Open MRI navigation system guided needle biopsy of lung lesions: experience with 137 cases

Objective: To evaluate the feasibility, accuracy and its clinical value of MRI-guided needle biopsy of lung lesions. Methods: A total of 137 patients with pulmonary nodules or masses underwent lung biopsy in low-field open MRI equipped with iPath 200 optical tracking systems. Among them, 103 cases had solitary pulmonary lesion; the other 34 cases had multiple foci. The maximum diameter of the lesion was not smaller than 3.5 cm (≥3.5 cm) in 57 patients, between 1.5 cm and 3.4 cm (1.5- 3.4 cm) in 71 patients, not greater than 1.4 cm (≤1.4 cm) in 9 patients. Results: The puncture success rate was 100.0% (57/57) for lesions ≥ 3.5 cm, 98.6% (70/71) for lesions 1.5-3.4 cm, 77.8% (7/9) for lesions $1.4 cm and 97. 8% (134/137) for total cases, respectively. According to the pathological results, pulmonary lesions were malignant in 98 cases and benign in 39 cases. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MRI-guided lung biopsy were 94.2% (98/104), 100.0% (33/33), 95.6% (131/137), 100.0% (98/98) and 84.6% (33/39), respectively. Conclusion: MRI-guided needle biopsy of lung lesion can be performed precisely in a low- field open MRI with a low risk of complications. As a supplement to US or CT-guided biopsy, it is worth further promotion and application. (authors)