nach oben

CardioVascular and Interventional Radiology

Erschienen in:

01.12.2014 | Laboratory Investigation

MR-Guided Vertebroplasty With Augmented Reality Image Overlay Navigation

verfasst von: Jan Fritz, Paweena U-Thainual, Tamas Ungi, Aaron J. Flammang, Sudhir Kathuria, Gabor Fichtinger, Iulian I. Iordachita, John A. Carrino

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the feasibility of magnetic resonance imaging (MRI)-guided vertebroplasty at 1.5 Tesla using augmented reality image overlay navigation.

Materials and Methods

Twenty-five unilateral vertebroplasties [5 of 25 (20 %) thoracic, 20 of 25 (80 %) lumbar] were prospectively planned in 5 human cadavers. A clinical 1.5-Teslan MRI system was used. An augmented reality image overlay navigation system and 3D Slicer visualization software were used for MRI display, planning, and needle navigation. Intermittent MRI was used to monitor placement of the MRI-compatible vertebroplasty needle. Cement injections (3 ml of polymethylmethacrylate) were performed outside the bore. The cement deposits were assessed on intermediate-weighted MR images. Outcome variables included type of vertebral body access, number of required intermittent MRI control steps, location of final needle tip position, cement deposit location, and vertebroplasty time.

Results

All planned procedures (25 of 25, 100 %) were performed. Sixteen of 25 (64 %) transpedicular and 9 of 25 (36 %) parapedicular access routes were used. Six (range 3–9) MRI control steps were required for needle placement. No inadvertent punctures were visualized. Final needle tip position and cement location were adequate in all cases (25 of 25, 100 %) with a target error of the final needle tip position of 6.1 ± 1.9 mm (range 0.3–8.7 mm) and a distance between the planned needle tip position and the center of the cement deposit of 4.3 mm (range 0.8–6.8 mm). Time requirement for one level was 16 (range 11–21) min.

Conclusion

MRI-guided vertebroplasty using image overlay navigation is feasible allowing for accurate vertebral body access and cement deposition in cadaveric thoracic and lumbar vertebral bodies.

Anselmetti GC, Manca A, Montemurro F et al (2012) Percutaneous vertebroplasty in multiple myeloma: prospective long-term follow-up in 106 consecutive patients. Cardiovasc Intervent Radiol 35(1):139–145PubMedCrossRef

Masala S, Pipitone V, Tomassini M, Massari F, Romagnoli A, Simonetti G (2006) Percutaneous vertebroplasty in painful Schmorl nodes. Cardiovasc Intervent Radiol 29(1):97–101PubMedCrossRef

Anselmetti GC, Corrao G, Monica PD et al (2007) Pain relief following percutaneous vertebroplasty: results of a series of 283 consecutive patients treated in a single institution. Cardiovasc Intervent Radiol 30(3):441–447PubMedCrossRef

Gangi A, Clark WA (2010) Have recent vertebroplasty trials changed the indications for vertebroplasty? Cardiovasc Intervent Radiol 33(4):677–680PubMedCrossRef

Gangi A, Sabharwal T, Irani FG, Buy X, Morales JP, Adam A (2006) Quality assurance guidelines for percutaneous vertebroplasty. Cardiovasc Intervent Radiol 29(2):173–178PubMedCrossRef

Orgera G, Krokidis M, Matteoli M et al (2013) Percutaneous vertebroplasty for pain management in patients with multiple myeloma: is radiofrequency ablation necessary? Cardiovasc Intervent Radiol 37(1):203–210PubMedCrossRef

Gronemeyer DH, Schirp S, Gevargez A (2002) Image-guided radiofrequency ablation of spinal tumors: preliminary experience with an expandable array electrode. Cancer J 8(1):33–39PubMedCrossRef

Schaefer O, Lohrmann C, Markmiller M, Uhrmeister P, Langer M (2003) Technical innovation. Combined treatment of a spinal metastasis with radiofrequency heat ablation and vertebroplasty. AJR Am J Roentgenol 180(4):1075–1077PubMedCrossRef

Kelekis A, Filippiadis DK, Martin JB, Kelekis NL (2013) Aggressive vertebral hemangioma treated with combination of vertebroplasty and sclerotherapy through transpedicular and direct approach. Cardiovasc Intervent Radiol [Epub ahead of print]

10.

Masala S, Roselli M, Manenti G, Mammucari M, Bartolucci DA, Simonetti G (2008) Percutaneous cryoablation and vertebroplasty: a case report. Cardiovasc Intervent Radiol 31(3):669–672PubMedCrossRef

11.

Amoretti N, Lesbats V, Marcy PY et al (2010) Dual guidance (CT and fluoroscopy) vertebroplasty: radiation dose to radiologists. How much and where? Skeletal Radiol 39(12):1229–1235PubMedCrossRef

12.

Braak SJ, Zuurmond K, Aerts HC et al (2013) Feasibility study of needle placement in percutaneous vertebroplasty: cone-beam computed tomography guidance versus conventional fluoroscopy. Cardiovasc Intervent Radiol 36(4):1120–1126PubMedCrossRef

13.

Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 15(1):83–86PubMed

14.

Perisinakis K, Damilakis J, Theocharopoulos N, Papadokostakis G, Hadjipavlou A, Gourtsoyiannis N (2004) Patient exposure and associated radiation risks from fluoroscopically guided vertebroplasty or kyphoplasty. Radiology 232(3):701–707PubMedCrossRef

15.

Joemai RM, Zweers D, Obermann WR, Geleijns J (2009) Assessment of patient and occupational dose in established and new applications of MDCT fluoroscopy. AJR Am J Roentgenol 192(4):881–886PubMedCrossRef

16.

Fritz J, Tzaribachev N, Thomas C et al (2012) Magnetic resonance imaging-guided osseous biopsy in children with chronic recurrent multifocal osteomyelitis. Cardiovasc Intervent Radiol 35(1):146–153PubMedCrossRef

17.

Maurer MH, Disch AC, Hartwig T, et al (2013) Outcome study of real-time MR-guided cervical periradicular injection therapy in an open 1.0 Tesla MRI system. Cardiovasc Intervent Radiol [Epub ahead of print]

18.

Streitparth F, Gebauer B, Melcher I et al (2009) MR-guided laser ablation of osteoid osteoma in an open high-field system (1.0 T). Cardiovasc Intervent Radiol 32(2):320–325PubMedCrossRef

19.

Akural E, Ojala RO, Jarvimaki V, Kariniemi J, Tervonen OA, Blanco SR (2013) MR-guided neurolytic celiac plexus ablation: an evaluation of effect and injection spread pattern in cancer patients with celiac tumor infiltration. Cardiovasc Intervent Radiol 36(2):472–478PubMedCrossRef

20.

Fritz J, Henes JC, Thomas C et al (2008) Diagnostic and interventional MRI of the sacroiliac joints using a 1.5-T open-bore magnet: a one-stop-shopping approach. AJR Am J Roentgenol 191(6):1717–1724PubMedCrossRef

21.

Fritz J, Thomas C, Tzaribachev N et al (2009) MRI-guided injection procedures of the temporomandibular joints in children and adults: technique, accuracy, and safety. AJR Am J Roentgenol 193(4):1148–1154PubMedCrossRef

22.

Binkert CA, Nanz D, Bootz F et al (2002) Laser-induced thermotherapy of the vertebral body: preliminary assessment of safety and real-time magnetic resonance monitoring in an animal model. Invest Radiol 37(10):557–561PubMedCrossRef

23.

Streitparth F, Walter T, Wonneberger U, et al. (2013) MR guidance and thermometry of percutaneous laser disc decompression in open MRI: An ex vivo study. Cardiovasc Intervent Radiol [Epub ahead of print]

24.

Fritz J, Thainual P, Ungi T et al (2013) Augmented reality visualization using image overlay technology for MR-guided interventions: cadaveric bone biopsy at 1.5 T. Invest Radiol 48(6):464–470PubMedCrossRef

25.

U-Thainual P, Fritz J, Moonjaita C et al (2012) MR image overlay guidance: system evaluation for preclinical use. Int J Comput Assist Radiol Surg 8(3):365–378PubMedCrossRef

26.

Kikinis R, Pieper S (2011) 3D Slicer as a tool for interactive brain tumor segmentation. Conf Proc IEEE Eng Med Biol Soc 1:6982–6984

27.

Vikal S, Thainual P, Carrino JA, Iordachita I, Fischer GS, Fichtinger G (2010) Perk Station—Percutaneous surgery training and performance measurement platform. Comput Med Imaging Graph 34(1):19–32PubMedCentralPubMedCrossRef

28.

Fritz J, Thainual P, Ungi T et al (2012) Augmented reality visualization with use of image overlay technology for MR imaging-guided interventions: assessment of performance in cadaveric shoulder and hip arthrography at 1.5 T. Radiology 265(1):254–259PubMedCentralPubMedCrossRef

29.

Obesity: preventing and managing the global epidemic Report of a WHO consultation (2000) World Health Organ Tech Rep Ser 894(i–xii):1–253

30.

Streitparth F, Walter T, Wonneberger U et al (2010) Image-guided spinal injection procedures in open high-field MRI with vertical field orientation: feasibility and technical features. Eur Radiol 20(2):395–403PubMedCrossRef

31.

Fritz J, Thainual P, Ungi T et al (2012) Augmented reality visualisation using an image overlay system for MR-guided interventions: technical performance of spine injection procedures in human cadavers at 1.5 Tesla. Eur Radiol 23(1):235–245PubMedCrossRef

32.

Blanco SR, Klemola R, Ojala R et al (2002) MRI-guided trephine biopsy and fine-needle aspiration in the diagnosis of bone lesions in low-field (0.23 T) MRI system using optical instrument tracking. Eur Radiol 12(4):830–835CrossRef

33.

Blanco SR, Carrino JA (2005) Musculoskeletal interventional MR imaging. Magn Reson Imaging Clin North Am 13(3):519–532CrossRef

34.

Carrino JA, Blanco R (2006) Magnetic resonance–guided musculoskeletal interventional radiology. Semin Musculoskelet Radiol 10(2):159–174PubMedCrossRef

35.

Carrino JA, Khurana B, Ready JE, Silverman SG, Winalski CS (2007) Magnetic resonance imaging-guided percutaneous biopsy of musculoskeletal lesions. J Bone Joint Surg Am 89(10):2179–2187PubMedCrossRef

36.

Genant JW, Vandevenne JE, Bergman AG et al (2002) Interventional musculoskeletal procedures performed by using MR imaging guidance with a vertically open MR unit: assessment of techniques and applicability. Radiology 223(1):127–136PubMedCrossRef

37.

Koenig CW, Duda SH, Truebenbach J et al (2001) MR-guided biopsy of musculoskeletal lesions in a low-field system. J Magn Reson Imaging 13(5):761–768PubMedCrossRef

38.

Lewin JS, Petersilge CA, Hatem SF et al (1998) Interactive MR imaging-guided biopsy and aspiration with a modified clinical C-arm system. AJR Am J Roentgenol 170(6):1593–1601PubMedCrossRef

39.

Ojala R, Sequeiros RB, Klemola R, Vahala E, Jyrkinen L, Tervonen O (2002) MR-guided bone biopsy: preliminary report of a new guiding method. J Magn Reson Imaging 15(1):82–86PubMedCrossRef

40.

Parkkola RK, Mattila KT, Heikkila JT et al (2001) Dynamic contrast-enhanced MR imaging and MR-guided bone biopsy on a 0.23 T open imager. Skeletal Radiol 30(11):620–624PubMedCrossRef

41.

Smith KA, Carrino J (2008) MRI-guided interventions of the musculoskeletal system. J Magn Reson Imaging 27(2):339–346PubMedCrossRef

42.

Weiss CR, Nour SG, Lewin JS (2008) MR-guided biopsy: a review of current techniques and applications. J Magn Reson Imaging 27(2):311–325PubMedCrossRef

43.

Kerimaa P, Marttila A, Hyvonen P et al (2013) MRI-guided biopsy and fine needle aspiration biopsy (FNAB) in the diagnosis of musculoskeletal lesions. Eur J Radiol 82(12):2328–2333PubMedCrossRef

44.

Fritz J, Thomas C, Clasen S, Claussen CD, Lewin JS, Pereira PL (2009) Freehand real-time MRI-guided lumbar spinal injection procedures at 1.5 T: feasibility, accuracy, and safety. AJR Am J Roentgenol 192(4):W161–W167PubMedCrossRef

45.

Seimenis I, Tsekos NV, Keroglou C, Eracleous E, Pitris C, Christoforou EG (2012) An approach for preoperative planning and performance of MR-guided interventions demonstrated with a manual manipulator in a 1.5 T MRI scanner. Cardiovasc Intervent Radiol 35(2):359–367PubMedCrossRef

46.

Rothgang E, Gilson WD, Wacker F, Hornegger J, Lorenz CH, Weiss CR (2013) Rapid freehand MR-guided percutaneous needle interventions: an image-based approach to improve workflow and feasibility. J Magn Reson Imaging 37(5):1202–1212PubMedCrossRef

47.

Fritz J, Thainual P, Ungi T et al (2012) Augmented reality visualization with image overlay for MRI-guided intervention: accuracy for lumbar spinal procedures with a 1.5-T MRI system. AJR Am J Roentgenol 198(3):W266–W273PubMedCrossRef

48.

Baumann C, Fuchs H, Kiwit J, Westphalen K, Hierholzer J (2007) Complications in percutaneous vertebroplasty associated with puncture or cement leakage. Cardiovasc Intervent Radiol 30(2):161–168PubMedCrossRef

49.

Wichlas F, Seebauer CJ, Schilling R et al (2012) A signal-inducing bone cement for magnetic resonance imaging-guided spinal surgery based on hydroxyapatite and polymethylmethacrylate. Cardiovasc Intervent Radiol 35(3):661–667PubMedCrossRef

50.

Nour SG, Aschoff AJ, Mitchell IC, Emancipator SN, Duerk JL, Lewin JS (2002) MR imaging-guided radio-frequency thermal ablation of the lumbar vertebrae in porcine models. Radiology 224(2):452–462PubMedCrossRef

Titel: MR-Guided Vertebroplasty With Augmented Reality Image Overlay Navigation
verfasst von: Jan Fritz
Paweena U-Thainual
Tamas Ungi
Aaron J. Flammang
Sudhir Kathuria
Gabor Fichtinger
Iulian I. Iordachita
John A. Carrino
Publikationsdatum: 01.12.2014
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 6/2014
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-014-0885-2

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

MR-Guided Vertebroplasty With Augmented Reality Image Overlay Navigation