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Feasibility of MRI-guided large-core-needle biopsy of suspiscious breast lesions at 3 T.

Peters NH, Meeuwis C, Bakker CJ, Mali WP, Fernandez-Gallardo AM, van Hillegersberg R, Schipper ME, van den Bosch MA - Eur Radiol (2009)

Bottom Line: Tissue sampling was technically successful in 29/31 (94%) lesions.Histopathological analysis showed 19 benign lesions (66%) and one inconclusive biopsy result (3%).Follow-up MRI at 6 months after the biopsy should be performed in case of a benign biopsy result.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584 CX, Utrecht, The Netherlands. n.peters@umcutrecht.nl

ABSTRACT
The feasibility of large-core-needle magnetic resonance imaging (MRI)-guided breast biopsy at 3 T was assessed. Thirty-one suspicious breast lesions shown only by MRI were detected in 30 patients. Biopsy procedures were performed in a closed-bore 3-T clinical MR system on a dedicated phased-array breast coil with a commercially available add-on stereotactic biopsy device. Tissue sampling was technically successful in 29/31 (94%) lesions. Median lesion size (n = 29) was 9 mm. Histopathological analysis showed 19 benign lesions (66%) and one inconclusive biopsy result (3%). At follow-up of these lesions, 15 lesions showed no malignancy, no information was available in three patients and two lesions turned out to be malignant (one lesion at surgical excision 1 month after biopsy and one lesion at a second biopsy because of a more malignant enhancement curve at 12-months follow-up MRI). Nine biopsy results showed a malignant lesion (31%) which were all surgically removed. No complications occurred. MRI-guided biopsy at 3 T is a safe and effective method for breast biopsy in lesions that are occult on mammography and ultrasound. Follow-up MRI at 6 months after the biopsy should be performed in case of a benign biopsy result.

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Typical example of a biopsy procedure. a Diagnostic post-contrast T1-weighted image shows suspicious lesion. b Pre-biopsy image, compressed breast with guiding marker tube at the same location as the lesion. c The needle is inserted in front of the lesion; 3-5 samples were obtained. Histology: DCIS
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Fig3: Typical example of a biopsy procedure. a Diagnostic post-contrast T1-weighted image shows suspicious lesion. b Pre-biopsy image, compressed breast with guiding marker tube at the same location as the lesion. c The needle is inserted in front of the lesion; 3-5 samples were obtained. Histology: DCIS

Mentions: Of the 32 suspicious MRI-only lesions, one lesion was seen on second-look ultrasound, and was therefore sampled under ultrasound guidance. In all other cases, MRI-guided biopsy was performed. In two cases, MRI-guided biopsy was not feasible: in one patient a 9-mm lesion was located directly posterior to the mammilla and in another patient a 9-mm lesion was located directly anterior to the thoracic wall (Fig. 2). No adequate compression could be achieved in the region in which the lesions were located, which made introduction of the biopsy needle not feasible in both cases. In the other 28 patients with 29 lesions, the 3-T MRI-guided LCNB was considered to be technically successful. The size of the needle artifact was 9.5 mm. A typical example of the acquired images during the procedure is shown in Fig. 3. None of the procedures had to be interrupted or stopped. No severe side effects were observed.Fig. 2a, b


Feasibility of MRI-guided large-core-needle biopsy of suspiscious breast lesions at 3 T.

Peters NH, Meeuwis C, Bakker CJ, Mali WP, Fernandez-Gallardo AM, van Hillegersberg R, Schipper ME, van den Bosch MA - Eur Radiol (2009)

Typical example of a biopsy procedure. a Diagnostic post-contrast T1-weighted image shows suspicious lesion. b Pre-biopsy image, compressed breast with guiding marker tube at the same location as the lesion. c The needle is inserted in front of the lesion; 3-5 samples were obtained. Histology: DCIS
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2691521&req=5

Fig3: Typical example of a biopsy procedure. a Diagnostic post-contrast T1-weighted image shows suspicious lesion. b Pre-biopsy image, compressed breast with guiding marker tube at the same location as the lesion. c The needle is inserted in front of the lesion; 3-5 samples were obtained. Histology: DCIS
Mentions: Of the 32 suspicious MRI-only lesions, one lesion was seen on second-look ultrasound, and was therefore sampled under ultrasound guidance. In all other cases, MRI-guided biopsy was performed. In two cases, MRI-guided biopsy was not feasible: in one patient a 9-mm lesion was located directly posterior to the mammilla and in another patient a 9-mm lesion was located directly anterior to the thoracic wall (Fig. 2). No adequate compression could be achieved in the region in which the lesions were located, which made introduction of the biopsy needle not feasible in both cases. In the other 28 patients with 29 lesions, the 3-T MRI-guided LCNB was considered to be technically successful. The size of the needle artifact was 9.5 mm. A typical example of the acquired images during the procedure is shown in Fig. 3. None of the procedures had to be interrupted or stopped. No severe side effects were observed.Fig. 2a, b

Bottom Line: Tissue sampling was technically successful in 29/31 (94%) lesions.Histopathological analysis showed 19 benign lesions (66%) and one inconclusive biopsy result (3%).Follow-up MRI at 6 months after the biopsy should be performed in case of a benign biopsy result.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584 CX, Utrecht, The Netherlands. n.peters@umcutrecht.nl

ABSTRACT
The feasibility of large-core-needle magnetic resonance imaging (MRI)-guided breast biopsy at 3 T was assessed. Thirty-one suspicious breast lesions shown only by MRI were detected in 30 patients. Biopsy procedures were performed in a closed-bore 3-T clinical MR system on a dedicated phased-array breast coil with a commercially available add-on stereotactic biopsy device. Tissue sampling was technically successful in 29/31 (94%) lesions. Median lesion size (n = 29) was 9 mm. Histopathological analysis showed 19 benign lesions (66%) and one inconclusive biopsy result (3%). At follow-up of these lesions, 15 lesions showed no malignancy, no information was available in three patients and two lesions turned out to be malignant (one lesion at surgical excision 1 month after biopsy and one lesion at a second biopsy because of a more malignant enhancement curve at 12-months follow-up MRI). Nine biopsy results showed a malignant lesion (31%) which were all surgically removed. No complications occurred. MRI-guided biopsy at 3 T is a safe and effective method for breast biopsy in lesions that are occult on mammography and ultrasound. Follow-up MRI at 6 months after the biopsy should be performed in case of a benign biopsy result.

Show MeSH
Related in: MedlinePlus