X‐ray magnetic resonance fusion modality may reduce radiation exposure and contrast dose in diagnostic cardiac catheterization of congenital heart disease

Hazeem, Anas Abu; Dori, Yoav; Whitehead, Kevin K.; Harris, Matthew A.; Fogel, Mark A.; Gillespie, Matthew J.; Rome, Jonathan J.; Glatz, Andrew C.

doi:10.1002/ccd.25473

Cited by 33 publications

(13 citation statements)

References 13 publications

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“…However, after initial studies first on animal models and later on patients that were able to show feasibility and advantages [1,61,62], the use of endovascular MRI for this indication has barely been pursued in recent years due to a lack of availability of instruments and the effort and cost of adapting currently available units to endovascular interventions. To still be able to profit from the advantages of MRI, MRI datasets are increasingly being superimposed on angiography images used for interventions [63,64].…”

Section: Endovascular and Cardiac Interventionsmentioning

confidence: 99%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function.Method The current status of interventional MRI for the clinical routine was analyzed.Results The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion IntroductionMRI has an intrinsically high soft-tissue contrast and can be used to measure physiological parameters, such as blood flow (flow rate and flow volume), diffusion, temperature, and movement. Since its introduction into the clinical routine in the 1980 s, it has also been used for guiding and monitoring interventions. However, in contrast to CT and ultrasound, the use of MRI for guiding interventions requires significant technical effort. Due to the disruptive effect of the strong main magnetic field and the alternating electromagnetic fields, the monitoring of patients during an intervention by measuring ECG signals, oxygen saturation, or blood pressure requires special equipment. These monitoring systems must not interfere with the MRI scan and must be MR-safe (according to DIN EN 62 570:2010 -05). The list of requirements regarding monitoring equipment provides an indication of the development effort, with suitable monitoring equipment representing only one of the components necessary for MR-guided interventions.In addition to MRI safety, all catheters and instruments must be adapted to this modality. To ensure MRI safety, metal must be largely avoided since, depending on the length and orientation to the main magnetic field, it can heat up and consequently even result in burns. Achieving rigidity and torsion stability of catheters or guide wires without the use of metal for reinforcement represents a technical challenge. In the case of needles, breaking resistance is one of the more difficult properties to achieve for MR-safe designs. Moreover, instruments must be able to be effectively visualized without adjacent structures being superimposed by artifacts. The tip must be able to be identified and definitively differentiated from the shaft since MRI as a cross-sectional imaging method typically uses individual slices even for guiding interventions and does not use projections as in fluoroscopy...

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Section: Endovascular and Cardiac Interventionsmentioning

confidence: 99%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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“…The procedural time was shorter, but anesthetic time tended to be longer, partly due to the time needed for performing the MRI study itself [17]. Nevertheless, a few patients already had prior MRI studies for clinical reasons, irrespective of the need for cardiac catheterization.…”

Section: Ct/mr Image Overlaymentioning

confidence: 99%

Multimodality Medical Image Fusion: Applications in Congenital Cardiology

Narayan

Qureshi

2017

Future Cardiol.

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KEYWORDS• congenital cardiology • image fusion • image registration • medical image computing Image fusion: definition Image fusion consists of registering and visualizing different sets of images of a given object or scene. In medical disorders, pathology affects different tissues in a variable manner. These are best imaged in different modalities using diverse technologies. Image fusion helps to integrate all of the information and aids in accurate diagnosis and treatment. The implicit image fusion composed by the treating physician can be subjective and prone to error, which image fusion systems can help to mitigate. Medical image fusion is a very broad field covering aspects of computer vision, pattern recognition, machine learning and artificial intelligence in addition to image processing. Brief historyThe earliest mention of the word 'image fusion' in the clinical context was in 1992 by Swayne, who reported on computer-assisted fusion of single-photon emission computed tomographic (SPECT) and computed tomographic (CT) images in localizing inflammatory processes in 10 patients [1]. A combination of standard scaling, rotation, translation and stretching transformations were used to fuse images with anatomic and external landmarks. Stereotactic neurosurgery [2] was the next major application for image fusion, closely followed by oncology [3]. Rapid improvements in computers and their processing power led to increasing development and use of image fusion, particularly in imageguided surgery in a variety of medical specialties. The problems with software-based posthoc image fusion have led to the development of combined scanners, which acquire both anatomical and functional images during a single imaging session. This is achieved by fusing of technologies such as PET/CT scanner and PET/MRI scanner [4]. This also stimulated the development of co-location of complementary imaging modalities such

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“…1). Early experience suggests that XFM can reduce procedure time, iodinated contrast use, and ionizing radiation dose [4]. Importantly, aside from additional software, which is currently investigational, no new hardware is required.…”

Section: X-ray Fused With Mri or “Xfm”mentioning

confidence: 99%

Interventional CMR: Clinical Applications and Future Directions

Rogers

Lederman

2015

Curr Cardiol Rep

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Interventional cardiovascular magnetic resonance (iCMR) promises to enable radiation-free catheterization procedures and to enhance contemporary image guidance for structural heart and electrophysiological interventions. However, clinical translation of exciting pre-clinical interventions has been limited by availability of devices that are safe to use in the magnetic resonance (MR) environment. We discuss challenges and solutions for clinical translation, including MR-conditional and MR-safe device design, and how to configure an interventional suite. We review the recent advances that have already enabled diagnostic MR right heart catheterization and simple electrophysiologic ablation to be performed in humans and explore future clinical applications.

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X‐ray magnetic resonance fusion modality may reduce radiation exposure and contrast dose in diagnostic cardiac catheterization of congenital heart disease

Abstract: Select diagnostic cardiac catheterization cases that utilized XMRF used less radiation and contrast than similar cases where XMRF was not used. Future work is needed to determine whether similar benefits can be extended to other types of diagnostic and complex interventional procedures.

Cited by 33 publications

References 13 publications

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application

Multimodality Medical Image Fusion: Applications in Congenital Cardiology

Interventional CMR: Clinical Applications and Future Directions

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