MRI-Guided 9-Gauge Vacuum-Assisted Breast Biopsy: Initial Clinical Experience

Liberman, Laura; Bracero, Nanette; Morris, Elizabeth A.; Thornton, Cynthia; Dershaw, D. David

doi:10.2214/ajr.185.1.01850183

Cited by 195 publications

(120 citation statements)

References 32 publications

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“…The ATEC system contains a vacuum-assisted biopsy probe, a plastic coaxial introducer sheath, a sharp nonferrous trocar, and a plastic obturator. The VACNB biopsy method is similar to those previously reported in closed magnets (5,6) with a few important differences. First, because the open magnet allows the physician direct access to the patient, the entire procedure including targeting, needle adjustment, and VACNB is done at one setting without sliding the patient in and out of the magnet bore.…”

Section: Vacnbmentioning

confidence: 52%

“…Magnetic resonance imaging (MRI)-guided vacuumassisted core needle biopsy (VACNB) samples suspicious lesions detectable only by MRI, or most clearly seen on MRI, and has similarly evolved to include marker placement. Some facilities use this marker for preoperative needle localization under x-ray guidance to localize the MRI site for subsequent excisional biopsy (5)(6)(7).…”

mentioning

confidence: 99%

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Freehand MRI‐guided preoperative needle localization of breast lesions after MRI‐guided vacuum‐assisted core needle biopsy without marker placement

Ven

Lin

Daniel

et al. 2010

Magnetic Resonance Imaging

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Purpose: To evaluate the feasibility of magnetic resonance imaging (MRI)-guided preoperative needle localization (PNL) of breast lesions previously sampled by MRI-guided vacuum-assisted core needle biopsy (VACNB) without marker placement. Materials and Methods:We reviewed 15 women with 16 breast lesions undergoing MRI-guided VACNB without marker placement who subsequently underwent MRIguided PNL, both on an open 0.5T magnet using freehand techniques. Mammograms and specimen radiographs were rated for lesion visibility; MRI images were rated for lesion visibility and hematoma formation. Imaging findings were correlated with pathology.Results: The average prebiopsy lesion size was 16 mm (range 4-50 mm) with 13/16 lesions located in mammographically dense breasts. Eight hematomas formed during VACNB (average size 13 mm, range 8-19 mm). PNL was performed for VACNB pathologies of cancer (5), highrisk lesions (5), or benign but discordant findings (6) at 2-78 days following VACNB. PNL targeted the lesion (2), hematoma (4), or surrounding breast architecture (10). Wire placement was successful in all 16 lesions. Final pathology showed six cancers, five high-risk lesions, and five benign findings.Conclusion: MRI-guided PNL is successful in removing lesions that have previously undergone VACNB without marker placement by targeting the residual lesion, hematoma, or surrounding breast architecture, even in mammographically dense breasts.

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Section: Vacnbmentioning

confidence: 52%

mentioning

confidence: 99%

Freehand MRI‐guided preoperative needle localization of breast lesions after MRI‐guided vacuum‐assisted core needle biopsy without marker placement

Ven

Lin

Daniel

et al. 2010

Magnetic Resonance Imaging

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“…After biopsy, the breast was compressed; sterile strips and a sterile gauze bandage were applied. When a clip was placed, a two-view digital mammogram was obtained to document clip placement (6)(7)(8)(9).…”

Section: Biopsy Radiologists and Techniquementioning

confidence: 99%

“…Moreover, MRI of the breast is superior not only for diagnosis of invasive carcinoma but also for detection of ductal carcinoma in situ (DCIS) and even premalignant breast lesions [4,5]. MRI-guided vacuumassisted breast biopsy (MRgVABB) is a safe and accurate technique for evaluation of otherwise occult MRI-detected breast lesions [6][7][8][9][10][11][12]. However, a considerable proportion of lesions diagnosed on percutaneous breast biopsies are classified as high-risk lesions [13].…”

Section: Introductionmentioning

confidence: 99%

High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

et al. 2010

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Objectives To evaluate the frequency of diagnosis of highrisk lesions at MRI-guided vacuum-assisted breast biopsy (MRgVABB) and to determine whether underestimation may be predicted. Methods Retrospective review of the medical records of 161 patients who underwent MRgVABB was performed. The underestimation rate was defined as an upgrade of a high-risk lesion at MRgVABB to malignancy at surgery. Clinical data, MRI features of the biopsied lesions, and histological diagnosis of cases with and those without underestimation were compared. Results Of 161 MRgVABB, histology revealed 31 (19%) high-risk lesions. Of 26 excised high-risk lesions, 13 (50%) were upgraded to malignancy. The underestimation rates of lobular neoplasia, atypical apocrine metaplasia, atypical ductal hyperplasia, and flat epithelial atypia were 50%

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“…The complication rate is up to 7 % in vacuum-assisted biopsy and up to 5 % in MR-guided wire marking with hematomas not requiring treatment, bleeding from the puncture channel, and pain at the puncture site being the most common complications [29,30].…”

Section: Mr-guided Breast Interventionsmentioning

confidence: 99%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function.Method The current status of interventional MRI for the clinical routine was analyzed.Results The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion IntroductionMRI has an intrinsically high soft-tissue contrast and can be used to measure physiological parameters, such as blood flow (flow rate and flow volume), diffusion, temperature, and movement. Since its introduction into the clinical routine in the 1980 s, it has also been used for guiding and monitoring interventions. However, in contrast to CT and ultrasound, the use of MRI for guiding interventions requires significant technical effort. Due to the disruptive effect of the strong main magnetic field and the alternating electromagnetic fields, the monitoring of patients during an intervention by measuring ECG signals, oxygen saturation, or blood pressure requires special equipment. These monitoring systems must not interfere with the MRI scan and must be MR-safe (according to DIN EN 62 570:2010 -05). The list of requirements regarding monitoring equipment provides an indication of the development effort, with suitable monitoring equipment representing only one of the components necessary for MR-guided interventions.In addition to MRI safety, all catheters and instruments must be adapted to this modality. To ensure MRI safety, metal must be largely avoided since, depending on the length and orientation to the main magnetic field, it can heat up and consequently even result in burns. Achieving rigidity and torsion stability of catheters or guide wires without the use of metal for reinforcement represents a technical challenge. In the case of needles, breaking resistance is one of the more difficult properties to achieve for MR-safe designs. Moreover, instruments must be able to be effectively visualized without adjacent structures being superimposed by artifacts. The tip must be able to be identified and definitively differentiated from the shaft since MRI as a cross-sectional imaging method typically uses individual slices even for guiding interventions and does not use projections as in fluoroscopy...

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MRI-Guided 9-Gauge Vacuum-Assisted Breast Biopsy: Initial Clinical Experience

Abstract: MRI-guided vacuum-assisted biopsy is a fast and safe alternative to surgical biopsy for MRI-detected breast lesions. Imaging-histologic correlation is necessary to ensure lesion sampling.

Cited by 195 publications

References 32 publications

Freehand MRI‐guided preoperative needle localization of breast lesions after MRI‐guided vacuum‐assisted core needle biopsy without marker placement

Freehand MRI‐guided preoperative needle localization of breast lesions after MRI‐guided vacuum‐assisted core needle biopsy without marker placement

High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted?

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

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