Biomedical subjects

Stephen F Keevil

Publications and source records attributed to Stephen F Keevil.

6 recordsLinked to original sources

PubMed2006

Spatial localization in nuclear magnetic resonance spectroscopy.

The ability to select a discrete region within the body for signal acquisition is a fundamental requirement of in vivo NMR spectroscopy. Ideally, it should be possible to tailor the selected volume to coincide exactly with the lesion or tissue of interest, without loss of signal from within this volume or contamination with extraneous signals. Many techniques have been developed over the past 25 years employing a combination of RF coil properties, static magnetic field gradients and pulse sequence design in an attempt to meet these goals. This review presents a comprehensive survey of these techniques, their various advantages and disadvantages, and implications for clinical applications. Particular emphasis is placed on the reliability of the techniques in terms of signal loss, contamination and the effect of nuclear relaxation and J-coupling. The survey includes techniques based on RF coil and pulse design alone, those using static magnetic field gradients, and magnetic resonance spectroscopic imaging. Although there is an emphasis on techniques currently in widespread use (PRESS, STEAM, ISIS and MRSI), the review also includes earlier techniques, in order to provide historical context, and techniques that are promising for future use in clinical and biomedical applications.

Algorithms↗

PubMed2006

Interactive MR imaging and tracking of catheters with multiple tuned fiducial markers.

PURPOSE: The lack of magnetic resonance (MR) safe catheters and guide wires remains an important obstacle to widespread clinical use of MR-guided endovascular procedures. The authors looked at the feasibility of using multiple tuned fiducial markers (TFM) and novel imaging sequences to track catheters reliably under MR and to evaluate the safety of such markers in terms of heating. MATERIALS AND METHODS: The visualization and tracking of a catheter with six quadrature tuned fiducial coils was carried out in a special designed in-vitro setup within a 1.5-T MR imager simulating an MR-guided endovascular intervention. The fiducial markers were also tested for heating. RESULTS: The excellent signal contrast between the fiducial and the background when using novel interleaved real time and interactive sequences allowed for rapid and reliable identification of the fiducial markers and therefore the catheter. No significant heating of the marker was noted. CONCLUSIONS: The authors have shown that catheters with multiple tuned fiducial markers are superior to passive catheter designs in terms of visualization and do not carry the risk of heating that is commonly associated with active catheters.

Cardiac Catheterization↗

PubMed2005

Impact of electromagnetic field exposure limits in Europe: is the future of interventional MRI safe?

The European Union (EU) has recently introduced a directive that aims to protect workers from adverse effects of exposure to electromagnetic fields. All countries within the EU are required to incorporate this directive into their national law by 2008. This legislation applies to all types of occupational exposure to electromagnetic fields with frequencies from 0 Hz to 300 GHz. It has dramatic implications for interventional magnetic resonance (MR) imaging, because workers who are close to the MR scanner while scanning is taking place are exposed at levels substantially above the exposure limits. This is especially the case for time-varying magnetic fields in the 110 Hz-5 kHz range, which includes the field from the imaging gradients. In this article, the scientific evidence on which the limits are based is brought into question. It is concluded that an urgent review of the directive is required and that more research, especially at MR gradient frequencies, is needed.

Electromagnetic Fields↗

PubMed2004

Visualization and tracking of an inflatable balloon catheter using SSFP in a flow phantom and in the heart and great vessels of patients.

Passive catheter tracking involves direct interaction between the device and its surroundings, creating a local signal loss or enhancement of the image. Using only standard balloon catheters filled with CO(2) and imaged with a steady-state free precession sequence, it was possible to visualize and passively track catheters in a flow phantom and in the heart and great vessels of 20 patients without any additional image processing. The phantom work demonstrated that it was advantageous to sacrifice spatial resolution in order to increase temporal resolution. Frame rates greater than 10/sec were necessary for ease of catheter manipulation. Although only the tip of the catheter was visualized, this technique proved to be effective in patients undergoing cardiac catheterization.

Adolescent↗

PubMed2003

Cardiac catheterisation guided by MRI in children and adults with congenital heart disease.

BACKGROUND: Fluoroscopically guided cardiac catheterisation is an essential tool for diagnosis and treatment of congenital heart disease. Drawbacks include poor soft tissue visualisation and exposure to radiation. We describe the first 16 cases of a novel method of cardiac catheterisation guided by MRI with radiographic support. METHODS: In our cardiac catheterisation laboratory, we combine magnetic resonance and radiographic imaging facilities. We used MRI to measure flow and morphology, and real-time MRI sequences to visualise balloon angiographic catheters. 12 patients underwent diagnostic cardiac catheterisation, two had interventional cardiac catheterisations, and for two patients, MRI was used to plan radiofrequency ablation for treatment of tachyarrhythmias. FINDINGS: In 14 patients, some or all of the cardiac catheterisation was guided by MRI. In two patients undergoing radiofrequency ablation, catheters were manipulated with use of fluoroscopic guidance and outcome was assessed with MRI. All patients received lower amounts of radiation than controls. There was some discrepancy between pulmonary vascular resistance calculated by flow derived from MRI and the traditional Fick method. We were able to superimpose fluoroscopic images of electro physiology electrode catheters on the three dimensional MRI of the cardiac anatomy. INTERPRETATION: We have shown that cardiac catheterisation guided by MRI is safe and practical in a clinical setting, allows better soft tissue visualisation, provides more pertinent physiological information, and results in lower radiation exposure than do fluoroscopically guided procedures. MRI guidance could become the method of choice for diagnostic cardiac catheterisation in patients with congenital heart disease, and an important tool in interventional cardiac catheterisation and radiofrequency ablation.

Adult↗

PubMed2002

Simultaneous PET and NMR.

There is currently great interest in combining data from different imaging modalities, either by image registration methods that are performed after the data has been acquired or using new devices that can acquire data from two modalities simultaneously, or near simultaneously. In this paper a small prototype NMR-compatible PET scanner capable of acquiring PET images simultaneously with either NMR images or NMR spectra is described. In an associated paper [1], Pamela Garlick describes some investigations of cardiac metabolism that have been made using this system. One of the main challenges in constructing an NMR-compatible PET scanner is that photomultiplier tubes, which are an essential element of nearly all current PET systems, will not function in a high magnetic field. In collaboration with Simon Cherry and the Crump Institute of Biomedical Imaging at UCLA Medical School, a small (5.4 cm diameter) NMR-compatible PET scanner that will operate within the bore of an NMR magnet has been developed. Long optical fibres are used to transport light from the scintillation crystals that form the detector head to photomultiplier tubes situated in a low magnetic field region several metres from the magnet. This system has been used to perform simultaneous PET and NMR spectroscopy measurements with a 9.4T spectroscopy system, and has also been used to obtain simultaneous PET and MR images in several MRI scanners including a 4.7T small bore animal imaging system. Current efforts in the development of this technology are directed at experimental studies on small animals, both because this is less demanding technically and because it is in this area that applications are likely to appear first. However, there is no reason in principle why human PET-MR would not be feasible. Below, work with the prototype system and the next stage in its development are described, and some of the future possibilities and challenges are discussed.

Animals↗