J Cancer 2020; 11(16):4671-4682. doi:10.7150/jca.46329

Review

Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy

Peng Gao1*, Xiangyi Kong1*, Ying Song2*, Yan Song3*, Yi Fang1✉, Han Ouyang2✉, Jing Wang1✉

1. Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
2. Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
3. Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
*These authors contribute equally to this article.

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Citation:
Gao P, Kong X, Song Y, Song Y, Fang Y, Ouyang H, Wang J. Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy. J Cancer 2020; 11(16):4671-4682. doi:10.7150/jca.46329. Available from http://www.jcancer.org/v11p4671.htm

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Abstract

With a high sensitivity of breast lesions, MRI can detect suspicious lesions which are occult in traditional breast examination equipment. However, the lower and variable specificity of MRI makes the MRI-guided intervention, including biopsies and localizations, necessary before surgery, especially for patients who need the treatment of breast-conserving surgery (BCS). MRI techniques and patient preparation should be first carefully considered before the intervention to avoid lengthening the procedure time and compromising targeting accuracy. Doctors and radiologists need to reconfirm the target of the lesion and be very familiar with the process approach and equipment techniques involving the computer-aided diagnosis (CAD) tools and the biopsy system and follow a correct way. The basic steps of MRI-guided biopsy and localization are nearly the same regardless of the vendor or platform, and this article systematically introduces detailed methods and techniques of MRI-guided intervention. The two interventions both face different challenging situations during procedures with solutions given in the article. Post-operative statistics show that the complications of MRI-guided intervention are infrequent and mild, and MRI-guided biopsy provides the pathological information for the subsequent surgical decisions and MRI-guided localization fully prepared for follow-up surgical biopsy. New techniques for MRI-guided intervention are also elaborated in the article, which leads to future development. In a word, MRI-guided intervention is a safe, accurate, and effective technique with a low complication rate and successful MRI-guided intervention is truly teamwork with efforts from patients to surgeons, radiologists, MRI technologists, and nurses.

Keywords: Breast cancer, MRI-guided, Breast surgery, Breast biopsy, Preoperative needle localization