A case to use MRI for vascular intervention with XFM

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For vascular intervention, MRI should be used for diagnoses, particularly with x-ray fiducial markers (XFM), which fuses x-ray technology with MRI, according to Robert Lederman, MD, clinical research branch of the National Heart and Blood Institute. Lederman presented his view at the lecture series, “The Latest Advances in Cardiovascular MRI,” this week at the Transcatheter Cardiovascular Therapeutics conference in Washington, D.C.

He said that MRI can render multi-slice 3D images, but catheters present a problem. Lederman suggested that cardiologists “turn the catheters into an antenna,” so that it can be displayed, even in color, as an “active guidewire.” He also said that a major advantage of using an MRI in vascular intervention is the “immediate detection of an aortic wall rupture during a balloon angioplasty.”

Lederman did concede that real-time MRI (rtMRI) is not always helpful for cardiac imaging, saying that it is “easy to poke a hole in the wrong place.” He noted that in animal cardiac imaging, digital subtraction angiography (DSA) has a 17 percent success rate with the 79 percent success rate of rtMRI.

He said that rtMRI has had successful pre-clinical procedures, and there is a need to further investigate its advantages.

In particular, Lederman highlighted the advantages of XFM because it allows a lot of movement. He said that XFM “combines the best of MR and x-ray, and the images are available almost immediately.” Though, he did say that future development leaves room for improvement in automation.