title: Freehand iMRI-guided large-gauge core needle biopsy: a new minimally invasive technique for diagnosis of enhancing breast lesions.
abstract: The lack of reliable methods for minimally invasive biopsy of suspicious enhancing breast lesions has hindered the utilization of contrast-enhanced magnetic resonance imaging (MRI) for the detection and diagnosis of breast cancer. In this study, a freehand method was developed for large-gauge core needle biopsy (LCNB) guided by intraprocedural MRI (iMRI). Twenty-seven lesions in nineteen patients were biopsied using iMRI-guided LCNB without significant complications. Diagnostic tissue was obtained in all cases. Nineteen of the 27 lesions were subsequently surgically excised. Histopathologic analysis confirmed that iMRI-guided LCNB correctly distinguished benign lesions from malignancy in 18 of the 19 lesions. The histology revealed by core biopsy was partially discrepant with surgical biopsy in 2 of the other 19 lesions. Freehand iMRI-guided LCNB of enhancing breast lesions is promising. Larger studies are needed to determine the smallest lesion that can be sampled reliably and to precisely measure the accuracy of iMRI-guided LCNB as a minimally invasive tool to diagnose suspicious lesions found by breast MRI. J. Magn. Reson. Imaging 2001;13:896-902.
authors.affiliation: Department of Radiology, Stanford University, Stanford, California 94305, USA. bdaniel@s-word.stanford.edu
authors.forename: B L
authors.initials: BL
authors.lastname: Daniel
authors.forename: R L
authors.initials: RL
authors.lastname: Birdwell
authors.forename: K
authors.initials: K
authors.lastname: Butts
authors.forename: K W
authors.initials: KW
authors.lastname: Nowels
authors.forename: D M
authors.initials: DM
authors.lastname: Ikeda
authors.forename: S G
authors.initials: SG
authors.lastname: Heiss
authors.forename: C R
authors.initials: CR
authors.lastname: Cooper
authors.forename: S S
authors.initials: SS
authors.lastname: Jeffrey
authors.forename: F M
authors.initials: FM
authors.lastname: Dirbas
authors.forename: R J
authors.initials: RJ
authors.lastname: Herfkens
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D018275:Carcinoma, Lobular / Q000473:pathology; D004867:Equipment Design; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D015203:Reproducibility of Results