title: Nonpalpable breast lesions: preoperative radiological guidance in radioguided occult lesion localisation (ROLL).
abstract: OBJECTIVE
  This study evaluated the methods, technical aspects and impact of preoperative radiological guidance in radioguided occult lesion localisation (ROLL) for single nonpalpable breast lesions.
  
  
  METHODS
  A total of 288 patients underwent ROLL before surgery. Human serum albumin macroaggregates labelled with 3.7-7.4 MBq of technetium(99) were injected into the lesion. In the case of ultrasonographic guidance (221/288 patients), inoculum positioning resulted in a change of echogenicity at the lesion site. In the case of mammographic guidance (67/288 patients), iodinated contrast medium was injected following the radiotracer for subsequent mammographic evaluation. Patients underwent surgery within 24 h from ROLL. A gamma-detecting probe was used to locate the lesion during surgery and guide its removal. After excision, the specimen was examined by either ultrasonography or mammography to verify complete lesion removal before histological evaluation.
  
  
  RESULTS
  The lesion was correctly localised in 281/288 patients (97.5%). One ROLL procedure failed because surgery could not be performed within 24 h and the radioactivity decayed. Of the six incorrect localisations, 2 were due to the radiological guidance and 4 to technetium(99) dispersion.
  
  
  CONCLUSIONS
  Radiological guidance in ROLL ensured the outcome of the procedure of localisation and removal of single, nonpalpable breast lesions in the majority of cases.
authors: Radiology Department, Vita-Salute University, San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. belloni.elena@alice.it
authors: E
authors: E
authors: Belloni
authors: C
authors: C
authors: Canevari
authors: P
authors: P
authors: Panizza
authors: A
authors: A
authors: Marassi
authors: M
authors: M
authors: Rodighiero
authors: S
authors: S
authors: Tacchini
authors: V
authors: V
authors: Zuber
authors: I
authors: I
authors: Sassi
authors: L
authors: L
authors: Gianolli
authors: F
authors: F
authors: Fazio
authors: A
authors: A
authors: Del Maschio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008875:Middle Aged; D010173:Palpation; D015641:Radiography, Interventional; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin / Q000008:administration & dosage; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin