Magnetic resonance guided localization and biopsy of suspicious breast lesions.
Contrast-enhanced magnetic resonance imaging (MRI) is being used increasingly as a complementary diagnostic modality in breast imaging of preselected patients. The exclusion of multicentricity before surgery and the differentiation between a scar and a carcinoma are well-accepted indications of this method. Problems result when suspicious lesions found with MRI cannot be visualized with mammography or ultrasonography. In these cases, MRI-based guidance systems are needed to guide needle biopsy or allow localization of the lesion before surgery. At our institution, 167 MR-guided interventions (35 percutaneous biopsies and 132 preoperative localizations) have been performed with the use of different types of add-on devices during the past 3 years. Percutaneous biopsy (31 fine needle aspiration and four core biopsies) revealed 24 benign and 8 malignant lesions, 3 biopsies were insufficient. Histologic examination after MR-guided wire localization showed benign findings in 68 lesions (52%) and malignancy in 64 lesions (48%). Technical aspects, experiences, advantages, and disadvantages of our system as well as those of other devices are reported and discussed. MR-compatible equipment for interventions of the breast is demonstrated. In conclusion, we perform MR-guided interventions of the breast routinely in indicated cases at a rate of approximately 3-5% for all patients undergoing diagnostic contrast-enhanced MRI of the breast.
Fischer
U
U
Department of Radiology, University of Goettingen, Germany. ufischer@med.uni-goettingen.de
Kopka
L
L
Grabbe
E
E
D000328:Adult; D000465:Algorithms; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged
D003287:Contrast Media