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、骨骼和关节状况成像的金标准，但迄今为止，在利用这种优秀的成像方式进行介入性手术方面取得的成功有限。与此同时，由于接触病人的机会有限，以及强大的磁场阻碍了传统材料和电子设备的使用，MRI带来了巨大的研究挑战。目前，还没有紧急的技术解决方案能够以准确、简单和经济的方式协助mri引导下的置针过程。提出的研究计划的目的是使诊断封闭高场MRI扫描仪可用于引导针头放置在肌肉骨骼和脊柱干预。我们的方法是应用图像叠加技术，使磁共振图像以正确的排列和放大方式在患者体内漂浮，就好像操作员拥有“MRI视觉”来虚拟地切片身体一样。技术假设是，MR图像覆盖引导适用于各种基于针的介入程序，并且它允许在常规封闭高场MRI扫描仪上进行肌肉骨骼和脊柱干预时适当的程序准确性和一致性。具体目标是证明我们的技术假设如下：(1)开发一种临床适用的集成图像覆盖系统，用于指导高视场（1.5T-3T）封闭MRI扫描仪上的针头插入。(2)完善程序工作流程，对系统进行鬼怪和人体尸体的技术验证。(3)对人体进行关节造影、MSK活检（肉瘤）、椎体活检和椎间盘间隙抽吸手术的临床系统性能评估试验。拟议研究的潜在社会效益是显著的。我们的长期目标是开发出普遍适用的室内核磁共振引导针头放置技术。随着MRI逐渐变得负担得起，MRI图像覆盖技术可以促进广泛的诊断和治疗干预，包括经皮针插入。一个有效的、简单的和负担得起的引导系统将为使用当前磁铁安装基础的设施提供更多的访问。它还可以减少从业者之间的差异，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.