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In situ guidance for MRI interventions using projected feedback

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

To develop and evaluate an augmented reality instrument guidance system for MRI-guided needle placement procedures such as musculoskeletal biopsy and arthrography. Our system guides the physician to insert a needle toward a target while looking at the insertion site without requiring special headgear.

Methods

The system is comprised of a pair of stereo cameras, a projector, and a computational unit with a touch screen. All components are designed to be used within the MRI suite (Zone 4). Multi-modality fiducial markers called VisiMARKERs, detectable in both MRI and camera images, facilitate automatic registration after the initial scan. The navigation feedback is projected directly onto the intervention site allowing the interventionalist to keep their focus on the insertion site instead of a secondary monitor which is often not in front of them.

Results

We evaluated the feasibility and accuracy of this system on custom-built shoulder phantoms. Two radiologists used the system to select targets and entry points on initial MRIs of these phantoms over three sessions. They performed 80 needle insertions following the projected guidance. The system targeting error was 1.09 mm, and the overall error was 2.29 mm.

Conclusion

We demonstrated both feasibility and accuracy of this MRI navigation system. The system operated without any problems inside the MRI suite close to the MRI bore. The two radiologists were able to easily follow the guidance and place the needle close to the target without any intermediate imaging.

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References

  1. Ceraulo A, Ouziel A, Lavergne E, Perrier L, Decouvelaere A-V, Chotel F, Thiesse P, Marec-Berard P (2017) Percutaneous guided biopsy for diagnosing suspected primary malignant bone tumors in pediatric patients: a safe, accurate, and cost-saving procedure. Pediatr Radiol 47(2):235–244. https://doi.org/10.1007/s00247-016-3735-3

    Article  PubMed  Google Scholar 

  2. Smith KA, Carrino J (2008) MRI-guided interventions of the musculoskeletal system. J Magn Reson Imaging Off J Int Soc Magn Reson Med 27(2):339–346. https://doi.org/10.1002/jmri.21274

    Article  Google Scholar 

  3. Health at a Glance (2019) OECD indicators. OECD Publishing, Paris. https://doi.org/10.1787/4dd50c09-en. Accessed 31 Dec 2019

  4. Roguin A, Goldstein J, Bar O, Goldstein JA (2013) Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol 111(9):1368–1372. https://doi.org/10.1016/j.amjcard.2012.12.060

    Article  PubMed  Google Scholar 

  5. Pavic R, Margetic P, Bensic M, Brnadic RL (2013) Diagnostic value of US, MR and MR arthrography in shoulder instability. Injury 44:26–32. https://doi.org/10.1016/S0020-1383(13)70194-3

    Article  Google Scholar 

  6. Atay E (2014) Prevalence of sport injuries among middle school children and suggestions for their prevention. J Phys Ther Sci 26(9):1455–1457. https://doi.org/10.1589/jpts.26.1455

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lim S, Sharma K, Li P, Petrisor D, Fricke S, Stoianovici D, Cleary K (2019) Robotically assisted long bone biopsy under MRI: cadaver study results. Int J Comput Assist Radiol Surg 14(1):147–156. https://doi.org/10.1007/s11548-018-1889-1

  8. FDA MRI Safety. https://www.fda.gov/media/101221/download. Accessed 26 Jan 2023

  9. Fritz J, U-Thainual P, Ungi T, Flammang AJ, Cho NB, Fichtinger G, Iordachita II, Carrino JA (2012) Augmented reality visualization with image overlay for MRI-guided intervention: accuracy for lumbar spinal procedures with a 1.5-T MRI system. Am J Roentgenol 198(3):266–273. https://doi.org/10.2214/AJR.11.6918

    Article  Google Scholar 

  10. Mewes A, Heinrich F, Kägebein U, Hensen B, Wacker F, Hansen C (2019) Projector-based augmented reality system for interventional visualization inside MRI scanners. Int J Med Robot Comput Assist Surg 15(1):1950. https://doi.org/10.1002/rcs.1950

    Article  Google Scholar 

  11. Heinrich F, Joeres F, Lawonn K, Hansen C (2019) Comparison of projective augmented reality concepts to support medical needle insertion. IEEE Trans Visual Comput Graph 25(6):2157–2167. https://doi.org/10.1109/TVCG.2019.2903942

    Article  Google Scholar 

  12. Andress S, Johnson A, Unberath M, Winkler AF, Yu K, Fotouhi J, Weidert S, Osgood G, Navab N (2018) On-the-fly augmented reality for orthopedic surgery using a multimodal fiducial. J Med Imaging 5(2):021209–021209. https://doi.org/10.1117/1.JMI.5.2.021209

    Article  Google Scholar 

  13. Olson E (2011) Apriltag: a robust and flexible visual fiducial system. In: 2011 IEEE international conference on robotics and automation, pp 3400–3407. https://doi.org/10.1109/ICRA.2011.5979561

  14. Yaniv Z (2015) Which pivot calibration? In: Medical imaging 2015: image-guided procedures, robotic interventions, and modeling, vol 9415, pp 542–550. https://doi.org/10.1117/12.2081348. SPIE

  15. Bradski G (2000) The openCV library. Dr. Dobb’s J Softw Tools Prof Program 25(11):120–123

    Google Scholar 

  16. Horn BK, Hilden HM, Negahdaripour S (1988) Closed-form solution of absolute orientation using orthonormal matrices. JOSA A 5(7):1127–1135. https://doi.org/10.1364/JOSAA.5.001127

    Article  Google Scholar 

  17. Embodi3D. https://www.embodi3d.com. Accessed 19 Dec 2019

  18. Kikinis R, Pieper SD, Vosburgh KG (2014) 3D slicer: a platform for subject-specific image analysis, visualization, and clinical support. In: Jolesz FA (ed) Intraoperative Imaging and Image-Guided Therapy. Springer, New York, pp 277–289. https://doi.org/10.1007/978-1-4614-7657-3_19

    Chapter  Google Scholar 

  19. Crossan K, Rawson D (2022) Shoulder arthrogram. StatPearls Publishing

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Funding

This work has been supported by NIH Grant Numbers 1R43EB028722-01A1 and 2R44EB028722-02A1.

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Authors and Affiliations

  1. Clear Guide Medical Inc., Baltimore, MD, 21211, USA

    Pezhman Foroughi, Alican Demir, Martin Hossbach & Purnima Rajan

  2. Children’s National, Washington, DC, 20010, USA

    Pavel Yarmolenko, Ranjith Vellody, Kevin Cleary & Karun Sharma

Authors
  1. Pezhman Foroughi
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  2. Alican Demir
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  3. Martin Hossbach
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  4. Purnima Rajan
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  5. Pavel Yarmolenko
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  6. Ranjith Vellody
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  7. Kevin Cleary
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  8. Karun Sharma
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Correspondence to Pezhman Foroughi.

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Foroughi, P., Demir, A., Hossbach, M. et al. In situ guidance for MRI interventions using projected feedback. Int J CARS 18, 1069–1076 (2023). https://doi.org/10.1007/s11548-023-02897-z

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