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Published in: European Radiology 2/2006

01-02-2006 | Urogenital

MR-guided biopsies of lesions in the retroperitoneal space: technique and results

Authors: S. Zangos, K. Eichler, A. Wetter, T. Lehnert, R. Hammerstingl, T. Diebold, P. Reichel, C. Herzog, M.-L. Hansmann, M. G. Mack, T. J. Vogl

Published in: European Radiology | Issue 2/2006

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Abstract

The purpose of this study was to evaluate the safety and precision of MRI-guided biopsies of retroperitoneal space-occupying tumors in an open low-field system. In 30 patients with indistinct retroperitoneal tumors [paraaortic lesion (n=20), kidney (n=2), suprarenal gland (n=3) and pancreas (n=5)] MR-guided biopsies were performed using a low-field system (0.2 T, Magnetom Concerto, Siemens, Germany). For the monitoring of the biopsies T1-weighted FLASH sequences (TR/TE=160/5 ms; 90°) were used in all patients and modified FLASH sequences (TR/TE=160/13 ms; 90°) in ten patients. After positioning of the needle in the tumors 114 biopsy specimens were acquired in coaxial technique with 16-gauge cutting needles (Somatex, Germany). The biopsies were successfully performed in all patients without vascular or organ injuries. The visualization of the aortic blood flow with MRI facilitated the biopsy procedures of paraaortic lesions. The size of the lesions ranged from 1.6 to 7.5 cm. The median distance of the biopsy access path was 10.4 cm. Adequate specimens were obtained in 28 cases (93.3%) resulting in a correct histological classification of 27 lesions (90%). In conclusion, MR-guided biopsies of retroperitoneal lesions using an open low-field system can be performed safely and accurately and is an alternative to CT-guided biopsies.
Literature
1.
go back to reference Bellin MF, Roy C, Kinkel K et al (1998) Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles-initial clinical experience. Radiology 207:799–808PubMed Bellin MF, Roy C, Kinkel K et al (1998) Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles-initial clinical experience. Radiology 207:799–808PubMed
2.
go back to reference Hopper K (1995) Percutaneous, radiographically guided biopsy: a history. Radiology 196:329–333PubMed Hopper K (1995) Percutaneous, radiographically guided biopsy: a history. Radiology 196:329–333PubMed
3.
go back to reference Sheafor DH, Paulson EK, Simmons CM, DeLong DM, Nelson RC (1998) Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology 207:705–710PubMed Sheafor DH, Paulson EK, Simmons CM, DeLong DM, Nelson RC (1998) Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology 207:705–710PubMed
4.
go back to reference Schulz T, Puccini S, Schneider J, Kahn T (2004) Interventional and intraoperative MR: review and update of techniques and clinical experience. Eur Radiol 14:2212–2227CrossRefPubMed Schulz T, Puccini S, Schneider J, Kahn T (2004) Interventional and intraoperative MR: review and update of techniques and clinical experience. Eur Radiol 14:2212–2227CrossRefPubMed
5.
go back to reference Zangos S, Kiefl D, Eichler K, Engelmann K, Heller M, Herzog C, Mack MG, Jacobi V, Vogl TJ (2003) MR-guided biopsies of undetermined liver lesions: technique and results. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 175:688–694CrossRefPubMed Zangos S, Kiefl D, Eichler K, Engelmann K, Heller M, Herzog C, Mack MG, Jacobi V, Vogl TJ (2003) MR-guided biopsies of undetermined liver lesions: technique and results. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 175:688–694CrossRefPubMed
6.
go back to reference Sofocleous C, Schubert J, Brown K, Brody L, Covey A, Getrajdman G (2004) CT-guided transvenous or transcaval needle biopsy of pancreatic and peripancreatic lesions. J Vasc Interv Radiol 15:1099–1104PubMed Sofocleous C, Schubert J, Brown K, Brody L, Covey A, Getrajdman G (2004) CT-guided transvenous or transcaval needle biopsy of pancreatic and peripancreatic lesions. J Vasc Interv Radiol 15:1099–1104PubMed
7.
go back to reference Wutke R, Schmid A, Fellner F, Horbach T, Kastl S, Papadopoulos T, Hohenberger W, Bautz W (2001) CT-guided percutaneous core biopsy: effective accuracy, diagnostic utility and effective costs. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:1025–1033CrossRefPubMed Wutke R, Schmid A, Fellner F, Horbach T, Kastl S, Papadopoulos T, Hohenberger W, Bautz W (2001) CT-guided percutaneous core biopsy: effective accuracy, diagnostic utility and effective costs. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:1025–1033CrossRefPubMed
8.
go back to reference Harisinghani MG, Saini S, Weissleder R, Hahn PF, Yantiss RK, Tempany C, Wood BJ, Mueller PR (1999) MR lymphangiography using ultrasmall superparamagnetic iron oxide in patients with primary abdominal and pelvic malignancies: radiographic-pathologic correlation. AJR Am J Roentgenol 172:1347–1351PubMed Harisinghani MG, Saini S, Weissleder R, Hahn PF, Yantiss RK, Tempany C, Wood BJ, Mueller PR (1999) MR lymphangiography using ultrasmall superparamagnetic iron oxide in patients with primary abdominal and pelvic malignancies: radiographic-pathologic correlation. AJR Am J Roentgenol 172:1347–1351PubMed
9.
go back to reference Matalon TA, Silver B (1990) US guidance of interventional procedures. Radiology 174:43–47PubMed Matalon TA, Silver B (1990) US guidance of interventional procedures. Radiology 174:43–47PubMed
10.
go back to reference Charboneau JW, Reading CC, Welch TJ (1990) CT and sonographically guided needle biopsy: current techniques and new innovations. AJR Am J Roentgenol 154:1–10PubMed Charboneau JW, Reading CC, Welch TJ (1990) CT and sonographically guided needle biopsy: current techniques and new innovations. AJR Am J Roentgenol 154:1–10PubMed
11.
go back to reference Dupuy DE, Rosenberg AE, Punyaratabandhu T, Tan MH, Mankin HJ (1998) Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. AJR Am J Roentgenol 171:759–762PubMed Dupuy DE, Rosenberg AE, Punyaratabandhu T, Tan MH, Mankin HJ (1998) Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. AJR Am J Roentgenol 171:759–762PubMed
12.
go back to reference Zangos S, Eichler K, Engelmann K et al (2004) MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results. Eur Radiol 15:174–182CrossRefPubMed Zangos S, Eichler K, Engelmann K et al (2004) MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results. Eur Radiol 15:174–182CrossRefPubMed
13.
go back to reference Adam G, Bucker A, Nolte-Ernsting C, Tacke J, Gunther RW (1999) Interventional MR imaging: percutaneous abdominal and skeletal biopsies and drainages of the abdomen. Eur Radiol 9:1471–1478CrossRefPubMed Adam G, Bucker A, Nolte-Ernsting C, Tacke J, Gunther RW (1999) Interventional MR imaging: percutaneous abdominal and skeletal biopsies and drainages of the abdomen. Eur Radiol 9:1471–1478CrossRefPubMed
14.
go back to reference Carlson SK, Bender CE, Classic KL, Zink FE, Quam JP, Ward EM, Oberg AL (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520PubMed Carlson SK, Bender CE, Classic KL, Zink FE, Quam JP, Ward EM, Oberg AL (2001) Benefits and safety of CT fluoroscopy in interventional radiologic procedures. Radiology 219:515–520PubMed
15.
go back to reference Arellano R, Boland G, Mueller P (2000) Adrenal biopsy in a patient with lung cancer: imaging algorithm and biopsy indications, technique, and complications. AJR Am J Roentgenol 175:1613–1617PubMed Arellano R, Boland G, Mueller P (2000) Adrenal biopsy in a patient with lung cancer: imaging algorithm and biopsy indications, technique, and complications. AJR Am J Roentgenol 175:1613–1617PubMed
16.
go back to reference Daly B, Krebs TL, Wong-You-Cheong JJ, Wang SS (1999) Percutaneous abdominal and pelvic interventional procedures using CT fluoroscopy guidance. AJR Am J Roentgenol 173:637–644PubMed Daly B, Krebs TL, Wong-You-Cheong JJ, Wang SS (1999) Percutaneous abdominal and pelvic interventional procedures using CT fluoroscopy guidance. AJR Am J Roentgenol 173:637–644PubMed
17.
go back to reference Froelich JJ, Ishaque N, Saar B, Regn J, Walthers EM, Mauermann F, Klose KJ (1999) Control of percutaneous biopsy with CT fluoroscopy. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 170:191–197PubMed Froelich JJ, Ishaque N, Saar B, Regn J, Walthers EM, Mauermann F, Klose KJ (1999) Control of percutaneous biopsy with CT fluoroscopy. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 170:191–197PubMed
18.
go back to reference Silverman SG, Tuncali K, Adams DF, Nawfel RD, Zou KH, Judy PF (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212:673–681PubMed Silverman SG, Tuncali K, Adams DF, Nawfel RD, Zou KH, Judy PF (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212:673–681PubMed
19.
go back to reference Nawfel R, Judy P, Silverman S, Hooton S, Tuncali K, Adams D (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216:180–184PubMed Nawfel R, Judy P, Silverman S, Hooton S, Tuncali K, Adams D (2000) Patient and personnel exposure during CT fluoroscopy-guided interventional procedures. Radiology 216:180–184PubMed
20.
go back to reference Lufkin RB, Gronemeyer DH, Seibel RM (1997) Interventional MRI: update. Eur Radiol 7:187–200CrossRef Lufkin RB, Gronemeyer DH, Seibel RM (1997) Interventional MRI: update. Eur Radiol 7:187–200CrossRef
21.
go back to reference Konig CW, Pereira PL, Trubenbach J, Fritz J, Duda SH, Schick F, Claussen CD (2003) MR imaging-guided adrenal biopsy using an open low-field-strength scanner and MR fluoroscopy. AJR Am J Roentgenol 180:1567–1570PubMed Konig CW, Pereira PL, Trubenbach J, Fritz J, Duda SH, Schick F, Claussen CD (2003) MR imaging-guided adrenal biopsy using an open low-field-strength scanner and MR fluoroscopy. AJR Am J Roentgenol 180:1567–1570PubMed
22.
go back to reference Schweiger GD, Yip VY, Brown BP (2000) CT fluoroscopic guidance for percutaneous needle placement into abdominopelvic lesions with difficult access routes. Abdom Imaging 25:633–637CrossRefPubMed Schweiger GD, Yip VY, Brown BP (2000) CT fluoroscopic guidance for percutaneous needle placement into abdominopelvic lesions with difficult access routes. Abdom Imaging 25:633–637CrossRefPubMed
23.
go back to reference Frahm C, Gehl HB, Melchert UH, Weiss HD (1996) Visualization of magnetic resonance-compatible needles at 1.5 and 0.2 Tesla. Cardiovasc Intervent Radiol 19:335–340CrossRefPubMed Frahm C, Gehl HB, Melchert UH, Weiss HD (1996) Visualization of magnetic resonance-compatible needles at 1.5 and 0.2 Tesla. Cardiovasc Intervent Radiol 19:335–340CrossRefPubMed
24.
go back to reference Ladd ME, Erhart P, Debatin JF, Romanowski BJ, Boesiger P, McKinnon GC (1996) Biopsy needle susceptibility artifacts. Magn Reson Med 36:646–651 Ladd ME, Erhart P, Debatin JF, Romanowski BJ, Boesiger P, McKinnon GC (1996) Biopsy needle susceptibility artifacts. Magn Reson Med 36:646–651
25.
go back to reference Lewin JS, Duerk JL, Jain VR, Petersilge CA, Chao CP, Haaga JR (1996) Needle localization in MR-guided biopsy and aspiration: effects of field strength, sequence design, and magnetic field orientation. AJR Am J Roentgenol 166:1337–1345PubMed Lewin JS, Duerk JL, Jain VR, Petersilge CA, Chao CP, Haaga JR (1996) Needle localization in MR-guided biopsy and aspiration: effects of field strength, sequence design, and magnetic field orientation. AJR Am J Roentgenol 166:1337–1345PubMed
26.
go back to reference Alanen J, Keski-Nisula L, Blanco-Sequeiros R, Tervonen O (2004) Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies. Eur Radiol 14:123–128CrossRefPubMed Alanen J, Keski-Nisula L, Blanco-Sequeiros R, Tervonen O (2004) Cost comparison analysis of low-field (0.23 T) MRI- and CT-guided bone biopsies. Eur Radiol 14:123–128CrossRefPubMed
27.
go back to reference Langen HJ, Kugel H, Ortmann M, Noack M, de Rochemont RM, Landwehr P (2001) Functional capacity of MRI-compatible biopsy needles in comparison with ferromagnetic biopsy needles. In vitro studies. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:658–662CrossRefPubMed Langen HJ, Kugel H, Ortmann M, Noack M, de Rochemont RM, Landwehr P (2001) Functional capacity of MRI-compatible biopsy needles in comparison with ferromagnetic biopsy needles. In vitro studies. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:658–662CrossRefPubMed
28.
go back to reference Sklair-Levy M, Lebensart P, Applbaum Y et al (2001) Percutaneous image-guided needle biopsy in children-summary of our experience with 57 children. Pediatr Radiol 31:732–736CrossRefPubMed Sklair-Levy M, Lebensart P, Applbaum Y et al (2001) Percutaneous image-guided needle biopsy in children-summary of our experience with 57 children. Pediatr Radiol 31:732–736CrossRefPubMed
29.
go back to reference Hussain H, Kingston J, Domizio P, Norton A, Reznek R (2001) Imaging-guided core biopsy for the diagnosis of malignant tumors in pediatric patients. AJR Am J Roentgenol 176:43–47PubMed Hussain H, Kingston J, Domizio P, Norton A, Reznek R (2001) Imaging-guided core biopsy for the diagnosis of malignant tumors in pediatric patients. AJR Am J Roentgenol 176:43–47PubMed
31.
go back to reference Hohenberger W, Kastl S (2000) Neoadjuvant and adjuvant therapy of ductal pancreatic carcinoma. Zentralbl Chir 125:348–355PubMed Hohenberger W, Kastl S (2000) Neoadjuvant and adjuvant therapy of ductal pancreatic carcinoma. Zentralbl Chir 125:348–355PubMed
32.
go back to reference Demharter J, Muller P, Wagner T, Schlimok G, Haude K, Bohndorf K (2001) Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. Eur Radiol 11:276–283CrossRefPubMed Demharter J, Muller P, Wagner T, Schlimok G, Haude K, Bohndorf K (2001) Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. Eur Radiol 11:276–283CrossRefPubMed
33.
go back to reference Ghaye B, Dondelinger RF, Dewe W (1999) Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study. Eur Radiol 9:1317–1320CrossRefPubMed Ghaye B, Dondelinger RF, Dewe W (1999) Percutaneous CT-guided lung biopsy: sequential versus spiral scanning. A randomized prospective study. Eur Radiol 9:1317–1320CrossRefPubMed
Metadata
Title
MR-guided biopsies of lesions in the retroperitoneal space: technique and results
Authors
S. Zangos
K. Eichler
A. Wetter
T. Lehnert
R. Hammerstingl
T. Diebold
P. Reichel
C. Herzog
M.-L. Hansmann
M. G. Mack
T. J. Vogl
Publication date
01-02-2006
Publisher
Springer-Verlag
Published in
European Radiology / Issue 2/2006
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-005-2870-2

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