The disappearing clip: an unusual complication in MRI biopsy

Bourke, Anita G.; Peter, P; Jose, Chaitra

doi:10.1136/bcr-2014-204092

Cited by 9 publications

(9 citation statements)

References 11 publications

(12 reference statements)

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“…In the third recorded event, a non-serious AE involving a HydroMARK biopsy marker occurred where post-biopsy mammography and sonography at the time of localization demonstrated appropriate placement of the marker; however, it was missing from the resected surgical specimen. Complete disappearance of markers following biopsy has also been documented in the literature [7][8][9]. Shah et al [28] hypothesized that non-visualization of the marker at post-biopsy mammogram might be due to failed deployment or extrusion of the marker out of the breast.…”

Section: Discussionmentioning

confidence: 92%

“…Biopsy markers have proven to be generally safe with very few incidences of adverse events (AE) documented in the literature. Reports of AEs have been mostly centered on marker migration/ displacement, disappearance, and allergic reactions [4,[6][7][8][9][10][11]. Most of the studies done to evaluate adverse effects involved smaller sample sizes and case reports [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Long-term safety and efficacy of breast biopsy markers in clinical practice

Smith

Taylor

Kanevsky³

et al. 2020

Expert Review of Medical Devices

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Objective: Percutaneous breast and axillary core biopsy followed by marker placement are integral parts of a breast imager's practice benefiting both patients and clinicians. Marker placement is the standard to facilitate future care. The purpose of this study is to characterize the safety and performance of MammoMARK, CorMARK, and HydroMARK biopsy markers by evaluating device-related adverse events, device deficiencies, and long-term safety. Methods: A retrospective review of three radiology practices identified patients who underwent imageguided breast or axillary biopsies followed by marker placement between 1 January 2012 and 1 January 2017. Medical records were reviewed with adverse events related to marker placement and use recorded. Results: 768 markers were placed with three (0.4%) events recorded. Two device deficiencies and one non-serious adverse event occurred in three patients. Device deficiency events involved user errors deploying the markers, one to inability to locate the marker on post-biopsy imaging, and the second to misplacement relative to biopsy target. One non-serious adverse event involved inability to locate/ retain the marker in a surgically resected specimen. No serious adverse events were reported. Conclusion: Placement of breast biopsy markers is safe with minimal associated risks. Issues related to device malfunction, durability, reliability, safety, or performance were not reported.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Long-term safety and efficacy of breast biopsy markers in clinical practice

Smith

Taylor

Kanevsky³

et al. 2020

Expert Review of Medical Devices

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“…Efforts have been made to reduce costs with regard to clip marking [25] in a climate of increasingly restrictive reimbursement. As one drawback of marker placement, immediate and delayed migration of marker clips has been reported, though [16, 27]. A couple of attempts have been made to avoid clip migration and to improve the visibility of the tissue marker.…”

Section: Discussionmentioning

confidence: 99%

Subsequent Marking under Ultrasound Guidance of Vacuum-Assisted Breast Biopsy Areas after Receipt of Histology: A Feasibility Study of a New Technique

Park

Chevalier²,

Möbus³

et al. 2020

Breast Care

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The aim of this study was to evaluate the feasibility and the accuracy of a secondary, metachronous ultrasound (US)-guided marking of the stereotactic vacuum-assisted breast biopsy (ST-VABB) area. Materials and Methods: The institutional ethics committee approved the study. The retrospective study included 98 patients. In ST-VABB of 45 women, no tissue markers were deployed at the biopsy site, even if no residual calcifications remained. After histology proved the necessity for a subsequent operation, the biopsy site was marked under US guidance using a coil marker. All interventions were technically successful. No complications occurred. Mammography was done to visualize the coil deployment. The distances from the center of the lesion and the biopsy cavity to the coil location were measured in both planes to evaluate the accuracy of the marking procedure. Results: In 24 of the 46 cases, the whole lesion was biopsied without residual elements. The mean time between ST-VABB and sonographic marking of the lesion was 9.7 days (median 6.5). The biopsy cavity could be detected in 40 (87%) cases and thus marked exactly. The mean time of US-guided marking was 12.5 min. The mean distance between the coil and the target lesion was 0.6 ± 1.5 cm in the craniocaudal (cc) view and 0.5 ± 1.5 cm in the mediolateral (ml) view for all markings. The mean delta value from the distance nippleoriginal lesion and from the distance nipple-coil was 0.85 ± 1.2 cm (median 0.5) in the cc view and 0.88 ± 1.2 cm (median 0.6) in the ml view for all cases. Clip migration was not observed. Conclusion: Our study demonstrates the feasibility and the technical success of secondary metachronous coil marking of the biopsy site under US guidance after receipt of histology. This approach seems to be a cost-effective alternative to the standard procedure of the primary coil marking especially in all completely removed lesions. It may offer advantages for allergic patients.

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“…Third, MRI-based confirmation of marker deployment would permit immediate insertion of a second marker if the first failed to deploy. 4,5 To confirm biopsy marker placement and to distinguish markers from surrounding air, multispectral imaging (MSI) techniques (e.g., SEMAC, MAVRIC), commonly used for metal artifact reduction, [6][7][8][9][10][11][12][13][14][15] can be retooled to selectively excite the magnetic field isocontours of metallic markers. 16 There are well-established methods of computing field maps from MSI, but they are generally performed with large numbers of spectral bins.…”

Section: Introductionmentioning

confidence: 99%

“…Second, it would improve workflow because patients are already in the MRI scanner (a mammogram would take longer). Third, MRI‐based confirmation of marker deployment would permit immediate insertion of a second marker if the first failed to deploy …”

Section: Introductionmentioning

confidence: 99%

Dipole modeling of multispectral signal for detecting metallic biopsy markers during MRI‐guided breast biopsy: a pilot study

Eskreis‐Winkler

Simon

Reichman

et al. 2019

Magnetic Resonance in Med

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Purpose: During MRI-guided breast biopsy, a metallic biopsy marker is deployed at the biopsy site to guide future interventions. Conventional MRI during biopsy cannot distinguish such markers from biopsy site air, and a post-biopsy mammogram is therefore performed to localize marker placement. The purpose of this pilot study is to develop dipole modeling of multispectral signal (DIMMS) as an MRI alternative to eliminate the cost, inefficiency, inconvenience, and ionizing radiation of a mammogram for biopsy marker localization. Methods: DIMMS detects and localizes the biopsy marker by fitting the measured multispectral imaging (MSI) signal to the MRI signal model and marker properties. MSI was performed on phantoms containing titanium biopsy markers and air to illustrate the clinical challenge that DIMMS addresses and on 20 patients undergoing MRI-guided breast biopsy to assess DIMMS feasibility for marker detection. DIMMS was compared to conventional MSI field map thresholding, using the postprocedure mammogram as the reference standard. Results: Biopsy markers were detected and localized in 20 of 20 cases using MSI with automated DIMMS post-processing (using a threshold of 0.7) and in 18 of 20 cases using MSI field mapping (using a threshold of 0.65 kHz). Conclusion: MSI with DIMMS post-processing is a feasible technique for biopsy marker detection and localization during MRI-guided breast biopsy. With a 2-min MSI scan, DIMMS is a promising MRI alternative to the standard-of-care postbiopsy mammogram.

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The disappearing clip: an unusual complication in MRI biopsy

Cited by 9 publications

References 11 publications

Long-term safety and efficacy of breast biopsy markers in clinical practice

Long-term safety and efficacy of breast biopsy markers in clinical practice

Subsequent Marking under Ultrasound Guidance of Vacuum-Assisted Breast Biopsy Areas after Receipt of Histology: A Feasibility Study of a New Technique

Dipole modeling of multispectral signal for detecting metallic biopsy markers during MRI‐guided breast biopsy: a pilot study

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