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Magnetic Resonance Imaging–Guided Biopsy in the Musculoskeletal System Using a Cylindrical 1.5-T Magnetic Resonance Imaging Unit

Ahrar, Judy U. MD*; Stafford, R. Jason PhD; Alzubaidi, Sadeer MD*; Ahrar, Kamran MD*

Topics in Magnetic Resonance Imaging: August 2011 - Volume 22 - Issue 4 - p 189–196
doi: 10.1097/RMR.0b013e31827c2e66
Original Articles
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Objectives The objective of this study was to report a single-center experience with magnetic resonance imaging (MRI)–guided biopsy in the musculoskeletal system using a closed-bore, cylindrical, high-magnetic-field (1.5-T) MRI unit.

Methods From May 2010 to July 2011, 100 consecutive MRI-guided biopsy sessions were undertaken for musculoskeletal lesions in 97 patients. Patient demographics, tumor characteristics, and biopsy techniques were recorded. Biopsy results, treatment outcomes, and follow-up imaging studies were reviewed.

Results Biopsy procedures were technically successful in 99 cases (99%). Despite a mean body mass index of 30 kg/m2, all patients fit within the bore of the magnet. There were 69 soft-tissue and 31 bone tumors. Most patients had both tissue core (n = 93) and fine-needle aspiration (n = 84) biopsies. All lesions were adequately imaged, localized, and targeted using rapid balanced steady-state free precession imaging (89%), fast T1 (4%), or combination of the 2 techniques (7%). A prototype real-time imaging sequence was used in 29 cases (29%) to guide biopsy needle insertion. There were no major complications. Sensitivity, specificity, and overall accuracy were 97%, 100%, and 97.6%, respectively.

Conclusions Magnetic resonance imaging–guided biopsy in a closed-bore, high-field-strength magnet is a safe, easy, and effective technique for evaluation of musculoskeletal lesions. Ideally, the MRI suite should be equipped with an in-room radiofrequency-shielded monitor and a communication system. However, surface coils with adequate opening to grant access to the biopsy site, MRI-compatible needles, and MRI-compatible patient monitoring devices are absolutely necessary to perform MRI-guided biopsies.

From the *Section of Interventional Radiology and †Department of ImagingPhysics, The University of Texas MD Anderson Cancer Center, Houston, TX.

Reprints: Kamran Ahrar, MD, Section of Interventional Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1471, Houston, TX 77030 (e-mail: kahrar@mdanderson.org).

The authors declare no conflict of interest.

© 2011 Lippincott Williams & Wilkins, Inc.