The value and feasibility of the freehand technique in MRI-guided breast lesion localization: A retrospective cohort study

This study aims to evaluate the value and feasibility of the freehand technique in magnetic resonance imaging-guided breast lesion localization. The effects of the extent of background parenchymal enhancement, proportion of fibroglandular tissue (FGT), histopathological results, breast imaging reporting and data system (BI-RADS) category, lesion type, lesion location and seniority of the radiologist on repositioning after puncture and therefore on the operation time were analyzed. The chi-square test and the Kaplan-Meier and log-rank tests were used for statistical analysis, and logistic and Cox regression analyses were used to construct a predictive model. Repositioning after puncture was more frequently required for radiologists with low seniority than for those with high seniority (P < .001) and for nonmass enhanced (NME) lesions than for mass lesions (P = .029). Logistic regression analysis revealed that high seniority radiologists rarely had to reposition patients (odds ratio [OR] = 0.077, 95% CI = 0.023-0.262, P < .001), whereas NME lesions required patient repositioning (OR = 2.363, 95% CI = 1.219-4.583, P = .011). The median localization times for high and low seniority radiologists were 9 and 13 minutes, respectively (P < .001). The median localization times for NME and mass lesions were 14 and 10 minutes, respectively (P < .001). Cox regression analysis revealed that high seniority shortened the operation time (OR = 2.306, 95% CI = 1.630-3.263, P < .001) and that NME lesions prolonged the operation time (OR = 0.409, 95% CI = 0.297-0.564, P < .001). The freehand technique is a feasible technique that reduces the duration of magnetic resonance imaging-guided breast lesion localization and is not affected by many factors, highlighting its potential for widespread adoption.