title: Use of real-time magnetic resonance guidance to assist bone biopsy in pediatric malignancy.
abstract: Magnetic resonance (MR) imaging (MRI) has the advantage of demonstrating lesions not visualized by other radiologic modalities. We present a case involving pediatric malignancy where MR-guided bone biopsy confirmed correct histologic diagnosis and was used to plan additional treatment. A 2-year, 9-month-old boy had a history of spontaneous regression of stage 4S neuroblastoma. (123)I-metaiodobenzylguanidine scintigraphy showed a hot spot at his right lower leg; however, neither plain radiograph (99m)Tc diphosphonate bone scan was positive. Only MRI depicted a lesion at the distal third of his right tibia, and a subsequent MR-guided bone biopsy was diagnostic of bone marrow metastasis. After 6 courses of intensive chemotherapy, he has been in complete remission. MR-guided biopsy technique is likely to be particularly useful for the resection of invisible metastatic lesions, especially those that are only visible using MRI.
authors.affiliation: Department of Pediatric Surgery, Tokai University, School of Medicine, Kanagawa, Japan. ueno@is.icc.u-tokai.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ueno
authors.forename: Seishichi
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirakawa
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yabe
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Hideki
authors.initials: H
authors.lastname: Atsumi
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Matsumae
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy / Q000379:methods; D001859:Bone Neoplasms / Q000473:pathology* / Q000556:secondary*; D002675:Child, Preschool; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009365:Neoplasm Regression, Spontaneous; D009447:Neuroblastoma / Q000175:diagnosis* / Q000556:secondary*; D012074:Remission Induction / Q000379:methods; D012878:Skin Neoplasms / Q000556:secondary
chemical_list: D014408:Biomarkers, Tumor