Browse > Article
http://dx.doi.org/10.3348/kjr.2013.14.2.171

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)
Publication Information
Korean Journal of Radiology / v.14, no.2, 2013 , pp. 171-178 More about this Journal
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
Breast neoplasms; Magnetic resonance imaging; Biopsy; High field; Freehand technique; Needle localization;
Citations & Related Records
연도 인용수 순위
  • Reference
1 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)   DOI
2 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)   DOI
3 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)   DOI
4 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)   DOI
5 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)   DOI
6 Coulthard A. Magnetic resonance imaging-guided preoperative breast localization using a "freehand technique". Br J Radiol 1996;69:482-483
7 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)   DOI
8 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)   DOI
9 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)   DOI
10 American College of Radiology (ACR). BI-RADS$^{\circledR}$ Breast Imaging Reporting and Data System, Breast Imaging Atlas. Reston, VA: American College of Radiology, 2003
11 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)   DOI
12 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)   DOI
13 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)
14 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)   DOI
15 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)   DOI
16 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)   DOI
17 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)   DOI
18 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)   DOI
19 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   DOI
20 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)   DOI
21 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)   DOI
22 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)   DOI
23 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)   DOI
24 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)   DOI
25 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)   DOI
26 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)   DOI
27 Orel, SG, Schnall, MD, LiVolsi, VA, Troupin, RH,Suspicious breast lesions: MR imaging with radiologic-pathologic correlation, Radiology, 190, 1, 485-493(1994)   DOI
28 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)   DOI
29 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)   DOI