Interventional magnetic resonance imaging: an alternative to image guidance with ionising radiation

At present, interventional procedures, such as stent placement, are performed under X-ray image guidance. Unfortunately with X-ray imaging, both patient and interventionalist are exposed to ionising radiation. Furthermore, X-ray imaging is lacking soft tissue contrast and is not capable of true 3-D displays of either interventional device or tissue morphology. Magnetic resonance imaging (MRI) offers excellent soft tissue contrast, 3-D acquisition techniques, as well as rapid image acquisition and reconstruction. Despite these advantages, MR-guided interventions are challenging owing to the limited access to the patient, strong magnetic and radio-frequency fields that require special interventional devices, inferior image frame rates and spatial resolution, and high MRI scanner noise. For MR-guided intravascular interventions, where access to the target organ is achieved through catheters, dedicated hardware and automated image slice positioning techniques have been developed. We illustrate that MR-guided renal embolisations can be performed in closed-bore high-field MR scanners.