MR IMAGING-GUIDED BIOPSY AND LOCALIZATION OF THE BREAST

If suspicious lesions found with MR imaging cannot be visualized by ei ther mammography or ultrasound, MR imaging - based guidance systems ar e needed to guide needle biopsy or to allow localization of the lesion before surgery. The authors give an overview of the advantages and di sadvantages of biopsy devices presented by different working groups. F urthermore, MR-compatible needle equipment for interventions of the br east is demonstrated. The angulation of the needle and the type of seq uence are the most important factors for signal loss due to susceptibi lity. The strategy in special problem cases (multicentricity, bilatera l lesions) is discussed. Control MR imaging within the first week afte r open biopsy is the best way to document the complete excision of a s uspicious hypervascularized lesion after MR-guided wire localization. At our institute, percutaneous biopsy(36 interventions) revealed benig n findings in 67 % and malignant lesions in 25 % of cases. Three biops ies were insufficient. Histology after MR-guided wire localization (13 6 interventions) showed benign findings in 51 % and malignancy in 49 % of cases. The suspicious lesion was missed by the surgeion in three c ases. We perform MR-guided interventions of the breast routinely in in dicated cases.