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P134
Ultrasound in Medicine and Biology
Volume 32, Number 5S, 2006
Results: There were two cases of severe bleeding during the procedure and one case of large hematoma in immediate post-biopsy period, but none of infection or skin defect. The lesions were pathologically proved as benign in 492 cases and malignant in 19 cases. Among 32 of radiologic and pathologic discordant lesions, none of them showed histopathologic upgrading on the following open surgical biopsy. On the 6-mo follow-up US, we observed 9% of residual lesion, 19% of post-biopsy scar and 0.2% of recurred lesion. Conclusions: Mammotome biopsy is a minimally invasive technique with accurate histologic diagnosis by removal of sonographic evidence of the lesions. This technique can potentially be a useful alternative to some parts of surgical biopsy for properly indicated patients.
Conclusions: Ultrasound-guided, mammotome biopsy was an effective method for microcalcifications on mammogram. The results suggested that mammotome biopsy after mammogram-guided, needle localization is a good alternative method for the diagnosis of microcalcifications which are undetectable in the ultrasound images.
2225
Objectives: To evaluate the usefulness of ultrasound-guided mammotome excision of gynecomastia and to suggest a new approach for treatment of gynecomastia instead of surgical excision. Methods: Three males (aged 28 to 55 years) with gynecomastia underwent ultrasound-guided mammotome excision. One male (46 years) with gynecomastia underwent subcutaneous mastectomy under the general anesthesia. We compared these two methods for treatment of gynecomastia about lesion size, procedure time and complication. Results: Ultrasound-guided, mammotome excision removed gynecomastia in three cases. A mean size of lesion was 1.2 ⫻ 0.5 cm and 12 specimens per case were obtained. The procedure time was 10 minutes. Clinically significant complications did not occur on follow-up examination in any of the cases. In the case of operation, the lesion size was 7 ⫻ 5.6 cm and operation time is 55 minutes. Conclusions: Ultrasound-guided, mammotome excision was effective treatment method for gynecomastia, especially small, persistent troublesome lesion.
US-guided 11-gauge vacuum-assisted biopsy of mammographically suspicious microcalcifications Cho N, Moon WK, Seoul National University Hospital, Korea Objectives: To evaluate whether digital mammography-guided skin marking can improve the visualization and targeting of suspicious microcalcifications for US-guided biopsy. Methods: Sixty-eight consecutive women with 68 nonpalpable suspicious microcalcifications underwent US after skin marking using a full-field digital mammography. US detected lesions underwent USguided, 11-gauge vacuum-assisted biopsies and lesions not seen on US underwent mammography-guided needle localization and surgical excision. The frequencies of calcification retrieval and histologic underestimations were analyzed. The patient age, number of core specimens, lesion size, BI-RADS category, frequency of calcification retrieval, and histologic diagnosis were compared according to the US findings. Results: Of 68 microcalcifications, 66 (97%) lesions were identified and underwent US-guided, 11-gauge vacuum-assisted biopsies. USguided biopsy retrieved calcifications in 61/66 (92%) lesions. Calcifications associated masses or dilated ducts at US had significantly larger size (p ⫽ 0.019), higher calcification retrieval rate (100% [40/40] versus 81% [21/26], p ⫽ 0.007), and more likely to have a malignant histology (60% [24/40] versus 27% [7/26], p ⫽ 0.009). Surgery revealed no carcinoma of 3 ADH lesions at biopsy and infiltrating carcinoma in 5 (23%) of 22 DCIS lesions at biopsy. Conclusions: Digital mammography-guided skin marking can improve the visualization of suspicious microcalcifications for US and resulted in successful calcification retrieval in 61 (92%) of 66 cases. 2226 Effectiveness of mammotome biopsy for microcalcifications on mammogram Kim YM, Ryu JW, Park HB, Dankook University Hospital, Cheonan, Korea; Choongmu Hospital, Cheonan, Korea; Park Breast Clinic, Korea Objectives: To evaluate the usefulness of ultrasound-guided mammotome biopsy for microcalcification and to suggest a new approach for the localization of microcalcifications which are not detected on ultrasound. Methods: Twenty-one calcific lesions in 21 women (aged 33 to 56 years) underwent ultrasound-guided mammotome biopsy. In the 13 cases of calcifications, which were not detected on ultrasound imaging, mammotome biopsy was performed after localization of one or two needles at the microcalcifications under mammogram-guidance. Results: Ultrasound-guided, mammotome biopsy removed all calcifications in 21 lesions. Eight (38%) lesions showed visible calcifications on the ultrasound while 13 (62%) lesions were invisible, which underwent mammotome biopsy after needle localization under mammography-guidance.
2227 Usefulness of ultrasound-guided mammotome excision of gynecomastia Kim YM, Ryu JW, Suh K, Dankook University Hospital, Cheonan, Korea; Choongmu Hospital, Cheonan, Korea
FOCAL LIVER DISEASE 2228 Efficacy of focused US to characterize small hepatic lesion on CT for staging cancer Hahn SY, Lee GY, Lee JK, Baek SY, College of Medicine, Ewha Women’s University, Korea Objectives: To evaluate the efficacy of focused US to characterize small undetermined hepatic lesion on abdominal CT for staging cancer. Methods: From December 2004 to October 2005, 70 small undetermined hepatic lesions (mean, 7 mm in size) of 43 patients with cancer were included in this study. Two radiologists reviewed the size and location of lesion on contrast-enhanced CT and then focused US was performed after 4.6 days on the average evaluating the existence of lesion, determining whether the lesion was cyst or solid, and differentiating solid lesions. To diagnose the hepatic lesion, operation (two cases), biopsy (three cases), MR (three cases) and F18-FDG PET (six cases) were performed. Follow-up CT was done in all cases. Results: US demonstrated 40 cases of cyst, seven cases of hemangioma and four cases of metastasis. The rest 19 cases were not seen on US. One case out of seven hemangiomas on US was considered as metastasis on follow-up CT. Among 19 cases that were not seen on US, 13 cases did not change on follow-up CT, four cases were pseudolesions on follow-up CT or MR, one case was hemangioma on MR and one case was metastasis confirmed by operation. Conclusions: Focused US is a very efficient and precise examination to characterize small undetermined hepatic lesion.
Ultrasound in Medicine and Biology
Volume 32, Number 5S, 2006
Results: There were two cases of severe bleeding during the procedure and one case of large hematoma in immediate post-biopsy period, but none of infection or skin defect. The lesions were pathologically proved as benign in 492 cases and malignant in 19 cases. Among 32 of radiologic and pathologic discordant lesions, none of them showed histopathologic upgrading on the following open surgical biopsy. On the 6-mo follow-up US, we observed 9% of residual lesion, 19% of post-biopsy scar and 0.2% of recurred lesion. Conclusions: Mammotome biopsy is a minimally invasive technique with accurate histologic diagnosis by removal of sonographic evidence of the lesions. This technique can potentially be a useful alternative to some parts of surgical biopsy for properly indicated patients.
Conclusions: Ultrasound-guided, mammotome biopsy was an effective method for microcalcifications on mammogram. The results suggested that mammotome biopsy after mammogram-guided, needle localization is a good alternative method for the diagnosis of microcalcifications which are undetectable in the ultrasound images.
2225
Objectives: To evaluate the usefulness of ultrasound-guided mammotome excision of gynecomastia and to suggest a new approach for treatment of gynecomastia instead of surgical excision. Methods: Three males (aged 28 to 55 years) with gynecomastia underwent ultrasound-guided mammotome excision. One male (46 years) with gynecomastia underwent subcutaneous mastectomy under the general anesthesia. We compared these two methods for treatment of gynecomastia about lesion size, procedure time and complication. Results: Ultrasound-guided, mammotome excision removed gynecomastia in three cases. A mean size of lesion was 1.2 ⫻ 0.5 cm and 12 specimens per case were obtained. The procedure time was 10 minutes. Clinically significant complications did not occur on follow-up examination in any of the cases. In the case of operation, the lesion size was 7 ⫻ 5.6 cm and operation time is 55 minutes. Conclusions: Ultrasound-guided, mammotome excision was effective treatment method for gynecomastia, especially small, persistent troublesome lesion.
US-guided 11-gauge vacuum-assisted biopsy of mammographically suspicious microcalcifications Cho N, Moon WK, Seoul National University Hospital, Korea Objectives: To evaluate whether digital mammography-guided skin marking can improve the visualization and targeting of suspicious microcalcifications for US-guided biopsy. Methods: Sixty-eight consecutive women with 68 nonpalpable suspicious microcalcifications underwent US after skin marking using a full-field digital mammography. US detected lesions underwent USguided, 11-gauge vacuum-assisted biopsies and lesions not seen on US underwent mammography-guided needle localization and surgical excision. The frequencies of calcification retrieval and histologic underestimations were analyzed. The patient age, number of core specimens, lesion size, BI-RADS category, frequency of calcification retrieval, and histologic diagnosis were compared according to the US findings. Results: Of 68 microcalcifications, 66 (97%) lesions were identified and underwent US-guided, 11-gauge vacuum-assisted biopsies. USguided biopsy retrieved calcifications in 61/66 (92%) lesions. Calcifications associated masses or dilated ducts at US had significantly larger size (p ⫽ 0.019), higher calcification retrieval rate (100% [40/40] versus 81% [21/26], p ⫽ 0.007), and more likely to have a malignant histology (60% [24/40] versus 27% [7/26], p ⫽ 0.009). Surgery revealed no carcinoma of 3 ADH lesions at biopsy and infiltrating carcinoma in 5 (23%) of 22 DCIS lesions at biopsy. Conclusions: Digital mammography-guided skin marking can improve the visualization of suspicious microcalcifications for US and resulted in successful calcification retrieval in 61 (92%) of 66 cases. 2226 Effectiveness of mammotome biopsy for microcalcifications on mammogram Kim YM, Ryu JW, Park HB, Dankook University Hospital, Cheonan, Korea; Choongmu Hospital, Cheonan, Korea; Park Breast Clinic, Korea Objectives: To evaluate the usefulness of ultrasound-guided mammotome biopsy for microcalcification and to suggest a new approach for the localization of microcalcifications which are not detected on ultrasound. Methods: Twenty-one calcific lesions in 21 women (aged 33 to 56 years) underwent ultrasound-guided mammotome biopsy. In the 13 cases of calcifications, which were not detected on ultrasound imaging, mammotome biopsy was performed after localization of one or two needles at the microcalcifications under mammogram-guidance. Results: Ultrasound-guided, mammotome biopsy removed all calcifications in 21 lesions. Eight (38%) lesions showed visible calcifications on the ultrasound while 13 (62%) lesions were invisible, which underwent mammotome biopsy after needle localization under mammography-guidance.
2227 Usefulness of ultrasound-guided mammotome excision of gynecomastia Kim YM, Ryu JW, Suh K, Dankook University Hospital, Cheonan, Korea; Choongmu Hospital, Cheonan, Korea
FOCAL LIVER DISEASE 2228 Efficacy of focused US to characterize small hepatic lesion on CT for staging cancer Hahn SY, Lee GY, Lee JK, Baek SY, College of Medicine, Ewha Women’s University, Korea Objectives: To evaluate the efficacy of focused US to characterize small undetermined hepatic lesion on abdominal CT for staging cancer. Methods: From December 2004 to October 2005, 70 small undetermined hepatic lesions (mean, 7 mm in size) of 43 patients with cancer were included in this study. Two radiologists reviewed the size and location of lesion on contrast-enhanced CT and then focused US was performed after 4.6 days on the average evaluating the existence of lesion, determining whether the lesion was cyst or solid, and differentiating solid lesions. To diagnose the hepatic lesion, operation (two cases), biopsy (three cases), MR (three cases) and F18-FDG PET (six cases) were performed. Follow-up CT was done in all cases. Results: US demonstrated 40 cases of cyst, seven cases of hemangioma and four cases of metastasis. The rest 19 cases were not seen on US. One case out of seven hemangiomas on US was considered as metastasis on follow-up CT. Among 19 cases that were not seen on US, 13 cases did not change on follow-up CT, four cases were pseudolesions on follow-up CT or MR, one case was hemangioma on MR and one case was metastasis confirmed by operation. Conclusions: Focused US is a very efficient and precise examination to characterize small undetermined hepatic lesion.