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Liu M, Feng Q, Zhang H, Guo Y, Fan H. Progress in ultrasmall ferrite nanoparticles enhanced T1 magnetic resonance angiography. J Mater Chem B 2024; 12:6521-6531. [PMID: 38860874 DOI: 10.1039/d4tb00803k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
Contrast-enhanced magnetic resonance angiography (CE-MRA) plays a critical role in diagnosing and monitoring various vascular diseases. Achieving high-sensitivity detection of vascular abnormalities in CE-MRA depends on the properties of contrast agents. In contrast to clinically used gadolinium-based contrast agents (GBCAs), the new generation of ultrasmall ferrite nanoparticles-based contrast agents have high relaxivity, long blood circulation time, easy surface functionalization, and high biocompatibility, hence showing promising prospects in CE-MRA. This review aims to comprehensively summarize the advancements in ultrasmall ferrite nanoparticles-enhanced MRA for detecting vascular diseases. Additionally, this review also discusses the future clinical translational potential of ultrasmall ferrite nanoparticles-based contrast agents for vascular imaging. By investigating the current status of research and clinical applications, this review attempts to outline the progress, challenges, and future directions of using ultrasmall ferrite nanoparticles to drive the field of CE-MRA into a new frontier of accuracy and diagnostic efficacy.
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Affiliation(s)
- Minrui Liu
- Key Laboratory of Synthetic and Natural Functional Molecule of the Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi'an, Shaanxi, 710127, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 614001, China
| | - Quanqing Feng
- Key Laboratory of Synthetic and Natural Functional Molecule of the Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi'an, Shaanxi, 710127, China.
| | - Huan Zhang
- Key Laboratory of Synthetic and Natural Functional Molecule of the Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi'an, Shaanxi, 710127, China.
- Department of Radiology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai 519000, China
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, 614001, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 614001, China
| | - Haiming Fan
- Key Laboratory of Synthetic and Natural Functional Molecule of the Ministry of Education, College of Chemistry and Materials Science, Northwest University, Xi'an, Shaanxi, 710127, China.
- Center for Nanomedicine and Engineering, School of Medicine, Northwest University, Xi'an, Shaanxi, 710127, China.
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Nijsink H, Overduin CG, Willems LH, Warlé MC, Fütterer JJ. Current State of MRI-Guided Endovascular Arterial Interventions: A Systematic Review of Preclinical and Clinical Studies. J Magn Reson Imaging 2022; 56:1322-1342. [PMID: 35420239 PMCID: PMC9790618 DOI: 10.1002/jmri.28205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND MRI guidance of arterial endovascular interventions could be beneficial as it does not require radiation exposure, allows intrinsic blood-tissue contrast, and enables three-dimensional and functional imaging, however, clinical applications are still limited. PURPOSE To review the current state of MRI-guided arterial endovascular interventions and to identify the most commonly reported challenges. STUDY TYPE Systematic review. POPULATION Pubmed, Embase, Web of Science, and The Cochrane Library were systematically searched to find relevant articles. The search strategy combined synonyms for vascular pathology, endovascular therapy, and real-time MRI guidance. FIELD STRENGTH/SEQUENCE No field strength or sequence restrictions were applied. ASSESSMENT Two reviewers independently identified and reviewed the original articles and extracted relevant data. STATISTICAL TESTS Results of the included original articles are reported. RESULTS A total of 24,809 studies were identified for screening. Eighty-eight studies were assessed for eligibility, after which data were extracted from 43 articles (6 phantom, 33 animal, and 4 human studies). Reported technical success rates for animal and human studies ranged between 42% to 100%, and the average complication rate was 5.8% (animal studies) and 8.8% (human studies). Main identified challenges were related to spatial and temporal resolution as well as safety, design, and scarcity of current MRI-compatible endovascular devices. DATA CONCLUSION MRI guidance of endovascular arterial interventions seems feasible, however, included articles included mostly small single-center case series. Several hurdles remain to be overcome before larger trials can be undertaken. Main areas of research should focus on adequate imaging protocols with integrated tracking of dedicated endovascular devices.
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Affiliation(s)
- Han Nijsink
- Department of Medical ImagingRadboudumcNijmegenNetherlands
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Chen L, Liu J, Chu C, Han Z, Yadav N, Xu J, Bai R, Staedtke V, Pearl M, Walczak P, van Zijl P, Janowski M, Liu G. Deuterium oxide as a contrast medium for real-time MRI-guided endovascular neurointervention. Theranostics 2021; 11:6240-6250. [PMID: 33995656 PMCID: PMC8120199 DOI: 10.7150/thno.55953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/20/2021] [Indexed: 12/28/2022] Open
Abstract
Rationale: Endovascular intervention plays an important role in the treatment of various diseases, in which MRI-guidance can potentially improve precision. However, the clinical applications of currently available contrast media, including Gadolinium-based contrast agents and superparamagnetic iron oxide particles (SPIO), are hindered by safety concerns. In the present study, we sought to develop D2O as a novel contrast agent for guiding endovascular neurointervention. Methods: Animal studies were approved by institutional ACUC and conducted using an 11.7 T Bruker Biospec system and a 3T Siemens Trio clinical scanner for rodent and canine imaging, respectively. The locally selective blood brain barrier opening (BBBO) in rat brains was obtained by intraarterial (IA) injection of mannitol. The dynamic T2w* EPI MRI sequence was used to study the trans-catheter perfusion territory by IA administered SPIO before mannitol administration, whereas a dynamic T1w FLASH sequence was used to acquire Gd contrast-enhanced MRI for assessing BBBO after injection of mannitol. The contrast generated by D2O assessed by either EPI or FLASH methods was compared with the corresponding results assessed by SPIO or Gd. The utility of D2O MRI was also demonstrated to guide drug delivery to glioma in a mouse model. Finally, the clinical utility of D2O-MRI was demonstrated in a canine model. Results: Our study has shown that the contrast generated by D2O can be used to precisely delineate trans-catheter perfusion territory in both small and large animals. The perfusion territories determined by D2O-MRI show moderate correlation with those by SPIO-MRI (Spearman coefficient r = 0.5234, P < 0.001). Moreover, our results show that the perfusion territory determined by D2O-MRI can successfully predict the areas with BBBO after mannitol treatment similar to that assessed by Gd-MRI (Spearman coefficient r = 0.6923, P < 0.001). Using D2O-MRI as imaging guidance, the optimal infusion rate in the mouse brain was determined to be 150 µL/min to maximize the delivery efficacy to the tumor without serious off-target delivery to the brain parenchyma. The enhanced drug delivery of antibodies to the brain tumor was confirmed by fluorescence imaging. Conclusion: Our study demonstrated that D2O can be used as a negative MRI contrast medium to guide endovascular neurointervention. The established D2O -MRI method is safe and quantitative, without the concern of contrast accumulation. These qualities make it an attempting approach for a variety of endovascular procedures.
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Affiliation(s)
- Lin Chen
- Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, School of Electronic Science and Engineering, National Model Microelectronics College, Xiamen University, Xiamen, Fujian, China
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jing Liu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Chengyan Chu
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA
| | - Zheng Han
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Nirhbay Yadav
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jiadi Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Renyuan Bai
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Verena Staedtke
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Monica Pearl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Piotr Walczak
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA
| | - Peter van Zijl
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Miroslaw Janowski
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA
| | - Guanshu Liu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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Duschka RL, Wojtczyk H, Panagiotopoulos N, Haegele J, Bringout G, Buzug TM, Barkhausen J, Vogt FM. Safety measurements for heating of instruments for cardiovascular interventions in magnetic particle imaging (MPI) - first experiences. JOURNAL OF HEALTHCARE ENGINEERING 2014; 5:79-93. [PMID: 24691388 DOI: 10.1260/2040-2295.5.1.79] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Magnetic particle imaging (MPI) has emerged as a new imaging method with the potential of delivering images of high spatial and temporal resolutions and free of ionizing radiation. Recent studies demonstrated the feasibility of differentiation between signal-generating and non-signal-generating devices in Magnetic Particle Spectroscopy (MPS) and visualization of commercially available catheters and guide-wires in MPI itself. Thus, MPI seems to be a promising imaging tool for cardiovascular interventions. Several commercially available catheters and guide-wires were tested in this study regarding heating. Heating behavior was correlated to the spectra generated by the devices and measured by the MPI. The results indicate that each instrument should be tested separately due to the wide spectrum of measured temperature changes of signal-generating instruments, which is up to 85°C in contrast to non-signal-generating devices. Development of higher temperatures seems to be a limitation for the use of these devices in cardiovascular interventions.
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Affiliation(s)
- Robert L Duschka
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Hanne Wojtczyk
- Institute of Medical Engineering, University of Luebeck, Luebeck, Germany
| | - Nikolaos Panagiotopoulos
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Julian Haegele
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Gael Bringout
- Institute of Medical Engineering, University of Luebeck, Luebeck, Germany
| | - Thorsten M Buzug
- Institute of Medical Engineering, University of Luebeck, Luebeck, Germany
| | - Joerg Barkhausen
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
| | - Florian M Vogt
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Luebeck, Germany
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Haegele J, Biederer S, Wojtczyk H, Gräser M, Knopp T, Buzug TM, Barkhausen J, Vogt FM. Toward cardiovascular interventions guided by magnetic particle imaging: first instrument characterization. Magn Reson Med 2012; 69:1761-7. [PMID: 22829518 DOI: 10.1002/mrm.24421] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 06/06/2012] [Accepted: 06/25/2012] [Indexed: 11/11/2022]
Abstract
Magnetic particle imaging has emerged as a new technique for the visualization and quantification of superparamagnetic iron oxide nanoparticles. It seems to be a very promising application for cardiovascular interventional radiology. A prerequisite for interventions is the artifact-free visualization of the required instruments and implants. Various commercially available catheters, guide wires, and a catheter experimentally coated with superparamagnetic iron oxide nanoparticles were tested regarding their signal characteristics using magnetic particle spectroscopy to evaluate their performance in magnetic particle imaging. The results indicate that signal-generating and non-signal-generating instruments can be distinguished. Furthermore, coating or loading non-signal-generating instruments with superparamagnetic iron oxide nanoparticles seems to be a promising approach, but optimized nanoparticles need yet to be developed.
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Affiliation(s)
- Julian Haegele
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
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Deloison B, Siauve N, Aimot S, Balvay D, Thiam R, Cuenod CA, Ville Y, Clement O, Salomon LJ. SPIO-enhanced magnetic resonance imaging study of placental perfusion in a rat model of intrauterine growth restriction. BJOG 2012; 119:626-33. [DOI: 10.1111/j.1471-0528.2011.03251.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Figueroa-Espí V, Alvarez-Paneque A, Torrens M, Otero-González A, Reguera E. Conjugation of manganese ferrite nanoparticles to an anti Sticholysin monoclonal antibody and conjugate applications. Colloids Surf A Physicochem Eng Asp 2011. [DOI: 10.1016/j.colsurfa.2011.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Due to their high magnetization, superparamagnetic iron oxide nanoparticles induce an important decrease in the transverse relaxation of water protons and are, therefore, very efficient negative MRI contrast agents. The knowledge and control of the chemical and physical characteristics of nanoparticles are of great importance. The choice of the synthesis method (microemulsions, sol-gel synthesis, laser pyrolysis, sonochemical synthesis or coprecipitation) determines the magnetic nanoparticle's size and shape, as well as its size distribution and surface chemistry. Nanoparticles can be used for numerous in vivo applications, such as MRI contrast enhancement and hyperthermia drug delivery. New developments focus on targeting through molecular imaging and cell tracking.
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MR Imaging Guided Percutaneous Nephrostomy using a 1.0 Tesla Open MR Scanner. Cardiovasc Intervent Radiol 2010; 34:857-63. [DOI: 10.1007/s00270-010-0065-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 11/19/2010] [Indexed: 10/18/2022]
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Bock M, Wacker FK. MR-guided intravascular interventions: techniques and applications. J Magn Reson Imaging 2008; 27:326-38. [PMID: 18219686 DOI: 10.1002/jmri.21271] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Magnetic resonance imaging (MRI) offers several advantages over other imaging modalities that make it an attractive imaging tool for diagnostic and therapeutic procedures. This tremendous potential of MRI has provided the rationale for increased attention toward MR-guided endovascular interventions. MR guidance has been used recently to navigate endovascular catheters and deliver stents, vena cava filters, embolization materials, and septum closure devices. However, its potential goes beyond just copying existing procedures toward the development of new minimally invasive techniques that cannot be performed with conventional guiding techniques. Because of technical limitations and safety issues associated with some of the currently available devices, a limited number of clinical studies have been performed so far. The overall success for this developing field requires considerable interdisciplinary research within both the interventional and the MR community. Only through a combined effort can this complex technology find its way into clinical practice. This review discusses the hardware and software improvements that have helped to advance endovascular interventions under MR imaging guidance from a pure research tool to become a clinical reality. In addition, technical and safety issues specific to endovascular MR image guidance will be described and practical applications will be shown that take advantage of the benefits of MR for endovascular interventions.
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Affiliation(s)
- Michael Bock
- Deutsches Krebsforschungszentrum, Department of Medical Physics in Radiology (E020), Heidelberg, Germany
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Kos S, Huegli R, Bongartz GM, Jacob AL, Bilecen D. MR-guided endovascular interventions: a comprehensive review on techniques and applications. Eur Radiol 2007; 18:645-57. [PMID: 18071710 DOI: 10.1007/s00330-007-0818-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Revised: 10/01/2007] [Accepted: 10/30/2007] [Indexed: 10/22/2022]
Abstract
The magnetic resonance (MR) guidance of endovascular interventions is probably one of the greatest challenges of clinical MR research. MR angiography is not only an imaging tool for the vasculature but can also simultaneously depict high tissue contrast, including the differentiation of the vascular wall and perivascular tissues, as well as vascular function. Several hurdles had to be overcome to allow MR guidance for endovascular interventions. MR hardware and sequence design had to be developed to achieve acceptable patient access and to allow real-time or near real-time imaging. The development of interventional devices, both applicable and safe for MR imaging (MRI), was also mandatory. The subject of this review is to summarize the latest developments in real-time MRI hardware, MRI, visualization tools, interventional devices, endovascular tracking techniques, actual applications and safety issues.
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Affiliation(s)
- Sebastian Kos
- Institute of Radiology, Division of Interventional Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
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Bremerich J, Bilecen D, Reimer P. MR angiography with blood pool contrast agents. Eur Radiol 2007; 17:3017-24. [PMID: 17639407 DOI: 10.1007/s00330-007-0712-0] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 05/21/2007] [Accepted: 06/05/2007] [Indexed: 01/09/2023]
Abstract
Contrast-enhanced magnetic resonance angiography (CE-MRA) with standard extracellular contrast material is well established for vascular imaging. Recently, the first blood pool contrast agent (BPA) has become clinically available. This paper reviews characteristics and classification of BPA as well as first clinical experience in various vascular territories. BPAs comprise gadolinium-based compounds, synthetic compounds, and ultrasmall superparamagnetic iron-oxide (USPIO) particles. Such BPAs are retained in blood with a prolonged time-window of enhancement as compared to extracellular gadolinium chelates. Promising results from USPIO at first-pass and steady-state angiography have been published, but no USPIO is approved yet. Gadofosveset is the first clinically approved BPA. After bolus injection, gadofosveset binds noncovalently to serum-albumine, thus enhancing relaxivity. First published results from carotid, coronary, renal, and peripheral angiography are encouraging; particularly helpful is prolonged enhancement during steady state. More BPAs have been clinically evaluated, but no approval has been granted. Bolus-injectable BPAs allow for first-pass CE-MRA similar to standard extracellular contrast media, but with higher relaxivity, allowing lower doses and reduced injection rates. An additional feature of BPA is the steady-state phase with a broad time window enabling high-resolution angiography or double-gated angiography of coronary arteries to compensate for the complex motion pattern.
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Affiliation(s)
- Jens Bremerich
- Department of Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
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Simon GH, von Vopelius-Feldt J, Wendland MF, Fu Y, Piontek G, Schlegel J, Chen MH, Daldrup-Link HE. MRI of arthritis: comparison of ultrasmall superparamagnetic iron oxide vs. Gd-DTPA. J Magn Reson Imaging 2006; 23:720-7. [PMID: 16557494 DOI: 10.1002/jmri.20556] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To compare the ability of the ultrasmall superparamagnetic iron oxide (USPIO) SHU555C vs. gadopentetate dimeglumine (Gd-DTPA) to detect antigen-induced monoarthritis with MRI. MATERIALS AND METHODS Twelve seven-week-old female rats with an antigen-induced monoarthritis of the right knee were randomly assigned to two groups. Animals in group I (N = 6) underwent MRI using T1-weighted gradient-echo sequences before injection and at 2, 9, 17, 25, 33, 40, 47, 55, and 63 minutes postinjection (p.i.) of Gd-DTPA on day 1, and before injection and at 3, 23, 43, and 123 minutes p.i. of SHU555C on day 2. Animals in group II (N = 6) were imaged before injection and at 3, 23, 43, and 123 minutes p.i. using identical sequences. Signal-to-noise ratios (SNRs) and relative enhancement (DeltaSI%) of arthritic and normal synovium were determined from region-of-interest (ROI) measurements in consensus reading by two experienced radiologists. Data were tested for significant differences between the two agents and between the arthritic and normal knees using a mixed-effect model and F-tests (P < 0.05). Joints were processed for histopathology as the gold standard. RESULTS USPIO and Gd-DTPA showed significant enhancement differences (P < 0.001). USPIO provided a progressive and persistent enhancement of arthritic joints while Gd-DTPA provided an early and rapidly declining enhancement. Maximal enhancement in synovitis was 400% at 40-120 minutes p.i. of USPIO vs. 300% at two minutes p.i. of Gd-DTPA. USPIO provided a significant higher difference in enhancement between the arthritic and normal synovium than Gd-DTPA (P < 0.001). Histopathology confirmed marked inflammatory synovial changes in all arthritis-induced right knee joints and normal synovium in all left knee joints. CONCLUSION Both USPIO and Gd-DTPA detect arthritis by positive T1-enhancement. Compared to standard Gd-DTPA, the USPIO SHU555C provides a comparable maximal T1-enhancement (at two minutes p.i for Gd-DTPA and between 43 and 123 minutes p.i. for SHU555C), but in addition it provides a prolonged T1-enhancement of synovitis and a higher difference between the relative enhancement of arthritic and normal synovium.
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Affiliation(s)
- Gerhard H Simon
- Department of Radiology, UCSF Medical Center, University of California San Francisco, San Francisco, California 94143, USA.
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Krueger JJ, Ewert P, Yilmaz S, Gelernter D, Peters B, Pietzner K, Bornstedt A, Schnackenburg B, Abdul-Khaliq H, Fleck E, Nagel E, Berger F, Kuehne T. Magnetic resonance imaging-guided balloon angioplasty of coarctation of the aorta: a pilot study. Circulation 2006; 113:1093-100. [PMID: 16490822 DOI: 10.1161/circulationaha.105.578112] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND MRI guidance of percutaneous transluminal balloon angioplasty (PTA) of aortic coarctation (CoA) would be desirable for continuous visualization of anatomy and to eliminate x-ray exposure. The aim of this study was (1) to determine the suitability of MRI-controlled PTA using the iron oxide-based contrast medium Resovist (ferucarbotran) for catheter visualization and (2) to subsequently apply this technique in a pilot study with patients with CoA. METHODS AND RESULTS The MRI contrast-to-noise ratio and artifact behavior of Resovist-treated balloon catheters was optimized in in vitro and animal experiments (pigs). In 5 patients, anatomy of the CoA was evaluated before and after intervention with high-resolution respiratory-navigated 3D MRI and multiphase cine MRI. Position monitoring of Resovist-treated catheters was realized with interactive real-time MRI. Aortic pressures were continuously recorded. Conventional catheterization was performed before and after MRI to confirm interventional success. During MRI, catheters filled with 25 micromol of iron particles per milliliter of Resovist produced good signal contrast between catheters and their background anatomy but no image distortion due to susceptibility artifacts. All MRI procedures were performed successfully in the patient study. There was excellent agreement between the diameters of CoA and pressure gradients as measured during MRI and conventional catheterization. In 4 patients, PTA resulted in substantial widening of the CoA and a decrease in pressure gradients. In 1 patient, PTA was ineffective. CONCLUSIONS The MRI method described represents a potential alternative to conventional x-ray fluoroscopy for catheter-based treatment of patients with CoA.
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Affiliation(s)
- Julia J Krueger
- Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
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Omary RA, Gehl JA, Schirf BE, Green JD, Lu B, Pereles FS, Huang J, Larson AC, Li D. MR Imaging– versus Conventional X-ray Fluoroscopy–guided Renal Angioplasty in Swine: Prospective Randomized Comparison. Radiology 2006; 238:489-96. [PMID: 16436813 DOI: 10.1148/radiol.2382050109] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To test the hypothesis that the technical success rates, complication rates, and procedural times for magnetic resonance (MR) imaging-guided percutaneous transluminal angioplasty (PTA) and conventional (x-ray) fluoroscopy-guided PTA for treatment of renal artery stenosis are similar. MATERIALS AND METHODS The study was animal care and use committee approved. After surgically inducing bilateral renal artery stenosis in 11 swine, the authors performed baseline digital subtraction angiography. They transferred each animal to a 1.5-T MR imaging unit and randomly decided which artery would be treated with MR-guided PTA. With MR imaging guidance, angioplastic devices were tracked by using active and passive techniques. Vascular depiction was achieved by using catheter-directed MR angiography. Stenotic vessels were dilated by using 5-6-mm-diameter balloon catheters. PTA was then performed in the contralateral artery by using conventional fluoroscopy-guided techniques. With the intention to treat, the authors compared the technical success (residual stenosis < 50%) rates, complication rates, and procedural times for each guidance method. They compared technical successes and complications by using the McNemar test and procedural times by using a paired t test, with P < .05 indicating a significant difference. RESULTS The authors successfully dilated nine (82%) of 11 renal arteries with MR guidance and all 11 arteries (100%) with conventional fluoroscopic guidance. The difference was not significant (P = .5). Complications occurred in three (27%) arteries with MR guidance and in one (9%) artery with fluoroscopic guidance, with no significant differences (P = .5). The mean MR-guided PTA procedural time was 46 minutes longer than the fluoroscopy-guided PTA procedural time; this difference was significant (P = .01). CONCLUSION In a small cohort of swine, the authors did not observe a significant difference between MR imaging- and conventional fluoroscopy-guided renal artery PTA in terms of success and complication rates. However, no evidence of similarity between the techniques should be assumed. Procedural times differed significantly.
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Affiliation(s)
- Reed A Omary
- Departments of Radiology, Biomedical Engineering, and Preventive Medicine, Northwestern University, Suite 700, 448 E Ontario St, Chicago, IL 60611, USA
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Maes RM, Lewin JS, Duerk JL, Misselwitz B, Kiewiet CJM, Wacker FK. A new type of susceptibility-artefact-based magnetic resonance angiography: intra-arterial injection of superparamagnetic iron oxide particles (SPIO) A Resovist® in combination with TrueFisp imaging: a feasibility study. CONTRAST MEDIA & MOLECULAR IMAGING 2006; 1:189-95. [PMID: 17193696 DOI: 10.1002/cmmi.105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The goal of this study was to evaluate the use of super paramagnetic particles of iron oxide (SPIO) as a dark blood contrast agent, in combination with a bright blood steady-state free precession sequence for magnetic resonance angiography (MRA), in an animal model. The original concentration of the SPIO of 500 mmol Fe/l and dilutions to 250, 125, 60, 30, 10 and 5 mmol Fe/l were intra-arterially injected into the aorta of a pig. Then the dilution of 10 mmol Fe/l was chosen for repeated intra-arterial injections into two pigs. During these intra-arterial SPIO injections MR images were acquired with a 1.5 T scanner. Signal intensity measurements were performed in the aorta. The signal-to-noise ratio during SPIO bolus passage was significantly less than during baseline conditions (Fisher's F-ratio 159.8, p < 0.005) or the recovery signal-to-noise ratio (Fisher's F-ratio 144.6, p < 0.005). Also, confirmation of flow distal to the catheter-tip position was possible. The use of SPIO as a dark blood agent in combination with a bright blood MR imaging sequence is feasible. Temporary loss of intraluminal signal occurs due to local decrease of the signal because of induction of local inhomogeneities after mixture the present blood and SPIO solution. It provides immediate information about blood flow distal to the catheter and is a potentially useful to guide intravascular MR-interventional procedures.
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Affiliation(s)
- Robbert M Maes
- Department of Radiology, Gemini-ziekenhuis, Huisduinerweg 3, 1782 GZ Den Helder, The Netherlands.
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Terashima M, Hyon M, de la Pena-Almaguer E, Yang PC, Hu BS, Nayak KS, Pauly JM, McConnell MV. High-resolution real-time spiral MRI for guiding vascular interventions in a rabbit model at 1.5T. J Magn Reson Imaging 2005; 22:687-90. [PMID: 16217745 DOI: 10.1002/jmri.20409] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To study the feasibility of a combined high spatial and temporal resolution real-time spiral MRI sequence for guiding coronary-sized vascular interventions. MATERIALS AND METHODS Eight New Zealand White rabbits (four normal and four with a surgically-created stenosis in the abdominal aorta) were studied. A real-time interactive spiral MRI sequence combining 1.1 x 1.1 mm(2) in-plane resolution and 189-msec total image acquisition time was used to image all phases of an interventional procedure (i.e., guidewire placement, balloon angioplasty, and stenting) in the rabbit aorta using coronary-sized devices on a 1.5 T MRI system. RESULTS Real-time spiral MRI identified all rabbit aortic stenoses and provided high-temporal-resolution visualization of guide-wires crossing the stenoses in all animals. Angioplasty balloon dilatation and deployment of coronary-sized copper stents in the rabbit aorta were also successfully imaged by real-time spiral MRI. CONCLUSION Combining high spatial and temporal resolution with spiral MRI allows real-time MR-guided vascular intervention using coronary-sized devices in a rabbit model. This is a promising approach for guiding coronary interventions.
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Affiliation(s)
- Masahiro Terashima
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California 94305-5233, USA
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Wacker FK, Hillenbrand CM, Duerk JL, Lewin JS. MR-guided endovascular interventions: device visualization, tracking, navigation, clinical applications, and safety aspects. Magn Reson Imaging Clin N Am 2005; 13:431-9. [PMID: 16084411 DOI: 10.1016/j.mric.2005.04.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reliable visualization and tracking are essential for guiding endovascular devices within blood vessels. The most commonly used methods are susceptibility artifact-based tracking that relies on the artifact created within the image by the device and microcoil- or antenna-based tracking that uses the high signal generated by small MR endovascular receive coils when the transmit coil emits a nonselective radiofrequency pulse. To date, the use of endovascular MR guidance techniques has primarily been confined to animal experiments. There are only a few reports on MR-guided endovascular applications in patients. Therefore, access to the patient within the scanner, dedicated devices, and safety issues remain major challenges. To face these challenges, attention from all radiologists, especially interventional radiologists, is required to make MR-guided endovascular procedures a clinical reality.
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Affiliation(s)
- Frank K Wacker
- Department of Radiology, Klinik und Hochschulambulanz für Radiologie und Nuklearmedizin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
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Wacker FK, Hillenbrand C, Elgort DR, Zhang S, Duerk JL, Lewin JS. MR imaging-guided percutaneous angioplasty and stent placement in a swine model comparison of open- and closed-bore scanners. Acad Radiol 2005; 12:1085-8. [PMID: 16112511 DOI: 10.1016/j.acra.2005.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2005] [Revised: 05/12/2005] [Accepted: 05/25/2005] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study is to compare the feasibility and precision of renal artery angioplasty and stent placement using two different MR scanners. MATERIALS AND METHODS MR imaging-guided angioplasty and stent placements were performed on seven pigs using 0.2 and 1.5 T scanners (Magnetom Open and Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany). For guidance of catheters, guide wires and stents susceptibility artifact-based tracking was used. The end point of each intervention was to position a stent in the renal artery with its proximal end at the level of the aortic wall. Procedure time and stent position were evaluated. RESULTS Catheterization, angioplasty, and stent placement were feasible using MRI guidance at both 0.2 and 1,5 Tesla. At 1.5 T all catheter manipulations and interventions were performed in less than 30 minutes. At 0.2 T the interventions took up to 90 minutes. No significant difference in the stent deviation was noted between the two scanners. CONCLUSION The use of a high-performance 1.5 T scanner helped to reduce the procedure time to half of that of a low-field system. Since no difference in stent placement precision was noted, a dedicated MR-stent might be mandatory for more precise stent placement.
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Affiliation(s)
- Frank K Wacker
- Department of Radiology, Charité-Campus Benjamin Franklin, Hindenburgdamm 30 12200 Berlin Germany.
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Hood MN, Ho VB. Contrast Agents: Innovations and Potential Applications for Body MR Angiography. Magn Reson Imaging Clin N Am 2005; 13:189-203, vii. [PMID: 15760765 DOI: 10.1016/j.mric.2004.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Maureen N Hood
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA.
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Wacker FK, Elgort D, Hillenbrand CM, Duerk JL, Lewin JS. The Catheter-Driven MRI Scanner: A New Approach to Intravascular Catheter Tracking and Imaging-Parameter Adjustment for Interventional MRI. AJR Am J Roentgenol 2004; 183:391-5. [PMID: 15269031 DOI: 10.2214/ajr.183.2.1830391] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our aim was to test the feasibility of a hands-free approach to MRI that allows the interventionalist to track an angiographic catheter in real time throughout the procedure and to automatically change imaging parameters by catheter manipulation. MATERIALS AND METHODS A tracking method that is based on an active device localization was implemented on a 1.5-T MRI scanner. The system determines the current position and orientation of a catheter in 3D space in an endless feedback loop. Automatic scanning plane-adjustment procedures written in the software of the MRI system ensure image acquisition at the location of the catheter tip. The system calculates the device velocity to automatically adjust parameters such as field of view (FOV) and resolution. To evaluate the feasibility and performance in vivo and ex vivo, we performed experiments in two vessel phantoms and on six pigs. RESULTS The system collected the tracking data within 40 msec; an additional 10-20 msec was then required to perform the localization and velocity calculations and to update the image parameters. The system could localize a motionless catheter in the aorta in 100% and a moving catheter in 98% of measured attempts. The system responded in real time to changes in device velocity by dynamically adjusting spatial resolution and FOV in both phantom and porcine trials. Using this technique, we successfully catheterized the renal artery in two pigs. CONCLUSION Active tracking, combined with automatic scanning plane and imaging parameter adjustment, provides an intuitive MRI scanner interface for the guidance of the vascular procedure.
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Affiliation(s)
- Frank K Wacker
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave., MRI Bolwel B124, Cleveland, OH 44106, USA.
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Caldana RP, Bezerra ASDA, Soares AFDF, D'Ippolito G. Angiografia por ressonância magnética: aspectos técnicos de um método de estudo vascular não-invasivo. Radiol Bras 2004. [DOI: 10.1590/s0100-39842004000100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
As primeiras técnicas de angiografia por ressonância magnética (angio-RM) utilizavam seqüências sensíveis ao fluxo sanguíneo para estabelecimento do contraste vascular. Há três técnicas fundamentadas neste princípio: contraste de fase ("phase-contrast"), TOF ("time-of-flight") e as técnicas de sangue escuro ("black blood"). Estas seqüências, de aquisição demorada, são mais suscetíveis a artefatos de movimento, perda de sinal em áreas de estenoses ou turbilhonamento de fluxo, e apresentam ainda baixa sensibilidade à detecção do fluxo lento. O uso do contraste paramagnético para estudos angiográficos pela ressonância magnética ofereceu um método simples, rápido e de excelente detalhamento vascular, baseando o contraste da imagem no realce do sinal vascular em oposição à supressão dos demais tecidos. Metodologias modernas que priorizam a obtenção do espaço k central, responsável pelo contraste da imagem, e o aperfeiçoamento das técnicas de planejamento do intervalo temporal para aquisição dos dados foram fatores fundamentais para o aprimoramento técnico da angio-RM. O papel atual da angio-RM como ferramenta diagnóstica merece destaque na avaliação de anomalias anatômicas, estenoses, oclusões e complicações vasculares pós-cirúrgicas, principalmente nos casos de transplantes de órgãos. Suas principais vantagens estão na não utilização do contraste iodado ou radiação ionizante, rapidez e fácil execução, mínima invasividade e possibilidade de avaliar complementarmente o parênquima de órgãos adjacentes de interesse diagnóstico.
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Fink C, Bock M, Umathum R, Volz S, Zuehlsdorff S, Grobholz R, Kauczor HU, Hallscheidt P. Renal Embolization: Feasibility of Magnetic Resonance-Guidance Using Active Catheter Tracking and Intraarterial Magnetic Resonance Angiography. Invest Radiol 2004; 39:111-9. [PMID: 14734926 DOI: 10.1097/01.rli.0000110744.70512.df] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES Magnetic resonance (MR)-guidance of endovascular interventions offers various advantages, including the absence of ionizing radiation, excellent soft tissue contrast, and multiplanar and functional imaging capabilities. The objective of this study was to assess the feasibility of MR-guided renal embolization using active catheter tracking with automatic slice positioning and intraarterial contrast-enhanced MR angiography (MRA). MATERIALS AND METHODS MR-guided embolization of 16 kidneys was attempted in 15 pigs using real-time tracking of active 5-Fr. catheters. Embolization was monitored by selective intraarterial projection MRA. Intraarterial three-dimensional (3D) MRA was used for the assessment of embolization results. Additional pathologic correlation was available in 2 animals. The image quality of intraarterial 3D contrast-enhanced-MRA was rated by an independent radiologist who was not involved in the animal experiments. RESULTS Active catheter tracking with automatic slice positioning allowed reliable catheter guidance and catheterization of the renal artery in all animals. Embolization was successful in all kidneys (11 left, 5 right), as verified by intraarterial 3D contrast-enhanced MRA (ce-MRA) and/or pathology. The image quality of intraarterial 3D ce-MRA was rated excellent in 10 animals, moderate in 4 animals, and poor in 1 animal. CONCLUSION Renal embolization using active catheter tracking and intraarterial ce-MRA is feasible. Selective intraarterial ce-MRA allows the assessment of blood supply and organ perfusion before, during, and after therapeutic interventions, thereby complementing MR-guided endovascular interventions.
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Affiliation(s)
- Christian Fink
- Department of Radiology (E010), Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany.
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