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  • 1
    ISSN: 1432-1084
    Keywords: Key words: MR-guided biopsy ; Ameloblastoma ; Non-Hodgkin's lymphoma ; Dental cysts ; Head and neck biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to explore the potential of interactive MR-guided biopsies in the maxillary and skull base region using a 0.5-T open-configuration scanner in patients with tumours affecting the maxilla or skull base. Ten patients with cystic or solid tumours affecting the maxillary and skull base regions underwent MR-guided biopsy in a superconducting, open 0.5-T MR system equipped with an optical frameless stereotaxic system. T2-weighted spin-echo images were acquired prior to and following biopsy, which was performed with 18- or 22-G needles using an enoral or percutaneous approach following infiltration of the skin, mucosa and periosteum with local anaesthetics. The position of the needle tip was continuously updated on fast T1-weighted gradient-recalled-echo images (TR 19 ms, TE 7.1 ms, flip angle 30 °, slice thickness 1 cm, field of view 24 × 24 cm) using the frameless stereotaxic system. In addition, the needle was identified based on the associated susceptibility artefact in all three planes. Once the target lesion had been reached, cytology material was aspirated. All ten patients tolerated the interactive MR-guided biopsies well without complications. Vital structures, including the brain, neurovascular bundles, vessels and eyes, were visualized on MR imaging and could be spared. There was no difference in the use of 18- or 22-G non-ferromagnetic needles concerning the susceptibility artefact. Sufficient material for cytological analysis was obtained in nine of ten cases. The mean biopsy time was 15 min. Interactive MR-guided biopsies of the head and neck in an open system are technically feasible and safe. Monitoring of the needle path in multiple planes permits the interactive adjustment of the needle course in near real time. Interactive MR-guided biopsies may well replace open surgical procedures in the maxillary region in selected patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Breast MRI ; Mammography ; Breast neoplasm ; Contrast-enhanced MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to compare the diagnostic performance of conventional mammography and dynamic contrast-enhanced fast 3D gradient-echo (GRE) MRI regarding the detection and characterization of breast lesions relative to histopathologic analysis and to assess the results of a combined evaluation of both methods. fifty consecutive patients with 63 histopathologically verified breast lesions underwent dynamic contrast-enhanced GRE MRI in addition to routine conventional mammography. All lesions were classified by both methods on a five-point scale as benign or malignant, and the results were correlated to histopathology. Conventional mammography and dynamic MRI yielded a sensitivity and specificity of 82 and 64 %, and 92 and 76 %, respectively. The difference between the results was statistically not significant (p 〉 0.05) with areas under the receiver-operating-characteristics curves of 0.807 for mammography and 0.906 for MR imaging. Combination of the results of both methods slightly increased the sensitivity for detection of breast cancer to 95 % but decreased specificity to 52 %. In this selected patient subset, including only patients referred for excisional biopsy, contrast-enhanced dynamic MRI proved more sensitive and specific than conventional mammography regarding the detection of malignancy. While a combination of both methods yields a slightly improved sensitivity, specificity is vastly reduced.
    Type of Medium: Electronic Resource
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