Improving CT-guided transthoracic biopsy of mediastinal lesions by diffusion-weighted magnetic resonance imaging

Authors

  • Marcos Duarte Guimarães AC Camargo Cancer Center; Department of Imaging
  • Bruno Hochhegger Universidade Federal de Ciências da Saúde de Porto Alegre; Department of Radiology
  • Marcelo Felipe Kuperman Benveniste University of Texas; MD Anderson Cancer Center; Department of Diagnostic Radiology
  • Bruno Calazans Odisio University of Texas; MD Anderson Cancer Center; Department of Diagnostic and Interventional Radiology
  • Jefferson Luiz Gross AC Camargo Cancer Center; Department of Thoracic Surgery
  • Charles Edouard Zurstrassen AC Camargo Cancer Center; Department of Interventional Radiology
  • Chiang Cheng Tyng AC Camargo Cancer Center; Department of Imaging
  • Almir Galvão Vieira Bitencourt AC Camargo Cancer Center; Department of Imaging
  • Edson Marchiori Universidade Federal do Rio de Janeiro; Department of Radiology

DOI:

https://doi.org/10.6061/clinics/2014(11)13

Abstract

OBJECTIVES: To evaluate the preliminary results obtained using diffusion-weighted magnetic resonance imaging and the apparent diffusion coefficient for planning computed tomography-guided biopsies of selected mediastinal lesions. METHODS: Eight patients with mediastinal lesions suspicious for malignancy were referred for computed tomography-guided biopsy. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient measurement were performed to assist in biopsy planning with diffusion/computed tomography fused images. We selected mediastinal lesions that could provide discordant diagnoses depending on the biopsy site, including large heterogeneous masses, lesions associated with lung atelectasis or consolidation, lesions involving large mediastinal vessels and lesions for which the results of biopsy using other methods and histopathological examination were divergent from the clinical and radiological suspicion. RESULTS: In all cases, the biopsy needle was successfully directed to areas of higher signal intensity on diffusion-weighted sequences and the lowest apparent diffusion coefficient within the lesion (mean, 0.8 [range, 0.6-1.1]×10-3 mm2/s), suggesting high cellularity. All biopsies provided adequate material for specific histopathological diagnoses of four lymphomas, two sarcomas and two thymomas. CONCLUSION: Functional imaging tools, such as diffusion-weighted imaging and the apparent diffusion coefficient, are promising for implementation in noninvasive and imaging-guided procedures. However, additional studies are needed to confirm that mediastinal biopsy can be improved with these techniques.

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Published

2014-11-01

Issue

Section

Rapid Communication

How to Cite

Improving CT-guided transthoracic biopsy of mediastinal lesions by diffusion-weighted magnetic resonance imaging . (2014). Clinics, 69(11), 787-791. https://doi.org/10.6061/clinics/2014(11)13