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MRI-guided needle localization of suspicious breast lesions: results of a freehand technique
Authors:M. A. A. J. van den Bosch  B. L. Daniel  S. Pal  K. W. Nowels  R. L. Birdwell  S. S. Jeffrey  D. M. Ikeda
Affiliation:(1) Department of Radiology, Stanford University Medical Center, Stanford, 94305-5105, USA;(2) Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584 CX Utrecht, The Netherlands;(3) Department of Pathology, Stanford University Medical Center, Stanford, CA 94305-5105, USA;(4) Department of Surgery, Stanford University Medical Center, Stanford, CA 94305-5105, USA;(5) Department of Radiology, Stanford Center for Advanced Medicine, 873 Blake Wilbur Drive, Room 2234, Stanford, CA 94305-5105, USA
Abstract:Magnetic resonance imaging (MRI) can detect clinically and mammographically occult breast lesions. In this study we report the results of MRI-guided needle localization of suspicious breast lesions by using a freehand technique. Preoperative MRI-guided single-needle localization was performed in 220 patients with 304 MRI-only breast lesions at our hospital between January 1997 and July 2004. Procedures were performed in an open 0.5-T Signa-SP imager allowing real-time monitoring, with patient in prone position, by using a dedicated breast coil. MRI-compatible hookwires were placed in a noncompressed breast by using a freehand technique. MRI findings were correlated with pathology and follow-up. MRI-guided needle localization was performed for a single lesion in 150 patients, for two lesions in 56 patients, and for three lesions in 14 patients. Histopathologic analysis of these 304 lesions showed 104 (34%) malignant lesions, 51 (17%) high-risk lesions, and 149 (49%) benign lesions. The overall lesion size ranged from 2.0–65.0 mm (mean 11.2 mm). No direct complications occurred. Follow-up MRI in 54 patients showed that two (3.7%) lesions were missed by surgical biopsy. MRI-guided freehand needle localization is accurate and allows localization of lesions anterior in the breast, the axillary region, and near the chest wall.
Keywords:Magnetic resonance imaging (MRI)  Breast  Needle localization  Freehand technique
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