Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 22:11:605014.
doi: 10.3389/fonc.2021.605014. eCollection 2021.

Multispectral Imaging for Metallic Biopsy Marker Detection During MRI-Guided Breast Biopsy: A Feasibility Study for Clinical Translation

Sarah Eskreis-Winkler  1   2 , Katherine Simon  1 , Melissa Reichman  1 , Pascal Spincemaille  1 , Thanh D Nguyen  1 , Paul J Christos  3 , Michele Drotman  1 , Martin R Prince  1 , Katja Pinker  2 , Elizabeth J Sutton  2 , Elizabeth A Morris  2 , Yi Wang  1
Affiliations

Multispectral Imaging for Metallic Biopsy Marker Detection During MRI-Guided Breast Biopsy: A Feasibility Study for Clinical Translation

Sarah Eskreis-Winkler et al. Front Oncol. .

Abstract

Purpose: To assess the feasibility and diagnostic accuracy of multispectral MRI (MSI) in the detection and localization of biopsy markers during MRI-guided breast biopsy.

Methods: This prospective study included 20 patients undergoing MR-guided breast biopsy. In 10 patients (Group 1), MSI was acquired following tissue sampling and biopsy marker deployment. In the other 10 patients (Group 2), MSI was acquired following tissue sampling but before biopsy marker deployment (to simulate deployment failure). All patients received post-procedure mammograms. Group 1 and Group 2 designations, in combination with the post-procedure mammogram, served as the reference standard. The diagnostic performance of MSI for biopsy marker identification was independently evaluated by two readers using two-spectral-bin MR and one-spectral-bin MR. The κ statistic was used to assess inter-rater agreement for biopsy marker identification.

Results: The sensitivity, specificity, and accuracy of biopsy marker detection for readers 1 and 2 using 2-bin MSI were 90.0% (9/10) and 90.0% (9/10), 100.0% (10/10) and 100.0% (10/10), 95.0% (19/20) and 95.0% (19/20); and using 1-bin MSI were 70.0% (7/10) and 80.0% (8/10), 100.0% (8/8) and 100.0% (10/10), 85.0% (17/20) and 90.0% (18/20). Positive predictive value was 100% for both readers for all numbers of bins. Inter-rater agreement was excellent: κ was 1.0 for 2-bin MSI and 0.81 for 1-bin MSI.

Conclusion: MSI is a feasible, diagnostically accurate technique for identifying metallic biopsy markers during MRI-guided breast biopsy and may eliminate the need for a post-procedure mammogram.

Keywords: biopsy marker; breast magnetic resonance imaging (MRI); magnetic resonance imaging (MRI)-guided breast biopsy; mammography; multispectral imaging.

PubMed Disclaimer

Conflict of interest statement

YW and PS are inventors on QSM-related patents issued to Cornell University and hold equity in Medimagemetric LLC. KP received payment for activities not related to the present article including lectures including service on speakers bureaus and for travel/accommodations/meeting expenses unrelated to activities listed from the European Society of Breast Imaging (MRI educational course, annual scientific meeting), and the IDKD 2019 (educational course). EM has received a grant from GRAIL, Inc. for research not related to the present article. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Biopsy marker study design.
Figure 2
Figure 2
MSI of agarose-based phantom containing a biopsy marker (yellow arrow) and adjacent air (green arrow).
Figure 3
Figure 3
MSI and mammogram performed after MR-guided breast biopsy in 5 patients. For each patient, columns (A, B) display the MSI acquired at 0.7 and 1.5 kHz, respectively. Column (C) displays the corresponding post-procedure mammogram. Biopsy markers are denoted with a yellow arrow. Adjacent air, if present, is denoted with a green arrow. Patient 3 had a known adjacent tumor, denoted with a magenta arrow.
Figure 4
Figure 4
A difficult case where the biopsy marker is within an air pocket, thus partially masking the signature high signal foci that denote biopsy marker location. Both readers failed to identify the presence of the biopsy marker. (A, B) display the multispectral images acquired at 0.7 and 1.5 kHz, respectively. (C) displays the corresponding post-procedure mammogram. Biopsy marker and air are denoted with a yellow arrow.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Lee CI, Ichikawa L, Rochelle MC, Kerlikowske K, Miglioretti DL, Sprague BL, et al. . Breast MRI BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices. Acad Radiol (2014) 21(11):1370–6. 10.1016/j.acra.2014.06.003 - DOI - PMC - PubMed
    1. Morris EA. Diagnostic breast MR imaging: current status and future directions. Magn Reson Imaging Clin N Am (2010) 18(1):57–74. 10.1016/j.mric.2009.09.005 - DOI - PubMed
    1. Mahoney MC, Newell MS. Breast Intervention: How I Do It. Radiology (2013) 268(1):12–24. 10.1148/radiol.13120985 - DOI - PubMed
    1. Schenck JF. The role of magnetic susceptibility in magnetic resonance imaging: MRI magnetic compatibility of the first and second kinds. Med Phys (1996) 23(6):815–50. 10.1118/1.597854 - DOI - PubMed
    1. Bourke AG, Peter P, Jose CL. The disappearing clip: an unusual complication in MRI biopsy. BMJ Case Rep (2014) 2014:bcr2014204092. 10.1136/bcr-2014-204092 - DOI - PMC - PubMed