MR-guided core biopsies using a closed 1.0 T imager. First clinical results

Objective: High soft-tissue contrast and multiplanar imaging capabilities of MRI may be advantageous in biopsy guidance compared to CT. We report our first results with MR-guided core biopsies using a closed 1.0 T MR imager. Methods and patients: In ten patients, seven liver lesions and one lesion each in the muscle of the back, the gluteal muscle and in the breast were biopsied under MR guidance using MR-compatible needles (Tru-Cut type, 18G and 14G). For control scans T1-weighted turbo-spin-echo (TSE), gradient-echo and T2-weighted TSE sequences were used. Results: In all patients, the suspicious lesions and the biopsy needle were exactly delineated in MR control scans. In nine out of ten patients, the suspicious lesion was clarified histologically. Controls of needle position in a second plane were performed twice. Pushing the inner stylet alone resulted in a distortion of the needle in several cases in its flat area. The small diameter of the MR gantry was inconvenient for a few patients. One complication (intrahepatic bleeding) was observed, which healed up without consequences. Conclusion: Using a closed 1.0 T MR imager MR-guided core biopsies can be conducted efficiently. Core biopsies should be taken by pulling and pushing the outer cannula. Advantageous compared to CT are the multiplanar imaging capabilities, while the smaller gantry is disadvantageous.