REGULAR CONTENT
Final ID
611
Type
Educational Exhibit-Poster Only
Authors
R Chao1, J Sung1, A Chen2
Institutions
1Santa Clara Valley Medical Center, San Jose, CA, 2National Institutes of Health, Bethesda, MD
Purpose
The educational goal of this exhibit is to describe the anatomy, diagnostic imaging, indications, contraindications, potential complications, procedural approach, and outcomes related to percutaneous CT-guided cryoablation of axillary lymph node metastasis from breast cancer.
Materials & Methods
The use of percutaneous CT-guided cryoablation for the treatment of breast cancer has been well-described as an alternative to surgical lumpectomy. However, its use for treatment of axillary lymph node metastasis has not been well described. In patients who have undergone axillary lymphadenectomy, surgical excision of recurrent axillary nodal disease is often not possible, making cryoablation an important therapeutic option. The purpose of this exhibit is to discuss the technical aspects of CT-guided cryoablation of axillary lymph node metastasis and its potential as an alternative treatment.
Results
A detailed understanding of the anatomy of the axilla is required to select the proper approach for percutaneous cryoablation. Some important structures include the thoracodorsal neurovascular bundle, long thoracic nerve, intercostobrachial nerve, medial pectoral nerve, and axillary artery and vein. Awareness of their location is required as damage can cause significant morbidity. Vascular damage can cause hemorrhage or venous obstruction and extremity swelling. Nerve damage can lead to paresthesias and significant loss of mobility at the shoulder joint. In particular, damage to the long thoracic nerve can lead to scapular winging causing significant debilitation and pain.Using CT guidance, the location of the target lymph node(s) must be identified in relation to the important neurovascular structures. Hydrodissection or dissection with air or carbon dioxide can be performed to separate the target lymph node(s) from important structures. Once there is adequate separation, cryoablation can then be achieved safely.
Conclusions
CT-guided cryoablation is a safe and effective alternative in select patients with isolated axillary lymph node metastasis. The performing radiologist requires keen awareness of the important structures of the axilla to successfully perform this procedure without significant complication.
Final ID
611
Type
Educational Exhibit-Poster Only
Authors
R Chao1, J Sung1, A Chen2
Institutions
1Santa Clara Valley Medical Center, San Jose, CA, 2National Institutes of Health, Bethesda, MD
Purpose
The educational goal of this exhibit is to describe the anatomy, diagnostic imaging, indications, contraindications, potential complications, procedural approach, and outcomes related to percutaneous CT-guided cryoablation of axillary lymph node metastasis from breast cancer.
Materials & Methods
The use of percutaneous CT-guided cryoablation for the treatment of breast cancer has been well-described as an alternative to surgical lumpectomy. However, its use for treatment of axillary lymph node metastasis has not been well described. In patients who have undergone axillary lymphadenectomy, surgical excision of recurrent axillary nodal disease is often not possible, making cryoablation an important therapeutic option. The purpose of this exhibit is to discuss the technical aspects of CT-guided cryoablation of axillary lymph node metastasis and its potential as an alternative treatment.
Results
A detailed understanding of the anatomy of the axilla is required to select the proper approach for percutaneous cryoablation. Some important structures include the thoracodorsal neurovascular bundle, long thoracic nerve, intercostobrachial nerve, medial pectoral nerve, and axillary artery and vein. Awareness of their location is required as damage can cause significant morbidity. Vascular damage can cause hemorrhage or venous obstruction and extremity swelling. Nerve damage can lead to paresthesias and significant loss of mobility at the shoulder joint. In particular, damage to the long thoracic nerve can lead to scapular winging causing significant debilitation and pain.Using CT guidance, the location of the target lymph node(s) must be identified in relation to the important neurovascular structures. Hydrodissection or dissection with air or carbon dioxide can be performed to separate the target lymph node(s) from important structures. Once there is adequate separation, cryoablation can then be achieved safely.
Conclusions
CT-guided cryoablation is a safe and effective alternative in select patients with isolated axillary lymph node metastasis. The performing radiologist requires keen awareness of the important structures of the axilla to successfully perform this procedure without significant complication.