Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner

ABSTRACT: Background: Low-field (0.55T) magnetic resonance imaging (MRI) may allow MRI-guided interventions using available catheterization equipment, as radiofrequency-induced heating of interventional devices is reduced at low field. The purpose of this study was to test the feasibility of real-t...

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Main Authors: Aimee K. Armstrong, Yixuan Liu, John M. Kelly, Ramkumar Krishnamurthy, Jason Swinning, Yingmin Liu, Matthew Joseph, Ning Jin, Jianing Pang, Florian Maier, Axel J. Krafft, Orville Bramwell, Nathan Ooms, Jesse Roll, Joshua Krieger, David C. Gross, Lucien de Mos, Paul Borm, Orlando P. Simonetti
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Cardiovascular Magnetic Resonance
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Online Access:http://www.sciencedirect.com/science/article/pii/S1097664725000201
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author Aimee K. Armstrong
Yixuan Liu
John M. Kelly
Ramkumar Krishnamurthy
Jason Swinning
Yingmin Liu
Matthew Joseph
Ning Jin
Jianing Pang
Florian Maier
Axel J. Krafft
Orville Bramwell
Nathan Ooms
Jesse Roll
Joshua Krieger
David C. Gross
Lucien de Mos
Paul Borm
Orlando P. Simonetti
author_facet Aimee K. Armstrong
Yixuan Liu
John M. Kelly
Ramkumar Krishnamurthy
Jason Swinning
Yingmin Liu
Matthew Joseph
Ning Jin
Jianing Pang
Florian Maier
Axel J. Krafft
Orville Bramwell
Nathan Ooms
Jesse Roll
Joshua Krieger
David C. Gross
Lucien de Mos
Paul Borm
Orlando P. Simonetti
author_sort Aimee K. Armstrong
collection DOAJ
description ABSTRACT: Background: Low-field (0.55T) magnetic resonance imaging (MRI) may allow MRI-guided interventions using available catheterization equipment, as radiofrequency-induced heating of interventional devices is reduced at low field. The purpose of this study was to test the feasibility of real-time MRI-guided right and left heart catheterization (R&LHC) as well as angioplasty and stenting of the inferior vena cava using a commercially available 0.55T MRI system (MAGNETOM Free.Max, Siemens Healthineers AG, Erlangen, Germany) with 80 cm patient bore and maximum gradient amplitude and slew rate of 26 mT/m and 45 mT/m/ms, respectively. A secondary aim was to evaluate three different sizes of magnetic resonance (MR)-visible markers. Methods: Sheaths were placed in the femoral vein and artery of juvenile Yorkshire pigs under general anesthesia. Air-filled balloon wedge catheters and Judkins right catheters were used for R&LHC, respectively, aided by an MR-compatible guidewire. Ferumoxytol was administered as a T1-shortening contrast agent and real-time visualization was carried out with a research interactive sequence using different spatiotemporal resolution settings. IVC angioplasty was performed using balloons filled with 1% gadolinium, and IVC stenting was performed with stainless-steel stents and one platinum-iridium-covered sten. Results: RHC was successful in all eight attempts with balloon tip visibility in all real-time protocols. One pig expired with ferumoxytol infusion, but the catheterization was completed post-mortem. LHC and IVC angioplasty were attempted and successful in two and four pigs, respectively. For stenting, higher resolution, lower frame rate imaging was used. All six attempted stent implantations were successful. The MR markers on the angioplasty balloon with widths of 0.5 and 1 mm were more visible than the 0.25 mm markers. Marker placement affected distinguishability from the crimped stent. Stainless-steel stents created only minimal signal voids pre- and post-deployment; however, the platinum-iridium stent caused significant artifact obscuring wall apposition assessment. Conclusion: This study is the first to demonstrate the technical feasibility of R&LHC, IVC angioplasty, and IVC stenting using real-time MRI on a commercially available low-field scanner.
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spelling doaj-art-b60a72b3fcb440429fd6aee856619a3d2025-08-20T02:34:15ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110185810.1016/j.jocmr.2025.101858Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scannerAimee K. Armstrong0Yixuan Liu1John M. Kelly2Ramkumar Krishnamurthy3Jason Swinning4Yingmin Liu5Matthew Joseph6Ning Jin7Jianing Pang8Florian Maier9Axel J. Krafft10Orville Bramwell11Nathan Ooms12Jesse Roll13Joshua Krieger14David C. Gross15Lucien de Mos16Paul Borm17Orlando P. Simonetti18The Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, USA; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USADepartment of Biomedical Engineering, The Ohio State University, Columbus, Ohio, USAThe Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, USA; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USAMedical and Scientific Affairs, Icon Clinical Research, Blue Bell, Pennsylvania, USAThe Heart Center, Nationwide Children’s Hospital, Columbus, Ohio, USADorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USADorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, USASiemens Medical Solutions USA Inc., Malvern, Pennsylvania, USASiemens Medical Solutions USA Inc., Malvern, Pennsylvania, USASiemens Healthineers AG, Erlangen,GermanySiemens Healthineers AG, Erlangen,GermanyCook Advanced Technologies, West Lafayette, Indiana, USACook Advanced Technologies, West Lafayette, Indiana, USACook Advanced Technologies, West Lafayette, Indiana, USACook Advanced Technologies, West Lafayette, Indiana, USAMED Institute, West Lafayette, Indiana, USANano4Imaging GmbH, Life Sciences Centre, Düsseldorf, GermanyNano4Imaging GmbH, Life Sciences Centre, Düsseldorf, GermanyDepartment of Radiology, The Ohio State University, Columbus, Ohio, USA; Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA; Corresponding author.ABSTRACT: Background: Low-field (0.55T) magnetic resonance imaging (MRI) may allow MRI-guided interventions using available catheterization equipment, as radiofrequency-induced heating of interventional devices is reduced at low field. The purpose of this study was to test the feasibility of real-time MRI-guided right and left heart catheterization (R&LHC) as well as angioplasty and stenting of the inferior vena cava using a commercially available 0.55T MRI system (MAGNETOM Free.Max, Siemens Healthineers AG, Erlangen, Germany) with 80 cm patient bore and maximum gradient amplitude and slew rate of 26 mT/m and 45 mT/m/ms, respectively. A secondary aim was to evaluate three different sizes of magnetic resonance (MR)-visible markers. Methods: Sheaths were placed in the femoral vein and artery of juvenile Yorkshire pigs under general anesthesia. Air-filled balloon wedge catheters and Judkins right catheters were used for R&LHC, respectively, aided by an MR-compatible guidewire. Ferumoxytol was administered as a T1-shortening contrast agent and real-time visualization was carried out with a research interactive sequence using different spatiotemporal resolution settings. IVC angioplasty was performed using balloons filled with 1% gadolinium, and IVC stenting was performed with stainless-steel stents and one platinum-iridium-covered sten. Results: RHC was successful in all eight attempts with balloon tip visibility in all real-time protocols. One pig expired with ferumoxytol infusion, but the catheterization was completed post-mortem. LHC and IVC angioplasty were attempted and successful in two and four pigs, respectively. For stenting, higher resolution, lower frame rate imaging was used. All six attempted stent implantations were successful. The MR markers on the angioplasty balloon with widths of 0.5 and 1 mm were more visible than the 0.25 mm markers. Marker placement affected distinguishability from the crimped stent. Stainless-steel stents created only minimal signal voids pre- and post-deployment; however, the platinum-iridium stent caused significant artifact obscuring wall apposition assessment. Conclusion: This study is the first to demonstrate the technical feasibility of R&LHC, IVC angioplasty, and IVC stenting using real-time MRI on a commercially available low-field scanner.http://www.sciencedirect.com/science/article/pii/S1097664725000201Interventional cardiovascular magnetic resonance imagingLow-field MRIMRI-guided procedures
spellingShingle Aimee K. Armstrong
Yixuan Liu
John M. Kelly
Ramkumar Krishnamurthy
Jason Swinning
Yingmin Liu
Matthew Joseph
Ning Jin
Jianing Pang
Florian Maier
Axel J. Krafft
Orville Bramwell
Nathan Ooms
Jesse Roll
Joshua Krieger
David C. Gross
Lucien de Mos
Paul Borm
Orlando P. Simonetti
Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner
Journal of Cardiovascular Magnetic Resonance
Interventional cardiovascular magnetic resonance imaging
Low-field MRI
MRI-guided procedures
title Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner
title_full Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner
title_fullStr Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner
title_full_unstemmed Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner
title_short Feasibility of magnetic resonance imaging-guided cardiac catheterization, angioplasty, and stenting in a commercial wide-bore 0.55T scanner
title_sort feasibility of magnetic resonance imaging guided cardiac catheterization angioplasty and stenting in a commercial wide bore 0 55t scanner
topic Interventional cardiovascular magnetic resonance imaging
Low-field MRI
MRI-guided procedures
url http://www.sciencedirect.com/science/article/pii/S1097664725000201
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