Prospective evaluation of MR overlay on real-time fluoroscopy for percutaneous extremity biopsies of bone lesions visible on MRI but not on CT in children in the interventional radiology suite

Pediatr Radiol. 2018 Feb;48(2):270-278. doi: 10.1007/s00247-017-3995-6. Epub 2017 Nov 12.

Abstract

Magnetic resonance imaging (MRI) often provides better visualization of bone marrow abnormalities than computed tomography (CT) or fluoroscopy, but bone biopsies are usually performed using conventional CT or, more recently, C-arm CT guidance. Biopsies of bone lesions solely visible on MRI are often challenging to localize and require the operator to review the MRI on a separate console to correlate with MRI anatomical landmarks during the biopsy. The MR overlay technique facilitates such biopsies in the angiographic suite by allowing the pre-procedural 3-D MRI to be overlaid on intraprocedural 2-D fluoroscopy. This study describes our initial experience with the MR overlay technique in the angiography suite during pediatric percutaneous extremity bone biopsies of lesions visible on MRI but not on CT or fluoroscopy and demonstrates its utility in relevant clinical cases.

Keywords: Biopsy; Bone; Fluoroscopy; Image fusion; Interventional radiology; Magnetic resonance imaging.

MeSH terms

  • Anatomic Landmarks
  • Biopsy, Needle
  • Bone Diseases / diagnostic imaging*
  • Bone Diseases / pathology
  • Child
  • Female
  • Fluoroscopy
  • Humans
  • Image Interpretation, Computer-Assisted
  • Imaging, Three-Dimensional
  • Magnetic Resonance Angiography / methods*
  • Male
  • Prospective Studies
  • Radiation Dosage
  • Radiography, Interventional
  • Tomography, X-Ray Computed