title: Preoperative and intraoperative sonographic visibility of collagen-based breast biopsy marker clips.
abstract: OBJECTIVE
  The aim of this study was to determine the sonographic visibility of implanted collagen-based breast biopsy marker clips in the clinic and operating room.
  
  
  METHODS
  Female patients aged > or =18 years who presented for preoperative surgical evaluation within 4 weeks of ultrasound-guided breast biopsy and collagen-based marker clip placement were eligible for this pilot study. The sonographic visibility of the marker clips was rated from 1 (not visible) to 5 (clearly visible) by surgeons at the preoperative appointment, by radiologists at wire localization, and by surgeons in the operating room. Visibility was considered inadequate for values of 1 or 2 and adequate for values of 3, 4, or 5. The data were compared using Wilcoxon's signed-rank test for paired differences across physician (radiologist vs surgeon), time (preoperative visit vs day of surgery), and target (lesion vs clip).
  
  
  RESULTS
  Twenty-five patients with 26 lesions were enrolled, and 19 patients returned for all imaging procedures. The mean lesion size was 12 mm (range, 5-24 mm). Adequate marker clip visibility assessed by the surgeons decreased from 80% (20 of 25) at the preoperative appointment to 65% (11 of 17) in the operating room, but the difference was not significant (P=.27). Visibilities of the lesions and clips were similar at the preoperative appointment (P=.61), but the clips were significantly less visible on the day of operation (P=.03).
  
  
  CONCLUSIONS
  The sonographic visibility of collagen-based marker clips is variable and likely decreases over time but may be adequate to guide intraoperative surgical excision in many cases.
authors.affiliation: Department of Radiology, University of Washington Medical Center, Seattle, WA, USA. preby@u.washington.edu
authors.forename: Peter R
authors.initials: PR
authors.lastname: Eby
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Calhoun
authors.forename: Brenda F
authors.initials: BF
authors.lastname: Kurland
authors.forename: Wendy B
authors.initials: WB
authors.lastname: Demartini
authors.forename: Robert L
authors.initials: RL
authors.lastname: Gutierrez
authors.forename: Sue
authors.initials: S
authors.lastname: Peacock
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Anderson
authors.forename: David R
authors.initials: DR
authors.lastname: Byrd
authors.forename: Gary N
authors.initials: GN
authors.lastname: Mann
authors.forename: Constance D
authors.initials: CD
authors.lastname: Lehman
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003094:Collagen; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation; D011300:Preoperative Care / Q000295:instrumentation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013525:Surgical Instruments; D018084:Ultrasonography, Interventional / Q000295:instrumentation*; D016217:Ultrasonography, Mammary / Q000295:instrumentation*
chemical_list: D003094:Collagen