RadteraMRI-Guided Breast Biopsy
MR+ ContrastBreast
Indications
- Suspicious MRI-only lesion (mass or non-mass enhancement) with no mammographic or sonographic correlate after second-look workup
- BI-RADS 4/5 enhancing lesion identified on contrast MRI requiring histology
Patient prep
- Repeat gadolinium/renal and MRI safety screening; manage anticoagulation per policy
- Premenopausal scheduling on days 7-14 ideal to control BPE and keep lesion conspicuous
- Prone positioning in dedicated breast biopsy coil with grid/pillar compression; IV access for contrast
Contrast
AgentGadolinium-based contrast agent (macrocyclic preferred)
RouteIV
Dose0.1 mmol/kg
TimingContrast given to relocalize lesion; biopsy performed promptly before enhancement fades (typically within several minutes)
Technique
- Acquire contrast-enhanced sequence to identify the target; use grid/fiducial to compute coordinates
- Insert MR-compatible introducer/obturator to target depth; confirm position with imaging
- Vacuum-assisted biopsy (VAB) acquires multiple cores; deploy MR-compatible marker clip
- Post-procedure mammogram to document clip; image lesion site to confirm sampling
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Pre-contrast + dynamic post-contrast localizer | Axial | Identify and target enhancing lesion |
| 2 | Confirmation post-introducer | Axial | Verify obturator/needle within target |
| 3 | Post-clip | Axial + mammogram | Document marker placement |
Key points
- Enhancement may fade after contrast — work efficiently; target localization is time-sensitive
- VAB is standard for MRI-guided sampling; always place a clip since lesion may be invisible on other modalities afterward
- Confirm rad-path concordance; non-visualization/discordance may require repeat MRI follow-up or surgical excision
- Reserve for true MRI-only lesions after a diligent second-look ultrasound and mammographic correlation
References
• ACR Practice Parameter for the Performance of MRI-Guided Breast Interventional Procedures
• ACR Practice Parameter for Contrast-Enhanced Breast MRI
• ACR BI-RADS Atlas, 5th ed. (MRI)
• Radiopaedia: MRI-guided breast biopsy ( link
• ACR Practice Parameter for Contrast-Enhanced Breast MRI
• ACR BI-RADS Atlas, 5th ed. (MRI)
• Radiopaedia: MRI-guided breast biopsy ( link
Source: Researched — verify against your institution
‹ PreviousMRI Breast With and Without Contrast (Bilateral)Next ›Targeted / Diagnostic Breast Ultrasound
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.