Percutaneous MR-guided biopsy of suspicious breast MR finding using vacuum-assisted devices
Biopsy itself typically performed outside magnet (unless open bore)
MR used to identify lesion and confirm plastic cannula tip at edge of lesion
May be performed either with grid or free-hand
Obturator: MR-compatible plastic stylet, often impregnated with Gd, used to confirm proper placement of coaxial cannula at target
Trocar: Metallic stylet to aid insertion of plastic cannula
Fiducial: T1-hyperintense marker on skin surface (vitamin E or fish oil capsule, Gd-impregnated marker)
Grid: Fenestrated compression paddle
Template: Paper, clear sheet of film, or software to record location of lesion with respect to fiducial
Facilitates translation of images as viewed on scanner to prone position of patient
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
OUTCOMES
Problems
Complications
Selected References
Pinnamaneni N et al: Canceled MRI-guided Breast Biopsies Due to Nonvisualization: Follow-up and Outcomes. Acad Radiol. ePub, 2018
Huang ML et al: Imaging-concordant benign MRI-guided vacuum-assisted breast biopsy may not warrant MRI follow-up. AJR Am J Roentgenol. 208(4):916-922, 2017
Maglione KD et al: Radiologic-pathologic correlation for benign results after MRI-guided breast biopsy. AJR Am J Roentgenol. 209(2):442-453, 2017
Verheyden C et al: Underestimation rate at MR imaging-guided vacuum-assisted breast biopsy: A multi-institutional retrospective study of 1509 breast biopsies. Radiology. 281(3):708-719, 2016
Spick C et al: Diagnostic utility of second-look US for breast lesions identified at MR imaging: systematic review and meta-analysis. Radiology. 273(2):401-9, 2014
Brennan SB et al: Papilloma diagnosed at MRI-guided vacuum-assisted breast biopsy: is surgical excision still warranted? AJR Am J Roentgenol. 199(4):W512-9, 2012
Meeuwis C et al: MR-guided breast biopsy at 3T: diagnostic yield of large core needle biopsy compared with vacuum-assisted biopsy. Eur Radiol. 22(2):341-9, 2012
Brennan SB et al: Cancellation of MR imaging-guided breast biopsy due to lesion nonvisualization: frequency and follow-up. Radiology. 261(1):92-9, 2011
Crystal P et al: High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted? Eur Radiol. 21(3):582-9, 2011
Meeuwis C et al: MRI-guided breast biopsy at 3T using a dedicated large core biopsy set: feasibility and initial results. Eur J Radiol. 79(2):257-61, 2011
Li J et al: MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy. AJR Am J Roentgenol. 193(3):850-5, 2009
Meissnitzer M et al: Targeted ultrasound of the breast in women with abnormal MRI findings for whom biopsy has been recommended. AJR Am J Roentgenol. 193(4):1025-9, 2009
Peters NH et al: Feasibility of MRI-guided large-core-needle biopsy of suspiscious breast lesions at 3 T. Eur Radiol. 19(7):1639-44, 2009
Han BK et al: Outcome of MRI-guided breast biopsy. AJR Am J Roentgenol. 191(6):1798-804, 2008
Lee JM et al: Complete excision of the MRI target lesion at MRI-guided vacuum-assisted biopsy of breast cancer. AJR Am J Roentgenol. 191(4):1198-202, 2008
Lee JM et al: Imaging histologic discordance at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 189(4):852-9, 2007
Lee JM et al: Underestimation of DCIS at MRI-guided vacuum-assisted breast biopsy. AJR Am J Roentgenol. 189(2):468-74, 2007
Liberman L et al: Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 188(3):684-90, 2007
Meeuwis C et al: Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet. Eur J Radiol. 62(2):283-8, 2007
Ghate SV et al: MRI-guided vacuum-assisted breast biopsy with a handheld portable biopsy system. AJR Am J Roentgenol. 186(6):1733-6, 2006
Liberman L et al: Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 186(2):426-30, 2006
Orel SG et al: MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology. 238(1):54-61, 2006
Perlet C et al: Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions. Cancer. 106(5):982-90, 2006
Beran L et al: Correlation of targeted ultrasound with magnetic resonance imaging abnormalities of the breast. Am J Surg. 190(4):592-4, 2005
Lehman CD et al: Clinical experience with MRI-guided vacuum-assisted breast biopsy. AJR Am J Roentgenol. 184(6):1782-7, 2005
Liberman L et al: MRI-guided 9-gauge vacuum-assisted breast biopsy: initial clinical experience. AJR Am J Roentgenol. 185(1):183-93, 2005
Morris EA et al: Breast MRI: Diagnosis and Intervention. 1st ed. New York: Springer. 297-315, 2005
Sim LS et al: US correlation for MRI-detected breast lesions in women with familial risk of breast cancer. Clin Radiol. 60(7):801-6, 2005
Hefler L et al: Follow-up of breast lesions detected by MRI not biopsied due to absent enhancement of contrast medium. Eur Radiol. 13(2):344-6, 2003
LaTrenta LR et al: Breast lesions detected with MR imaging: utility and histopathologic importance of identification with US. Radiology. 227(3):856-61, 2003
Related Anatomy
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References
Tables
Tables
KEY FACTS
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Definitions
Percutaneous MR-guided biopsy of suspicious breast MR finding using vacuum-assisted devices
Biopsy itself typically performed outside magnet (unless open bore)
MR used to identify lesion and confirm plastic cannula tip at edge of lesion
May be performed either with grid or free-hand
Obturator: MR-compatible plastic stylet, often impregnated with Gd, used to confirm proper placement of coaxial cannula at target
Trocar: Metallic stylet to aid insertion of plastic cannula
Fiducial: T1-hyperintense marker on skin surface (vitamin E or fish oil capsule, Gd-impregnated marker)
Grid: Fenestrated compression paddle
Template: Paper, clear sheet of film, or software to record location of lesion with respect to fiducial
Facilitates translation of images as viewed on scanner to prone position of patient
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
OUTCOMES
Problems
Complications
Selected References
Pinnamaneni N et al: Canceled MRI-guided Breast Biopsies Due to Nonvisualization: Follow-up and Outcomes. Acad Radiol. ePub, 2018
Huang ML et al: Imaging-concordant benign MRI-guided vacuum-assisted breast biopsy may not warrant MRI follow-up. AJR Am J Roentgenol. 208(4):916-922, 2017
Maglione KD et al: Radiologic-pathologic correlation for benign results after MRI-guided breast biopsy. AJR Am J Roentgenol. 209(2):442-453, 2017
Verheyden C et al: Underestimation rate at MR imaging-guided vacuum-assisted breast biopsy: A multi-institutional retrospective study of 1509 breast biopsies. Radiology. 281(3):708-719, 2016
Spick C et al: Diagnostic utility of second-look US for breast lesions identified at MR imaging: systematic review and meta-analysis. Radiology. 273(2):401-9, 2014
Brennan SB et al: Papilloma diagnosed at MRI-guided vacuum-assisted breast biopsy: is surgical excision still warranted? AJR Am J Roentgenol. 199(4):W512-9, 2012
Meeuwis C et al: MR-guided breast biopsy at 3T: diagnostic yield of large core needle biopsy compared with vacuum-assisted biopsy. Eur Radiol. 22(2):341-9, 2012
Brennan SB et al: Cancellation of MR imaging-guided breast biopsy due to lesion nonvisualization: frequency and follow-up. Radiology. 261(1):92-9, 2011
Crystal P et al: High-risk lesions diagnosed at MRI-guided vacuum-assisted breast biopsy: can underestimation be predicted? Eur Radiol. 21(3):582-9, 2011
Meeuwis C et al: MRI-guided breast biopsy at 3T using a dedicated large core biopsy set: feasibility and initial results. Eur J Radiol. 79(2):257-61, 2011
Li J et al: MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy. AJR Am J Roentgenol. 193(3):850-5, 2009
Meissnitzer M et al: Targeted ultrasound of the breast in women with abnormal MRI findings for whom biopsy has been recommended. AJR Am J Roentgenol. 193(4):1025-9, 2009
Peters NH et al: Feasibility of MRI-guided large-core-needle biopsy of suspiscious breast lesions at 3 T. Eur Radiol. 19(7):1639-44, 2009
Han BK et al: Outcome of MRI-guided breast biopsy. AJR Am J Roentgenol. 191(6):1798-804, 2008
Lee JM et al: Complete excision of the MRI target lesion at MRI-guided vacuum-assisted biopsy of breast cancer. AJR Am J Roentgenol. 191(4):1198-202, 2008
Lee JM et al: Imaging histologic discordance at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 189(4):852-9, 2007
Lee JM et al: Underestimation of DCIS at MRI-guided vacuum-assisted breast biopsy. AJR Am J Roentgenol. 189(2):468-74, 2007
Liberman L et al: Underestimation of atypical ductal hyperplasia at MRI-guided 9-gauge vacuum-assisted breast biopsy. AJR Am J Roentgenol. 188(3):684-90, 2007
Meeuwis C et al: Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet. Eur J Radiol. 62(2):283-8, 2007
Ghate SV et al: MRI-guided vacuum-assisted breast biopsy with a handheld portable biopsy system. AJR Am J Roentgenol. 186(6):1733-6, 2006
Liberman L et al: Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 186(2):426-30, 2006
Orel SG et al: MR imaging-guided 9-gauge vacuum-assisted core-needle breast biopsy: initial experience. Radiology. 238(1):54-61, 2006
Perlet C et al: Magnetic resonance-guided, vacuum-assisted breast biopsy: results from a European multicenter study of 538 lesions. Cancer. 106(5):982-90, 2006
Beran L et al: Correlation of targeted ultrasound with magnetic resonance imaging abnormalities of the breast. Am J Surg. 190(4):592-4, 2005
Lehman CD et al: Clinical experience with MRI-guided vacuum-assisted breast biopsy. AJR Am J Roentgenol. 184(6):1782-7, 2005
Liberman L et al: MRI-guided 9-gauge vacuum-assisted breast biopsy: initial clinical experience. AJR Am J Roentgenol. 185(1):183-93, 2005
Morris EA et al: Breast MRI: Diagnosis and Intervention. 1st ed. New York: Springer. 297-315, 2005
Sim LS et al: US correlation for MRI-detected breast lesions in women with familial risk of breast cancer. Clin Radiol. 60(7):801-6, 2005
Hefler L et al: Follow-up of breast lesions detected by MRI not biopsied due to absent enhancement of contrast medium. Eur Radiol. 13(2):344-6, 2003
LaTrenta LR et al: Breast lesions detected with MR imaging: utility and histopathologic importance of identification with US. Radiology. 227(3):856-61, 2003
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