title: Vacuum-assisted breast biopsies (VAB) carried out on an open 1.0T MR imager: Influence of patient and target characteristics on the procedural and clinical results.
abstract: OBJECTIVE
  The study was conducted in order to assess the clinical impact of MRI-guided vacuum-assisted breast biopsies carried out using an open 1.0T open MRI-system.
  
  
  METHODS
  The clinical, imaging, interventional and histological data of all 132 patients with a first MRI-guided vacuum-assisted breast biopsy carried out between 07/2005 and 03/2012at the Radiological Department were extracted from the clinical files. The clinical outcome of patients with benign histological findings was assessed based on the clinical files and queries of the local gynecologists in charge. In the 103 interventional image data sets available target localization and target size were evaluated by two board-certified senior radiologists. Clinical data, lesion characteristics and interventional results were evaluated statistically using subgroup analyses.
  
  
  RESULTS
  131 of 132 MRI-guided breast biopsies (99.2%) were carried out successfully. The median interventional duration was 30min (25%-percentile 25min, 75%-percentile 35min, maximum 75min). Minor complications occurred in 12 interventions of the 131 (9.2%). The histological work-up of the biopsy specimen showed benign results in 98 of 131 interventions (74.8%), lesions with uncertain biological potential in 5 biopsies (3.8%) and malignant findings in 28 biopsies (21.4%). There were 2 false negative histological findings. Neither the patient age nor the medical history nor the anticipated risk of developing breast cancer had an impact on the success rates and the complication rates. In the 103 interventions with available image data sets the maximum target lesion diameters were 1-5mm in 16 lesions (15.5%), 6-10mm in 41 lesions (39.8%) and 11-15mm in 29 lesions (28.2%). There was a positive correlation between the maximum diameters and the rate of malignancy of the target lesions (p=0.020) as well as a trend towards longer interventional procedure durations in smaller target lesions (p=0.183).
  
  
  CONCLUSIONS
  MRI-guided vacuum-assisted breast biopsy for suspicious breast lesions is a clinically safe and feasible method even in small target lesions when using an open high-field MRI-system.
authors.affiliation: Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany. Electronic address: Barbara.krug@uk-koeln.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Krug
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.affiliation: Breast Center and Dept. of Obstetrics and Gynecology, University Hospital of Cologne, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Ulhaas
authors.affiliation: Breast Center and Dept. of Obstetrics and Gynecology, University Hospital of Cologne, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Krämer
authors.affiliation: Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital of Cologne, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Rhiem
authors.affiliation: Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital of Cologne, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Zarghooni
authors.affiliation: Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Püsken
authors.affiliation: Dept. of Diagnostical Radiology, Helios Hospital, Siegburg, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Schwabe
authors.affiliation: Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany.
authors.forename: Olga
authors.initials: O
authors.lastname: Grinstein
authors.affiliation: Dept. of Pathology, University Hospital of Cologne, Germany.
authors.forename: Birgid
authors.initials: B
authors.lastname: Markiefka
authors.affiliation: Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Maintz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D053783:Magnetic Resonance Imaging, Interventional / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D014618:Vacuum