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Biomedical subjects

Frank K Wacker

Publications and source records attributed to Frank K Wacker.

18 recordsLinked to original sources

Toward rapid high resolution in vivo intravascular MRI: evaluation of vessel wall conspicuity in a porcine model using multiple imaging protocols.

PURPOSE: To assess magnetic resonance (MR) pulse sequences for high resolution intravascular imaging. MATERIALS AND METHODS: Intravascular imaging of the abdominal aorta and iliac arteries was performed in vivo in a porcine model at 1.5 T using catheter-mounted micro-receive coils. Ten protocols, including spin-echo (SE)-echo planar imaging (SE-EPI), segmented EPI, half-Fourier single-shot turbo spin-echo (HASTE), fast imaging with steady-state free precession (TrueFISP), turbo spin-echo (TSE), and SE acquisition schemes were employed in 13 trials. Images were analyzed by six expert raters with respect to wall-conspicuity, wall-to-lumen/tissue contrast, visible layers of the arterial wall, anticipated clinical usefulness, and overall image quality. Mean differences between sequence-types were evaluated using analysis of variance (ANOVA) between groups with planned comparisons. RESULTS: The vessel wall was delineated in almost all protocols. Motion artifacts from physiological and device motion were reduced in fast techniques. The best contrast between the wall and surrounding tissue was provided by a HASTE protocol. Anatomic layers of the vessel wall were best depicted on dark blood T2-weighted TSE. Overall, TrueFISP was ranked highest on the remaining measures. CONCLUSION: Dedicated catheter-coils combined with fast sequences have potential for in vivo characterization of vessel walls. TrueFISP offered the best overall image quality and acquisition speed, but suffered from the inability to delineate the multiple layers of the wall, which seems associated with dark blood- and T2-weighted contrast. We believe future intra-arterial trials should proceed from this study in normal artery imaging and initially focus on fast T2-weighted dark blood techniques in trials with pathology.

Analysis of Variance↗

In vivo cardiovascular catheterization under real-time MRI guidance.

PURPOSE: To test the hypothesis that cardiac and coronary catheterization can be successfully performed under real-time MR guidance using a conventional x-ray angiographic catheter. MATERIALS AND METHODS: Cardiac and coronary catheterization was conducted on eight farm pigs using a real-time True FISP sequence. A pigtail catheter was used for both left- and right-heart catheterizations performed on all eight animals, while an Amplatz or Judkins catheter was used for the right coronary catheterization that was attempted on five animals. The intravascular devices were visualized by means of their native susceptibility artifacts. For right coronary artery catheterizations, 25% diluted gadolinium (Gd) contrast material was injected to confirm engagement of the right coronary artery. RESULTS: Cardiac catheterization of both the right- and left-heart chambers was successfully performed in all eight pigs. In addition, right coronary catheterization was successfully completed in four of the five pigs in which it was attempted. The procedure time for cardiac catheterization was one minute, while the time range required for coronary catheterization was 32-91 minutes. CONCLUSION: This work demonstrates that MRI-guided cardiac catheterization using conventional X-ray angiographic catheters is feasible; however, coronary catheterization with this passive-tracking technique is limited.

Animals↗

An augmented reality system for MR image-guided needle biopsy: initial results in a swine model.

PURPOSE: To evaluate an augmented reality (AR) system in combination with a 1.5-T closed-bore magnetic resonance (MR) imager as a navigation tool for needle biopsies. MATERIALS AND METHODS: The experimental protocol had institutional animal care and use committee approval. Seventy biopsies were performed in phantoms by using 20 tube targets, each with a diameter of 6 mm, and 50 virtual targets. The position of the needle tip in AR and MR space was compared in multiple imaging planes, and virtual and real needle tip localization errors were calculated. Ten AR-guided biopsies were performed in three pigs, and the duration of each procedure was determined. After successful puncture, the distance to the target was measured on MR images. The confidence limits for the achieved in-plane hit rate and for lateral deviation were calculated. A repeated measures analysis of variance was used to determine whether the placement error in a particular dimension (x, y, or z) differed from the others. RESULTS: For the 50 virtual targets, a mean error of 1.1 mm +/- 0.5 (standard deviation) was calculated. A repeated measures analysis of variance indicated no statistically significant difference (P > .99) in the errors in any particular orientation. For the real targets, all punctures were inside the 6-mm-diameter tube in the transverse plane. The needle depth was within the target plane in 11 biopsy procedures; the mean distance to the center of the target was 2.55 mm (95% confidence interval: 1.77 mm, 3.34 mm). For nine biopsy procedures, the needle tip was outside the target plane, with a mean distance to the edge of the target plane of 1.5 mm (range, 0.07-3.46 mm). In the animal experiments, the puncture was successful in all 10 cases, with a mean target-needle distance of 9.6 mm +/- 4.85. The average procedure time was 18 minutes per puncture. CONCLUSION: Biopsy procedures performed with a combination of a closed-bore MR system and an AR system are feasible and accurate.

Animals↗

Combined use of the intravascular blood-pool agent, gadomer, and carbon dioxide: a novel type of double-contrast magnetic resonance angiography (MRA).

PURPOSE: To evaluate the combined use of carbon dioxide (CO(2)) and a gadolinium-based blood-pool agent for magnetic resonance angiography (MRA). MATERIALS AND METHODS: After an initial intravenous injection of the blood-pool agent Gadomer (Schering AG, Germany), repeated transcatheter CO(2) injections were performed in the aorta and the renal arteries of two fully-anesthetized pigs. Real-time images were acquired using a true fast imaging with steady-state precession (FISP) sequence. RESULTS: During the CO(2) injections, the Gadomer-enhanced blood was totally replaced, resulting in an immediate, temporary, total signal loss in the vessel lumen. Susceptibility artifacts during the injections or catheter manipulations rarely occurred. CONCLUSION: Due to T1-shortening, the circulating blood-pool agent prevents flow artifacts during catheter manipulations because the steady-state is reached much earlier. Therefore, this double-contrast MRA method improves catheter conspicuity and might be helpful for guiding and controlling intravascular procedures during interventional MRI.

Animals↗

MR imaging-guided percutaneous angioplasty and stent placement in a swine model comparison of open- and closed-bore scanners.

RATIONALE AND OBJECTIVES: The purpose of this study is to compare the feasibility and precision of renal artery angioplasty and stent placement using two different MR scanners. MATERIALS AND METHODS: MR imaging-guided angioplasty and stent placements were performed on seven pigs using 0.2 and 1.5 T scanners (Magnetom Open and Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany). For guidance of catheters, guide wires and stents susceptibility artifact-based tracking was used. The end point of each intervention was to position a stent in the renal artery with its proximal end at the level of the aortic wall. Procedure time and stent position were evaluated. RESULTS: Catheterization, angioplasty, and stent placement were feasible using MRI guidance at both 0.2 and 1,5 Tesla. At 1.5 T all catheter manipulations and interventions were performed in less than 30 minutes. At 0.2 T the interventions took up to 90 minutes. No significant difference in the stent deviation was noted between the two scanners. CONCLUSION: The use of a high-performance 1.5 T scanner helped to reduce the procedure time to half of that of a low-field system. Since no difference in stent placement precision was noted, a dedicated MR-stent might be mandatory for more precise stent placement.

Angioplasty, Balloon↗

MR-guided endovascular interventions: device visualization, tracking, navigation, clinical applications, and safety aspects.

Reliable visualization and tracking are essential for guiding endovascular devices within blood vessels. The most commonly used methods are susceptibility artifact-based tracking that relies on the artifact created within the image by the device and microcoil- or antenna-based tracking that uses the high signal generated by small MR endovascular receive coils when the transmit coil emits a nonselective radiofrequency pulse. To date, the use of endovascular MR guidance techniques has primarily been confined to animal experiments. There are only a few reports on MR-guided endovascular applications in patients. Therefore, access to the patient within the scanner, dedicated devices, and safety issues remain major challenges. To face these challenges, attention from all radiologists, especially interventional radiologists, is required to make MR-guided endovascular procedures a clinical reality.

Animals↗

Inter- and Intra-Observer Variability Assessment of in Vivo Carotid Plaque Burden Quantification Using Multi-Contrast Dark Blood MR Images.

UNLABELLED: The chapter presents the research to test the hypotheses that (1) vessel wall volume measurements from dark blood MR images with multiple contrast-weightings (T1W, T2W and PDW) are highly reproducible, and that (2) the intra-observer and inter-observer variability of carotid wall volume measurements will be less than those obtained with maximum wall area (MaxWA) measurements. METHODS: Sixteen patients (aged 72 +/- 7years) with carotid stenosis documented by duplex ultrasound were recruited for the study. Dark blood T1W, PDW and T2W MR images were used to measure carotid wall volume and MaxWA by two independent observers for inter-observer and intra-observer variability assessment. RESULTS: The intra-observer absolute difference of carotid wall volume for T1W, T2W and PDW images were 67.3 +/- 47.5 mm(3) (2.3 +/- 1.8%), 63.2 +/- 52.2 mm(3) (2.0 +/- 1.3%), and 69.8 +/- 45.2 mm(3) (2.4 +/- 1.7%) respectively. The inter-observer absolute difference of carotid wall volume for T1W, T2W and PDW images were 103.5 +/- 141.8 mm(3) (3.0 +/- 3.1%), 95.9 +/- 102.1 mm(3) (3.1 +/- 2.6%), and 132.1 +/- 87.8 mm(3) (4.3 +/- 2.7%) respectively. The intra-observer absolute difference of carotid MaxWA for T1W, T2W and PDW images were 6.9 +/- 5.0 mm(2) (4.2 +/- 2.9%), 5.1 +/- 4.2 mm(2) (3.1 +/- 2.3%) and 7.5 +/- 4.7 mm(2) (4.2 +/- 2.7%) respectively. The inter-observer absolute difference of carotid MaxWA for T1W, T2W and PDW images were 9.5 +/- 4.2 mm(2) (5.8 +/- 2.3%), 6.4 +/- 6.1 mm(2) (3.8 +/- 3.1%) and 10.8 +/- 7.3 mm(2) (6.1 +/- 3.7%) respectively. Both intra- and inter-observer variability in carotid volume measurement tend to be smaller than that in carotid MaxWA measurement with intraclass correlation coefficients ranged 0.932 to 0.987 for volume measurement and 0.822 to 0.946 for MaxWA measurement.

Carotid Artery Diseases↗

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.

Animals↗

Percutaneous MR imaging-guided radiofrequency interstitial thermal ablation of tongue base in porcine models: implications for obstructive sleep apnea syndrome.

PURPOSE: To test the feasibility and safety of a percutaneous magnetic resonance (MR) imaging-guided technique for radiofrequency (RF) interstitial thermal ablation of the tongue base and to correlate MR appearance of induced thermal lesions with histopathologic findings in pigs in acute and chronic porcine models. MATERIALS AND METHODS: A 1-cm-tip RF electrode was inserted percutaneously into the tongue in 10 pigs with 0.2-T real-time MR guidance. The RF electrode was advanced up the midline between lingual arteries and stopped short of tongue mucosa. RF interstitial thermal ablation was performed at 90 degrees C +/- 2 and lasted 10 minutes. Postablation images were obtained with a 1.5-T MR imager. Five pigs were sacrificed immediately (acute model), while five were followed up for 1 month (chronic model) before they were sacrificed. MR-compatible fiducial coils were inserted into tongues with MR imaging guidance prior to RF ablation in the chronic group. Tongues were harvested for histopathologic analysis. Mean thermal lesion volume was compared with the Student t test on images obtained immediately, 2 weeks, and 1 month after RF ablation. Interclass correlation coefficients of lesion diameters at gross pathologic analysis and corresponding diameters with each pulse sequence were calculated. RESULTS: Successful MR imaging-guided electrode positioning was achieved in all procedures without intra- or postprocedure complications because there was high vascular conspicuity and tissue contrast. Thermal lesions appeared hypointense with hyperintense surrounding rims with all sequences in both groups. At pathologic analysis, acute lesions appeared as pale necrotic areas surrounded by hyperemic rims, while chronic lesions demonstrated progressive circumferential fibrosis and significant volume shrinkage (P <.01). Thermal lesion diameters measured at gross pathologic analysis best agreed with corresponding diameters measured on short inversion time inversion-recovery images (interclass correlation coefficient = 0.85). CONCLUSION: The results of this investigation demonstrate MR imaging-guided RF interstitial thermal ablation of the tongue base is feasible and safe and illustrate imaging and pathologic phenomena associated with creation and evolution of the induced thermal lesions.

Animals↗

The catheter-driven MRI scanner: a new approach to intravascular catheter tracking and imaging-parameter adjustment for interventional MRI.

OBJECTIVE: Our aim was to test the feasibility of a hands-free approach to MRI that allows the interventionalist to track an angiographic catheter in real time throughout the procedure and to automatically change imaging parameters by catheter manipulation. MATERIALS AND METHODS: A tracking method that is based on an active device localization was implemented on a 1.5-T MRI scanner. The system determines the current position and orientation of a catheter in 3D space in an endless feedback loop. Automatic scanning plane-adjustment procedures written in the software of the MRI system ensure image acquisition at the location of the catheter tip. The system calculates the device velocity to automatically adjust parameters such as field of view (FOV) and resolution. To evaluate the feasibility and performance in vivo and ex vivo, we performed experiments in two vessel phantoms and on six pigs. RESULTS: The system collected the tracking data within 40 msec; an additional 10-20 msec was then required to perform the localization and velocity calculations and to update the image parameters. The system could localize a motionless catheter in the aorta in 100% and a moving catheter in 98% of measured attempts. The system responded in real time to changes in device velocity by dynamically adjusting spatial resolution and FOV in both phantom and porcine trials. Using this technique, we successfully catheterized the renal artery in two pigs. CONCLUSION: Active tracking, combined with automatic scanning plane and imaging parameter adjustment, provides an intuitive MRI scanner interface for the guidance of the vascular procedure.

Algorithms↗

MRI-guided radiofrequency thermal ablation of normal lung tissue: in vivo study in a rabbit model.

OBJECTIVE: The purpose of this study was to assess the feasibility of MRI to guide and monitor radiofrequency ablation of normal pulmonary tissue in a rabbit model. MATERIALS AND METHODS: Percutaneous puncture and lung radiofrequency ablation were performed in six New Zealand white rabbits under MRI control using a 0.2-T open MRI scanner. Technical feasibility and complication detection were evaluated. The ablation zone appearance and size were assessed using MRI, CT, and gross pathology. Interclass correlation coefficients (ICCs) of the maximum short-axis diameters of the lesions on gross pathology and the corresponding diameters as measured on each MRI pulse sequence and on CT scans were calculated. RESULTS: MRI guidance of percutaneous puncture and radiofrequency ablation of pulmonary tissue is feasible. A pneumothorax was detected and treated using MRI. In the specimen, the mean coagulation necrosis diameter was 9.8 mm. The T1-weighted spoiled gradient-echo fast low-angle shot images showed the highest ICC (0.81) for the thermal lesion diameter. CONCLUSION: Our results indicate that MRI guidance is feasible and useful for radiofrequency ablation of normal pulmonary tissue.

Animals↗

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.

Animals↗

Endoscopically inserted endoluminal receiver coil for high-resolution magnetic resonance imaging of the pancreas: Initial results in an animal model.

BACKGROUND: This study assessed the feasibility of high-resolution magnetic resonance imaging of the pancreas by means of an endoscopically inserted endoluminal magnetic resonance receiver coil. METHOD: A 0.032-inch diameter internal magnetic resonance imaging receiver coil was endoscopically inserted into the pancreatic duct in 4 pigs through the accessory channel of a standard duodenoscope to obtain high-resolution magnetic resonance images by using T1- and T2-weighted sequences. RESULTS: The pig anatomy precluded the usual transoral approach; however, transgastric access allowed endoscopic transpapillary insertion of a receiver coil into the pancreatic duct in all animals without the need for sphincterotomy. The small swine pancreas could then be visualized by magnetic resonance imaging with a 0.3 x 0.3-mm in-plane resolution. CONCLUSION: High-resolution pancreas magnetic resonance imaging is feasible by using an endoscopically inserted endoluminal receiver coil. The smaller stomach and larger pancreatic duct diameter in humans will facilitate clinical application of the imaging procedure.

Animals↗

MR image-guided endovascular procedures with the ultrasmall superparamagnetic iron oxide SH U 555 C as an intravascular contrast agent: study in pigs.

PURPOSE: To evaluate the feasibility of using the ultrasmall superparamagnetic iron oxide (USPIO) SH U 555 C as an intravascular contrast agent for magnetic resonance (MR) image-guided vascular procedures with an open MR imaging system. MATERIALS AND METHODS: All experiments were performed with MR imaging at 0.2 T. MR image-guided interventions were performed in USPIO-enhanced vessels in four pigs. With near real-time MR image guidance (acquisition time, 0.64 second per section), the splenic and renal arteries were consecutively catheterized by using a susceptibility artifact-based catheter-guide wire combination. Angioplasty and stent implantation were performed four times in the renal artery and twice in the iliac artery. Intraaortal signal intensity (SI) was measured during the interventions. RESULTS: After administration of SH U 555 C (40 micromol of iron per kilogram of body weight), a three-dimensional MR angiographic sequence was performed that allowed visualization of the abdominal and pelvic vessels that were as small as 2 mm in diameter. Catheterization, angioplasty, and stent implantation were successfully guided in the USPIO-enhanced vasculature. Sixty minutes after contrast agent injection, the mean aortic SI was 70% of the maximum measured enhancement levels. CONCLUSION: One intravenous injection of SH U 555 C enabled long, continuous intravascular SI enhancement at MR angiography, and, in combination with susceptibility artifact-based device tracking, the injection allowed the performance of MR imaging-guided intravascular interventions in an open MR imaging system.

Animals↗

MR imaging-guided vascular procedures using CO2 as a contrast agent.

OBJECTIVE: The purpose of this study was to test the use of CO(2) as a black blood contrast agent for MR imaging-guided vascular procedures in an animal model. MATERIALS AND METHODS: Repeated intraarterial CO(2) injections were performed through a catheter located in the aorta and the renal arteries of three fully anesthetized pigs. Real-time images were acquired using a steady-state free precession sequence. RESULTS: During the CO(2) injections, the bright blood in the aorta and the main renal artery was totally replaced, and this procedure resulted in an immediate, statistically significant signal loss in the vessel lumen. In more peripheral vessels, CO(2) improved the vessel conspicuity substantially. Confirmation of vessel patency distal to the catheter tip position was possible. CONCLUSION: The use of carbon dioxide in combination with a bright blood MR imaging sequence improves vessel conspicuity and provides immediate information about blood flow distal to the catheter. This technique may be used to facilitate MR imaging-guided intravascular procedures.

Animals↗

Use of a blood-pool contrast agent for MR-guided vascular procedures: feasibility of ultrasmall superparamagnetic iron oxide particles.

RATIONALE AND OBJECTIVES: The purpose of this study was to examine the dose dependency of the intravascular signal intensity after injection of ultrasmall superparamagnetic iron oxide (USPIO) particles (SH U 555 C) in a rabbit model studied with a low-field-strength magnetic resonance (MR) imaging system. The results were used to facilitate MR-guided vascular procedures in a pig. MATERIALS AND METHODS: All experiments were performed at 0.2 T. To determine the optimum USPIO (or SH U 555 C) dose for intravascular interventions, the authors acquired coronal three-dimensional MR angiographic images in 12 rabbits after injection of four dose levels (10, 20, 30, and 40 micromol of iron per kilogram body weight). The intraaortic signal intensities were measured in user-defined regions of interest. For numerical analysis, signal intensity enhancement was computed. Subsequently MR image-guided procedures were performed in USPIO-enhanced vessels in one pig. RESULTS: The signal intensity evaluation shows a clear-cut dose dependence in both early and late phases after administration of SH U 555 C. A high-spatial-resolution MR angiogram acquired 20 minutes after injection yielded the best results with the highest dose (40 micromol of iron per kilogram); at that dose, intravascular enhancement was sufficient for vascular procedures for 60 minutes after injection. CONCLUSION: SH U 555 C is a promising contrast agent for MR angiography and MR-guided vascular procedures in an open low-field-strength MR imager.

Animals↗

Use of intra-articular carbon dioxide and air for MR arthrography: a feasibility study.

During animal experiments, carbon dioxide (CO(2)) and air were used as a novel contrast agent for direct magnetic resonance arthrography (MRAr). MRAr was performed after injection of CO(2) and air in the knee joints of two pigs. MR images of phantoms containing air, CO(2) and nitrogen were compared. After intra-articular injection, both present as a signal void on various sequences and permit sharp delineation of cartilage and other adjacent structures. Despite the potential for artefact generation, only a slight susceptibility artefact was seen after injection of CO(2) and air. In phantom experiments, air, CO(2) and nitrogen demonstrated identical slight regular susceptibility artefacts at the phantom margins. CO(2) MRAr can yield high contrast between cartilage, ligaments and synovium relative to the joint compartment. Therefore, this technique might be useful as an investigational method for the evaluation of cartilage surface lesions and possibly as an alternative contrast agent for clinical use.

Air↗

A new type of susceptibility-artefact-based magnetic resonance angiography: intra-arterial injection of superparamagnetic iron oxide particles (SPIO) A Resovist in combination with TrueFisp imaging: a feasibility study.

The goal of this study was to evaluate the use of super paramagnetic particles of iron oxide (SPIO) as a dark blood contrast agent, in combination with a bright blood steady-state free precession sequence for magnetic resonance angiography (MRA), in an animal model. The original concentration of the SPIO of 500 mmol Fe/l and dilutions to 250, 125, 60, 30, 10 and 5 mmol Fe/l were intra-arterially injected into the aorta of a pig. Then the dilution of 10 mmol Fe/l was chosen for repeated intra-arterial injections into two pigs. During these intra-arterial SPIO injections MR images were acquired with a 1.5 T scanner. Signal intensity measurements were performed in the aorta. The signal-to-noise ratio during SPIO bolus passage was significantly less than during baseline conditions (Fisher's F-ratio 159.8, p < 0.005) or the recovery signal-to-noise ratio (Fisher's F-ratio 144.6, p < 0.005). Also, confirmation of flow distal to the catheter-tip position was possible. The use of SPIO as a dark blood agent in combination with a bright blood MR imaging sequence is feasible. Temporary loss of intraluminal signal occurs due to local decrease of the signal because of induction of local inhomogeneities after mixture the present blood and SPIO solution. It provides immediate information about blood flow distal to the catheter and is a potentially useful to guide intravascular MR-interventional procedures.

Animals↗