Magnetic resonance imaging appearance of oxidized regenerated cellulose in breast cancer surgery.
OBJECTIVE
To describe magnetic resonance imaging (MRI) findings in patients who underwent breast-conserving surgery followed by oxidized regenerated cellulose (ORC) implantation in surgical cavity.


METHODS
We retrospectively reviewed 51 MRI examinations performed between January 2009 and January 2014 in 51 patients who underwent BCS with ORC implantation.


RESULTS
In 29/51 (57 %) cases, MRIs showed abnormal findings with three main MRI patterns: (1) complex masses: hyperintense collections on T2-weighted (w) images with internal round hypointense nodules without contrast enhancement (55 %); (2) completely hyperintense collections (17 %); and (3) completely hypointense lesions (28 %). All lesions showed rim enhancement on T1w images obtained in the late phase of the dynamic study with a type 1 curve. Diffusion-weighted imaging was negative in all MRIs and, in particular, 22/29 (76 %) lesions were hyperintense but showing ADC values >1.4 × 10(-3) mm(2)/s, while the remaining 7/29 (24 %) lesions were hypointense. In four cases, linear non-mass-like enhancement was detected at the periphery of surgical cavity; these patients were addressed to a short-term follow-up, and the subsequent examinations showed the resolution of these findings.


CONCLUSIONS
When applied to surgical residual cavity, ORC can lead alterations in surgical scar. This could induce radiologists to misinterpret ultrasonographic and mammographic findings, addressing patients to MRI or biopsy; so knowledge of MRI specific features of ORC, it is essential to avoid misdiagnosis of recurrence.
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy. micgiuli@yahoo.it.|, Largo Francesco Vito 1, 00168, Rome, Italy. micgiuli@yahoo.it.
Michela
M
Giuliani
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Rossella
R
Rella
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Rita
R
Fubelli
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Federica
F
Patrolecco
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Silvia Eleonora
SE
Di Giovanni
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Chiara
C
Buccheri
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Federico
F
Padovano
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Paolo
P
Belli
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Maurizio
M
Romani
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Pierluigi
P
Rinaldi
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Enida
E
Bufi
Department of General Surgery, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Gianluca
G
Franceschini
Department of Radiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome, Italy.
Lorenzo
L
Bonomo
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018427:Breast Implants; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D012189:Retrospective Studies
D002483:Cellulose, Oxidized; D003287:Contrast Media; D019786:Gadolinium DTPA
Absorbable implants; Breast-conserving surgery; Magnetic resonance imaging; Oncoplastic procedures; Oxidized regenerated cellulose