MIGRATION AND ACCUMULATION OF SILICONE IN THE LIVER OF WOMEN WITH SILICONE GEL-FILLED BREAST IMPLANTS

H-1 NMR localized spectroscopy (STEAM), combined with echocardiography (EGG), respiratory gating, and water and fat suppression, was used to quantify silicone concentrations in the liver of women with silicone gel-filled breast implants. Localized spectroscopy was performed on 15 patients with silicone gel-filled breast prostheses and on eight volu nteers with no implants. The H-1 spectra in the liver of patients show ed silicone resonances from 0.3 to -0.8 ppm, attributable to protons i n the methyl groups of silicone. The presence of silicone in the liver could first be detected 3-4 years after breast prostheses implantatio n. No correlation between silicone concentrations and implantation tim es was observed, However, our results indicated that silicone concentr ations may reflect implant integrity: detectable silicone concentratio ns in the liver appeared to be higher when the implants were ruptured than when the implants appeared intact. Moreover, new resonances in th e range of -2.6 to -4 ppm were observed in most patients after long-te rm implantation, As these species increase with implantation time, the new resonances may reflect chemically changed silicone (paramagnetica lly shifted silicon complexes bound to iron) accumulated over time, Th e sensitivity of H-1 NMR localized spectroscopy is sufficient to detec t silicon concentrations as low as 0.20 mM. Results from one patient w hose implants had been removed 14 months prior to the NMR examination showed no detectable silicone in the liver, indicating that it may hav e been excreted via bile or degraded to silica and high coordinated si licon complexes. Quantitative H-1 localized spectroscopy of the liver in women with silicone gel-filled breast implants may provide valuable information concerning silicone accumulation and degradation in vivo, as well as about the kinetics of its elimination from the body after implant removal.