Intraluminal MRI and interventions: Innovation and application
Year: 2024
Type: article
Abstract: Intraluminal magnetic resonance imaging (MRI) is a promising option to guide interventions, offering several advantages over other imaging modalities. It provides high spatial and contrast resolution for imaging luminal structures, excellent extra-luminal soft tissue visualization, real-time tracking of interventional devices, and operates without ionizing radiation. The applications of intraluminal MRI range from high-resolution imaging of vessel walls to MRI-guided interventions for managing life-threatening conditions such as cardiovascular atherosclerotic disease and malignancies within luminal structures. Clinical use of intraluminal MR technology optimizes endovascular delivery of therapeutics to targeted vessel segments and guides myocardial delivery of stem cells. However, advancements are still required, such as the refinement of MR-compatible interventional devices, development of real-time “MR fluoroscopy” similar to X-ray fluoroscopy, and establishment of safe clinical environments with large bore and short magnets. These improvements are essential for broader clinical adoption of intraluminal MR technology in healthcare. Intravascular MRI-guided and radiofrequency heat (RFH)-enhanced VEGF gene therapy of in-stent restenosis. (A) A multi-functional balloon catheter, with (1) a channel for inflation of the balloon against the target vessel wall; (2) a channel for local therapeutic infusion into the vessel wall though the micro-pores of the balloon under intravascular MRI guidance; and (3) a guidewire channel for placement of the MR imaging-heating-guidewire (MRIHG). (B) The protocol for intravascular MRI-guided and RFH-enhanced VEGF gene therapy to inhibit in-stent neointimal hyperplasia includes 1) initiation of a high-cholesterol diet; 2) delivery of VEGF genes into bilateral femoral-iliac arteries with local MRIHG-mediated RFH on the left; 3) placement of identical stents in gene-targeted bilateral artery segments; 4) continuation of high-cholesterol diet for additional two months; and 5) harvesting targeted tissues for pathology correlation. (C) Comparison between VEGF-only treated right femoral artery and VEGF/RFH-treated left femoral artery. (Upper panel) Radiographs obtained two months after bilateral femoral artery stenting. (Lower panel) Histologic examination of the stented arteries confirms the presence of neointimal hyperplasia (green lines) in VEGF-only treated right femoral-iliac artery, which is not detected in the VEGF/RFH-treated left femoral-iliac artery.
Source: EngMedicine
Authors: Feng Zhang, Grace Laidlaw, Guy Johnson, Hugh McGregor, Hongxiu Ji, Xiaoming Yang
Institution: University of Washington
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,300
OpenAlex ID: W4404663590