title: MR-guided freehand biopsy of breast lesions in a 1.0-T open MR imager with a near-real-time interactive platform: preliminary experience.
abstract: OBJECTIVE
  To identify the most appropriate magnetic resonance (MR) sequence for breast biopsy with regard to lesion visibility and artifact size and to assess feasibility and safety of this approach in a clinical setting.
  
  
  METHODS
  MR-guided interventions were performed in an open 1.0-T MR imager between November 2009 and January 2011. The prospective clinical study was approved by the institutional review board. Written informed consent was obtained. Four different fast dynamic sequences (balanced steady-state free precession, T1-weighted turbo gradient-echo, T1-weighted turbo spin-echo [SE], and T2-weighted single-shot SE sequences) were evaluated for artifact size of biopsy needle and in vivo for lesion visibility. In vivo breast biopsies were performed with the freehand technique and without immobilization or a positioning device by using an interactive MR mode that allowed continuous imaging in two orthogonal planes for guidance.
  
  
  RESULTS
  On the basis of good lesion detection in combination with small artifact size, T1-weighted SE imaging was used for biopsy. A total of 75 biopsies were performed successfully in 69 patients (mean age, 53 years; age range, 35-78 years) (mean lesion size, 7.1 mm; range, 4-15 mm). The interactive MR platform enabled immediate localization and correction of intended needle trajectory. Average time for freehand biopsy was 12 minutes (range, 8-23 minutes). No major complications were recorded.
  
  
  CONCLUSIONS
  MR-guided freehand biopsy of breast lesions with the near-real-time interactive MR platform in an open 1.0-T MR imager is safe and feasible in a clinical setting. The method simplifies work flow and intervention performance.
authors.affiliation: Department of Radiology, Otto von Guericke University, Medical School, Leipziger Strasse 44, 39120 Magdeburg, Germany. frank.fischbach@med.ovgu.de
authors.forename: Frank
authors.initials: F
authors.lastname: Fischbach
authors.forename: Holm
authors.initials: H
authors.lastname: Eggemann
authors.forename: Juergen
authors.initials: J
authors.lastname: Bunke
authors.forename: Uta
authors.initials: U
authors.lastname: Wonneberger
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
authors.forename: Katharina
authors.initials: K
authors.lastname: Strach
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D003199:Computer Systems; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D061705:Image-Guided Biopsy / Q000295:instrumentation / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity