Use of diagnostic dynamic contrast-enhanced (DCE)-MRI for targeting of soft tissue tumour biopsies at 3T: preliminary results

• Published in: European radiology 2015-07, Vol.25 (7), p.2041-2048
• Main Authors: Noebauer-Huhmann, Iris-Melanie, Amann, Gabriele, Krssak, Martin, Panotopoulos, Joannis, Szomolanyi, Pavol, Weber, Michael, Czerny, Christian, Breitenseher, Martin, Grabner, Guenther, Bogner, Wolfgang, Nemec, Stefan, Dominkus, Martin, Funovics, Philipp, Windhager, Reinhard, Trattnig, Siegfried
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Biopsy; Biopsy, Needle - methods; Bone surgery; Contrast agents; Contrast Media; Diagnostic Radiology; Feasibility Studies; Female; Histology; Humans; Image-Guided Biopsy; Imaging; Internal Medicine; Interventional Radiology; Magnetic Resonance; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging, Interventional - methods; Male; Medicine; Medicine & Public Health; Meglumine - analogs & derivatives; Middle Aged; Neoplasm Staging; Neuroradiology; Organometallic Compounds; Preoperative Care; Prospective Studies; Radiology; Soft Tissue Neoplasms - pathology; Soft Tissue Neoplasms - surgery; Tumors; Ultrasound; Young Adult
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-014-3576-0

Objectives To test the feasibility and accuracy of MR-guided soft tissue tumour biopsy at 3T, using the dynamic contrast-enhanced (DCE) information from staging MRI for intralesional targeting. Methods After obtaining written informed consent for this institutional review board-approved study, 53 patients with suspected soft tissue tumours prospectively underwent preoperative staging MRI at 3T, including DCE, and subsequent MR-guided core needle biopsy. In 44/53 cases, DCE was heterogeneous and was used for intralesional biopsy targeting. Surgical, whole-specimen histology was used as the gold standard in 43/44 patients and revealed 42 soft tissue tumours (24 men; 18 women; mean age, 52 years; range, 19 – 84). Results Final surgical histology revealed eight benign lesions, six tumours of intermediate dignity, and 28 malignancies. All malignancies had shown heterogeneous DCE. The diagnostic yield of the biopsies was 100 % (42/42). Histological accuracy rates of biopsy were 100 % in predicting the dignity (42/42; 95 % CI [0.916 – 1.000]), 95.2 % for the tissue-specific entity (40/42; 95 % CI [0.847 – 0.987]), and 90.5 % for the tumour grade (38/42; 95 % CI [0.779 – 0.962]). Conclusions Our preliminary study indicates that biopsy of soft tissue tumours can be performed accurately and safely with DCE targeted MR-guidance at 3T, using a combined staging/biopsy MRI protocol. Key Points • MR-guided soft tissue tumour biopsy using DCE for intralesional targeting is feasible. • Targeting by staging-MRI allows reliable planning of the biopsy approach. • The method seems accurate and safe as a combined staging/biopsy procedure in outpatients. • DCE-targeted biopsy seems useful in challenging large and heterogeneous tumours.