MRI-guided breast biopsy: clinical experience with 14-gauge stainless steel core biopsy needle.
OBJECTIVE
Core needle biopsy has proven advantages for wire localization and excision; however, MRI-guided core biopsy has been limited by less satisfactory sampling efficiency and less availability of MRI-compatible biopsy needles. We evaluated the feasibility and diagnostic yield of MRI-guided biopsy using 14-gauge stainless steel core biopsy needles and MRI-compatible coaxial sheaths in a closed 1.5-T scanner.


METHODS
Thirty-five consecutive breast biopsies performed in 29 women between March 2001 and August 2002 were retrospectively reviewed. For each procedure, an MRI-compatible sheath was placed under MRI guidance using a dedicated breast coil and biopsy guidance system. With the patient out of the magnet, a 14-gauge steel core biopsy needle was used to obtain multiple samples. Lesion characteristics, including size, morphology, and enhancement, were recorded. Histology of all the lesions was obtained; and surgical, imaging, or clinical follow-up was performed.


RESULTS
Targeted masses and enhancing foci ranged from 3 to 17 mm. Regional enhancement ranged from 14 to 70 mm. Thirty-four of the 35 biopsies were technically successful. Histology revealed malignancy in eight lesions (23%), atypical ductal hyperplasia in five lesions (14%), and benign entities in 21 lesions (60%). Surgery confirmed all eight core biopsies with malignant findings. Two of five lesions with atypical ductal hyperplasia were upgraded to malignancy after surgery.


CONCLUSIONS
This new method of MRI-guided breast biopsy with a 14-gauge stainless steel core biopsy needle and a closed 1.5-T MRI scanner is feasible, safe, and effective and produces satisfactory diagnostic yield. This method offers an alternative to MRI-guided wire localization and to MRI-guided core biopsy with nonferrous needles.
Chen
Xiaoming
X
Department of Radiology, University of Washington Medical Center, 1959 NE Pacific, Seattle, WA 98195, USA.
Lehman
Constance D
CD
Dee
Katherine E
KE
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001941:Breast Diseases / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009339:Needles; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013193:Stainless Steel
D013193:Stainless Steel