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MRI is capable of detecting small malignancies or malignant foci not visible by other methods. However, its specificity is limited. In order to render work-up of MR-detected lesions as cost-effective and as minimally invasive as possible, percutaneous MR-guided biopsy is desirable.

So far various biopsy coils for imaging and fixation of the breast during percutaneous biopsy have been developed. However, MR-guided core or fine needle biopsy has so far been limited to few cases mainly with lesions >1 cm.

An overview will be given over the presently available equipment and techniques for percutaneous core needle biopsy.

Furthermore, MR-guided vacuum biopsy will be presented. It allows percutaneous biopsy of an area of up to 15 mm diameter and thus can compensate for inaccuracies which might occur during needle insection or due to field distortion. Furthermore, in most cases disappearance of the enhancing lesion or visualisation of the cavity directly after the procedure allows us to directly prove representative removal.

First-year results of a multicentre study on MR-guided vacuum biopsy will be shown as well.

Conclusion

MR-guided vacuum biopsy promises accurate and reproducible work-up of MR-detected lesions.

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