title: Tailored interactive sequences for continuous MR-image-guided freehand biopsies of different organs in an open system at 1.0 tesla (T) - Initial experience.
abstract: OBJECTIVE
  To assess the feasibility, image quality, and accuracy of freehand biopsies of liver, bone, muscle, vertebral disc, soft tissue, and other lesions using balanced steady-state free precession (SSFP, balanced fast field echo: bFFE), spoiled and nonspoiled gradient echo (FFE), and turbo spin echo (TSE) sequences for interactive continuous navigation in an open magnetic resonance imaging (MRI) system at 1.0 tesla (T).
  
  
  METHODS
  Twenty-six MR-guided biopsies (five liver, five bone, four muscle, four vertebral disc, one lung, one kidney, one suprarenal gland, and five soft or other tissue) were performed in 23 patients in a 1.0-T open magnetic resonance (MR) scanner (Panorama HFO, Philips Healthcare, Best, the Netherlands). A total of 42 samples were obtained. Depending on lesion size and location, 14-18-gauge MR-compatible biopsy sets with a length of 100 or 200 mm (Somatex Medical, Teltow, Germany), 14-18-gauge MR-compatible semiautomatic biopsy guns with a length of 100 or 150 mm (Invivo, Schwerin, Germany), or 11-gauge MR-compatible bone marrow biopsy needles with a length of 100 mm (Somatex Medical, Teltow, Germany) were employed.
  
  
  RESULTS
  All lesions were visible with continuous interactive imaging. Our initial results indicate that bFFE is particularly suitable for fast-moving organs (pulmonary, paracardial); moving organs are targeted better with T1-weighted (T1W) TSE, T1W FFE (liver) or T2-weighted (T2W) TSE (complicated cysts, adrenal glands), and static organs are successfully approached with proton density (PD) (spine) or T1W TSE (peripheral bones, musculoskeletal system). No adverse events related to the use of MRI were obtained. No complications occurred according to the Society of Interventional Radiology (SIR) clinical practice guidelines.
  
  
  CONCLUSIONS
  Applying tailored interactive dynamic imaging sequences for continuous navigation to liver, bone, muscle, vertebral disc, soft tissue, and other lesions can improve the feasibility, image quality, and interventional accuracy of freehand MR-guided biopsies and may hence reduce the risk of complications.
authors.affiliation: .
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.affiliation: .
authors.forename: Christian
authors.initials: C
authors.lastname: Althoff
authors.affiliation: .
authors.forename: Martin
authors.initials: M
authors.lastname: Jonczyk
authors.affiliation: .
authors.forename: Felix
authors.initials: F
authors.lastname: Guettler
authors.affiliation: .
authors.forename: Martin
authors.initials: M
authors.lastname: Maurer
authors.affiliation: .
authors.forename: Hendrik
authors.initials: H
authors.lastname: Rathke
authors.affiliation: .
authors.forename: Keno Moritz
authors.initials: KM
authors.lastname: Sponheuer
authors.affiliation: .
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: .
authors.forename: Ulf K
authors.initials: UK
authors.lastname: Teichgräber
authors.affiliation: .
authors.forename: Maximilian
authors.initials: M
authors.lastname: de Bucourt
mesh_terms: D001706:Biopsy; D005858:Germany; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*
keywords: MRI; biopsies; real-time image guidance