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Monfaredi R, Cleary K, Sharma K. MRI Robots for Needle-Based Interventions: Systems and Technology. Ann Biomed Eng 2018; 46:1479-1497. [PMID: 29922958 DOI: 10.1007/s10439-018-2075-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/11/2018] [Indexed: 01/13/2023]
Abstract
Magnetic resonance imaging (MRI) provides high-quality soft-tissue images of anatomical structures and radiation free imaging. The research community has focused on establishing new workflows, developing new technology, and creating robotic devices to change an MRI room from a solely diagnostic room to an interventional suite, where diagnosis and intervention can both be done in the same room. Closed bore MRI scanners provide limited access for interventional procedures using intraoperative imaging. MRI robots could improve access and procedure accuracy. Different research groups have focused on different technology aspects and anatomical structures. This paper presents the results of a systematic search of MRI robots for needle-based interventions. We report the most recent advances in the field, present relevant technologies, and discuss possible future advances. This survey shows that robotic-assisted MRI-guided prostate biopsy has received the most interest from the research community to date. Multiple successful clinical experiments have been reported in recent years that show great promise. However, in general the field of MRI robotic systems is still in the early stage. The continued development of these systems, along with partnerships with commercial vendors to bring this technology to market, is encouraged to create new and improved treatment opportunities for future patients.
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Affiliation(s)
- Reza Monfaredi
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA.
| | - Kevin Cleary
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA
| | - Karun Sharma
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA.,Diagnostic Imaging and Radiology Department, Children's National Health System, 111 Michigan ave. NW, Washington, DC, 20010, USA
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van Griethuysen JJM, Bus EM, Hauptmann M, Lahaye MJ, Maas M, Ter Beek LC, Beets GL, Bakers FCH, Beets-Tan RGH, Lambregts DMJ. Gas-induced susceptibility artefacts on diffusion-weighted MRI of the rectum at 1.5 T - Effect of applying a micro-enema to improve image quality. Eur J Radiol 2017; 99:131-137. [PMID: 29362144 DOI: 10.1016/j.ejrad.2017.12.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/20/2017] [Accepted: 12/25/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE Assess whether application of a micro-enema can reduce gas-induced susceptibility artefacts in Single-shot Echo Planar Imaging (EPI) Diffusion-weighted imaging of the rectum at 1.5 T. MATERIALS AND METHODS Retrospective analysis of n = 50 rectal cancer patients who each underwent multiple DWI-MRIs (1.5 T) from 2012 to 2016 as part of routine follow-up during a watch-and-wait approach after chemoradiotherapy. From March 2014 DWI-MRIs were routinely acquired after application of a preparatory micro-enema (Microlax®; 5 ml; self-administered shortly before acquisition); before March 2014 no bowel preparation was given. In total, 335 scans were scored by an experienced reader for the presence/severity of gas-artefacts (on b1000 DWI), ranging from 0 (no artefact) to 5 (severe artefact). A score ≥3 (moderate-severe) was considered a clinically relevant artefact. A random sample of 100 scans was re-assessed by a second independent reader to study inter-observer effects. Scores were compared between the scans performed without and with a preparatory micro-enema using univariable and multivariable logistic regression taking into account potential confounding factors (age/gender, acquisition parameters, MRI-hardware, rectoscopy prior to MRI). RESULTS Clinically relevant gas-artefacts were seen in 24.3% (no micro-enema) vs. 3.7% (micro-enema), odds ratios were 0.118 in univariable and 0.230 in multivariable regression (P = 0.0005 and 0.0291). Mean severity score (±SD) was 1.19 ± 1.71 (no-enema) vs 0.32 ± 0.77 (micro-enema), odds ratios were 0.321 (P < 0.0001) and 0.489 (P = 0.0461) in uni- and multivariable regression, respectively. Inter-observer agreement was excellent (κ0.85). CONCLUSION Use of a preparatory micro-enema shortly before rectal EPI-DWI examinations performed at 1.5 T MRI significantly reduces both the incidence and severity of gas-induced artefacts, compared to examinations performed without bowel preparation.
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Affiliation(s)
- Joost J M van Griethuysen
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elyse M Bus
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michael Hauptmann
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Max J Lahaye
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monique Maas
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Leon C Ter Beek
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Geerard L Beets
- GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Surgery, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Frans C H Bakers
- Department of Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; GROW School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Doenja M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Zhu J, Zhang J, Gao JY, Li JN, Yang DW, Chen M, Zhou C, Yang ZH. Apparent diffusion coefficient normalization of normal liver: Will it improve the reproducibility of diffusion-weighted imaging at different MR scanners as a new biomarker? Medicine (Baltimore) 2017; 96:e5910. [PMID: 28099354 PMCID: PMC5279099 DOI: 10.1097/md.0000000000005910] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Apparent diffusion coefficient (ADC) measurement in diffusion-weighted imaging (DWI) has been reported to be a helpful biomarker for detection and characterization of lesion. In view of the importance of ADC measurement reproducibility, the aim of this study was to probe the variability of the healthy hepatic ADC values measured at 3 MR scanners from different vendors and with different field strengths, and to investigate the reproducibility of normalized ADC (nADC) value with the spleen as the reference organ. Thirty enrolled healthy volunteers received DWI with GE 1.5T, Siemens 1.5T, and Philips 3.0T magnetic resonance (MR) systems on liver and spleen (session 1) and were imaged again after 10 to 14 days using only GE 1.5T MR and Philips 3.0T MR systems (session 2). Interscan agreement and reproducibility of ADC measurements of liver and the calculated nADC values (ADCliver/ADCspleen) were statistically evaluated between 2 sessions. In session 1, ADC and nADC values of liver were evaluated for the scanner-related variability by 2-way analysis of variance and intraclass correlation coefficients (ICCs). Coefficients of variation (CVs) of ADCs and nADCs of liver were calculated for both 1.5 and 3.0-T MR system. Interscan agreement and reproducibility of ADC measurements of liver and related nADCs between 2 sessions were found to be satisfactory with ICC values of 0.773 to 0.905. In session 1, the liver nADCs obtained from different scanners were consistent (P = 0.112) without any significant difference in multiple comparison (P = 0.117 to >0.99) by using 2-way analysis of variance with post-hoc analysis of Bonferroni method, although the liver ADCs varied significantly (P < 0.001). nADCs measured by 3 scanners were in good interscanner agreements with ICCs of 0.685 to 0.776. The mean CV of nADCs of both 1.5T MR scanners (9.6%) was similar to that of 3.0T MR scanner (8.9%). ADCs measured at 3 MR scanners with different field strengths and vendors could not be compared directly. Normalization of ADCs, however, may provide better reproducibility by overcoming these potential issues.
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Affiliation(s)
- Jie Zhu
- Department of Radiology, Beijing Hospital, National Center of Gerontology
| | - Jie Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jia-Yin Gao
- Department of Radiology, Beijing Hospital, National Center of Gerontology
| | - Jin-Ning Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology
| | - Da-Wei Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology
| | - Cheng Zhou
- Department of Radiology, Beijing Hospital, National Center of Gerontology
| | - Zheng-Han Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Fifty Years of Technological Innovation: Potential and Limitations of Current Technologies in Abdominal Magnetic Resonance Imaging and Computed Tomography. Invest Radiol 2016; 50:584-93. [PMID: 26039773 DOI: 10.1097/rli.0000000000000173] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Magnetic resonance imaging (MRI) has become an important modality for the diagnosis of intra-abdominal pathology. Hardware and pulse sequence developments have made it possible to derive not only morphologic but also functional information related to organ perfusion (dynamic contrast-enhanced MRI), oxygen saturation (blood oxygen level dependent), tissue cellularity (diffusion-weighted imaging), and tissue composition (spectroscopy). These techniques enable a more specific assessment of pathologic lesions and organ functionality. Magnetic resonance imaging has thus transitioned from a purely morphologic examination to a modality from which image-based disease biomarkers can be derived. This fits well with several emerging trends in radiology, such as the need to accurately assess response to costly treatment strategies and the need to improve lesion characterization to potentially avoid biopsy. Meanwhile, the cost-effectiveness, availability, and robustness of computed tomography (CT) ensure its place as the current workhorse for clinical imaging. Although the lower soft tissue contrast of CT relative to MRI is a long-standing limitation, other disadvantages such as ionizing radiation exposure have become a matter of public concern. Nevertheless, recent technical developments such as dual-energy CT or dynamic volume perfusion CT also provide more functional imaging beyond morphology.The aim of this article was to review and discuss the most important recent technical developments in abdominal MRI and state-of-the-art CT, with an eye toward the future, providing examples of their clinical utility for the evaluation of hepatic and renal pathologies.
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Gurney-Champion OJ, Lens E, van der Horst A, Houweling AC, Klaassen R, van Hooft JE, Stoker J, van Tienhoven G, Nederveen AJ, Bel A. Visibility and artifacts of gold fiducial markers used for image guided radiation therapy of pancreatic cancer on MRI. Med Phys 2015; 42:2638-47. [DOI: 10.1118/1.4918753] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Brink WM, Gulani V, Webb AG. Clinical applications of dual-channel transmit MRI: A review. J Magn Reson Imaging 2015; 42:855-69. [PMID: 25854179 DOI: 10.1002/jmri.24791] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 09/04/2014] [Accepted: 09/04/2014] [Indexed: 11/09/2022] Open
Abstract
This article reviews the principle of dual-channel transmit MRI and highlights current clinical applications which are performed primarily at 3 Tesla. The main benefits of dual-channel transmit compared with single-transmit systems are the increased image contrast homogeneity and the decreased scanning time due to the more accurate local specific absorption ratio estimation, meaning that less conservative safety limits are needed. The dual-transmit approach has been particularly beneficial in body imaging applications, and is also promising in terms of cardiac, spine, and fetal imaging. Future advances in transmit SENSE, the combination of dual-channel transmit with high permittivity pads, as well as the potential increase in the number of transmit channels are also discussed.
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Affiliation(s)
- Wyger M Brink
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vikas Gulani
- Department of Radiology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Andrew G Webb
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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