MR Imaging–guided Large-Core (14-Gauge) Needle Biopsy of Small Lesions Visible at Breast MR Imaging Alone

Kuhl, Christiane K.; Morakkabati, N.; Leutner, C.; Schmiedel, A; Wardelmann, Eva; Schild, Hans H.

doi:10.1148/radiology.220.1.r01jl0731

Cited by 126 publications

(73 citation statements)

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“…Histopathological assessment can be performed by MRI-guided wire localisation followed by surgical excision [6,9,10], or by alternative techniques to surgery such as MRI-guided percutaneous biopsy using fine needles [11], core needles [12,13] or vacuum-assisted biopsy devices [7,14]. For such a breast intervention to be clinically useful, factors such as safety, accuracy, availability, cost, patient preference for surgical biopsy and surgeon's request should be considered.…”

mentioning

confidence: 99%

Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results

Yılmaz

Kılıç²,

Icten³

et al. 2012

BJR

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Objective: The purpose of this study was to present an alternative technique for the pre-operative localisation of solely MRI-detected suspicious breast lesions using a computer-assisted MRI-guided radio-guided occult lesion localisation (ROLL) technique. Methods: Between January 2009 and June 2010, 25 females with a total of 25 suspicious breast lesions that could be detected only by MRI, and for whom breast surgery was planned, underwent the computer-assisted MRI-guided ROLL technique. A seven-channel biopsy breast array coil and computerised diagnostic workstation were used for the localisation procedure. Three-phase dynamic contrast-enhanced axial images were taken. After investigating the localisation co-ordinates with the help of intervention software on a workstation, an 18 G coaxial cannula was placed in the exact position determined. Following verification of the cannula position by additional axial scans, 99m Tc-labelled macroalbumin aggregate and MRI contrast material were injected. Post-procedure MRI scans were used to confirm the correct localisation. Results: All the procedures were technically successful. The mean lesion size was 10.8 mm (range: 4-25 mm). The mean total magnet and the mean localisation times were 28.6 min (range: 18-46 min) and 13.1 min (range: 8-20 min), respectively. Grid and pillar methods were used for localisation in 24 procedures and 1 procedure, respectively. On histopathological examination, 6 malignant, 10 high-risk and 9 benign lesions were identified. All patients tolerated the procedure well. There were no major complications. Conclusion: This is the first report documenting the application of MRI-guided ROLL. Based on our preliminary results, this technique is very efficient and seems to be a good alternative to wire localisation.

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mentioning

confidence: 99%

Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results

Yılmaz

Kılıç²,

Icten³

et al. 2012

BJR

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“…Even the smallest lesions can be clearly identified due to the high soft-tissue contrast of MR imaging. For punctures of the breast it has long been established to use MR-guided biopsy in lesions that cannot be visualized with other modalities [12]. This advantage resulted in the extensive clinical application of this method.…”

Section: Interstitial Free-hand Interventions On Open Scannersmentioning

confidence: 99%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function.Method The current status of interventional MRI for the clinical routine was analyzed.Results The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion IntroductionMRI has an intrinsically high soft-tissue contrast and can be used to measure physiological parameters, such as blood flow (flow rate and flow volume), diffusion, temperature, and movement. Since its introduction into the clinical routine in the 1980 s, it has also been used for guiding and monitoring interventions. However, in contrast to CT and ultrasound, the use of MRI for guiding interventions requires significant technical effort. Due to the disruptive effect of the strong main magnetic field and the alternating electromagnetic fields, the monitoring of patients during an intervention by measuring ECG signals, oxygen saturation, or blood pressure requires special equipment. These monitoring systems must not interfere with the MRI scan and must be MR-safe (according to DIN EN 62 570:2010 -05). The list of requirements regarding monitoring equipment provides an indication of the development effort, with suitable monitoring equipment representing only one of the components necessary for MR-guided interventions.In addition to MRI safety, all catheters and instruments must be adapted to this modality. To ensure MRI safety, metal must be largely avoided since, depending on the length and orientation to the main magnetic field, it can heat up and consequently even result in burns. Achieving rigidity and torsion stability of catheters or guide wires without the use of metal for reinforcement represents a technical challenge. In the case of needles, breaking resistance is one of the more difficult properties to achieve for MR-safe designs. Moreover, instruments must be able to be effectively visualized without adjacent structures being superimposed by artifacts. The tip must be able to be identified and definitively differentiated from the shaft since MRI as a cross-sectional imaging method typically uses individual slices even for guiding interventions and does not use projections as in fluoroscopy...

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“…1 cm'den büyük solid lezyonların tanısında 14G tru-cut KİB sistemleri kullanılabilir. İlk yapılan çalışmalarda elde edilen sonuçlar başarılı olup günümüzde de kullanılmaktadır; MR rehberliğinde uygulanan tru-cut biyopsilerin sensitivitesi %97, spesifitesi %100, teknik başarısı %97 düzeyin-dedir [44].…”

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Meme Biyopsisi: Hasta ve Yöntem Seçimi; Hangi Lezyonda Ne Yapalım?

Kılıç¹,

Yılmaz²

2014

Trd Sem

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MR Imaging–guided Large-Core (14-Gauge) Needle Biopsy of Small Lesions Visible at Breast MR Imaging Alone

Abstract: MR imaging--guided large-core stereotactic breast biopsy is sufficiently accurate for obtaining histologic proof of lesions visible only at MR imaging. It can change patient treatment by reducing unnecessary surgical biopsy and can enable one-step surgery for breast cancers.

Cited by 126 publications

References 34 publications

Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results

Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Meme Biyopsisi: Hasta ve Yöntem Seçimi; Hangi Lezyonda Ne Yapalım?

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