programma & abstracts - Nederlandse Vereniging voor Radiologie

Mammadiagnostiek 1 4
tly be visualized for evaluation in most patients.
To date, 50 patients are evaluated: 3D-US evaluation of the
breast shows a sensitivity of 88% and specificity of 97%,
compared to MR imaging findings (and histology). In coming
months all 201 patients will be evaluated.
Conclusion: In our study so far, 3D-US shows high sensitivity
and specificity in the detection of suspicious lesions compared
to MRI. Automated breast volume scanning seems a promising
new ultrasound technique in breast evaluation.
O4.3
MEDICOLEGAL CLAIMS FOLLOWING
SCREENING MAMMOGRAPHY IN THE
NETHERLANDS
V. van Breest Smallenburg, W. Setz-Pels, F.H. Jansen,
L.E.M. Duijm
Catharina Ziekenhuis, Eindhoven
Purpose: To determine the type and frequency of medicolegal
claims at a Dutch breast cancer screening programme.
Materials and methods: The study population consisted of
all 80019 women who underwent screening mammography
at a southern breast screening region of the Netherlands
between January 1997 and July 2007 (301139 screens). We
included all medicolegal claims that had been recorded at the
central screening department within 3 years following screening
mammography. During 2-year follow-up, we collected the
biopsy results and surgery reports of all referred women. Two
screening radiologists reviewed the screening mammograms
of all screen detected cancers (SDC) and interval cancers (IC)
and determined whether the cancer had been missed at the
previous screen (in case of SDC) or latest screen (in case of
IC). The radiologists were blinded to each others review; discrepant
readings were followed by consensus reading.
Results: Just 3 medicolegal claims had been reported,
all of them related to financial compensation following a
diagnosis of IC. The verdicts of these cases still have to be
finalized. Excisional biopsy had been performed in 10.7%
(234/2183) of false positive referrals. Review showed that
20.8% (261/1254) of SDC had been missed at the previous
screen and 23.6% (139/588) of IC should have been detected
at the latest screen.
Conclusions: Medicolegal claims were very rare, although
a substantial proportion of false positive referred women
had been confronted with excision biopsy and over 20% of
cancers had been missed at the previous screen or latest
screen, respectively.
O4.4
RADIOFREQUENCY-ASSISTED INTACT
SPECIMEN BIOPSY OF BREAST TUMORS:
AN EVALUATION ACCORDING TO THE
IDEAL GUIDELINES
S.C.E. Diepstraten 1 , H.M. Verkooijen 1 , P.J. van Diest 1 ,
M.A. Fernandez-Gallardo 1 , K.M. Duvivier 1 , A.J. Witkamp 1 ,
T. van Dalen 2 , W.P.Th.M. Mali 1 , M.A.A.J. van den Bosch 1
1
Universitair Medisch Centrum Utrecht, Utrecht
2
Diakonessenhuis, Utrecht
Purpose: Radiofrequency-assisted intact specimen biopsy
(RFIB) has been introduced for percutaneous biopsy or
removal of breast tumors. Using radiofrequency cutting,
the system enables the interventional radiologist to obtain
an intact sample of the target lesion. According to IDEAL
guidelines, we performed a critical evaluation of our initial
experience with RFIB.
Methods: Between June and November of 2010, X-ray guided
RFIB was performed in 19 female patients. All patients
presented with suspicious microcalcifications (BI-RADS
III-V) on mammography. Biopsy specimen integrity, thermal
damage and histological diagnosis were assessed by an
expert breast pathologist. Data on technical success,
diagnostic and therapeutic accuracy and peri-procedural
complications were collected and analyzed according to the
IDEAL guidelines.
Results: Median age was 59 years. Median lesion diameter
on mammography was 8 mm (range 2-76 mm). The procedure
was successful in 17/19 (89%) patients and unsuccessful
in 2/19 (11%) patients (1 nonrepresentative sample,
1 sample with extensive thermal damage). Histological
analysis of the RFIB specimen revealed 12/19 (63%) benign
lesions and 7/19 (37%) malignancies (4 DCIS lesions and 3
invasive ductal carcinomas). In 1 patient a DCIS lesion was
completely removed with RFIB. Overall, 3 peri-procedural
complications occurred (1 wound leakage, 1 arterial hemorrhage
and 1 infection requiring oral antibiotics).
Conclusion: Tissue sampling of suspicious breast lesions
can be performed successfully with RFIB. In 1 patient DCIS
was radically excised with RFIB, which illustrates its potential
as a minimally invasive therapeutic procedure for removal
of small breast tumors. This is an interesting focus for
further research when larger probe sizes become available.
1 6 E R A D I O L O G E N D A G E N - 2 9 e n 3 0 S E P T E M B E R 2 0 1 1
35