Interventional Magnetic Resonance Imaging

In Spring 2001, a unique interventional radiology facility was installed at UCSF, consisting of two main imaging suites, joined with an X-ray / MR-shielded door which combined a 1.5T magnetic resonance imaging system and an X-ray angiography system into one laboratory (Philips MedicalSystems, Intera 1.5T MRI, Integris V5000 angiography system). The suite includes patient anesthesia preparation and holding areas and hardware and software development bays with state of the art equipment (3D rotational X-ray Reconstruction Workstation (SGI), 2 Easy Vision Image Review and Analysis Workstations (Sun), and a Research Workstation (PC) with integrated access to MR data stream).

Our Facilities

The combination of these two units allows rapid transport of patients from one device to the other; seamless transportation of patients is accomplished via a "floating table top," compatible with both MRI and X-ray systems.

With this new facility, both types of images can be acquired withinminutes, without changing the patient's position relative to the examination table. This arrangement will allow the pursuit of severalprimary clinical and research goals, including:

  1. the design of comparative studies of the angiographic capabilities of the two modalities
  2. the definition of medical procedures which could profit from the complementary features of the two systems ("MR-assisted angiography")
  3. the development of hardware and software for "interventional MR" procedures (i.e., interventional procedures performed under MR guidance alone, without the need for X-ray imaging).

This facility combines state of the art X-ray angiography and MRI. New areas of intervention are being exploredas we develop a new dimension for interventional radiology; the use ofmagnetic resonance imaging for interventional procedures is in itsinfancy and represents a new horizon for clinical development.

Research Directions

  • Evaluation of benefit added by using MRI in combination with an interventional angiography suite
  • Development of real-time MRI methods for guiding interventions in the MRI scanner
  • Assessing the use of MR-determined hemodynamic measures for monitoring interventional procedures such as stenting or angioplasty
  • Determination of changes in end-organ perfusion in response to interventional procedures
  • Development of methods for site-specific delivery of therapeutic agents
  • Development of MR guided cardiac catheterization
  • Evaluation of MR monitoring of tumor embolization therapy
  • MR guidance of Deep Brain Stimulator placement

Key References

  • Saeed M, Weber O, Lee R, Do L, Martin A, Saloner D, Ursell P, Robert P, Corot C, Higgins CB. Discrimination of myocardial acute and chronic (scar) infarctions on delayed contrast enhanced magnetic resonance imaging with intravascular magnetic resonance contrast media. J Am Coll Cardiol. 2006; 48(10): 1961-8
  • Acevedo-Bolton G, Jou LD, Dispensa BP, Lawton MT, Higashida RT, Martin AJ, Young WL, Saloner D. Estimating the hemodynamic impact of interventional treatments of aneurysms: Numerical simulation with experimental validation: Technical case report. Neurosurgery. 2006;59:E429-430; author reply E429-430.
  • Saeed M, Martin AJ, Lee RJ, Weber O, Revel D, Saloner D, Higgins CB. MR Guidance of Targeted Injections into Border and Core of Scarred Myocardium in Pigs. Radiology 2006 240(2): 419-26.
  • Saeed M, Henk CB, Weber O, Martin A, Wilson M, Shunk K, Saloner D, Higgins CB. Delivery and assessment of endovascular stents to repair aortic coarctation using MR and X-ray imaging. J Magn Reson Imaging 2006, 24(2): 371-8.
  • Saloner D, Acevedo-Bolton G, Rayz V, Wintermark M, Martin A, Dispensa B, Young W, Lawton M, Rapp J, and Jou, L-D. Imaging and CFD in the analysis of vascular disease progression Proc. SPIE 2006, 6143, 144-153.
  • Saeed M, Lee RJ, Weber O, Do L, Martin A, Ursell P, Saloner D, Higgins CB. Scarred myocardium imposes additional burden on remote viable myocardium despite a reduction in the extent of area with late contrast MR enhancement. Eur Radiol. 2006;16(4):827-36.
  • Martin AJ, Larson PS, Ostrem JL, Sootsman WK, Talke P, Weber OM, Levesque N, Myers J, Starr PA. Placement of deep brain stimulator electrodes using real-time high field interventional MRI. Magn Reson Med, 2005; 54: 1107 - 1114.
  • Henk CB, Higgins CB, Saeed M. Endovascular interventional MRI. J Magn Reson Imaging. 2005 Oct;22(4):451-60.
  • Ko NU, Achrol AS, Martin AJ, Chopra M, Saloner DA, Higashida RT, Young WL. Magnetic Resonance Perfusion Tracks 133Xe Cerebral Blood Flow Changes after Carotid Stenting. Stroke, 2005; 36(3): 676-678.
  • Saeed M, Lee R, Martin AJ, Weber OM, Krombach G, Schalla S, Lee M, Saloner D, Higgins CB. MRI in Guiding and Assessing Intramyocardial Therapy. European Radiology 2005; 15(5):851-63).

 

 

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