American Journal of Roentgenology, Vol 170, 1593-1601, Copyright © 1998 by American Roentgen Ray Society

ARTICLES

Interactive MR imaging-guided biopsy and aspiration with a modified clinical C-arm system

JS Lewin, CA Petersilge, SF Hatem, JL Duerk, G Lenz, ME Clampitt, ML Williams, KR Kaczynski, CF Lanzieri, AL Wise and JR Haaga
Department of Radiology, University Hospitals of Cleveland and Case Western Reserve University, OH 44106, USA.

OBJECTIVE: This investigation was performed to test the hypotheses that interactive guidance of MR image acquisition during needle-directed procedures using a clinical 0.2-T C-arm open MR imaging system integrated with a frameless optically linked stereotaxy system is feasible, and that procedure times can be sufficiently short to be well tolerated by the patient. SUBJECTS AND METHODS: One hundred six MR- guided procedures were performed in 86 patients (ranging in age from 5 months to 88 years) using a clinical C-arm imaging system supplemented with an in-room RF-shielded liquid crystal display monitor, a frameless stereotaxy system, rapid gradient-echo sequences for needle guidance, and MR-compatible monitoring and surgical lighting equipment. We performed 50 biopsies and aspirations of the head and neck in 37 patients, 23 biopsies of musculoskeletal lesions in 22 patients, 16 biopsies of abdominal sites in 10 patients, six biopsies of the thoracolumbar spine or sacrum in six patients, and 11 shoulder joint injections for MR arthrography in 11 patients, in addition to 38 MR arthrographic injections on the same imaging system described in a previous report. Tissue sampling included fine-needle aspiration (n = 90) and cutting needle core biopsy (n = 41). Thirty-five patients underwent both procedures. Procedures were evaluated for success of needle placement, procedure time, and complications. RESULTS: Needle placement was successful in all cases, and no complications occurred. Tissue was sufficient for pathologic diagnosis for all but eight patients. Passes per patient averaged 2.1. For fine-needle aspiration, instrument time averaged 7 min 42 sec per pass, cutting needle core biopsy averaged 6 min 24 sec, and shoulder injection averaged 8 min. CONCLUSION: MR imaging guidance for needle procedures on a clinical 0.2- T C-arm system with supplemental interventional accessories is feasible, with relatively rapid needle placement.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. A. Carrino, B. Khurana, J. E. Ready, S. G. Silverman, and C. S. Winalski Magnetic Resonance Imaging-Guided Percutaneous Biopsy of Musculoskeletal Lesions J. Bone Joint Surg. Am., October 1, 2007; 89(10): 2179 - 2187. [Abstract] [Full Text] [PDF]

				F. K. Wacker, S. Vogt, A. Khamene, J. A. Jesberger, S. G. Nour, D. R. Elgort, F. Sauer, J. L. Duerk, and J. S. Lewin An Augmented Reality System for MR Image-guided Needle Biopsy: Initial Results in a Swine Model Radiology, February 1, 2006; 238(2): 497 - 504. [Abstract] [Full Text] [PDF]

				S. N. Goldberg, C. J. Grassi, J. F. Cardella, J. W. Charboneau, G. D. Dodd II, D. E. Dupuy, D. Gervais, A. R. Gillams, R. A. Kane, F. T. Lee Jr, et al. Image-guided Tumor Ablation: Standardization of Terminology and Reporting Criteria Radiology, June 1, 2005; 235(3): 728 - 739. [Abstract] [Full Text] [PDF]

				D. T. Boll, E. M. Merkle, and J. S. Lewin Low-Flow Vascular Malformations: MR-guided Percutaneous Sclerotherapy in Qualitative and Quantitative Assessment of Therapy and Outcome Radiology, November 1, 2004; 233(2): 376 - 384. [Abstract] [Full Text] [PDF]

				P. M. Sherman, D. M. Yousem, and L. A. Loevner CT-Guided Aspirations in the Head and Neck: Assessment of the First 216 Cases AJNR Am. J. Neuroradiol., October 1, 2004; 25(9): 1603 - 1607. [Abstract] [Full Text] [PDF]

				S. G. Nour, J. S. Lewin, M. Gutman, C. Hillenbrand, F. K. Wacker, J. W. Wong, I. C. Mitchell, C. B. Armstrong, M. M. Hashim, J. L. Duerk, et al. Percutaneous MR Imaging- guided Radiofrequency Interstitial Thermal Ablation of Tongue Base in Porcine Models: Implications for Obstructive Sleep Apnea Syndrome Radiology, February 1, 2004; 230(2): 359 - 368. [Abstract] [Full Text] [PDF]

				S. N. Goldberg, J. W. Charboneau, G. D. Dodd III, D. E. Dupuy, D. A. Gervais, A. R. Gillams, R. A. Kane, F. T. Lee Jr, T. Livraghi, J. P. McGahan, et al. Image-guided Tumor Ablation: Proposal for Standardization of Terms and Reporting Criteria Radiology, August 1, 2003; 228(2): 335 - 345. [Abstract] [Full Text] [PDF]

				C. W. Konig, P. L. Pereira, J. Trubenbach, J. Fritz, S. H. Duda, F. Schick, and C. D. Claussen MR Imaging-Guided Adrenal Biopsy Using an Open Low-Field-Strength Scanner and MR Fluoroscopy Am. J. Roentgenol., June 1, 2003; 180(6): 1567 - 1570. [Abstract] [Full Text] [PDF]

				N. Hayashi, T. Masumoto, T. Okubo, O. Abe, N. Kaji, K. Tokioka, S. Aoki, and K. Ohtomo Hemangiomas in the Face and Extremities: MR-guided Sclerotherapy--Optimization with Monitoring of Signal Intensity Changes in Vivo Radiology, February 1, 2003; 226(2): 567 - 572. [Abstract] [Full Text] [PDF]

				C. S. Winalski, M. I. Robbins, S. G. Silverman, and J. A.K. Davies Interactive Magnetic Resonance Image-Guided Aspiration Therapy of a Glenoid Labral Cyst : A Case Report J. Bone Joint Surg. Am., August 1, 2001; 83(8): 1237 - 1242. [Full Text]

				E. M. Merkle, J. R. Haaga, J. L. Duerk, G. H. Jacobs, H.-J. Brambs, and J. S. Lewin MR Imaging-guided Radio-frequency Thermal Ablation in the Pancreas in a Porcine Model with a Modified Clinical C-Arm System Radiology, November 1, 1999; 213(2): 461 - 467. [Abstract] [Full Text]

				J. Lewin Interventional MR Imaging: Concepts, Systems, and Applications in AJNR Am. J. Neuroradiol., May 1, 1999; 20(5): 735 - 748. [Full Text]

				J. S. Lewin, E. M. Merkle, J. L. Duerk, and R. W. Tarr Low-Flow Vascular Malformations in the Head and Neck: Safety and Feasibility of MR Imaging–guided Percutaneous Sclerotherapy—Preliminary Experience with 14 Procedures in Three Patients Radiology, May 1, 1999; 211(2): 566 - 570. [Abstract] [Full Text]

				J. W. Genant, J. E. Vandevenne, A. G. Bergman, C. F. Beaulieu, S. T. Kee, A. M. Norbash, and P. Lang Interventional Musculoskeletal Procedures Performed by Using MR Imaging Guidance with a Vertically Open MR Unit: Assessment of Techniques and Applicability Radiology, April 1, 2002; 223(1): 127 - 136. [Abstract] [Full Text] [PDF]