Rapid freehand MR-guided percutaneous needle interventions: an image-based approach to improve workflow and feasibility

J Magn Reson Imaging. 2013 May;37(5):1202-12. doi: 10.1002/jmri.23894. Epub 2013 Jan 18.

Abstract

Purpose: To develop and evaluate software-based methods for improving the workflow of magnetic resonance (MR)-guided percutaneous interventions.

Materials and methods: A set of methods was developed that allows the user to: 1) plan an entire procedure, 2) directly apply this plan to skin entry site localization without further imaging, and 3) place a needle under real-time MR guidance with automatic alignment of three orthogonal slices along a planned trajectory with preference to the principal patient axes. To validate targeting accuracy and time, phantom experiments (96 targets) and in vivo paraspinal and kidney needle punctures in two pigs (55 targets) were performed. The influence of trajectory obliquity, level of experience, and organ motion on targeting accuracy and time was analyzed.

Results: Mean targeting error was 1.8 ± 0.9 mm (in vitro) and 2.9 ± 1.0 mm (in vivo) in all directions. No statistically significant differences in targeting accuracy between single- and double-oblique trajectories, novice and expert users, or paraspinal and kidney punctures were observed. The average time (in vivo) from trajectory planning to verification of accurate needle placement was 6 minutes.

Conclusion: The developed methods allow for accurate needle placement along complex trajectories and are anticipated to reduce table time for MR-guided percutaneous needle interventions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ablation Techniques / instrumentation
  • Ablation Techniques / methods*
  • Algorithms
  • Animals
  • Biopsy, Needle / instrumentation
  • Biopsy, Needle / methods*
  • Feasibility Studies
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Image-Guided Biopsy / instrumentation
  • Image-Guided Biopsy / methods*
  • Imaging, Three-Dimensional / methods
  • Injections / instrumentation
  • Injections / methods*
  • Magnetic Resonance Imaging, Interventional / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Software
  • Swine
  • Workflow*