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[Musculoskeletal biopsies in an open 0.5-T-MR system].

INTRODUCTION: MR-guided interventions have been successful in different medical disciplines. The aim of this paper is to report our results with the application of MR-guided biopsies of musculoskeletal lesions using an open 0.5-T-MR scanner and further to discuss these results on the basis of the available literature. PATIENTS AND METHODS: Between 1998 and 2003 30 patients (average age 44.1 years) underwent a total of 31 biopsies. The interventions were performed in an open 0.5-T MRI system using an active optical localization system as well as a navigation system. For the motion tracking we used T (1)-weighted real-time sequences with 0.25 pictures per second. For the sampling MR-compatible instruments were used that were specially developed for this purpose. The data of this retrospective investigation are based on the evaluation of the patient documents and the radiological findings. On the basis of the histological findings the technical success rate and the histological overall accuracy were determined. RESULTS: In 81 % of the biopsies the histological diagnosis was correct. In cases of suspected inflammation the histological accuracy was smaller (70 %). No differences were observed between skeletal and soft-tissue lesions. The technical success rate amounted to 77.5 %. No procedural or anesthesiological complications occurred. The mean operating time amounted to 65 min including the time for motion tracking. DISCUSSION: In cases of suspected lesions of the musculoskeletal system, the MR-guided biopsy represents a promising and safe procedure to get a histological diagnosis. In cases of sufficient size of the lesion sampling of a representative probe is possible. On account of the outstanding performance in soft-part contrasting, the sensitive structures surrounding the lesion can be saved. Substantial disadvantages of the procedure are the high costs for personal and material and the long operating time.

Adult↗
PubMed2003

Stereotactic histologic biopsy with patients prone: technical feasibility in 98% of mammographically detected lesions.

OBJECTIVE: The purpose of this retrospective study was to determine which mammographically detected lesions in need of imaging-guided biopsy could undergo prone, stereotactic biopsy. MATERIALS AND METHODS: From July 1991 through June 2001, 1687 consecutive patients (age range, 29-94 years; median age, 58 years) with 1894 lesions were referred by clinicians in a multispecialty clinic. The patients underwent stereotactic, prone, histologic biopsy of 1851 lesions (98%) and needle-localized breast biopsy of 43 lesions (2%). We performed stereotactic biopsies successively with 14-gauge automated large-core devices and 14- or 11-gauge vacuum-assisted devices. We evaluated lesions by patient, breast, lesion, and procedural variables to determine why stereotactic biopsy was not performed. RESULTS: Of 1851 lesions referred for stereotactic biopsy, biopsies were canceled in 42 lesions (2%) not considered suspicious enough to warrant biopsy. Of 1809 lesions in which stereotactic biopsy was considered to be warranted, stereotactic biopsy was canceled for technical reasons in 29 lesions (2%). Of 43 lesions referred for surgical biopsy, stereotactic biopsy was thought to be technically problematic in five (12%). Inability to accomplish a stereotactic biopsy in 34 (2%) of 1852 lesions needing a biopsy was due to proximity to the chest wall (n = 10, 29%), inadequate lesion visualization unrelated to lesion depth (n = 19, 56%), and patient factors (n = 5, 15%). CONCLUSION: Stereotactic biopsy had a technical success rate of 98% (1780/1809) and was used for histologic diagnosis in 96% (1780/1852) of mammographically detected lesions. Inadequate lesion visualization accounted for 85% (29/34) of stereotactic biopsy failures.

Adult↗
PubMed1992

[Microscopic anatomy from the viewpoint of the macroscopic anatomist: the Vienna anatomist Joseph Hyrtl and his microscopic injection specimen].

Mainly due to an intellectual opposition to microscopy the promising early investigations in this field had come to an untimely end resulting in a neglect of the microscope during the 18th century. In this situation micro-injected specimens were to become an important link on the way to the microscopical science of histology establishing in the first half of the 19th century. Starting without optical instrumentation on the solid grounds of visual experience injected vessels and ducts provided a pathway from well known macroscopical into unknown microscopical dimensions. Without changing their level of perception anatomists could look through a microscope with macroscopist's eyes. Under this aspect Joseph Hyrtl's specimens are not part of a systematic microscopic anatomy or histology but technically demanding preparations to study body morphology and function by comparative anatomy.

Anatomy↗
PubMed1975

[Endometrial cyto-histology by PISTOLET-aspiration technic (author's transl)].

A modified intrauterine aspiration technic for detection of endometrial adenocarcinoma and its precursors has been described. This method which is simple, inexpensive and requires neither anaesthesia nor analgesia, allows cyto-histologic diagnoses of endometrial lesions. A correct cytologic or cyto-histologic diagnosis was made in 93.9% of the 277 cases examined. Of the premalignant and malignant endometrial lesions, the diagnostic accuracy was 100%.

Biopsy, Needle↗
PubMed1993

The diagnostic potential of fetal renal biopsy.

The feasibility of fetal renal biopsy has been investigated in order to assess the diagnostic value of the histological specimen. Two fetuses with a severe bilateral renal abnormality (multicystic dysplastic kidney, Meckel-Gruber syndrome with polycystic kidney) and one fetus with Down syndrome (no detectable structural anomaly) were sampled. Histological findings in the biopsy specimens of cases 1 and 2 were diagnostic of an early obstructive renal disease. In case 3, the findings were consistent with normal development for gestational age of the kidney. Fetal renal biopsy is technically feasible; histological examination of the samples showed a good correlation with postnatal findings. Further studies of its diagnostic value are required.

Adult↗