Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast

Abstract

The purpose of this multicenter study was to determine the accuracy and clinical value of a dedicated breast biopsy system which allows for MR-guided vacuum biopsy (VB) of contrast-enhancing lesions. In five European centers, MR-guided 11-gauge VB was performed on 341 lesions. In 7 cases VB was unsuccessful. This was immediately realized on postinterventional images or direct follow-up combined with histopathology-imaging correlation; thus, a false-negative diagnosis was avoided. Histology of 334 successful biopsies yielded 84 (25%) malignancies, 17 (5%) atypical ductal hyperplasias, and 233 (70%) benign entities. Verification of malignant or borderline lesions included reexcision of the biopsy cavity. Benign histologic biopsy results were verified by retrospective correlation with the pre- and postinterventional MRI and by subsequent follow-up. Our results indicate that MR-guided VB, in combination with the dedicated biopsy coil, offers the possibility to accurately diagnose even very small lesions that can only be visualized or localized by MRI.

Initial clinical experience with a new MRI vacuum‐assisted breast biopsy device

“…The number of underestimates identified at follow-up surgery or imaging was not reported (Table 5). Perlet et al (21,22) reported interim results of a prospective, multicenter study of MR-guided breast biopsy in 2002, and published the final results in 2006. As with the study reported by Viehweg et al, an adaptation of the original stereotactic Mammotome was used to perform the MRI-guided biopsies.…”

Minimal-invasive Biopsie und präoperative Markierung suspekter Mammaläsionen

“…Nur in der Magnetresonanztomographie sichtbare Lä-sionen müssen auch unter magnetresonanztomographischer Kontrolle minimal-invasiv biopsiert werden [3,18,19]. Da bei der magnetresonanztomographisch gesteuerten Intervention, wie bei der mammographischen Stereotaxie, keine direkte Kontrolle des Biopsievorganges mög-lich ist, ist auch in diesen Fällen die Anwendung der vakuumunterstützten Verfahren zu empfehlen (Abb.…”

“…Da bei der magnetresonanztomographisch gesteuerten Intervention, wie bei der mammographischen Stereotaxie, keine direkte Kontrolle des Biopsievorganges mög-lich ist, ist auch in diesen Fällen die Anwendung der vakuumunterstützten Verfahren zu empfehlen (Abb. 4) [3,18,19].…”

“…Als bedingte Kontraindikationen werden in der Bildgebung sichtbare Architekturstörungen und hautnahe Befunde angesehen [3]. [18,19]. Die Anforderungen der Methode an die Erfahrung der interventionellen Diagnostiker und die apparative Ausstattung sind sehr hoch, so dass diese Methode Zentren mit besonders intensiver Erfahrung mit dieser Technik vorenthalten sein sollte [3].…”

Breast Magnetic Resonance Imaging-Guided Biopsy

“…A computer-assisted diagnostic system that improves accuracy and speed of the procedure is also commercially available. About 8-13% of MRIguided biopsy target lesions are not visible at the time of biopsy (21)(22)(23). If the target is not visible on the first postcontrast image, it is sometimes identified on a delayed image.…”