title: Use of diagnostic dynamic contrast-enhanced (DCE)-MRI for targeting of soft tissue tumour biopsies at 3T: preliminary results.
abstract: OBJECTIVE
  To test the feasibility and accuracy of MR-guided soft tissue tumour biopsy at 3T, using the dynamic contrast-enhanced (DCE) information from staging MRI for intralesional targeting.
  
  
  METHODS
  After obtaining written informed consent for this institutional review board-approved study, 53 patients with suspected soft tissue tumours prospectively underwent preoperative staging MRI at 3T, including DCE, and subsequent MR-guided core needle biopsy. In 44/53 cases, DCE was heterogeneous and was used for intralesional biopsy targeting. Surgical, whole-specimen histology was used as the gold standard in 43/44 patients and revealed 42 soft tissue tumours (24 men; 18 women; mean age, 52 years; range, 19 - 84).
  
  
  RESULTS
  Final surgical histology revealed eight benign lesions, six tumours of intermediate dignity, and 28 malignancies. All malignancies had shown heterogeneous DCE. The diagnostic yield of the biopsies was 100% (42/42). Histological accuracy rates of biopsy were 100% in predicting the dignity (42/42; 95% CI [0.916 - 1.000]), 95.2% for the tissue-specific entity (40/42; 95% CI [0.847 - 0.987]), and 90.5% for the tumour grade (38/42; 95% CI [0.779 - 0.962]).
  
  
  CONCLUSIONS
  Our preliminary study indicates that biopsy of soft tissue tumours can be performed accurately and safely with DCE targeted MR-guidance at 3T, using a combined staging/biopsy MRI protocol.
  
  
  CONCLUSIONS
  • MR-guided soft tissue tumour biopsy using DCE for intralesional targeting is feasible. • Targeting by staging-MRI allows reliable planning of the biopsy approach. • The method seems accurate and safe as a combined staging/biopsy procedure in outpatients. • DCE-targeted biopsy seems useful in challenging large and heterogeneous tumours.
authors.affiliation: Department of Biomedical Imaging and Image-guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria, iris.noebauer@meduniwien.ac.at.
authors.forename: Iris-Melanie
authors.initials: IM
authors.lastname: Noebauer-Huhmann
authors.forename: Gabriele
authors.initials: G
authors.lastname: Amann
authors.forename: Martin
authors.initials: M
authors.lastname: Krssak
authors.forename: Joannis
authors.initials: J
authors.lastname: Panotopoulos
authors.forename: Pavol
authors.initials: P
authors.lastname: Szomolanyi
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.forename: Christian
authors.initials: C
authors.lastname: Czerny
authors.forename: Martin
authors.initials: M
authors.lastname: Breitenseher
authors.forename: Guenther
authors.initials: G
authors.lastname: Grabner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bogner
authors.forename: Stefan
authors.initials: S
authors.lastname: Nemec
authors.forename: Martin
authors.initials: M
authors.lastname: Dominkus
authors.forename: Philipp
authors.initials: P
authors.lastname: Funovics
authors.forename: Reinhard
authors.initials: R
authors.lastname: Windhager
authors.forename: Siegfried
authors.initials: S
authors.lastname: Trattnig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D008279:Magnetic Resonance Imaging / Q000379:methods; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009367:Neoplasm Staging; D009942:Organometallic Compounds; D011300:Preoperative Care; D011446:Prospective Studies; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; C090600:gadobutrol; D008536:Meglumine