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首页> 外文期刊>Medecine Nucleaire >Technique ROLL: une nouvelle methode pour le reperage des lesions mammaires infracliniques
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Technique ROLL: une nouvelle methode pour le reperage des lesions mammaires infracliniques

机译：ROLL技术：追踪亚临床乳腺病变的新方法

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Background: the frequency of occult breast lesions has increased during the last 20 years, thanks to the development of screening mammography. Radioguided occult lesion localization (ROLL) is a new method for guiding the surgeon in the excision of non palpable breast lesions. A gamma emitting radiotracer is injected preoperatively in the center of the tumor. The surgeon can locate precisely the lesion with a gamma probe. The use of nanocolloids allows sentinel node biopsy without another injection. The aim of this study is to evaluate the feasibility of this technique. Materials and methods: we performed ROLL on 49 women with occult breast abnormalities. On the day before surgery, 95 MBq of ~(99m)Tc-labelled sulfur rhenium colloids (NANOCIS~(~R), Cis bio international Schering) were injected in 0,2 ml, under ultrasonographic (33 cases) or mammographic guidance (17 cases), into the center of the target lesion. Detection was performed with a gamma probe equipped with an additional high-resolution collimator (Gammasup~(~R), Clerad, France). Sentinel lymph node detection was performed in case of documented or suspected invasive carcinoma. Results: ROLL was performed on 50 occult breast lesions. During surgery, the hot spot was always found easily with the gamma probe and the lesion was located in all cases in the excised tissue. Benign lesions were found in 14/50 (28%) cases, borderline lesions in 8 (16%) cases, in situ carcinoma in 5 (10%) cases and invasive carcinoma in 23 (46%) cases. Sentinel lymph node was researched in 22 cases and biopsy was performed in 20 cases (91%). Conclusion: radioguided occult lesion localization proved to be a simple, fast and accurate new method for guiding the surgeon in the excision of non palpable breast lesions. It could rapidly replace the colorimetric or wire localization techniques. This approach also allows to detect the sentinel lymph node without another injection.
机译：背景：由于乳腺X线摄影筛查技术的发展，隐匿性乳腺病变的发生率在过去20年中有所增加。放射性隐匿性病变定位（ROLL）是一种指导外科医生切除不可触及的乳腺病变的新方法。术前将发射伽马射线的放射性示踪剂注入肿瘤中心。外科医生可以使用伽马探针精确定位病变。纳米胶体的使用无需进一步注射即可进行前哨淋巴结活检。这项研究的目的是评估这种技术的可行性。材料和方法：我们对49名隐匿性乳房异常的女性进行了ROLL。在手术前一天，在超声检查（33例）或在乳腺X线照片的指导下，以0.2 ml注射〜（99m）Tc标记的硫label胶（NANOCIS〜（R），Cis bio international Schering）95 MBq。 17例），进入目标病变的中心。用配备有额外的高分辨率准直仪的伽马探针进行检测（Gammasup®，法国克莱拉德）。如果有记录或怀疑为浸润性癌，则进行前哨淋巴结检测。结果：对50例隐匿性乳腺病变进行了ROLL检查。在手术过程中，总是很容易用伽玛探针发现热点，并且在所有情况下病变都位于切除的组织中。良性病变占14/50（28％），边缘性病变占8（16％），原位癌占5（10％），浸润性癌占23（46％）。前哨淋巴结研究22例，活检20例（91％）。结论：放射性隐匿性病变定位被证明是一种指导外科医生切除不可触及的乳腺病变的简单，快速，准确的新方法。它可以快速取代比色法或导线定位技术。该方法还允许无需另外注射即可检测前哨淋巴结。

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