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Pediatric Radiology

, Volume 46, Issue 3, pp 407–412 | Cite as

MR cone-beam CT fusion image overlay for fluoroscopically guided percutaneous biopsies in pediatric patients

  • Avnesh S. ThakorEmail author
  • Premal A. Patel
  • Richard Gu
  • Vanessa Rea
  • Joao Amaral
  • Bairbre L. Connolly
Technical Innovation

Abstract

Lesions only visible on magnetic resonance (MR) imaging cannot easily be targeted for image-guided biopsy using ultrasound or X-rays but instead require MR guidance with MR-compatible needles and long procedure times (acquisition of multiple MR sequences). We developed an alternative method for performing these difficult biopsies in a standard interventional suite, by fusing MR with cone-beam CT images. The MR cone-beam CT fusion image is then used as an overlay to guide a biopsy needle to the target area under live fluoroscopic guidance. Advantages of this technique include (i) the ability for it to be performed in a conventional interventional suite, (ii) three-dimensional planning of the needle trajectory using cross-sectional imaging, (iii) real-time fluoroscopic guidance for needle trajectory correction and (iv) targeting within heterogeneous lesions based on MR signal characteristics to maximize the potential biopsy yield.

Keywords

Biopsy Bone Children Cone-beam computed tomography Image fusion Magnetic resonance imaging Soft tissue 

Notes

Compliance with ethical standards

Conflicts of interest

None

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Avnesh S. Thakor
    • 1
    • 2
    Email author
  • Premal A. Patel
    • 1
  • Richard Gu
    • 1
  • Vanessa Rea
    • 1
  • Joao Amaral
    • 1
  • Bairbre L. Connolly
    • 1
  1. 1.Image Guided Therapy, The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  2. 2.Division of Interventional Radiology, Department of Radiology, Lucile Packard Children’s HospitalStanford UniversityPalo AltoUSA

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