Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 May;17(5):31.
doi: 10.1007/s11886-015-0580-1.

Interventional CMR: Clinical applications and future directions

Toby Rogers  1 , Robert J Lederman
Affiliations
Review

Interventional CMR: Clinical applications and future directions

Toby Rogers et al. Curr Cardiol Rep. 2015 May.

Abstract

Interventional cardiovascular magnetic resonance (iCMR) promises to enable radiation-free catheterization procedures and to enhance contemporary image guidance for structural heart and electrophysiological interventions. However, clinical translation of exciting pre-clinical interventions has been limited by availability of devices that are safe to use in the magnetic resonance (MR) environment. We discuss challenges and solutions for clinical translation, including MR-conditional and MR-safe device design, and how to configure an interventional suite. We review the recent advances that have already enabled diagnostic MR right heart catheterization and simple electrophysiologic ablation to be performed in humans and explore future clinical applications.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Toby Rogers and Robert J. Lederman are full-time employees of NHLBI, NIH.

Robert J. Lederman is a co-inventor on patents, assigned to NIH, for catheter devices to be used under MR guidance.

Figures

Fig. 1
Fig. 1
Clinical X-ray fused with MRI (XFM)-guided closure of ventricular-atrial (Gerbode) defect. a Four-chamber cine MRI showing defect between left ventricle and right atrium (arrow). Left-to-right flow is clearly seen. b XFM image in which the defect appears as a red overlay on the fluoroscopy (arrow). c Nitinol closure device on its delivery cable positioned across the defect. Both discs have been deployed. d Closure device after release. (Courtesy of Kanishka Ratnayaka (2014), Department of Cardiology, Children’s National Hospital Center, Washington DC, USA)
Fig. 2
Fig. 2
Clinical MRI right heart catheterization. The gadolinium-filled balloon at the tip of the catheter is visible as a white ball (arrows) in the inferior vena cava (a), superior vena cava (b), right ventricle (c), and right pulmonary artery (d)
Fig. 3
Fig. 3
Clinical MR-guided electroanatomic mapping and ablation. a Real-time MR imaging of the electroanatomic mapping and ablation catheter. The passively tracked tip (arrow) is positioned above the cavo-tricuspid isthmus. Post-ablation T2-weighted (b) and late gadolinium enhancement (c) images of the cavo-tricuspid isthmus showing the ablation lesion (arrows). AA ascending aorta, MV mitral valve, RA right atrium, RV right ventricle. (Courtesy of M. Gutberlet, M. Grothoff and G. Hindricks (2014), University of Leipzig, Germany)
See this image and copyright information in PMC

References

    1. de Silva R, Gutierrez LF, Raval AN, McVeigh ER, Ozturk C, Lederman RJ. X-ray fused with magnetic resonance imaging (XFM) to target endomyocardial injections: validation in a swine model of myocardial infarction. Circulation. 2006;114(22):2342–50. doi: 10.1161/CIRCULATIONAHA.105.598524. - DOI - PMC - PubMed
    1. Dori Y, Sarmiento M, Glatz AC, Gillespie MJ, Jones VM, Harris MA, et al. X-ray magnetic resonance fusion to internal markers and utility in congenital heart disease catheterization. Circ: Cardiovascular Imaging. 2011;4(4):415–24. doi: 10.1161/circimaging.111.963868. - DOI - PMC - PubMed
    1. Faranesh AZ, Kellman P, Ratnayaka K, Lederman RJ. Integration of cardiac and respiratory motion into MRI roadmaps fused with x-ray. Med Phys. 2013;40(3):032302. doi: 10.1118/1.4789919. - DOI - PMC - PubMed
    1. Abu Hazeem AA, Dori Y, Whitehead KK, Harris MA, Fogel MA, Gillespie MJ, et al. X-ray magnetic resonance fusion modality may reduce radiation exposure and contrast dose in diagnostic cardiac catheterization of congenital heart disease. Catheter Cardiovasc Interv. 2014 doi: 10.1002/ccd.25473. - DOI - PubMed
    1. Avula S, Mallucci CL, Pizer B, Garlick D, Crooks D, Abernethy LJ. Intraoperative 3-Tesla MRI in the management of paediatric cranial tumours–initial experience. Pediatr Radiol. 2012;42(2):158–67. doi: 10.1007/s00247-011-2261-6. - DOI - PubMed

Publication types

LinkOut - more resources