Chao Liu1, Ligang Wang2, Xiangmeng He3, Yujun Xu3, Dong Lu4, Peipei Li5, Rongbin Lv6, Yong Feng1, Ming Liu3, Chengli Li3. 1. Department of Minimally Invasive Tumor, Tai'an Central Hospital, Tai'an, Shandong, P.R. China. 2. Department of Interventional Therapy, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, P.R. China. 3. Department of Interventional MRI, Shandong Medical Imaging Research Institute affiliated to Shandong University, Jinan, Shandong, P.R. China. 4. Department of Interventional Radiology, Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei, Anhui, P.R. China. 5. Department of Oncology, Liaocheng Tumor Hospital, Liaocheng, Shandong, P.R. China. 6. Department of Nuclear Medicine, Tai'an Central Hospital, Tai'an, Shandong, P.R. China.
Abstract
BACKGROUND: Pancreatic carcinoma is a common cause of cancer deaths worldwide. Biopsy is often required for the initial diagnosis of pancreatic masses. Biopsy can be performed endoscopically or percutaneously with computed tomography (CT) and ultrasound (US) guidance. MRI offers many inherent advantages over CT and US. PURPOSE/HYPOTHESIS: To prospectively evaluate the feasibility, accuracy, and safety of MRI-guided percutaneous coaxial cutting needle biopsy of pancreatic lesions using an open 1.0T high-field MR scanner. STUDY TYPE: Prospective. POPULATION: Thirty-one patients with 31 pancreatic lesions underwent MR-guided percutaneous coaxial cutting needle biopsy. FIELD STRENGTH/SEQUENCE: 1.0T T2 WI-TSE PDW-aTSE T1 WI-TFE. ASSESSMENT: Final diagnosis was confirmed by surgery and clinical follow-up for at least 12 months. The accuracy, sensitivity, and specificity were calculated. Complications were recorded. STATISTICAL TESTS: There was no statistical analysis in this study. RESULTS: The procedure was technically successful and final biopsy samples were adequate for histopathological examination in all patients. Biopsy pathology revealed malignant pancreatic tumor in 25 patients (25/31, 80.6%), and benign pancreatic lesions were present in six patients (6/31, 19.4%). The final diagnosis was pancreatic malignancy in 27 patients and benign disease in four patients, which was confirmed by surgery and clinical follow-up. Two biopsy results were false-negative. The diagnostic accuracy in biopsies was 93.5% (29 of 31). The sensitivity to detect a malignant disease was 92.6% (25 of 27), and the specificity was 100%. All patients tolerated the procedure well; minor peripancreatic hemorrhage was found in two patients after the procedure, and none had major complications either during or after the procedure. DATA CONCLUSION: MRI-guided percutaneous biopsy of pancreatic lesions using an open 1.0T high-field scanner has high diagnostic accuracy, which is feasible and safe for use in clinical practice. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:382-388.
BACKGROUND:Pancreatic carcinoma is a common cause of cancer deaths worldwide. Biopsy is often required for the initial diagnosis of pancreatic masses. Biopsy can be performed endoscopically or percutaneously with computed tomography (CT) and ultrasound (US) guidance. MRI offers many inherent advantages over CT and US. PURPOSE/HYPOTHESIS: To prospectively evaluate the feasibility, accuracy, and safety of MRI-guided percutaneous coaxial cutting needle biopsy of pancreatic lesions using an open 1.0T high-field MR scanner. STUDY TYPE: Prospective. POPULATION: Thirty-one patients with 31 pancreatic lesions underwent MR-guided percutaneous coaxial cutting needle biopsy. FIELD STRENGTH/SEQUENCE: 1.0T T2 WI-TSE PDW-aTSE T1 WI-TFE. ASSESSMENT: Final diagnosis was confirmed by surgery and clinical follow-up for at least 12 months. The accuracy, sensitivity, and specificity were calculated. Complications were recorded. STATISTICAL TESTS: There was no statistical analysis in this study. RESULTS: The procedure was technically successful and final biopsy samples were adequate for histopathological examination in all patients. Biopsy pathology revealed malignant pancreatic tumor in 25 patients (25/31, 80.6%), and benign pancreatic lesions were present in six patients (6/31, 19.4%). The final diagnosis was pancreatic malignancy in 27 patients and benign disease in four patients, which was confirmed by surgery and clinical follow-up. Two biopsy results were false-negative. The diagnostic accuracy in biopsies was 93.5% (29 of 31). The sensitivity to detect a malignant disease was 92.6% (25 of 27), and the specificity was 100%. All patients tolerated the procedure well; minor peripancreatic hemorrhage was found in two patients after the procedure, and none had major complications either during or after the procedure. DATA CONCLUSION: MRI-guided percutaneous biopsy of pancreatic lesions using an open 1.0T high-field scanner has high diagnostic accuracy, which is feasible and safe for use in clinical practice. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;48:382-388.