Fully MR-guided hepatic artery catheterization for selective drug delivery: a feasibility study in pigs.
OBJECTIVE
To demonstrate the feasibility of hepatic catheterization for selective delivery of therapeutic agents using a clinical MRI scanner for real-time image guidance.


METHODS
Experiments were performed in three domestic pigs (70-80 kg) using a clinical 1.5-T MR scanner. After abdominal three-dimensional contrast-enhanced MR angiography (3D-CE-MRA) was performed, endovascular devices with susceptibility markers were tracked with passive tracking techniques. Catheters were maneuvered into the primary and secondary hepatic arteries. Selective catheterization was verified using selective time-resolved CE angiography. Paramagnetic microspheres were administered to a different region for each liver. The resulting biodistributions were investigated using MR images.


RESULTS
Successful selective hepatic catheterization was repeatedly demonstrated using passive tracking techniques. 3D-CE-MRA significantly aided the interventional procedure by showing the vascular anatomy, and maximum-intensity projections (MIPs) were used as roadmaps during the interventions. In all cases, microspheres were successfully delivered to the selected regions. The catheters were visualized at a maximum frame rate of five frames per second, allowing a good depiction of the devices and a reliable catheterization of the hepatic arteries.


CONCLUSIONS
Fully MR-guided real-time navigation of endovascular devices permits complex procedures such as selective intra-arterial delivery of therapeutic agents to parts of the liver.
Seppenwoolde
Jan-Henry
JH
Image Sciences Institute, Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. j.seppenwoolde@azu.nl
Bartels
Lambertus W
LW
van der Weide
Remko
R
Nijsen
Johannes F W
JF
van het Schip
Alfred D
AD
Bakker
Chris J G
CJ
D000818:Animals; D004195:Disease Models, Animal; D016503:Drug Delivery Systems / Q000379:methods*; D005240:Feasibility Studies; D006503:Hepatic Veins; D021621:Imaging, Three-Dimensional; D007261:Infusions, Intra-Arterial; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008863:Microspheres; D015642:Radiology, Interventional / Q000295:instrumentation / Q000379:methods*; D012680:Sensitivity and Specificity; D034421:Sus scrofa