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MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility

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Abstract

Objective

To evaluate the diagnostic accuracy and safety of magnetic resonance imaging (MRI)-guided percutaneous biopsy of mediastinal masses performed using a wide-bore high-field scanner.

Materials and Methods

This is a retrospective study of 16 consecutive patients (8 male, 8 female; mean age 74 years) who underwent MRI-guided core needle biopsy of a mediastinal mass between February 2010 and January 2014. Size and location of lesion, approach taken, time for needle placement, overall duration of procedure, and post-procedural complications were evaluated. Technical success rates and correlation with surgical pathology (where available) were assessed.

Results

Target lesions were located in the anterior (n = 13), middle (n = 2), and posterior mediastinum (n = 1), respectively. Mean size was 7.2 cm (range 3.6–11 cm). Average time for needle placement was 9.4 min (range 3–18 min); average duration of entire procedure was 42 min (range 27–62 min). 2–5 core samples were obtained from each lesion (mean 2.6). Technical success rate was 100 %, with specimens successfully obtained in all 16 patients. There were no immediate complications. Histopathology revealed malignancy in 12 cases (4 of which were surgically confirmed), benign lesions in 3 cases (1 of which was false negative following surgical resection), and one inconclusive specimen (treated as inaccurate since repeat CT-guided biopsy demonstrated thymic hyperplasia). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in our study were 92.3, 100, 100, 66.7, and 87.5 %, respectively.

Conclusion

MRI-guided mediastinal biopsy is a safe procedure with high diagnostic accuracy, which may offer a non-ionizing alternative to CT guidance.

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Abbreviations

MRI:

Magnetic resonance imaging

CT:

Computed tomography

PET:

Positron emission tomography

TP:

True positive

TN:

True negative

FP:

False positive

FN:

False negative

NPV:

Negative predictive value

PPV:

Positive predictive value

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Authors and Affiliations

  1. Department of Interventional Radiology, Nouvel Hôpital Civil, Strasbourg, France

    J. Garnon, J. Caudrelier J, G. Tsoumakidou, P. Rao & A. Gangi

  2. Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK

    N. Ramamurthy

  3. ICube, University of Strasbourg, CNRS, Strasbourg, France

    G. Erceg, E. Breton, P. Rao & A. Gangi

Authors
  1. J. Garnon
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  2. N. Ramamurthy
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  3. J. Caudrelier J
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  4. G. Erceg
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  5. E. Breton
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  6. G. Tsoumakidou
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  7. P. Rao
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  8. A. Gangi
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Corresponding author

Correspondence to J. Garnon.

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Conflict of Interest

J.G, N.R, J.C, G.E, E.B, G.T, P.R, A.G declare no conflict of interest or relevant disclosures.

Ethical Approval

All procedures were performed in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Garnon, J., Ramamurthy, N., Caudrelier J, J. et al. MRI-Guided Percutaneous Biopsy of Mediastinal Masses Using a Large Bore Magnet: Technical Feasibility. Cardiovasc Intervent Radiol 39, 761–767 (2016). https://doi.org/10.1007/s00270-015-1246-5

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  • DOI: https://doi.org/10.1007/s00270-015-1246-5

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