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Akbar T, Gershkovich P, Stamatopoulos K, Gowland PA, Stolnik S, Butler J, Marciani L. Use of Magnetic Resonance Imaging for Visualization of Oral Dosage Forms in the Human Stomach: A Scoping Review. Mol Pharm 2024; 21:1553-1562. [PMID: 38440796 PMCID: PMC10988553 DOI: 10.1021/acs.molpharmaceut.3c01123] [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: 11/28/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 03/06/2024]
Abstract
Oral dosage forms are the most widely and frequently used formulations to deliver active pharmaceutical ingredients (APIs), due to their ease of administration and noninvasiveness. Knowledge of intragastric release rates and gastric mixing is crucial for predicting the API release profile, especially for immediate release formulations. However, knowledge of the intragastric fate of oral dosage forms in vivo to date is limited, particularly for dosage forms administered when the stomach is in the fed state. An improved understanding of gastric food processing, dosage form location, disintegration times, and food effects is essential for greater understanding for effective API formulation design. In vitro standard and controlled modeling has played a significant role in predicting the behavior of dosage forms in vivo. However, discrepancies are reported between in vitro and in vivo disintegration times, with these discrepancies being greatest in the fed state. Studying the fate of a dosage form in vivo is a challenging process, usually requiring the use of invasive methods, such as intubation. Noninvasive, whole body imaging techniques can however provide unique insights into this process. A scoping review was performed systematically to identify and critically appraise published studies using MRI to visualize oral solid dosage forms in vivo in healthy human subjects. The review identifies that so far, an all-purpose robust contrast agent or dosage form type has not been established for dosage form visualization and disintegration studies in the gastrointestinal system. Opportunities have been identified for future studies, with particular focus on characterizing dosage form disintegration for development after the consumption food, as exemplified by the standard Food and Drug Administration (FDA) high fat meal.
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Affiliation(s)
- Tejal Akbar
- Nottingham
Digestive Diseases Centre and National Institute for Health Research
(NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, U.K.
| | - Pavel Gershkovich
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, U.K.
| | | | - Penny A. Gowland
- Sir
Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2QX, U.K.
| | - Snow Stolnik
- School
of Pharmacy, University of Nottingham, Nottingham NG7 2RD, U.K.
| | - James Butler
- Drug
Product Development, GSK R&D, Ware, Hertfordshire SG12 0GX, U.K.
| | - Luca Marciani
- Nottingham
Digestive Diseases Centre and National Institute for Health Research
(NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, U.K.
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Chrisochoides N, Liu Y, Drakopoulos F, Kot A, Foteinos P, Tsolakis C, Billias E, Clatz O, Ayache N, Fedorov A, Golby A, Black P, Kikinis R. Comparison of physics-based deformable registration methods for image-guided neurosurgery. Front Digit Health 2023; 5:1283726. [PMID: 38144260 PMCID: PMC10740151 DOI: 10.3389/fdgth.2023.1283726] [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: 08/26/2023] [Accepted: 11/02/2023] [Indexed: 12/26/2023] Open
Abstract
This paper compares three finite element-based methods used in a physics-based non-rigid registration approach and reports on the progress made over the last 15 years. Large brain shifts caused by brain tumor removal affect registration accuracy by creating point and element outliers. A combination of approximation- and geometry-based point and element outlier rejection improves the rigid registration error by 2.5 mm and meets the real-time constraints (4 min). In addition, the paper raises several questions and presents two open problems for the robust estimation and improvement of registration error in the presence of outliers due to sparse, noisy, and incomplete data. It concludes with preliminary results on leveraging Quantum Computing, a promising new technology for computationally intensive problems like Feature Detection and Block Matching in addition to finite element solver; all three account for 75% of computing time in deformable registration.
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Affiliation(s)
- Nikos Chrisochoides
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Yixun Liu
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Fotis Drakopoulos
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Andriy Kot
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Panos Foteinos
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Christos Tsolakis
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Emmanuel Billias
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
| | - Olivier Clatz
- Inria, French Research Institute for Digital Science, Sophia Antipolis, Valbonne, France
| | - Nicholas Ayache
- Inria, French Research Institute for Digital Science, Sophia Antipolis, Valbonne, France
| | - Andrey Fedorov
- Center for Real-Time Computing, Computer Science Department, Old Dominion University, Norfolk, VA, United States
- Neuroimaging Analysis Center, Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Alex Golby
- Neuroimaging Analysis Center, Department of Radiology, Harvard Medical School, Boston, MA, United States
- Image-guided Neurosurgery, Department of Neurosurgery, Harvard Medical School, Boston, MA, United States
| | - Peter Black
- Image-guided Neurosurgery, Department of Neurosurgery, Harvard Medical School, Boston, MA, United States
| | - Ron Kikinis
- Neuroimaging Analysis Center, Department of Radiology, Harvard Medical School, Boston, MA, United States
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Brock KK, Chen SR, Sheth RA, Siewerdsen JH. Imaging in Interventional Radiology: 2043 and Beyond. Radiology 2023; 308:e230146. [PMID: 37462500 PMCID: PMC10374939 DOI: 10.1148/radiol.230146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Since its inception in the early 20th century, interventional radiology (IR) has evolved tremendously and is now a distinct clinical discipline with its own training pathway. The arsenal of modalities at work in IR includes x-ray radiography and fluoroscopy, CT, MRI, US, and molecular and multimodality imaging within hybrid interventional environments. This article briefly reviews the major developments in imaging technology in IR over the past century, summarizes technologies now representative of the standard of care, and reflects on emerging advances in imaging technology that could shape the field in the century ahead. The role of emergent imaging technologies in enabling high-precision interventions is also briefly reviewed, including image-guided ablative therapies.
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Affiliation(s)
- Kristy K Brock
- From the Departments of Imaging Physics (K.K.B., J.H.S.), Interventional Radiology (S.R.C., R.A.S.), Neurosurgery (J.H.S.), and Radiation Physics (J.H.S.), The University of Texas MD Anderson Cancer Center, 1400 Pressler St, FCT14.6050 Pickens Academic Tower, Houston, TX 77030-4000
| | - Stephen R Chen
- From the Departments of Imaging Physics (K.K.B., J.H.S.), Interventional Radiology (S.R.C., R.A.S.), Neurosurgery (J.H.S.), and Radiation Physics (J.H.S.), The University of Texas MD Anderson Cancer Center, 1400 Pressler St, FCT14.6050 Pickens Academic Tower, Houston, TX 77030-4000
| | - Rahul A Sheth
- From the Departments of Imaging Physics (K.K.B., J.H.S.), Interventional Radiology (S.R.C., R.A.S.), Neurosurgery (J.H.S.), and Radiation Physics (J.H.S.), The University of Texas MD Anderson Cancer Center, 1400 Pressler St, FCT14.6050 Pickens Academic Tower, Houston, TX 77030-4000
| | - Jeffrey H Siewerdsen
- From the Departments of Imaging Physics (K.K.B., J.H.S.), Interventional Radiology (S.R.C., R.A.S.), Neurosurgery (J.H.S.), and Radiation Physics (J.H.S.), The University of Texas MD Anderson Cancer Center, 1400 Pressler St, FCT14.6050 Pickens Academic Tower, Houston, TX 77030-4000
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Fiorito M, Yushchenko M, Cicolari D, Sarracanie M, Salameh N. Fast, interleaved, Look-Locker-based T 1 mapping with a variable averaging approach: Towards temperature mapping at low magnetic field. NMR IN BIOMEDICINE 2023; 36:e4826. [PMID: 36057925 PMCID: PMC10078420 DOI: 10.1002/nbm.4826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 08/18/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Proton resonance frequency shift (PRFS) is currently the gold standard method for magnetic resonance thermometry. However, the linearity between the temperature-dependent phase accumulation and the static magnetic field B0 confines its use to rather high-field scanners. Applications such as thermal therapies could naturally benefit from lower field MRI settings through leveraging increased accessibility, a lower physical and economical footprint, and further consideration of the technical challenges associated with the integration of heating systems into conventional clinical scanners. T 1 -based thermometry has been proposed as an alternative to the gold standard; however, because of longer acquisition times, it has found clinical use solely with adipose tissue where PRFS fails. At low field, the enhanced T 1 dispersion, combined with reduced relaxation times, make T 1 mapping an appealing candidate. Here, an interleaved Look-Locker-based T 1 mapping sequence was proposed for temperature quantification at 0.1 T. A variable averaging scheme was introduced, to maximize the signal-to-noise ratio throughout T 1 recovery. In calibrated samples, an average T 1 accuracy of 85% ± 4% was achieved in 10 min, compared with the 77% ± 7% obtained using a standard averaging scheme. Temperature maps between 29.0 and 41.7°C were eventually reconstructed, with a precision of 3.0 ± 1.1°C and an accuracy of 1.5 ± 1.0°C. Accounting for longer thermal treatments and less strict temperature constraints, applications such as MR-guided mild hyperthermia treatments at low field could be envisioned.
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Affiliation(s)
- Marco Fiorito
- Department of Biomedical EngineeringCenter for Adaptable MRI Technology, University of BaselAllschwilSwitzerland
| | - Maksym Yushchenko
- Department of Biomedical EngineeringCenter for Adaptable MRI Technology, University of BaselAllschwilSwitzerland
| | | | - Mathieu Sarracanie
- Department of Biomedical EngineeringCenter for Adaptable MRI Technology, University of BaselAllschwilSwitzerland
| | - Najat Salameh
- Department of Biomedical EngineeringCenter for Adaptable MRI Technology, University of BaselAllschwilSwitzerland
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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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Hofstetter LW, Hadley JR, Merrill R, Pham H, Fine GC, Parker DL. MRI-compatible electromagnetic servomotor for image-guided medical robotics. COMMUNICATIONS ENGINEERING 2022; 1:4. [PMID: 36700241 PMCID: PMC9873480 DOI: 10.1038/s44172-022-00001-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/22/2022] [Indexed: 02/01/2023]
Abstract
The soft-tissue imaging capabilities of magnetic resonance imaging (MRI) combined with high precision robotics has the potential to improve the precision and safety of a wide range of image-guided medical procedures. However, functional MRI-compatible robotics have not yet been realized in part because conventional electromagnetic servomotors can become dangerous projectiles near the strong magnetic field of an MRI scanner. Here we report an electromagnetic servomotor constructed from non-magnetic components, where high-torque and controlled rotary actuation is produced via interaction between electrical current in the servomotor armature and the magnetic field generated by the superconducting magnet of the MRI scanner itself. Using this servomotor design, we then build and test an MRI-compatible robot which can achieve the linear forces required to insert a large-diameter biopsy instrument in tissue during simultaneous MRI. Our electromagnetic servomotor can be safely operated (while imaging) in the patient area of a 3 Tesla clinical MRI scanner.
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Affiliation(s)
- Lorne W. Hofstetter
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132 USA
| | - J. Rock Hadley
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132 USA
| | - Robb Merrill
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132 USA
| | - Huy Pham
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132 USA
| | - Gabriel C. Fine
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132 USA
| | - Dennis L. Parker
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132 USA
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7
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Bastos DCDA, Juvekar P, Tie Y, Jowkar N, Pieper S, Wells WM, Bi WL, Golby A, Frisken S, Kapur T. Challenges and Opportunities of Intraoperative 3D Ultrasound With Neuronavigation in Relation to Intraoperative MRI. Front Oncol 2021; 11:656519. [PMID: 34026631 PMCID: PMC8139191 DOI: 10.3389/fonc.2021.656519] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction Neuronavigation greatly improves the surgeons ability to approach, assess and operate on brain tumors, but tends to lose its accuracy as the surgery progresses and substantial brain shift and deformation occurs. Intraoperative MRI (iMRI) can partially address this problem but is resource intensive and workflow disruptive. Intraoperative ultrasound (iUS) provides real-time information that can be used to update neuronavigation and provide real-time information regarding the resection progress. We describe the intraoperative use of 3D iUS in relation to iMRI, and discuss the challenges and opportunities in its use in neurosurgical practice. Methods We performed a retrospective evaluation of patients who underwent image-guided brain tumor resection in which both 3D iUS and iMRI were used. The study was conducted between June 2020 and December 2020 when an extension of a commercially available navigation software was introduced in our practice enabling 3D iUS volumes to be reconstructed from tracked 2D iUS images. For each patient, three or more 3D iUS images were acquired during the procedure, and one iMRI was acquired towards the end. The iUS images included an extradural ultrasound sweep acquired before dural incision (iUS-1), a post-dural opening iUS (iUS-2), and a third iUS acquired immediately before the iMRI acquisition (iUS-3). iUS-1 and preoperative MRI were compared to evaluate the ability of iUS to visualize tumor boundaries and critical anatomic landmarks; iUS-3 and iMRI were compared to evaluate the ability of iUS for predicting residual tumor. Results Twenty-three patients were included in this study. Fifteen patients had tumors located in eloquent or near eloquent brain regions, the majority of patients had low grade gliomas (11), gross total resection was achieved in 12 patients, postoperative temporary deficits were observed in five patients. In twenty-two iUS was able to define tumor location, tumor margins, and was able to indicate relevant landmarks for orientation and guidance. In sixteen cases, white matter fiber tracts computed from preoperative dMRI were overlaid on the iUS images. In nineteen patients, the EOR (GTR or STR) was predicted by iUS and confirmed by iMRI. The remaining four patients where iUS was not able to evaluate the presence or absence of residual tumor were recurrent cases with a previous surgical cavity that hindered good contact between the US probe and the brainsurface. Conclusion This recent experience at our institution illustrates the practical benefits, challenges, and opportunities of 3D iUS in relation to iMRI.
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Affiliation(s)
| | - Parikshit Juvekar
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Yanmei Tie
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Nick Jowkar
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Steve Pieper
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Willam M Wells
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexandra Golby
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah Frisken
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
| | - Tina Kapur
- Department of Neurosurgery, Brigham and Womens Hospital, Harvard Medical School, Boston, MA, United States
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Brunnquell CL, Hoff MN, Balu N, Nguyen XV, Oztek MA, Haynor DR. Making Magnets More Attractive: Physics and Engineering Contributions to Patient Comfort in MRI. Top Magn Reson Imaging 2020; 29:167-174. [PMID: 32541257 DOI: 10.1097/rmr.0000000000000246] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Patient comfort is an important factor of a successful magnetic resonance (MR) examination, and improvements in the patient's MR scanning experience can contribute to improved image quality, diagnostic accuracy, and efficiency in the radiology department, and therefore reduced cost. Magnet designs that are more open and accessible, reduced auditory noise of MR examinations, light and flexible radiofrequency (RF) coils, and faster motion-insensitive imaging techniques can all significantly improve the patient experience in MR imaging. In this work, we review the design, development, and implementation of these physics and engineering approaches to improve patient comfort.
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Affiliation(s)
- Christina L Brunnquell
- Department of Radiology, University of Washington, Seattle, WA Department of Radiology, The Ohio State University Wexler Medical Center, Columbus, OH
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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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Yamada A, Tokuda J, Naka S, Murakami K, Tani T, Morikawa S. Magnetic resonance and ultrasound image-guided navigation system using a needle manipulator. Med Phys 2019; 47:850-858. [PMID: 31829440 DOI: 10.1002/mp.13958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Image guidance is crucial for percutaneous tumor ablations, enabling accurate needle-like applicator placement into target tumors while avoiding tissues that are sensitive to injury and/or correcting needle deflection. Although ultrasound (US) is widely used for image guidance, magnetic resonance (MR) is preferable due to its superior soft tissue contrast. The objective of this study was to develop and evaluate an MR and US multi-modal image-guided navigation system with a needle manipulator to enable US-guided applicator placement during MR imaging (MRI)-guided percutaneous tumor ablation. METHODS The MRI-compatible needle manipulator with US probe was installed adjacent to a 3 Tesla MRI scanner patient table. Coordinate systems for the MR image, patient table, manipulator, and US probe were all registered using an optical tracking sensor. The patient was initially scanned in the MRI scanner bore for planning and then moved outside the bore for treatment. Needle insertion was guided by real-time US imaging fused with the reformatted static MR image to enhance soft tissue contrast. Feasibility, targeting accuracy, and MR compatibility of the system were evaluated using a bovine liver and agar phantoms. RESULTS Targeting error for 50 needle insertions was 1.6 ± 0.6 mm (mean ± standard deviation). The experiment confirmed that fused MR and US images provided real-time needle localization against static MR images with soft tissue contrast. CONCLUSIONS The proposed MR and US multi-modal image-guided navigation system using a needle manipulator enabled accurate needle insertion by taking advantage of static MR and real-time US images simultaneously. Real-time visualization helped determine needle depth, tissue monitoring surrounding the needle path, target organ shifts, and needle deviation from the path.
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Affiliation(s)
- Atsushi Yamada
- Department of Research and Development for Innovative Medical Devices and Systems, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Junichi Tokuda
- National Center for Image Guided Therapy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Shigeyuki Naka
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Koichiro Murakami
- Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Tohru Tani
- Department of Research and Development for Innovative Medical Devices and Systems, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
| | - Shigehiro Morikawa
- Molecular Neuroscience Research Center, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan
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Fried MP, Kleefield J, Jolesz FA, Hsu L, Gopal HV, Deshmukh V, Taylor RJ, Morrison PR. Intraoperative Image Guidance during Endoscopic Sinus Surgery. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065896781794860] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Endoscopic sinus surgery (ESS) is one of the most commonly performed procedures in otorhinolaryngology and is associated with a definite risk for both intraoperative and postoperative complications. Intraoperative image guidance is expected to have a major effect on procedures such as ESS by allowing the clinician to more efficiently remove pathology and by improving surgeon confidence and knowledge of anatomy, particularly in revision procedures or in patients with altered anatomy. As a consequence, complications during these pro-’ cedures will decrease and patient safety will increase. Several guidance modalities are available including computed tomography (CT), magnetic resonance imaging (MRI), and fluoroscopy. This article will describe current applications of each of these three techniques with respect to ESS while focusing on innovative techniques that use MRI and CT to provide intraoperative guidance with unmatched convenience, reliability, and utility.
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Affiliation(s)
- Marvin P. Fried
- Department of Otology & Laryngology, Harvard Medical School, Joint Center for Otolaryngology, Beth Israel Health Care, and Brigham & Women's Hospital, Boston, Massachusetts
| | - Jonathan Kleefield
- Department of Radiology, Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ferenc A. Jolesz
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, and Consultant Visualization Technology, Boston, Massachusetts
| | - Liangge Hsu
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, and Consultant Visualization Technology, Boston, Massachusetts
| | - Harsha V. Gopal
- Department of Otology & Laryngology, Harvard Medical School, Joint Center for Otolaryngology, Beth Israel Health Care, and Brigham & Women's Hospital, Boston, Massachusetts
| | - Vivek Deshmukh
- University of Florida College of Medicine, Gainesville, Florida
| | | | - Paul R. Morrison
- Department of Otology & Laryngology, Harvard Medical School, Joint Center for Otolaryngology, Beth Israel Health Care, and Brigham & Women's Hospital, Boston, Massachusetts
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, and Consultant Visualization Technology, Boston, Massachusetts
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Chen Y, Ge M, Ali R, Jiang H, Huang X, Qiu B. Quantitative MR thermometry based on phase-drift correction PRF shift method at 0.35 T. Biomed Eng Online 2018; 17:39. [PMID: 29631576 PMCID: PMC5892038 DOI: 10.1186/s12938-018-0472-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/30/2018] [Indexed: 11/30/2022] Open
Abstract
Background Noninvasive magnetic resonance thermometry (MRT) at low-field using proton resonance frequency shift (PRFS) is a promising technique for monitoring ablation temperature, since low-field MR scanners with open-configuration are more suitable for interventional procedures than closed systems. In this study, phase-drift correction PRFS with first-order polynomial fitting method was proposed to investigate the feasibility and accuracy of quantitative MR thermography during hyperthermia procedures in a 0.35 T open MR scanner. Methods Unheated phantom and ex vivo porcine liver experiments were performed to evaluate the optimal polynomial order for phase-drift correction PRFS. The temperature estimation approach was tested in brain temperature experiments of three healthy volunteers at room temperature, and in ex vivo porcine liver microwave ablation experiments. The output power of the microwave generator was set at 40 W for 330 s. In the unheated experiments, the temperature root mean square error (RMSE) in the inner region of interest was calculated to assess the best-fitting order for polynomial fit. For ablation experiments, relative temperature difference profile measured by the phase-drift correction PRFS was compared with the temperature changes recorded by fiber optic temperature probe around the microwave ablation antenna within the target thermal region. Results The phase-drift correction PRFS using first-order polynomial fitting could achieve the smallest temperature RMSE in unheated phantom, ex vivo porcine liver and in vivo human brain experiments. In the ex vivo porcine liver microwave ablation procedure, the temperature error between MRT and fiber optic probe of all but six temperature points were less than 2 °C. Overall, the RMSE of all temperature points was 1.49 °C. Conclusions Both in vivo and ex vivo experiments showed that MR thermometry based on the phase-drift correction PRFS with first-order polynomial fitting could be applied to monitor temperature changes during microwave ablation in a low-field open-configuration whole-body MR scanner.
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Affiliation(s)
- Yuping Chen
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Mengke Ge
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Rizwan Ali
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Hejun Jiang
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Xiaoyan Huang
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Bensheng Qiu
- Centers for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, China.
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Foo TKF, Laskaris E, Vermilyea M, Xu M, Thompson P, Conte G, Van Epps C, Immer C, Lee SK, Tan ET, Graziani D, Mathieu JB, Hardy CJ, Schenck JF, Fiveland E, Stautner W, Ricci J, Piel J, Park K, Hua Y, Bai Y, Kagan A, Stanley D, Weavers PT, Gray E, Shu Y, Frick MA, Campeau NG, Trzasko J, Huston J, Bernstein MA. Lightweight, compact, and high-performance 3T MR system for imaging the brain and extremities. Magn Reson Med 2018. [PMID: 29536587 DOI: 10.1002/mrm.27175] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE To build and evaluate a small-footprint, lightweight, high-performance 3T MRI scanner for advanced brain imaging with image quality that is equal to or better than conventional whole-body clinical 3T MRI scanners, while achieving substantial reductions in installation costs. METHODS A conduction-cooled magnet was developed that uses less than 12 liters of liquid helium in a gas-charged sealed system, and standard NbTi wire, and weighs approximately 2000 kg. A 42-cm inner-diameter gradient coil with asymmetric transverse axes was developed to provide patient access for head and extremity exams, while minimizing magnet-gradient interactions that adversely affect image quality. The gradient coil was designed to achieve simultaneous operation of 80-mT/m peak gradient amplitude at a slew rate of 700 T/m/s on each gradient axis using readily available 1-MVA gradient drivers. RESULTS In a comparison of anatomical imaging in 16 patients using T2 -weighted 3D fluid-attenuated inversion recovery (FLAIR) between the compact 3T and whole-body 3T, image quality was assessed as equivalent to or better across several metrics. The ability to fully use a high slew rate of 700 T/m/s simultaneously with 80-mT/m maximum gradient amplitude resulted in improvements in image quality across EPI, DWI, and anatomical imaging of the brain. CONCLUSIONS The compact 3T MRI system has been in continuous operation at the Mayo Clinic since March 2016. To date, over 200 patient studies have been completed, including 96 comparison studies with a clinical 3T whole-body MRI. The increased gradient performance has reliably resulted in consistently improved image quality.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Seung-Kyun Lee
- GE Global Research, Niskayuna, New York.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Ek T Tan
- GE Global Research, Niskayuna, New York
| | | | | | | | | | | | | | | | | | | | - Yihe Hua
- GE Global Research, Niskayuna, New York
| | - Ye Bai
- GE Global Research, Niskayuna, New York
| | | | | | - Paul T Weavers
- Department of Radiology, Mayo Clinic, Rochester, Minnesota.,GE Healthcare, Waukesha, Wisconsin
| | - Erin Gray
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Yunhong Shu
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Joshua Trzasko
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - John Huston
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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14
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Busse H, Kahn T, Moche M. Techniques for Interventional MRI Guidance in Closed-Bore Systems. Top Magn Reson Imaging 2018; 27:9-18. [PMID: 29406410 DOI: 10.1097/rmr.0000000000000150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Efficient image guidance is the basis for minimally invasive interventions. In comparison with X-ray, computed tomography (CT), or ultrasound imaging, magnetic resonance imaging (MRI) provides the best soft tissue contrast without ionizing radiation and is therefore predestined for procedural control. But MRI is also characterized by spatial constraints, electromagnetic interactions, long imaging times, and resulting workflow issues. Although many technical requirements have been met over the years-most notably magnetic resonance (MR) compatibility of tools, interventional pulse sequences, and powerful processing hardware and software-there is still a large variety of stand-alone devices and systems for specific procedures only.Stereotactic guidance with the table outside the magnet is common and relies on proper registration of the guiding grids or manipulators to the MR images. Instrument tracking, often by optical sensing, can be added to provide the physicians with proper eye-hand coordination during their navigated approach. Only in very short wide-bore systems, needles can be advanced at the extended arm under near real-time imaging. In standard magnets, control and workflow may be improved by remote operation using robotic or manual driving elements.This work highlights a number of devices and techniques for different interventional settings with a focus on percutaneous, interstitial procedures in different organ regions. The goal is to identify technical and procedural elements that might be relevant for interventional guidance in a broader context, independent of the clinical application given here. Key challenges remain the seamless integration into the interventional workflow, safe clinical translation, and proper cost effectiveness.
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Affiliation(s)
- Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany
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15
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Abstract
The use of magnetic resonance imaging (MRI) for image-guided intervention poses both great opportunity and challenges. Although MRI is distinguished by its excellent contrast resolution and lack of ionizing radiation, it was not till the 1990s that technologic innovations allowed for adoption of MRI as a guidance modality for intervention. With advances in magnet, protocol, coil, biopsy needle, and ablation probe design, MRI has emerged as a viable, and increasingly, preferable alternative to other image guidance modalities. With the development of targeting software, augmented reality, robotic assist devices, and MR thermometry, the future of MRI-guided interventions remains promising.
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Affiliation(s)
- Farzad Sedaghat
- Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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16
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Lucas AJ, Hawkes RC, Ansorge RE, Williams GB, Nutt RE, Clark JC, Fryer TD, Carpenter TA. Development of a Combined microPET®-MR System. Technol Cancer Res Treat 2016; 5:337-41. [PMID: 16866564 DOI: 10.1177/153303460600500405] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
As evidenced by the success of PET-CT, there are many benefits from combining imaging modalities into a single scanner. The combination of PET and MR offers potential advantages over PET-CT, including improved soft tissue contrast, access to the multiplicity of contrast mechanisms available to MR, simultaneous imaging and fast MR sequences for motion correction. In addition, PET-MR is more suitable than PET-CT for cancer screening due to the elimination of the radiation dose from CT. A key issue associated with combining PET and MR is the fact that the performance of the photomultiplier tubes (PMTs) used in conventional PET detectors is degraded in the magnetic field required for MR. Two approaches have been adopted to circumvent that issue: retention of conventional, magnetic field-sensitive PMT-based PET detectors by modification of other features of the MR or PET system, or the use of new, magnetic field-insensitive devices in the PET detectors including avalanche photo-diodes (APDs) and silicon photomultipliers (SiPMs). Taking the former approach, we are assembling a modified microPET® Focus 120 within a gap in a novel, 1T superconducting magnet. The PMTs are located in a low magnetic field (~30mT) through a combination of magnet design and the use of fiber optic ‘bundles’. Two main features of the modified PET system have been tested, namely the effect of using long fiber optic bundles in the PET detector, and the impact of magnetic field upon the performance of the position sensitive PMTs. The design of a modified microPET®-MR system for small animal imaging is completed, and assembly and testing is underway.
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Affiliation(s)
- A J Lucas
- Wolfson Brain Imaging Centre, University of Cambridge, Box 65, Addenbrookes Hospital, Cambridge CB2 2QQ, UK
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Fu T, Chen Y, Hao J, Wang X, Liu G, Li Y, Liu Z, Cheng L. Facile preparation of uniform FeSe2 nanoparticles for PA/MR dual-modal imaging and photothermal cancer therapy. NANOSCALE 2015; 7:20757-20768. [PMID: 26603315 DOI: 10.1039/c5nr06840a] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recently, magnetic photothermal nanomaterials have emerged as a new class of bio-nanomaterials for application in cancer diagnosis and therapy. Hence, we developed a new kind of magnetic nanomaterials, iron diselenide (FeSe(2)) nanoparticles, for multimodal imaging-guided photothermal therapy (PTT) to improve the efficacy of cancer treatment. By controlling the reaction time and temperature, FeSe(2) nanoparticles were synthesized by a simple solution-phase method. After modification with polyethylene glycol (PEG), the obtained FeSe(2)-PEG nanoparticles showed high stability under various physiological conditions. FeSe(2)-PEG could serve as a T2-weighted magnetic resonance (MR) imaging contrast agent because of its strong superparamagnetic properties, with its r(2) relaxivity determined to be 133.38 mM(-1) S(-1), a value higher than that of the clinically used Feridex. On the other hand, with high absorbance in the near-infrared (NIR) region, FeSe(2)-PEG also appeared to be a useful contrast agent for photoacoustic imaging (PA) as well as an effective photothermal agent for PTT cancer treatment, as demonstrated in our animal tumor model experiments. Moreover, long-term toxicity tests have proven that FeSe(2)-PEG nanoparticles after systematic administration rendered no appreciable toxicity to the treated animals, and could be gradually excreted from the major organs of mice. Our work indicates that FeSe(2)-PEG nanoparticles would be a new class of theranostic agents promising for application in bioimaging and cancer therapy.
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Affiliation(s)
- Tingting Fu
- Department of Radiology, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, 215006, China.
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18
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Etezadi-Amoli M, Stang P, Kerr A, Pauly J, Scott G. Controlling radiofrequency-induced currents in guidewires using parallel transmit. Magn Reson Med 2015; 74:1790-802. [PMID: 25521751 PMCID: PMC4470871 DOI: 10.1002/mrm.25543] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 10/31/2014] [Accepted: 11/02/2014] [Indexed: 11/09/2022]
Abstract
PURPOSE Elongated conductors, such as pacemaker leads, neurostimulator leads, and conductive guidewires used for interventional procedures can couple to the MRI radiofrequency (RF) transmit field, potentially causing dangerous tissue heating. The purpose of this study was to demonstrate the feasibility of using parallel transmit to control induced RF currents in elongated conductors, thereby reducing the RF heating hazard. METHODS Phantom experiments were performed on a four-channel parallel transmit system at 1.5T. Parallel transmit "null mode" excitations that induce minimal wire current were designed using coupling measurements derived from axial B1 (+) maps. The resulting current reduction performance was evaluated with B1 (+) maps, current sensor measurements, and fluoroptic temperature probe measurements. RESULTS Null mode excitations reduced the maximum coupling mode current by factors ranging from 2 to 80. For the straight wire experiment, a current null imposed at a single wire location was sufficient to reduce tip heating below detectable levels. For longer insertion lengths and a curved geometry, imposing current nulls at two wire locations resulted in more distributed current reduction along the wire length. CONCLUSION Parallel transmit can be used to create excitations that induce minimal RF current in elongated conductors, thereby decreasing the RF heating risk, while still allowing visualization of the surrounding volume.
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Affiliation(s)
- Maryam Etezadi-Amoli
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Pascal Stang
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Adam Kerr
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - John Pauly
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Greig Scott
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California, USA
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19
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Preiswerk F, Toews M, Hoge WS, Chiou JYG, Panych LP, Wells WM, Madore B. Hybrid Utrasound and MRI Acquisitions for High-Speed Imaging of Respiratory Organ Motion. ACTA ACUST UNITED AC 2015; 9349:315-322. [PMID: 27135063 DOI: 10.1007/978-3-319-24553-9_39] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Magnetic Resonance (MR) imaging provides excellent image quality at a high cost and low frame rate. Ultrasound (US) provides poor image quality at a low cost and high frame rate. We propose an instance-based learning system to obtain the best of both worlds: high quality MR images at high frame rates from a low cost single-element US sensor. Concurrent US and MRI pairs are acquired during a relatively brief offine learning phase involving the US transducer and MR scanner. High frame rate, high quality MR imaging of respiratory organ motion is then predicted from US measurements, even after stopping MRI acquisition, using a probabilistic kernel regression framework. Experimental results show predicted MR images to be highly representative of actual MR images.
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Affiliation(s)
| | - Matthew Toews
- Brigham and Women's Hospital, Harvard Medical School
| | - W Scott Hoge
- Brigham and Women's Hospital, Harvard Medical School
| | | | | | | | - Bruno Madore
- Brigham and Women's Hospital, Harvard Medical School
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20
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Vandenberghe S, Marsden PK. PET-MRI: a review of challenges and solutions in the development of integrated multimodality imaging. Phys Med Biol 2015; 60:R115-54. [PMID: 25650582 DOI: 10.1088/0031-9155/60/4/r115] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The integration of positron emission tomography (PET) and magnetic resonance imaging (MRI) has been an ongoing research topic for the last 20 years. This paper gives an overview of the different developments and the technical problems associated with combining PET and MRI in one system. After explaining the different detector concepts for integrating PET-MRI and minimising interference the limitations and advantages of different solutions for the detector and system are described for preclinical and clinical imaging systems. The different integrated PET-MRI systems are described in detail. Besides detector concepts and system integration the challenges and proposed solutions for attenuation correction and the potential for motion correction and resolution recovery are also discussed in this topical review.
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Affiliation(s)
- Stefaan Vandenberghe
- Department of Electronics and Information Systems, MEDISIP, Ghent University-iMinds Medical IT-IBiTech, De Pintelaan 185 block B, B-9000 Ghent, Belgium
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21
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Impact of intraoperative magnetic resonance imaging and functional neuronavigation on surgical outcome in patients with gliomas involving language areas. Neurosurg Rev 2014; 38:319-30; discussion 330. [DOI: 10.1007/s10143-014-0585-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/21/2014] [Accepted: 06/22/2014] [Indexed: 11/26/2022]
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22
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Haydon DH, Chicoine MR, Dacey RG. The Impact of High-Field-Strength Intraoperative Magnetic Resonance Imaging on Brain Tumor Management. Neurosurgery 2013; 60 Suppl 1:92-7. [DOI: 10.1227/01.neu.0000430321.39870.be] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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23
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Orringer DA, Golby A, Jolesz F. Neuronavigation in the surgical management of brain tumors: current and future trends. Expert Rev Med Devices 2013; 9:491-500. [PMID: 23116076 DOI: 10.1586/erd.12.42] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Neuronavigation has become an ubiquitous tool in the surgical management of brain tumors. This review describes the use and limitations of current neuronavigational systems for brain tumor biopsy and resection. Methods for integrating intraoperative imaging into neuronavigational datasets developed to address the diminishing accuracy of positional information that occurs over the course of brain tumor resection are discussed. In addition, the process of integration of functional MRI and tractography into navigational models is reviewed. Finally, emerging concepts and future challenges relating to the development and implementation of experimental imaging technologies in the navigational environment are explored.
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Affiliation(s)
- Daniel A Orringer
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
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24
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Linte CA, Davenport KP, Cleary K, Peters C, Vosburgh KG, Navab N, Edwards PE, Jannin P, Peters TM, Holmes DR, Robb RA. On mixed reality environments for minimally invasive therapy guidance: systems architecture, successes and challenges in their implementation from laboratory to clinic. Comput Med Imaging Graph 2013; 37:83-97. [PMID: 23632059 PMCID: PMC3796657 DOI: 10.1016/j.compmedimag.2012.12.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 11/16/2012] [Accepted: 12/24/2012] [Indexed: 11/21/2022]
Abstract
Mixed reality environments for medical applications have been explored and developed over the past three decades in an effort to enhance the clinician's view of anatomy and facilitate the performance of minimally invasive procedures. These environments must faithfully represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical instrument tracking, and display technology into a common framework centered around and registered to the patient. However, in spite of their reported benefits, few mixed reality environments have been successfully translated into clinical use. Several challenges that contribute to the difficulty in integrating such environments into clinical practice are presented here and discussed in terms of both technical and clinical limitations. This article should raise awareness among both developers and end-users toward facilitating a greater application of such environments in the surgical practice of the future.
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25
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Liang D, Schulder M. The role of intraoperative magnetic resonance imaging in glioma surgery. Surg Neurol Int 2012; 3:S320-7. [PMID: 23230537 PMCID: PMC3514913 DOI: 10.4103/2152-7806.103029] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 09/04/2012] [Indexed: 11/04/2022] Open
Abstract
For patients with gliomas, the goal of surgery is to maximize the extent of tumor resection while avoiding injury to functional tissue. The hope is to improve patients' survival and maintain the highest quality of life as possible. However, because of the infiltrative nature of gliomas these two goals often oppose each other so a compromise must be met. Many tools have been developed to help with this challenge of glioma surgery. Over the past two decades, intraoperative-magnetic resonance imaging (iMRI) has emerged as an increasingly important modality to enhance surgical safety while providing the surgeon with updated information to guide their resection. Here the authors review the studies that demonstrate a positive correlation between extent of resection (EOR) and overall survival (OS), although the data is clearer in patients with low-grade gliomas (LGG) and still somewhat controversial in those with higher-grade tumors. We will then review some of the studies that support the role of iMRI and how it has impacted glioma surgery by increasing the EOR. The value of iMRI usage in regards to overall patient outcome can be extrapolated through its effect on EOR. Overall, available data support the safe use of iMRI and as an effective adjunct in glioma surgery.
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Affiliation(s)
- Danny Liang
- Department of Neurological Surgery, Hofstra North Shore-LIJ School of Medicine, Manhasset, New York, USA
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26
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Magnetic resonance imaging-guided biopsy of musculoskeletal lesions using open low-field systems. Top Magn Reson Imaging 2011; 22:135-41. [PMID: 23514921 DOI: 10.1097/rmr.0b013e3182805f7b] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
With the development of open-configuration magnetic resonance imaging (MRI) systems, magnetic resonance-compatible navigational tools, and fast pulse sequences, MRI-guided biopsy of musculoskeletal lesions has evolved into an effective and safe, minimally invasive technique. Magnetic resonance-guided percutaneous biopsy of musculoskeletal lesions is especially suited for lesions that are detectable only with MRI, lesions that require double-angulated needle paths, and for patients in which radiation exposure needs to be avoided. In this article, we review pertinent principles, techniques, and clinical applications of low-field MRI for biopsy procedures in the musculoskeletal system.
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Abstract
This article highlights some of current state-of-the-art applications of interventional magnetic resonance imaging (MRI) technology pertaining to the musculoskeletal soft tissues. The rationale for the use of these techniques is to provide modes of minimally invasive diagnosis and/or therapy for a subset of patients whose lesions are not approachable by the traditional modes of interventional radiology and to introduce methods to mark subtle and infiltrative lesions to improve the outcomes of subsequent surgery or radiation therapy. These techniques build on the inherent attributes of MRI, particularly the high soft tissue contrast that made MRI the current mainstay diagnostic modality to identify and characterize musculoskeletal soft tissue lesions. The application of MRI technology to the musculoskeletal system, particularly for lesions related to the appendicular skeleton, does not typically suffer from the complexity related to involuntary organ motion. In addition, MRI-compatible versions of most of the needed instruments and devices for these interventions are currently available on commercial basis. Although musculoskeletal applications were not adopted early during the development of interventional MRI technology, we are likely to observe an increasing use of this technology for musculoskeletal soft tissue applications in the future.
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Affiliation(s)
- Sherif G Nour
- Department of Radiology and Imaging Sciences, Divisions of Abdominal Imaging, Interventional Radiology and Image-Guided Medicine, Emory University Hospitals and School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322, USA.
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Dual-room 1.5-T intraoperative magnetic resonance imaging suite with a movable magnet: implementation and preliminary experience. Neurosurg Rev 2011; 35:95-109; discussion 109-10. [PMID: 21674146 DOI: 10.1007/s10143-011-0336-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 03/31/2011] [Accepted: 04/03/2011] [Indexed: 10/18/2022]
Abstract
We hereby report our initial clinical experience of a dual-room intraoperative magnetic resonance imaging (iMRI) suite with a movable 1.5-T magnet for both neurosurgical and independent diagnostic uses. The findings from the first 45 patients who underwent scheduled neurosurgical procedures with iMRI in this suite (mean age, 41.3 ± 12.0 years; intracranial tumors, 39 patients; cerebral vascular lesions, 5 patients; epilepsy surgery, 1 patient) were reported. The extent of resection depicted at intraoperative imaging, the surgical consequences of iMRI, and the clinical practicability of the suite were analyzed. Fourteen resections with a trans-sphenoidal/transoral approach and 31 craniotomies were performed. Eighty-two iMRI examinations were performed in the operating room, while during the same period of time, 430 diagnostic scans were finished in the diagnostic room. In 22 (48.9%) of 45 patients, iMRI revealed accessible residual tumors leading to further resection. No iMRI-related adverse event occurred. Complete lesion removal was achieved in 36 (80%) of all 45 cases. It is concluded that the dual-room 1.5-T iMRI suite can be successfully integrated into standard neurosurgical workflow. The layout of the dual-room suite can enable the maximum use of the system and save costs by sharing use of the 1.5-T magnet between neurosurgical and diagnostic use. Intraoperative MR imaging may provide valuable information that allows intraoperative modification of the surgical strategy.
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Schmidt T, König R, Hlavac M, Antoniadis G, Wirtz CR. Lows and highs: 15 years of development in intraoperative magnetic resonance imaging. ACTA NEUROCHIRURGICA. SUPPLEMENT 2011; 109:17-20. [PMID: 20960315 DOI: 10.1007/978-3-211-99651-5_3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Intraoperative magnetic resonance imaging (ioMRI) during neurosurgical procedures was first implemented in 1995. In the following decade ioMRI and image guided surgery has evolved from an experimental stage into a safe and routinely clinically applied technique. The development of ioMRI has led to a variety of differently designed systems which can be basically classified in one- or two-room concepts and low- and high-field installations. Nowadays ioMRI allows neurosurgeons not only to increase the extent of tumor resection and to preserve eloquent areas or white matter tracts but it also provides physiological and biological data of the brain and tumor tissue. This article tries to give a comprehensive review of the milestones in the development of ioMRI and neuronavigation over the last 15 years and describes the personal experience in intraoperative low and high-field MRI.
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Affiliation(s)
- T Schmidt
- Department of Neurosurgery, District Hospital Günzburg, University of Ulm, Ludwig Heilmeyer Straße 2, 89312 Günzburg, Germany.
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Moriarty TM, Titsworth WL. The evolution of iMRI utilization for pediatric neurosurgery: a single center experience. ACTA NEUROCHIRURGICA. SUPPLEMENT 2011; 109:89-94. [PMID: 20960326 DOI: 10.1007/978-3-211-99651-5_14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
From its inception intraoperative magnetic resonance imaging (ioMRI) was envisioned to have significant applications in neurosurgery in general and pediatrics specifically. Over the last 9 years we have noted a dramatic shift in our ioMRI usage from intracranial tumors to cerebrospinal fluid management and complex cysts. Here we present seven selected cases to illustrate lessons learned from our operative experience within the GE Signa SP/I open-configuration "double-doughnut" MRI. These cases including a ganglioglioma, ependymoma, and pilocytic astrocytoma tumor resection, as well as arachnoid cysts, complex cyst, and microabscess drainage reflect our current use of ioMRI in pediatric neurosurgical cases. Namely that ioMRI is optimal for (1) resection of small tumors with poorly differentiated tumor margins, (2) large tumors with mass effect, and (3) shunt or catheter placement requiring either extreme accuracy or intraoperative confirmation of catheter placement. We also comment on the legitimate limitations of this technology in certain operations. Additionally emphasized are cases in which ioMRI imaging drives operative decision making, highlighting the unique and unequaled abilities of this technology for a subset of pediatric neurosurgical cases.
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Affiliation(s)
- Thomas M Moriarty
- Kosair Children's Hospital, Norton Neuroscience Institute, 210 E Gray St.Suite 1105, Louisville, KY 40202, USA.
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Intraoperative imaging in neurosurgery: where will the future take us? ACTA NEUROCHIRURGICA. SUPPLEMENT 2011; 109:21-5. [PMID: 20960316 DOI: 10.1007/978-3-211-99651-5_4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Intraoperative MRI (ioMRI) dates back to the 1990s and since then has been successfully applied in neurosurgery for three primary reasons with the last one becoming the most significant today: (1) brain shift-corrected navigation, (2) monitoring/controlling thermal ablations, and (3) identifying residual tumor for resection. IoMRI, which today is moving into other applications, including treatment of vasculature and the spine, requires advanced 3T MRI platforms for faster and more flexible image acquisitions, higher image quality, and better spatial and temporal resolution; functional capabilities including fMRI and DTI; non-rigid registration algorithms to register pre- and intraoperative images; non-MRI imaging improvements to continuously monitor brain shift to identify when a new 3D MRI data set is needed intraoperatively; more integration of imaging and MRI-compatible navigational and robot-assisted systems; and greater computational capabilities to handle the processing of data. The Brigham and Women's Hospital's "AMIGO" suite is described as a setting for progress to continue in ioMRI by incorporating other modalities including molecular imaging. A call to action is made to have other researchers and clinicians in the field of image guided therapy to work together to integrate imaging with therapy delivery systems (such as laser, MRgFUS, endoscopic, and robotic surgery devices).
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Lumbar axial loading device alters lumbar sagittal alignment differently from upright standing position: a computed tomography study. Spine (Phila Pa 1976) 2010; 35:995-1001. [PMID: 20139804 DOI: 10.1097/brs.0b013e3181bb8188] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
STUDY DESIGN A study was performed using an axial loading device in healthy young subjects. OBJECTIVE To determine whether sagittal alignment during axial loading using a compression device can accurately simulate the standing posture. SUMMARY OF BACKGROUND DATA Axial compression devices are widely used for simulation of standing position during magnetic resonance imaging (MRI) or computed tomography (CT) scans. However, images taken during axial loading have not been compared with those obtained in a standing posture. METHODS The study population comprised 14 asymptomatic healthy volunteers (7 men and 7 women: age 21-32, mean 27 years). Lumbar lateral radiograph films obtained in the standing posture (standing condition), lumbar CT images with axial loading using a DynaWell compression device (axial loading condition), and CT images without loading (control) were compared. Changes in spinal length, lumbar disc height, segmental lordotic angle, and total lumbar lordotic angle were compared among the conditions. RESULTS Spinal length was significantly decreased in both the axial loading and standing conditions compared with controls. The magnitude of the changes was greater in the standing condition than in the axial loading condition. Segmental lordotic angle at L2/3 and L3/4 was significantly increased in both axial loading and standing conditions. However, disc lordotic angle at L5/S was significantly decreased in the axial loading condition, while the standing condition showed no significant change. Consequently, the pelvic angle showed a significant decrease in the axial loading condition. CONCLUSION The compression device simulates the lumbar segmental alignment change from supine to standing posture in L1/2, L2/3, L3/4, and L4/5. However, in L5/S, axial loading using the DynaWell altered lumbar segmental alignment with a kyphotic change, while no significant difference was observed in this level between standing and supine positions. Awareness of these phenomena are essential for accurate interpretation of imaging results.
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Abstract
Neurosurgical diagnosis and intervention has evolved through improved neuroimaging, allowing better visualization of anatomy and pathology. This article discusses the various systems that have been designed over the last decade to meet the requirements of neurosurgical patients and opines on the potential future developments in the technology and application of intraoperative MRI. Because the greatest amount of experience with intraoperative MRI comes from its use in brain tumor resection, this article focuses on the origins of intraoperative MRI in relation to this field.
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Nabavi A, Mamisch CT, Gering DT, Kacher DF, Pergolizzi RS, Wells WM, Kikinis R, McL Black P, Jolesz FA. Image-guided therapy and intraoperative MRI in neurosurgery. MINIM INVASIV THER 2010; 9:277-86. [DOI: 10.1080/13645700009169658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hynynen K. MRI-guided focused ultrasound treatments. ULTRASONICS 2010; 50:221-229. [PMID: 19818981 DOI: 10.1016/j.ultras.2009.08.015] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 08/27/2009] [Accepted: 08/27/2009] [Indexed: 05/28/2023]
Abstract
Focused ultrasound (FUS) allows noninvasive focal delivery of energy deep into soft tissues. The focused energy can be used to modify and eliminate tissue for therapeutic purposes while the energy delivery is targeted and monitored using magnetic resonance imaging (MRI). MRI compatible methods to deliver these exposures have undergone rapid development over the past 10 years such that clinical treatments are now routinely performed. This paper will review the current technical and clinical status of MRI-guided focused ultrasound therapy and discuss future research and development opportunities.
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Affiliation(s)
- Kullervo Hynynen
- Sunnybrook Health Sciences Centre, Imaging Research, Department of Medical Biophysics, University of Toronto, 2075 Bayview Ave., Toronto, ON, Canada M4N 3M5.
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Oguro S, Tokuda J, Elhawary H, Haker S, Kikinis R, Tempany CMC, Hata N. MRI signal intensity based B-spline nonrigid registration for pre- and intraoperative imaging during prostate brachytherapy. J Magn Reson Imaging 2010; 30:1052-8. [PMID: 19856437 DOI: 10.1002/jmri.21955] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To apply an intensity-based nonrigid registration algorithm to MRI-guided prostate brachytherapy clinical data and to assess its accuracy. MATERIALS AND METHODS A nonrigid registration of preoperative MRI to intraoperative MRI images was carried out in 16 cases using a Basis-Spline algorithm in a retrospective manner. The registration was assessed qualitatively by experts' visual inspection and quantitatively by measuring the Dice similarity coefficient (DSC) for total gland (TG), central gland (CG), and peripheral zone (PZ), the mutual information (MI) metric, and the fiducial registration error (FRE) between corresponding anatomical landmarks for both the nonrigid and a rigid registration method. RESULTS All 16 cases were successfully registered in less than 5 min. After the nonrigid registration, DSC values for TG, CG, PZ were 0.91, 0.89, 0.79, respectively, the MI metric was -0.19 +/- 0.07 and FRE presented a value of 2.3 +/- 1.8 mm. All the metrics were significantly better than in the case of rigid registration, as determined by one-sided t-tests. CONCLUSION The intensity-based nonrigid registration method using clinical data was demonstrated to be feasible and showed statistically improved metrics when compare to only rigid registration. The method is a valuable tool to integrate pre- and intraoperative images for brachytherapy.
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Affiliation(s)
- Sota Oguro
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Bootz F, Schulz T, Weber A, Scheffler B, Keiner S. The Use of Open MRI in Otorhinolaryngology: Initial Experience. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929080109146095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Klotz HP, Flury R, Schönenberger A, Debatin JF, Uhlschmid G, Largiadèr F. Experimental Cryosurgery of the Liver Under Magnetic Resonance Guidance. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929089709149834] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Liu H, Hall WA, Truwit CL. Remotely-Controlled Approach for Stereotactic Neurobiopsy. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929080209146032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wirtz CR, Bonsanto MM, Knauth M, Tronnier VM, Albert FK, Staubert A, Kunze S. Intraoperative Magnetic Resonance Imaging to Update Interactive Navigation in Neurosurgery: Method and Preliminary Experience. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929089709148110] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Excerpts from the Final Report for the Second International Workshop on Robotics and Computer Assisted Medical Interventions, June 23–26, 1996, Bristol, England. ACTA ACUST UNITED AC 2010. [DOI: 10.3109/10929089709150524] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Linte CA, White J, Eagleson R, Guiraudon GM, Peters TM. Virtual and Augmented Medical Imaging Environments: Enabling Technology for Minimally Invasive Cardiac Interventional Guidance. IEEE Rev Biomed Eng 2010; 3:25-47. [DOI: 10.1109/rbme.2010.2082522] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Neurosurgical diagnosis and intervention has evolved through improved neuroimaging, allowing better visualization of anatomy and pathology. This article discusses the various systems that have been designed over the last decade to meet the requirements of neurosurgical patients and opines on the potential future developments in the technology and application of intraoperative MRI. Because the greatest amount of experience with intraoperative MRI comes from its use in brain tumor resection, this article focuses on the origins of intraoperative MRI in relation to this field.
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Affiliation(s)
- John M K Mislow
- Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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Wendt M, Zhang Q, Melzer A, Dupont E, Lewin JS, Duerk JL. Visualisation, tracking and navigation of instruments for MRI-guided interventional procedures. MINIM INVASIV THER 2009. [DOI: 10.3109/13645709909153181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
This paper introduces some of the authors' recent attempts to enhance image-guided treatment in intraoperative magnetic resonance imaging (MRI). These include the deformable registration of preoperative images obtained by 1.5 Tesla MRI to the intraoperative images, and a needle-holding robotic system that is MR-compatible and optimized to work with intraoperative MRI. The role of deformable registration is to enhance intraoperative planning and simulation, and the robotic system is to systematically link the result of such planning and simulation to active surgical assistance. The former was retrospectively examined in prostate cancer biopsy cases and statistically suggested that deformable registration significantly improved the quality of registration. The latter, which is planned to be applied to prostate brachytherapy, was found to have good MR compatibility and its maneuvering had no adverse effect on the imaging and <I>vice versa</I>.
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Duprez TP, Jankovski A, Grandin C, Hermoye L, Cosnard G, Raftopoulos C. Intraoperative 3T MR imaging for spinal cord tumor resection: feasibility, timing, and image quality using a "twin" MR-operating room suite. AJNR Am J Neuroradiol 2008; 29:1991-4. [PMID: 18617591 DOI: 10.3174/ajnr.a1134] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We assessed feasibility, safety, and timing of an original intraoperative MR procedure in 3 cases of resection of spinal cord glioma by using a clinical 3T MR system connected to an adjacent operating room in a design being coined "twin" or "dual" MR-operating room suite.
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Affiliation(s)
- T P Duprez
- Department of Radiology and Medical Imaging, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Jankovski A, Francotte F, Vaz G, Fomekong E, Duprez T, Van Boven M, Docquier MA, Hermoye L, Cosnard G, Raftopoulos C. Intraoperative Magnetic Resonance Imaging at 3-T Using a Dual Independent Operating Room-Magnetic Resonance Imaging Suite: Development, Feasibility, Safety, and Preliminary Experience. Neurosurgery 2008; 63:412-24; discussion 424-6. [DOI: 10.1227/01.neu.0000324897.59311.1c] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Hushek SG, Martin AJ, Steckner M, Bosak E, Debbins J, Kucharzyk W. MR systems for MRI-guided interventions. J Magn Reson Imaging 2008; 27:253-66. [PMID: 18219680 DOI: 10.1002/jmri.21269] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The field of MR imaging has grown from diagnosis via morphologic imaging to more sophisticated diagnosis via both physiologic and morphologic imaging and finally to the guidance and control of interventions. A wide variety of interventional procedures from open brain surgeries to noninvasive focused ultrasound ablations have been guided with MR and the differences between diagnostic and interventional MR imaging systems have motivated the creation of a new field within MR. This review discusses the various systems that research groups and vendors have designed to meet the requirements of interventional MR and suggest possible solutions to those requirements that have not yet been met. The common requirements created by MR imaging guidance of interventional procedures are reviewed and different imaging system designs will be independently considered. The motivation and history of the different designs are discussed and the ability of the designs to satisfy the requirements is analyzed.
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Weiss CR, Nour SG, Lewin JS. MR-guided biopsy: a review of current techniques and applications. J Magn Reson Imaging 2008; 27:311-25. [PMID: 18219685 DOI: 10.1002/jmri.21270] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Biopsy has become a cornerstone of modern medicine and most modern biopsies are performed percutaneously using image guidance, typically computed tomography or ultrasound. MR-guided biopsy offers many advantages over these more traditional modalities, and the recent development of interventional MR imaging techniques has made MR-guided percutaneous biopsies and aspirations a clinical reality. As the field of MR-guided procedures continues to expand and to attract more attention from radiologists, it is important to understand the concepts, techniques, applications, advantages, and limitations of MR-guided biopsy/percutaneous procedures. Radiologists should also recognize the need for their significant involvement in the technical aspects of MR-guided procedures, since several user-defined parameters can alter device visualization in the MR imaging environment and affect procedure safety. This article reviews the prerequisites, systems, and applications of MR-guided biopsy.
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Affiliation(s)
- Clifford R Weiss
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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