Comparison of Sonography versus Digital Breast Tomosynthesis to Locate Intramammary Marker Clips

 

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Abstract

Introduction: This study aimed to compare the accuracy of sonography versus digital breast tomosynthesis to locate intramammary marker clips placed under ultrasound guidance. Patients and Methods: Fifty patients with suspicion of breast cancer (lesion diameter less than 2 cm [cT1]) had ultrasound-guided core needle biopsy with placement of a marker clip in the center of the tumor. Intramammary marker clips were subsequently located with both sonography and digital breast tomosynthesis. Results: Sonography detected no dislocation of intrammammary marker clips in 42 of 50 patients (84 %); dislocation was reported in 8 patients (16 %) with a maximum dislocation of 7 mm along the x-, y- or z-axis. Digital breast tomosynthesis showed accurate placement without dislocation of the intramammary marker clip in 48 patients (96 %); 2 patients (4 %) had a maximum clip dislocation of 3 mm along the x-, y- or z-axis (p < 0.05). Conclusion: The use of digital breast tomosynthesis could improve the accuracy when locating intramammary marker clips compared to sonography and could, in future, be used to complement or even completely replace sonography.

Zusammenfassung

Einleitung: In dieser Untersuchung sollte die Genauigkeit der Lokalisationsbestimmung der intramammären, sonografiegesteuerten Clipmarkierung sowohl durch Sonografie als auch durch digitale Brusttomosynthese verglichen werden. Patientinnen und Methoden: Bei 50 Patientinnen wurde bei Verdacht auf ein Mammakarzinom mit einem Durchmesser von kleiner 2 cm (cT1), eine sonografisch gesteuerte Stanzbiopsie mit gleichzeitiger adaptierter Clipmarkierung in das Tumorzentrum durchgeführt. Anschließend wurde eine Lokalisationsbestimmung der intramammären Clipmarkierung sowohl durch Sonografie als auch durch eine digitale Brusttomosynthese durchgeführt. Ergebnisse: Bei 42 der 50 Patientinnen war sonografisch keine Dislokation der intramammären Clipmarkierung diagnostizierbar (84 %), bei 8 Patientinnen (16 %) ergab sich eine Dislokation von max. 7 mm in x-, y- bzw. z-Achse. Die digitale Brusttomosynthese zeigte eine exakte Platzierung ohne Dislokation der intramammären Clipmarkierung bei 48 Patientinnen (96 %), und hier stellte sich im Unterschied nur bei 2 Patientinnen (4 %) eine Dislokation von max. 3 mm in x-, y- bzw. z-Achse dar (p < 0,05). Schlussfolgerung: Der Einsatz der digitalen Brusttomosynthese könnte die Genauigkeit der Lokalisationsbestimmung einer intramammären Clipmarkierung im Vergleich zur Sonografie verbessern und diese in Zukunft ergänzen bzw. ablösen.

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