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Okamoto S, Matsui Y, Hiraki T, Iguchi T, Komaki T, Yamauchi T, Uka M, Tomita K, Sakurai J, Gobara H, Kanazawa S. Needle artifact characteristics and insertion accuracy using a 1.2T open MRI scanner: A phantom study. Diagn Interv Imaging 2021; 102:363-370. [PMID: 33518449 DOI: 10.1016/j.diii.2020.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate the characteristics of needle artifacts and the accuracy of needle insertion using a 1.2 Tesla open magnetic resonance imaging (MRI) system in a phantom. MATERIALS AND METHODS First, the apparent width of the needle on the MRI and the needle tip position error of 16- and 18-gauge MRI-compatible introducer needles and a 17-gauge cryoneedle were examined with different needle angles (0°, 30°, 45°, 60°, and 90°) to the main magnetic field (B0), sequence types (balanced steady-state acquisition with rewound gradient echo [BASG] and T2-weighted fast spin echo [FSE] sequence), and frequency encoding directions. Second, the accuracy of needle insertion was evaluated after 10 MRI fluoroscopy-guided insertions in a phantom. RESULTS The apparent needle widths was larger when the angle of the needle axis relative to B0 was larger. The needles appeared larger on BASG than on T2-weighted FSE images, with the largest apparent widths of 16-, 17-, and 18-gauge needles of 14.3, 11.6, and 11.0mm, respectively. The apparent needle tip position was always more distal than the actual position on BASG images, with the largest longitudinal error of 4.0mm. Meanwhile, the 16- and 18-gauge needle tips appeared more proximal on T2-weighted FSE images with right-to-left frequency encoding direction. The mean accuracy of MRI fluoroscopy-guided needle insertion was 3.1mm. CONCLUSION These experiments clarify the characteristics of needle artifacts in a 1.2 Tesla open MRI. With this system, the MRI fluoroscopy-guided needle insertion demonstrated an acceptable accuracy for clinical use.
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Affiliation(s)
- Soichiro Okamoto
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Yusuke Matsui
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
| | - Takao Hiraki
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Toshihiro Iguchi
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Toshiyuki Komaki
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Takatsugu Yamauchi
- Central Division of Radiology, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Mayu Uka
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Koji Tomita
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Jun Sakurai
- Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
| | - Hideo Gobara
- Division of Medical Informatics, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, 700-8558, Okayama, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan
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Kägebein U, Godenschweger F, Armstrong BSR, Rose G, Wacker FK, Speck O, Hensen B. Percutaneous MR-guided interventions using an optical Moiré Phase tracking system: Initial results. PLoS One 2018; 13:e0205394. [PMID: 30325955 PMCID: PMC6191114 DOI: 10.1371/journal.pone.0205394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 09/25/2018] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was the development and evaluation of a real-time guidance support using optical Moiré Phase Tracking (MPT) for magnetic resonance (MR) guided percutaneous interventions. A gradient echo sequence, capable of real-time position updates by the MPT system, was modified to enable needle guidance based on four rigidly attached MPT markers at the back of a needle. Two perpendicular imaging planes were automatically aligned along the calibrated needle and centered at its tip. For user guidance, additional information about the needle trajectory and the tip to target distance were added as image overlay. Both, images and guiding information were displayed on the in-room monitor to facilitate MR guided interventions. The guidance support was evaluated by four experienced interventional radiologists and four novices targeting rubber O-rings embedded in a custom-made phantom on a 3T wide-bore MRI system (80 punctures). The skin to target time, user error, system error and total error were analyzed. The mean skin to target time was 146s±68s with no statistically significant difference between experts and novices. A low mean user error (0.91mm±0.43mm), system error (0.53mm±0.27mm) and total error (0.99mm±0.47mm) was reached in all directions. No statistically significant difference in user error, system error and total error could be found between experts and novices. The presented tracking and image guidance system combined with the user interface offers continuous and interactive control of the imaging plane while puncturing in the magnet enabling accurate real-time feedback for both, experienced and non-experienced users.
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Affiliation(s)
- Urte Kägebein
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Department Biomedical Magnetic Resonance, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- STIMULATE – Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
- * E-mail:
| | - Frank Godenschweger
- Department Biomedical Magnetic Resonance, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Brian S. R. Armstrong
- Department of Electrical Engineering, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, United States of America
| | - Georg Rose
- STIMULATE – Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
- Chair in Healthcare Telematics and Medical Engineering, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Frank K. Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE – Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
| | - Oliver Speck
- Department Biomedical Magnetic Resonance, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- STIMULATE – Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
| | - Bennet Hensen
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- STIMULATE – Solution Centre for Image Guided Local Therapies, Magdeburg, Germany
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Mewes A, Heinrich F, Hensen B, Wacker F, Lawonn K, Hansen C. Concepts for augmented reality visualisation to support needle guidance inside the MRI. Healthc Technol Lett 2018; 5:172-176. [PMID: 30464849 PMCID: PMC6222244 DOI: 10.1049/htl.2018.5076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 08/20/2018] [Indexed: 11/20/2022] Open
Abstract
During MRI-guided interventions, navigation support is often separated from the operating field on displays, which impedes the interpretation of positions and orientations of instruments inside the patient's body as well as hand–eye coordination. To overcome these issues projector-based augmented reality can be used to support needle guidance inside the MRI bore directly in the operating field. The authors present two visualisation concepts for needle navigation aids which were compared in an accuracy and usability study with eight participants, four of whom were experienced radiologists. The results show that both concepts are equally accurate (\documentclass[12pt]{minimal}
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}{}$1.7 \pm 0.5\, {\rm mm}$\end{document}1.7±0.5mm), useful and easy to use, with clear visual feedback about the state and success of the needle puncture. For easier clinical applicability, a dynamic projection on moving surfaces and organ movement tracking are needed. For now, tests with patients with respiratory arrest are feasible.
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Affiliation(s)
- André Mewes
- Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Germany.,Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, Germany
| | - Florian Heinrich
- Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Germany.,Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, Germany
| | - Bennet Hensen
- Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, Germany.,Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Germany
| | - Frank Wacker
- Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, Germany.,Institute of Diagnostic and Interventional Radiology, Hanover Medical School, Germany
| | - Kai Lawonn
- Faculty of Computer Science, University of Koblenz-Landau, Germany
| | - Christian Hansen
- Faculty of Computer Science, Otto-von-Guericke University Magdeburg, Germany.,Research Campus STIMULATE, Otto-von-Guericke University Magdeburg, Germany
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Mewes A, Heinrich F, Kägebein U, Hensen B, Wacker F, Hansen C. Projector-based augmented reality system for interventional visualization inside MRI scanners. Int J Med Robot 2018; 15:e1950. [DOI: 10.1002/rcs.1950] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/11/2018] [Accepted: 08/01/2018] [Indexed: 11/09/2022]
Affiliation(s)
- André Mewes
- Faculty of Computer Science; Otto von Guericke University Magdeburg; Magdeburg Germany
| | - Florian Heinrich
- Faculty of Computer Science; Otto von Guericke University Magdeburg; Magdeburg Germany
| | - Urte Kägebein
- Faculty of Computer Science; Otto von Guericke University Magdeburg; Magdeburg Germany
| | - Bennet Hensen
- Institute of Diagnostic and Interventional Radiology; Hannover Medical School; Hanover Germany
| | - Frank Wacker
- Institute of Diagnostic and Interventional Radiology; Hannover Medical School; Hanover Germany
| | - Christian Hansen
- Faculty of Computer Science; Otto von Guericke University Magdeburg; Magdeburg Germany
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Busse H, Kahn T, Moche M. Techniques for Interventional MRI Guidance in Closed-Bore Systems. Top Magn Reson Imaging 2018; 27:9-18. [PMID: 29406410 DOI: 10.1097/rmr.0000000000000150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Efficient image guidance is the basis for minimally invasive interventions. In comparison with X-ray, computed tomography (CT), or ultrasound imaging, magnetic resonance imaging (MRI) provides the best soft tissue contrast without ionizing radiation and is therefore predestined for procedural control. But MRI is also characterized by spatial constraints, electromagnetic interactions, long imaging times, and resulting workflow issues. Although many technical requirements have been met over the years-most notably magnetic resonance (MR) compatibility of tools, interventional pulse sequences, and powerful processing hardware and software-there is still a large variety of stand-alone devices and systems for specific procedures only.Stereotactic guidance with the table outside the magnet is common and relies on proper registration of the guiding grids or manipulators to the MR images. Instrument tracking, often by optical sensing, can be added to provide the physicians with proper eye-hand coordination during their navigated approach. Only in very short wide-bore systems, needles can be advanced at the extended arm under near real-time imaging. In standard magnets, control and workflow may be improved by remote operation using robotic or manual driving elements.This work highlights a number of devices and techniques for different interventional settings with a focus on percutaneous, interstitial procedures in different organ regions. The goal is to identify technical and procedural elements that might be relevant for interventional guidance in a broader context, independent of the clinical application given here. Key challenges remain the seamless integration into the interventional workflow, safe clinical translation, and proper cost effectiveness.
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Affiliation(s)
- Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
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Fütterer JJ, Moche M, Busse H, Yakar D. In-Bore MR-Guided Biopsy Systems and Utility of PI-RADS. Top Magn Reson Imaging 2016; 25:119-123. [PMID: 27187168 DOI: 10.1097/rmr.0000000000000090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A diagnostic dilemma exists in cases wherein a patient with clinical suspicion for prostate cancer has a negative transrectal ultrasound-guided biopsy session. Although transrectal ultrasound-guided biopsy is the standard of care, a paradigm shift is being observed. In biopsy-naive patients and patients with at least 1 negative biopsy session, multiparametric magnetic resonance imaging (MRI) is being utilized for tumor detection and subsequent targeting. Several commercial devices are now available for targeted prostate biopsy ranging from transrectal ultrasound-MR fusion biopsy to in bore MR-guided biopsy. In this review, we will give an update on the current status of in-bore MRI-guided biopsy systems and discuss value of prostate imaging-reporting and data system (PIRADS).
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Affiliation(s)
- Jurgen J Fütterer
- *Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen †MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands ‡Department of Diagnostic and Interventional Radiology, University Hospital, Leipzig, Germany
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Navigated MRI-guided liver biopsies in a closed-bore scanner: experience in 52 patients. Eur Radiol 2015; 26:2462-70. [PMID: 26563349 PMCID: PMC4927599 DOI: 10.1007/s00330-015-4097-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/26/2015] [Accepted: 10/28/2015] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To evaluate clinical effectiveness and diagnostic efficiency of a navigation device for MR-guided biopsies of focal liver lesions in a closed-bore scanner. METHODS In 52 patients, 55 biopsies were performed. An add-on MR navigation system with optical instrument tracking was used for image guidance and biopsy device insertion outside the bore. Fast control imaging allowed visualization of the true needle position at any time. The biopsy workflow and procedure duration were recorded. Histological analysis and clinical course/outcome were used to calculate sensitivity, specificity and diagnostic accuracy. RESULTS Fifty-four of 55 liver biopsies were performed successfully with the system. No major and four minor complications occurred. Mean tumour size was 23 ± 14 mm and the skin-to-target length ranged from 22 to 177 mm. In 39 cases, access path was double oblique. Sensitivity, specificity and diagnostic accuracy were 88 %, 100 % and 92 %, respectively. The mean procedure time was 51 ± 12 min, whereas the puncture itself lasted 16 ± 6 min. On average, four control scans were taken. CONCLUSIONS Using this navigation device, biopsies of poorly visible and difficult accessible liver lesions could be performed safely and reliably in a closed-bore MRI scanner. The system can be easily implemented in clinical routine workflow. KEY POINTS • Targeted liver biopsies could be reliably performed in a closed-bore MRI. • The navigation system allows for image guidance outside of the scanner bore. • Assisted MRI-guided biopsies are helpful for focal lesions with a difficult access. • Successful integration of the method in clinical workflow was shown. • Subsequent system installation in an existing MRI environment is feasible.
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Targeting Accuracy, Procedure Times and User Experience of 240 Experimental MRI Biopsies Guided by a Clinical Add-On Navigation System. PLoS One 2015. [PMID: 26222443 PMCID: PMC4519044 DOI: 10.1371/journal.pone.0134370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES MRI is of great clinical utility for the guidance of special diagnostic and therapeutic interventions. The majority of such procedures are performed iteratively ("in-and-out") in standard, closed-bore MRI systems with control imaging inside the bore and needle adjustments outside the bore. The fundamental limitations of such an approach have led to the development of various assistance techniques, from simple guidance tools to advanced navigation systems. The purpose of this work was to thoroughly assess the targeting accuracy, workflow and usability of a clinical add-on navigation solution on 240 simulated biopsies by different medical operators. METHODS Navigation relied on a virtual 3D MRI scene with real-time overlay of the optically tracked biopsy needle. Smart reference markers on a freely adjustable arm ensured proper registration. Twenty-four operators - attending (AR) and resident radiologists (RR) as well as medical students (MS) - performed well-controlled biopsies of 10 embedded model targets (mean diameter: 8.5 mm, insertion depths: 17-76 mm). Targeting accuracy, procedure times and 13 Likert scores on system performance were determined (strong agreement: 5.0). RESULTS Differences in diagnostic success rates (AR: 93%, RR: 88%, MS: 81%) were not significant. In contrast, between-group differences in biopsy times (AR: 4:15, RR: 4:40, MS: 5:06 min:sec) differed significantly (p<0.01). Mean overall rating was 4.2. The average operator would use the system again (4.8) and stated that the outcome justifies the extra effort (4.4). Lowest agreement was reported for the robustness against external perturbations (2.8). CONCLUSIONS The described combination of optical tracking technology with an automatic MRI registration appears to be sufficiently accurate for instrument guidance in a standard (closed-bore) MRI environment. High targeting accuracy and usability was demonstrated on a relatively large number of procedures and operators. Between groups with different expertise there were significant differences in experimental procedure times but not in the number of successful biopsies.
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Riffe MJ, Yutzy SR, Jiang Y, Twieg MD, Blumenthal CJ, Hsu DP, Pan L, Gilson WD, Sunshine JL, Flask CA, Duerk JL, Nakamoto D, Gulani V, Griswold MA. Device localization and dynamic scan plane selection using a wireless magnetic resonance imaging detector array. Magn Reson Med 2013; 71:2243-9. [PMID: 23900921 DOI: 10.1002/mrm.24853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/17/2013] [Accepted: 06/02/2013] [Indexed: 11/10/2022]
Abstract
PURPOSE A prototype wireless guidance device using single sideband amplitude modulation (SSB) is presented for a 1.5T magnetic resonance imaging system. METHODS The device contained three fiducial markers each mounted to an independent receiver coil equipped with wireless SSB technology. Acquiring orthogonal projections of these markers determined the position and orientation of the device, which was used to define the scan plane for a subsequent image acquisition. Device localization and scan plane update required approximately 30 ms, so it could be interleaved with high temporal resolution imaging. Since the wireless device is used for localization and does not require full imaging capability, the design of the SSB wireless system was simplified by allowing an asynchronous clock between the transmitter and receiver. RESULTS When coupled to a high readout bandwidth, the error caused by the lack of a shared frequency reference was quantified to be less than one pixel (0.78 mm) in the projection acquisitions. Image guidance with the prototype was demonstrated with a phantom where a needle was successfully guided to a target and contrast was delivered. CONCLUSION The feasibility of active tracking with a wireless detector array is demonstrated. Wireless arrays could be incorporated into devices to assist in image-guided procedures.
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Affiliation(s)
- Matthew J Riffe
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
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Augmented Reality Visualization Using Image Overlay Technology for MR-Guided Interventions. Invest Radiol 2013; 48:464-70. [DOI: 10.1097/rli.0b013e31827b9f86] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rothgang E, Gilson WD, Wacker F, Hornegger J, Lorenz CH, Weiss CR. Rapid freehand MR-guided percutaneous needle interventions: An image-based approach to improve workflow and feasibility. J Magn Reson Imaging 2013; 37:1202-12. [DOI: 10.1002/jmri.23894] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 09/17/2012] [Indexed: 11/11/2022] Open
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Fritz J, U-Thainual P, Ungi T, Flammang AJ, Fichtinger G, Iordachita II, Carrino JA. Augmented reality visualization with use of image overlay technology for MR imaging-guided interventions: assessment of performance in cadaveric shoulder and hip arthrography at 1.5 T. Radiology 2012; 265:254-9. [PMID: 22843764 DOI: 10.1148/radiol.12112640] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively assess overlay technology in providing accurate and efficient targeting for magnetic resonance (MR) imaging-guided shoulder and hip joint arthrography. MATERIALS AND METHODS A prototype augmented reality image overlay system was used in conjunction with a clinical 1.5-T MR imager. A total of 24 shoulder joint and 24 hip joint injections were planned in 12 human cadavers. Two operators (A and B) participated, each performing procedures on different cadavers using image overlay guidance. MR imaging was used to confirm needle positions, monitor injections, and perform MR arthrography. Accuracy was assessed according to the rate of needle adjustment, target error, and whether the injection was intraarticular. Efficiency was assessed according to arthrography procedural time. Operator differences were assessed with comparison of accuracy and procedure times between the operators. Mann-Whitney U test and Fisher exact test were used to assess group differences. RESULTS Forty-five arthrography procedures (23 shoulders, 22 hips) were performed. Three joints had prostheses and were excluded. Operator A performed 12 shoulder and 12 hip injections. Operator B performed 11 shoulder and 10 hip injections. Needle adjustment rate was 13% (six of 45; one for operator A and five for operator B). Target error was 3.1 mm±1.2 (standard deviation) (operator A, 2.9 mm±1.4; operator B, 3.5 mm±0.9). Intraarticular injection rate was 100% (45 of 45). The average arthrography time was 14 minutes (range, 6-27 minutes; 12 minutes [range, 6-25 minutes] for operator A and 16 minutes [range, 6-27 min] for operator B). Operator differences were not significant with regard to needle adjustment rate (P=.08), target error (P=.07), intraarticular injection rate (P>.99), and arthrography time (P=.22). CONCLUSION Image overlay technology provides accurate and efficient MR guidance for successful shoulder and hip arthrography in human cadavers.
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Affiliation(s)
- Jan Fritz
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 5165, Baltimore, MD 21287, USA
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Referencing of markerless CT data sets with cone beam subvolume including registration markers to ease computer-assisted surgery - A clinical and technical research. Int J Med Robot 2012; 9:e39-45. [DOI: 10.1002/rcs.1444] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2012] [Indexed: 11/07/2022]
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Thörmer G, Garnov N, Moche M, Haase J, Kahn T, Busse H. Simultaneous 3D localization of multiple MR-visible markers in fully reconstructed MR images: proof-of-concept for subsecond position tracking. Magn Reson Imaging 2012; 30:371-81. [DOI: 10.1016/j.mri.2011.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 08/26/2011] [Accepted: 10/21/2011] [Indexed: 11/27/2022]
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Augmented Reality Visualization With Image Overlay for MRI-Guided Intervention: Accuracy for Lumbar Spinal Procedures With a 1.5-T MRI System. AJR Am J Roentgenol 2012; 198:W266-73. [DOI: 10.2214/ajr.11.6918] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Garnov N, Thormer G, Trampel R, Grunder W, Kahn T, Moche M, Busse H. Suitability of miniature inductively coupled RF coils as MR-visible markers for clinical purposes. Med Phys 2012; 38:6327-35. [PMID: 22047397 DOI: 10.1118/1.3655027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE MR-visible markers have already been used for various purposes such as image registration, motion detection, and device tracking. Inductively coupled RF (ICRF) coils, in particular, provide a high contrast and do not require connecting wires to the scanner, which makes their application highly flexible and safe. This work aims to thoroughly characterize the MR signals of such ICRF markers under various conditions with a special emphasis on fully automatic detection. METHODS The small markers consisted of a solenoid coil that was wound around a glass tube containing the MR signal source and tuned to the resonance frequency of a 1.5 T MRI. Marker imaging was performed with a spoiled gradient echo sequence (FLASH) and a balanced steady-state free precession (SSFP) sequence (TrueFISP) in three standard projections. The signal intensities of the markers were recorded for both pulse sequences, three source materials (tap water, distilled water, and contrast agent solution), different flip angles and coil alignments with respect to the B(0) direction as well as for different marker positions in the entire imaging volume (field of view, FOV). Heating of the ICRF coils was measured during 10-min RF expositions to three conventional pulse sequences. Clinical utility of the markers was assessed from their performance in computer-aided detection and in defining double oblique scan planes. RESULTS For almost the entire FOV (±215 mm) and an estimated 82% of all possible RF coil alignments with respect to B(0), the ICRF markers generated clearly visible MR signals and could be reliably localized over a large range of flip angles, in particular with the TrueFISP sequence (0.3°-4.0°). Generally, TrueFISP provided a higher marker contrast than FLASH. RF exposition caused a moderate heating (≤5 °C) of the ICRF coils only. CONCLUSIONS Small ICRF coils, imaged at low flip angles with a balanced SSFP sequence showed an excellent performance under a variety of experimental conditions and therefore make for a reliable, compact, flexible, and relatively safe marker for clinical use.
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Affiliation(s)
- Nikita Garnov
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
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Busse H, Kahn T, Moche M. Navigation concepts for magnetic resonance imaging-guided musculoskeletal interventions. Top Magn Reson Imaging 2011; 22:179-188. [PMID: 23514925 DOI: 10.1097/rmr.0b013e31827c2d13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Image-guided musculoskeletal (MSK) interventions are a widely used alternative to open surgical procedures for various pathological findings in different body regions. They traditionally involve one of the established x-ray imaging techniques (radiography, fluoroscopy, computed tomography) or ultrasound scanning. Over the last decades, magnetic resonance imaging (MRI) has evolved into one of the most powerful diagnostic tools for nearly the whole body and has therefore been increasingly considered for interventional guidance as well.The strength of MRI for MSK applications is a combination of well-known general advantages, such as multiplanar and functional imaging capabilities, wide choice of tissue contrasts, and absence of ionizing radiation, as well as a number of MSK-specific factors, for example, the excellent depiction of soft-tissue tumors, nonosteolytic bone changes, and bone marrow lesions. On the downside, the magnetic resonance-compatible equipment needed, restricted space in the magnet, longer imaging times, and the more complex workflow have so far limited the number of MSK procedures under MRI guidance.Navigation solutions are generally a natural extension of any interventional imaging system, in particular, because powerful hardware and software for image processing have become routinely available. They help to identify proper access paths, provide accurate feedback on the instrument positions, facilitate the workflow in an MRI environment, and ultimately contribute to procedural safety and success.The purposes of this work were to describe some basic concepts and devices for MRI guidance of MSK procedures and to discuss technical and clinical achievements and challenges for some selected implementations.
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Affiliation(s)
- Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany.
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