title: Magnetic resonance-guided transcortical biopsy of bone marrow lesions using a magnetic resonance imaging-compatible piezoelectric power drill: preliminary experience.
abstract: OBJECTIVE
  To test utility and specific properties of a commercially available MRI compatible power drill for MR guided transcortical bone biopsy.
  
  
  METHODS
  In 17 patients MR-guided bone biopsy was performed in an open low-field scanner (0.2 T), using a piezoelectrically powered drilling machine. Target lesions were osteoblastic in four and nonsclerosed intramedullary in 13 cases. Titanium drills sized 3 to 4 mm and an outer cannula were coaxially used for power assisted cortical trephination. For intramedullary lesion sampling, spring loaded biopsy guns and sharpened cannulas were additionally applied in seven and fluid aspiration in two patients, respectively.
  
  
  RESULTS
  The piezoelectric device proved to be fully MR compatible. Trephination and subsequent biopsy was successful in all patients without major complications. The drilling procedure could entirely be performed inside the magnet in case of a lateral approach (n = 11). The net drilling time averaged 7.8 minutes for trephination of nonimpaired diaphyseal bone, but was up to 50 minutes in case of thickened femoral bone. Procedures were complicated by frequent drill loosening, drill obstruction by cortical bone (n = 4) and impaired periosteal grip (n = 5) with damage to the outer cannula (n = 3).
  
  
  CONCLUSIONS
  The piezoelectric power drill can be applied safely in a low-field MRI environment and is a valuable tool to facilitate transcortical bone biopsy.
authors.affiliation: Department of Diagnostic Radiology, University of Tuebingen, Tuebingen, Germany. claudius.koenig@med.uni-tuebingen.de
authors.forename: Claudius W
authors.initials: CW
authors.lastname: König
authors.forename: Jochen
authors.initials: J
authors.lastname: Trübenbach
authors.forename: Paul
authors.initials: P
authors.lastname: Böhm
authors.forename: Jan
authors.initials: J
authors.lastname: Fritz
authors.forename: Stephan H
authors.initials: SH
authors.lastname: Duda
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000295:instrumentation; D001847:Bone Diseases / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged