title: [Clip marker placement following MR-guided vacuum biopsy of the breast].
abstract: OBJECTIVE
  The purpose of our study was to determine the placement accuracy, usefulness as a guide for wire localization, and long-term stability of tissue marker clips following MR-guided vacuum-assisted biopsy (VB) of breast lesions.
  
  
  METHODS
  During a 2-year period, MR-guided VB with an 11-gauge device was performed in 79 lesions. In 26 lesions a marker clip was placed at the biopsy site.
  
  
  RESULTS
  In 18 cases, the clip was shown to be closely adjacent to the lesion on post-interventional MR images. In seven cases in which minor bleeding occurred, the clip dislocated (< or =15 mm) in the direction of the needle pathway. In one case dislocation in the dorsal direction (< or =5 mm) was observed. In eight cases with a malignant or borderline histology according to the VB, the marker clips served as targets for mammographically guided wire localization. In all of those patients, histology results derived from open surgery confirmed those of VB. Eighteen patients with benign findings according to the VB were followed up 6 months later. Among these cases we found a significant displacement of the marker clip in one case (3 cm). The clip generally caused a round artifact (diameter of 9+/-2 mm). In two cases it was not possible to determine whether the lesion had been removed completely or was just behind the artifact caused by the clip.
  
  
  CONCLUSIONS
  Based on our results, clip marker placement following MR-guided vacuum biopsy should be called into question due to the possibility of masking the lesion by a metallic artifact and because of possible dislocation.
authors.affiliation: Abteilung für bildgebende und interventionelle Mammadiagnostik, Klinikum rechts der Isar der TU München. claudia.perlet@lrz.tum.de
authors.forename: C
authors.initials: C
authors.lastname: Perlet
authors.forename: H
authors.initials: H
authors.lastname: Sittek
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.forename: S H
authors.initials: SH
authors.lastname: Heywang-Köbrunner
mesh_terms: D000328:Adult; D016477:Artifacts; D001707:Biopsy, Needle / Q000295:instrumentation* / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005858:Germany; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation* / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014618:Vacuum
references.citation: Radiographics. 2004 Jan-Feb;24(1):147-56
references.pmid: 14730043
references.citation: Radiologe. 2002 Jan;42(1):6-10
references.pmid: 11930543
references.citation: Arch Surg. 2000 Jun;135(6):700-3
references.pmid: 10843367
references.citation: Radiology. 1997 Nov;205(2):407-15
references.pmid: 9356621
references.citation: Ann Surg Oncol. 1998 Apr-May;5(3):265-70
references.pmid: 9607630
references.citation: Am Surg. 1999 Jan;65(1):59-60
references.pmid: 9915534
references.citation: Radiologe. 1997 Sep;37(9):710-7
references.pmid: 9424616
references.citation: J Comput Assist Tomogr. 1994 Nov-Dec;18(6):876-81
references.pmid: 7962793
references.citation: J Exp Clin Cancer Res. 2002 Sep;21(3 Suppl):107-14
references.pmid: 12585664
references.citation: Radiology. 1999 Dec;213(3):881-8
references.pmid: 10580970
references.citation: Radiology. 1997 Nov;205(2):417-22
references.pmid: 9356622
references.citation: Rofo. 2002 Jan;174(1):88-95
references.pmid: 11793291
references.citation: J Natl Cancer Inst. 2001 Jul 18;93(14 ):1095-102
references.pmid: 11459871
references.citation: Eur Radiol. 2002 Jun;12(6):1463-70
references.pmid: 12042955
references.citation: Radiology. 1999 Aug;212(2):543-9
references.pmid: 10429716
references.citation: AJR Am J Roentgenol. 2003 Nov;181(5):1275-82
references.pmid: 14573420
references.citation: MAGMA. 1998 Dec;7(3):141-52
references.pmid: 10050940
references.citation: Breast J. 2004 Nov-Dec;10(6):539-42
references.pmid: 15569213
references.citation: Radiology. 1997 Aug;204(2):485-8
references.pmid: 9240540