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Initial experience with magnetic resonance-guided vacuum-assisted biopsy in korean women with breast cancer.

Jung HN, Han BK, Ko EY, Shin JH - J Breast Cancer (2014)

Bottom Line: VAB histology was compared with surgical histology and follow-up imaging findings.In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions.MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study is to describe our initial experience with magnetic resonance (MR)-guided biopsy and to determine the malignancy rate of additional lesions identified by MR only in Korean women with breast cancer.

Methods: A retrospective review identified 22 consecutive patients with breast cancer who had undergone MR-guided vacuum-assisted biopsies (VAB) of MR-only identified lesions from May 2009 to October 2011.We evaluated the rate of compliance, the technical success for MR-guided VAB and the MR imaging findings of the target lesions. VAB histology was compared with surgical histology and follow-up imaging findings.

Results: The biopsy recommendations for MR-only identified lesions were accepted in 46.8% (22/47) of patients. One of 22 procedures failed due to the target's posterior location. Among 21 MR-guided VAB procedures, the target lesions were considered as a mass in 12 cases and a nonmass enhancement in nine cases. VAB histology revealed malignancies in 14% (3/21) of cases, high-risk lesions in 24% (5/21) and benign lesions in 62% (13/21). Eleven cases (52%, 11/21) had a positive surgical correlation, and one of them was upgraded from atypical ductal hyperplasia to invasive ductal carcinoma. In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions. The final malignancy rate was 19% (4/21).

Conclusion: MR-guided VAB for MR-only identified lesions yielded a 19% malignancy rate in Korean women with breast cancer. MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

No MeSH data available.


Related in: MedlinePlus

A method of determining the lesion location. (A, B) After reviewing the images on the console, a cursor was placed over the lesion (in a circle) and fiducial marker (in a rectangle) on the monitor. The differences in dorsal-ventral (x), cranial-caudal (y), and medial-lateral (z) direction coordinates of the lesion and fiducial marker were calculated on the basis of the spatial relationship between the lesion, vitamin E marker, and grid lines. The difference in z direction was calculated by a following formula: difference of imaging number of the lesion and fiducial marker×slice thickness of the magnetic resonance images.
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Figure 3: A method of determining the lesion location. (A, B) After reviewing the images on the console, a cursor was placed over the lesion (in a circle) and fiducial marker (in a rectangle) on the monitor. The differences in dorsal-ventral (x), cranial-caudal (y), and medial-lateral (z) direction coordinates of the lesion and fiducial marker were calculated on the basis of the spatial relationship between the lesion, vitamin E marker, and grid lines. The difference in z direction was calculated by a following formula: difference of imaging number of the lesion and fiducial marker×slice thickness of the magnetic resonance images.

Mentions: A vitamin E capsule was taped near the expected lesion site to serve as a fiducial marker for determining the lesion location, and a sagittal T1-weighted 3D turbo field-echo sequence was obtained. A contrast agent (0.1 mmol/kg bolus of gadobutrol (Gadovist; Bayer Healthcare Pharmaceuticals, Berlin, Germany) was injected and flushed with 10 mL of saline. Postcontrast images were obtained 1 minute after contrast administration. After reviewing the images on the console, a cursor was placed over the fiducial marker and the lesion on the monitor. The differences between the horizontal (dorsal-ventral, x), vertical (cranial-caudal, y), and depth (medial-lateral, z) coordinates of the fiducial marker and the lesion were calculated based on the spatial relationship between the lesion, vitamin E marker, and grid lines (Figure 3).


Initial experience with magnetic resonance-guided vacuum-assisted biopsy in korean women with breast cancer.

Jung HN, Han BK, Ko EY, Shin JH - J Breast Cancer (2014)

A method of determining the lesion location. (A, B) After reviewing the images on the console, a cursor was placed over the lesion (in a circle) and fiducial marker (in a rectangle) on the monitor. The differences in dorsal-ventral (x), cranial-caudal (y), and medial-lateral (z) direction coordinates of the lesion and fiducial marker were calculated on the basis of the spatial relationship between the lesion, vitamin E marker, and grid lines. The difference in z direction was calculated by a following formula: difference of imaging number of the lesion and fiducial marker×slice thickness of the magnetic resonance images.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197358&req=5

Figure 3: A method of determining the lesion location. (A, B) After reviewing the images on the console, a cursor was placed over the lesion (in a circle) and fiducial marker (in a rectangle) on the monitor. The differences in dorsal-ventral (x), cranial-caudal (y), and medial-lateral (z) direction coordinates of the lesion and fiducial marker were calculated on the basis of the spatial relationship between the lesion, vitamin E marker, and grid lines. The difference in z direction was calculated by a following formula: difference of imaging number of the lesion and fiducial marker×slice thickness of the magnetic resonance images.
Mentions: A vitamin E capsule was taped near the expected lesion site to serve as a fiducial marker for determining the lesion location, and a sagittal T1-weighted 3D turbo field-echo sequence was obtained. A contrast agent (0.1 mmol/kg bolus of gadobutrol (Gadovist; Bayer Healthcare Pharmaceuticals, Berlin, Germany) was injected and flushed with 10 mL of saline. Postcontrast images were obtained 1 minute after contrast administration. After reviewing the images on the console, a cursor was placed over the fiducial marker and the lesion on the monitor. The differences between the horizontal (dorsal-ventral, x), vertical (cranial-caudal, y), and depth (medial-lateral, z) coordinates of the fiducial marker and the lesion were calculated based on the spatial relationship between the lesion, vitamin E marker, and grid lines (Figure 3).

Bottom Line: VAB histology was compared with surgical histology and follow-up imaging findings.In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions.MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The aim of this study is to describe our initial experience with magnetic resonance (MR)-guided biopsy and to determine the malignancy rate of additional lesions identified by MR only in Korean women with breast cancer.

Methods: A retrospective review identified 22 consecutive patients with breast cancer who had undergone MR-guided vacuum-assisted biopsies (VAB) of MR-only identified lesions from May 2009 to October 2011.We evaluated the rate of compliance, the technical success for MR-guided VAB and the MR imaging findings of the target lesions. VAB histology was compared with surgical histology and follow-up imaging findings.

Results: The biopsy recommendations for MR-only identified lesions were accepted in 46.8% (22/47) of patients. One of 22 procedures failed due to the target's posterior location. Among 21 MR-guided VAB procedures, the target lesions were considered as a mass in 12 cases and a nonmass enhancement in nine cases. VAB histology revealed malignancies in 14% (3/21) of cases, high-risk lesions in 24% (5/21) and benign lesions in 62% (13/21). Eleven cases (52%, 11/21) had a positive surgical correlation, and one of them was upgraded from atypical ductal hyperplasia to invasive ductal carcinoma. In the remaining 10 lesions, follow-up breast ultrasound and mammography were available (range, 15-44 months; mean, 32.1 months) and did not show suspicious lesions. The final malignancy rate was 19% (4/21).

Conclusion: MR-guided VAB for MR-only identified lesions yielded a 19% malignancy rate in Korean women with breast cancer. MR-guided VAB helps surgeons avoid an unnecessary wide excision or additional excisional biopsy.

No MeSH data available.


Related in: MedlinePlus