Biopsy Needles, Markers, and Devices

Magnetic resonance (MR) imaging has been used to guide tissue biopsy and apply markers for many years. These specialized procedures require tools that are acceptable for use with MR systems. Many commercially available biopsy needles, markers, and devices (i.e., guide wires, stylets, marking wires, marking clips, biopsy guns, etc.) have been evaluated with respect to producing artifacts and being safe with MR procedures. The results have indicated that most of the commercially available biopsy needles, markers, and devices are not useful for MR-guided biopsy procedures due to the presence of excessive ferromagnetism and the associated artifacts that may limit or obscure the area of interest.

For many of the commercially available devices, studies have reported that the presence of ferromagnetic biopsy needles and lesion marking wires in a tissue phantom used for testing produced such substantial artifacts that they would not be useful for MR-guided procedures. Needles or devices containing any type of ferromagnetic material tend to have too much magnetic susceptibility to allow effective use for MR-guided procedures. Fortunately, several needles, markers, and devices have been constructed out of materials with low magnetic susceptibility specifically for use in MR-guided procedures.

Although most of the biopsy guns tested for magnetic field interactions and artifacts were found to be ferromagnetic, since they are not used in the immediate area of the target tissue, artifacts associated with these devices are unlikely to affect the resulting images during MR-guided biopsy procedures. Nevertheless, the presence of ferromagnetism may preclude the optimal use of most biopsy guns in the MR environment, especially if a 3-Tesla scanner is being used for the procedure. Currently, there are several commercially available biopsy devices, including vacuum-assisted systems, developed specifically for use in MR-guided procedures.

REFERENCES

Causer PA, Piron CA, Jong RA, et al. MR imaging-guided breast localization system with medial or lateral access. Radiology. 2006;240:369-79.

Chen X, Lehman CD, Dee KE. MRI-guided breast biopsy: clinical experience with 14-gauge stainless steel core biopsy needle. AJR Am J Roentgenol. 2004;182:1075-80.

Daniel BL, Freeman LJ, Pyzoha JM, et al. An MRI-compatible semiautomated vacuum-assisted breast biopsy system: initial feasibility study. J Magn Reson Imaging. 2005;21:637-44.

Hall WA, Galicich W, Bergman T, Truwit CL. 3-Tesla intraoperative MR imaging for neurosurgery. J Neurooncol. 2006;77:297-303.

Lehman CD, Eby PR, Chen X, Dee KE, Thursten B, McCloskey J. MR imaging-guided breast biopsy using a coaxial technique with a 14-gauge stainless steel core biopsy needle and a titanium sheath. AJR Am J Roentgenol. 2003;181:183-5.

Lewin JS, et al. Needle localization in MR-guided biopsy and aspiration: Effect of field strength, sequence design, and magnetic field orientation. AJR Am J Roentgenol 1996;166:1337-1341.

Lufkin R, Layfield L. Coaxial needle system of MR- and CT-guided aspiration cytology. J Computer Assist Tomogr 1989;13:1105-1107.

Lufkin R, Teresi L, Hanafee W. New needle for MR-guided aspiration cytology of the head and neck. AJR Am J Roentgenol 1987;149:380-382.

Moscatel M, Shellock FG, Morisoli S. Biopsy needles and devices: assessment of ferromagnetism and artifacts during exposure to a 1.5-Tesla MR system. J Magn Reson Imaging 1995;5:369-372.

Shellock FG. Magnetic Resonance Procedures: Health Effects and Safety. CRC Press, LLC, Boca Raton, FL, 2001.

Shellock FG, Kanal E. Magnetic Resonance: Bioeffects, Safety, and Patient Management. Second Edition, Lippincott-Raven Press, New York, 1996.

Shellock FG, Shellock VJ. Additional information pertaining to the MR-compatibility of biopsy needles and devices. J Magn Reson Imaging 1996;6:411.

Shellock FG, Shellock VJ. Metallic marking clips used after stereotactic breast biopsy: ex vivo testing of ferromagnetism, heating, and artifacts associated with MRI. AJR Am J Roentgenol 1999;172:1417-1419.

Veltman J, Boetes C, Wobbes T, Blickman JG, Barentsz JO. Magnetic resonance-guided biopsies and localizations of the breast: initial experiences using an open breast coil and compatible intervention device. Invest Radiol. 2005;40:379-84.

Zangos S, Herzog C, Eichler K, et al. MR-compatible assistance system for punction in a high-field system: device and feasibility of transgluteal biopsies of the prostate gland. Eur Radiol. 2007;17:1118-24.