Method for rapid MRI needle tracking.

A new method for MRI needle tracking within a given two-dimensional (2D) image slice is presented. The method is based on k-space investigation of the difference image between the current dynamic frame and a reference frame. Using only a few central k-lines of the difference image and a nonlinear optimization procedure, one can resolve the parameters that define the 2D sinc function that best characterizes the needle in k-space. The spatial location and orientation of the needle are determined from these parameters. Rapid needle tracking is obtained by repeated acquisitions of the same set of several central k-lines (as in a "keyhole" protocol) and repeated computation of these parameters. The calculated needle tip is depicted on the reference image by means of a graphic overlay. The procedure was tested in computer simulations and in actual MRI scans (the computations were done offline). It was demonstrated that six k-lines out of 128 usually suffice to locate the needle. The refresh rate of the needle location depends on the time required to sample the subset of k-lines, calculate the current needle location, and refresh the reference image.     

Real-time catheter tracking and adaptive imaging

PURPOSE: To evaluate the performance of a real-time MR system for interventional procedures that adjusts specific image parameters in real time based on a catheter's speed of insertion. MATERIALS AND METHODS: The system was implemented using only the hardware provided with a standard short-bore 1.5 T scanner (Siemens Magnetom Sonata) (with the exception of small tracking markers affixed to the catheter). The system tracks the position of an MR microcoil-instrumented catheter and automatically updates the scan plane's position and orientation, as well as other features, including, but not limited to, field of view, resolution, tip angle, and TE. A real-time feedback loop continuously localizes the tracking markers, updates the scan plane position and orientation, calculates the catheter's speed, adjusts the value of specific image parameters, then collects new image data, reconstructs an image, and provides it for immediate display. The system was evaluated in phantom and in vivo porcine experiments. RESULTS: The system is able to accurately localize a moving catheter in the abdominal aorta, calculate the device speed, and respond by adjusting specified image parameters 98% of the time, with precision of approximately 2 mm and 1.5 degrees. CONCLUSION: Simply slowing the speed of the catheter allows the clinician to adjust predetermined image parameters. This work also has the potential to build a degree of intelligence into the scanner, enabling it to react to changes in the clinical environment and automatically optimize specific image parameters.     

In vivo safe catheter visualization and slice tracking using an optically detunable resonant marker.

The purpose of this study was to test the in vivo feasibility of safe automatic catheter tracking based on an optically detunable resonant marker installed on the catheter tip, and also to test the compatibility of this approach with guidewire materials. The design of the resonant marker and the integration into the real-time MR environment is described. The catheter was used for real-time MR-guided catheterization of the aorta, left ventricle, and carotid in two swine. For in-plane visualization, the marker was repeatedly detuned. For automatic slice tracking, a projection difference measurement including detuning was interleaved with the imaging sequence. In vitro experiments were conducted to investigate the RF-safety of the marker and the effect of the guidewires on the signal intensity. For all orientations the marker provided excellent in vivo contrast using a radial steady-state free-precession sequence. Flashing of the marker by repetitive tuning/detuning further improved the in-plane visualization. Automatic slice tracking during real-time imaging was successfully performed. The plastic guidewires did not interfere with the marker, and detuning by guidewires containing nitinol could be compensated. In conclusion, automatic slice tracking as well as excellent in-plane visualization can be achieved with this approach and it is safe with respect to RF transmission.     

A Method to measure arbitrary k-space trajectories for rapid MR imaging

A method to measure arbitrary k-space trajectories was developed to compensate for nonideal gradient performance during rapid magnetic resonance (MR) imaging with actively or nonactively shielded gradients at a magnetic field strength of 4.1 T. Accurate MR image reconstruction requires knowledge of the k-trajectory produced by the gradient waveforms during k-space sampling. Even with shielded gradients, residual eddy currents and imperfections in gradient amplifier performance can cause the true k-space trajectory to deviate from the ideal trajectory. The k-space determination was used for spiral gradient-echo imaging of the human brain. While individual calibrations are needed for new pulse sequences, the method of k-space determination can be used for any sequence of preparation pulses and readout gradient waveforms and should prove useful for other trajectories, including the rastered lines of echo-planar imaging.     

Pair of resonant fiducial markers for localization of endovascular catheters at all catheter orientations

PURPOSE: To test wireless resonance circuits (RC) to be used as fiducial marker of endovascular catheters during MR-guided interventions. Current markers loose their signal enhancement for certain catheter orientations. The purpose of this study was to test a marker setup which overcomes this orientation problem. MATERIALS AND METHODS: The markers were constructed from a pair of two RCs. The RCs were individually tuned and the coil axes were oriented perpendicular to each other in order to decouple the two RCs. The markers were mounted on the tip of endovascular catheters and tested in vitro and in one porcine in vivo experiment. RESULTS: An intense MR signal at similar signal levels was noted at all catheter orientations. In the in vivo experiment the markers allowed for fast and reliable MR guidance of the catheters. CONCLUSION: A pair of two individually tuned and decoupled RCs is well suited for MR guidance of endovascular catheters.     

MR imaging during endovascular procedures: An evaluation of the potential for catheter heating

MRI in catheterized patients is considered unsafe due to the potential for focal heating. This concern arises from the continuous metallic braid that is incorporated into catheters to provide their desired physical properties. The potential for catheter heating during MR scanning was assessed in an in vitro model simulating a patient undergoing a neurovascular procedure in which MR scans of the brain will be performed. Heating adjacent to endovascular devices was assessed with fluoroptic temperature probes in a polyacrylamide gel. The effect of variable immersion lengths, lateral and longitudinal offsets, position along the endovascular device, physical MR system, and specific absorption rate (SAR) level were studied to determine their effect on catheter heating. A rapid temperature rise was evident next to endovascular devices during MR scanning and varied moderately with immersed length, position within the bore, measurement point on the device, and MR system used. Peak heating rates were less than 1°C/min with maximal SAR exposure and anatomically realistic geometries. Heating scaled linearly with SAR and SAR values below 0.2 W/kg produced negligible heating near catheters. For the evaluated application, substantial SAR restrictions, coupled with limited imaging durations, are proposed as sufficient to permit MRI without concern for thermal injury. Magn Reson Med 61:45–53, 2009. © 2008 Wiley‐Liss, Inc.     

Passive catheter tracking during interventional MRI using hyperpolarized 13C.

Interventional procedures in MRI can be performed preclinically using active or passive catheter-tracking methods. A novel passive nonproton technique is suggested that uses a catheter filled with a hyperpolarized (13)C contrast agent. A prototype three-lumen catheter was built with two closed lumens containing a flowing hyperpolarized (13)C contrast agent. Entire-length (13)C catheter projection visualization could be performed in vivo with a catheter SNR of approximately 80, one dual projection frame per approximately 700 ms, and an in-plane resolution of 2 x 2 mm(2) while traveling through the aorta of a pig. The traveling path of the (13)C catheter was visualized after back-projection catheter reconstruction and after image fusion with an anatomical offline proton road map. Catheter length visualization was aided by an oblique planar visualization mode. The high catheter signal demonstrated, together with the entire catheter length visualization and high surrounding soft-tissue contrast, warrants further development into a real-time technique.     

A catheter tracking method using reverse polarization for MR-guided interventions.

To conduct interventional procedures in MRI, reliable visualization of interventional devices such as catheters is necessary. For this purpose, the use of inductively-coupled radio frequency (ICRF) coils has been proposed. Without a wired connection, the signal around the ICRF coil is amplified, enabling catheters to be visualized. The wireless connection allows easy handling of catheters, in some pulse sequences, however, it might be difficult to differentiate the catheters from anatomical background information. In this work, a novel ICRF coil visualization method, which allows separation of the catheter and the anatomical information by using the reverse and forward polarization modes of a coil, is proposed. This method allows images of the anatomy and the catheter to be combined into a color-coded image. First, an ICRF coil with decoupling diodes was constructed; we call this a receive-coupled RF (RCRF) coil. The RF safety profile of the RCRF coil is shown to be better than the ICRF coil. Second, to demonstrate the feasibility of this method, a receive-only birdcage coil without a hybrid coupler was constructed and then connected to a scanner as a two-channel phased-array coil. MR signals acquired from two channels were added after phase adjustments to create the reverse and forward polarization mode images. The reverse polarization mode image contained signal only from the RCRF coil, but the forward polarization mode displayed both anatomical information and the RCRF coil. The performance of this novel tracking method was tested in phantom and animal experiments. Color-coded images demonstrate the feasibility of the method to track catheters using RCRF coils.     

Accelerated 3D catheter visualization from triplanar MR projection images

One major obstacle for MR‐guided catheterizations is long acquisition times associated with visualizing interventional devices. Therefore, most techniques presented hitherto rely on single‐plane imaging to visualize the catheter. Recently, accelerated three‐dimensional (3D) imaging based on compressed sensing has been proposed to reduce acquisition times. However, frame rates with this technique remain low, and the 3D reconstruction problem yields a considerable computational load. In X‐ray angiography, it is well understood that the shape of interventional devices can be derived in 3D space from a limited number of projection images. In this work, this fact is exploited to develop a method for 3D visualization of active catheters from multiplanar two‐dimensional (2D) projection MR images. This is favorable to 3D MRI as the overall number of acquired profiles, and consequently the acquisition time, is reduced. To further reduce measurement times, compressed sensing is employed. Furthermore, a novel single‐channel catheter design is presented that combines a solenoidal tip coil in series with a single‐loop antenna, enabling simultaneous tip tracking and shape visualization. The tracked tip and catheter properties provide constraints for compressed sensing reconstruction and subsequent 2D/3D curve fitting. The feasibility of the method is demonstrated in phantoms and in an in vivo pig experiment. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

MR coil design for simultaneous tip tracking and curvature delineation of a catheter.

In active catheter tracking, small RF coils are attached to the catheter for localization. For interactive catheter steering at vessel branchings, it is necessary to visualize not only a single point near the catheter tip but also the entire shape and orientation of the catheter's distal end. Therefore, a 35-mm-long twisted-pair RF coil was added to a 5 French intravascular catheter with a single tip-tracking coil. With the use of small nonmagnetic electronic components at the catheter tip, and a special switching circuitry outside the catheter, the coil assembly could be operated in two different modes. During MRI, the tip-tracking coil was detuned so that the MR signal was received by the visualization coil only. During tracking, detuning was switched off and the MR signal was predominantly received by the more sensitive tracking coil. The catheter was used in combination with a MR pulse sequence with automatic slice positioning so that the current imaging slice was always placed at the position of the catheter tip. Phantom and animal experiments showed that the catheter tip is better visualized with the combined approach than with a tracking coil alone.     

Multiple field of view MR fluoroscopy.

This work describes a real-time imaging and visualization technique that allows multiple field of view (FOV) imaging. A stream of images from a single receiver channel can be reconstructed at multiple FOVs within each image frame. Alternately, or in addition, when multiple receiver channels are available, image streams from each channel can be independently reconstructed at multiple FOVs. The implementation described here provides for real-time visualization of the placement of guidewires and catheters on a dynamic roadmap during interventional procedures. The loopless catheter antenna, an electrically active intravascular probe, was used for MR signal reception. In 2D projection images, the catheter and surrounding structures within its diameter of sensitivity appear as bright signal. The simplicity of the resulting images allows very-narrow-FOV imaging to decrease imaging time. Very-narrow-FOV images are acquired on MR receiver channels that collect guidewire or catheter data. These very-narrow-FOV images provide very high frame rate continuous, real-time imaging of the interventional devices (25 fps). Large-FOV images are formed from receiver channels that collect anatomical data from standard imaging surface coils, and simultaneously provide a dynamic, frequently updated roadmap. These multiple-FOV images are displayed together, improving visualization of interventional device placement.     

Catheter tracking and visualization using 19F nuclear magnetic resonance.

This work presents an investigation into catheter visualization and localization using 19F nuclear magnetic resonance (NMR) in conjunction with proton imaging. For this purpose, the imaging capabilities of a standard system were extended to allow for 19F excitation and signal detection. Two modes of operation were implemented: 1) a real-time tracking mode that provides tip tracking and automatic slice position updates interleaved with real-time, interactive proton imaging; and 2) a non-real-time catheter length visualization mode in which the entire length of a catheter can be assessed. Initial phantom experiments were conducted with the use of an angiographic balloon catheter filled with the blood substitute perfluorooctylbromide (PFOB). Using limited bandwidth excitation centered at the resonances of the CF2 groups of PFOB, we found that sufficient signal could be received to facilitate tip tracking during catheter motion and length visualization for various catheter configurations. The present approach is considered a promising alternative to existing methods, which either are associated with safety concerns (if active markers are employed) or suffer from insufficient, direction-dependent contrast (if passive visualization is used). Furthermore, our approach enables visualization of the entire length of the catheter. The proposed method provides a safe technique that, unlike electrical or optical devices, does not require modification of commercially available catheters.     

Multifunctional interventional devices for MRI: a combined electrophysiology/MRI catheter.

The design and application of a two-wire electrophysiology (EP) catheter that simultaneously records the intracardiac electrogram and receives the MR signal for active catheter tracking is described. The catheter acts as a long loop receiver, allowing for visualization of the entire catheter length while simultaneously behaving as a traditional two-wire EP catheter, allowing for intracardiac electrogram recording and ablation. The application of the device is demonstrated by simultaneously tracking the catheter and recording the intracardiac electrogram in canine models using 7 and 10 frame/sec real-time imaging sequences. Using solely MR imaging, the entire catheter was visualized and guided from the jugular vein into the cardiac chambers, where the intracardiac electrogram was recorded. By combining several functions in a single, simple structure, the excellent tissue contrast and functional imaging capabilities of MR can be used to improve the efficacy of EP interventions. This catheter will facilitate MR-guided interventions and demonstrates the design of multifunctional interventional devices for use in MRI.     

A deflectable guiding catheter for real-time MRI-guided interventions

Purpose:

To design a deflectable guiding catheter that omits long metallic components yet preserves mechanical properties to facilitate therapeutic interventional MRI procedures.

Materials and Methods:

The catheter shaft incorporated Kevlar braiding. A 180° deflection was attained with a 5‐cm nitinol slotted tube, a nitinol spring, and a Kevlar pull string. We tested three designs: passive, passive incorporating an inductively coupled coil, and active receiver. We characterized mechanical properties, MRI properties, RF induced heating, and in vivo performance in swine.

Results:

Torque and tip deflection force were satisfactory. Representative procedures included hepatic and azygos vein access, laser cardiac septostomy, and atrial septal defect crossing. Visualization was best in the active configuration, delineating profile and tip orientation. The passive configuration could be used in tandem with an active guidewire to overcome its limited conspicuity. There was no RF‐induced heating in all configurations under expected use conditions in vitro and in vivo.

Conclusion:

Kevlar and short nitinol component substitutions preserved mechanical properties. The active design offered the best visibility and usability but reintroduced metal conductors. We describe versatile deflectable guiding catheters with a 0.057” lumen for interventional MRI catheterization. Implementations are feasible using active, inductive, and passive visualization strategies to suit application requirements. J. Magn. Reson. Imaging 2012;35:908–915. © 2011 Wiley Periodicals, Inc.     

Use of k-space segmentation in MR velocity mapping for rapid quantification of CSF flow

In this work, a k-space segmentation technique for quantitative studies of pulsatile cerebrospinal fluid (CSF) flow is suggested. Three k-space lines are sampled for each of two interleaved gradient-echo sequences (velocity-compensated and velocity-encoded) within each repetition interval. Nine cardiac phases are obtained at a heart rate of 60 bpm with maintained nominal resolution and a factor of 3 in reduction of acquisition time relative to our conventional nonsegmented flow quantification protocol. Segmented and conventional sequences were compared in phantoms, in healthy volunteers, and in two patients with clinically suspected normal pressure hydrocephalus. Good agreement between flow curves obtained with the two sequences was demonstrated in vitro as well as in vivo. A slight underestimation of flow values in volunteers was attributed to data filtering when using the segmented sequence. Because the CSF circulation is complex and tightly connected to the vascular circulation, specific clinical applications may require flow studies at multiple positions and with different velocity encoding. In such cases, the proposed sequence can be used to gain time, but alternatively, the segmentation technique can be used to further increase spatial resolution within reasonable examination times.     

Undersampled projection reconstruction for active catheter imaging with adaptable temporal resolution and catheter-only views.

In this study undersampled projection reconstruction (PR) was used for rapid catheter imaging in the heart, employing steady-state free precession (SSFP) contrast. Active catheters and phased-array coils were used for combined imaging of anatomy and catheter position in swine. Real-time imaging of catheter position was performed with relatively high spatial and temporal resolution, providing 2 x 2 x 8 mm spatial resolution and four to eight frames per second. Two interactive features were introduced. The number of projections (Np) was adjusted interactively to trade off imaging speed and artifact reduction, allowing acquisition of high-quality or high-frame-rate images. Thin-slice imaging was performed, with interactive requests for thick-slab projection images of the signal received solely from the active catheter. Briefly toggling on catheter-only projection images was valuable for verifying that the catheter tip was contained within the selected slice, or for locating the catheter when part of it was outside the selected slice.     

Active device tracking and high-resolution intravascular MRI using a novel catheter-based, opposed-solenoid phased array coil.

A novel two-element, catheter-based phased array coil was designed and built for both active MR device tracking and high-resolution vessel wall imaging. The device consists of two independent solenoid coils that are wound in opposite directions, connected to separate receive channels, and mounted collinearly on an angiographic catheter. The elements were used independently or together for tracking or imaging applications, respectively. The array's dual functionality was tested on a clinical 1.5 T MRI scanner in vitro, in vivo, and in situ. During real-time catheter tracking, each element gave rise to a high-amplitude peak in the respective projection data, which enabled reliable and robust device tracking as well as automated slice positioning. In vivo microimaging with 240 microm in-plane resolution was achieved in 9 s using the device and TrueFISP imaging. Therefore, a single device was successfully implemented that met the combined requirements of intravascular device tracking and imaging.     

MR-visible coatings for endovascular device visualization

PURPOSE: To investigate the potential utility of magnetic resonance (MR)-visible coatings for passive visualization of therapeutic endovascular devices such as catheters and guidewires. MATERIALS AND METHODS: Using a multistep coating process, gadolinium-based coatings were applied to commercially available off-the-shelf catheters and guidewires. These coated devices were imaged in phantoms made of fat-free yogurt, saline, and whole blood and also in live canine aorta on a 1.5-T cardiovascular MR scanner using T1-weighted two-dimensional radiofrequency (RF)-spoiled gradient-recalled echo, two-dimensional spin echo, and three-dimensional RF-spoiled gradient-recalled echo techniques. RESULTS: Commercially available off-the shelf catheters (4, 5, and 6 French) and guidewires (0.038 inch) were clearly visualized in all phantoms and canine aorta and the coatings proved to be durable and imageable without degradation in signal intensity up to 24 hours. MR-visible coatings address some of the shortcomings that have previously limited the role of MR as a guidance tool. CONCLUSION: Both in vitro and in vivo visualization of therapeutic endovascular devices coated with MR-visible coatings are found to be clinically viable.     

Adaptive vessel tracking: automated computation of vessel trajectories for improved efficiency in 2D coronary MR angiography

A new method was investigated for improving the efficiency of ECG-gated coronary magnetic resonance angiography (CMRA) by accurate, automated tracking of the vessel motion over the cardiac cycle. Vessel tracking was implemented on a spiral gradient-echo pulse sequence with sub-millimeter in-plane spatial resolution as well as high image signal to noise ratio. Breath hold 2D CMRA was performed in 18 healthy adult subjects (mean age 46 +/- 14 years). Imaging efficiency, defined as the percentage of the slices where more than 30 mm of the vessel is visualized, was computed in multi-slice spiral scans with and without vessel tracking. There was a significant improvement in the efficiency of the vessel tracking sequence compared to the multi-slice sequence (56% vs. 32%, P < 0.001). The imaging efficiency increased further when the true motion of the coronary arteries (determined using a cross correlation algorithm) was used for vessel tracking as opposed to a linear model for motion (71% vs. 57%, P < 0.05). The motion of the coronary arteries was generally found to be linear during the systolic phase and nonlinear during the diastolic phase. The use of subject-tailored, automated tracking of vessel positions resulted in improved efficiency of coronary artery illustration on breath held 2D CMRA.