MR-guided Percutaneous Biopsy Research Articles

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

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.

MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open high-field MRI scanner with respiratory gating.

To prospectively evaluate the feasibility, safety and accuracy of MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open MR scanner with respiratory gating. Sixty-five patients with 65 solitary pulmonary lesions underwent MR-guided percutaneous coaxial cutting needle biopsy using a 1.0-T open MR scanner with respiratory gating. Lesions were divided into two groups according to maximum lesion diameters: ≤2.0cm (n = 31) and >2.0cm (n = 34). The final diagnosis was established in surgery and subsequent histology. Diagnostic accuracy, sensitivity and specificity were compared between the groups using Fisher's exact test. Accuracy, sensitivity and specificity of MRI-guided percutaneous pulmonary biopsy in diagnosing malignancy were 96.9%, 96.4% and 100%, respectively. Accuracy, sensitivity and specificity were 96.8%, 96.3% and 100% for lesions 2.0cm or smaller and 97.1%, 96.4% and 100%, respectively, for lesions larger than 2.0cm. There was no significant difference between the two groups (P > 0.05). Biopsy-induced complications encountered were pneumothorax in 12.3% (8/65) and haemoptysis in 4.6% (3/65). There were no serious complications. MRI-guided percutaneous biopsy using a 1.0-T open MR scanner with respiratory gating is an accurate and safe diagnostic technique in evaluation of pulmonary lesions. • MRI-guided percutaneous lung biopsy using a 1.0-T open MR scanner is feasibility. • 96.9% differentiation accuracy of malignant and benign lung lesions is possible. • No serious complications occurred in MRI-guided lung biopsy.

Kontrastmittel-MRT der Brust bei Staging und Früherkennung: Wo benötigen wir sie?

PURPOSE: When imaging is used for screening or preoperative staging, a considerable number of diagnoses show normal breasts or breast tissue. Thus, in contrast to other indications, a high specificity of the methods employed is required in addition to a good sensitivity. Ample data is available for both indications and is analyzed here. MATERIAL AND METHODS: A search of the Pubmed und Cochrane libraries was performed. Original work, systematic reviews, meta-analyses, national and international recommendations and guidelines were considered. RESULTS: Contrast-enhanced breast MRI proved to be the most sensitive method for high risk patients. However, false positive findings leading to “short-term” (4-6 months) follow-up recommendations or to histopathological assessment may occur in 15-20 % of cases, and MR-guided histopathological assessment and, in particular, MR-guided percutaneous biopsy, constitute a bottleneck. The most important advantage of intensified screening programs using MRI is the earlier detection of malignancy, even though evidence from randomized studies is lacking. For preoperative staging no evidence exists to date for an improved outcome, as measured by a decreased number of re-excisions, a decreased rate of recurrences, or improved survival. However, more aggressive treatment has been documented after preoperative MRI. Therefore updated guidelines have not recommended using MRI for preoperative staging in general, but only recommend it for certain subgroups. CONCLUSION: MRI can be recommended as an additional imaging method for the screening of high risk women. However, good quality control and appropriate patient information is necessary. Preoperative MRI is only recommended for selected subgroups. More research is needed before further recommendations can be given.

Application value of interventional MR-guided biopsy in musculoskeletal lesions

目的 介绍介入性MR引导下骨骼肌肉系统活检的技术操作方法,并评价其应用价值.方法 26例骨骼肌肉系统病变患者,均在介入性MR引导下进行经皮活检, 所用设备为开放式0.23 T常导MR检查仪,并配有iPath200光学引导系统(Proview,Philips).其中10例病人术后行外科手术治疗或活检.活检针为MR兼容性. 结果 24例病人获得了组织病理学诊断(24/26).在10例后来行外科手术治疗或活检的病人中,MR活检诊断与最终诊断基本符合(10/10).未发现明显并发症. 结论介入性MR引导下骨骼肌肉系统病变的经皮活检是1种安全、准确的新技术。

Localization and biopsy of breast lesions by magnetic resonance imaging guidance.

Contrast-enhanced MRI of the breast has proved to be a valuable tool in the detection and work-up of breast lesions. Most of these lesions are small and not visible by other imaging modalities, such as mammography or US. Thus, only MR-guided preoperative localization techniques or MR-guided percutaneous biopsy can provide a histologic work-up of such lesions. MR-guided preoperative localization seems to be a well-established procedure. However, MR-guided biopsy is still problematic. Although prototypical biopsy systems have been developed, considerable progress is still required. Problems exist with MR-guided biopsy due to severe needle artifacts and tissue shift during the intervention. Thus, needle biopsy currently is not recommended for lesions smaller than 10 mm. This work reviews current techniques for MR-guided preoperative localization and percutaneous biopsy in breast lesions. The diagnostic accuracy achievable with these techniques will be discussed, as well as the potential for new research opportunities and directions. J. Magn. Reson. Imaging 2001;13:903-911.