The purpose of this study was to develop, standardize, and test reproducibility of a lexicon for reporting contrastenhanced breast magnetic resonance imaging (MRI) examinations. To standardize breast MRI lesion description and reporting, seven radiologists with extensive breast MRI experience developed consensus on technical detail, clinical history, and terminology reporting to describe kinetic and architectural features of lesions detected on contrastenhanced breast MR images. This lexicon adapted American College of Radiology Breast Imaging and Data Reporting System terminology for breast MRI reporting, including recommendations for reporting clinical history, technical parameters for breast MRI, descriptions for general breast composition, morphologic and kinetic characteristics of mass lesions or regions of abnormal enhancement, and overall impression and management recommendations. To test morphology reproducibility, seven radiologists assessed morphology characteristics of 85 contrast-enhanced breast MRI studies. Data from each independent reader were used to compute weighted and unweighted kappa () statistics for interobserver agreement among readers. The MR lexicon differentiates two lesion types, mass and non-mass-like enhancement based on morphology and geographical distribution, with descriptors of shape, margin, and internal enhancement. Index terms: breast; magnetic resonance; breast neoplasms; breast neoplasm diagnosis; observer performance; kappa THERE IS A WIDE VARIETY of breast magnetic resonance imaging (MRI) techniques, resulting in varying interpretation criteria for benign or malignant lesions. This results in a major problem in consolidating data from breast MRI studies. A second problem is lack of a standard language to report breast lesion architecture and/or kinetic data. Varying terms have been used to describe findings to distinguish between benign and malignant breast disease on high spatial resolution scans emphasizing lesion morphology (1-5), contrast enhancement studies that describe signal intensity variations over time (6 -8), and technologies that collect both high spatial and temporal resolution data (9).This lack of consensus in terminology impairs comparison of MR research data among studies, decreases the assessment of the applicability of any one MR technique, and impedes the scientific evaluation of the efficacy of MRI for breast cancer. Clearly, there is a need to reach consensus among experts in how to describe lesions found on breast MRI, to standardize MRI reporting, and to reconcile terms describing breast lesion morphology and enhancement. A standard language for breast MRI would unify the breast MR research field by

No abstract

The aim of this study was the realisation and clinical application of MR-guided vacuum biopsy for percutaneous excisional and incisional biopsy of enhancing breast lesions. A breast biopsy system and procedure have been developed which allow precise and safe access to breast lesions in any location and use of vacuum biopsy (VB) under MR guidance. Fifty-one patients with 55 MR-detected lesions were examined. Verification of these diagnoses included re-excision histology of all 14 malignancies and for benign lesions retrospective correlation of histology and imaging, assessment of complete or partial removal of the enhancing area directly after VB (40 of 40 lesions) and follow-up MRI (33 of 40 lesions), which in contrast to conventional needle biopsy can be used as proof of representative removal. Fifty-four of 55 procedures (including 15 lesions

The purpose of our study was the assessment of the diagnostic value of vacuum core biopsy, which promises high accuracy by minimally invasive percutaneous excision of 1-2 cm3 of tissue. The materials used were a digital stereotaxic biopsy table (Fischer Imaging) and a Mammotome-gun (Biopsys). A total of 236 patients with 261 predominantly indeterminate lesions (indeterminate: 230; suspicious: 26; malignant: 5) underwent vacuum core biopsy (VCB). Verification was as follows: (a) demonstration of complete or partial removal of the lesion or replacement of the lesion by a small hematoma by comparison of the pre- and post-VCB mammogram; (b) reexcision of 45 malignant and 6 borderline lesions; (c) radiologic-histologic correlation; and (d) 6-month-follow-up mammograms in 129 cases. Two VCBs were not possible because very fine microcalcifications could not be visualized. Two puncture errors occurred which, however, were immediately recognized and VCB was repeated. Based on the above verification a 100 % accuracy was achieved. No relevant side effects occurred. Except for 2 cases mammographically hardly any scarring was visible. Based on the excellent accuracy and excellent tolerance of the procedure VCB appears to be the future method of choice for the workup of those indeterminate mammographically detected lesions that up to now have still required surgical biopsy.

No abstract