A method for fast 3D tracking using tuned fiducial markers and a limited projection reconstruction FISP (LPR-FISP) sequence

Iterative Jacobian-Based Inverse Kinematics and Open-Loop Control of an MRI-Guided Magnetically Actuated Steerable Catheter System

This paper presents an iterative Jacobian-based inverse kinematics method for an MRI-guided magnetically-actuated steerable intravascular catheter system. The catheter is directly actuated by magnetic torques generated on a set of current-carrying micro-coils embedded on the catheter tip, by the magnetic field of the magnetic resonance imaging (MRI) scanner. The Jacobian matrix relating changes of the currents through the coils to changes of the tip position is derived using a three dimensional kinematic model of the catheter deflection. The inverse kinematics is numerically computed by iteratively applying the inverse of the Jacobian matrix. The damped least square method is implemented to avoid numerical instability issues that exist during the computation of the inverse of the Jacobian matrix. The performance of the proposed inverse kinematics approach is validated using a prototype of the robotic catheter by comparing the actual trajectories of the catheter tip obtained via open-loop control with the desired trajectories. The results of reproducibility and accuracy evaluations demonstrate that the proposed Jacobian-based inverse kinematics method can be used to actuate the catheter in open-loop to successfully perform complex ablation trajectories required in atrial fibrillation ablation procedures. This study paves the way for effective and accurate closed-loop control of the robotic catheter with real-time feedback from MRI guidance in subsequent research.

Manipulator-driven selection of semi-active MR-visible markers

BACKGROUND

A method for the identification of semi-active fiducial magnetic resonance (MR) markers is presented based on selectively optically tuning and detuning them.

METHODS

Four inductively coupled solenoid coils with photoresistors were connected to light sources. A microcontroller timed the optical tuning/detuning of coils and image collection. The markers were tested on an MR manipulator linking the microcontroller to the manipulator control to visibly select the marker subset according to the actuated joint.

RESULTS

In closed-loop control, the average and maximum were 0.76° ± 0.41° and 1.18° errors for a rotational joint, and 0.87 mm ± 0.26 mm and 1.13 mm for the prismatic joint.

CONCLUSIONS

This technique is suitable for MR-compatible actuated devices that use semi-active MR-compatible markers.

Design and Fabrication of MR-Tracked Metallic Stylet for Gynecologic Brachytherapy

Active magnetic resonance (MR) tracking for gynecologic brachytherapy was made possible by attaching the micro radiofrequency coils to the brachytherapy applicator. The rectangular planar micro coil was fabricated using flexible printed circuits with dimensions of 8mm×1.5mm. A 5-Fr (1.6mm) tungsten brachytherapy stylet was custom-machined to incorporate the micro coils. The finite element analysis and the phantom tissue studies show that the proposed device enables in situ, real-time guidance of access routes to the target anatomy safely and accurately. The setup was tested in a Siemens 3T MR scanner. The micro coils can be localized rapidly (up to 40 Hz) and precisely (resolution: 0.6×0.6×0.6mm³) using an MR-tracking sequence.

Fast and accurate localization of multiple RF markers for tracking in MRI-guided interventions

OBJECT

A new method for 3D localization of N fiducial markers from 1D projections is presented and analysed. It applies to semi-active markers and active markers using a single receiver channel.

MATERIALS AND METHODS

The novel algorithm computes candidate points using peaks in three optimally selected projections and removes fictitious points by verifying detected peaks in additional projections. Computational complexity was significantly reduced by avoiding cluster analysis, while higher accuracy was achieved by using optimal projections and by applying Gaussian interpolation in peak detection. Computational time, accuracy and robustness were analysed through Monte Carlo simulations and experiments. The method was employed in a prototype MRI guided prostate biopsy system and used in preclinical experiments.

RESULTS

The computational time for 6 markers was better than 2 ms, an improvement of up to 100 times, compared to the method by Flask et al. (J Magn Reson Imaging 14(5):617-627, 2001). Experimental maximum localization error was lower than 0.3 mm; standard deviation was 0.06 mm. Targeting error was about 1 mm. Tracking update rate was about 10 Hz.

CONCLUSION

The proposed method is particularly suitable in systems requiring any of the following: high frame rate, tracking of three or more markers, data filtering or interleaving.

Prospective real-time head motion correction using inductively coupled wireless NMR probes

PURPOSE

Head motion continues to be a major source of artifacts and data quality degradation in MRI. The goal of this work was to develop and demonstrate a novel technique for prospective, 6 degrees of freedom (6DOF) rigid body motion estimation and real-time motion correction using inductively coupled wireless nuclear magnetic resonance (NMR) probe markers.

METHODS

Three wireless probes that are inductively coupled with the scanner's RF setup serve as fiducials on the subject's head. A 12-ms linear navigator module is interleaved with the imaging sequence for head position estimation, and scan geometry is updated in real time for motion compensation. Flip angle amplification in the markers allows the use of extremely small navigator flip angles (∼1°). A novel algorithm is presented to identify marker positions in the absence of marker specific receive channels. Motion correction is demonstrated in high resolution 2D and 3D gradient recalled echo experiments in a phantom and humans.

RESULTS

Significant improvement of image quality is demonstrated in phantoms and human volunteers under different motion conditions.

CONCLUSION

A novel real-time 6DOF head motion correction technique based on wireless NMR probes is demonstrated in high resolution imaging at 7 Tesla.

Device localization and dynamic scan plane selection using a wireless magnetic resonance imaging detector array

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.

Prospective active marker motion correction improves statistical power in BOLD fMRI

Group level statistical maps of blood oxygenation level dependent (BOLD) signals acquired using functional magnetic resonance imaging (fMRI) have become a basic measurement for much of systems, cognitive and social neuroscience. A challenge in making inferences from these statistical maps is the noise and potential confounds that arise from the head motion that occurs within and between acquisition volumes. This motion results in the scan plane being misaligned during acquisition, ultimately leading to reduced statistical power when maps are constructed at the group level. In most cases, an attempt is made to correct for this motion through the use of retrospective analysis methods. In this paper, we use a prospective active marker motion correction (PRAMMO) system that uses radio frequency markers for real-time tracking of motion, enabling on-line slice plane correction. We show that the statistical power of the activation maps is substantially increased using PRAMMO compared to conventional retrospective correction. Analysis of our results indicates that the PRAMMO acquisition reduces the variance without decreasing the signal component of the BOLD (beta). Using PRAMMO could thus improve the overall statistical power of fMRI based BOLD measurements, leading to stronger inferences of the nature of processing in the human brain.

Catheter tracking with phase information in a magnetic resonance scanner

The purpose of this study is to describe a new active technique for accurately determining both the position and orientation of the tip of a catheter during magnetic resonance (MR)-guided percutaneous cardiovascular procedures. The technique utilizes phase information introduced into the MR signal from a small receive coil located on the distal tip of the catheter. Phase patterns around a small receive coil are rich in information that is directly related to position and orientation. This information can be collected over a large spherical volume with a diameter several times that of the receive coil. The high degree of redundancy yields the potential for an accurate and robust method of catheter tracking. A tracking algorithm is presented that performs catheter tip localization using phase images acquired in two orthogonal planes without any a priori knowledge of catheter position. Associated experimentation demonstrating feasibility is also presented.

Suitability of miniature inductively coupled RF coils as MR-visible markers for clinical purposes

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.

MR fluoroscopy in vascular and cardiac interventions (review)

Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.

Evaluation of an image-based tracking workflow using a passive marker and resonant micro-coil fiducials for automatic image plane alignment in interventional MRI

In this paper, an original workflow is presented for MR image plane alignment based on tracking in real-time MR images. A test device consisting of two resonant micro-coils and a passive marker is proposed for detection using image-based algorithms. Micro-coils allow for automated initialization of the object detection in dedicated low flip angle projection images; then the passive marker is tracked in clinical real-time MR images, with alternation between two oblique orthogonal image planes along the test device axis; in case the passive marker is lost in real-time images, the workflow is reinitialized. The proposed workflow was designed to minimize dedicated acquisition time to a single dedicated acquisition in the ideal case (no reinitialization required). First experiments have shown promising results for test-device tracking precision, with a mean position error of 0.79 mm and a mean orientation error of 0.24°.

Echo-planar imaging with prospective slice-by-slice motion correction using active markers

Head motion is a fundamental problem in functional magnetic resonance imaging and is often a limiting factor in its clinical implementation. This work presents a rigid-body motion correction strategy for echo-planar imaging sequences that uses micro radiofrequency coil "active markers" for real-time, slice-by-slice prospective correction. Before the acquisition of each echo-planar imaging-slice, a short tracking pulse-sequence measures the positions of three active markers integrated into a headband worn by the subject; the rigid-body transformation that realigns these markers to their initial positions is then fed back to dynamically update the scan-plane, maintaining it at a fixed orientation relative to the head. Using this method, prospectively-corrected echo-planar imaging time series are acquired on volunteers performing in-plane and through-plane head motions, with results demonstrating increased image stability over conventional retrospective image-realignment. The benefit of this improved image stability is assessed in a blood oxygenation level dependent functional magnetic resonance imaging application. Finally, a non-rigid-body distortion-correction algorithm is introduced to reduce the remaining signal variation.

Simulations and experimental demonstration of coupling molecular and macroscopic level modalities with a robotic manipulator

Established and emerging molecular and cellular modalities, such as optical imaging and spectroscopy, offer new opportunities for assessing tissue pathophysiology in situ. A challenge with such applications is their limited tissue penetration and low sensitivity that can be addressed with trans-needle or trans-catheter access. In this work, we describe the use of an actuated manipulator to physically manipulate such sensors to scan an area of interest generating 1-D scans while registering them to a guiding modality. Simulations were performed for a miniature RF coil to determine the voxel size, and experimental studies were conducted using a miniature RF coil manipulated by the MR-compatible device. The experimental results on phantom studies show that potential diagnostic information can be collected by using this methodology. This system was pursued to address a critical limitation of emerging molecular and near-cellular modalities; the limited tissue penetration.

Prospective real-time correction for arbitrary head motion using active markers

Patient motion during an MRI exam can result in major degradation of image quality, and is of increasing concern due to the aging population and its associated diseases. This work presents a general strategy for real-time, intraimage compensation of rigid-body motion that is compatible with multiple imaging sequences. Image quality improvements are established for structural brain MRI acquired during volunteer motion. A headband integrated with three active markers is secured to the forehead. Prospective correction is achieved by interleaving a rapid track-and-update module into the imaging sequence. For every repetition of this module, a short tracking pulse-sequence remeasures the marker positions; during head motion, the rigid-body transformation that realigns the markers to their initial positions is fed back to adaptively update the image-plane-maintaining it at a fixed orientation relative to the head-before the next imaging segment of k-space is acquired. In cases of extreme motion, corrupted lines of k-space are rejected and reacquired with the updated geometry. High-precision tracking measurements (0.01 mm) and corrections are accomplished in a temporal resolution (37 ms) suitable for real-time application. The correction package requires minimal additional hardware and is fully integrated into the standard user interface, promoting transferability to clinical practice.

MR-guided biopsy: a review of current techniques and applications

Biopsy has become a cornerstone of modern medicine and most modern biopsies are performed percutaneously using image guidance, typically computed tomography or ultrasound. MR-guided biopsy offers many advantages over these more traditional modalities, and the recent development of interventional MR imaging techniques has made MR-guided percutaneous biopsies and aspirations a clinical reality. As the field of MR-guided procedures continues to expand and to attract more attention from radiologists, it is important to understand the concepts, techniques, applications, advantages, and limitations of MR-guided biopsy/percutaneous procedures. Radiologists should also recognize the need for their significant involvement in the technical aspects of MR-guided procedures, since several user-defined parameters can alter device visualization in the MR imaging environment and affect procedure safety. This article reviews the prerequisites, systems, and applications of MR-guided biopsy.

MR-guided intravascular interventions: techniques and applications

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.

MR-guided endovascular interventions: a comprehensive review on techniques and applications

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.

Dynamic imaging of contrast-enhanced coronary vessels with a magnetization prepared rotated stripe keyhole acquisition

PURPOSE

To evaluate dynamic coronary imaging based on a magnetization prepared contrast-enhanced (CE) rotated stripe keyhole acquisition scheme.

MATERIALS AND METHODS

Background suppression of long T(1) tissue was used so that the k-space would be selectively dominated by the contribution of the CE vessel. The phase-encoding axis was then adjusted parallel to the long axis of the vessel to sample the significant power spectrum of the vessel. The performance of this approach was evaluated by means of computer simulations and experimental studies on phantoms and a pig model instrumented with an intracoronary catheter for infusion of contrast media.

RESULTS

Computer simulations and phantom studies demonstrated that by rotating the gradient axes to match the k-space pattern of the frequency spectrum, one can reduce the keyhole band to 20% of the full k-space while preserving the structure's lumen width and sharpness. In vivo studies validated those findings, and dynamic angiograms of the CE coronary arteries were obtained as rapidly as 140 msec per image, with an in-plane spatial resolution of 1.5 mm.

CONCLUSION

With efficient background suppression, a rotated stripes keyhole acquisition can efficiently acquire the significant k-space of a CE vessel, and provide improved vessel definition with a reduced acquisition matrices scheme.

Method for automatic localization of MR-visible markers using morphological image processing and conventional pulse sequences: Feasibility for image-guided procedures

PURPOSE

To evaluate the feasibility and accuracy of an automated method to determine the 3D position of MR-visible markers.

MATERIALS AND METHODS

Inductively coupled RF coils were imaged in a whole-body 1.5T scanner using the body coil and two conventional gradient echo sequences (FLASH and TrueFISP) and large imaging volumes up to (300 mm(3)). To minimize background signals, a flip angle of approximately 1 degrees was used. Morphological 2D image processing in orthogonal scan planes was used to determine the 3D positions of a configuration of three fiducial markers (FMC). The accuracies of the marker positions and of the orientation of the plane defined by the FMC were evaluated at various distances r(M) from the isocenter.

RESULTS

Fiducial marker detection with conventional equipment (pulse sequences, imaging coils) was very reliable and highly reproducible over a wide range of experimental conditions. For r(M) </= 100 mm, the estimated maximum errors in 3D position and angular orientation were 1.7 mm and 0.33 degrees , respectively. For r(M) </= 175 mm, the respective values were 2.9 mm and 0.44 degrees .

CONCLUSIONS

Detection and localization of MR-visible markers by morphological image processing is feasible, simple, and very accurate. In combination with safe wireless markers, the method is found to be useful for image-guided procedures.

Image-guided and -monitored renal artery stenting using only MRI

PURPOSE

To demonstrate the ability of a unique interventional MR system to be used safely and effectively as the only imaging modality for all phases of MR-guided stent-supported angioplasty.

MATERIALS AND METHODS

An experimental disease model of renal stenosis was created in six pigs. An interventional MR system, which employed previously reported tools for real-time catheter tracking with automated scan-plane positioning, adaptive image parameters, and radial true-FISP imaging with steady-state precession (True-FISP) imaging coupled with a high-speed reconstruction technique, was then used to guide all phases of the intervention, including: guidewire and catheter insertion, stent deployment, and confirmation of therapeutic success. Pre- and postprocedural X-ray imaging was used as a gold standard to validate the experimental results.

RESULTS

All of the stent-supported angioplasty interventions were a technical success and were performed without complications. The average postoperative residual stenosis was 14.9%. The image guidance enabled the stents to be deployed with an accuracy of 0.98 +/- 0.69 mm. Additionally, using this interventional MRI system to guide renal artery stenting significantly reduces the procedure time, as compared to using X-ray fluoroscopy.

CONCLUSION

This study has clearly demonstrated the first successful treatment of renal artery stenting in an experimental animal model solely under MRI guidance and monitoring.

Motion correction properties of the shells k-space trajectory

The feasibility of a k-space trajectory that samples data on a set of 3D shells is demonstrated with phantom and volunteer experiments. Details of an interleaved multi-shot, helical spiral pulse sequence and a gridding reconstruction algorithm that uses Voronoi diagrams are provided. The motion-correction properties of the shells k-space trajectory are described. It is shown that when used in conjunction with three point markers, k-space data acquired with the shells trajectory provide a generalization of the RINGLET method, allowing for correction of arbitrary rigid-body motion with six degrees of freedom. Use of dedicated navigator echoes or redundant acquisitions of k-space data are not required. Retrospective motion correction is demonstrated with controlled phantom experiments and with seven healthy human volunteers. The motion correction is shown to improve the images, both qualitatively and quantitatively with a metric calculated from image entropy. Advantages and challenges of the shells trajectory are discussed, with particular attention to acquisition efficiency.

MR-guided endovascular interventions: device visualization, tracking, navigation, clinical applications, and safety aspects

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.

A review of technical advances in interventional magnetic resonance imaging

Initial research in the development of interventional magnetic resonance (MR) imaging in the late 1980s and early to mid-1990s focused on pulse sequences, devices, and clinical applications. This focus was largely a result of the limited number of areas in which the academic research community leading the development could provide innovation on the MR systems of the time. However, during the past decade, computational power, higher bandwidth graphical displays, faster computer networks, improved pulse sequence architectures, and improved technical specifications have accelerated the pace of development on modern MR systems. Today, it is the combination of multiple system factors that are enabling the future of interventional MR. These developments, their impact on the field, and newly emerging applications are described.

Radiofrequency Thermal Ablation: The Role of MR Imaging in Guiding and Monitoring Tumor Therapy

Performing RFA procedures under MR imaging involves two distinct processes: interactive guidance of the RF electrode into the targeted tumor and monitoring the effect of therapy. The justification for using MR imaging for electrode guidance is quite similar to its use to guide biopsy and aspiration procedures, where MR imaging offers advantages related to superior soft tissue contrast, multiplanar capabilities, and high vascular conspicuity that facilitate safe and accurate guidance in selected lesions. The major contribution of MR imaging to thermal ablation procedures is its ability to monitor tissue changes associated with the heating process instantaneously, an attribute that is not paralleled by any other currently available imaging modality. Such ability facilitates a controlled approach to ablation by helping to detect inadequately treated tumor foci for subsequent interactive repositioning of the RF electrode during therapy. As such, MR imaging guidance and monitoring enable treatment of the entire tumor on a single-visit basis while avoiding undue overtreatment and preserving often critically needed organ function. Although knowledge of interventional MR imaging concepts and familiarity with its technology and with the related safety issues are indispensable for interventional radiologists attempting thermal ablation procedures in the MR imaging environment, understanding the tissue basis of necrosis imaging is becoming an essential part of the knowledge base for the larger sector of general radiologists who are required to interpret the follow-up MR imaging scans of the increasing number of thermal ablation patients.

Percutaneous Biopsy from Blinded to MR Guided: An Update on Current Techniques and Applications

The advent of interventional MR imaging techniques as well as their adoption to guide percutaneous biopsies and aspirations has served as a further step along a series of technical refinements that commenced with the implementation of image-guided approaches for tissue sampling. Nowadays, the practice of and the expectations from these procedures are quite different from those of the blind percutaneous thrusts performed in the late nineteenth and early twentieth centuries. As the field of interventional MR imaging continues to flourish and to attract more radiologists who realize the many opportunities that this technology can offer to their patients, there is a need for a full comprehension of the concepts, techniques, limitations, and cost-effectiveness of MR imaging guidance to present this service to clinical partners in the appropriate setting. Radiologists should also recognize the need for their significant involvement in the technical aspects of MR-guided procedures, because several user-defined parameters and trajectory decisions can alter device visualization in the MR imaging environment and hence affect procedure safety.

[Measurements of respiratory motion using fast magnetic resonance imaging and inductively-coupled marker coils]

The respiratory motion of the thoracic wall provides indirect information about the breathing displacement of the inner organs. To analyze the correlation between thoracic wall and lung motion for applications in radiation therapy, the breathing displacement of the lung is visualized with a fast gradient echo pulse sequence (trueFISP) at a rate of 2-3 images/sec. For quantification of the motion, a small inductively-coupled marker coil is attached to the chest wall and detected with a fast projection technique. Since the marker coil generates a flip angle amplification (factor 15) in its interior, very small nominal flip angles of 2 degrees can be used during the projection measurements which do not affect the image quality of the trueFISP images. Volunteer studies with the marker coil showed a good agreement with simultaneously acquired breathing belt data and position information extracted from the MR images. Whereas the breathing belt provided reliable data only within a certain dynamic range, the marker coil could detect also extreme breathing excursions with a precision better than 2 millimeters.

The Catheter-Driven MRI Scanner: A New Approach to Intravascular Catheter Tracking and Imaging-Parameter Adjustment for Interventional MRI

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.

Active device tracking and high-resolution intravascular MRI using a novel catheter-based, opposed-solenoid phased array coil

A novel two-element, catheter-based phased array coil was designed and built for both active MR device tracking and high-resolution vessel wall imaging. The device consists of two independent solenoid coils that are wound in opposite directions, connected to separate receive channels, and mounted collinearly on an angiographic catheter. The elements were used independently or together for tracking or imaging applications, respectively. The array's dual functionality was tested on a clinical 1.5 T MRI scanner in vitro, in vivo, and in situ. During real-time catheter tracking, each element gave rise to a high-amplitude peak in the respective projection data, which enabled reliable and robust device tracking as well as automated slice positioning. In vivo microimaging with 240 microm in-plane resolution was achieved in 9 s using the device and TrueFISP imaging. Therefore, a single device was successfully implemented that met the combined requirements of intravascular device tracking and imaging.

MRI-guided prostate brachytherapy with single needle method—a planning study

BACKGROUND AND PURPOSE

Magnetic resonance image (MRI)-guided prostate brachytherapy with a conventional closed MR scanner is hampered by the limited access to the prostate. To handle this problem, we have designed a new implantation method, based on a patient lying in a closed MR scanner, a robotic device to be placed between patient's legs, and one needle with one insertion point.

MATERIALS AND METHODS

The MRI-guided robotic system inserts the needle into the prostate to deliver the seeds. Each time, the needle will be retracted to the rotation point (in the body), and the insertion angle can be changed. The possible angles of the needle are limited by the geometry of the closed MR scanner and the presence of the symphysis, rectum and urethra. We have done a planning study to investigate the feasibility of this single needle method.

RESULTS

The treatment plans made with the single needle method showed the possibility to cover the prostate with the prescribed dose without piercing the urethra or rectum and without pubic bone interference. The plans were comparable to the plans made for the multi parallel needle method, and the 144Gy isodose enclosed the prostate with a margin of about 2 mm. The planned angles of the needle were within the range of possible angles.

CONCLUSIONS

This planning study has shown the feasibility of adequate prostate coverage with the divergent single needle method within the limited space inside the closed MR scanner.

Real-time catheter tracking and adaptive imaging

PURPOSE

To evaluate the performance of a real-time MR system for interventional procedures that adjusts specific image parameters in real time based on a catheter's speed of insertion.

MATERIALS AND METHODS

The system was implemented using only the hardware provided with a standard short-bore 1.5 T scanner (Siemens Magnetom Sonata) (with the exception of small tracking markers affixed to the catheter). The system tracks the position of an MR microcoil-instrumented catheter and automatically updates the scan plane's position and orientation, as well as other features, including, but not limited to, field of view, resolution, tip angle, and TE. A real-time feedback loop continuously localizes the tracking markers, updates the scan plane position and orientation, calculates the catheter's speed, adjusts the value of specific image parameters, then collects new image data, reconstructs an image, and provides it for immediate display. The system was evaluated in phantom and in vivo porcine experiments.

RESULTS

The system is able to accurately localize a moving catheter in the abdominal aorta, calculate the device speed, and respond by adjusting specified image parameters 98% of the time, with precision of approximately 2 mm and 1.5 degrees.

CONCLUSION

Simply slowing the speed of the catheter allows the clinician to adjust predetermined image parameters. This work also has the potential to build a degree of intelligence into the scanner, enabling it to react to changes in the clinical environment and automatically optimize specific image parameters.

RINGLET motion correction for 3D MRI acquired with the elliptical centric view order

A new rigid-body motion correction algorithm is described that is compatible with 3D image sets acquired with the elliptical centric (EC) view order. With this view order, an annular ring of k-space data is acquired in the ky-kz plane during any short time interval. Images for tracking motion can be reconstructed in the yz-plane from any ring of the acquisition data. In these tracking images, a point source (such as an external marker) shows a characteristic bull's-eye pattern that permits motion monitoring and correction. The true position of the point object is located at the center of the bull's-eye pattern. Cross correlation can be performed to automatically track the positions of markers reconstructed from adjacent rings of k-space. To increase the marker signal, the markers are encased in inductively coupled RF coils. Rigid-body motion in the yz-plane is calculated directly with the Euclidean group for rotation and translation, and corrected by rotating and applying phase shifts to any corrupted rings of data. In the current work we present a theoretical analysis of this method, as well as results of volunteer and controlled phantom experiments that demonstrate its initial feasibility. Although the EC view order has mainly been used for MR angiography (MRA), it can also be used for most 3D acquisitions.

Undersampled projection reconstruction for active catheter imaging with adaptable temporal resolution and catheter-only views

In this study undersampled projection reconstruction (PR) was used for rapid catheter imaging in the heart, employing steady-state free precession (SSFP) contrast. Active catheters and phased-array coils were used for combined imaging of anatomy and catheter position in swine. Real-time imaging of catheter position was performed with relatively high spatial and temporal resolution, providing 2 x 2 x 8 mm spatial resolution and four to eight frames per second. Two interactive features were introduced. The number of projections (Np) was adjusted interactively to trade off imaging speed and artifact reduction, allowing acquisition of high-quality or high-frame-rate images. Thin-slice imaging was performed, with interactive requests for thick-slab projection images of the signal received solely from the active catheter. Briefly toggling on catheter-only projection images was valuable for verifying that the catheter tip was contained within the selected slice, or for locating the catheter when part of it was outside the selected slice.

Automatische Schichtverfolgung in der interventionellen Magnetresonanztomographie

Magnetic resonance imaging (MRI) is ideally suited to monitor minimally invasive operations with catheters or needles, since it offers both a superior soft-tissue contrast and the possibility to perform functional tests. In the present study, small radio-frequency coils were attached to the instruments in order to localize the MR-invisible instruments. The implementation of active instrument tracking is described on the basis of the example of active catheter tracking. In this case, the current position information of the instrument is used to automatically position the MRI slice at the catheter location. In combination with a user interface, the interventional radiologist is offered the possibility to perform vascular interventions from within the MR scanner room. At image update rates of approximately 3 Hz, tracking and placement of catheters in vascular structures are possible with interactive switching of slice orientation and image contrast. In an animal model, the technique was successfully used to selectively visualize the abdominal vessels and their branches under MRI guidance.