Rapid freehand MR-guided percutaneous needle interventions: An image-based approach to improve workflow and feasibility

Eva Rothgang, Wesley D. Gilson, Frank Wacker, Joachim Hornegger, Christine H. Lorenz, Clifford R. Weiss

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Purpose: To develop and evaluate software-based methods for improving the workflow of magnetic resonance (MR)-guided percutaneous interventions. Materials and Methods: A set of methods was developed that allows the user to: 1) plan an entire procedure, 2) directly apply this plan to skin entry site localization without further imaging, and 3) place a needle under real-time MR guidance with automatic alignment of three orthogonal slices along a planned trajectory with preference to the principal patient axes. To validate targeting accuracy and time, phantom experiments (96 targets) and in vivo paraspinal and kidney needle punctures in two pigs (55 targets) were performed. The influence of trajectory obliquity, level of experience, and organ motion on targeting accuracy and time was analyzed. Results: Mean targeting error was 1.8 ± 0.9 mm (in vitro) and 2.9 ± 1.0 mm (in vivo) in all directions. No statistically significant differences in targeting accuracy between single- and double-oblique trajectories, novice and expert users, or paraspinal and kidney punctures were observed. The average time (in vivo) from trajectory planning to verification of accurate needle placement was 6 minutes. Conclusion: The developed methods allow for accurate needle placement along complex trajectories and are anticipated to reduce table time for MR-guided percutaneous needle interventions.

Original languageEnglish (US)
Pages (from-to)1202-1212
Number of pages11
JournalJournal of Magnetic Resonance Imaging
Issue number5
StatePublished - May 2013


  • MR-guided interventions
  • MR-guided therapy
  • interventional MRI
  • percutaneous interventions

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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