[MR-guided preoperative localization and percutaneous core biopsy of suspected breast lesions. Possibilities and experience on the vertically open 0.5-T-system].
OBJECTIVE
To evaluate the feasibility of performing breast interventions in a vertically open 0.5 T MR system (SIGNA SP/i, GE Medical Systems). To develop fitted equipment and to establish preoperative wire localization and percutaneous breast core biopsy as clinical routine procedures.


METHODS
Initially, we applied a localization method with the patient placed in a sitting position in 31 cases using a single loop coil and a self-developed fixation device. Subsequently, 46 wire localizations and 28 percutaneous core biopsies were carried out in prone patient position using an open breast coil with an integrated biopsy device. The used instruments were either MR-compatible (18 G biopsy needle and localization wire, 14 G coaxial needle, prototype of a 16 G double-shoot gun) or MR-safe (double-shoot gun with 16 G needle).


RESULTS
After biopsy we found the needle tip (18 G for a wire localization and 14 G for a percutaneous core biopsy, respectively) placed either within or close to the lesions (< 10 mm distance) for all patients. Out of a total of 66 benign lesions and 39 malignant tumors we missed the lesion (12 mm mean diameter, 4-25 mm range) during open biopsy in two cases and obtained a false negative result for one percutaneous biopsy of a 5 mm lesion.


CONCLUSIONS
Preoperative wire localization and percutaneous core biopsy of suspicious breast lesions demonstrated by MRI can be carried out a vertically open 0.5 T MR scanner. The degree of accuracy is comparable with that of X-ray or ultrasound-guided procedures. A follow-up has to be performed in cases with a negative biopsy.
Schneider
J P
JP
Klinik und Poliklinik für Diagnostische Radiologie, Universitätsklinikum Leipzig, Liebigstr. 20a, 04103 Leipzig. schneidj@medizin.uni-leipzig.de
Schulz
T
T
Rüger
S
S
Horn
L C
LC
Leinung
S
S
Briest
S
S
Schmidt
F
F
Kahn
T
T
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011187:Posture; D011300:Preoperative Care; D016684:Prone Position
MRT-gestützte Markierung und Stanzbiopsie suspekter Mammaläsionen. Möglichkeiten und Erfahrungen an einem vertikal offenen 0,5-T-System.