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MRI-guided needle localization of suspicious breast lesions: results of a freehand technique

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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.

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Authors and Affiliations

  1. Department of Radiology, Stanford University Medical Center, Stanford, 94305-5105, USA

    M. A. A. J. van den Bosch, B. L. Daniel, S. Pal, R. L. Birdwell & D. M. Ikeda

  2. Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3584, CX Utrecht, The Netherlands

    M. A. A. J. van den Bosch

  3. Department of Pathology, Stanford University Medical Center, Stanford, CA, 94305-5105, USA

    K. W. Nowels

  4. Department of Surgery, Stanford University Medical Center, Stanford, CA, 94305-5105, USA

    S. S. Jeffrey

  5. Department of Radiology, Stanford Center for Advanced Medicine, 873 Blake Wilbur Drive, Room 2234, Stanford, CA, 94305-5105, USA

    D. M. Ikeda

Authors
  1. M. A. A. J. van den Bosch
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  2. B. L. Daniel
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  3. S. Pal
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  4. K. W. Nowels
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  5. R. L. Birdwell
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  6. S. S. Jeffrey
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  7. D. M. Ikeda
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Correspondence to D. M. Ikeda.

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van den Bosch, M.A.A.J., Daniel, B.L., Pal, S. et al. MRI-guided needle localization of suspicious breast lesions: results of a freehand technique. Eur Radiol 16, 1811–1817 (2006). https://doi.org/10.1007/s00330-006-0214-5

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  • DOI: https://doi.org/10.1007/s00330-006-0214-5

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