MR-guided Percutaneous Biopsy of Focal Hepatic Dome Lesions with Free-hand Combined with MR Fluoroscopy Using 1.0-T Open High-field Scanner.

Abstract

To prospectively estimate the safety, feasibility and accuracy of 1.0T open-magnetic resonance (MR)-guided percutaneous biopsy in free-hand of focal lesions located in the hepatic dome. All percutaneous MR-guided biopsies of the lesions were performed at the Shandong Medical Imaging Research Institute. Thirty-six patients with focal liver lesions located in the hepatic dome measuring 6-36 mm in the maximum diameter were included in this study. Lesions were divided into two groups on the basis of maximum nodule diameters: ≤1.5 cm (n=14) and >1.5 cm (n=22). Surgical pathology of nodules or clinical and imaging follow-up for at least 12 months were used to establish final diagnosis. Diagnostic accuracy, specificity, sensitivity, average procedure time and complications were recorded and analyzed. All obtained samples were sufficient for diagnosis. Accuracy, sensitivity and specificity of MRI-guided percutaneous liver lesions biopsy in diagnosing malignant tumors were 97.2%, 96.7% and 100%, respectively. Accuracy, sensitivity and specificity were 92.9%, 90.9% and 100% for the lesions that were 1.5 cm or smaller in diameter and 100%, 100% and 100% for lesions larger than 1.5 cm in diameter, respectively. There was no significant difference between the two groups (p>0.05). The average procedure time for each pass of the needle from skin entry to the target lesion was 1.1 min and the total procedural time was 28.5 min. Biopsy-induced complications included peri-hepatic hemorrhage in 8.3% (3/36) of cases. No serious complications occurred. 1.0T open-MR-guided free-hand percutaneous biopsy is a safe, feasible and highly accurate diagnostic method for pathological diagnosis of focal liver lesions located in the hepatic dome.