MR-guided freehand biopsy of breast lesions in a 1.0-T open MR imager with a near-real-time interactive platform: preliminary experience.

PURPOSE: To identify the most appropriate magnetic resonance (MR) sequence for breast biopsy with regard to lesion visibility and artifact size and to assess feasibility and safety of this approach in a clinical setting. MATERIALS AND METHODS: MR-guided interventions were performed in an open 1.0-T MR imager between November 2009 and January 2011. The prospective clinical study was approved by the institutional review board. Written informed consent was obtained. Four different fast dynamic sequences (balanced steady-state free precession, T1-weighted turbo gradient-echo, T1-weighted turbo spin-echo [SE], and T2-weighted single-shot SE sequences) were evaluated for artifact size of biopsy needle and in vivo for lesion visibility. In vivo breast biopsies were performed with the freehand technique and without immobilization or a positioning device by using an interactive MR mode that allowed continuous imaging in two orthogonal planes for guidance. RESULTS: On the basis of good lesion detection in combination with small artifact size, T1-weighted SE imaging was used for biopsy. A total of 75 biopsies were performed successfully in 69 patients (mean age, 53 years; age range, 35-78 years) (mean lesion size, 7.1 mm; range, 4-15 mm). The interactive MR platform enabled immediate localization and correction of intended needle trajectory. Average time for freehand biopsy was 12 minutes (range, 8-23 minutes). No major complications were recorded. CONCLUSION: MR-guided freehand biopsy of breast lesions with the near-real-time interactive MR platform in an open 1.0-T MR imager is safe and feasible in a clinical setting. The method simplifies work flow and intervention performance.

Functional MRI using multiple receiver coils: BOLD signal changes and signal-to-noise ratio for three-dimensional-PRESTO vs. single shot EPI in comparison to a standard quadrature head coil.

PURPOSE: To compare the performance of single shot echo planar imaging (SSEPI) with three-dimensional-multishot echo-planar imaging (EPI) based on principles-of-echo-shifting-with-a-train-of-observations (PRESTO) in combination with a standard quadrature head coil and, as an alternative, a multiple receiver coil in intraoperative functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS: Six healthy subjects underwent fMRI with visual stimulation using a SSEPI and a PRESTO-sequence with both coil systems. Statistical evaluation was done with a scanner-based post-processing software and SPM 99. The number of activated voxels in the visual cortex, the percent signal change between rest and activation, and finally the signal-to-noise ratio (SNR) during time course were measured and compared for both coil systems and both sequences, used in four different combinations. RESULTS: Blood oxygen level dependent (BOLD) signal changes were the lowest with PRESTO and standard head coil and the highest for SSEPI and phased array coil. For the latter combination, a significantly higher signal change and larger activation size was observed together with a better SNR. SSEPI yielded similar performance using both coils. CONCLUSION: SSEPI was superior due to its better SNR and a higher BOLD signal change in the defined settings, irrespective of the coil used. In a stereotactical setup the phased array coil can be used to generate fMRI data without loss of image quality.