<strong>Background:</strong> Specimen radiography is important for the biopsy of breast microcalcifications, and MRI is limited in the detection of microcalcifications. It is unknown whether or not the pre...<strong>Background:</strong> Specimen radiography is important for the biopsy of breast microcalcifications, and MRI is limited in the detection of microcalcifications. It is unknown whether or not the presence of microcalcifications on MRI-guided biopsies is significant. <strong>Purpose:</strong> To determine whether specimen radiography of MRI-guided biopsy samples provides any added benefits in tissue assessment. <strong>Materials and Methods:</strong> This is an IRB-approved, HIPPA-compliant retrospective review of MRI-guided biopsy reports whose tissue underwent specimen radiography from 2010 to 2017. Pathology reports were queried to compare samples with and without calcium and reviewed to determine if calcifications correlated with the lesion of interest. If there was a correlation, the original MRI was reviewed. Final pathology reports were also reviewed if excision was performed. <strong>Results:</strong> A total of 889 patients ages 22 - 85 were included with 140 (15.7%, 140/889) containing calcifications. Of 140 specimens, 119 (85.0%, 119/140) cases separated the calcifications. A total of 41 (34.5%, 41/119) were malignant or high-risk lesions/atypia of which 15 (36.6%, 15/41) showed a higher-grade lesion in the specimen containing calcium. Out of these 15, 4 (26.7%, 4/15) were pathologically associated with calcium;however, pathologic diagnosis was not dependent on the presence of calcifications. All 4 were high-risk lesions and none were malignancies. MRI in these cases showed three enhancing masses and one non-mass enhancement. None were upgraded at excision. <strong>Conclusion:</strong> The presence of microcalcifications on MRI-guided biopsies does not aid in tissue assessment and does not impact pathologic diagnosis. Specimen radiography provides no added benefits in the setting of MRI-guided biopsies.展开更多
Magnetic Resonance Imaging(MRI)is now a widely used modality for providing multimodal,high-quality soft tissue contrast images with good spatiotemporal resolution but without subjecting patients to ionizing radiation....Magnetic Resonance Imaging(MRI)is now a widely used modality for providing multimodal,high-quality soft tissue contrast images with good spatiotemporal resolution but without subjecting patients to ionizing radiation.In addition to its diagnostic potential,its future theranostic value lies in its ability to provide MRI-guided robot intervention with combined structural and functional mapping,as well as integrated instrument localization,target recognition,and in situ,in vivo monitoring of the therapeutic efficacy.Areas of current applications include neurosurgery,breast biopsy,cardiovascular intervention,prostate biopsy and radiotherapy.Emerging applications in targeted drug delivery and MRI-guided chemoembolization are also being pursued.Whilst promising progress has been made in recent years,there are still significant basic science research and engineering challenges.This paper provides a comprehensive review of the current state-of-the-art in MRI-guided robot intervention and allied technologies in actuation,sensing,new materials,interventional instruments,and interactive/real-time MRI.Potential future research directions and new clinical developments are also discussed.展开更多
文摘<strong>Background:</strong> Specimen radiography is important for the biopsy of breast microcalcifications, and MRI is limited in the detection of microcalcifications. It is unknown whether or not the presence of microcalcifications on MRI-guided biopsies is significant. <strong>Purpose:</strong> To determine whether specimen radiography of MRI-guided biopsy samples provides any added benefits in tissue assessment. <strong>Materials and Methods:</strong> This is an IRB-approved, HIPPA-compliant retrospective review of MRI-guided biopsy reports whose tissue underwent specimen radiography from 2010 to 2017. Pathology reports were queried to compare samples with and without calcium and reviewed to determine if calcifications correlated with the lesion of interest. If there was a correlation, the original MRI was reviewed. Final pathology reports were also reviewed if excision was performed. <strong>Results:</strong> A total of 889 patients ages 22 - 85 were included with 140 (15.7%, 140/889) containing calcifications. Of 140 specimens, 119 (85.0%, 119/140) cases separated the calcifications. A total of 41 (34.5%, 41/119) were malignant or high-risk lesions/atypia of which 15 (36.6%, 15/41) showed a higher-grade lesion in the specimen containing calcium. Out of these 15, 4 (26.7%, 4/15) were pathologically associated with calcium;however, pathologic diagnosis was not dependent on the presence of calcifications. All 4 were high-risk lesions and none were malignancies. MRI in these cases showed three enhancing masses and one non-mass enhancement. None were upgraded at excision. <strong>Conclusion:</strong> The presence of microcalcifications on MRI-guided biopsies does not aid in tissue assessment and does not impact pathologic diagnosis. Specimen radiography provides no added benefits in the setting of MRI-guided biopsies.
基金supported in part by the National Key R&D Program of China(2022YFB4702700)the Science and Technology Commission of Shanghai Municipality(21DZ1100300)the Science and Technology Commission of Shanghai Municipality(20DZ2220400).
文摘Magnetic Resonance Imaging(MRI)is now a widely used modality for providing multimodal,high-quality soft tissue contrast images with good spatiotemporal resolution but without subjecting patients to ionizing radiation.In addition to its diagnostic potential,its future theranostic value lies in its ability to provide MRI-guided robot intervention with combined structural and functional mapping,as well as integrated instrument localization,target recognition,and in situ,in vivo monitoring of the therapeutic efficacy.Areas of current applications include neurosurgery,breast biopsy,cardiovascular intervention,prostate biopsy and radiotherapy.Emerging applications in targeted drug delivery and MRI-guided chemoembolization are also being pursued.Whilst promising progress has been made in recent years,there are still significant basic science research and engineering challenges.This paper provides a comprehensive review of the current state-of-the-art in MRI-guided robot intervention and allied technologies in actuation,sensing,new materials,interventional instruments,and interactive/real-time MRI.Potential future research directions and new clinical developments are also discussed.
