This is a report of our experience with percutaneous, MRI-guided biopsies i
n 25 patients with skeletal lesions ruing a 1.5-T MR hybrid system. Twenty-
five consecutive patients with skeletal lesions were referred for MRI-guide
d biopsy, Biopsies were performed with a 1.5-T Philips Gyroscan (Philips Me
dical Systems, Best, The Netherlands) combined with a c-arm fluoroscopy. Sp
ecimens were obtained percutaneously either with a le or 18-gauge "side-sli
t" type of biopsy needle (n = 10 skeletal lesions that had penetrated throu
gh the cortex), or using a prototype coaxial drill system powered either by
hand or an optional motor (n = 15 skeletal lesions still covered with cort
ical bone). All but two biopsies could be completed within the MR unit, For
one patient, who required a transpedicular approach to a lumbar vertebra,
and for one child, who required general anesthesia, we decided to switch to
CT guidance. In 19 of the 25 cases (17 of the 23 cases performed in MR), t
he sample was sufficient and the histopathologic diagnosis was confirmed. T
hree patients had an inadequate sample, and three others had adequate sampl
es but inaccurate results. No procedural complications occurred. Percutaneo
us biopsy of skeletal lesions performed under MRI-guidance was found to be
safe and reasonably accurate. There were no procedural complications in our
small series, MRI may be used as an alternative to CT, but its role vis-a-
vis CT has yet to be ascertained.