PubMed Health⌕ Search

Biomedical subjects

Daniel F Kacher

Publications and source records attributed to Daniel F Kacher.

9 recordsLinked to original sources
PubMed2006

Intraoperative and interventional MRI: recommendations for a safe environment.

In this paper we report on current experience and review magnetic resonance safety protocols and literature in order to define practices surrounding MRI-guided interventional and surgical procedures. Direct experience, the American College of Radiology White paper on MR Safety, and various other sources are summarized. Additional recommendations for interventional and surgical MRI-guided procedures cover suite location/layout, accessibility, safety policy, personnel training, and MRI compatibility issues. Further information is freely available for sites to establish practices to minimize risk and ensure safety. Interventional and intraoperative MRI is emerging from its infancy, with twelve years since the advent of the field and well over 10,000 cases collectively performed. Thus, users of interventional and intraoperative MRI should adapt guidelines utilizing universal standards and terminology and establish a site-specific policy. With policy enforcement and proper training, the interventional and intraoperative MR imaging suite can be a safe and effective environment.

Equipment Safety↗
PubMed2006

DuraSeal magnetic resonance and computed tomography imaging: evaluation in a canine craniotomy model.

OBJECTIVE: Several novel sealing materials have been proposed as an adjunct to sutured dural closure to help insure watertight closure, thus diminishing the risk of pseudomeningocele formation. This evaluation was undertaken to clarify the in vivo magnetic resonance imaging (MRI) and computed tomographic (CT) scan characteristics of one such sealant, which has a high water content, permitting similar imaging characteristics to pseudomeningoceles and inflammatory collections. METHODS: After a craniotomy in two canine subjects, we sprayed a novel, water-soluble, self-polymerizing, absorbable, hydrogel sealant onto the dura and the bone flap was replaced. After recovery, both animals underwent MRI and CT scans after 3 days and again at 2, 4, 6, 8, and 10 weeks after the craniotomy. The appearance of the gel at each timepoint was characterized and compared with the macroscopic and microscopic findings obtained 14 weeks after implantation. RESULTS: Both animals remained neurologically intact. Hydrogel sealant was readily apparent with all imaging techniques through Week 6. Diagnostic distinction from inflammatory collections and pseudomeningoceles was possible with MRI, using inversion recovery and contrast-enhanced sequences; such distinctions were occasionally challenging with a contrast-enhanced CT scan. Temporal absorption of the gel and subsequent closure of the remaining void was documented. Histopathology showed minimal changes, and excellent tissue compatibility of the gel was noted. CONCLUSION: The hydrogel sealant can be observed with cross sectional imaging and can be distinguished from cerebrospinal fluid using a CT scan, complemented by an occasional MRI scan. In addition, complete absorption of the hydrogel, with closure of the remaining void was noted. Histological examination found an unremarkable response with no neurotoxicity or space-filling defect.

Animals↗
PubMed2005

Characterization of human atherosclerotic plaques by intravascular magnetic resonance imaging.

BACKGROUND: Development and validation of novel imaging modalities to assess the composition of human atherosclerotic plaques will improve the understanding of atheroma evolution and could facilitate evaluation of therapeutic strategies for plaque modification. Surface MRI can characterize tissue content of carotid but not deeper arteries. This study evaluated the usefulness of intravascular MRI (IVMRI) to discern the composition of human iliac arteries in vivo. METHODS AND RESULTS: Initial studies validated IVMRI against histopathology of human atherosclerotic arteries ex vivo. A 0.030-inch-diameter IVMRI detector coil was advanced into isolated human aortoiliac arteries and coupled to a 1.5-T scanner. Information from combined T1-, moderate T2-, and proton-density-weighted images differentiated lipid, fibrous, and calcified components with favorable sensitivity and specificity and allowed accurate quantification of plaque size. The validated approach was then applied to image iliac arteries of 25 human subjects in vivo, and results were compared with those of intravascular ultrasound (IVUS). IVMRI readily visualized inner and outer plaque boundaries in all arteries, even those with extensive calcification that precluded IVUS interpretation. It also revealed the expected heterogeneity of atherosclerotic plaque content that was noted during ex vivo validation. Again, IVUS did not disclose this heterogeneity. The level of interobserver and intraobserver agreement in the interpretation of plaque composition was high for IVMRI but poor for IVUS. CONCLUSIONS: IVMRI can reliably identify plaque composition and size in arteries deep within the body. Identification of plaque components by IVMRI in vivo has important implications for the understanding and modification of human atherosclerosis.

Adult↗
PubMed2005

On the strong field dependence and nonlinear response to gadolinium contrast agent of proton transverse relaxation rates in dairy cream.

Dairy cream, as a suspension of lipid droplets in water, is a potentially useful magnetic resonance imaging (MRI) phantom material and an interesting material for studying fundamental relaxation mechanisms. Here we report a strong increase in the transverse relaxation rates with field strength for both the water and lipid protons in dairy cream. Also, studies at 4.7 T reveal a nonlinear response of transverse relaxation rates with increasing concentration of a common gadolinium (Gd)-based contrast agent, including an initial decrease of water relaxation rates as measured with Hahn spin echoes at the lower Gd concentrations. The results are treated within the framework of a model in which the magnetic susceptibility difference between the lipid droplets and the aqueous phase plays the prominent role for transverse relaxation. Second-order polynomial fits of the water proton transverse relaxation rate dependence on field strength and on Gd concentration at 4.7 T provided experimental parameters from which model parameters are extracted and compared with expectations available from the literature.

Contrast Media↗
PubMed2004

MR imaging--guided breast ablative therapy.

The integration of imaging and thermal therapy can provide a minimally invasive or even noninvasive alternative to breast surgery for small tumors. Ongoing trials seek to show safety and efficacy for laser, radiofrequency, microwave, cryoablation, and focused ultrasound surgery. To be successful, these therapies must achieve equivalent or even greater efficacy as surgical outcomes and must demonstrate total ablation of the dominant lesion with negative margins, while sparing normal tissue beyond the target tissue. Procedures have been validated by histopathology subsequent to resection.

Breast↗
PubMed2003

Superconducting RF coils for clinical MR imaging at low field.

RATIONALE AND OBJECTIVES: A number of recent reports in the MRI literature have established that substantial signal-to-noise ratio (SNR) gains can be achieved with small samples or low resonance frequencies, through the use of high-quality factor high-temperature superconducting (HTS) RF receive coils. We show the application of HTS coils to the imaging of human subjects with improved SNR compared with copper coils. MATERIALS AND METHODS: HTS coils were constructed from 7.62-cm YBa2Cur3O7-delta thin films on LaAlO3 substrate and cooled in a liquid nitrogen cryostat. Human and phantom images were acquired on a 0.2-T scanner. The SNR improvements compared with equivalent-sized copper coils are reported. RESULTS: SNR gains of 2.8-fold and 1.4-fold were observed in images of a phantom acquired with an HTS coil versus a room temperature copper coil and a liquid nitrogen-cooled copper coil, respectively. Preliminary results suggest higher image quality can be obtained in vivo with an HTS coil compared with copper coil imaging. Images of human orbit, brain, temporomandibular joint, and wrist are presented. CONCLUSION: The experimental results show that benefits can be expected from application of HTS surface coils in human MR imaging with low-field scanners. These potential benefits justify the continued development of practical HTS coil imaging systems despite the considerable technical difficulties involved in cryostat and coil design.

Brain↗
PubMed2002

Intraoperative magnetic resonance imaging and magnetic resonance imaging-guided therapy for brain tumors.

Since their introduction into surgical practice in the mid 1990s, intraoperative MRI systems have evolved into essential, routinely used tools for the surgical treatment of brain tumors in many centers. Clear delineation of the lesion, "under-the-surface" vision, and the possibility of obtaining real-time feedback on the extent of resection and the position of residual tumor tissue (which may change during surgery due to "brain-shift") are the main strengths of this method. High-performance computing has further extended the capabilities of intraoperative MRI systems, opening the way for using multimodal information and 3D anatomical reconstructions, which can be updated in "near real time." MRI sensitivity to thermal changes has also opened the way for innovative, minimally invasive (LASER ablations) as well as noninvasive therapeutic approaches for brain tumors (focused ultrasound). Although we have not used intraoperative MRI in clinical applications sufficiently long to assess long-term outcomes, this method clearly enhances the ability of the neurosurgeon to navigate the surgical field with greater accuracy, to avoid critical anatomic structures with greater efficacy, and to reduce the overall invasiveness of the surgery itself.

Brain↗
PubMed2002

Feasibility of MR imaging-guided breast lumpectomy for malignant tumors in a 0.5-T open-configuration MR imaging system.

RATIONALE AND OBJECTIVES: The authors performed this study to develop the technology for and evaluate the utility of a 0.5-T vertical open-configuration magnetic resonance (MR) imaging system for imaging-guided breast lumpectomy of malignant tumors. MATERIALS AND METHODS: Twenty women with breast cancer underwent MR imaging-guided lumpectomy in a 0.5-T vertical open-configuration MR system. During lumpectomy, pre- and postresection images were acquired with and without contrast material. Images were used both for tumor localization and to monitor resection. If residual enhancement was observed, additional resection was performed in an effort to secure negative pathologic margins. RESULTS: The procedure evolved over time with technology innovations and improvements. Specifically, instruments were acquired that were compatible with MR imaging breast procedures, the echo time with the Dixon technique was modified to optimize image quality, contrast material injection was timed for maximum lesion enhancement, breath-hold image acquisition was instituted, and the biopsy cavity was filled with saline and the incision closed before image acquisition. CONCLUSION: All breast lesions were identified despite limited spatial resolution and fat-suppression techniques. The evolved techniques facilitated intraoperative margin evaluation and prompted additional surgical margin resection in five patients, sparing four from an additional surgical procedure. Intraoperative MR imaging has the potential to improve the complete pathologic excision of invasive breast cancer.

Breast Neoplasms↗