Ultra-small iron particle-enhanced magnetic resonance imaging of axillary lymph nodes in breast cancer

Objective

To report the diagnostic value of ultra-small iron particle (USPIO)-enhanced magnetic resonance imaging (MRI) in the detection of axillary lymph node metastases in patients with breast carcinomas.

Methods

Patients with breast carcinomas were enrolled in a prospective phase III study. MRI of the axilla was performed at 1 Tesla prior to and 24 to 36 hours after intravenous administration of USPIO (Sinerem^®; Guerbet, France). MRI sequences were performed pre and post USPIO administration (axial T1 3D FFE, axial and sagittal T2* FFE, and T2 TSE). Imaging results were compared with histopathologic findings.

Results

A total of 154 lymph nodes were detected equally by pre and post USPIO-MRI. USPIO-MRI revealed a node-by-node sensitivity, specificity, and accuracy of 92%, 99%, and 98%, respectively. USPIO-enhanced MRI did not miss any lymph node metastases in a patient-by-patient correlation.

Conclusion

USPIO-MRI is a valuable method in the assessment of axillary lymph node metastases in patients with breast carcinomas and has potential as a noninvasive sentinel lymph node technique.