The aim of this study is to report our five-years experience using US-MR co-registrationin approaching breast additional lesion blinded at second-look US, the so-called MR volume navigation (V Nav). It is anew technique in which during live US exam could be performedsecond-look and biopsy of US blinded lesions. Finally, demonstrate how this technique could increaseUSdetection rate (sensitivity) and reduce the number of patients to nominate MR guided biopsy increasing US and MR specificity.

During a five-year period we enrolled 115 consecutive patients (53±12 years, range 24-79) with 157 breast additional lesions only MR-detected and negative at second-look US.The same radiologist who has read MR exams performed all second-look US exams. The exclusion criterion was gynecomastia evaluated with two morphologic measurements. After positioning three pairs of markers made by soft gel capsules of natural d-alpha-tocopherol (Vitamin E), over a corresponding blue surgical skin marker all the patient underwent supine MR Fig. 2. We used a 1.5 T MR unit...

Second-look US with V Nav allowed to detect 60 (38%) MR detected breast additional lesions but 97 (62%) lesions were still blinded or not clearly visible at US even using US and MR co-registration. Twenty-eight (47%) lesions were malignant and 32 (53%) were benign in the US with V Nav group with Fig. 4 and Fig. 5. In the remaining, 57 (59%) lesions were malignant and 40 (41%) were benign. Seventeen (24%) out of 72 benign lesions were classified as high-risk lesions. All malignancies were...

US with V Nav is a very useful tool exploiting the MR higher sensitivity for breast lesions and US advantages in performing live exam. The application of this technique increases US detection and specificity reducing MR guided breast costs considering the increasing numbers of breast MR examinations. US biopsy using MR V Nav is a safe technique allowing to detect and biopsy every MR additional lesion in particular for lesions next to the chest wall or under the skin surface in which MR guided biopsy...

NuniziaCapozzi1,2 AlfonsoFausto3 Donatella Spina4 Francesco Gentili1 Francesco Giuseppe Mazzei3 Maria Antonietta Mazzei1 Luca Volterrani1 1Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese.Viale Bracci 10, 53100, Siena, Italy. 2Department of Experimental, Diagnostic and Specialty Medicine,University of Bologna, Policlinico Sant’Orsola-Malpighi, Via Massarenti 9, 40138, Bologna, Italy 3Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese,Viale Bracci 10, 53100, Siena, Italy. 4Pathological Anatomy, Azienda Ospedaliera Universitaria Senese,Viale Bracci 10, 53100, Siena, Italy.

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