Clinical application of MRI-guided vacuum-assisted biopsy for breast lesions
Objective:To explore the feasibility and the diagnostic accuracy of MRI-guided vacuum-assisted biopsy(VAB)in lesions visualized by MRI only.Materials and Methods:Retrospective analyzed 27 patients with 27 lesions who underwent MR-guided VAB between September 2019 and December 2022.All of the breast lesions were categorized as 4 or 5 BI-RADS.All biopsies were performed on a 3.0 T system with a dedicated eight-channel open breast coil,an MRI compatible biopsy positioning frame and consumables.We recorded the lesion's imaging characteristics,the pathological outcomes of the biopsy and the final pathological results of the malignant lesions,as well as intraoperative and postoperative complications.The pathological results after surgery or the follow-up results of benign lesions at least six months later were used as the gold standard,the diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of VAB were calculated,as well as the histological underestimation of biopsied lesions.Results:Technical success was achieved in all biopsies.The average operation time was(39.92±8.34)min.After biopsy,7 of 27 lesions(25.93％)were malignant,2 of 27 lesions(7.41％)were atypical ductal hyperplasia,and 18 of 27 lesions(66.67％)were remaining benign.When the pathological results were compared with preoperative MRI images,no radiology-pathology inconsistency were discovered.All patients who were diagnosed with malignant tumors or atypical ductal hyperplasia underwent additional surgical resection.Without any histological underestimate,the biopsy results were consistent with the postoperative pathological outcomes.The lesions of two mammary inflammatory lesions diminished in half a year follow-up in all patients who were diagnosed with benign lesions by biopsy,and no significant changes were seen in the rest.The results of VAB showed 100％(27/27)accuracy,100％(7/7)sensitivity,100％(20/20)specificity,100％(7/7)positive predictive and 100％(20/20)negative predictive value.One patient experienced vagal response symptoms during the procedure,which were primarily brought on by emotional stress,and immediately recovered.Conclusions:For breast suspicious lesions detected on MRI only,MRI-guided VAB provides a safe,accurate and efficient procedure for pathological diagnosis,with high accuracy of pathological diagnosis and few complications,which is worthy of clinical application and advancement.
breast lesionspathological diagnosisradiological pathological correlationmagnetic resonance guidancebiopsyvacuum assistedmagnetic resonance imaging
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维普
