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MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques.

ABSTRACT: OBJECTIVES: To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. METHODS: We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. RESULTS: MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P?=?0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P?

SUBMITTER: Imschweiler T

PROVIDER: S-EPMC3889280 | biostudies-other | 2014 Jan

REPOSITORIES: biostudies-other

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MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques.

Imschweiler Thomas T Haueisen Harald H Kampmann Gert G Rageth Luzi L Seifert Burkhardt B Rageth Christoph C Freiwald Bianka B Kubik-Huch Rahel A RA

European radiology 20130827 1

<h4>Objectives</h4>To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB.<h4>Methods</h4>We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided.<h4>Results</h4>MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guid ...[more]

PMID: 23979106

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Project description:BackgroundThe varying experience of surgeons and ultrasound physicians, and their collaboration with physicians, may affect operation time and efficiency. We evaluated the learning curve of ultrasound-guided vacuum-assisted excision (VAE) of breast lesion with collaboration between different physicians, and assessed characteristics associated with operation time.MethodsThe sample population of this retrospective study was divided into two groups: 49 consecutive patient surgeries completed by skilled surgeons and novice ultrasound physicians (U group); and 30 consecutive patient surgeries completed by skilled ultrasound physicians and novice surgeons (S group). Cumulative summation graphs were used to evaluate operation time and calculate the turning point of the learning curve. Patients in the U and S groups were divided into exploration stage and proficiency stage according to the turning point, and the differences in influencing factors were compared. A total of 548 patients who underwent vacuum-assisted breast excision performed by a combination of skilled surgeons and skilled ultrasound physicians were selected as the reference group (R group). The differences among the three groups were compared. The relationship between the operation time and other factors in the different groups was analyzed using linear regression.ResultsThe best learning curve of the sample population was the quadratic fitting equation, and the turning point was the 19th case in the U group and the 14th case in the S group. The total operation times in the proficiency stage were significantly shorter than those in the exploration stage in the U and S groups (P=0.012 and P=0.003, separately). Patient age, long diameter, short diameter, and depth of masses related to the operation time.ConclusionsOur data suggest the existence of different learning curves in ultrasound-guided vacuum-assisted excision for the collaborations of different stages surgeons and ultrasound physicians. Through the accumulation of experience, it is feasible to safely perform ultrasound-guided VAE of breast lesions.

Project description:ImportanceTargeted magnetic resonance (MR)/ultrasound fusion prostate biopsy has been shown to detect prostate cancer. The implications of targeted biopsy alone vs standard extended-sextant biopsy or the 2 modalities combined are not well understood.ObjectiveTo assess targeted vs standard biopsy and the 2 approaches combined for the diagnosis of intermediate- to high-risk prostate cancer.Design, setting, and participantsProspective cohort study of 1003 men undergoing both targeted and standard biopsy concurrently from 2007 through 2014 at the National Cancer Institute in the United States. Patients were referred for elevated level of prostate-specific antigen (PSA) or abnormal digital rectal examination results, often with prior negative biopsy results. Risk categorization was compared among targeted and standard biopsy and, when available, whole-gland pathology after prostatectomy as the "gold standard."InterventionsPatients underwent multiparametric prostate magnetic resonance imaging to identify regions of prostate cancer suspicion followed by targeted MR/ultrasound fusion biopsy and concurrent standard biopsy.Main outcomes and measuresThe primary objective was to compare targeted and standard biopsy approaches for detection of high-risk prostate cancer (Gleason score ≥ 4 + 3); secondary end points focused on detection of low-risk prostate cancer (Gleason score 3 + 3 or low-volume 3 + 4) and the biopsy ability to predict whole-gland pathology at prostatectomy.ResultsTargeted MR/ultrasound fusion biopsy diagnosed 461 prostate cancer cases, and standard biopsy diagnosed 469 cases. There was exact agreement between targeted and standard biopsy in 690 men (69%) undergoing biopsy. Targeted biopsy diagnosed 30% more high-risk cancers vs standard biopsy (173 vs 122 cases, P < .001) and 17% fewer low-risk cancers (213 vs 258 cases, P < .001). When standard biopsy cores were combined with the targeted approach, an additional 103 cases (22%) of mostly low-risk prostate cancer were diagnosed (83% low risk, 12% intermediate risk, and 5% high risk). The predictive ability of targeted biopsy for differentiating low-risk from intermediate- and high-risk disease in 170 men with whole-gland pathology after prostatectomy was greater than that of standard biopsy or the 2 approaches combined (area under the curve, 0.73, 0.59, and 0.67, respectively; P < .05 for all comparisons).Conclusions and relevanceAmong men undergoing biopsy for suspected prostate cancer, targeted MR/ultrasound fusion biopsy, compared with standard extended-sextant ultrasound-guided biopsy, was associated with increased detection of high-risk prostate cancer and decreased detection of low-risk prostate cancer. Future studies will be needed to assess the ultimate clinical implications of targeted biopsy.Trial registrationclinicaltrials.gov Identifier: NCT00102544.

Project description:ObjectiveWe aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy.Materials and methodsWe prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications.ResultsOf 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P = 0.027). The overall satisfaction scores did not differ between the two groups (P = 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group).ConclusionUS-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

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MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques.

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MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques.

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