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In-room ultrasound fusion combined with fully compatible 3D-printed holding arm – rethinking interventional MRI

Authors Friebe M, Sanchez J, Balakrishnan S, Illanes A, Nagaraj Y, Odenbach R, Matooq M, Krombach G, Vogele M, Boese A

Received 31 August 2017

Accepted for publication 12 January 2018

Published 15 March 2018 Volume 2018:11 Pages 77—85

DOI https://doi.org/10.2147/MDER.S150459

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Video abstract presented by Michael Friebe.

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Michael Friebe,1 Juan Sanchez,1 Sathish Balakrishnan,1 Alfredo Illanes,1 Yeshaswini Nagaraj,2 Robert Odenbach,1 Marwah Matooq,1 Gabriele Krombach,3 Michael Vogele,4 Axel Boese1

1Chair of Intelligent Catheter, Otto-von-Guericke-University, Magdeburg, Germany; 2University of Groningen, University Medical Center Groningen, Center for Medical Imaging North East Netherlands, Groningen, the Netherlands; 3Universitätsklinikum Giessen, Radiologische Klinik, Giessen, Germany; 4Interventional Systems GmbH, Kitzbühel, Austria

Abstract: There is no real need to discuss the potential advantages – mainly the excellent soft tissue contrast, nonionizing radiation, flow, and molecular information – of magnetic resonance imaging (MRI) as an intraoperative diagnosis and therapy system particularly for neurological applications and oncological therapies. Difficult patient access in conventional horizontal-field superconductive magnets, very high investment and operational expenses, and the need for special nonferromagnetic therapy tools have however prevented the widespread use of MRI as imaging and guidance tool for therapy purposes. The interventional use of MRI systems follows for the last 20+ years the strategy to use standard diagnostic systems and add more or less complicated and expensive components (eg, MRI-compatible robotic systems, specially shielded in-room monitors, dedicated tools and devices made from low-susceptibility materials, etc) to overcome the difficulties in the therapy process. We are proposing to rethink that approach using an in-room portable ultrasound (US) system that can be safely operated till 1 m away from the opening of a 3T imaging system. The live US images can be tracked using an optical inside–out approach adding a camera to the US probe in combination with optical reference markers to allow direct fusion with the MRI images inside the MRI suite. This leads to a comfortable US-guided intervention and excellent patient access directly on the MRI patient bed. This was combined with an entirely mechanical MRI-compatible 7 degrees of freedom holding arm concept, which shows that this test environment is a different way to create a cost-efficient and effective setup that combines the advantages of MRI and US by largely avoiding the drawbacks of current interventional MRI concepts.

Keywords:
interventional MRI, fusion imaging, ultrasound/MRI hybrid, MRI-compatible, medical holding arm ultrasound guided MRI intervention

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