@article {Marker2017, title = {1.5 Tesla augmented reality navigated interventional magnetic resonance imaging: paravertebral sympathetic plexus injections}, journal = {Diagnostic and Interventional Radiology}, year = {In Press}, month = {01/2017}, author = {David R. Marker and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino and Jan Fritz} } @article {Marker2016, title = {MR-guided perineural injection of the ganglion impar: technical considerations and feasibility}, journal = {Skeletal Radiology}, year = {2016}, month = {01/2016}, abstract = {

Objective

Perineural ganglion impar injections are used in the management of pelvic pain syndromes; however, there is no consensus regarding the optimal image guidance. Magnetic resonance imaging (MRI) provides high soft tissue contrast and the potential to directly visualize and target the ganglion. The purpose of this study was to assess the feasibility of MR-guided percutaneous perineural ganglion impar injections.

Materials and methods

Six MR-guided ganglion impar injections were performed in six human cadavers. Procedures were performed with a clinical 1.5-Tesla MRI system through a far lateral transgluteus approach. Ganglion impar visibility, distance from the sacrococcygeal joint, number of intermittent MRI control steps required to place the needle, target error between the intended and final needle tip location, inadvertent punctures of non-targeted vulnerable structures, injectant distribution, and procedure time were determined.

Results

The ganglion impar was seen on MRI in 4/6 (66\ \%) of cases and located 0.8\ mm cephalad to 16.3\ mm caudad (average 1.2\ mm caudad) to the midpoint of the sacrococcygeal joint. Needle placement required an average of three MRI control steps (range, 2{\textendash}6). The average target error was 2.2 {\textpm} 2.1\ mm. In 6/6 cases (100\ \%), there was appropriate periganglionic distribution and filling of the presacrococcygeal space. No punctures of non-targeted structures occurred. The median procedure time was 20\ min (range, 12{\textendash}29\ min).

Conclusion

Interventional MRI can visualize and directly target the ganglion impar for accurate needle placement and successful periganglionic injection with the additional benefit of no ionizing radiation exposure to patient and staff. Our results support clinical evaluation.

}, url = {http://dx.doi.org/10.1007/s00256-016-2333-7}, author = {David R. Marker and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino and Jan Fritz} } @conference {Anand2014b, title = {Design and Development of a Mobile Image Overlay System for Image-Guided Needle Interventions}, booktitle = {36th Annual International Conference of IEEE EMBS}, year = {2014}, month = {Accepted}, publisher = {IEEE EMBS}, organization = {IEEE EMBS}, address = {Chicago, IL, USA}, author = {Manjunath Anand and Franklin King and Tamas Ungi and Andras Lasso and John Rudan and Jagadeesan Jayender and Jan Fritz and John A Carrino and Ferenc Jolesz and Gabor Fichtinger} } @article {Anand2014a, title = {Design of mobile image overlay system for image-guided interventions}, year = {2014}, month = {03/2014}, publisher = {ImNO}, address = {Toronto, Canada. March 24-25}, author = {Manjunath Anand and Franklin King and Tamas Ungi and Andras Lasso and John Rudan and Jagadeesan Jayender and Jan Fritz and Ferenc Jolesz and John A Carrino and Gabor Fichtinger} } @article {Fritz2014, title = {MR-Guided Vertebroplasty With Augmented Reality Image Overlay Navigation}, journal = {Cardiovasc Intervent Radiol}, year = {2014}, month = {04/2014}, doi = {10.1007/s00270-014-0885-2}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Sudhir Kathuria and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2013a, title = {Augmented reality visualisation using an image overlay system for MR-guided interventions: technical performance of spine injection procedures in human cadavers at 1.5 Tesla}, journal = {European Radiology}, volume = {23}, year = {2013}, month = {01/2013}, pages = {235-245}, issn = {0938-7994}, doi = {10.1007/s00330-012-2569-0}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22797956}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2013b, title = {Augmented Reality Visualization Using Image Overlay Technology for MR-Guided Interventions: Cadaveric Bone Biopsy at 1.5 T}, journal = {Investigative Radiology}, volume = {48}, number = {6}, year = {2013}, month = {06/2013}, keywords = {augmented reality, image overlay, interventional MR imaging, MR-guided, MRI guidance, MRI-guided bone biopsy, navigation, osscous biopsy}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23328911}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and McCarthy, EF. and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Anand2013a, title = {Mobile Image Overlay System for Image Guided Interventions}, year = {2013}, month = {03/2013}, address = {Washington DC, USA, March 21-23, 2013.}, keywords = {image guided interventions, mobile image overlay, needle placement interventions, percutaneous interventions, static image overlay}, author = {Manjunath Anand and Tamas Ungi and Andras Lasso and Paweena U-Thainual and Jagadeesan Jayender and Jan Fritz and John A Carrino and Ferenc Jolesz and Gabor Fichtinger} } @article {Anand2013c, title = {MOBILE IMAGE OVERLAY SYSTEM (MIOS) FOR IMAGE GUIDED INTERVENTIONS}, year = {2013}, month = {06/2013}, address = {Faculty of Health Sciences, Queen{\textquoteright}s University}, author = {Manjunath Anand and Tamas Ungi and Andras Lasso and Paweena U-Thainual and Jagadeesan Jayender and Jan Fritz and John A Carrino and Ferenc Jolesz and Gabor Fichtinger} } @article {U-Thainual2013a, title = {MR Image Overlay Adjustable Plane System for Musculoskeletal Interventions}, year = {2013}, address = {Toronto, Ontario, Canada, February 4-5, 2013}, keywords = {adjustable plane overlay system, augmented reality system, image overlay, MRI-guided}, author = {Paweena U-Thainual and Jan Fritz and Tamas Ungi and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {U-Thainual2013b, title = {MR image overlay guidance: system evaluation for preclinical use}, journal = {International Journal of Computer Assisted Radiology and Surgery}, volume = {8}, year = {2013}, month = {05/2013}, pages = {365-378}, issn = {1861-6410}, doi = {10.1007/s11548-012-0788-0}, author = {Paweena U-Thainual and Jan Fritz and Choladawan Moonjaita and Tamas Ungi and Aaron J Flammang and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @conference {Anand2013b, title = {Workspace Analysis and Calibration Method for Mobile Image Overlay System used for Image-Guided Interventions}, booktitle = {The Hamlyn Symposium on Medical Robotics - 2013}, year = {2013}, month = {06/2013}, author = {Manjunath Anand and Tamas Ungi and Andras Lasso and Paweena U-Thainual and Jagadeesan Jayender and Jan Fritz and John A Carrino and Ferenc Jolesz and Gabor Fichtinger} } @article {Fritz2012c, title = {Augmented Reality Visualization Using Image-Overlay for MR-guided Interventions: Performance Assessment of Paravertebral Sympathetic Perineural Injections in Cadavers at 1.5 Tesla}, year = {2012}, month = {06/2012}, pages = {S509-S511}, address = {Pisa, Italy, June 27-30}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2012a, title = {Augmented Reality Visualization Using Image-Overlay for MR-Guided Interventions: Accuracy for Lumbar Spinal Procedures with a 1.5-Tesla MRI scanner.}, journal = {American Journal of Roentgenology}, volume = {198}, year = {2012}, month = {03/2012}, pages = {W266-73}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Nathan Bongjoon Cho and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {Fritz2012b, title = {Augmented Reality Visualization with Use of Image Overlay Technology for MR Imaging{\textendash}guided Interventions: Assessment of Performance in Cadaveric Shoulder and Hip Arthrography at 1.5 T}, journal = {Radiology}, volume = {265}, number = {1}, year = {2012}, month = {10/2012}, pages = {254-259}, doi = {10.1148/radiol.12112640}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {U-Thainual2012a, title = {MR Image Overlay Guidance: System Evaluation for Clinical Use}, year = {2012}, month = {06/2012}, pages = {S179-S180}, address = {Pisa, Italy, June 27-30}, keywords = {augmented reality, image overlay, needle guidance, percutaneous interventions}, author = {Paweena U-Thainual and Jan Fritz and Choladawan Moonjaita and Tamas Ungi and Aaron J Flammang and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {Weiss2009, title = {Augmented Reality Visualization for MR-guided Interventions using "Image Overlay": System Description, Feasibility, and Initial Evaluation in a spine phantom}, journal = {American Journal of Roentgenology}, volume = {196}, number = {3}, year = {2011}, month = {03/2011}, pages = {W305 - W307}, author = {Clifford Weiss and David R.Marker and Gregory Fischer and Gabor Fichtinger and Antonio J. Machado and John A Carrino} } @article {Fritz2011, title = {Augmented reality visualization using image-overlay for MR-guided interventions: assessment of accuracy for lumbar spinal procedures with a 1.5-Tesla MRI scanner}, year = {2011}, month = {09/2011}, address = {Munich, Germany}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Nathan Bongjoon Cho and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @conference {Fritz2011a, title = {Augmented Reality Visualization Using Image-overlay for MR-guided Interventions: Assessment of Performance in Cadaveric Shoulder and Hip Arthrography}, booktitle = {RSNA 97th Scientific Assembly and Annual Meeting}, year = {2011}, month = {07/2012}, address = {Chicago, IL}, doi = {10.1148/radiol.12112640}, url = {http://radiology.rsna.org/content/early/2012/07/24/radiol.12112640.abstract}, author = {Jan Fritz and Paweena U-Thainual and Tamas Ungi and Aaron J Flammang and Nathan Bongjoon Cho and Gabor Fichtinger and Iulian Iordachita and John A Carrino} } @article {U-Thainual2011, title = {MR Image Overlay Adjustable Plane System for Percutaneous Musculoskeletal Interventions}, volume = {4}, year = {2011}, month = {10/2011}, address = {Arlington VA, October 12-13, 2011}, author = {Paweena U-Thainual and Tamas Ungi and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @article {U-Thainual2010, title = {Evaluation of accuracy and clinical feasibility of the MR-compatible image overlay}, year = {2010}, address = {Leipzig, Germany, September 24-25, 2010}, keywords = {augmented reality, Image overlay system, MRI-guided}, author = {Paweena U-Thainual and Jan Fritz and Nathan Bongjoon Cho and Tamas Ungi and Segundo, AJM and John A Carrino and Gabor Fichtinger and Lewin, JS and Iulian Iordachita} } @article {Vikal2009a, title = {Perk Station-Percutaneous surgery training and performance measurement platform}, journal = {Computerized Medical Imaging and Graphics}, volume = {34}, year = {2009}, month = {05/2009}, pages = {19-32}, abstract = {

MOTIVATION: Image-guided percutaneous (through the skin) needle-based surgery has become part of routine clinical practice in performing procedures such as biopsies, injections, therapeutic implants A novice physician typically performs needle interventions under the supervision of a senior physician; a slow, inherently subjective training process that lacks objective, quantitative assessment of the surgical skill, performance Shortening the learning curve, increasing procedural consistency are important factors in assuring high-quality medical care METHODS: This paper describes a laboratory validation system, called Perk Station, for standardized training, performance measurement under different assistance techniques for needle-based surgical guidance systems The initial goal of the Perk Station is to assess, compare different techniques: 2D image overlay, biplane laser guide, laser protractor, conventional freehand The main focus of this manuscript is the planning, guidance software system developed on the 3D Slicer platform, a free, open source software package designed for visualization, analysis of medical image data RESULTS: The prototype Perk Station has been successfully developed, the associated needle insertion phantoms were built, and the graphical user interface was fully implemented The system was inaugurated in undergraduate teaching, a wide array of outreach activities Initial results, experiences, ongoing activities, future plans are reported

}, doi = {10.1016/j.compmedimag.2009.05.001}, url = {http://dx.doi.org/10.1016/j.compmedimag.2009.05.001}, author = {Siddharth Vikal and Paweena U-Thainual and John A Carrino and Iulian Iordachita and Gregory Fischer and Gabor Fichtinger} } @conference {U-Thainual2008, title = {MR/CT Percutaneous Intervention Training Suite}, booktitle = {7th International Symposium on Interventional MRI}, year = {2008}, pages = {81-85}, author = {Paweena U-Thainual and Gregory Fischer and John A Carrino and Gabor Fichtinger and Iulian Iordachita} } @conference {Fischer2008c, title = {A Training Suite for Image Overlay and Other Needle Insertion Techniques}, booktitle = {2008 MICCAI Workshop - Augmented Environments for Medical Imaging and Computer-Aided Surgery (AMI-ARCS)}, year = {2008}, author = {Gregory Fischer and Iulian Iordachita and Paweena U-Thainual and John A Carrino and Gabor Fichtinger} } @conference {Fischer2007c, title = {Evaluation of MR Image Overlay for Spinal Interventions}, booktitle = {International Society for Magnetic Resonance in Medicine 15th Scientific Meeting - ISMRM}, year = {2007}, pages = {3394}, author = {Gregory Fischer and Clifford Weiss and Eva Dyer and Csaba Csoma and Anton Degeut and John A Carrino and Gabor Fichtinger} } @article {Fischer2007, title = {MRI image overlay: application to arthrography needle insertion}, journal = {Journal of Computer Aided Surgery}, volume = {12}, number = {1}, year = {2007}, month = {Jan}, pages = {2{\textendash}14}, publisher = {Engineering Research Center, Johns Hopkins University, Baltimore, Maryland, USA gfisch@jhu edu}, abstract = {

Magnetic Resonance Imaging (MRI) offers great potential for planning, guiding, monitoring, controlling interventions MR arthrography (MRAr) is the imaging gold standard for assessing small ligament, fibrocartilage injury in joints In contemporary practice, MRAr consists of two consecutive sessions: (1) an interventional session where a needle is driven to the joint space, MR contrast is injected under fluoroscopy or CT guidance;, (2) a diagnostic MRI imaging session to visualize the distribution of contrast inside the joint space, evaluate the condition of the joint Our approach to MRAr is to eliminate the separate radiologically guided needle insertion, contrast injection procedure by performing those tasks on conventional high-field closed MRI scanners We propose a 2D augmented reality image overlay device to guide needle insertion procedures This approach makes diagnostic high-field magnets available for interventions without a complex, expensive engineering entourage In preclinical trials, needle insertions have been performed in the joints of porcine, human cadavers using MR image overlay guidance; in all cases, insertions successfully reached the joint space on the first attempt

}, keywords = {Arthrography, Cartilage, Contrast Media, diagnosis, Humans, injuries, instrumentation, Joint Diseases, Ligaments, Magnetic Resonance Imaging, Needles}, doi = {10 1080/10929080601169930}, url = {http://dx doi org/10 1080/10929080601169930}, author = {Gregory Fischer and Anton Degeut and Csaba Csoma and Russell H. Taylor and Laura Fayad and John A Carrino and James Zinreich and Gabor Fichtinger} } @conference {Fischer2006h, title = {Image Overlay for MR-Guided Joint Arthrography}, booktitle = {6th Interventional MRI Symposium}, year = {2006}, pages = {240-242}, author = {Gregory Fischer and Anton Degeut and Csaba Csoma and Russell H. Taylor and Laura Fayad and John A Carrino and James Zinreich and Gabor Fichtinger} } @conference {Fischer2006i, title = {MRI Image Overlay: Application to Arthrography Needle Insertion}, booktitle = {AMI-ARCS workshop to the 9th MICCAI Conference}, year = {2006}, author = {Gregory Fischer and Anton Degeut and Csaba Csoma and Russell H. Taylor and Laura Fayad and John A Carrino and James Zinreich and Gabor Fichtinger} }