Abstract
The purpose of this study was to evaluate the safety and precision of MRI-guided biopsies of retroperitoneal space-occupying tumors in an open low-field system. In 30 patients with indistinct retroperitoneal tumors [paraaortic lesion (n=20), kidney (n=2), suprarenal gland (n=3) and pancreas (n=5)] MR-guided biopsies were performed using a low-field system (0.2 T, Magnetom Concerto, Siemens, Germany). For the monitoring of the biopsies T1-weighted FLASH sequences (TR/TE=160/5 ms; 90°) were used in all patients and modified FLASH sequences (TR/TE=160/13 ms; 90°) in ten patients. After positioning of the needle in the tumors 114 biopsy specimens were acquired in coaxial technique with 16-gauge cutting needles (Somatex, Germany). The biopsies were successfully performed in all patients without vascular or organ injuries. The visualization of the aortic blood flow with MRI facilitated the biopsy procedures of paraaortic lesions. The size of the lesions ranged from 1.6 to 7.5 cm. The median distance of the biopsy access path was 10.4 cm. Adequate specimens were obtained in 28 cases (93.3%) resulting in a correct histological classification of 27 lesions (90%). In conclusion, MR-guided biopsies of retroperitoneal lesions using an open low-field system can be performed safely and accurately and is an alternative to CT-guided biopsies.
Similar content being viewed by others
References
Bellin MF, Roy C, Kinkel K et al (1998) Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles-initial clinical experience. Radiology 207:799–808
Hopper K (1995) Percutaneous, radiographically guided biopsy: a history. Radiology 196:329–333
Sheafor DH, Paulson EK, Simmons CM, DeLong DM, Nelson RC (1998) Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology 207:705–710
Schulz T, Puccini S, Schneider J, Kahn T (2004) Interventional and intraoperative MR: review and update of techniques and clinical experience. Eur Radiol 14:2212–2227
Zangos S, Kiefl D, Eichler K, Engelmann K, Heller M, Herzog C, Mack MG, Jacobi V, Vogl TJ (2003) MR-guided biopsies of undetermined liver lesions: technique and results. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 175:688–694
Sofocleous C, Schubert J, Brown K, Brody L, Covey A, Getrajdman G (2004) CT-guided transvenous or transcaval needle biopsy of pancreatic and peripancreatic lesions. J Vasc Interv Radiol 15:1099–1104
Wutke R, Schmid A, Fellner F, Horbach T, Kastl S, Papadopoulos T, Hohenberger W, Bautz W (2001) CT-guided percutaneous core biopsy: effective accuracy, diagnostic utility and effective costs. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:1025–1033
Harisinghani MG, Saini S, Weissleder R, Hahn PF, Yantiss RK, Tempany C, Wood BJ, Mueller PR (1999) MR lymphangiography using ultrasmall superparamagnetic iron oxide in patients with primary abdominal and pelvic malignancies: radiographic-pathologic correlation. AJR Am J Roentgenol 172:1347–1351
Matalon TA, Silver B (1990) US guidance of interventional procedures. Radiology 174:43–47
Charboneau JW, Reading CC, Welch TJ (1990) CT and sonographically guided needle biopsy: current techniques and new innovations. AJR Am J Roentgenol 154:1–10
Dupuy DE, Rosenberg AE, Punyaratabandhu T, Tan MH, Mankin HJ (1998) Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. AJR Am J Roentgenol 171:759–762
Zangos S, Eichler K, Engelmann K et al (2004) MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results. Eur Radiol 15:174–182
Adam G, Bucker A, Nolte-Ernsting C, Tacke J, Gunther RW (1999) Interventional MR imaging: percutaneous abdominal and skeletal biopsies and drainages of the abdomen. Eur Radiol 9:1471–1478
Carlson SK, Bender CE, Classic KL, Zink FE, Quam JP, Ward EM, Oberg AL (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520
Arellano R, Boland G, Mueller P (2000) Adrenal biopsy in a patient with lung cancer: imaging algorithm and biopsy indications, technique, and complications. AJR Am J Roentgenol 175:1613–1617
Daly B, Krebs TL, Wong-You-Cheong JJ, Wang SS (1999) Percutaneous abdominal and pelvic interventional procedures using CT fluoroscopy guidance. AJR Am J Roentgenol 173:637–644
Froelich JJ, Ishaque N, Saar B, Regn J, Walthers EM, Mauermann F, Klose KJ (1999) Control of percutaneous biopsy with CT fluoroscopy. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 170:191–197
Silverman SG, Tuncali K, Adams DF, Nawfel RD, Zou KH, Judy PF (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212:673–681
Nawfel R, Judy P, Silverman S, Hooton S, Tuncali K, Adams D (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216:180–184
Lufkin RB, Gronemeyer DH, Seibel RM (1997) Interventional MRI: update. Eur Radiol 7:187–200
Konig CW, Pereira PL, Trubenbach J, Fritz J, Duda SH, Schick F, Claussen CD (2003) MR imaging-guided adrenal biopsy using an open low-field-strength scanner and MR fluoroscopy. AJR Am J Roentgenol 180:1567–1570
Schweiger GD, Yip VY, Brown BP (2000) CT fluoroscopic guidance for percutaneous needle placement into abdominopelvic lesions with difficult access routes. Abdom Imaging 25:633–637
Frahm C, Gehl HB, Melchert UH, Weiss HD (1996) Visualization of magnetic resonance-compatible needles at 1.5 and 0.2 Tesla. Cardiovasc Intervent Radiol 19:335–340
Ladd ME, Erhart P, Debatin JF, Romanowski BJ, Boesiger P, McKinnon GC (1996) Biopsy needle susceptibility artifacts. Magn Reson Med 36:646–651
Lewin JS, Duerk JL, Jain VR, Petersilge CA, Chao CP, Haaga JR (1996) Needle localization in MR-guided biopsy and aspiration: effects of field strength, sequence design, and magnetic field orientation. AJR Am J Roentgenol 166:1337–1345
Alanen J, Keski-Nisula L, Blanco-Sequeiros R, Tervonen O (2004) Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies. Eur Radiol 14:123–128
Langen HJ, Kugel H, Ortmann M, Noack M, de Rochemont RM, Landwehr P (2001) Functional capacity of MRI-compatible biopsy needles in comparison with ferromagnetic biopsy needles. In vitro studies. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:658–662
Sklair-Levy M, Lebensart P, Applbaum Y et al (2001) Percutaneous image-guided needle biopsy in children-summary of our experience with 57 children. Pediatr Radiol 31:732–736
Hussain H, Kingston J, Domizio P, Norton A, Reznek R (2001) Imaging-guided core biopsy for the diagnosis of malignant tumors in pediatric patients. AJR Am J Roentgenol 176:43–47
Hoffer F (2005) Interventional radiology in pediatric oncology. Eur J Radiol 53:3–13
Hohenberger W, Kastl S (2000) Neoadjuvant and adjuvant therapy of ductal pancreatic carcinoma. Zentralbl Chir 125:348–355
Demharter J, Muller P, Wagner T, Schlimok G, Haude K, Bohndorf K (2001) Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. Eur Radiol 11:276–283
Ghaye B, Dondelinger RF, Dewe W (1999) Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study. Eur Radiol 9:1317–1320
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zangos, S., Eichler, K., Wetter, A. et al. MR-guided biopsies of lesions in the retroperitoneal space: technique and results. Eur Radiol 16, 307–312 (2006). https://doi.org/10.1007/s00330-005-2870-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-005-2870-2