title: MRI image overlay: application to arthrography needle insertion.
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.
authors: Engineering Research Center, Johns Hopkins University, Baltimore, Maryland, USA. gfisch@jhu.edu
authors: Gregory S
authors: GS
authors: Fischer
authors: Anton
authors: A
authors: Deguet
authors: Csaba
authors: C
authors: Csoma
authors: Russell H
authors: RH
authors: Taylor
authors: Laura
authors: L
authors: Fayad
authors: John A
authors: JA
authors: Carrino
authors: S James
authors: SJ
authors: Zinreich
authors: Gabor
authors: G
authors: Fichtinger
mesh_terms: D001175:Arthrography / Q000295:instrumentation*; D002356:Cartilage / Q000293:injuries; D003287:Contrast Media; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis*; D008022:Ligaments / Q000293:injuries; D008279:Magnetic Resonance Imaging; D009339:Needles
chemical_list: D003287:Contrast Media