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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 3/2014

01-06-2014 | Laboratory Investigation

MR Guidance and Thermometry of Percutaneous Laser Disc Decompression in Open MRI: An Ex Vivo Study

Authors: Florian Streitparth, Thula Walter, Uta Wonneberger, Bernhard Schnackenburg, Carsten M. Philipp, Federico Collettini, Ulf K. M. Teichgräber, Bernhard Gebauer

Published in: CardioVascular and Interventional Radiology | Issue 3/2014

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Abstract

Purpose

To assess the feasibility of guidance and thermometry by open 1.0 T magnetic resonance (MR) imaging during percutaneous laser disc decompression (PLDD).

Methods

A fluoroscopic proton-density-weighted turbo spin echo sequence was used for positioning a laser fiber and a reference thermosensor within the targeted spinal disc. In 30 lumbar discs from human donors, nonspoiled gradient-echo (GRE) sequences with different echo times (TE) were compared to monitor thermal laser effects (Nd:YAG laser, 1,064 nm). Temperature distribution was visualized in real time on the basis of T1-weighted images and the proton resonance frequency (PRF) technique. Image quality, temperature accuracy, and correlation with macroscopic lesion sizes were analyzed. Image quality was confirmed in healthy volunteers.

Results

MR-guided placement of the laser fiber in the center of the targeted disk was precise. Best overall PLDD results—considering image quality (contrast-to-noise ratio), temperature accuracy (R 2 = 0.96), and correlation between the macroscopic and MR lesions (R 2 = 0.63)—were achieved with TE at 7 ms. The same TE value also gave the best image quality with healthy volunteers.

Conclusion

Instrument guidance and PRF-based thermometry of PLDD in the lumbar spine are feasible and accurate. Open 1.0 T MR imaging with fast spin-echo and GRE sequence designs may render laser discectomies more effective and controllable.
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Metadata
Title
MR Guidance and Thermometry of Percutaneous Laser Disc Decompression in Open MRI: An Ex Vivo Study
Authors
Florian Streitparth
Thula Walter
Uta Wonneberger
Bernhard Schnackenburg
Carsten M. Philipp
Federico Collettini
Ulf K. M. Teichgräber
Bernhard Gebauer
Publication date
01-06-2014
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 3/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-013-0734-8

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