Method of visualizing the SLNB procedure using an ultrasound and photoacoustic tomography-US methods. Figure 3A shows the US image of a fine biopsy needle in sampling the SLN under US guidance. reported a reduced level of false negative SLNs with 94.8%–100% specificity but low sensitivity using intra-operative ultrasonography. The imaging system is chosen based upon some of the many parameters like specificity, sensitivity, accuracy, availability, economics, procedure correctness and quality assurance in the diagnosis. The below-listed imaging systems are the most commonly used image guiding systems for SLNB procedures. Systems and toolsĬurrently, SLNB is performed as an open surgery (Figure 2B) and, with image guidance, could lead to a true minimally invasive procedure, maybe even in an outpatient setup. (B) Breast tissue with isosulfan dye differentiating the SLN from the neighboring tissue for suitable navigation in the biopsy procedure. (A) Injecting blue dye images the SLN using an ultrasound probe as an imaging modality. Visualization of injecting contrast medium for SLN identification and the pigmented SLN ready for biopsy under image guidance. This could also lead to a minimally invasive SLNB rather than a axillary lymph node dissection (ALND). Choosing the right imaging method navigates the correct SLN accurately and that could reduce the loss of healthy breast tissue and false-negative results. During SLNB, unnecessary dissection for metastasis is not very common under image guidance. It becomes more accurate when an imaging modality is used for identifying the SLN near the tumor during the biopsy procedure. Medical imaging procedures have become an essential tool in oncological diagnosis and in treatment planning. The need for accurate tumor identification during interventions has increased the demand for image guidance in the operating room. The specimen obtained is pathologically evaluated to confirm the presence of tumor cells. SLN biopsy (SLNB) is the standard clinical method for identifying and determining the presence of cancer in the lymph nodes via special surgical tools. The extent of SLN identification is variable in a few reference centers as navigating visually to the correct breast SLN is a challenging procedure. The diagnosis of these SLNs by biopsy determines the ability of cancer cells to become metastatic. Sometimes, there can be more than one SLN as a branch, depending on the location of the primary tumor, as shown in Figure 1B. A sentinel lymph node (SLN) is the first lymphatic drainage found near the tumor, which can be one of the earliest sites of cancer spread, as shown in Figure 1A. In most of the cases, the cancer spreads from loci to other regions of the body through the lymphatic system. The number of people diagnosed reached nearly 14.5 million in 2014 and is expected to rise to more than 19 million by 2024 in many other countries. In 2015, an estimated 1,658,370 new cases of cancer were diagnosed in the United States, and it is expected that 589,430 people will die from breast cancer.
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