MR-guided biopsies of lesions in the retroperitoneal space: technique and results

Zangos, Stephan; Eichler, Katrin; Wetter, Axel; Lehnert, Thomas; Hammerstingl, Renate; Diebold, T.; Reichel, P.; Herzog, Christopher; Hansmann, Martin Leo; Mack, Martin G.; Vogl, Thomas J.

doi:10.1007/s00330-005-2870-2

Cited by 28 publications

(19 citation statements)

References 31 publications

(50 reference statements)

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“…The sensitivity of 95.5% in our series is superior to the results from previous studies [6,[11][12][13], where a range of 75-94% has been reported. Although our data are based on only 25 patients, it seems reasonable that the usage of a wide-bore high-field MR machine improves biopsy results.…”

Section: Discussioncontrasting

confidence: 56%

“…Their titanium alloys are generally softer; therefore, the overall needle performance is inferior to normal stainless steel needles [5,16,21]. We found that, especially in cirrhosis, the needle movement inside the liver does not follow the examiners manoeuvres outside the patient.…”

Section: Discussionmentioning

confidence: 79%

“…In addition, multiplanar imaging capabilities allow freely selectable access routes, especially beneficial for angled approaches to the hepatic dome [10]. Several studies have reported MR results comparable with CT guidance, with a sensitivity and accuracy in the range of 90% [11][12][13]. However, as the patient access is restricted in conventional high-field MR systems, and the imaging speed and quality are limited on low-field systems [8,13], MR guidance is usually performed in a time-consuming stepwise procedure on both types of systems.…”

Section: Introductionmentioning

confidence: 93%

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MR-guided liver biopsy within a short, wide-bore 1.5 Tesla MR system

et al. 2008

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The purpose of this study was to evaluate the diagnostic efficacy of magnetic resonance (MR)-guided biopsy of focal liver lesions within a short, wide-bore 1.5-T MR system and to determine the duration and accuracy of needle placement using MR fluoroscopy guidance in 25 patients. Accuracy of needle placement was evaluated in two orthogonal planes, and the out-of-plane angle of needle deflection was measured. Needle positioning was characterised subjectively as centred, peripheral, or exterior relative to the lesion. Exterior positioning was corrected by a step-by-step procedure. Surgical resection (n = 6), previous histologies (n = 8), or clinical/radiological follow-up (n = 11) served as the 'gold standard'. The guidance needle could be placed successfully using MR fluoroscopy in 20 of 25 patients (80%). Needle placement was rated as 'centred' in 11 and as 'peripheral' in nine patients. Median needle deflection was 2.6 degrees, with a median deviation of 3.4 mm. In five patients, the direct approach failed or was rated as 'exterior'; therefore, repositioning after needle stabilisation with a stainless-steel stylet was necessary. The diagnostic yield of all biopsies was: sensitivity 95.5%, specificity 100.0% and accuracy 96.0%. In conclusion, MR-guided biopsies in a short, wide-bore MR system yielded highly reliable biopsy results, and in most cases the direct approach with MR fluoroscopy guidance proved to be fast and accurate.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 93%

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MR-guided liver biopsy within a short, wide-bore 1.5 Tesla MR system

et al. 2008

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“…All facet joint injections were performed as outpatient procedures without premedication at a C-shaped open 0.2-T MR imaging system (Magnetom Concerto, Siemens Medical Solutions, Erlangen, Germany) equipped with a vertically oriented static magnet field (B 0 ) [13][14][15]. A flexible single loop body coil with a diameter of 45 cm was used.…”

Section: Methodsmentioning

confidence: 99%

Real-time MR fluoroscopy-navigated lumbar facet joint injections: feasibility and technical properties

et al. 2008

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We prospectively evaluated the feasibility and technical properties of a dedicated interventional magnetic resonance (MR) imaging protocol for near-real-time MR fluoroscopy-guided bilateral lumbar facet joint injections. A total of 44 facet joint injections were performed in 22 patients using a C-shaped open 0.2-T MR imaging system (Magnetom Concerto, Siemens Medical Solutions, Erlangen, Germany). A T1/T2-weighted fast-imaging-with-steady-precession (FISP) sequence with an end-to-end latency of 1.2 s facilitated sufficient near real-time MR imaging guidance in all cases. A T1-weighted two dimensional fast-low-angle-shot (FLASH2D) MR sequence identified final needle tip location. Different angles of the needle path had only minimal influence on the appearance of the needle artifact produced by both sequences, resulting in a symmetrical needle tip artifact. The joint cavity was successfully punctured in 79.5% (35/44) of joints, which was followed by intra-articular fluid accumulation in 75% (33/44). Inaccessible joints demonstrated a significantly (p=0.044) higher number of posterior osteophytes (66.7%, 6/9 joints) compared to accessible joints (26%, 9/35 joints). No complications occurred. Table time showed significant shortening over time with average table time of 33 (21-68.5) min. We conclude that MR fluoroscopy-navigated lumbar facet joint injections are feasible and safe.

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“…Different imaging methods, with specific advantages and disadvantages, such as ultrasound (US), Xray fluoroscopy, CT and MRI, have been used to guide the interventions [1][2][3][4][5][6][7][8]. MR imaging has proven to be accurate as a guiding method in performing biopsies for a variety of indications [9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

MR-guided biopsies with a newly designed cordless coil in an open low-field system: Initial findings

et al. 2005

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The purpose of this study was to examine the feasibility and safety of MR-guided biopsies with a newly designed cordless coil in an open low-field magnetic resonance (MR) system. Eleven patients were biopsied using a low-field system (0.2 T, Magnetom Concerto, Siemens) by using the new cordless coil (Siemens). The biopsies were performed in different organ systems [liver (n = 7), abdomen (n = 1), shoulder (n = 1), pelvis (n = 1) and hip (n = 1)]. The procedures were guided using T1-weighted FLASH (fast low-angle shot) sequences. The lesions were biopsied using the coaxial technique through a 15-gauge puncture needle with a 16-gauge biopsy handy. Coil handling, image quality and complications were evaluated. Imaging quality and visualization of the lesions were optimal up to a penetration depth of 9 cm. In all cases the biopsy procedures were successfully performed with MR guidance without any complications. Pathological findings revealed seven cases of malignant tissue and four cases of non-malignant tissue. The use of the cordless coil allows improved patient access during the biopsy and an improved handling of the coil system. MR-guided biopsy using the novel cordless coil system can be performed safely and precisely with easy handling of the coil. This coil concept, however, is restricted to special indications.

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MR-guided biopsies of lesions in the retroperitoneal space: technique and results

Cited by 28 publications

References 31 publications

MR-guided liver biopsy within a short, wide-bore 1.5 Tesla MR system

MR-guided liver biopsy within a short, wide-bore 1.5 Tesla MR system

Real-time MR fluoroscopy-navigated lumbar facet joint injections: feasibility and technical properties

MR-guided biopsies with a newly designed cordless coil in an open low-field system: Initial findings

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