Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results.
OBJECTIVE
The purpose of this study was to present an alternative technique for the pre-operative localisation of solely MRI-detected suspicious breast lesions using a computer-assisted MRI-guided radio-guided occult lesion localisation (ROLL) technique.


METHODS
Between January 2009 and June 2010, 25 females with a total of 25 suspicious breast lesions that could be detected only by MRI, and for whom breast surgery was planned, underwent the computer-assisted MRI-guided ROLL technique. A seven-channel biopsy breast array coil and computerised diagnostic workstation were used for the localisation procedure. Three-phase dynamic contrast-enhanced axial images were taken. After investigating the localisation co-ordinates with the help of intervention software on a workstation, an 18 G coaxial cannula was placed in the exact position determined. Following verification of the cannula position by additional axial scans, (99m)Tc-labelled macroalbumin aggregate and MRI contrast material were injected. Post-procedure MRI scans were used to confirm the correct localisation.


RESULTS
All the procedures were technically successful. The mean lesion size was 10.8 mm (range: 4-25 mm). The mean total magnet and the mean localisation times were 28.6 min (range: 18-46 min) and 13.1 min (range: 8-20 min), respectively. Grid and pillar methods were used for localisation in 24 procedures and 1 procedure, respectively. On histopathological examination, 6 malignant, 10 high-risk and 9 benign lesions were identified. All patients tolerated the procedure well. There were no major complications.


CONCLUSIONS
This is the first report documenting the application of MRI-guided ROLL. Based on our preliminary results, this technique is very efficient and seems to be a good alternative to wire localisation.
Department of Radiology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
M H
MH
Yilmaz
F
F
Kilic
G E
GE
Icten
F
F
Aydogan
V
V
Ozben
M
M
Halac
D C
DC
Olgun
E
E
Gazioglu
V
V
Celik
C
C
Uras
Z A
ZA
Altug
D001706:Biopsy / Q000379:methods*; D001943:Breast Neoplasms / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*