title: Navigated MRI-guided liver biopsies in a closed-bore scanner: experience in 52 patients.
abstract: OBJECTIVE
  To evaluate clinical effectiveness and diagnostic efficiency of a navigation device for MR-guided biopsies of focal liver lesions in a closed-bore scanner.
  
  
  METHODS
  In 52 patients, 55 biopsies were performed. An add-on MR navigation system with optical instrument tracking was used for image guidance and biopsy device insertion outside the bore. Fast control imaging allowed visualization of the true needle position at any time. The biopsy workflow and procedure duration were recorded. Histological analysis and clinical course/outcome were used to calculate sensitivity, specificity and diagnostic accuracy.
  
  
  RESULTS
  Fifty-four of 55 liver biopsies were performed successfully with the system. No major and four minor complications occurred. Mean tumour size was 23 ± 14 mm and the skin-to-target length ranged from 22 to 177 mm. In 39 cases, access path was double oblique. Sensitivity, specificity and diagnostic accuracy were 88 %, 100 % and 92 %, respectively. The mean procedure time was 51 ± 12 min, whereas the puncture itself lasted 16 ± 6 min. On average, four control scans were taken.
  
  
  CONCLUSIONS
  Using this navigation device, biopsies of poorly visible and difficult accessible liver lesions could be performed safely and reliably in a closed-bore MRI scanner. The system can be easily implemented in clinical routine workflow.
  
  
  CONCLUSIONS
  • Targeted liver biopsies could be reliably performed in a closed-bore MRI. • The navigation system allows for image guidance outside of the scanner bore. • Assisted MRI-guided biopsies are helpful for focal lesions with a difficult access. • Successful integration of the method in clinical workflow was shown. • Subsequent system installation in an existing MRI environment is feasible.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany. Michael.Moche@medizin.uni-leipzig.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Moche
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Susann
authors.initials: S
authors.lastname: Heinig
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Nikita
authors.initials: N
authors.lastname: Garnov
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Fuchs
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Tim-Ole
authors.initials: TO
authors.lastname: Petersen
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Seider
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Brandmaier
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kahn
authors.affiliation: Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstr. 20, 04103, Leipzig, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Busse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
keywords: Image-guided biopsy; Interventional magnetic resonance imaging; Liver biopsy; Puncture biopsy; Stereotactic techniques