Percutaneous MR-guided discography in a low-field system using optical instrument tracking: a feasibility study

Area of Science:

• Radiology
• Interventional Radiology
• Spinal Imaging

Background:

• Lumbar discogenic pain is a common cause of chronic low back pain.
• Accurate diagnosis of discogenic pain can be challenging.
• Conventional imaging modalities may not always identify the pain generator.

Purpose of the Study:

• To assess the feasibility of Magnetic Resonance Imaging (MRI)-guided discography.
• To evaluate the efficacy of optical tracking for instrument guidance during the procedure.
• To determine the accuracy and safety of MRI-guided discography for diagnosing lumbar discogenic pain.

Main Methods:

• 12 patients with suspected lumbar discogenic pain underwent MRI-guided discography.
• An open-configuration 0.23 T MRI device with an optical guidance tool was utilized.
• Gadolinium contrast was injected into the discs, followed by MRI sequences to confirm needle placement and discogram formation.

Main Results:

• 34 out of 35 attempted MRI discograms were successfully obtained.
• All procedures yielded a positive or negative pain response, aiding diagnosis.
• The average procedure time for three discs was 1 hour 25 minutes.
• One complication (disc collapse) occurred during follow-up.

Conclusions:

• MRI-guided discography with optical tracking is accurate and relatively safe.
• The technique is comparable to CT-guided or fluoroscopic methods.
• This approach offers a viable option for diagnosing lumbar discogenic pain.