Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy

Abstract

With a high sensitivity of breast lesions, MRI can detect suspicious lesions which are occult in traditional breast examination equipment. However, the lower and variable specificity of MRI makes the MRI-guided intervention, including biopsies and localizations, necessary before surgery, especially for patients who need the treatment of breast-conserving surgery (BCS). MRI techniques and patient preparation should be first carefully considered before the intervention to avoid lengthening the procedure time and compromising targeting accuracy. Doctors and radiologists need to reconfirm the target of the lesion and be very familiar with the process approach and equipment techniques involving the computer-aided diagnosis (CAD) tools and the biopsy system and follow a correct way. The basic steps of MRI-guided biopsy and localization are nearly the same regardless of the vendor or platform, and this article systematically introduces detailed methods and techniques of MRI-guided intervention. The two interventions both face different challenging situations during procedures with solutions given in the article. Post-operative statistics show that the complications of MRI-guided intervention are infrequent and mild, and MRI-guided biopsy provides the pathological information for the subsequent surgical decisions and MRI-guided localization fully prepared for follow-up surgical biopsy. New techniques for MRI-guided intervention are also elaborated in the article, which leads to future development. In a word, MRI-guided intervention is a safe, accurate, and effective technique with a low complication rate and successful MRI-guided intervention is truly teamwork with efforts from patients to surgeons, radiologists, MRI technologists, and nurses.

Application value of MRI-guided wire localization to the non-palpable breast lesions only shown in Breast MRI

“…However, both surgeons and patients hope to have a more accurate MRI assessment of lesions like US and x-ray in clinical practice. Maltez (27,36). Brennan et al (37) found that severe and moderate BPE may lead to a higher cancellation rate of MRI biopsy.…”

MRI-Guided Breast Biopsy-Histopathological Verification of Suspicious Breast Lesions Visible on MRI Only

“…While the sensitivity is high, the specificity is not satisfactory, resulting from the fact that normal breast tissue or benign lesions show enhancement on MRI. Therefore, suspicious lesions found on MRI are subjected to mammography or ultrasound in order to confirm their presence and then imaging guided localization or biopsy procedure is performed [16]. However, using the three-dimensional information about lesion location from MRI requires knowledge and experience in both techniques, including the ability to process the data pertaining to the lesion position from one modality to another.…”

Simulation verification and finite element analysis of Raven-II

“…Forward kinematics [9][10][11][12] derives the spatial position and posture of the end motion point relative to the basic coordinate system from the driving angle or displacement of each joint. By solving forward kinematics, the workspace of the mechanism can be obtained, and whether the designed mechanism meets the design requirements can be detected.…”