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van Lanschot C, Schut TB, Barroso E, Sewnaik A, Hardillo J, Monserez D, Meeuwis C, Keereweer S, de Jong RB, Puppels G, Koljenović S. Raman spectroscopy to discriminate laryngeal squamous cell carcinoma from non-cancerous surrounding tissue. Lasers Med Sci 2023; 38:193. [PMID: 37624524 PMCID: PMC10457228 DOI: 10.1007/s10103-023-03849-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023]
Abstract
As for many solid cancers, laryngeal cancer is treated surgically, and adequate resection margins are critical for survival. Raman spectroscopy has the capacity to accurately differentiate between cancer and non-cancerous tissue based on their molecular composition, which has been proven in previous work. The aim of this study is to investigate whether Raman spectroscopy can be used to discriminate laryngeal cancer from surrounding non-cancerous tissue. Patients surgically treated for laryngeal cancer were included. Raman mapping experiments were performed ex vivo on resection specimens and correlated to histopathology. Water concentration analysis and CH-stretching region analysis were performed in the high wavenumber range of 2500-4000 cm-1. Thirty-four mapping experiments on 22 resection specimens were used for analysis. Both laryngeal cancer and all non-cancerous tissue structures showed high water concentrations of around 75%. Discriminative information was only found to be present in the CH-stretching region of the Raman spectra of the larynx (discriminative power of 0.87). High wavenumber region Raman spectroscopy can discriminate laryngeal cancer from non-cancerous tissue structures. Contrary to the findings for oral cavity cancer, water concentration is not a discriminating factor for laryngeal cancer.
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Affiliation(s)
- Cornelia van Lanschot
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Tom Bakker Schut
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Elisa Barroso
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jose Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Dominiek Monserez
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Cees Meeuwis
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Stijn Keereweer
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Rob Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Gerwin Puppels
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Senada Koljenović
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Pathology, Antwerp University Hospital, 2650, Antwerp, Belgium
- Faculty of Medicine, University of Antwerp, 2610, Antwerp, Belgium
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Aaboubout Y, Barroso E, Soares RN, van Lanschot C, Schut TCB, ten Hove I, Mast H, Smits S, Sewnaik A, Hardillo J, Meeuwis C, Monserez D, Keereweer S, Hegt VN, Caspers P, de Jong RB, Wolvius EB, Bocharnikov A, Artyushenko V, Usenov I, Puppels GJ, Koljenović S. INTRAOPERATIVE ASSESSMENT OF RESECTION MARGINS BASED ON RAMAN SPECTROSCOPY IN OCSCC SURGERY. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barroso E, van Lanschot C, Schut TB, Smits R, Aaboubout Y, Soares RN, ten Hove I, Mast H, Sewnaik A, Hardillo J, Meeuwis C, Monserez D, Keereweer S, Caspers P, Hegt VN, de Jong RJB, Wolvius E, Puppels G, Koljenović S. RAMAN SPECTROSCOPY FOR INTRAOPERATIVE ASSESSMENT OF BONE RESECTION MARGINS IN ORAL CAVITY SQUAMOUS CELL CARCINOMA. Oral Surg Oral Med Oral Pathol Oral Radiol 2021. [DOI: 10.1016/j.oooo.2021.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Verloop J, Klijn F, van Vegchel T, Bessems M, Meeuwis C, Wijers L, Honkoop A, Heijns J, Siesling S, Verbeek X. Development of an information standard for breast cancer in the Netherlands. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30575-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Menezes GL, Mann RM, Meeuwis C, Bisschops B, Veltman J, Lavin PT, van de Vijver MJ, Pijnappel RM. Abstract P2-08-43: Can optoacoustic imaging combined with ultrasound non-invasively offer prognosis for breast cancer molecular subtypes? Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aim: To investigate the role of optoacoustic imaging combined with gray-scale ultrasound (OA/US) to better differentiate between breast cancer molecular subtypes.
Materials and Methods:
This prospective 5-center study was performed in the Netherlands between March 2015 and February 2016. Only masses considered suspicious at conventional diagnostic breast ultrasound (US) were included. The study was approved by the institutional ethical boards of the participating hospitals and written informed consent was obtained from all patients. Dedicated breast radiologists evaluated the included masses using OA/US and scored the internal and external OA/US features accordingly. Spearman Correlation was used to analyze the relationship between OA/US features and mitotic figures. The same statistical method was also used to evaluate the correlation between OA/US features and percentages of ER, PR and Ki67. Wilcoxon-Mann-Whitney tests were used to analyze the relationship between OA/US features and molecular subtypes of breast cancer (Luminal A, Luminal B, Triple Negative and HER2-enriched breast cancers).
Results: Overall, 209 patients with 215 breast lesions were included in this study. Sixty-seven masses were considered malignant and the 59 masses classified as invasive breast cancers were included in the final mitotic figures, ER, PR, Ki-67 and molecular subtype analyses. Significant correlations were found between OA/US Total Internal Features and ER (p = 0.0333) and Ki-67 (p = 0.0092) percentages. Regarding molecular subtypes, Internal Vessels (p = 0.0257), Total Internal Features (p = 0.0196) and combined Total Internal and External Features (p = 0.0289) helped to differentiate between Luminal A and Luminal B cancers. Internal Vessels (p = 0.0030), Internal Blush (p = 0.0044), Total Internal Hemoglobin (p = 0.0053), Total Internal Features (p = 0.0010), Total Internal divided by Total External Features (p=0.0255) and combined Total Internal and External Features (p = 0.0108) helped to differentiate between Luminal A and Triple Negative breast cancers. Total Internal Features showed a borderline result (p = 0.0551) regarding the differentiation between Triple Negative and HER2-enriched subtypes.
Conclusions: The use of OA/US features to non-invasively differentiate between breast cancer molecular subtypes may help to establish an earlier prognosis and treatment planning, potentially decreasing costs and facilitating larger scale diagnosis. Future research with larger sample sizes may confirm these preliminary results.
Citation Format: Menezes GL, Mann RM, Meeuwis C, Bisschops B, Veltman J, Lavin PT, van de Vijver MJ, Pijnappel RM. Can optoacoustic imaging combined with ultrasound non-invasively offer prognosis for breast cancer molecular subtypes? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-43.
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Affiliation(s)
- GL Menezes
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - RM Mann
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - C Meeuwis
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - B Bisschops
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - J Veltman
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - PT Lavin
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - MJ van de Vijver
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
| | - RM Pijnappel
- UTHSCSA, San Antonio; Radboud University Medical Center, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT, Almelo, Netherlands; Boston Biostatistics Research Foundation, Framingham; Netherlands Cancer Institute, Amsterdam, Netherlands; University Medical Center Utrecht, Utrecht, Netherlands
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Santos IP, Barroso EM, Bakker Schut TC, Caspers PJ, van Lanschot CGF, Choi DH, van der Kamp MF, Smits RWH, van Doorn R, Verdijk RM, Noordhoek Hegt V, von der Thüsen JH, van Deurzen CHM, Koppert LB, van Leenders GJLH, Ewing-Graham PC, van Doorn HC, Dirven CMF, Busstra MB, Hardillo J, Sewnaik A, Ten Hove I, Mast H, Monserez DA, Meeuwis C, Nijsten T, Wolvius EB, Baatenburg de Jong RJ, Puppels GJ, Koljenović S. Raman spectroscopy for cancer detection and cancer surgery guidance: translation to the clinics. Analyst 2018; 142:3025-3047. [PMID: 28726868 DOI: 10.1039/c7an00957g] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Oncological applications of Raman spectroscopy have been contemplated, pursued, and developed at academic level for at least 25 years. Published studies aim to detect pre-malignant lesions, detect cancer in less invasive stages, reduce the number of unnecessary biopsies and guide surgery towards the complete removal of the tumour with adequate tumour resection margins. This review summarizes actual clinical needs in oncology that can be addressed by spontaneous Raman spectroscopy and it provides an overview over the results that have been published between 2007 and 2017. An analysis is made of the current status of translation of these results into clinical practice. Despite many promising results, most of the applications addressed in scientific studies are still far from clinical adoption and commercialization. The main hurdles are identified, which need to be overcome to ensure that in the near future we will see the first Raman spectroscopy-based solutions being used in routine oncologic diagnostic and surgical procedures.
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Affiliation(s)
- Inês P Santos
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Menezes GLG, Pijnappel RM, Meeuwis C, Bisschops B, Veltman J, Lavin PT, Mann RM. Abstract P4-02-08: Opto-acoustic imaging of the breast: Downclassification and upclassification of suspicious breast masses. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-02-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Imagio® is an opto-acoustic (OA) breast imaging system designed to concomitantly collect OA images together with diagnostic ultrasound (CDU). The device is intended to improve distinction between benign and malignant masses. In this interim analysis of the post-market surveillance MAESTRO study we report the results of 75 patients who had breast masses classified as BI-RADS 4a and 4b by CDU.
Aim
We assessed OA's sensitivity, specificity, and its ability to downgrade benign masses and upgrade malignant masses based on the probability of malignancy (POM) and BI-RADS category.
Methods
Seventy-five patients with 78 breast masses were evaluated with OA prior to biopsy. For each mass, the radiologist scored 5 OA features, assigned a POM and BI-RADS category. OA sensitivity, specificity, and BI-RADS downgrade and upgrade percentages were assessed with and without contribution from a previously derived nomogram.
Results
The mean POM difference between malignant and benign masses was higher for OA (37%) than for CDU (27%). OA specificity was 43% without the nomogram and 68% with the nomogram. OA sensitivity was 97% with and without the nomogram. With OA 43% of benign masses could be downgraded and 47% of malignant masses could be upgraded in BIRADS category.
Conclusion
These results appear to confirm the previously reported ability of OA to improve the differentiation between benign and malignant masses compared to CDU alone, to potentially decrease negative biopsies, and to upgrade BI-RADS category in malignant masses. The MAESTRO study (n=200) may further confirm these results.
Citation Format: Menezes GLG, Pijnappel RM, Meeuwis C, Bisschops B, Veltman J, Lavin PT, Mann RM. Opto-acoustic imaging of the breast: Downclassification and upclassification of suspicious breast masses [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-02-08.
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Affiliation(s)
- GLG Menezes
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
| | - RM Pijnappel
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
| | - C Meeuwis
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
| | - B Bisschops
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
| | - J Veltman
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
| | - PT Lavin
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
| | - RM Mann
- University Medical Centre Utrecht, Utrecht, Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; ZGT Almelo, Almelo, Netherlands; Lavin Consulting LLC, Framingham, MA
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Meeuwis C, Peters NHGM, Mali WPTM, Gallardo AMF, van Hillegersberg R, Schipper MEI, van den Bosch MAAJ. Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0T closed bore magnet. Eur J Radiol 2007; 62:283-8. [PMID: 17218074 DOI: 10.1016/j.ejrad.2006.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 12/01/2006] [Accepted: 12/06/2006] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the accuracy of magnetic resonance imaging (MRI)-guided needle localization for diagnosis of MRI detected suspicious breast lesions located in difficult accessible regions of the breast, using the freehand method in a 3.0 T closed bore magnet. MATERIALS AND METHODS In five patients with five MRI-only breast lesions underwent MRI-guided needle localization for histopathologic evaluation of the lesions. All interventional procedures were performed in a 3.0 T MRI system with the patient in prone position and by using a dedicated phased array breast coil. MRI-guided needle localizations were performed by using a freehand technique. In our study, the high-resolution scan allowed preprocedural localization of all lesions without use of contrast enhancement. In all cases contrast-enhanced MRI was performed after insertion of the wire to confirm the tip of the wire in direct contact with the enhancing lesion. RESULTS Needle localizations were performed in five patients. Histopathologic evaluation of tissue after surgery excision biopsy revealed one lymph node, three invasive ductal carcinoma and one ductal carcinoma in situ. Lesion size varied from 6 to 30 mm. Mean duration time was 25 min. No complications occurred during the intervention method. In the patient with the benign lesion control MRI of the breast after 6 months confirmed lesion removal. CONCLUSIONS MRI-guided needle localization by using a freehand technique in a 3.0 T closed bore magnet is a safe and accurate method for diagnosis of difficult accessible breast lesions only visible on MRI.
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MESH Headings
- Biopsy, Needle/methods
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Contrast Media
- Equipment Design
- Feasibility Studies
- Female
- Follow-Up Studies
- Humans
- Image Enhancement
- Image Interpretation, Computer-Assisted
- Lymphatic Metastasis
- Magnetic Resonance Imaging/instrumentation
- Magnetic Resonance Imaging/methods
- Magnetics
- Mastectomy, Segmental
- Middle Aged
- Treatment Outcome
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Affiliation(s)
- C Meeuwis
- Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584 CX Utrecht, The Netherlands.
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Meeuwis C, van den Bosch MAAJ, Houwert KAF, Fernandez-Gallardo AM, van Hillegersberg R, Mali WPTM. [MRI-guided biopsy of suspicious abnormalities in the breast]. Ned Tijdschr Geneeskd 2006; 150:1780-7. [PMID: 16948241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
In a 55-year-old woman, an echographically occult breast tumour was only visible in one direction on mammography. MRI-guided needle localisation of the lesion followed by surgical excision biopsy were then carried out for diagnostic purposes. In a second woman, 61 years of age, mammographic needle localisation of a deep, echographically occult, lesion was unsuccessful. She then also underwent MRI-guided needle localisation followed by surgical excision biopsy. A third woman, also 61 years of age, with known carcinoma underwent an MRI staging study. This revealed a second, mammographically and echographically occult, lesion for which MRI-guided large-core needle biopsy was done. MRI of the breast has a high sensitivity for the detection of invasive breast carcinoma. MRI of the breast reveals suspicious lesions that cannot be seen on the conventional mammogram or by echography in 15-25% of the cases. In order to obtain tissue from these lesions for histopathology, MRI-guided biopsy techniques have been developed. The most commonly used methods are MRI-guided needle localisation followed by surgical excision biopsy and MRI-guided large-core needle biopsy. The demand for MRI-guided breast interventions is growing because of the increasing use of MRI of the breast in clinical practice.
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Affiliation(s)
- C Meeuwis
- Afd. Radiologie, Universitair Medisch Centrum Utrecht, Heidelberglaan 100, 3584 CX Utrecht
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van den Hoogen FJ, Meeuwis C, Oudes MJ, Janssen P, Manni JJ. The Blom-Singer tracheostoma valve as a valuable addition in the rehabilitation of the laryngectomized patient. Eur Arch Otorhinolaryngol 1996; 253:126-9. [PMID: 8652152 DOI: 10.1007/bf00615108] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Prosthesis-assisted tracheo-esophageal speech has proven its value in post-laryngectomy voice rehabilitation, although manual occlusion of the tracheostoma during speech is necessary. In contrast a tracheostoma valve enables hands-free speech. We have now had experience with 30 patients using the Blom-Singer tracheostoma valve for more than 6 months and have found that most patients prefer prosthesis-assisted speech with the tracheostoma valve. Measurement of several speech parameters with digital and valve occlusion of the tracheostoma did not show any significant differences between the two speaking conditions. Problems included maintenance of an airtight seal, outward forcing of the valve diaphragm during forced expiration and subjective increased airflow resistance.
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Affiliation(s)
- F J van den Hoogen
- Department of ORL, Head and Neck Surgery, University Hospital Nijmegen, The Netherlands
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