E1491. Problems Encountered in MRI-Guided Breast Biopsies and Troubleshooting Techniques
  1. Alisa Mobley; University of Alabama Heersink School of Medicine
  2. Joseph Willis; University of Alabama Heersink School of Medicine
  3. Stephanie Colvin; University of Alabama at Birmingham
  4. Stefanie Woodard; University of Alabama at Birmingham
MRI-guided biopsy is frequently performed for lesions that are mammographically and sonographically occult. Despite better visualization of these lesions on MRI, several patient and technical factors may present unique challenges to biopsy. Previously described challenges include navigating breast implants, challenging locations, vanishing lesions, patient factors, and software/CAD malfunction. In challenging cases, specific troubleshooting techniques can be utilized to optimize the biopsy procedure, potentially preventing delays in patient care, improving lesion sampling, and reducing biopsy complications.

Educational Goals / Teaching Points
Discuss various problems encountered during MRI-guided breast biopsies. Present troubleshooting options and biopsy techniques for difficult cases. Use a case-based approach to apply troubleshooting techniques.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This is a pictorial review presenting common challenges encountered during MRI-guided breast biopsies with corresponding troubleshooting techniques to improve lesion sampling. The ten problems that will be presented include the wrong lesion, the missing lesion, the lesion outside of the grid, the lesion that is too deep, the lesion that is too superficial, errors during the procedure, the moving patient, the nauseous patient, the patient in pain, and equipment malfunctioning.

Troubleshooting techniques can be easily implemented in daily practice to improve tissue sampling in challenging cases. Awareness of troubleshooting techniques may prevent delays in care, improve lesion sampling, and reduce complications.