Jose de Arcos1, Ehud J Schmidt2, Wei Wang3, Junichi Tokuda3, Kamal Vij4, Ravi T Seethamraju5, Antonio L Damato6, Charles L Dumoulin7, Robert A Cormack6, Akila N Viswanathan8. 1. Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: jfdearcos@gmail.com. 2. Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland. 3. Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts. 4. Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts. 5. MRI Interventions Inc, Irvine, California. 6. Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 7. Siemens Healthineers, Boston, Massachusetts. 8. Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, Maryland. Electronic address: anv@jhu.edu.
Abstract
PURPOSE: We designed and built dedicated active magnetic resonance (MR)-tracked (MRTR) stylets. We explored the role of MRTR in a prospective clinical trial. METHODS AND MATERIALS: Eleven gynecologic cancer patients underwent MRTR to rapidly optimize interstitial catheter placement. MRTR catheter tip location and orientation were computed and overlaid on images displayed on in-room monitors at rates of 6 to 16 frames per second. Three modes of actively tracked navigation were analyzed: coarse navigation to the approximate region around the tumor; fine-tuning, bringing the stylets to the desired location; and pullback, with MRTR stylets rapidly withdrawn from within the catheters, providing catheter trajectories for radiation treatment planning (RTP). Catheters with conventional stylets were inserted, forming baseline locations. MRTR stylets were substituted, and catheter navigation was performed by a clinician working inside the MRI bore, using monitor feedback. RESULTS: Coarse navigation allowed repositioning of the MRTR catheters tips by 16 mm (mean), relative to baseline, in 14 ± 5 s/catheter (mean ± standard deviation [SD]). The fine-tuning mode repositioned the catheter tips by a further 12 mm, in 24 ± 17 s/catheter. Pullback mode provided catheter trajectories with RTP point resolution of ∼1.5 mm, in 1 to 9 s/catheter. CONCLUSIONS: MRTR-based navigation resulted in rapid and optimal placement of interstitial brachytherapy catheters. Catheters were repositioned compared with the initial insertion without tracking. In pullback mode, catheter trajectories matched computed tomographic precision, enabling their use for RTP.
PURPOSE: We designed and built dedicated active magnetic resonance (MR)-tracked (MRTR) stylets. We explored the role of MRTR in a prospective clinical trial. METHODS AND MATERIALS: Eleven gynecologic cancerpatients underwent MRTR to rapidly optimize interstitial catheter placement. MRTR catheter tip location and orientation were computed and overlaid on images displayed on in-room monitors at rates of 6 to 16 frames per second. Three modes of actively tracked navigation were analyzed: coarse navigation to the approximate region around the tumor; fine-tuning, bringing the stylets to the desired location; and pullback, with MRTR stylets rapidly withdrawn from within the catheters, providing catheter trajectories for radiation treatment planning (RTP). Catheters with conventional stylets were inserted, forming baseline locations. MRTR stylets were substituted, and catheter navigation was performed by a clinician working inside the MRI bore, using monitor feedback. RESULTS: Coarse navigation allowed repositioning of the MRTR catheters tips by 16 mm (mean), relative to baseline, in 14 ± 5 s/catheter (mean ± standard deviation [SD]). The fine-tuning mode repositioned the catheter tips by a further 12 mm, in 24 ± 17 s/catheter. Pullback mode provided catheter trajectories with RTP point resolution of ∼1.5 mm, in 1 to 9 s/catheter. CONCLUSIONS: MRTR-based navigation resulted in rapid and optimal placement of interstitial brachytherapy catheters. Catheters were repositioned compared with the initial insertion without tracking. In pullback mode, catheter trajectories matched computed tomographic precision, enabling their use for RTP.
Authors: Akila N Viswanathan; Jackie Szymonifka; Clare M Tempany-Afdhal; Desmond A O'Farrell; Robert A Cormack Journal: Brachytherapy Date: 2013-02-12 Impact factor: 2.362
Authors: Junichi Tokuda; Gregory S Fischer; Xenophon Papademetris; Ziv Yaniv; Luis Ibanez; Patrick Cheng; Haiying Liu; Jack Blevins; Jumpei Arata; Alexandra J Golby; Tina Kapur; Steve Pieper; Everette C Burdette; Gabor Fichtinger; Clare M Tempany; Nobuhiko Hata Journal: Int J Med Robot Date: 2009-12 Impact factor: 2.547
Authors: Anthony L Gunderman; Ehud J Schmidt; Marc Morcos; Junichi Tokuda; Ravi T Seethamraju; Henry R Halperin; Akila N Viswanathan; Yue Chen Journal: IEEE ASME Trans Mechatron Date: 2021-03-09 Impact factor: 5.303