Radio-guided occult lesion localisation for breast lesions under computer-aided MRI guidance: the first experience and initial results

• Published in: British journal of radiology 2012-04, Vol.85 (1012), p.395-402
• Main Authors: YILMAZ, M. H, KILIC, F, ALTUG, Z. A, ICTEN, G. E, AYDOGAN, F, OZBEN, V, HALAC, M, OLGUN, D. C, GAZIOGLU, E, CELIK, V, URAS, C
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Biopsy - methods; Breast Neoplasms - diagnosis; Diagnosis, Computer-Assisted; Female; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging - methods; Mammary gland diseases; Medical sciences; Tumors
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr/30798119

The purpose of this study was to present an alternative technique for the pre-operative localisation of solely MRI-detected suspicious breast lesions using a computer-assisted MRI-guided radio-guided occult lesion localisation (ROLL) technique. Between January 2009 and June 2010, 25 females with a total of 25 suspicious breast lesions that could be detected only by MRI, and for whom breast surgery was planned, underwent the computer-assisted MRI-guided ROLL technique. A seven-channel biopsy breast array coil and computerised diagnostic workstation were used for the localisation procedure. Three-phase dynamic contrast-enhanced axial images were taken. After investigating the localisation co-ordinates with the help of intervention software on a workstation, an 18 G coaxial cannula was placed in the exact position determined. Following verification of the cannula position by additional axial scans, (99m)Tc-labelled macroalbumin aggregate and MRI contrast material were injected. Post-procedure MRI scans were used to confirm the correct localisation. All the procedures were technically successful. The mean lesion size was 10.8 mm (range: 4-25 mm). The mean total magnet and the mean localisation times were 28.6 min (range: 18-46 min) and 13.1 min (range: 8-20 min), respectively. Grid and pillar methods were used for localisation in 24 procedures and 1 procedure, respectively. On histopathological examination, 6 malignant, 10 high-risk and 9 benign lesions were identified. All patients tolerated the procedure well. There were no major complications. This is the first report documenting the application of MRI-guided ROLL. Based on our preliminary results, this technique is very efficient and seems to be a good alternative to wire localisation.