REGULAR CONTENT
Final ID
474
Type
Original Scientific Research-Oral or Pos
Authors
J Huang1, A Boikov1, A Dunn1, B Englander1
Institutions
1Pennsylvania Hospital, Philadelphia, PA
Purpose
To evaluate the feasibility and utility of MRI-guided core biopsy of BI-RADS 4 and 5 lesions without intravenous gadolinium administration.
Materials & Methods
Between 2012 and 2014 a total of 187 MR-guided breast biopsies were performed at a single institution. 175 biopsies were performed using IV gadolinium enhanced MR guidance and 12 biopsies were performed without IV gadolinium using T2W (n=5) and T1W (n=7) MR sequences. Gadolinium was not used due to patient allergy (n=8), patient choice (n=2) and technical failure of IV placement (n=2).Efficacy of biopsy was determined based upon evaluation with radiologic/pathologic concordance. In addition, 6 and 12 month follow-up MRI evaluation was performed for benign biopsies.
Results
Technical success was achieved in all of the procedures with no immediate post-biopsy complications. Of the 12 non-contrast enhanced biopsies, 8 demonstrated malignancy and 4 demonstrated benign findings. Followup multisequence MR at 6 and 12 months demonstrated benign results for the 4 benign biopsies.
Conclusions
MRI-guided core biopsy serves an important role in the diagnosis of mammographically occult breast cancer, ipsilateral multicentric and multifocal breast cancer, and contralateral breast cancer. The standard of care requires intravenous gadolinium administration during the biopsy. There is increasing concern about the impact of recurrent use of gadolinium as demonstrated by physiologic accumulation. Attempts should be made to reduce the use of gadolinium. This small cohort demonstrates that MRI-guided core biopsy is feasbile without IV gadolinium.
Final ID
474
Type
Original Scientific Research-Oral or Pos
Authors
J Huang1, A Boikov1, A Dunn1, B Englander1
Institutions
1Pennsylvania Hospital, Philadelphia, PA
Purpose
To evaluate the feasibility and utility of MRI-guided core biopsy of BI-RADS 4 and 5 lesions without intravenous gadolinium administration.
Materials & Methods
Between 2012 and 2014 a total of 187 MR-guided breast biopsies were performed at a single institution. 175 biopsies were performed using IV gadolinium enhanced MR guidance and 12 biopsies were performed without IV gadolinium using T2W (n=5) and T1W (n=7) MR sequences. Gadolinium was not used due to patient allergy (n=8), patient choice (n=2) and technical failure of IV placement (n=2).Efficacy of biopsy was determined based upon evaluation with radiologic/pathologic concordance. In addition, 6 and 12 month follow-up MRI evaluation was performed for benign biopsies.
Results
Technical success was achieved in all of the procedures with no immediate post-biopsy complications. Of the 12 non-contrast enhanced biopsies, 8 demonstrated malignancy and 4 demonstrated benign findings. Followup multisequence MR at 6 and 12 months demonstrated benign results for the 4 benign biopsies.
Conclusions
MRI-guided core biopsy serves an important role in the diagnosis of mammographically occult breast cancer, ipsilateral multicentric and multifocal breast cancer, and contralateral breast cancer. The standard of care requires intravenous gadolinium administration during the biopsy. There is increasing concern about the impact of recurrent use of gadolinium as demonstrated by physiologic accumulation. Attempts should be made to reduce the use of gadolinium. This small cohort demonstrates that MRI-guided core biopsy is feasbile without IV gadolinium.