Technology and principles of tomographic image-guided interventions and surgery

Area of Science:

• Interventional Radiology
• Medical Imaging
• Surgical Navigation

Background:

• Image guidance is crucial for minimally invasive procedures, with various modalities available including fluoroscopy, ultrasound, CT, MRI, and stereotactic navigation.
• Significant advancements have recently occurred in MRI-based instrument guidance within interventional radiology.
• Implementing tomographic-guided surgery, particularly with MRI or CT in operating rooms, requires specialized technological and design considerations.

Purpose of the Study:

• To confirm the feasibility of Magnetic Resonance Imaging (MRI) guidance in interventional radiology.
• To present initial results on the expansion of MRI guidance for surgical endoscopic procedures.
• To describe the technological requirements and considerations for integrating MRI/CT scanning into operating room environments for image-guided surgery.

Main Methods:

• Conducted 168 clinical cases utilizing MRI-guided interventional procedures, including aspiration biopsy of neoplasms and tomographic microtherapy with local interstitial chemo-ablation.
• Evaluated the expansion of MRI guidance during surgical endoscopic procedures.
• Described necessary technological components such as fast MRI sequences, interventional protocols, in-room monitors, and MR-compatible instruments and equipment.

Main Results:

• The initial 168 clinical cases confirmed the feasibility and efficacy of MRI guidance for interventional procedures.
• Early results indicate potential for expanding MRI guidance into surgical endoscopic applications.
• Specific technological requirements for intraoperative MRI/CT integration were identified and described.

Conclusions:

• MRI guidance is a feasible and effective tool for interventional radiology procedures.
• Further development and evaluation are warranted for integrating MRI guidance into surgical endoscopy.
• Successful implementation of intraoperative tomographic-guided surgery necessitates careful consideration of technological and OR design factors.