ORCID Profile
0000-0002-3272-8085
Current Organisation
University of Miami
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Publisher: Wiley
Date: 29-08-2006
DOI: 10.1002/JMRI.20694
Abstract: 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. 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. 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. 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.
Publisher: Wiley
Date: 13-01-2006
DOI: 10.1002/JMRI.20497
Abstract: To assess magnetic resonance (MR) pulse sequences for high resolution intravascular imaging. 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. 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. 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.
Publisher: Wiley
Date: 20-10-2003
DOI: 10.1002/JMRI.10402
Abstract: 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. 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. 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. 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.
Publisher: SAGE Publications
Date: 02-2009
DOI: 10.1080/02841850802570553
Abstract: Background: Magnetic resonance (MR)-guided interventions have evolved from a pure research application to a preclinical method over the last decade. Among the device-tracking techniques, susceptibility artifact-based tracking relies on the contrast between the surrounding blood and the device, and radiofrequency coil-based tracking relies on the local gradient field lification in a resonating circuit attached to the interventional device. Purpose: To evaluate the feasibility and precision of susceptibility artifact-based and microcoil-based MR guidance methods for renal artery stent placement in a swine model. Material and Methods: MR imaging-guided renal artery stent placements were performed in six fully anesthetized pigs using a 1.5T short-bore MR scanner. Susceptibility artifact-based tracking with manual scan-plane adjustments and microcoil tracking with automatic scan-plane adjustments were used for renal artery stent placements in three pigs in each group. With both methods, near real-time steady-state free-precession (SSFP) imaging was used. Differences between the two tracking approaches on stenting time, total procedure time, and stent position were measured. Results: The microcoil-based approach yielded a shorter mean procedure time (17 vs. 23 min). There was no relevant difference for the mean stenting time (12 vs. 13 min). The mean stent deviation from the aortic wall with the susceptibility approach was larger than with the microcoil approach (10 vs. 4.0 mm). Conclusion: For MRI-guided renal artery stent placement, the microcoil-based technique had a shorter procedure time and a higher stent placement precision than the susceptibility artifact-based approach.
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1016/J.ACRA.2005.05.017
Abstract: The purpose of this study is to compare the feasibility and precision of renal artery angioplasty and stent placement using two different MR scanners. 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. 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. 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.
Publisher: Wiley
Date: 26-03-2004
DOI: 10.1002/MRM.20050
Abstract: 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- litude 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.
Publisher: Elsevier BV
Date: 08-2005
DOI: 10.1016/J.MRIC.2005.04.004
Abstract: 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.
Publisher: American Roentgen Ray Society
Date: 08-2004
DOI: 10.2214/AJR.183.2.1830391
Abstract: 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. 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. 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. Active tracking, combined with automatic scanning plane and imaging parameter adjustment, provides an intuitive MRI scanner interface for the guidance of the vascular procedure.
Publisher: Radiological Society of North America (RSNA)
Date: 02-2004
Publisher: Wiley
Date: 22-03-2006
DOI: 10.1002/JMRI.20554
Abstract: To demonstrate the ability of a unique interventional MR system to be used safely and effectively as the only imaging modality for all phases of MR-guided stent-supported angioplasty. An experimental disease model of renal stenosis was created in six pigs. An interventional MR system, which employed previously reported tools for real-time catheter tracking with automated scan-plane positioning, adaptive image parameters, and radial true-FISP imaging with steady-state precession (True-FISP) imaging coupled with a high-speed reconstruction technique, was then used to guide all phases of the intervention, including: guidewire and catheter insertion, stent deployment, and confirmation of therapeutic success. Pre- and postprocedural X-ray imaging was used as a gold standard to validate the experimental results. All of the stent-supported angioplasty interventions were a technical success and were performed without complications. The average postoperative residual stenosis was 14.9%. The image guidance enabled the stents to be deployed with an accuracy of 0.98 +/- 0.69 mm. Additionally, using this interventional MRI system to guide renal artery stenting significantly reduces the procedure time, as compared to using X-ray fluoroscopy. This study has clearly demonstrated the first successful treatment of renal artery stenting in an experimental animal model solely under MRI guidance and monitoring.
Publisher: Wiley
Date: 20-10-2003
DOI: 10.1002/JMRI.10399
Abstract: To examine the sensitivity of quantitative dynamic contrast enhanced MRI (DCE-MRI) perfusion maps to errors in the various source images and to determine optimal imaging parameters for reducing this sensitivity. A detailed analysis of the precision of a DCE-MRI protocol was performed using the "propagation of errors" technique to investigate the effect of errors in the source images on errors in K(trans). Optimal parameter values and interactions between parameters were examined. The propagation of errors analysis was validated by Monte-Carlo simulations. The precision of K(trans) was found to be most sensitive to artifacts in the tissue portion of the baseline images and least sensitive to noise in the arterial portion of the dynamic images. The tip-angle strongly affected the precision, with the optimum being a function of tissue T1(0). Protocol optimization requires matching the tip-angle to the anticipated T1(0) of the tissue of interest however such optimization yields a relatively small improvement. Future developmental efforts would be most productively focused on minimizing the artifact level.
No related grants have been discovered for Jeffrey Duerk.