Interventional breast MR imaging: clinical use of a stereotactic localization and biopsy device.

Kuhl, Christiane K.; Elevelt, Aaldert; Leutner, C.; Gieseke, J; Pakos, Emilios E.; Schild, Hans H.

doi:10.1148/radiology.204.3.9280242

Cited by 179 publications

(117 citation statements)

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“…If BI-RADS ® 4 or 5 findings detected on diagnostic MRI are no longer visible, it is necessary to first rule out technical causes. For example, strong breast compression may result in reduced contrast enhancement [25,27,30,31]. If there is reasonable suspicion that this is the case, a new MRI with reduced breast compression would be recommended.…”

Section: Mri-guided Lesion Markingmentioning

confidence: 99%

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Management of Breast Lesions Detectable Only on MRI

Siegmann-Luz¹,

Bahrs²,

Preibsch³

et al. 2013

Fortschr Röntgenstr

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Breast MR imaging has become established as?the most sensitive imaging method for diagnosing breast cancer. As a result of the increasing examination volume and improved image quality, the number of breast lesions detected only on MRI and requiring further clarification has risen in recent years. According to the S3-guideline ?Diagnosis, Therapy, and Follow-Up of Breast Cancer? as revised in July 2012, institutions performing breast MRI should provide the option of an MRI-guided intervention for clarification. This review describes the indications, methods and results of MRI-guided interventions for the clarification of breast lesions only visible on MRI. Recent guidelines and study results are also addressed and alternative methods and pitfalls are presented. Key points: Citation Format:

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Section: Mri-guided Lesion Markingmentioning

confidence: 99%

“…In these studies, MRI-guided lesion marking proved to be a valid and precise method [36]. Larger studies involving n> 50 lesions have reported technical success rates of 97 -98 % [30,37,38]. However, MRI-guided lesion marking has since been replaced by MRI-VAB and is only warranted in isolated cases (see above).…”

mentioning

confidence: 99%

Management of Breast Lesions Detectable Only on MRI

Siegmann-Luz¹,

Bahrs²,

Preibsch³

et al. 2013

Fortschr Röntgenstr

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“…The freehand method of MRI-guided breast interventions (8-10) differs from other facilities that use a grid and contrast enhancement prior to needle placement (6,7,(13)(14)(15)(16)(17)(18). This method uses noncontrast T1-weighted scans to identify unenhanced targets in the noncompressed breast without a grid (8,9).…”

Section: Vacnbmentioning

confidence: 99%

Freehand MRI‐guided preoperative needle localization of breast lesions after MRI‐guided vacuum‐assisted core needle biopsy without marker placement

Ven

Lin

Daniel

et al. 2010

Magnetic Resonance Imaging

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Purpose: To evaluate the feasibility of magnetic resonance imaging (MRI)-guided preoperative needle localization (PNL) of breast lesions previously sampled by MRI-guided vacuum-assisted core needle biopsy (VACNB) without marker placement. Materials and Methods:We reviewed 15 women with 16 breast lesions undergoing MRI-guided VACNB without marker placement who subsequently underwent MRIguided PNL, both on an open 0.5T magnet using freehand techniques. Mammograms and specimen radiographs were rated for lesion visibility; MRI images were rated for lesion visibility and hematoma formation. Imaging findings were correlated with pathology.Results: The average prebiopsy lesion size was 16 mm (range 4-50 mm) with 13/16 lesions located in mammographically dense breasts. Eight hematomas formed during VACNB (average size 13 mm, range 8-19 mm). PNL was performed for VACNB pathologies of cancer (5), highrisk lesions (5), or benign but discordant findings (6) at 2-78 days following VACNB. PNL targeted the lesion (2), hematoma (4), or surrounding breast architecture (10). Wire placement was successful in all 16 lesions. Final pathology showed six cancers, five high-risk lesions, and five benign findings.Conclusion: MRI-guided PNL is successful in removing lesions that have previously undergone VACNB without marker placement by targeting the residual lesion, hematoma, or surrounding breast architecture, even in mammographically dense breasts.

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“…Although MR-guided biopsy was not possible in current study, we included it in Fig. 3 because it has been reported to be the effective method in determining the nature of breast lesion that is undetectable in the other modalities (11,23).…”

Section: Discussionmentioning

confidence: 99%

Incidentally detected lesions on contrast‐enhanced MR imaging in candidates for breast‐conserving therapy: Correlation between MR findings and histological diagnosis

Yabuuchi

Kuroiwa

Kusumoto

et al. 2006

Magnetic Resonance Imaging

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Purpose:To investigate the correlation between MR findings and the histological diagnosis of incidentally detected lesions in candidates for breast-conserving therapy. Materials and Methods:MR images of 299 patients with breast cancer were reviewed. Incidentally detected lesions were noted in 59 of 299 (20%) patients, and a histological diagnosis was obtained in 48 of 59 (81%) patients. There were 25 benign and 23 malignant lesions. The number, size, location, morphologic character, and kinetic curve assessment of the MR findings were analyzed. Statistical analyses were performed to determine whether any differences could be observed between benign and malignant lesions. Results:Lesions of over 10 mm tended to be malignant (11/16; 69%), whereas those equal or less than 5 mm tended to be benign (12/17; 71%; P Ͻ 0.05). Lesions in the same quadrant as the main lesion tended to be malignant (20/27.5; 73%), whereas those in a different quadrant tended to be benign (17.5/20.5; 85%; P Ͻ 0.001). Lesions with early peak of enhancement tended to be malignant (20/25; 80%), whereas those with persistent enhancement tended to be benign (20/23; 87%; P Ͻ 0.001). Conclusion:Incidentally detected lesions that are found in a different quadrant from the main lesion, are smaller than 10 mm in diameter, and show persistent enhancement on MR imaging suggest benign lesions. Therefore, patients with such lesions should avoid unnecessary surgical procedures unless lesions are proved to be malignant by cytology or biopsy.

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Interventional breast MR imaging: clinical use of a stereotactic localization and biopsy device.

Abstract: MR imaging-guided stereotactic hook-wire placement and excisional biopsy are accurate and effective in managing lesions identified at only breast MR imaging. MR imaging-guided core biopsy holds promise for allowing a definite work-up of these lesions.

Cited by 179 publications

References 0 publications

Management of Breast Lesions Detectable Only on MRI

Management of Breast Lesions Detectable Only on MRI

Freehand MRI‐guided preoperative needle localization of breast lesions after MRI‐guided vacuum‐assisted core needle biopsy without marker placement

Incidentally detected lesions on contrast‐enhanced MR imaging in candidates for breast‐conserving therapy: Correlation between MR findings and histological diagnosis

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