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MRI image overlay: application to arthrography needle insertion
Gregory S Fischer1, Anton Deguet, Csaba Csoma
1Engineering Research Center, Johns Hopkins University, Baltimore, Maryland, USA. gfisch@jhu.edu
Abstract:
Magnetic Resonance Imaging (MRI) offers great potential for planning, guiding, monitoring and controlling interventions. MR arthrography (MRAr) is the imaging gold standard for assessing small ligament and fibrocartilage injury in joints. In contemporary practice, MRAr consists of two consecutive sessions: (1) an interventional session where a needle is driven to the joint space and MR contrast is injected under fluoroscopy or CT guidance; and (2) a diagnostic MRI imaging session to visualize the distribution of contrast inside the joint space and evaluate the condition of the joint. Our approach to MRAr is to eliminate the separate radiologically guided needle insertion and contrast injection procedure by performing those tasks on conventional high-field closed MRI scanners. We propose a 2D augmented reality image overlay device to guide needle insertion procedures. This approach makes diagnostic high-field magnets available for interventions without a complex and expensive engineering entourage. In preclinical trials, needle insertions have been performed in the joints of porcine and human cadavers using MR image overlay guidance; in all cases, insertions successfully reached the joint space on the first attempt.
Insights
This study introduces a novel augmented reality device for Magnetic Resonance Arthrography (MRAr) procedures. The system successfully guided needle insertion into joints in preclinical trials, improving efficiency for diagnosing joint injuries.
Area of Science:
- Medical Imaging
- Interventional Radiology
- Orthopedic Diagnostics
Background:
- Magnetic Resonance Imaging (MRI) is crucial for interventional guidance.
- MR Arthrography (MRAr) is the standard for small joint injury assessment.
- Current MRAr requires separate, guided needle insertion and contrast injection.
Purpose of the Study:
- To develop an integrated MRAr procedure within conventional high-field MRI scanners.
- To eliminate the need for separate fluoroscopy or CT guidance for needle insertion.
- To enhance the efficiency and accessibility of MRAr for joint diagnostics.
Main Methods:
- Developed a 2D augmented reality image overlay device for needle guidance.
- Integrated needle insertion and contrast injection into a single MRI session.
- Conducted preclinical trials on porcine and human cadaver joints.
Main Results:
- Successful joint space needle insertions were achieved in all preclinical cases.
- The augmented reality guidance enabled first-attempt accuracy.
- The proposed method streamlines MRAr without specialized equipment.
Conclusions:
- The augmented reality MRAr approach is effective and accurate for joint interventions.
- This innovation simplifies MRAr, making it more accessible.
- The technique holds promise for improved diagnosis of ligament and fibrocartilage injuries.
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