Image Overlay for MRI-Guided Needle Insertions

描述(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黄金标准，但迄今为止，将这种优秀的成像方式用于介入手术的成功有限。与此同时，核磁共振成像带来了巨大的研究挑战，因为接触患者的途径有限，而且强磁场阻止了传统材料和电子设备的使用。目前，还没有迫切的技术解决方案来帮助MRI引导的置针程序以准确、简单和经济的方式进行。拟议研究计划的目标是使诊断性闭合高场磁共振扫描仪可用于指导肌肉骨骼和脊柱干预中的针头放置。我们的方法是应用图像叠加技术，使磁共振图像以正确的对准和放大方式漂浮在患者体内，就像操作员拥有“MRI视力”，可以虚拟地切开身体。技术假设是，MR图像覆盖引导适用于各种基于针头的介入操作，并允许在传统封闭式高场磁共振扫描仪上进行肌肉骨骼和脊柱干预时具有适当的操作准确性和一致性。为了验证我们的技术假设，我们的具体目标是：(1)开发一个临床上适用的、集成的图像叠加系统，用于指导高场(1.5T-3T)闭合磁共振扫描仪的置针。(2)完善程序工作流程，在人体模型和人体身体上进行系统的技术验证。(3)在关节造影、MSK活检(肉瘤)、椎体活检和椎间盘抽吸术中对受试者进行临床系统性能评估试验。这项拟议研究的潜在社会效益是显著的。我们的长期目标是为室内MRI引导的针头放置提供普遍适用的技术。随着MRI逐渐变得负担得起，MR图像覆盖技术可能会促进涉及经皮针插入的广泛诊断和治疗干预。一个有效、简单和负担得起的导航系统将为使用当前磁铁安装基础的设施提供更多的通道。它还可以减少从业者之间的可变性，促进培训，并通过在MR指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.