Can the organic coating of breast tissue markers be sampled by an ultrasound guided core-cut-biopsy? A comparative proof of concept evaluation of two coated clip marker types in turkey breasts

Aim The aim of this preliminary study was to investigate the sonographic detectability of two coated clip markers (HydroMARK with hydrogel coating and UltraClip with PVA coating) and to test if the organic coating can be sampled by an ultrasound guided core-cut-biopsy without dislocating the marker.

Materials and Methods Ten HydroMARK and ten UltraClip were inserted in four turkey breasts. Two examiners subjectively rated the sonographic visibility of the clip markers. The 14G core-cut-biopsy was performed, aiming to sample the organic coating. Pre- and post-biopsy mammography (measuring the distance between the punch channel and the clip), specimen radiography and gross inspection of the biopsy samples were conducted to evaluate dislocation or removal of the clip markers.

Results The sonographic visibility of HydroMARK was mostly rated as very good by both examiners (M= 1.4 and 1.3, SD= 0.7 and 0.9) whereas UltraClip visibility was rated as good (M= 1.8 and 1.8, SD= 0.6 and 0.9). In the mammogram, the distance between the punch channel and the clip was shorter for HydroMARK than for UltraClip (M= 1.5, SD= 0.7 vs. M= 9.1, SD= 16.1), suggesting a more precise biopsy localization. No relevant clip dislocation occurred. The coating material was macroscopically visible in 7/10 (70%) biopsy specimen with HydroMARK compared to 0 specimen (0%) with UltraClip.

Conclusion The HydroMARK clip marker was superior regarding sonographic detectability. This feasibility study showed that the hydrogel coating can be identified in most core-cut-biopsy samples, which could potentially be used to objectify representativity of minimal invasive biopsies.

Publication History

Article published online:
21 June 2022