Department of Radiology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
Br J Radiol. 2012 Apr;85(1012):395-402. doi: 10.1259/bjr/30798119. Epub 2011 Oct 18.
The purpose of this study was to present an alternative technique for the pre-operative localisation of solely MRI-detected suspicious breast lesions using a computer-assisted MRI-guided radio-guided occult lesion localisation (ROLL) technique.
Between January 2009 and June 2010, 25 females with a total of 25 suspicious breast lesions that could be detected only by MRI, and for whom breast surgery was planned, underwent the computer-assisted MRI-guided ROLL technique. A seven-channel biopsy breast array coil and computerised diagnostic workstation were used for the localisation procedure. Three-phase dynamic contrast-enhanced axial images were taken. After investigating the localisation co-ordinates with the help of intervention software on a workstation, an 18 G coaxial cannula was placed in the exact position determined. Following verification of the cannula position by additional axial scans, (99m)Tc-labelled macroalbumin aggregate and MRI contrast material were injected. Post-procedure MRI scans were used to confirm the correct localisation.
All the procedures were technically successful. The mean lesion size was 10.8 mm (range: 4-25 mm). The mean total magnet and the mean localisation times were 28.6 min (range: 18-46 min) and 13.1 min (range: 8-20 min), respectively. Grid and pillar methods were used for localisation in 24 procedures and 1 procedure, respectively. On histopathological examination, 6 malignant, 10 high-risk and 9 benign lesions were identified. All patients tolerated the procedure well. There were no major complications.
This is the first report documenting the application of MRI-guided ROLL. Based on our preliminary results, this technique is very efficient and seems to be a good alternative to wire localisation.
本研究旨在介绍一种替代技术，用于术前定位仅通过 MRI 检测到的可疑乳腺病变，使用计算机辅助 MRI 引导的放射性引导隐匿性病变定位（ROLL）技术。
在 2009 年 1 月至 2010 年 6 月期间，对 25 名女性共 25 个可疑乳腺病变患者进行了计算机辅助 MRI 引导的 ROLL 技术。使用七通道活检乳腺阵列线圈和计算机诊断工作站进行定位程序。进行了三相动态对比增强轴位图像采集。在工作站上借助介入软件研究定位坐标后，将 18 G 同轴套管置于确定的精确位置。通过额外的轴向扫描验证套管位置后，注入 (99m)Tc 标记的大分子白蛋白聚集物和 MRI 对比剂。术后 MRI 扫描用于确认正确的定位。
所有程序均技术成功。病变平均大小为 10.8 毫米（范围：4-25 毫米）。平均总磁体和平均定位时间分别为 28.6 分钟（范围：18-46 分钟）和 13.1 分钟（范围：8-20 分钟）。24 个程序中使用了网格和支柱方法，1 个程序中使用了其中一种方法。在组织病理学检查中，发现 6 个恶性、10 个高危和 9 个良性病变。所有患者均耐受良好。无重大并发症。
这是首次报道 MRI 引导 ROLL 的应用。根据我们的初步结果，该技术非常有效，似乎是一种替代金属丝定位的良好选择。
