title: Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty.
abstract: OBJECTIVE
  Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries.
  
  
  METHODS
  A 1.5-T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed.
  
  
  RESULTS
  MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-ray-guided procedure.
  
  
  CONCLUSIONS
  MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular, the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation.
authors.affiliation: Division of Imaging and Technology, Institute for Medical Science and Technology, University of Dundee, Wilson House, 1 Wurzburg Loan, Dundee, DD2 1FD, UK, martin.a.rube@gmail.com.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Rube
authors.forename: Fabiola
authors.initials: F
authors.lastname: Fernandez-Gutierrez
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Cox
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Holbrook
authors.forename: J Graeme
authors.initials: JG
authors.lastname: Houston
authors.forename: Richard D
authors.initials: RD
authors.lastname: White
authors.forename: Helen
authors.initials: H
authors.lastname: McLeod
authors.forename: Mahsa
authors.initials: M
authors.lastname: Fatahi
authors.forename: Andreas
authors.initials: A
authors.lastname: Melzer
mesh_terms: D017130:Angioplasty / Q000379:methods*; D005240:Feasibility Studies; D005451:Fluorescein Angiography; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000601:surgery*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*
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