Fusion biopsy or real time virtual sonography (RVS) technique – the first experience in verification of hypervascular breast lesions under combined US/MR control

One of the actual problems of oncology is the early diagnosis of breast cancer. However, there are some difficulties not only in diagnostic but also in the verification of lesions. Image-guided cor-biopsy nowadays became the gold standard for verification of non-palpable breast lesions. The main issue is to choose the method of visualization. According to up-to-date recommendations, there is no universal method with all requirements (high visualization quality, convenience, and accessibility for biopsy). Fusion-biopsy or virtual real-time sonography can combine MRI diagnostic potential and facility of US

Aim: to leverage the technique of fusion biopsy under combined ultrasound/MR control for verification of breast lesions identified only on MRI and occult on MG and US.

Methods. 30 high-risk patients, who had pathological breast lesions detected by diagnostic CE-MRI, classified as BI-RADS 4, 5 yet occult on the other visualization methods were enrolled in the study. All patients underwent supine MRI prebiopsy examination, real-time virtual sonography of the lesions, image-guided biopsy or excisional biopsy, histopathologic examination.

Results. The breast fusion-biopsy method was developed based on up-to-date scientific publications and optimized for the technical equipment of N.N. Petrov National Medicine Research Center of Oncology. According to the designed protocol of examination, there were the following steps: interpretation of breast CE-MRI in the standard prone position for breast lesion detection, prebiopsy CE-MRI performed in the supine position, real-time virtual sonography for comparison of breast MRI and US, histopathologic examination.

Conclusion. Being one of the perspectives methodic of morphological verification Fusion-biopsy might become a more common procedure in breast lesions diagnostics. The simplicity of US-guided biopsy and high MRI breast diagnostic sensitivity are combined in fusion-biopsy technology.

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