of axillary lymph nodes in breast cancer.
abstract: OBJECTIVE
  To provide a strategy for precise co-localization of lymph nodes on axillary lymph-node dissection (ALND) specimens both on pathology and MR. To identify nodal features suggestive of metastatic involvement on a node-to-node basis.
  
  
  METHODS
  National Institutional review-board approved this prospective study of 18 patients with breast cancer referred for ALND. Ex vivo T1 and inversion recovery (IR) T2 WI of ALND specimens tightly positioned within scaled plastic cranes was performed immediately after surgery. The correspondence of MR-based or pathologically based nodes location was assessed. The MR size and morphological presentation of metastatic and normal nodes were compared (Student's t-test or Mann-Whitney test). Quantitative variables were compared using Pearson coefficient.
  
  
  RESULTS
  207 nodes were retrieved on pathology and 165 on MR. MR-pathological correlation of nodes location was high regarding MR-identified nodes (r=0.755). An MR short axis threshold of 4mm yielded the best predictive value for metastatic nodal involvement (Se=78.6%; Sp=62.3%). Irregular contours (Se=35.7%; Sp=96.7%), central nodal hyper-intensity on IR T2 WI (Se=57.1%; Sp=91.4%), and a cortical thickness above 3mm (Se=63.6%; Sp=83.2%) were significantly associated with metastatic involvement.
  
  
  CONCLUSIONS
  Ex vivo MR allows node-to-node correlation with pathology. Morphological MR criteria can suggest metastatic involvement.
authors.affiliation: Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Créteil, France. luciani@hmn.ap-hop-paris.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Luciani
authors.forename: Frederic
authors.initials: F
authors.lastname: Pigneur
authors.forename: Faridah
authors.initials: F
authors.lastname: Ghozali
authors.forename: Thu-Ha
authors.initials: TH
authors.lastname: Dao
authors.forename: Patrick
authors.initials: P
authors.lastname: Cunin
authors.forename: Evelyne
authors.initials: E
authors.lastname: Meyblum
authors.forename: Cecile
authors.initials: C
authors.lastname: De Baecque-Fontaine
authors.forename: Ali
authors.initials: A
authors.lastname: Alamdari
authors.forename: Patrick
authors.initials: P
authors.lastname: Maison
authors.forename: Jean François
authors.initials: JF
authors.lastname: Deux
authors.forename: Jean Léon
authors.initials: JL
authors.lastname: Lagrange
authors.forename: Laurent
authors.initials: L
authors.lastname: Lantieri
authors.forename: Alain
authors.initials: A
authors.lastname: Rahmouni
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods