Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

  • Choi, Hye Young (Department of Radiology, Gyeongsang National University Hospital) ;
  • Kim, Sun Mi (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Jang, Mijung (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Yun, Bo La (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kim, Sung-Won (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Kang, Eunyoung (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Park, So Yeon (Department of Pathology, Seoul National University Bundang Hospital) ;
  • Moon, Woo Kyung (Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Ko, Eun Sook (Department of Radiology, Samsung Medical Center)
  • Published : 2013.04.01
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Abstract

Objective: To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Materials and Methods: Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. Results: MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. Conclusion: MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.

Keywords

References

  1. Orel, SG, Schnall, MD, LiVolsi, VA, Troupin, RH,Suspicious breast lesions: MR imaging with radiologic-pathologic correlation, Radiology, 190, 1, 485-493(1994) https://doi.org/10.1148/radiology.190.2.8284404
  2. Stomper, PC, Herman, S, Klippenstein, DL, Winston, JS, Edge, SB, Arredondo, MA,Suspect breast lesions: findings at dynamic gadolinium-enhanced MR imaging correlated with mammographic and pathologic features, Radiology, 197, 2, 387-395(1995) https://doi.org/10.1148/radiology.197.2.7480682
  3. Bone, B, Aspelin, P, Bronge, L, Isberg, B, Perbeck, L, Veress, B,Sensitivity and specificity of MR mammography with histopathological correlation in 250 breasts, Acta Radiol, 37, 3, 208-213(1996) https://doi.org/10.1177/02841851960371P143
  4. Daniel, BL, Yen, YF, Glover, GH, Ikeda, DM, Birdwell, RL, Sawyer-Glover, AM,Breast disease: dynamic spiral MR imaging, Radiology, 209, 4, 499-509(1998) https://doi.org/10.1148/radiology.209.2.9807580
  5. Kuhl, CK, Elevelt, A, Leutner, CC, Gieseke, J, Pakos, E, Schild, HH,Interventional breast MR imaging: clinical use of a stereotactic localization and biopsy device, Radiology, 204, 5, 667-675(1997) https://doi.org/10.1148/radiology.204.3.9280242
  6. Daniel, BL, Birdwell, RL, Ikeda, DM, Jeffrey, SS, Black, JW, Block, WF,Breast lesion localization: a freehand, interactive MR imaging-guided technique, Radiology, 207, 6, 455-463(1998) https://doi.org/10.1148/radiology.207.2.9577495
  7. Brenner RJ, Shellock FG, Rothman BJ, Giuliano A. Technical note: magnetic resonance imaging-guided pre-operative breast localization using "freehand technique". Br J Radiol 1995;68:1095-1098 https://doi.org/10.1259/0007-1285-68-814-1095
  8. Lee, CH, Smith, RC, Levine, JA, Troiano, RN, Tocino, I,Clinical usefulness of MR imaging of the breast in the evaluation of the problematic mammogram, AJR Am J Roentgenol, 173, 8, 1323-1329(1999) https://doi.org/10.2214/ajr.173.5.10541112
  9. Morris, EA, Liberman, L, Dershaw, DD, Kaplan, JB, LaTrenta, LR, Abramson, AF,Preoperative MR imaging-guided needle localization of breast lesions, AJR Am J Roentgenol, 178, 9, 1211-1220(2002) https://doi.org/10.2214/ajr.178.5.1781211
  10. Kuhl, CK, Bieling, H, Gieseke, J, Ebel, T, Mielcarek, P, Far, F,Breast neoplasms: T2 susceptibility-contrast, first-pass perfusion MR imaging, Radiology, 202, 10, 87-89(1997) https://doi.org/10.1148/radiology.202.1.8988196
  11. Daniel, BL, Birdwell, RL, Butts, K, Nowels, KW, Ikeda, DM, Heiss, SG,Freehand iMRI-guided large-gauge core needle biopsy: a new minimally invasive technique for diagnosis of enhancing breast lesions, J Magn Reson Imaging, 13, 11, 896-902(2001) https://doi.org/10.1002/jmri.1128
  12. van den Bosch, MA, Daniel, BL, Pal, S, Nowels, KW, Birdwell, RL, Jeffrey, SS,MRI-guided needle localization of suspicious breast lesions: results of a freehand technique, Eur Radiol, 16, 12, 1811-1817(2006) https://doi.org/10.1007/s00330-006-0214-5
  13. Meeuwis, C, Peters, NH, Mali, WP, Gallardo, AM, van Hillegersberg, R, Schipper, ME,Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet, Eur J Radiol, 62, 13, 283-288(2007) https://doi.org/10.1016/j.ejrad.2006.12.006
  14. Hauth, EA, Jaeger, HJ, Lubnau, J, Maderwald, S, Otterbach, F, Kimmig, R,MR-guided vacuum-assisted breast biopsy with a handheld biopsy system: clinical experience and results in postinterventional MR mammography after 24 h, Eur Radiol, 18, 14, 168-176(2008) https://doi.org/10.1007/s00330-007-0704-0
  15. van de Ven, SM, Lin, MC, Daniel, BL, Sareen, P, Lipson, JA, Pal, S,Freehand MRI-guided preoperative needle localization of breast lesions after MRI-guided vacuum-assisted core needle biopsy without marker placement, J Magn Reson Imaging, 32, 15, 101-109(2010) https://doi.org/10.1002/jmri.22148
  16. American College of Radiology (ACR). BI-RADS$^{\circledR}$ Breast Imaging Reporting and Data System, Breast Imaging Atlas. Reston, VA: American College of Radiology, 2003
  17. Ikeda, DM, Hylton, NM, Kinkel, K, Hochman, MG, Kuhl, CK, Kaiser, WA,Development, standardization, and testing of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging studies, J Magn Reson Imaging, 13, 17, 889-895(2001) https://doi.org/10.1002/jmri.1127
  18. Veltman, J, Boetes, C, Wobbes, T, Blickman, JG, Barentsz, JO,Magnetic resonance-guided biopsies and localizations of the breast: initial experiences using an open breast coil and compatible intervention device, Invest Radiol, 40, 18, 379-384(2005) https://doi.org/10.1097/01.rli.0000163672.90247.70
  19. Fischer, U, Kopka, L, Grabbe, E,Magnetic resonance guided localization and biopsy of suspicious breast lesions, Top Magn Reson Imaging, 9, 19, 44-59(1998)
  20. Pfleiderer, SO, Reichenbach, JR, Azhari, T, Marx, C, Wurdinger, S, Kaiser, WA,Dedicated double breast coil for magnetic resonance mammography imaging, biopsy, and preoperative localization, Invest Radiol, 38, 20, 1-8(2003) https://doi.org/10.1097/00004424-200301000-00001
  21. Smith, LF, Henry-Tillman, R, Rubio, IT, Korourian, S, Klimberg, VS,Intraoperative localization after stereotactic breast biopsy without a needle, Am J Surg, 182, 21, 584-589(2001) https://doi.org/10.1016/S0002-9610(01)00790-5
  22. Fischer, U, Vosshenrich, R, Keating, D, Bruhn, H, Doler, W, Oestmann, JW,MR-guided biopsy of suspect breast lesions with a simple stereotaxic add-on-device for surface coils, Radiology, 192, 22, 272-273(1994) https://doi.org/10.1148/radiology.192.1.8208952
  23. Heywang-Köbrunner, SH, Heinig, A, Pickuth, D, Alberich, T, Spielmann, RP,Interventional MRI of the breast: lesion localisation and biopsy, Eur Radiol, 10, 23, 36-45(2000) https://doi.org/10.1007/s003300050005
  24. Orel, SG, Schnall, MD, Newman, RW, Powell, CM, Torosian, MH, Rosato, EF,MR imaging-guided localization and biopsy of breast lesions: initial experience, Radiology, 193, 24, 97-102(1994) https://doi.org/10.1148/radiology.193.1.8090928
  25. Carbognin, G, Girardi, V, Brandalise, A, Baglio, I, Bucci, A, Bonetti, F,MR-guided vacuum-assisted breast biopsy in the management of incidental enhancing lesions detected by breast MR imaging, Radiol Med, 116, 25, 876-885(2011) https://doi.org/10.1007/s11547-011-0631-7
  26. Youk, JH, Kim, EK, Kim, MJ, Ko, KH, Kwak, JY, Son, EJ,Concordant or discordant? Imaging-pathology correlation in a sonography-guided core needle biopsy of a breast lesion, Korean J Radiol, 12, 26, 232-240(2011) https://doi.org/10.3348/kjr.2011.12.2.232
  27. Doler, W, Fischer, U, Metzger, I, Harder, D, Grabbe, E,Stereotaxic add-on device for MR-guided biopsy of breast lesions, Radiology, 200, 27, 863-864(1996) https://doi.org/10.1148/radiology.200.3.8756945
  28. Coulthard A. Magnetic resonance imaging-guided preoperative breast localization using a "freehand technique". Br J Radiol 1996;69:482-483
  29. Kuhl, CK, Morakkabati, N, Leutner, CC, Schmiedel, A, Wardelmann, E, Schild, HH,MR imaging--guided large-core (14-gauge) needle biopsy of small lesions visible at breast MR imaging alone, Radiology, 220, 29, 31-39(2001) https://doi.org/10.1148/radiology.220.1.r01jl0731

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