Design, Performance, and Applications of a Hybrid X-Ray/MR System for Interventional Guidance

Image-guided minimally invasive procedures have made a substantial impact in improving patient management, reducing the cost, morbidity, and mortality of treatments and making therapies available to patients who would otherwise have no option. X-ray fluoroscopy and magnetic resonance imaging (MRI) are two powerful tools for guiding interventional procedures but with very different strengths and weaknesses. X-ray fluoroscopy offers very high spatial and temporal resolution and is excellent for guiding and deploying devices. MRI offers tomographic imaging with complete freedom of plane orientation, outstanding soft tissue discrimination, and the ability to portray physiological responses during treatment. We have shown that it is feasible to fully integrate an X-ray fluoroscopy system into the bore of an interventional MR scanner to provide a single congruent field of view, with integration requiring minor modifications to the flat-panel digital detector, and using a static-anode X-ray tube. Given the limited availability of the MR scanner platform (0.5T GE Signa SP magnet), and the X-ray fluence limitations of the static-anode X-ray tube, we are now investigating the technology developments required to place a rotating-anode digital flat-panel X-ray system immediately adjacent to a closed-bore MRI system. These types of hybrid systems could have enormous impact in the diagnosis and treatment of oncologic, cardiovascular, and other disorders.