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Tobias Schaeffter

Publications and source records attributed to Tobias Schaeffter.

18 recordsLinked to original sources

MR-guided breast biopsy using an active marker: a phantom study.

PURPOSE: To evaluate the advantages of using an active marker (active micro coil) for MR-guided breast biopsy procedures. MATERIALS AND METHODS: An add-on breast biopsy guidance device used with a standard breast coil was equipped with an active marker. The marker's position was determined with a dedicated MRI sequence. In combination with custom software, the biopsy planning process was reduced basically to defining the target in the diagnostic MR images. Automatic control scans verified the settings of the biopsy guidance device. To measure the targeting accuracy, x-ray control of the needle placement was performed in phantoms containing 36 small titanium cylinders. The reliability of the procedure was evaluated in 24 core needle biopsies on phantoms. Workflow enhancements were analyzed. RESULTS: The root mean square deviation of the needle position from the target perpendicular to the needle axis was 1.25 mm, in three-dimensions it was 1.35 mm. All targets were sampled successfully. The duration of a phantom biopsy was nine minutes. CONCLUSION: The use of an active marker can offer advantages for MR-guided breast biopsies in terms of handling and procedure time as well as accuracy.

Biomarkers↗

Simultaneous imaging and R2* mapping using a radial multi-gradient-echo (rMGE) sequence.

PURPOSE: To demonstrate a rapid MR technique that combines imaging and R2* mapping based on a single radial multi-gradient-echo (rMGE) data set. The technique provides a fast method for online monitoring of the administration of (super-)paramagnetic contrast agents as well as image-guided drug delivery. MATERIALS AND METHODS: Data are acquired using an rMGE sequence, resulting in interleaved undersampled radial k-spaces representing different echo times (TEs). These data sets are reconstructed separately, yielding a series of images with different TEs used for pixelwise R2* mapping. A fast numerical algorithm implemented on a real-time reconstruction platform provides online estimation of the relaxation rate R2*. Simultaneously the images are summed for the computation of a high-resolution image. RESULTS: Convenient high-resolution R2* maps of phantoms and the liver of a healthy volunteer were obtained. In addition to stable intrinsic baseline maps, the proposed technique provides particularly accurate results for the high relaxation rates observed during the presence of (super-)paramagnetic contrast agents. Assuming that the change in R2* is proportional to the concentration of the agent, the technique offers a rough estimate for dynamic dosage. CONCLUSION: The simultaneous online display of morphological and parametric information permits convenient, quantitative surveillance of contrast-agent administration.

Algorithms↗

MRI of coronary vessel walls using radial k-space sampling and steady-state free precession imaging.

OBJECTIVE: The objective of our study was to investigate the impact of radial k-space sampling and steady-state free precession (SSFP) imaging on image quality in MRI of coronary vessel walls. SUBJECTS AND METHODS: Eleven subjects were examined on a 1.5-T MR system using three high-resolution navigator-gated and cardiac-triggered 3D black blood sequences (cartesian gradient-echo [GRE], radial GRE, and radial SSFP) with identical spatial resolution (0.9 x 0.9 x 2.4 mm3). The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), vessel wall sharpness, and motion artifacts were analyzed. RESULTS: The mean SNR and CNR of the coronary vessel wall were improved using radial imaging and were best using radial k-space sampling combined with SSFP imaging. Vessel border definition was similar for all three sequences. Radial k-space sampling was found to be less sensitive to motion. Consistently good image quality was seen with the radial GRE sequence. CONCLUSION: Radial k-space sampling in MRI of coronary vessel walls resulted in fewer motion artifacts and improved SNR and CNR. The use of SSFP imaging, however, did not result in improved coronary vessel wall visualization.

Adult↗

Transmission line for improved RF safety of interventional devices.

A new concept is proposed to improve the safety of transmission lines with respect to heating during RF transmission. It is based on the integration of transformers into the transmission line. The concept was applied to an active tracking device. Miniature transformers were designed, and two types of tracking devices were built based on a standard line and a transformer line. Temperature measurements were performed for both devices during high specific absorption rate (SAR) scanning, and the suppression of RF heating to a physiologically non-relevant level was demonstrated for the transformer device. The transmission properties of the transformer line were examined in simulations and RF measurements. Active tracking with the transformer device performed robustly in the phantom. Because of the favorable signal transmission properties of the tested device, it is expected that the concept can be applied to the construction of clinical devices for tracking and intravascular imaging, which are RF-safe under clinical SAR conditions. Since the transformer line has a large bandwidth, the concept may also be applied for RF-safe transmission of non-MR signals.

Catheterization↗

SNR enhancement in radial SSFP imaging using partial k-space averaging.

The steady-state free precessing (SSFP) sequences, widely used in MRI today, acquire data only during a short fraction of the repetition time (TR). Thus, they exhibit a poor scan efficiency. In this paper, a novel approach to extending the acquisition window for a given TR without considerably modifying the basic sequence is explored for radial SSFP sequences. The additional data are primarily employed to increase the signal-to-noise ratio, rather than to improve the temporal resolution of the imaging. The approach is analyzed regarding its effect on the image SNR (signal to noise ratio) and the reconstruction algorithm. Results are presented for phantom experiments and cardiac functions studies. The gain in SNR is most notable in rapid imaging, since SNR enhancement for a constant repetition time may be used to compensate for the increase in noise resulting from angular undersampling.

Algorithms↗

Free-breathing 3D steady-state free precession coronary MR angiography with radial k-space sampling: comparison with cartesian k-space sampling and cartesian gradient-echo coronary MR angiography--pilot study.

The authors compared radial steady-state free precession (SSFP) coronary magnetic resonance (MR) angiography, cartesian k-space sampling SSFP coronary MR angiography, and gradient-echo coronary MR angiography in 16 healthy adults and four pilot study patients. Standard gradient-echo MR imaging with a T2 preparatory pulse and cartesian k-space sampling was the reference technique. Image quality was compared by using subjective motion artifact level and objective contrast-to-noise ratio and vessel sharpness. Radial SSFP, compared with cartesian SSFP and gradient-echo MR angiography, resulted in reduced motion artifacts and superior vessel sharpness. Cartesian SSFP resulted in increased motion artifacts (P <.05). Contrast-to-noise ratio with radial SSFP was lower than that with cartesian SSFP and similar to that with the reference technique. Radial SSFP coronary MR angiography appears preferable because of improved definition of vessel borders.

Adult↗

Catheter tracking and visualization using 19F nuclear magnetic resonance.

This work presents an investigation into catheter visualization and localization using 19F nuclear magnetic resonance (NMR) in conjunction with proton imaging. For this purpose, the imaging capabilities of a standard system were extended to allow for 19F excitation and signal detection. Two modes of operation were implemented: 1) a real-time tracking mode that provides tip tracking and automatic slice position updates interleaved with real-time, interactive proton imaging; and 2) a non-real-time catheter length visualization mode in which the entire length of a catheter can be assessed. Initial phantom experiments were conducted with the use of an angiographic balloon catheter filled with the blood substitute perfluorooctylbromide (PFOB). Using limited bandwidth excitation centered at the resonances of the CF2 groups of PFOB, we found that sufficient signal could be received to facilitate tip tracking during catheter motion and length visualization for various catheter configurations. The present approach is considered a promising alternative to existing methods, which either are associated with safety concerns (if active markers are employed) or suffer from insufficient, direction-dependent contrast (if passive visualization is used). Furthermore, our approach enables visualization of the entire length of the catheter. The proposed method provides a safe technique that, unlike electrical or optical devices, does not require modification of commercially available catheters.

Catheterization↗

In vivo safe catheter visualization and slice tracking using an optically detunable resonant marker.

The purpose of this study was to test the in vivo feasibility of safe automatic catheter tracking based on an optically detunable resonant marker installed on the catheter tip, and also to test the compatibility of this approach with guidewire materials. The design of the resonant marker and the integration into the real-time MR environment is described. The catheter was used for real-time MR-guided catheterization of the aorta, left ventricle, and carotid in two swine. For in-plane visualization, the marker was repeatedly detuned. For automatic slice tracking, a projection difference measurement including detuning was interleaved with the imaging sequence. In vitro experiments were conducted to investigate the RF-safety of the marker and the effect of the guidewires on the signal intensity. For all orientations the marker provided excellent in vivo contrast using a radial steady-state free-precession sequence. Flashing of the marker by repetitive tuning/detuning further improved the in-plane visualization. Automatic slice tracking during real-time imaging was successfully performed. The plastic guidewires did not interfere with the marker, and detuning by guidewires containing nitinol could be compensated. In conclusion, automatic slice tracking as well as excellent in-plane visualization can be achieved with this approach and it is safe with respect to RF transmission.

Animals↗

Brain perfusion territory imaging applying oblique-plane arterial spin labeling with a standard send/receive head coil.

A new method for the selective spin labeling of left- or right-sided supplying arteries of the brain without the need for additional RF coils is demonstrated. A clinical 1.5 T scanner was used. The spatial selectivity of the labeling process is based on the limited coverage of the excitation field of a standard send/receive head coil together with an oblique positioning of the labeling plane. A computer simulation was used to optimize key labeling parameters under the condition of laminar flow. The validity of the computer model results was confirmed by MRI measurements with a flow model. For human studies, a double-inversion continuous arterial spin labeling (CASL) sequence was modified to allow for arbitrary positioning of the labeling plane. The obtained perfusion-weighted images showed a clear delineation of the perfusion territories of the selected arteries in the anterior circulation of the brain and good gray/white matter contrast.

Brain Mapping↗

[An approach for safe visualization and localization of catheter during MR-guided intravascular procedures].

The present paper describes a method for the visualization and localization of a catheter during real-time imaging on a clinical magnetic resonance tomograph (MRT). This method includes the use of an apposite catheter hardware equipped with an optically tunable resonant marker on its tip (OptiMa-Catheter). In the tuned state, the marker produces an intense signal spot in the MR image. The signal is modulated by optical detuning controlled by the MRT system, which results in improved visualization of the catheter tip due to flashing. During real-time imaging, additionally, the localization of the tip is precisely detected and the slice tracking automatically performed. Experiments demonstrate that the OptiMa-Catheter does not generate relevant resonance heating during imaging. Consequently, it combines the visualization and localization known from active techniques with the safety of passive techniques.

Catheters, Indwelling↗

Fast interactive real-time magnetic resonance imaging of cardiac masses using spiral gradient echo and radial steady-state free precession sequences.

RATIONALE AND OBJECTIVES: Cardiac and respiratory controlled MR-imaging is the gold standard for imaging of cardiac masses. However, this technique may be limited in patients with dyspnoe or arrhythmia. The aim of this study was the evaluation of an interactive MR-approach for the detection and localization of cardiac masses. METHODS: Interactive real-time spiral gradient-echo (spiralGE) and radial steady-state-free-precession (radialSSFP) MR-imaging was performed during free-breathing and without cardiac triggering in 15 patients with 14 intracardiac or paracardiac masses. Standard cardiac triggered segmented k-space breath-hold steady-state-free-precession cine MR-imaging was used as the reference MR-imaging technique. Two groups of investigators blinded to clinical data were ask to rank image quality and to identify cardiac masses on real-time MR-images. RESULTS: Image quality was superior using radialSSFP when compared with spiralGE. Using radialSSFP all masses were correctly detected while 6 of 14 masses were missed on spiralGE. Mean real-time MR-imaging time was less than 3 minutes for both techniques. CONCLUSION: Interactive real-time radialSSFP MR-imaging allows for accurate and fast detection of cardiac masses without the need of cardiac or respiratory triggering.

Female↗

Gadolinium-enhanced magnetic resonance fluoroscopy used as micturating cystourethrography: experiences in adult male patients.

RATIONALE AND OBJECTIVE: To approach the concept of magnetic resonance (MR) imaging-monitored micturating cystourethrography (MRMCU) by using gadolinium-enhanced real-time MR fluoroscopy. METHODS: MRMCU was performed in 21 male patients (27-76 years) subsequent to gadolinium excretory MR urography. Patients were examined in supine position at 1.5 T. For MR fluoroscopy of the urethra during micturition, we used a T1-weighted single-slice gradient-echo sequence with continuous radial k-space acquisition. Image reconstruction was obtained with the sliding-window technique reaching a frame rate of 25/s. The image plane was guided interactively through the urethra, the bladder and the ureters without stopping the scan. RESULTS: Two patients were unable to void in supine position. With MR fluoroscopy, the flow of gadolinium-enhanced urine through the urethra was visualized in 19 patients, in 14 of whom with complete demonstration of the urethral anatomy subdivided into 5 segments. Four urethral segments were identified in 1 patient, 3 segments in 2 patients, 2 segments in 3 patients, and 1 segment in 1 patient. MRMCU demonstrated changes in the urethral anatomy and the urine flow in 2 patients with a neobladder and in 1 patient with hypertrophy of the prostate. Subject to the limitation of antegrade gadolinium application, interactive MRMCU allowed to determine whether the ureters were enhanced by gadolinium or not. CONCLUSION: Gadolinium-enhanced MR fluoroscopy using radial k-space acquisition has achieved complete demonstration of the segmental anatomy of the urethra in 74% of the male adult patients who were able to accomplish micturition. Although MR fluoroscopy was able to visualize the gadolinium-enhanced ureters, the current data do not permit to conclude that MRMCU can demonstrate vesicoureteral reflux, especially in children.

Adult↗

Real-time adaptive filtering for projection reconstruction MR fluoroscopy.

Magnetic resonance (MR) imaging has faced a dramatic increase in real-time capabilities over the last years. However, the application of fast pulse sequences still suffers from low signal-to-noise ratios (SNRs), which can be the limiting factor for the actual acquisition speed. In MR fluoroscopy, filtering along the time and/or spatial domain can be applied to increase the image quality. In this paper, a projection-based noise filter is presented that significantly enhances the SNR in projection reconstruction (PR) fluoroscopy without apparent loss of resolution in the reconstructed images. In contrast to an imaged-based approach, this method allows a very efficient computational implementation. The filter algorithm was implemented on a digital signal processor and was applied to real-time processing during PR fluoroscopy. A quantitative analysis of the improvement in SNR and results for different fluoroscopic MR applications are given. Apart from MR fluoroscopy, the proposed technique has the potential to be applied to low dose computed tomography fluoroscopy.

Algorithms↗

Quantitative assessment of left ventricular function with interactive real-time spiral and radial MR imaging.

An interactive real-time spiral gradient-echo and an interactive real-time radial steady-state free precession sequence were investigated for the quantitative assessment of left ventricular function. Data were acquired in 18 patients without electrocardiographic triggering and breath holding. With the interactive real-time spiral gradient-echo sequence, significant underestimation of endocardial and epicardial volumes was demonstrated; with the interactive real-time radial steady-state free precession sequence, excellent agreement was shown with standard cardiac-triggered segmented k-space breath-hold steady-state free precession MR imaging. Interactive real-time radial steady-state free precession imaging allows accurate quantitative assessment of left ventricular volumes.

Adult↗

Magnetic resonance-guided placement of atrial septal closure device in animal model of patent foramen ovale.

BACKGROUND: Percutaneous closure of the patent foramen ovale (PFO) is usually performed under x-ray in combination with ultrasound guidance. We tested the feasibility of applying magnetic resonance (MR) guidance for percutaneous closure of PFO in an animal model, thus avoiding the disadvantage of ionizing radiation. METHODS AND RESULTS: Real-time MRI with radial or spiral k-space filling (15 frames per second) on an interventional 1.5-T high-field whole-body system was exploited to examine the feasibility of MR-guided closure of the PFO in 7 piglets weighing approximately 14 kg. A specially designed prototype nonmagnetic closure device was introduced via the femoral vein. The short bore of the magnet and in-room monitors allowed for visualization and steering of the catheter with the loaded occluder. Catheterization of the left atrium and, finally, correct placement of the device was possible in all animals. Deployment of the device was depicted by real-time MR, and initial misplacement, which occurred in 2 animals, was easily detected and corrected. CONCLUSIONS: Real-time MR guidance of PFO closure, without the use of ionizing radiation, is feasible in an animal model.

Animals↗

Magnetic resonance--guided coronary artery stent placement in a swine model.

BACKGROUND: Magnetic resonance (MR)--guided coronary artery stent placement is a challenging vascular intervention because of the small size of the coronary arteries combined with incessant motion during the respiratory and cardiac cycles. These obstacles necessitate higher temporal and higher spatial resolution real-time MR imaging techniques when compared with interventional peripheral MR angiography. METHODS AND RESULTS: A new, ultrafast, real-time MR imaging technique that combines steady-state free precession (SSFP) for high signal-to-noise ratio and radial k-space sampling (rSSFP) for motion artifact suppression was implemented on a 1.5-T clinical whole-body interventional MR scanner. The sliding window reconstruction technique yielded a frame rate of 15/s allowing for data acquisition during free breathing and without cardiac triggering. Eleven balloon-expandable stainless steel coronary stents were placed in both coronary arteries of 7 pigs (40 to 70 kg body weight) using a nitinol guidewire and passive device visualization. Position of the coronary stents was controlled by a navigator-gated free-breathing ECG-triggered three-dimensional SSFP coronary MRA sequence and confirmed visually on the ex vivo heart. The presented real-time MR imaging sequence reliably allowed for high-quality coronary MR fluoroscopy without motion artifacts in all pigs. Ten of 11 coronary stents were correctly placed under MR guidance. One stent dislodged proximally from the left main coronary artery because of too-small balloon size. Stent dislocation was correctly predicted during real-time MR imaging. CONCLUSION: The presented approach allows for real-time MR-guided coronary artery stent placement in a swine model.

Angioplasty, Balloon, Coronary↗

Simultaneous real-time visualization of the catheter tip and vascular anatomy for MR-guided PTA of iliac arteries in an animal model.

PURPOSE: To examine the feasibility of simultaneous MR real-time active tip tracking and near real-time depiction of the vascular anatomy for percutaneous angioplasty of iliac arteries under MR guidance. MATERIALS AND METHODS: Nine surgically created stenoses of external iliac arteries in pigs were dilated with MR-compatible balloon catheters (Cordis, Roden, The Netherlands). These catheters were equipped with a microcoil for active tracking of the catheter tip with an in-plane update rate of 10 positions per second. The procedures were performed on an interventional 1.5 T Gyroscan ACS-NT scanner (Philips, Best, The Netherlands). Real-time calculation of images acquired by radial k-space filling was performed on a specially designed backprojector exploiting the sliding window reconstruction technique (Philips Research Laboratories, Hamburg, Germany). The image update rate was 20 frames per second using a radial gradient-echo technique (TR = 12 msec, TE = 3.3 msec, 300 radials). MR angiography and X-ray digital subtraction angiography on the X-ray system positioned in-line next to the interventional MR system served as control for the angioplasty results. RESULTS: Real-time guidance and positioning of the balloon catheters was possible. The actual position of the catheter tip was indicated in the MR images without any time delay for the reconstruction of the anatomical MR images, which were updated with a rate of 20 frames per second. This yielded a combination of a roadmap and fluoroscopy image, in which the catheter position and the anatomical background image both were continuously updated in real time. Six out of nine stenoses were successfully dilated. The effects of the angioplasty could be visualized by the real-time MR technique, as was proven by X-ray digital subtraction angiography. CONCLUSION: Active tip tracking simultaneous with MRI of the vascular anatomy-both in real time-is possible with the applied technique, enabling MR-guided percutaneous dilatation (PTA) of iliac arteries.

Angiography, Digital Subtraction↗