2002 Use of Real-Time Magnetic Resonance Guidance to Assist Bone Biopsy in Pediatric Malignancy

Description: Magnetic resonance (MR) imaging (MRI) has the advantage of demonstrating lesions not visualized by other radiologic modalities. We present a case involving pediatric malignancy where MR-guided bone biopsy confirmed correct histologic diagnosis and was used to plan additional treatment. A 2-year, 9-month-old boy had a history of spontaneous regression of stage 4S neuroblastoma. 123I-metaiodobenzylguanidine scintigraphy showed a hot spot at his right lower leg; however, neither plain radiograph 99mTc diphosphonate bone scan was positive. Only MRI depicted a lesion at the distal third of his right tibia, and a subsequent MR-guided bone biopsy was diagnostic of bone marrow metastasis. After 6 courses of intensive chemotherapy, he has been in complete remission. MR-guided biopsy technique is likely to be particularly useful for the resection of invisible metastatic lesions, especially those that are only visible using MRI.
PEDIATRICS Vol. 109 No. 1 January 2002, pp. e18 full text Use of Real-Time Magnetic Resonance Guidance to Assist Bone Biopsy in Pediatric Malignancy Shigeru Ueno, MD, Seishichi Yokoyama, MD, Hitoshi Hirakawa, MD*, Hiromasa Yabe, MD, Yutaka Suzuki, MD, Hideki Atsumi, MD and Mitsunori Matsumae, MD