MR-Guided Interventions and Surgery

This chapter covers the use of magnetic resonance imaging (MRI) for guidance of interventional and operative procedures, including the basics on MRI systems design, integration, workflow principles, device visualization, and instrument positioning and tracking. MRI provides soft tissue contrast superior to x-ray technology and ultrasound. The contrast can be weighted towards water or fat, and images acquired in arbitrary, multiplanar orientations and three-dimensional (3-D) volumes. MRI’s flow and temperature sensitivity alongside its lack of ionizing radiation and nephrotoxic iodinated contrast agents renders it a suitable imaging technique for vascular and percutaneous interventions. Intraoperative MR imaging allows detection of hidden structures of the tissue volume in the surgical field. Although MRI has been applied since the beginning of the 1990s during operation and intervention, the lack of approved MRI-compatible tools and the technical hurdles in integrating MRI systems into clinical applications have hampered its wider distribution. These problems can be overcome through appropriate technical solutions and the use of suitable nonmagnetic and nonconductive materials.