Image Overlay for MRI-Guided Needle Insertions

描述（由申请人提供）：磁共振成像（MRI）已成为许多软组织、骨和关节疾病成像的金标准，但迄今为止，利用这种出色的成像模式进行介入手术的成功有限。与此同时，MRI对患者的访问有限，并且强磁场阻止了传统材料和电子设备的使用，这给研究带来了巨大的挑战。目前，不存在紧急的技术解决方案来以准确、简单和经济的方式辅助MRI引导的针放置过程。拟议研究计划的目的是使诊断封闭高场MRI扫描仪可用于指导肌肉骨骼和脊柱干预中的针放置。我们的方法是应用图像叠加技术，使MR图像以正确的对齐和放大率在患者体内虚拟浮动，就好像操作员具有“MRI视觉”来虚拟地切开身体一样。技术假设是，MR图像叠加引导适用于各种基于针的介入手术，并且在常规封闭式高场MRI扫描仪上进行肌肉骨骼和脊柱介入时，其允许适当的手术准确性和一致性。证明我们的技术假设的具体目标如下：（1）开发临床上适当的集成图像叠加系统，以指导高场（1.5T-3 T）封闭式MRI扫描仪上的针插入。(2)优化程序工作流程，并在体模和人体尸体上对系统进行技术确认。(3)在关节造影、MSK活检（肉瘤）、椎体活检和椎间隙抽吸手术中对人类受试者进行临床系统性能评价试验。拟议研究的潜在社会效益是显著的。我们的长期目标是生产普遍适用的技术，用于室内MRI引导下的针放置。随着MRI逐渐变得经济实惠，MR图像叠加技术可以促进涉及经皮穿刺针插入的各种诊断和治疗干预。一个有效的，简单的，负担得起的引导系统将提供更大的访问设施使用目前的安装基地的磁铁。它还可以减少从业者之间的差异，促进培训，并通过在MR引导下提供精确放置的微创经皮导管作为研究验证工具。

DESCRIPTION (provided by applicant): Magnetic Resonance Imaging (MRI) has become the gold standard in the imaging of many soft tissues, osseous and joint conditions, but to date there has been limited success in harnessing this excellent imaging modality for interventional procedures. At the same time, MRI poses formidable research challenges by limited access to the patient and a strong magnetic field that prevents the use of conventional materials and electronic equipment. Currently, no exigent technical solution exists to assist MRI-guided needle placement procedures in an accurate, simple, and economical manner. The objective of the proposed research program is to make diagnostic closed high-field MRI scanners available for guiding needle placement in musculoskeletal and spinal interventions. Our approach is to apply image overlay technique to make an MR image virtually float inside the patient in correct alignment and magnification, as if the operator had "MRI vision" to virtually slice through the body. The technical hypothesis is that MR image overlay guidance is suitable for a variety of needle-based interventional procedures and it allows for appropriate procedural accuracy and consistency in musculoskeletal and spinal interventions on conventional closed high-field MRI scanners. The specific aims toward proving our technical hypothesis are the following: (1) Develop a clinically adequate and integrated image overlay system to guide needle insertion on high-field (1.5T-3T) closed MRI scanners. (2) Refine procedural workflow and perform technical validation of the system on phantoms and human cadavers. (3) Perform clinical system performance evaluation trial on human subjects in joint arthrography, MSK biopsy (sarcoma), vertebral biopsy, and disk space aspiration procedures. The potential societal benefit of the proposed research is significant. Our long-term objective is to produce generally applicable technology for in-room MRI-guided needle placement. As MRI is becoming gradually affordable, the MR image overlay technique may facilitate a wide array of diagnostic and therapeutic interventions involving percutaneous needle insertion. An effective, simple, and affordable guidance system would provide greater access for facilities using the current install base of magnets. It can also reduce variability among practitioners, facilitate training, and serve as a research validation tool by providing precisely placed minimally invasive percutaneous conduit under MR guidance.