title: Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet.
abstract: OBJECTIVE
  To report the accuracy of magnetic resonance imaging (MRI)-guided needle localization for diagnosis of MRI detected suspicious breast lesions located in difficult accessible regions of the breast, using the freehand method in a 3.0 T closed bore magnet.
  
  
  METHODS
  In five patients with five MRI-only breast lesions underwent MRI-guided needle localization for histopathologic evaluation of the lesions. All interventional procedures were performed in a 3.0 T MRI system with the patient in prone position and by using a dedicated phased array breast coil. MRI-guided needle localizations were performed by using a freehand technique. In our study, the high-resolution scan allowed preprocedural localization of all lesions without use of contrast enhancement. In all cases contrast-enhanced MRI was performed after insertion of the wire to confirm the tip of the wire in direct contact with the enhancing lesion.
  
  
  RESULTS
  Needle localizations were performed in five patients. Histopathologic evaluation of tissue after surgery excision biopsy revealed one lymph node, three invasive ductal carcinoma and one ductal carcinoma in situ. Lesion size varied from 6 to 30 mm. Mean duration time was 25 min. No complications occurred during the intervention method. In the patient with the benign lesion control MRI of the breast after 6 months confirmed lesion removal.
  
  
  CONCLUSIONS
  MRI-guided needle localization by using a freehand technique in a 3.0 T closed bore magnet is a safe and accurate method for diagnosis of difficult accessible breast lesions only visible on MRI.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584 CX Utrecht, The Netherlands. c.meeuwis@umcutrecht.nl
authors.forename: C
authors.initials: C
authors.lastname: Meeuwis
authors.forename: N H G M
authors.initials: NH
authors.lastname: Peters
authors.forename: W P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: A M Fernandez
authors.initials: AM
authors.lastname: Gallardo
authors.forename: R
authors.initials: R
authors.lastname: van Hillegersberg
authors.forename: M E I
authors.initials: ME
authors.lastname: Schipper
authors.forename: M A A J
authors.initials: MA
authors.lastname: van den Bosch
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008280:Magnetics; D015412:Mastectomy, Segmental; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media