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Liu J, Wang M, Sun Z, Wang Y, Yang G, Wang W, Wang Q. Method for determining matching capacitances for floating cable traps in magnetic resonance imaging up to 14 T. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2024; 358:107612. [PMID: 38118321 DOI: 10.1016/j.jmr.2023.107612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/22/2023]
Abstract
Floating cable traps (FCTs) enhance coil tuning, improve the signal-to-noise ratio of magnetic resonance imaging (MRI), and reduce the risks to patients. As MRI technology continues to advance, it becomes crucial to design efficient FCTs that are tailored to different magnetic fields and nuclei. Here, a method is proposed for determining and correcting the appropriate capacitances for FCTs in MRI systems. To validate the effectiveness of this approach, FCTs were designed and manufactured for hydrogen nuclei in magnetic fields of 1.5-14 T. The results of bench testing show that the attenuation of common-mode currents was more than -20 dB, and the maximum frequency deviation in all the FCTs was 0.345%. Furthermore, the results of magnetic resonance spin-echo imaging show that the signal-to-noise ratio was improved significantly by using the FCTs. Overall, this study shows the effectiveness of the designed FCTs in improving signal-to-noise ratio, and it provides valuable insights for designing efficient FCTs tailored to different magnetic fields and nuclei in MRI applications.
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Affiliation(s)
- Jinhao Liu
- School of Electrical Engineering, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Miutian Wang
- School of Electronics, Peking University, Beijing, 100871, China.
| | - Zhen Sun
- School of Electronics, Peking University, Beijing, 100871, China.
| | - Yaohui Wang
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing, 100190, China; Division of Superconducting Magnet Science and Technology, Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, 100190, China.
| | - Gang Yang
- Institute of Biomedical Engineering, Peking University Shenzhen Graduate School, Shenzhen, 518055, China.
| | - Weimin Wang
- School of Electronics, Peking University, Beijing, 100871, China; Institute of Biomedical Engineering, Peking University Shenzhen Graduate School, Shenzhen, 518055, China; Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, 518132, China.
| | - Qiuliang Wang
- School of Electronic, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing, 100190, China; Division of Superconducting Magnet Science and Technology, Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, 100190, China.
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Mooiweer R, Rogers C, Vidya Shankar R, Razavi R, Neji R, Roujol S. Feasibility of cardiac MR thermometry at 0.55 T. Front Cardiovasc Med 2023; 10:1233065. [PMID: 37859681 PMCID: PMC10584305 DOI: 10.3389/fcvm.2023.1233065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
Radiofrequency catheter ablation is an established treatment strategy for ventricular tachycardia, but remains associated with a low success rate. MR guidance of ventricular tachycardia shows promises to improve the success rate of these procedures, especially due to its potential to provide real-time information on lesion formation using cardiac MR thermometry. Modern low field MRI scanners (<1 T) are of major interest for MR-guided ablations as the potential benefits include lower costs, increased patient access and device compatibility through reduced device-induced imaging artefacts and safety constraints. However, the feasibility of cardiac MR thermometry at low field remains unknown. In this study, we demonstrate the feasibility of cardiac MR thermometry at 0.55 T and characterized its in vivo stability (i.e., precision) using state-of-the-art techniques based on the proton resonance frequency shift method. Nine healthy volunteers were scanned using a cardiac MR thermometry protocol based on single-shot EPI imaging (3 slices in the left ventricle, 150 dynamics, TE = 41 ms). The reconstruction pipeline included image registration to align all the images, multi-baseline approach (look-up-table length = 30) to correct for respiration-induced phase variations, and temporal filtering to reduce noise in temperature maps. The stability of thermometry was defined as the pixel-wise standard deviation of temperature changes over time. Cardiac MR thermometry was successfully acquired in all subjects and the stability averaged across all subjects was 1.8 ± 1.0°C. Without multi-baseline correction, the overall stability was 2.8 ± 1.6°C. In conclusion, cardiac MR thermometry is feasible at 0.55 T and further studies on MR-guided catheter ablations at low field are warranted.
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Affiliation(s)
- Ronald Mooiweer
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | - Charlotte Rogers
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Rohini Vidya Shankar
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
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3
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Rogers T, Campbell-Washburn AE, Ramasawmy R, Yildirim DK, Bruce CG, Grant LP, Stine AM, Kolandaivelu A, Herzka DA, Ratnayaka K, Lederman RJ. Interventional cardiovascular magnetic resonance: state-of-the-art. J Cardiovasc Magn Reson 2023; 25:48. [PMID: 37574552 PMCID: PMC10424337 DOI: 10.1186/s12968-023-00956-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
Transcatheter cardiovascular interventions increasingly rely on advanced imaging. X-ray fluoroscopy provides excellent visualization of catheters and devices, but poor visualization of anatomy. In contrast, magnetic resonance imaging (MRI) provides excellent visualization of anatomy and can generate real-time imaging with frame rates similar to X-ray fluoroscopy. Realization of MRI as a primary imaging modality for cardiovascular interventions has been slow, largely because existing guidewires, catheters and other devices create imaging artifacts and can heat dangerously. Nonetheless, numerous clinical centers have started interventional cardiovascular magnetic resonance (iCMR) programs for invasive hemodynamic studies or electrophysiology procedures to leverage the clear advantages of MRI tissue characterization, to quantify cardiac chamber function and flow, and to avoid ionizing radiation exposure. Clinical implementation of more complex cardiovascular interventions has been challenging because catheters and other tools require re-engineering for safety and conspicuity in the iCMR environment. However, recent innovations in scanner and interventional device technology, in particular availability of high performance low-field MRI scanners could be the inflection point, enabling a new generation of iCMR procedures. In this review we review these technical considerations, summarize contemporary clinical iCMR experience, and consider potential future applications.
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Affiliation(s)
- Toby Rogers
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA.
- Section of Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving St NW, Suite 4B01, Washington, DC, 20011, USA.
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - Rajiv Ramasawmy
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - D Korel Yildirim
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - Christopher G Bruce
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - Laurie P Grant
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - Annette M Stine
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - Aravindan Kolandaivelu
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
- Johns Hopkins Hospital, Baltimore, MD, USA
| | - Daniel A Herzka
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
| | - Kanishka Ratnayaka
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA
- Rady Children's Hospital, San Diego, CA, USA
| | - Robert J Lederman
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10/Room 2C713, 9000 Rockville Pike, Bethesda, MD, 20892-1538, USA.
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4
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Stehning C, Krueger S, Weiss S, Smink J, Koken P, Hindricks G, Jahnke C, Paetsch I. Silent active device tracking for MR-guided interventional procedures. Magn Reson Med 2023; 89:2005-2013. [PMID: 36585913 DOI: 10.1002/mrm.29567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE To evaluate a silent MR active catheter tracking sequence that allows conducting catheter interventions with low acoustic noise levels. METHODS To reduce the acoustic noise associated with MR catheter tracking, we implemented a technique previously used in conventional MRI. The gradient waveforms are modified to reduce the sound pressure level (SPL) and avoid acoustic resonances of the MRI system. The efficacy of the noise reduction was assessed by software-predicted SPL and verified by measurements. Furthermore, the quality of the catheter tracking signal was assessed in a phantom experiment and during interventional cardiovascular MRI sessions targeted at isthmus-related flutter ablation. RESULTS The maximum measured SPL in the scanner room was 104 dB(A) for real-time imaging, and 88 dB(A) and 69 dB(A) for conventional and silent tracking, respectively. The SPL measured at different positions in the MR suite using silent tracking were 65-69 dB(A), and thus within the range of a normal conversation. Equivalent signal quality and tracking accuracy were obtained using the silent variant of the catheter tracking sequence. CONCLUSION Our results indicate that silent MR catheter tracking capabilities are identical to conventional catheter tracking. The achieved acoustic noise reduction comes at no penalty in terms of tracking quality or temporal resolution, improves comfort and safety, and can overcome the need for MR-compatible communication equipment and background noise suppression during the actual interventional procedure.
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Affiliation(s)
| | | | | | | | - Peter Koken
- Philips Research Laboratories, Hamburg, Germany
| | - Gerhard Hindricks
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Cosima Jahnke
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
| | - Ingo Paetsch
- Department of Electrophysiology, HELIOS Heart Center Leipzig, Leipzig, Germany
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5
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Madore B, Hess AT, van Niekerk AMJ, Hoinkiss DC, Hucker P, Zaitsev M, Afacan O, Günther M. External Hardware and Sensors, for Improved MRI. J Magn Reson Imaging 2023; 57:690-705. [PMID: 36326548 PMCID: PMC9957809 DOI: 10.1002/jmri.28472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Complex engineered systems are often equipped with suites of sensors and ancillary devices that monitor their performance and maintenance needs. MRI scanners are no different in this regard. Some of the ancillary devices available to support MRI equipment, the ones of particular interest here, have the distinction of actually participating in the image acquisition process itself. Most commonly, such devices are used to monitor physiological motion or variations in the scanner's imaging fields, allowing the imaging and/or reconstruction process to adapt as imaging conditions change. "Classic" examples include electrocardiography (ECG) leads and respiratory bellows to monitor cardiac and respiratory motion, which have been standard equipment in scan rooms since the early days of MRI. Since then, many additional sensors and devices have been proposed to support MRI acquisitions. The main physical properties that they measure may be primarily "mechanical" (eg acceleration, speed, and torque), "acoustic" (sound and ultrasound), "optical" (light and infrared), or "electromagnetic" in nature. A review of these ancillary devices, as currently available in clinical and research settings, is presented here. In our opinion, these devices are not in competition with each other: as long as they provide useful and unique information, do not interfere with each other and are not prohibitively cumbersome to use, they might find their proper place in future suites of sensors. In time, MRI acquisitions will likely include a plurality of complementary signals. A little like the microbiome that provides genetic diversity to organisms, these devices can provide signal diversity to MRI acquisitions and enrich measurements. Machine-learning (ML) algorithms are well suited at combining diverse input signals toward coherent outputs, and they could make use of all such information toward improved MRI capabilities. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Bruno Madore
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron T Hess
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Adam MJ van Niekerk
- Karolinska Institutet, Solna, Sweden
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Patrick Hucker
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maxim Zaitsev
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Onur Afacan
- Computational Radiology Laboratory, Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthias Günther
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University Bremen, Bremen, Germany
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6
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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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Kilbride BF, Narsinh KH, Jordan CD, Mueller K, Moore T, Martin AJ, Wilson MW, Hetts SW. MRI-guided endovascular intervention: current methods and future potential. Expert Rev Med Devices 2022; 19:763-778. [PMID: 36373162 PMCID: PMC9869980 DOI: 10.1080/17434440.2022.2141110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Image-guided endovascular interventions, performed using the insertion and navigation of catheters through the vasculature, have been increasing in number over the years, as minimally invasive procedures continue to replace invasive surgical procedures. Such endovascular interventions are almost exclusively performed under x-ray fluoroscopy, which has the best spatial and temporal resolution of all clinical imaging modalities. Magnetic resonance imaging (MRI) offers unique advantages and could be an attractive alternative to conventional x-ray guidance, but also brings with it distinctive challenges. AREAS COVERED In this review, the benefits and limitations of MRI-guided endovascular interventions are addressed, systems and devices for guiding such interventions are summarized, and clinical applications are discussed. EXPERT OPINION MRI-guided endovascular interventions are still relatively new to the interventional radiology field, since significant technical hurdles remain to justify significant costs and demonstrate safety, design, and robustness. Clinical applications of MRI-guided interventions are promising but their full potential may not be realized until proper tools designed to function in the MRI environment are available. Translational research and further preclinical studies are needed before MRI-guided interventions will be practical in a clinical interventional setting.
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Affiliation(s)
- Bridget F. Kilbride
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Kazim H. Narsinh
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Teri Moore
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Alastair J. Martin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Mark W. Wilson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Steven W. Hetts
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Tuna EE, Poirot NL, Franson D, Bayona JB, Huang S, Seiberlich N, Griswold MA, Cavusoglu MC. MRI Distortion Correction and Robot-to-MRI Scanner Registration for an MRI-Guided Robotic System. IEEE ACCESS : PRACTICAL INNOVATIONS, OPEN SOLUTIONS 2022; 10:99205-99220. [PMID: 37041984 PMCID: PMC10085576 DOI: 10.1109/access.2022.3207156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Magnetic resonance imaging (MRI) guided robotic procedures require safe robotic instrument navigation and precise target localization. This depends on reliable tracking of the instrument from MR images, which requires accurate registration of the robot to the scanner. A novel differential image based robot-to-MRI scanner registration approach is proposed that utilizes a set of active fiducial coils, where background subtraction method is employed for coil detection. In order to use the presented preoperative registration approach jointly with the real-time high speed MRI image acquisition and reconstruction methods in real-time interventional procedures, the effects of the geometric MRI distortion in robot to scanner registration is analyzed using a custom distortion mapping algorithm. The proposed approach is validated by a set of target coils placed within the workspace, employing multi-planar capabilities of the scanner. Registration and validation errors are respectively 2.05 mm and 2.63 mm after the distortion correction showing an improvement of respectively 1.08 mm and 0.14 mm compared to the results without distortion correction.
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Affiliation(s)
- E Erdem Tuna
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Nate Lombard Poirot
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | | | - Juana Barrera Bayona
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sherry Huang
- General Electric Healthcare, Royal Oak, MI 48067, USA
| | - Nicole Seiberlich
- Department of Radiology, University of Michigan, Ann-Anbor, MI 48109, USA
| | - Mark A Griswold
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - M Cenk Cavusoglu
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
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Mooiweer R, Schneider R, Krafft AJ, Empanger K, Stroup J, Neofytou AP, Mukherjee RK, Williams SE, Lloyd T, O'Neill M, Razavi R, Schaeffter T, Neji R, Roujol S. Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle. Front Cardiovasc Med 2022; 9:971869. [PMID: 36093156 PMCID: PMC9453599 DOI: 10.3389/fcvm.2022.971869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Cardiac MR thermometry shows promise for real-time guidance of radiofrequency ablation of cardiac arrhythmias. This technique uses ECG triggering, which can be unreliable in this situation. A prospective cardiac triggering method was developed for MR thermometry using the active tracking (AT) signal measured from catheter microcoils. In the proposed AT-based cardiac triggering (AT-trig) sequence, AT modules were repeatedly acquired to measure the catheter motion until a cardiac trigger was identified to start cardiac MR thermometry using single-shot echo-planar imaging. The AT signal was bandpass filtered to extract the motion induced by the beating heart, and cardiac triggers were defined as the extremum (peak or valley) of the filtered AT signal. AT-trig was evaluated in a beating heart phantom and in vivo in the left ventricle of a swine during temperature stability experiments (6 locations) and during one ablation. Stability was defined as the standard deviation over time. In the phantom, AT-trig enabled triggering of MR thermometry and resulted in higher temperature stability than an untriggered sequence. In all in vivo experiments, AT-trig intervals matched ECG-derived RR intervals. Mis-triggers were observed in 1/12 AT-trig stability experiments. Comparable stability of MR thermometry was achieved using peak AT-trig (1.0 ± 0.4°C), valley AT-trig (1.1 ± 0.5°C), and ECG triggering (0.9 ± 0.4°C). These experiments show that continuously acquired AT signal for prospective cardiac triggering is feasible. MR thermometry with AT-trig leads to comparable temperature stability as with conventional ECG triggering. AT-trig could serve as an alternative cardiac triggering strategy in situations where ECG triggering is not effective.
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Affiliation(s)
- Ronald Mooiweer
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | | | | | - Katy Empanger
- Imricor Medical Systems, Burnsville, MN, United States
| | - Jason Stroup
- Imricor Medical Systems, Burnsville, MN, United States
| | - Alexander Paul Neofytou
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Rahul K. Mukherjee
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Steven E. Williams
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Tom Lloyd
- Imricor Medical Systems, Burnsville, MN, United States
| | - Mark O'Neill
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Tobias Schaeffter
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
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10
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Su H, Kwok KW, Cleary K, Iordachita I, Cavusoglu MC, Desai JP, Fischer GS. State of the Art and Future Opportunities in MRI-Guided Robot-Assisted Surgery and Interventions. PROCEEDINGS OF THE IEEE. INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS 2022; 110:968-992. [PMID: 35756185 PMCID: PMC9231642 DOI: 10.1109/jproc.2022.3169146] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of target anatomy, surrounding tissue, and instrumentation, but there are significant challenges in harnessing it for effectively guiding interventional procedures. Challenges include the strong static magnetic field, rapidly switching magnetic field gradients, high-power radio frequency pulses, sensitivity to electrical noise, and constrained space to operate within the bore of the scanner. MRI has a number of advantages over other medical imaging modalities, including no ionizing radiation, excellent soft-tissue contrast that allows for visualization of tumors and other features that are not readily visible by other modalities, true 3-D imaging capabilities, including the ability to image arbitrary scan plane geometry or perform volumetric imaging, and capability for multimodality sensing, including diffusion, dynamic contrast, blood flow, blood oxygenation, temperature, and tracking of biomarkers. The use of robotic assistants within the MRI bore, alongside the patient during imaging, enables intraoperative MR imaging (iMRI) to guide a surgical intervention in a closed-loop fashion that can include tracking of tissue deformation and target motion, localization of instrumentation, and monitoring of therapy delivery. With the ever-expanding clinical use of MRI, MRI-compatible robotic systems have been heralded as a new approach to assist interventional procedures to allow physicians to treat patients more accurately and effectively. Deploying robotic systems inside the bore synergizes the visual capability of MRI and the manipulation capability of robotic assistance, resulting in a closed-loop surgery architecture. This article details the challenges and history of robotic systems intended to operate in an MRI environment and outlines promising clinical applications and associated state-of-the-art MRI-compatible robotic systems and technology for making this possible.
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Affiliation(s)
- Hao Su
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Ka-Wai Kwok
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong
| | - Kevin Cleary
- Children's National Health System, Washington, DC 20010 USA
| | - Iulian Iordachita
- Laboratory for Computational Sensing and Robotics (LCSR), Johns Hopkins University, Baltimore, MD 21218 USA
| | - M Cenk Cavusoglu
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH 44106 USA
| | - Jaydev P Desai
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332 USA
| | - Gregory S Fischer
- Department of Robotics Engineering, Worcester Polytechnic Institute, Worcester, MA 01609 USA
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11
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Krahn PRP, Biswas L, Ferguson S, Ramanan V, Barry J, Singh SM, Pop M, Wright GA. MRI-Guided Cardiac RF Ablation for Comparing MRI Characteristics of Acute Lesions and Associated Electrophysiologic Voltage Reductions. IEEE Trans Biomed Eng 2022; 69:2657-2666. [PMID: 35171765 DOI: 10.1109/tbme.2022.3152145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Objective: Radiofrequency (RF) energy delivered to cardiac tissue produces a core ablation lesion with surrounding edema, the latter of which has been implicated in acute procedural failure of Ventricular Tachycardia (VT) ablation and late arrhythmia recurrence. This study sought to investigate the electrophysiological characteristics of acute RF lesions in the left ventricle (LV) visualized with native-contrast Magnetic Resonance Imaging (MRI). Methods: An MR-guided electrophysiology system was used to deliver RF ablation in the LV of 8 swine (9 RF lesions in total), then perform MRI and electroanatomic mapping. The permanent RF lesions and transient edema were delineated via native-contrast MRI segmentation of T1-weighted images and T2 maps respectively. Bipolar voltage measurements were matched with image characteristics of pixels adjacent to the catheter tip. Native-contrast MR visualization was verified with 3D late gadolinium enhanced MRI and histology. Results: The T2-derived edema was significantly larger than the T1-derived RF lesion (2.11.5 mL compared to 0.580.34 mL; p=0.01). Bipolar voltage was significantly reduced in the presence of RF lesion core (p<0.05) and edema (p<0.05), with similar trends suggesting that both the permanent lesion and transient edema contributed to the region of reduced voltage. While bipolar voltage was significantly decreased where RF lesions are present (p<0.05), voltage did not change significantly with lesion transmurality (p>0.05). Conclusion: Permanent RF lesions and transient edema are distinct in native-contrast MR images, but not differentiable using bipolar voltage. Significance: Intraprocedural native-contrast MRI may provide valuable lesion assessment in MR-guided ablation, whose clinical application is now feasible.
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12
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Nayak KS, Lim Y, Campbell-Washburn AE, Steeden J. Real-Time Magnetic Resonance Imaging. J Magn Reson Imaging 2022; 55:81-99. [PMID: 33295674 PMCID: PMC8435094 DOI: 10.1002/jmri.27411] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 01/03/2023] Open
Abstract
Real-time magnetic resonance imaging (RT-MRI) allows for imaging dynamic processes as they occur, without relying on any repetition or synchronization. This is made possible by modern MRI technology such as fast-switching gradients and parallel imaging. It is compatible with many (but not all) MRI sequences, including spoiled gradient echo, balanced steady-state free precession, and single-shot rapid acquisition with relaxation enhancement. RT-MRI has earned an important role in both diagnostic imaging and image guidance of invasive procedures. Its unique diagnostic value is prominent in areas of the body that undergo substantial and often irregular motion, such as the heart, gastrointestinal system, upper airway vocal tract, and joints. Its value in interventional procedure guidance is prominent for procedures that require multiple forms of soft-tissue contrast, as well as flow information. In this review, we discuss the history of RT-MRI, fundamental tradeoffs, enabling technology, established applications, and current trends. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Krishna S. Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California, USA,Address reprint requests to: K.S.N., 3740 McClintock Ave, EEB 400C, Los Angeles, CA 90089-2564, USA.
| | - Yongwan Lim
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California, USA
| | - Adrienne E. Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jennifer Steeden
- Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, University College London, London, UK
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13
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Ochoa M, Algorri JF, Roldán-Varona P, Rodríguez-Cobo L, López-Higuera JM. Recent Advances in Biomedical Photonic Sensors: A Focus on Optical-Fibre-Based Sensing. SENSORS (BASEL, SWITZERLAND) 2021; 21:6469. [PMID: 34640788 PMCID: PMC8513032 DOI: 10.3390/s21196469] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 01/22/2023]
Abstract
In this invited review, we provide an overview of the recent advances in biomedical photonic sensors within the last five years. This review is focused on works using optical-fibre technology, employing diverse optical fibres, sensing techniques, and configurations applied in several medical fields. We identified technical innovations and advancements with increased implementations of optical-fibre sensors, multiparameter sensors, and control systems in real applications. Examples of outstanding optical-fibre sensor performances for physical and biochemical parameters are covered, including diverse sensing strategies and fibre-optical probes for integration into medical instruments such as catheters, needles, or endoscopes.
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Affiliation(s)
- Mario Ochoa
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (J.F.A.); (P.R.-V.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
| | - José Francisco Algorri
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (J.F.A.); (P.R.-V.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
| | - Pablo Roldán-Varona
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (J.F.A.); (P.R.-V.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
- CIBER-bbn, Institute of Health Carlos III, 28029 Madrid, Spain;
| | | | - José Miguel López-Higuera
- Photonics Engineering Group, University of Cantabria, 39005 Santander, Spain; (J.F.A.); (P.R.-V.)
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), 39011 Santander, Spain
- CIBER-bbn, Institute of Health Carlos III, 28029 Madrid, Spain;
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14
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Yildirim DK, Bruce C, Uzun D, Rogers T, O'Brien K, Ramasawmy R, Campbell-Washburn A, Herzka DA, Lederman RJ, Kocaturk O. A 20-gauge active needle design with thin-film printed circuitry for interventional MRI at 0.55T. Magn Reson Med 2021; 86:1786-1801. [PMID: 33860962 DOI: 10.1002/mrm.28804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 03/05/2021] [Accepted: 03/23/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE This work aims to fabricate RF antenna components on metallic needle surfaces using biocompatible polyester tubing and conductive ink to develop an active interventional MRI needle for clinical use at 0.55 Tesla. METHODS A custom computer numeric control-based conductive ink printing method was developed. Based on electromagnetic simulation results, thin-film RF antennas were printed with conductive ink and used to fabricate a medical grade, 20-gauge (0.87 mm outer diameter), 90-mm long active interventional MRI needle. The MRI visibility performance of the active needle prototype was tested in vitro in 1 gel phantom and in vivo in 1 swine. A nearly identical active needle constructed using a 44 American Wire Gauge insulated copper wire-wound RF receiver antenna was a comparator. The RF-induced heating risk was evaluated in a gel phantom per American Society for Testing and Materials (ASTM) 2182-19. RESULTS The active needle prototype with printed RF antenna was clearly visible both in vitro and in vivo under MRI. The maximum RF-induced temperature rise of prototypes with printed RF antenna and insulated copper wire antenna after a 3.96 W/kg, 15 min. long scan were 1.64°C and 8.21°C, respectively. The increase in needle diameter was 98 µm and 264 µm for prototypes with printed RF antenna and copper wire-wound antenna, respectively. CONCLUSION The active needle prototype with conductive ink printed antenna provides distinct device visibility under MRI. Variations on the needle surface are mitigated compared to use of a 44 American Wire Gauge copper wire. RF-induced heating tests support device RF safety under MRI. The proposed method enables fabrication of small diameter active interventional MRI devices having complex geometries, something previously difficult using conventional methods.
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Affiliation(s)
- Dursun Korel Yildirim
- Institute of Biomedical Engineering, Bogazici University, Kandilli Campus, Istanbul, Turkey.,Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Christopher Bruce
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Dogangun Uzun
- Institute of Biomedical Engineering, Bogazici University, Kandilli Campus, Istanbul, Turkey.,Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Toby Rogers
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kendall O'Brien
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rajiv Ramasawmy
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Adrienne Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Daniel A Herzka
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Robert J Lederman
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ozgur Kocaturk
- Institute of Biomedical Engineering, Bogazici University, Kandilli Campus, Istanbul, Turkey.,Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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15
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McDannold N, Jason White P, Rees Cosgrove G. MRI-based thermal dosimetry based on single-slice imaging during focused ultrasound thalamotomy. Phys Med Biol 2020; 65:235018. [PMID: 32916666 PMCID: PMC8019066 DOI: 10.1088/1361-6560/abb7c4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Transcranial MRI-guided focused ultrasound (MRgFUS) is a noninvasive thermal ablation method approved for the treatment of essential tremor and tremor-dominant Parkinson's disease. This method uses MR temperature imaging (MRTI) to monitor the treatment. Accurately tracking the accumulated thermal dose is important for both safety and efficacy. Currently, MRTI is obtained in a single plane that varies between sonications, preventing direct tracking of the accumulated dose. In this work, we tested a method to estimate this dose during 120 MRgFUS treatments. This method used the MRTI to create simulated thermal images for sonications when the imaging plane was changed. This approach accurately predicted the lesion shapes. The mean Sørensen-Dice similarity coefficient between the lesion segmentations and dose regions at the 17 cumulative min at 43 °C (CEM43) threshold used by the device software was 0.82 but varied among different treatments (range: 0.34-0.95). Tissue swelling appeared to explain when mismatch occurred, although other errors probably contributed. Overall, the mean distance between the lesion segmentations and the 17 CEM43 dose contours was 0.37 ± 0.57 mm. The probability for thermal damage was estimated to be 50% at 13.6 CEM43 and a maximum temperature of 48.6 °C. Due to large thermal gradients, which exceeded 99 CEM43/mm on average, the area where the probability for thermal damage was uncertain was narrow. Overall these results show that the 17 CEM43 threshold is on average a good predictor for thermal lesions, although there will always be a narrow margin where the fate of the tissue is uncertain.
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Affiliation(s)
- Nathan McDannold
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
| | - P Jason White
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
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16
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McDannold N, White PJ, Cosgrove R. Predicting Bone Marrow Damage in the Skull After Clinical Transcranial MRI-Guided Focused Ultrasound With Acoustic and Thermal Simulations. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3231-3239. [PMID: 32324544 PMCID: PMC7529866 DOI: 10.1109/tmi.2020.2989121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Transcranial MRI-guided focused ultrasound (TcMRgFUS) thermal ablation is a noninvasive functional neurosurgery technique. Previous reports have shown that damage in the skull bone marrow can occur at high acoustic energies. While this damage is asymptomatic, it would be desirable to avoid it. Here we examined whether acoustic and thermal simulations can predict where the thermal lesions in the marrow occurred. Post-treatment imaging was obtained at 3-15 months after 40 clinical TcMRgFUS procedures, and bone marrow lesions were observed after 16 treatments. The presence of lesions was predicted by the acoustic energy with a threshold of 18.1-21.1 kJ (maximum acoustic energy used) and 97-112 kJ (total acoustic energy applied over the whole treatment). The size of the lesions was not always predicted by the acoustic energy used during treatment alone. In contrast, the locations, sizes, and shapes of the heated regions estimated by the acoustic and thermal simulations were qualitatively similar to those of the lesions. The lesions generally appeared in areas that were predicted to have high temperatures. While more work is needed to validate the temperature estimates in and around the skull, being able to predict the locations and onset for lesions in the bone marrow could allow for better distribution of the acoustic energy over the skull. Understanding skull absorption characteristics of TcMRgFUS could also be useful in optimizing transcranial focusing.
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17
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Tuna EE, Poirot NL, Bayona JB, Franson D, Huang S, Narvaez J, Seiberlich N, Griswold M, Çavuşoğlu MC. Differential Image Based Robot to MRI Scanner Registration with Active Fiducial Markers for an MRI-Guided Robotic Catheter System. PROCEEDINGS OF THE ... IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS. IEEE/RSJ INTERNATIONAL CONFERENCE ON INTELLIGENT ROBOTS AND SYSTEMS 2020; 2020:2958-2964. [PMID: 34136309 PMCID: PMC8202025 DOI: 10.1109/iros45743.2020.9341043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In magnetic resonance imaging (MRI) guided robotic catheter ablation procedures, reliable tracking of the catheter within the MRI scanner is needed to safely navigate the catheter. This requires accurate registration of the catheter to the scanner. This paper presents a differential, multi-slice image-based registration approach utilizing active fiducial coils. The proposed method would be used to preoperatively register the MRI image space with the physical catheter space. In the proposed scheme, the registration is performed with the help of a registration frame, which has a set of embedded electromagnetic coils designed to actively create MRI image artifacts. These coils are detected in the MRI scanner's coordinate system by background subtraction. The detected coil locations in each slice are weighted by the artifact size and then registered to known ground truth coil locations in the catheter's coordinate system via least-squares fitting. The proposed approach is validated by using a set of target coils placed withing the workspace, employing multi-planar capabilities of the MRI scanner. The average registration and validation errors are respectively computed as 1.97 mm and 2.49 mm. The multi-slice approach is also compared to the single-slice method and shown to improve registration and validation by respectively 0.45 mm and 0.66 mm.
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Affiliation(s)
- E Erdem Tuna
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Nate Lombard Poirot
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Juana Barrera Bayona
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Dominique Franson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Sherry Huang
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - Julian Narvaez
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH, USA
| | | | - Mark Griswold
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - M Cenk Çavuşoğlu
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH, USA
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18
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Simultaneous feedback control for joint field and motion correction in brain MRI. Neuroimage 2020; 226:117286. [PMID: 32992003 DOI: 10.1016/j.neuroimage.2020.117286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/21/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022] Open
Abstract
T2*-weighted gradient-echo sequences count among the most widely used techniques in neuroimaging and offer rich magnitude and phase contrast. The susceptibility effects underlying this contrast scale with B0, making T2*-weighted imaging particularly interesting at high field. High field also benefits baseline sensitivity and thus facilitates high-resolution studies. However, enhanced susceptibility effects and high target resolution come with inherent challenges. Relying on long echo times, T2*-weighted imaging not only benefits from enhanced local susceptibility effects but also suffers from increased field fluctuations due to moving body parts and breathing. High resolution, in turn, renders neuroimaging particularly vulnerable to motion of the head. This work reports the implementation and characterization of a system that aims to jointly address these issues. It is based on the simultaneous operation of two control loops, one for field stabilization and one for motion correction. The key challenge with this approach is that the two loops both operate on the magnetic field in the imaging volume and are thus prone to mutual interference and potential instability. This issue is addressed at the levels of sensing, timing, and control parameters. Performance assessment shows the resulting system to be stable and exhibit adequate loop decoupling, precision, and bandwidth. Simultaneous field and motion control is then demonstrated in examples of T2*-weighted in vivo imaging at 7T.
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19
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Lou M, Abdalla I, Zhu M, Wei X, Yu J, Li Z, Ding B. Highly Wearable, Breathable, and Washable Sensing Textile for Human Motion and Pulse Monitoring. ACS APPLIED MATERIALS & INTERFACES 2020; 12:19965-19973. [PMID: 32275380 DOI: 10.1021/acsami.0c03670] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
At present, pressure sensor textiles are of great significance in the area of wearable electronics, especially for making smart or intelligent textiles. However, the design of these textile-based devices with sensitive ability, simple fabrication, and low cost is still challenging. In this study, we developed a triboelectric sensing textile constructed with core-shell yarns. Nylon filament and polytetrafluoroethylene filament were selected as the positive and negative layers, respectively, in the woven structure while the built-in helical stainless steel yarn was serving as the inner electrode layer. The sensitivity of the sensing textile can reach up to 1.33 V·kPa-1 and 0.32 V·kPa-1 in the pressure range of 1.95-3.13 kPa and 3.20-4.61 kPa, respectively. This sensing textile presented good mechanical stability and sensing capability even after 4200 cycles of continuous operation or after 4 h continuous water washing. Benefiting from the favorable merits of being highly flexible, breathable, lightweight, and even dyeable, the fabricated device was capable of being placed on any desired body parts for quantifying the dynamic human motions. It can be effectively used to measure and monitor various human movements associated with different joints, such as the hand, elbow, knee, and underarm. Moreover, the sensing textile was able to capture real-time pulse signals and reflect the current health status for human beings. This study affords an innovative and promising track for multifunctional pressure sensor textiles with wide applications in smart textiles and personalized healthcare.
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Affiliation(s)
- Mengna Lou
- Key Laboratory of Science & Technology of Eco-Textile, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, P. R. China
| | - Ibrahim Abdalla
- College of Materials Science and Engineering, Donghua University, Shanghai 201620, P. R. China
| | - Miaomiao Zhu
- College of Materials Science and Engineering, Donghua University, Shanghai 201620, P. R. China
| | - Xuedian Wei
- Key Laboratory of Science & Technology of Eco-Textile, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, P. R. China
| | - Jianyong Yu
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai 200051, P. R. China
| | - Zhaoling Li
- Key Laboratory of Science & Technology of Eco-Textile, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, P. R. China
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai 200051, P. R. China
| | - Bin Ding
- Innovation Center for Textile Science and Technology, Donghua University, Shanghai 200051, P. R. China
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20
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Marjanovic J, Reber J, Brunner DO, Engel M, Kasper L, Dietrich BE, Vionnet L, Pruessmann KP. A Reconfigurable Platform for Magnetic Resonance Data Acquisition and Processing. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:1138-1148. [PMID: 31567076 DOI: 10.1109/tmi.2019.2944696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Developments in magnetic resonance imaging (MRI) in the last decades show a trend towards a growing number of array coils and an increasing use of a wide variety of sensors. Associated cabling and safety issues have been addressed by moving data acquisition closer to the coil. However, with the increasing number of radio-frequency (RF) channels and trend towards higher acquisition duty-cycles, the data amount is growing, which poses challenges for throughput and data handling. As it is becoming a limitation, early compression and preprocessing is becoming ever more important. Additionally, sensors deliver diverse data, which require distinct and often low-latency processing for run-time updates of scanner operation. To address these challenges, we propose the transition to reconfigurable hardware with an application tailored assembly of interfaces and real-time processing resources. We present an integrated solution based on a system-on-chip (SoC), which offers sufficient throughput and hardware-based parallel processing power for very challenging applications. It is equipped with fiber-optical modules serving as versatile interfaces for modular systems with in-field operation. We demonstrate the utility of the platform on the example of concurrent imaging and field sensing with hardware-based coil compression and trajectory extraction. The preprocessed data are then used in expanded encoding model based image reconstruction of single-shot and segmented spirals as used in time-series and anatomical imaging respectively.
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21
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Özen AC, Silemek B, Lottner T, Atalar E, Bock M. MR safety watchdog for active catheters: Wireless impedance control with real-time feedback. Magn Reson Med 2020; 84:1048-1060. [PMID: 31961965 DOI: 10.1002/mrm.28153] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/29/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To dynamically minimize radiofrequency (RF)-induced heating of an active catheter through an automatic change of the termination impedance. METHODS A prototype wireless module was designed that modifies the input impedance of an active catheter to keep the temperature rise during MRI below a threshold, ΔTmax . The wireless module (MR safety watchdog; MRsWD) measures the local temperature at the catheter tip using either a built-in thermistor or external data from a fiber-optical thermometer. It automatically changes the catheter input impedance until the temperature rise during MRI is minimized. If ΔTmax is exceeded, RF transmission is blocked by a feedback system. RESULTS The thermistor and fiber-optical thermometer provided consistent temperature data in a phantom experiment. During MRI, the MRsWD was able to reduce the maximum temperature rise by 25% when operated in real-time feedback mode. CONCLUSION This study demonstrates the technical feasibility of an MRsWD as an alternative or complementary approach to reduce RF-induced heating of active interventional devices. The automatic MRsWD can reduce heating using direct temperature measurements at the tip of the catheter. Given that temperature measurements are intrinsically slow, for a clinical implementation, a faster feedback parameter would be required such as the RF currents along the catheter or scattered electric fields at the tip.
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Affiliation(s)
- Ali Caglar Özen
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,German Consortium for Translational Cancer Research Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Berk Silemek
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey.,Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Thomas Lottner
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ergin Atalar
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey.,Department of Electrical and Electronics Engineering, Bilkent University, Ankara, Turkey
| | - Michael Bock
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Freiburg, Germany
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22
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Lou M, Abdalla I, Zhu M, Yu J, Li Z, Ding B. Hierarchically Rough Structured and Self-Powered Pressure Sensor Textile for Motion Sensing and Pulse Monitoring. ACS APPLIED MATERIALS & INTERFACES 2020; 12:1597-1605. [PMID: 31840486 DOI: 10.1021/acsami.9b19238] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Nowadays, real-time human motion sensing and pulse monitoring can provide significant basis for health assessment and medical diagnosis. Nevertheless, it is still a big challenge to design a lightweight, flexible, and energy-sustainable pressure sensor with high sensitivity and breathability. Here, we fabricated a triboelectric all-fiber structured pressure sensor via a facile electrospinning technique. The constructed sensor textile holds a composite structure made up of a polyvinylidene fluoride/Ag nanowire nanofibrous membrane (NFM), an ethyl cellulose NFM, and two layers of conductive fabrics. This wearable device with high shape adaptability exhibited excellent sensing capability because of the introduced hierarchically rough structure on the nanofibers. The sensitivity can reach up to 1.67 and 0.20 V·kPa-1 in the pressure range of 0-3 and 3-32 kPa, respectively. The fabricated sensor textile also showed a superior mechanical stability even after continuous operation of 7200 working cycles. This sensor textile was easily conformable on different desired body parts for dynamic motion sensing and real-time pulse monitoring. It can work in a self-powered manner to detect and quantify various human motions associated with joints, such as elbows, knees, and ankles. Additionally, it can be placed on the carotid artery to capture the pulse signals, serving as a reliable way to reflect the state of health. This work has great possibilities to promote the rapid advancement and broad applications of multifunctional pressure sensors and next-generation wearable electronics.
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Affiliation(s)
| | | | | | - Jianyong Yu
- Innovation Center for Textile Science and Technology , Donghua University , Shanghai 200051 , China
| | - Zhaoling Li
- Innovation Center for Textile Science and Technology , Donghua University , Shanghai 200051 , China
| | - Bin Ding
- Innovation Center for Textile Science and Technology , Donghua University , Shanghai 200051 , China
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23
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Godinez F, Scott G, Padormo F, Hajnal JV, Malik SJ. Safe guidewire visualization using the modes of a PTx transmit array MR system. Magn Reson Med 2019; 83:2343-2355. [PMID: 31722119 PMCID: PMC7048617 DOI: 10.1002/mrm.28069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023]
Abstract
Purpose MRI‐guided cardiovascular intervention using standard metal guidewires can produce focal tissue heating caused by induced radiofrequency guidewire currents. It has been shown that safe operation is made possible by using parallel transmit radiofrequency coils driven in the null current mode, which does not induce radiofrequency currents and hence allows safe tissue visualization. We propose that the maximum current modes, usually considered unsafe, be used at very low power levels to visualize conductive wires, and we investigate pulse sequences best suited for this application. Methods Spoiled gradient echo, balanced steady‐state free precession, and turbo spin echo sequences were evaluated for their ability to visualize a conductive guidewire embedded in a gel phantom when run in maximum current modes at very low power level. Temperature at the guidewire tip was monitored for safety assessment. Results Excellent guidewire visualization could be achieved using maximum current modes excitation, with the turbo spin echo sequence giving the best image quality. Although turbo spin echo is usually considered to be a high‐power sequence, our method reduced all pulses to 1% amplitude (0.01% power), and heating was not detected. In addition, visualization of background tissue can be achieved using null current mode, also with no recorded heating at the guidewire tip even when running at 100% (reported) specific absorption rate. Conclusion Parallel transmit is a promising approach for both guidewire and tissue visualization using maximum and null current modes, respectively, for interventional cardiac MRI. Such systems can switch excitation mode instantaneously, allowing for flexible integration into interactive sequences.
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Affiliation(s)
- Felipe Godinez
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Greig Scott
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | | | - Joseph V Hajnal
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Shaihan J Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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Bianchi F, Masaracchia A, Shojaei Barjuei E, Menciassi A, Arezzo A, Koulaouzidis A, Stoyanov D, Dario P, Ciuti G. Localization strategies for robotic endoscopic capsules: a review. Expert Rev Med Devices 2019; 16:381-403. [PMID: 31056968 DOI: 10.1080/17434440.2019.1608182] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Federico Bianchi
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | | | | | | | - Alberto Arezzo
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | | | - Danail Stoyanov
- Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
| | - Paolo Dario
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Gastone Ciuti
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
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Özen AC, Lottner T, Bock M. Safety of active catheters in MRI: Termination impedance versus RF‐induced heating. Magn Reson Med 2018; 81:1412-1423. [DOI: 10.1002/mrm.27481] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/08/2018] [Accepted: 07/15/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Ali Caglar Özen
- Department of Radiology, Medical Physics, Medical Center ‐ University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
- German Cancer Consortium Partner Site Freiburg, German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Thomas Lottner
- Department of Radiology, Medical Physics, Medical Center ‐ University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Michael Bock
- Department of Radiology, Medical Physics, Medical Center ‐ University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
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Abstract
Diagnostic and interventional cardiac catheterization is routinely used in the diagnosis and treatment of congenital heart disease. There are well-established concerns regarding the risk of radiation exposure to patients and staff, particularly in children given the cumulative effects of repeat exposure. Magnetic resonance imaging (MRI) offers the advantage of being able to provide better soft tissue visualization, tissue characterization, and quantification of ventricular volumes and vascular flow. Initial work using MRI catheterization employed fusion of x-ray and MRI techniques, with x-ray fluoroscopy to guide catheter placement and subsequent MRI assessment for anatomical and hemodynamic assessment. Image overlay of 3D previously acquired MRI datasets with live fluoroscopic imaging has also been used to guide catheter procedures.Hybrid x-ray and MRI-guided catheterization paved the way for clinical application and validation of this technique in the assessment of pulmonary vascular resistance and pharmacological stress studies. Purely MRI-guided catheterization also proved possible with passive catheter tracking. First-in-man MRI-guided cardiac catheter interventions were possible due to the development of MRI-compatible guidewires, but halted due to guidewire limitations.More recent developments in passive and active catheter tracking have led to improved visualization of catheters for MRI-guided catheterization. Improvements in hardware and software have also increased image quality and scanning times with better interactive tools for the operator in the MRI catheter suite to navigate through the anatomy as required in real time. This has expanded to MRI-guided electrophysiology studies and radiofrequency ablation in humans. Animal studies show promise for the utility of MRI-guided interventional catheterization. Ongoing investment and development of MRI-compatible guidewires will pave the way for MRI-guided diagnostic and interventional catheterization coming into the mainstream.
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Yaras YS, Satir S, Ozsoy C, Ramasawmy R, Campbell-Washburn AE, Lederman RJ, Kocaturk O, Degertekin FL. Acousto-Optic Catheter Tracking Sensor for Interventional MRI Procedures. IEEE Trans Biomed Eng 2018; 66:1148-1154. [PMID: 30188810 DOI: 10.1109/tbme.2018.2868830] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective of this paper is to introduce an acousto-optic optical fiber sensor for tracking catheter position during interventional magnetic resonance imaging (MRI) to overcome RF induced heating of active markers. METHODS The sensor uses a miniature coil coupled to a piezoelectric transducer, which is in turn mechanically connected to an optical fiber. The piezoelectric transducer converts the RF signal to acoustic waves in the optical fiber over a region including a fiber Bragg grating (FBG). The elastic waves in the fiber modulates the FBG geometry and hence the reflected light in the optical fiber. Since the coil is much smaller than the RF wavelength and the signal is transmitted on the dielectric optical fiber, the sensor effectively reduces RF induced heating risk. Proof of concept prototypes of the sensor are implemented using commercially available piezoelectric transducers and optical fibers with FBGs. The prototypes are characterized in a 1.5 T MRI system in comparison with an active tracking marker. RESULTS Acousto-optical sensor shows linear response with flip angle and it can be used to detect signals from multiple coils for potential orientation detection. It has been successfully used to detect the position of a tacking coil in phantom in an imaging experiment. CONCLUSION Acousto-optical sensing is demonstrated for tracking catheters during interventional MRI. Real-time operation of the sensor requires sensitivity improvements like using a narrow band FBG. SIGNIFICANCE Acousto-optics provides a compact solution to sense RF signals in MRI with dielectric transmission lines.
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28
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Guo Z, Leong MCW, Su H, Kwok KW, Chan DTM, Poon WS. Techniques for Stereotactic Neurosurgery: Beyond the Frame, Toward the Intraoperative Magnetic Resonance Imaging–Guided and Robot-Assisted Approaches. World Neurosurg 2018; 116:77-87. [DOI: 10.1016/j.wneu.2018.04.155] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/20/2018] [Accepted: 04/21/2018] [Indexed: 11/16/2022]
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Krahn PRP, Singh SM, Ramanan V, Biswas L, Yak N, Anderson KJT, Barry J, Pop M, Wright GA. Cardiovascular magnetic resonance guided ablation and intra-procedural visualization of evolving radiofrequency lesions in the left ventricle. J Cardiovasc Magn Reson 2018; 20:20. [PMID: 29544514 PMCID: PMC5856306 DOI: 10.1186/s12968-018-0437-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/15/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Radiofrequency (RF) ablation has become a mainstay of treatment for ventricular tachycardia, yet adequate lesion formation remains challenging. This study aims to comprehensively describe the composition and evolution of acute left ventricular (LV) lesions using native-contrast cardiovascular magnetic resonance (CMR) during CMR-guided ablation procedures. METHODS RF ablation was performed using an actively-tracked CMR-enabled catheter guided into the LV of 12 healthy swine to create 14 RF ablation lesions. T2 maps were acquired immediately post-ablation to visualize myocardial edema at the ablation sites and T1-weighted inversion recovery prepared balanced steady-state free precession (IR-SSFP) imaging was used to visualize the lesions. These sequences were repeated concurrently to assess the physiological response following ablation for up to approximately 3 h. Multi-contrast late enhancement (MCLE) imaging was performed to confirm the final pattern of ablation, which was then validated using gross pathology and histology. RESULTS Edema at the ablation site was detected in T2 maps acquired as early as 3 min post-ablation. Acute T2-derived edematous regions consistently encompassed the T1-derived lesions, and expanded significantly throughout the 3-h period post-ablation to 1.7 ± 0.2 times their baseline volumes (mean ± SE, estimated using a linear mixed model determined from n = 13 lesions). T1-derived lesions remained approximately stable in volume throughout the same time frame, decreasing to 0.9 ± 0.1 times the baseline volume (mean ± SE, estimated using a linear mixed model, n = 9 lesions). CONCLUSIONS Combining native T1- and T2-based imaging showed that distinctive regions of ablation injury are reflected by these contrast mechanisms, and these regions evolve separately throughout the time period of an intervention. An integrated description of the T1-derived lesion and T2-derived edema provides a detailed picture of acute lesion composition that would be most clinically useful during an ablation case.
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Affiliation(s)
- Philippa R. P. Krahn
- Department of Medical Biophysics, University of Toronto, Toronto, ON Canada
- Sunnybrook Research Institute, Toronto, ON Canada
| | - Sheldon M. Singh
- Schulich Heart Research Program, Sunnybrook Research Institute, Toronto, ON Canada
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON Canada
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | | | | | - Nicolas Yak
- Sunnybrook Research Institute, Toronto, ON Canada
| | | | | | - Mihaela Pop
- Department of Medical Biophysics, University of Toronto, Toronto, ON Canada
- Sunnybrook Research Institute, Toronto, ON Canada
- Schulich Heart Research Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Graham A. Wright
- Department of Medical Biophysics, University of Toronto, Toronto, ON Canada
- Sunnybrook Research Institute, Toronto, ON Canada
- Schulich Heart Research Program, Sunnybrook Research Institute, Toronto, ON Canada
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Schmidt EJ, Halperin HR. MRI use for atrial tissue characterization in arrhythmias and for EP procedure guidance. Int J Cardiovasc Imaging 2018; 34:81-95. [PMID: 28593399 PMCID: PMC5889521 DOI: 10.1007/s10554-017-1179-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/24/2017] [Indexed: 12/19/2022]
Abstract
We review the utilization of magnetic resonance imaging methods for classifying atrial tissue properties that act as a substrate for common cardiac arrhythmias, such as atrial fibrillation. We then review state-of-the-art methods for mapping this substrate as a predicate for treatment, as well as methods used to ablate the electrical pathways that cause arrhythmia and restore patients to sinus rhythm.
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Affiliation(s)
- Ehud J Schmidt
- Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Henry R Halperin
- Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
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31
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de Arcos J, Schmidt EJ, Wang W, Tokuda J, Vij K, Seethamraju RT, Damato AL, Dumoulin CL, Cormack RA, Viswanathan AN. Prospective Clinical Implementation of a Novel Magnetic Resonance Tracking Device for Real-Time Brachytherapy Catheter Positioning. Int J Radiat Oncol Biol Phys 2017; 99:618-626. [PMID: 28843373 DOI: 10.1016/j.ijrobp.2017.05.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/05/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE We designed and built dedicated active magnetic resonance (MR)-tracked (MRTR) stylets. We explored the role of MRTR in a prospective clinical trial. METHODS AND MATERIALS Eleven gynecologic cancer patients underwent MRTR to rapidly optimize interstitial catheter placement. MRTR catheter tip location and orientation were computed and overlaid on images displayed on in-room monitors at rates of 6 to 16 frames per second. Three modes of actively tracked navigation were analyzed: coarse navigation to the approximate region around the tumor; fine-tuning, bringing the stylets to the desired location; and pullback, with MRTR stylets rapidly withdrawn from within the catheters, providing catheter trajectories for radiation treatment planning (RTP). Catheters with conventional stylets were inserted, forming baseline locations. MRTR stylets were substituted, and catheter navigation was performed by a clinician working inside the MRI bore, using monitor feedback. RESULTS Coarse navigation allowed repositioning of the MRTR catheters tips by 16 mm (mean), relative to baseline, in 14 ± 5 s/catheter (mean ± standard deviation [SD]). The fine-tuning mode repositioned the catheter tips by a further 12 mm, in 24 ± 17 s/catheter. Pullback mode provided catheter trajectories with RTP point resolution of ∼1.5 mm, in 1 to 9 s/catheter. CONCLUSIONS MRTR-based navigation resulted in rapid and optimal placement of interstitial brachytherapy catheters. Catheters were repositioned compared with the initial insertion without tracking. In pullback mode, catheter trajectories matched computed tomographic precision, enabling their use for RTP.
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Affiliation(s)
- Jose de Arcos
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Ehud J Schmidt
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland
| | - Wei Wang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Junichi Tokuda
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kamal Vij
- Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Antonio L Damato
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Robert A Cormack
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Akila N Viswanathan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, Maryland.
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Markman TM, Nazarian S. Cardiac Magnetic Resonance for Lesion Assessment in the Electrophysiology Laboratory. Circ Arrhythm Electrophysiol 2017; 10:CIRCEP.117.005839. [PMID: 29079665 DOI: 10.1161/circep.117.005839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 09/29/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Timothy M Markman
- From the Division of Cardiology (T.M.M., S.N.) and Section for Cardiac Electrophysiology (S.N.), Hospital of the University of Pennsylvania, Philadelphia
| | - Saman Nazarian
- From the Division of Cardiology (T.M.M., S.N.) and Section for Cardiac Electrophysiology (S.N.), Hospital of the University of Pennsylvania, Philadelphia.
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Yang JK, Cote AM, Jordan CD, Kondapavulur S, Losey AD, McCoy D, Chu A, Yu JF, Moore T, Stillson C, Settecase F, Alexander MD, Nicholson A, Cooke DL, Saeed M, Barry D, Martin AJ, Wilson MW, Hetts SW. Interventional magnetic resonance imaging guided carotid embolectomy using a novel resonant marker catheter: demonstration of preclinical feasibility. Biomed Microdevices 2017; 19:88. [PMID: 28948399 DOI: 10.1007/s10544-017-0225-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To assess the visualization and efficacy of a wireless resonant circuit (wRC) catheter system for carotid artery occlusion and embolectomy under real-time MRI guidance in vivo, and to compare MR imaging modality with x-ray for analysis of qualitative physiological measures of blood flow at baseline and after embolectomy. The wRC catheter system was constructed using a MR compatible PEEK fiber braided catheter (Penumbra, Inc, Alameda, CA) with a single insulated longitudinal copper loop soldered to a printed circuit board embedded within the catheter wall. In concordance with IACUC protocol (AN103047), in vivo carotid artery navigation and embolectomy were performed in four farm pigs (40-45 kg) under real-time MRI at 1.5T. Industry standard clots were introduced in incremental amounts until adequate arterial occlusion was noted in a total of n=13 arteries. Baseline vasculature and restoration of blood flow were confirmed via MR and x-ray imaging, and graded by the Thrombolysis in Cerebral Infarction (TICI) scale. Wilcoxon signed-rank tests were used to analyze differences in recanalization status between DSA and MRA imaging. Successful recanalizations (TICI 2b/3) were compared to clinical rates reported in literature via binomial tests. The wRC catheter system was visible both on 5° sagittal bSSFP and coronal GRE sequence. Successful recanalization was demonstrated in 11 of 13 occluded arteries by DSA analysis and 8 of 13 by MRA. Recanalization rates based on DSA (0.85) and MRA (0.62) were not significantly different from the clinical rate of mechanical aspiration thrombectomy reported in literature. Lastly, a Wilcoxon signed rank test indicated no significant difference between TICI scores analyzed by DSA and MRA. With demonstrated compatibility and visualization under MRI, the wRC catheter system is effective for in vivo endovascular embolectomy, suggesting progress towards clinical endovascular interventional MRI.
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Affiliation(s)
- Jeffrey K Yang
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Andre M Cote
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Caroline D Jordan
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | | | - Aaron D Losey
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - David McCoy
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | | | - Jay F Yu
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Teri Moore
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Carol Stillson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Fabio Settecase
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Matthew D Alexander
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Andrew Nicholson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Daniel L Cooke
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Maythem Saeed
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | | | - Alastair J Martin
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Mark W Wilson
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA
| | - Steven W Hetts
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
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Localization of microscale devices in vivo using addressable transmitters operated as magnetic spins. Nat Biomed Eng 2017; 1:736-744. [DOI: 10.1038/s41551-017-0129-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/01/2017] [Indexed: 11/09/2022]
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Griffin GH, Anderson KJT, Wright GA. Miniaturizing Floating Traps to Increase RF Safety of Magnetic-Resonance-Guided Percutaneous Procedures. IEEE Trans Biomed Eng 2017; 64:329-340. [PMID: 28113187 DOI: 10.1109/tbme.2016.2553680] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE MRI in the area of cardiovascular catheter-based interventional procedures is an active field. A common intervention-revascularization of chronic total occlusions, requires a conductive guidewire for revascularization. The mechanical properties of guidewires are paramount to the successful execution of such procedures. Furthermore to benefit from MRI techniques, additional conductors are required to transmit signal from the tip of a catheter. Long thin conductors in MRI systems pose a safety risk in the form of RF heating due to induced RF currents on the conductors. Unfortunately many existing techniques to mitigate this risk require physical modification of the conductors, inevitably resulting in detrimental mechanical tradeoffs in the guidewire. This manuscript proposes a novel application and miniaturization of an existing device, the floating RF trap. The RF trap couples strongly to any thin conductor passing through the trap lumen inducing significant series impedance. This results in reduction of induced RF currents, and thus, heating. METHODS AND RESULTS This study shows theoretical and experimental analysis of induced impedance as well as theoretical reduction in heating due to various distributions of traps along the length of a catheter. Results of measuring induced current and heating in phantom experiments are also presented. Through comparison with commercial simulation packages and results of phantom experiments, it is shown that miniaturized RF traps can be modeled accurately, including their induced series impedance and effect on induced RF current. CONCLUSION AND SIGNIFICANCE It was demonstrated that floating RF traps present a feasible method to mitigate RF heating while maintaining important mechanical properties of guidewires.
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An J, Webb AG, Shah DJ, Chin K, Tsekos NV. Manipulator-driven selection of semi-active MR-visible markers. Int J Med Robot 2017; 14. [PMID: 28660676 DOI: 10.1002/rcs.1846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 04/18/2017] [Accepted: 05/06/2017] [Indexed: 11/12/2022]
Abstract
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.
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Affiliation(s)
- Junmo An
- Medical Robotics Laboratory, University of Houston, Houston, TX, USA
| | - Andrew G Webb
- C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, Netherlands
| | - Dipan J Shah
- Methodist DeBakey Cardiology Associates, Houston Methodist, Houston, TX, USA
| | - Karen Chin
- Methodist DeBakey Cardiology Associates, Houston Methodist, Houston, TX, USA
| | - Nikolaos V Tsekos
- Medical Robotics Laboratory, University of Houston, Houston, TX, USA
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Campbell-Washburn AE, Tavallaei MA, Pop M, Grant EK, Chubb H, Rhode K, Wright GA. Real-time MRI guidance of cardiac interventions. J Magn Reson Imaging 2017; 46:935-950. [PMID: 28493526 DOI: 10.1002/jmri.25749] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/29/2017] [Indexed: 11/09/2022] Open
Abstract
Cardiac magnetic resonance imaging (MRI) is appealing to guide complex cardiac procedures because it is ionizing radiation-free and offers flexible soft-tissue contrast. Interventional cardiac MR promises to improve existing procedures and enable new ones for complex arrhythmias, as well as congenital and structural heart disease. Guiding invasive procedures demands faster image acquisition, reconstruction and analysis, as well as intuitive intraprocedural display of imaging data. Standard cardiac MR techniques such as 3D anatomical imaging, cardiac function and flow, parameter mapping, and late-gadolinium enhancement can be used to gather valuable clinical data at various procedural stages. Rapid intraprocedural image analysis can extract and highlight critical information about interventional targets and outcomes. In some cases, real-time interactive imaging is used to provide a continuous stream of images displayed to interventionalists for dynamic device navigation. Alternatively, devices are navigated relative to a roadmap of major cardiac structures generated through fast segmentation and registration. Interventional devices can be visualized and tracked throughout a procedure with specialized imaging methods. In a clinical setting, advanced imaging must be integrated with other clinical tools and patient data. In order to perform these complex procedures, interventional cardiac MR relies on customized equipment, such as interactive imaging environments, in-room image display, audio communication, hemodynamic monitoring and recording systems, and electroanatomical mapping and ablation systems. Operating in this sophisticated environment requires coordination and planning. This review provides an overview of the imaging technology used in MRI-guided cardiac interventions. Specifically, this review outlines clinical targets, standard image acquisition and analysis tools, and the integration of these tools into clinical workflow. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2017;46:935-950.
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Affiliation(s)
- Adrienne E Campbell-Washburn
- Laboratory of Imaging Technology, Biochemistry and Biophysics Center, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mohammad A Tavallaei
- Physical Sciences Platform and Schulich Heart Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Mihaela Pop
- Physical Sciences Platform and Schulich Heart Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Elena K Grant
- Laboratory of Imaging Technology, Biochemistry and Biophysics Center, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.,Department of Cardiology, Children's National Medical Center, Washington, DC, USA
| | - Henry Chubb
- Division of Imaging Sciences and Biomedical Engineering, King's College London, UK
| | - Kawal Rhode
- Division of Imaging Sciences and Biomedical Engineering, King's College London, UK
| | - Graham A Wright
- Physical Sciences Platform and Schulich Heart Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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Abadi H, Krug J, Illanes A, Friebe M. Passive artifact behavior prediction of interventional tools in high-field MRI using a 0.55T portable benchtop MR scanner. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:1252-1255. [PMID: 28268552 DOI: 10.1109/embc.2016.7590933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Using magnetic resonance imaging (MRI) for guiding minimally invasive interventions requires surgical devices which on one hand are visible in the MR image but on the other hand do not generate large artifacts, which distort the overall imaging process. Passive markers are one way to visualize devices such as catheters or biopsy needles in MRI. The evaluation of newly developed passive markers usually requires access to high-field MRI scanners (1.5 T and 3 T). This makes the practical evaluation time-consuming and expensive. Hence, we propose to use a high-resolution, low field (0.55 T) benchtop MRI system to quantify the size of an artifact and to make a prediction for its corresponding size in a clinical high-field system. For the evaluation of the proposed method, catheters coated with different passive marker materials in varying concentrations were imaged in the 0. 55 T benchtop MRI scanner as well as in clinical 3 T MRI system using FLASH sequences. The experimental results revealed that an artifact prediction based on measurements in the 0. 55 T is possible for the tested marker materials. Hence, the proposed approach has a high potential for testing newly developed medical devices at a low cost, in less time and during the development process for fast feedback.
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Toupin S, Bour P, Lepetit-Coiffé M, Ozenne V, Denis de Senneville B, Schneider R, Vaussy A, Chaumeil A, Cochet H, Sacher F, Jaïs P, Quesson B. Feasibility of real-time MR thermal dose mapping for predicting radiofrequency ablation outcome in the myocardium in vivo. J Cardiovasc Magn Reson 2017; 19:14. [PMID: 28143574 PMCID: PMC5286737 DOI: 10.1186/s12968-017-0323-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical treatment of cardiac arrhythmia by radiofrequency ablation (RFA) currently lacks quantitative and precise visualization of lesion formation in the myocardium during the procedure. This study aims at evaluating thermal dose (TD) imaging obtained from real-time magnetic resonance (MR) thermometry on the heart as a relevant indicator of the thermal lesion extent. METHODS MR temperature mapping based on the Proton Resonance Frequency Shift (PRFS) method was performed at 1.5 T on the heart, with 4 to 5 slices acquired per heartbeat. Respiratory motion was compensated using navigator-based slice tracking. Residual in-plane motion and related magnetic susceptibility artifacts were corrected online. The standard deviation of temperature was measured on healthy volunteers (N = 5) in both ventricles. On animals, the MR-compatible catheter was positioned and visualized in the left ventricle (LV) using a bSSFP pulse sequence with active catheter tracking. Twelve MR-guided RFA were performed on three sheep in vivo at various locations in left ventricle (LV). The dimensions of the thermal lesions measured on thermal dose images, on 3D T1-weighted (T1-w) images acquired immediately after the ablation and at gross pathology were correlated. RESULTS MR thermometry uncertainty was 1.5 °C on average over more than 96% of the pixels covering the left and right ventricles, on each volunteer. On animals, catheter repositioning in the LV with active slice tracking was successfully performed and each ablation could be monitored in real-time by MR thermometry and thermal dosimetry. Thermal lesion dimensions on TD maps were found to be highly correlated with those observed on post-ablation T1-w images (R = 0.87) that also correlated (R = 0.89) with measurements at gross pathology. CONCLUSIONS Quantitative TD mapping from real-time rapid CMR thermometry during catheter-based RFA is feasible. It provides a direct assessment of the lesion extent in the myocardium with precision in the range of one millimeter. Real-time MR thermometry and thermal dosimetry may improve safety and efficacy of the RFA procedure by offering a reliable indicator of therapy outcome during the procedure.
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Affiliation(s)
- Solenn Toupin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Siemens Healthineers France, F-93210 Saint-Denis, France
| | - Pierre Bour
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Image Guided Therapy, F-33600 Pessac, France
| | | | - Valéry Ozenne
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
| | | | | | - Alexis Vaussy
- Siemens Healthineers France, F-93210 Saint-Denis, France
| | - Arnaud Chaumeil
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Hubert Cochet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Frédéric Sacher
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Pierre Jaïs
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Bruno Quesson
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
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Chubb H, Williams SE, Whitaker J, Harrison JL, Razavi R, O'Neill M. Cardiac Electrophysiology Under MRI Guidance: an Emerging Technology. Arrhythm Electrophysiol Rev 2017; 6:85-93. [PMID: 28845235 DOI: 10.15420/aer.2017.1.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
MR-guidance of electrophysiological (EP) procedures offers the potential for enhanced arrhythmia substrate assessment, improved procedural guidance and real-time assessment of ablation lesion formation. Accurate device tracking techniques, using both active and passive methods, have been developed to offer an interface similar to electroanatomic mapping platforms, and MR-compatible EP equipment continues to be developed. Progress to clinical implementation of these technically complex fields has been relatively slow over the last 10 years, but recent developments have led to successful clinical experience. However, further advances, particularly in harnessing the full imaging potential of CMR, are required to realise the mainstream adoption of this powerful guidance modality.
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Affiliation(s)
| | - Steven E Williams
- King's College London, London, UK.,Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - James L Harrison
- King's College London, London, UK.,Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Mark O'Neill
- King's College London, London, UK.,Guy's and St Thomas' NHS Foundation Trust, London, UK
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Kaiser M, Detert M, Rube MA, El-Tahir A, Elle OJ, Melzer A, Schmidt B, Rose GH. Resonant marker design and fabrication techniques for device visualization during interventional magnetic resonance imaging. ACTA ACUST UNITED AC 2016; 60:89-103. [PMID: 25460277 DOI: 10.1515/bmt-2013-0097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/24/2014] [Indexed: 11/15/2022]
Abstract
Magnetic resonance imaging (MRI) has great potential as an imaging modality for guiding minimally invasive interventions because of its superior soft tissue contrast and the possibility of arbitrary slice positioning while avoiding ionizing radiation and nephrotoxic iodine contrast agents. The major constraints are: limited patient access, the insufficient assortment of compatible instruments and the difficult device visualization compared to X-ray based techniques. For the latter, resonant MRI markers, fabricated by using the wire-winding technique, have been developed. This fabrication technique serves as a functional model but has no clinical use. Thus, the aim of this study is to illustrate a four-phase design process of resonant markers involving microsystems technologies. The planning phase comprises the definition of requirements and the simulation of electromagnetic performance of the MRI markers. The following technologies were considered for the realization phase: aerosol-deposition process, hot embossing technology and thin film technology. The subsequent evaluation phase involves several test methods regarding electrical and mechanical characterization as well as MRI visibility aspects. The degree of fulfillment of the predefined requirements is determined within the analysis phase. Furthermore, an exemplary evaluation of four realized MRI markers was conducted, focusing on the performance within the MRI environment.
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Wang W, Viswanathan AN, Damato AL, Chen Y, Tse Z, Pan L, Tokuda J, Seethamraju RT, Dumoulin CL, Schmidt EJ, Cormack RA. Evaluation of an active magnetic resonance tracking system for interstitial brachytherapy. Med Phys 2016; 42:7114-21. [PMID: 26632065 DOI: 10.1118/1.4935535] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In gynecologic cancers, magnetic resonance (MR) imaging is the modality of choice for visualizing tumors and their surroundings because of superior soft-tissue contrast. Real-time MR guidance of catheter placement in interstitial brachytherapy facilitates target coverage, and would be further improved by providing intraprocedural estimates of dosimetric coverage. A major obstacle to intraprocedural dosimetry is the time needed for catheter trajectory reconstruction. Herein the authors evaluate an active MR tracking (MRTR) system which provides rapid catheter tip localization and trajectory reconstruction. The authors assess the reliability and spatial accuracy of the MRTR system in comparison to standard catheter digitization using magnetic resonance imaging (MRI) and CT. METHODS The MRTR system includes a stylet with microcoils mounted on its shaft, which can be inserted into brachytherapy catheters and tracked by a dedicated MRTR sequence. Catheter tip localization errors of the MRTR system and their dependence on catheter locations and orientation inside the MR scanner were quantified with a water phantom. The distances between the tracked tip positions of the MRTR stylet and the predefined ground-truth tip positions were calculated for measurements performed at seven locations and with nine orientations. To evaluate catheter trajectory reconstruction, fifteen brachytherapy catheters were placed into a gel phantom with an embedded catheter fixation framework, with parallel or crossed paths. The MRTR stylet was then inserted sequentially into each catheter. During the removal of the MRTR stylet from within each catheter, a MRTR measurement was performed at 40 Hz to acquire the instantaneous stylet tip position, resulting in a series of three-dimensional (3D) positions along the catheter's trajectory. A 3D polynomial curve was fit to the tracked positions for each catheter, and equally spaced dwell points were then generated along the curve. High-resolution 3D MRI of the phantom was performed followed by catheter digitization based on the catheter's imaging artifacts. The catheter trajectory error was characterized in terms of the mean distance between corresponding dwell points in MRTR-generated catheter trajectory and MRI-based catheter digitization. The MRTR-based catheter trajectory reconstruction process was also performed on three gynecologic cancer patients, and then compared with catheter digitization based on MRI and CT. RESULTS The catheter tip localization error increased as the MRTR stylet moved further off-center and as the stylet's orientation deviated from the main magnetic field direction. Fifteen catheters' trajectories were reconstructed by MRTR. Compared with MRI-based digitization, the mean 3D error of MRTR-generated trajectories was 1.5 ± 0.5 mm with an in-plane error of 0.7 ± 0.2 mm and a tip error of 1.7 ± 0.5 mm. MRTR resolved ambiguity in catheter assignment due to crossed catheter paths, which is a common problem in image-based catheter digitization. In the patient studies, the MRTR-generated catheter trajectory was consistent with digitization based on both MRI and CT. CONCLUSIONS The MRTR system provides accurate catheter tip localization and trajectory reconstruction in the MR environment. Relative to the image-based methods, it improves the speed, safety, and reliability of the catheter trajectory reconstruction in interstitial brachytherapy. MRTR may enable in-procedural dosimetric evaluation of implant target coverage.
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Affiliation(s)
- Wei Wang
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 02115 and Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts 02115
| | - Akila N Viswanathan
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts 02115
| | - Antonio L Damato
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts 02115
| | - Yue Chen
- Department of Engineering, The University of Georgia, Athens, Georgia 30602
| | - Zion Tse
- Department of Engineering, The University of Georgia, Athens, Georgia 30602
| | - Li Pan
- Siemens Healthcare USA, Baltimore, Maryland 21287
| | - Junichi Tokuda
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 02115
| | | | - Charles L Dumoulin
- Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229
| | - Ehud J Schmidt
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts 02115
| | - Robert A Cormack
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts 02115
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Xiao X, Huang Z, Rube MA, Melzer A. Investigation of active tracking for robotic arm assisted magnetic resonance guided focused ultrasound ablation. Int J Med Robot 2016; 13. [DOI: 10.1002/rcs.1768] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/15/2016] [Accepted: 07/20/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Xu Xiao
- Institute for Medical Science and Technology; University of Dundee; Dundee UK
| | - Zhihong Huang
- School of Engineering, Physics and Mathematics; University of Dundee; Dundee UK
| | - Martin A. Rube
- Institute for Medical Science and Technology; University of Dundee; Dundee UK
| | - Andreas Melzer
- Institute for Medical Science and Technology; University of Dundee; Dundee UK
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Magnetic resonance imaging guided transatrial electrophysiological studies in swine using active catheter tracking - experience with 14 cases. Eur Radiol 2016; 27:1954-1962. [PMID: 27553931 DOI: 10.1007/s00330-016-4560-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/14/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the feasibility of performing comprehensive Cardiac Magnetic resonance (CMR) guided electrophysiological (EP) interventions in a porcine model encompassing left atrial access. METHODS After introduction of two femoral sheaths 14 swine (41 ± 3.6 kg) were transferred to a 1.5 T MR scanner. A three-dimensional whole-heart sequence was acquired followed by segmentation and the visualization of all heart chambers using an image-guidance platform. Two MR conditional catheters were inserted. The interventional protocol consisted of intubation of the coronary sinus, activation mapping, transseptal left atrial access (n = 4), generation of ablation lesions and eventually ablation of the atrioventricular (AV) node. For visualization of the catheter tip active tracking was used. Catheter positions were confirmed by passive real-time imaging. RESULTS Total procedure time was 169 ± 51 minutes. The protocol could be completed in 12 swine. Two swine died from AV-ablation induced ventricular fibrillation. Catheters could be visualized and navigated under active tracking almost exclusively. The position of the catheter tips as visualized by active tracking could reliably be confirmed with passive catheter imaging. CONCLUSIONS Comprehensive CMR-guided EP interventions including left atrial access are feasible in swine using active catheter tracking. KEY POINTS • Comprehensive CMR-guided electrophysiological interventions including LA access were conducted in swine. • Active catheter-tracking allows efficient catheter navigation also in a transseptal approach. • More MR-conditional tools are needed to facilitate left atrial interventions in humans.
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Daniels B, Ireland C, Kraus S, Racadio J, Hilvert N, Dunn R, Dumoulin C. Magnetic Resonance-Guided Nasogastric Feeding Tube Placement for Neonates: A Preclinical Study. JPEN J Parenter Enteral Nutr 2016; 41:1386-1392. [PMID: 27503934 DOI: 10.1177/0148607116662973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Establishing postnatal nutrition delivery is challenging in neonates with immature sucking and swallowing ability. Enteral feeding is the gold standard for such patients, but their small size and fragility present challenges in nasogastric (NG) feeding tube placement. Feeding tubes are typically placed with x-ray guidance, which provides minimal soft tissue contrast and exposes the baby to ionizing radiation. This research investigates magnetic resonance (MR) guidance of NG feeding tube placement in neonates to provide improved soft tissue visualization without ionizing radiation. MATERIALS AND METHODS A novel feeding tube incorporating 3 solenoid coils for real-time tracking and guidance in the MR environment was developed. The feeding tube was placed 5 times in a rabbit with conventional x-ray guidance to assess mechanical stability and function. After x-ray procedures, the rabbit was transferred to a neonatal MR system, and the tube was placed 5 more times. RESULTS In procedures guided by x-ray and MR, the feeding tube provided sufficient mechanical strength and functionality to access the esophagus and stomach of the rabbit. MR imaging provided significantly improved soft tissue contrast versus x-ray, which aided in proper tube guidance. Moreover, MR guidance allowed for real-time placement of the tube without the use of ionizing radiation. CONCLUSIONS The feasibility and benefits offered by an MR-guided approach to NG feeding tube placement were demonstrated. The ability to acquire high-quality MR images of soft tissue without ionizing radiation and a contrast agent, coupled with accurate 3-dimensional device tracking, promises to have a powerful impact on future neonatal feeding tube placements.
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Affiliation(s)
- Barret Daniels
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Christopher Ireland
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,2 Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
| | - Steven Kraus
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - John Racadio
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Nicole Hilvert
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Richard Dunn
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Charles Dumoulin
- 1 Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,2 Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
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Xu R, Athavale P, Krahn P, Anderson K, Barry J, Biswas L, Ramanan V, Yak N, Pop M, Wright GA. Feasibility Study of Respiratory Motion Modeling Based Correction for MRI-Guided Intracardiac Interventional Procedures. IEEE Trans Biomed Eng 2016; 62:2899-910. [PMID: 26595904 DOI: 10.1109/tbme.2015.2451517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
GOAL The purpose of this study is to improve the accuracy of interventional catheter guidance during intracardiac procedures. Specifically, the use of preprocedural magnetic resonance roadmap images for interventional guidance has limited anatomical accuracy due to intraprocedural respiratory motion of the heart. Therefore, we propose to build a novel respiratory motion model to compensate for this motion-induced error during magnetic resonance imaging (MRI)-guided procedures. METHODS We acquire 2-D real-time free-breathing images to characterize the respiratory motion, and build a smooth motion model via registration of 3-D prior roadmap images to the real-time images within a novel principal axes frame of reference. The model is subsequently used to correct the interventional catheter positions with respect to the anatomy of the heart. RESULTS We demonstrate that the proposed modeling framework can lead to smoother motion models, and potentially lead to more accurate motion estimates. Specifically, MRI-guided intracardiac ablations were performed in six preclinical animal experiments. Then, from retrospective analysis, the proposed motion modeling technique showed the potential to achieve a 27% improvement in ablation targeting accuracy. CONCLUSION The feasibility of a respiratory motion model-based correction framework has been successfully demonstrated. SIGNIFICANCE The improvement in ablation accuracy may lead to significant improvements in success rate and patient outcomes for MRI-guided intracardiac procedures.
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Svedin BT, Beck MJ, Hadley JR, Merrill R, de Bever JT, Bolster BD, Payne A, Parker DL. Focal point determination in magnetic resonance-guided focused ultrasound using tracking coils. Magn Reson Med 2016; 77:2424-2430. [PMID: 27418429 DOI: 10.1002/mrm.26294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/07/2016] [Accepted: 05/11/2016] [Indexed: 11/08/2022]
Abstract
PURPOSE To develop a method for rapid prediction of the geometric focus location in MR coordinates of a focused ultrasound (US) transducer with arbitrary position and orientation without sonicating. METHODS Three small tracker coil circuits were designed, constructed, attached to the transducer housing of a breast-specific MR-guided focused US (MRgFUS) system with 5 degrees of freedom, and connected to receiver channel inputs of an MRI scanner. A one-dimensional sequence applied in three orthogonal directions determined the position of each tracker, which was then corrected for gradient nonlinearity. In a calibration step, low-level heating located the US focus in one transducer position orientation where the tracker positions were also known. Subsequent US focus locations were determined from the isometric transformation of the trackers. The accuracy of this method was verified by comparing the tracking coil predictions to thermal center of mass calculated using MR thermometry data acquired at 16 different transducer positions for MRgFUS sonications in a homogeneous gelatin phantom. RESULTS The tracker coil predicted focus was an average distance of 2.1 ± 1.1 mm from the thermal center of mass. The one-dimensional locator sequence and prediction calculations took less than 1 s to perform. CONCLUSION This technique accurately predicts the geometric focus for a transducer with arbitrary position and orientation without sonicating. Magn Reson Med 77:2424-2430, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Bryant T Svedin
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Michael J Beck
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - J Rock Hadley
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Robb Merrill
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Joshua T de Bever
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Bradley D Bolster
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Allison Payne
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Dennis L Parker
- Radiology Department, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
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Ciuti G, Caliò R, Camboni D, Neri L, Bianchi F, Arezzo A, Koulaouzidis A, Schostek S, Stoyanov D, Oddo CM, Magnani B, Menciassi A, Morino M, Schurr MO, Dario P. Frontiers of robotic endoscopic capsules: a review. JOURNAL OF MICRO-BIO ROBOTICS 2016; 11:1-18. [PMID: 29082124 PMCID: PMC5646258 DOI: 10.1007/s12213-016-0087-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/24/2016] [Accepted: 04/07/2016] [Indexed: 12/15/2022]
Abstract
Digestive diseases are a major burden for society and healthcare systems, and with an aging population, the importance of their effective management will become critical. Healthcare systems worldwide already struggle to insure quality and affordability of healthcare delivery and this will be a significant challenge in the midterm future. Wireless capsule endoscopy (WCE), introduced in 2000 by Given Imaging Ltd., is an example of disruptive technology and represents an attractive alternative to traditional diagnostic techniques. WCE overcomes conventional endoscopy enabling inspection of the digestive system without discomfort or the need for sedation. Thus, it has the advantage of encouraging patients to undergo gastrointestinal (GI) tract examinations and of facilitating mass screening programmes. With the integration of further capabilities based on microrobotics, e.g. active locomotion and embedded therapeutic modules, WCE could become the key-technology for GI diagnosis and treatment. This review presents a research update on WCE and describes the state-of-the-art of current endoscopic devices with a focus on research-oriented robotic capsule endoscopes enabled by microsystem technologies. The article also presents a visionary perspective on WCE potential for screening, diagnostic and therapeutic endoscopic procedures.
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Affiliation(s)
- Gastone Ciuti
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
| | - R Caliò
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
| | - D Camboni
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
| | - L Neri
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy.,Ekymed S.r.l., Livorno, Italy
| | - F Bianchi
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
| | - A Arezzo
- Department of Surgical Disciplines, University of Torino, Torino, Italy
| | - A Koulaouzidis
- Endoscopy Unit, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
| | | | - D Stoyanov
- Centre for Medical Image Computing and the Department of Computer Science, University College London, London, UK
| | - C M Oddo
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
| | | | - A Menciassi
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
| | - M Morino
- Department of Surgical Disciplines, University of Torino, Torino, Italy
| | - M O Schurr
- Ovesco Endoscopy AG, Tübingen, Germany.,Steinbeis University Berlin, Berlin, Germany
| | - P Dario
- The BioRobotics Institute of Scuola Superiore Sant'Anna, Pontedera, Pisa 56025 Italy
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Chen Y, Wang W, Schmidt EJ, Kwok KW, Viswanathan AN, Cormack R, Tse ZTH. Design and Fabrication of MR-Tracked Metallic Stylet for Gynecologic Brachytherapy. IEEE/ASME TRANSACTIONS ON MECHATRONICS : A JOINT PUBLICATION OF THE IEEE INDUSTRIAL ELECTRONICS SOCIETY AND THE ASME DYNAMIC SYSTEMS AND CONTROL DIVISION 2016; 21:956-962. [PMID: 28989272 PMCID: PMC5627614 DOI: 10.1109/tmech.2015.2503427] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
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.
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Affiliation(s)
- Yue Chen
- College of Engineering, The University of Georgia, Athens, GA, 30605 USA, and is also with Department of Mechanical Engineering, The University of Hong Kong, HK, China (, )
| | - Wei Wang
- Department of Radiology, Brigham & Women's Hospital, Boston, MA, 02115 USA, and is also with the Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, 02115 USA
| | - Ehud J Schmidt
- Department of Radiology, Brigham & Women's Hospital, Boston, MA, 02115 USA
| | - Ka-Wai Kwok
- Department of Mechanical Engineering, The University of Hong Kong, HK, China
| | - Akila N Viswanathan
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, 02115
| | - Robert Cormack
- Department of Radiation Oncology, Brigham & Women's Hospital, Boston, MA, 02115
| | - Zion Tsz Ho Tse
- College of Engineering, The University of Georgia, Athens, GA, 30605 USA
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Lillaney PV, Yang JK, Losey AD, Martin AJ, Cooke DL, Thorne BRH, Barry DC, Chu A, Stillson C, Do L, Arenson RL, Saeed M, Wilson MW, Hetts SW. Endovascular MR-guided Renal Embolization by Using a Magnetically Assisted Remote-controlled Catheter System. Radiology 2016; 281:219-28. [PMID: 27019290 DOI: 10.1148/radiol.2016152036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose To assess the feasibility of a magnetically assisted remote-controlled (MARC) catheter system under magnetic resonance (MR) imaging guidance for performing a simple endovascular procedure (ie, renal artery embolization) in vivo and to compare with x-ray guidance to determine the value of MR imaging guidance and the specific areas where the MARC system can be improved. Materials and Methods In concordance with the Institutional Animal Care and Use Committee protocol, in vivo renal artery navigation and embolization were tested in three farm pigs (mean weight 43 kg ± 2 [standard deviation]) under real-time MR imaging at 1.5 T. The MARC catheter device was constructed by using an intramural copper-braided catheter connected to a laser-lithographed saddle coil at the distal tip. Interventionalists controlled an in-room cart that delivered electrical current to deflect the catheter in the MR imager. Contralateral kidneys were similarly embolized under x-ray guidance by using standard clinical catheters and guidewires. Changes in renal artery flow and perfusion were measured before and after embolization by using velocity-encoded and perfusion MR imaging. Catheter navigation times, renal parenchymal perfusion, and renal artery flow rates were measured for MR-guided and x-ray-guided embolization procedures and are presented as means ± standard deviation in this pilot study. Results Embolization was successful in all six kidneys under both x-ray and MR imaging guidance. Mean catheterization time with MR guidance was 93 seconds ± 56, compared with 60 seconds ± 22 for x-ray guidance. Mean changes in perfusion rates were 4.9 au/sec ± 0.8 versus 4.6 au/sec ± 0.6, and mean changes in renal flow rate were 2.1 mL/min/g ± 0.2 versus 1.9 mL/min/g ± 0.2 with MR imaging and x-ray guidance, respectively. Conclusion The MARC catheter system is feasible for renal artery catheterization and embolization under real-time MR imaging in vivo, and quantitative physiologic measures under MR imaging guidance were similar to those measured under x-ray guidance, suggesting that the MARC catheter system could be used for endovascular procedures with interventional MR imaging. (©) RSNA, 2016.
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Affiliation(s)
- Prasheel V Lillaney
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Jeffrey K Yang
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Aaron D Losey
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Alastair J Martin
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Daniel L Cooke
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Bradford R H Thorne
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - David C Barry
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Andrew Chu
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Carol Stillson
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Loi Do
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Ronald L Arenson
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Maythem Saeed
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Mark W Wilson
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
| | - Steven W Hetts
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry St, Suite 350, Room 320, San Francisco, CA 94107-5705 (P.V.L., J.K.Y., A.D.L., A.J.M., D.L.C., B.R.H.T., C.S., L.D., R.L.A., M.S., M.W.W., S.W.H.); and Penumbra, Alameda, Calif (D.C.B., A.C.)
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