title: MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner.
  
  
  METHODS
  This is a retrospective study of 16 consecutive patients (8 male, 8 female; mean age 74 years) who underwent MRI-guided core needle biopsy of a mediastinal mass between February 2010 and January 2014. Size and location of lesion, approach taken, time for needle placement, overall duration of procedure, and post-procedural complications were evaluated. Technical success rates and correlation with surgical pathology (where available) were assessed.
  
  
  RESULTS
  Target lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6-11 cm). Average time for needle placement was 9.4 min (range 3-18 min); average duration of entire procedure was 42 min (range 27-62 min). 2-5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100%, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5%, respectively.
  
  
  CONCLUSIONS
  MRI-guided mediastinal biopsy is a safe procedure with high diagnostic accuracy, which may offer a non-ionizing alternative to CT guidance.
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France. juliengarnon@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Garnon
authors.affiliation: Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK.
authors.forename: N
authors.initials: N
authors.lastname: Ramamurthy
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Caudrelier J
authors.affiliation: ICube, University of Strasbourg, CNRS, Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Erceg
authors.affiliation: ICube, University of Strasbourg, CNRS, Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Breton
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: G
authors.initials: G
authors.lastname: Tsoumakidou
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.|ICube, University of Strasbourg, CNRS, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Rao
authors.affiliation: Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France.|ICube, University of Strasbourg, CNRS, Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Gangi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods; D059346:Magnets; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: MRI guidance; Mediastinal masses; Percutaneous image-guided biopsy