title: X-ray Fused With Magnetic Resonance Imaging to Guide Endomyocardial Biopsy of a Right Ventricular Mass.
abstract: BACKGROUND
  A patient with a history of cancer in remission and congestive heart failure with no acute symptoms presented for a follow-up echocardiogram. The scan revealed a new echodense mass filling his right ventricular apex. An endomyocardial biopsy guided by x-ray fused with magnetic resonance (MR) imaging (XFM) was performed. This case report outlines the steps of XFM image preparation involving MR image acquisition, processing, and coregistration with x-ray fluoroscopy.
  
  
  CONCLUSIONS
  In cases of focal pathology or cardiac masses, endomyocardial biopsy can be challenging because x-ray fluoroscopy guidance offers limited visualization of soft-tissue structures. XFM overcomes this issue by overlaying high-resolution MR images onto x-ray fluoroscopy images.
  
  
  CONCLUSIONS
  This case report illustrates the clinical use of XFM for endomyocardial biopsy of an apical right ventricular mass and provides a practical, step-by-step description of MR image acquisition, processing, and coregistration with fluoroscopy, as performed by the MR technologist.
authors.forename: Delaney
authors.initials: D
authors.lastname: McGuirt
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mazal
authors.forename: Toby
authors.initials: T
authors.lastname: Rogers
authors.forename: Anthony Z
authors.initials: AZ
authors.lastname: Faranesh
authors.forename: William
authors.initials: W
authors.lastname: Schenke
authors.forename: Annette
authors.initials: A
authors.lastname: Stine
authors.forename: Laurie
authors.initials: L
authors.lastname: Grant
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Lederman
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D004452:Echocardiography; D057918:Fiducial Markers; D005471:Fluoroscopy; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D061705:Image-Guided Biopsy; D007479:Iopamidol; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D008875:Middle Aged; D064847:Multimodal Imaging; D000072078:Positron Emission Tomography Computed Tomography
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: cardiac mass; endomyocardial biopsy; image coregistration; x-ray fused with MRI