title: Correlation between the area of high-signal intensity on SPIO-enhanced MR imaging and the pathologic size of sentinel node metastases in breast cancer patients with positive sentinel nodes.
abstract: BACKGROUND
  We previously demonstrated that superparamagnetic iron oxide (SPIO)-enhanced MR imaging is promising for the detection of metastases in sentinel nodes localized by CT-lymphography in patients with breast cancer. The purpose of this study was to determine the predictive criteria of the size of nodal metastases with SPIO-enhanced MR imaging in breast cancer, with histopathologic findings as reference standard.
  
  
  METHODS
  This study included 150 patients with breast cancer. The patterns of SPIO uptake for positive sentinel nodes were classified into three; uniform high-signal intensity, partial high-signal intensity involving ≥50% of the node, and partial high-signal intensity involving <50% of the node. Imaging results were correlated with histopathologic findings.
  
  
  RESULTS
  Thirty-three pathologically positive sentinel nodes from 30 patients were evaluated. High-signal intensity patterns that were uniform or involved ≥50% of the node were observed in 23 nodes that contained macro-metastases and no node that contained micro-metastases, while high-signal intensity patterns involving <50% of the node were observed in 2 nodes that contained macro-metastases and 8 nodes that contained micro-metastases. When the area of high-signal intensity was compared with the pathological size of the metastases, a pathologic >2 mm sentinel node metastases correlated with the area of high-signal intensity, however, a pathologic ≤2 mm sentinel node metastases did not.
  
  
  CONCLUSIONS
  High-signal intensity patterns that are uniform or involve ≥50% of the node are features of nodes with macro-metastases. The area of high-signal intensity correlated with the pathological size of metastases for nodes with metastases >2 mm in this series.
authors.affiliation: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. motomurak@hotmail.com.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Motomura
authors.forename: Tetsuta
authors.initials: T
authors.lastname: Izumi
authors.forename: Souichirou
authors.initials: S
authors.lastname: Tateishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sumino
authors.forename: Atsushi
authors.initials: A
authors.lastname: Noguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Horinouchi
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Nakanishi
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D002277:Carcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000556:secondary*; D003287:Contrast Media; D003911:Dextrans; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000706:statistics & numerical data*; D007564:Japan / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; C097921:ferumoxtran-10
references.citation: J Clin Oncol. 2009 Oct 1;27(28):4679-84
references.pmid: 19720928
references.citation: J Clin Oncol. 2008 Nov 10;26(32):5213-9
references.pmid: 18838709
references.citation: J Clin Oncol. 1997 Jun;15(6):2345-50
references.pmid: 9196149
references.citation: Radiology. 2003 Sep;228(3):777-88
references.pmid: 12954896
references.citation: J Clin Oncol. 2007 Aug 20;25(24):3657-63
references.pmid: 17485711
references.citation: J Magn Reson Imaging. 2002 Jul;16(1):60-8
references.pmid: 12112504
references.citation: Lancet Oncol. 2006 Jan;7(1):52-60
references.pmid: 16389184
references.citation: J Natl Cancer Inst. 2010 Mar 17;102(6):410-25
references.pmid: 20190185
references.citation: J Clin Oncol. 2005 Apr 20;23(12):2813-21
references.pmid: 15837995
references.citation: Radiology. 2008 Mar;246(3):804-11
references.pmid: 18195379
references.citation: J Surg Oncol. 2001 Feb;76(2):95-9
references.pmid: 11223834
references.citation: Ann Surg Oncol. 2006 Apr;13(4):491-500
references.pmid: 16514477
references.citation: J Surg Oncol. 2003 Feb;82(2):91-6; discussion 96-7
references.pmid: 12561063
references.citation: N Engl J Med. 2003 Jun 19;348(25):2491-9
references.pmid: 12815134
references.citation: Ann Surg Oncol. 2011 Nov;18(12):3422-9
references.pmid: 21607775
references.citation: Lancet. 1997 Jun 28;349(9069):1864-7
references.pmid: 9217757
references.citation: AJR Am J Roentgenol. 2003 Jun;180(6):1665-9
references.pmid: 12760939
references.citation: AJNR Am J Neuroradiol. 2002 Apr;23(4):649-56
references.pmid: 11950660
references.citation: N Engl J Med. 2009 Aug 13;361(7):653-63
references.pmid: 19675329
references.citation: Ann Surg. 1994 Sep;220(3):391-8; discussion 398-401
references.pmid: 8092905
references.citation: Breast Cancer. 1999 Jul 25;6(3):259-262
references.pmid: 11091726
references.citation: Ann Surg. 2008 May;247(5):839-42
references.pmid: 18438122
references.citation: N Engl J Med. 1998 Oct 1;339(14):941-6
references.pmid: 9753708