Magnetic Resonance-guided Procedures: Consensus on Rationale, Techniques, and Outcomes

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Moritz T. Winkelmann, Jens Kübler, Rüdiger Hoffmann
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引用次数: 0

Abstract

Magnetic resonance (MR) image guidance has demonstrated significant potential in the field of interventional radiology in several applications. This article covers the main points of MR-guided hepatic tumor ablation as a representative of MR-guided procedures. Patient selection and appropriate equipment utilization are essential for successful MR-guided tumor ablation. Intra-procedural planning imaging enables the visualization of the tumor and surrounding anatomical structures in most cases without the application of a contrast agent, ensuring optimal planning of the applicator tract. MRI enables real-time, multiplanar imaging, thus simultaneous observation of the applicator and target tumor is possible during targeting with adaptable slice angulations in case of challenging tumor positions. Typical ablation zone appearance during therapy monitoring with MRI enables safe assessment of the therapy result, resulting in a high primary efficacy rate. Recent advancements in ablation probes have shortened treatment times, while technical strategies address applicator visibility issues. MR-imaging immediately after the procedure is used to rule out complications and to assess technical success. Especially in smaller neoplasms, MRI-guided liver ablation demonstrates positive outcomes in terms of technical success rates, as well as promising survival and recurrence rates. Additionally, percutaneous biopsy under MR guidance offers an alternative to classic guidance modalities, providing high soft tissue contrast and thereby increasing the reliability of lesion detection, particularly in cases involving smaller lesions. Despite these advantages, the use of MR guidance in clinical routine is still limited to few indications and centers, due to by high costs, extended duration, and the need for specialized expertise. In conclusion, MRI-guided interventions could benefit from ongoing advancements in hardware, software, and devices. Such progress has the potential to expand diagnostic and treatment options in the field of interventional radiology.

磁共振引导程序:基本原理、技术和结果的共识
磁共振成像在介入放射学领域的一些应用中显示出巨大的潜力。本文介绍了核磁共振引导下肝脏肿瘤消融作为核磁共振引导手术的代表。患者选择和适当的设备使用是成功的核磁共振引导肿瘤消融的关键。在大多数情况下,术中规划成像可以在不使用造影剂的情况下可视化肿瘤和周围解剖结构,确保最佳规划涂抹器束。MRI能够实现实时、多平面成像,因此在具有挑战性的肿瘤位置的情况下,在靶向过程中可以同时观察涂抹器和目标肿瘤。MRI监测治疗过程中出现的典型消融区可以安全评估治疗结果,从而获得较高的初级有效率。消融探针的最新进展缩短了治疗时间,同时技术策略解决了涂抹器可见性问题。手术后立即进行核磁共振成像以排除并发症并评估技术成功与否。特别是在较小的肿瘤中,mri引导下的肝脏消融在技术成功率、生存率和复发率方面显示出积极的结果。此外,MR引导下的经皮活检提供了经典引导方式的替代方案,提供了高软组织对比度,从而增加了病变检测的可靠性,特别是在涉及较小病变的情况下。尽管有这些优势,但由于成本高、持续时间长和需要专业知识,MR指导在临床常规中的应用仍然局限于少数适应症和中心。总之,mri引导的干预可以从硬件、软件和设备的不断进步中受益。这一进展有可能扩大介入放射学领域的诊断和治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Techniques in Vascular and Interventional Radiology
Techniques in Vascular and Interventional Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.70
自引率
0.00%
发文量
47
期刊介绍: Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.
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