Patent Publication Number: US-2022218317-A1

Title: Tissue Removal Devices and Kits Useful for Performing Treatment under Magnetic Resonance Imaging and Related Methods

Description:
RELATED APPLICATIONS 
     This application claims priority to U.S. Provisional Application No. 63/135,935, filed Jan. 11, 2021. The entire contents of this related application are hereby incorporated by reference into this disclosure. 
    
    
     FIELD 
     The disclosure relates generally to the field of medical devices. More particularly, the disclosure relates to tissue removal devices useful in performing treatment under magnetic resonance imaging (MRI), kits useful in performing treatment under MRI, and methods of performing interventional medical treatment under MRI. 
     BACKGROUND 
     The field of interventional MRI is gaining wider acceptance and seeing an increase in the number of procedures that can be performed. Interventional procedures conducted under MRI have several benefits over X-Ray-guided interventions. For example, the patient is not exposed to ionizing radiation. Also, MRI provides the ability to characterize tissue and functional flow during an interventional procedure. 
     The development of interventional procedures conducted under MRI has been limited as a result of the tools needed to perform these procedures being unavailable. Therefore, patients are required to make multiple visits to treatment facilities to visualize, diagnose, and treat various conditions. In addition, multiple imaging modalities are often needed, which impacts the accuracy of utilizing a magnetic resonance image in directing intervention. For example, when addressing prostate cancer, visualization, biopsy, and treatment are currently completed over the course of three patient visits. At a first visit, a scan is completed using a magnetic resonance scanner to produce an image showing the prostate and any abnormalities. The patient then leaves the facility and awaits a review of the image. If abnormalities exist, a second patient visit will occur such that a biopsy sample of the abnormal tissue can be completed. Currently, software is used to fuse the magnetic resonance image with the procedural ultrasound to provide guidance in conducting the biopsy. This fusion decreases the value of the diagnostic magnetic resonance image. The patient then leaves the facility again and awaits a review of the biopsy sample to determine whether further treatment is required (e.g., if the review results in a positive prostate cancer diagnosis). If further treatment is required, the patient will visit the facility a third time such that treatment can be performed. Completion of these three patient visits can take months, prevents the patient from receiving rapid treatment, and increases the overall costs associated with treatment. Furthermore, software used to fuse magnetic resonance images with other images (e.g., those obtained via ultrasound) have drawbacks, such as potential image overlay issues and the potential for compression shifting of tissues (e.g., prostate). 
     A need exists, therefore, for new and improved tissue removal devices useful in performing treatment under MRI, kits useful in performing treatment under MRI, and methods of performing interventional medical treatment under MRI. 
     SUMMARY OF SELECTED EXAMPLE EMBODIMENTS 
     Various example tissue removal devices useful in performing treatment under MRI, kits useful in performing treatment under MRI, and methods of performing interventional medical treatment under MRI are described herein. 
     An example tissue removal device useful in performing treatment under MRI includes an elongate member and a tubular member partially disposed over the elongate member. The elongate member has a lengthwise axis and a main body that defines a lumen, a proximal portion, a coil member, and a sharp edge. The coil member has a first end and a second end. The first end is attached to the proximal portion. The second end is free of attachment to the proximal portion. The coil member extends from the first end around a portion of the lengthwise axis in a first direction to the second end. The coil member extends from the first end and away from the lengthwise axis to the second end. The coil member extends away from the first end and away from proximal portion to the second end. The sharp edge is defined on the second end of the coil member. The tubular member has a proximal end, a distal end, and a main body that defines a lumen and a slot. The lumen of the tubular member extends from the proximal end of the tubular member to the distal end of the tubular member. The slot extends from the distal end of the tubular member toward the proximal end of the tubular member. The slot is sized to receive a portion of the coil member. 
     An example kit useful in performing treatment under MRI includes a tissue removal device and a system for use with a tissue removal device. 
     An example method of performing an interventional medical treatment under MRI comprises: positioning a patient within a magnetic resonance scanner; scanning a first portion of the patient using the magnetic resonance scanner; obtaining a magnetic resonance image of the first portion of the patient; identifying a tissue that has predefined characteristics using the magnetic resonance image; while the patient remains positioned within the magnetic resonance scanner used to scan a portion of the patient, advancing a medical device into a bodily passage and to the tissue while scanning a second portion of the patient that includes the medical device using the magnetic resonance scanner; comprises obtaining a magnetic resonance image of the second portion of the patient that includes the medical device; confirming the position of the medical device within the bodily passage; advancing a biopsy device through the medical device and to the tissue while scanning a third portion of the patient that includes the biopsy device using the magnetic resonance scanner; obtaining a magnetic resonance image of the third portion of the patient that includes the biopsy device; confirming the position of the biopsy device; collecting a tissue sample from the tissue using the biopsy device while scanning a fourth portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner; obtaining a magnetic resonance image of the fourth portion of the patient that includes the biopsy device; confirming the tissue sample has been collected; withdrawing the biopsy device and the tissue sample through the medical device; determining whether the tissue sample meets a predefined criterion; if the tissue sample does not meet the predefined criterion, withdrawing the medical device from the bodily passage and removing the patient from the magnetic resonance scanner; if the tissue sample meets the predefined criterion, advancing an anchor member through the medical device through which the biopsy device was advanced and to the tissue while the patient remains positioned within the magnetic resonance scanner; securing the anchor member to the tissue to retain the position of the medical device relative to the tissue; advancing a first inner sheath over the medical device and toward the tissue to dilate the bodily passage; advancing a second inner sheath over the first inner sheath and toward the tissue to dilate the bodily passage; advancing an outer sheath over the second inner sheath and toward the tissue to dilate the bodily passage; removing the anchor member from the tissue; withdrawing the anchor member from the bodily passage; withdrawing the medical device from the bodily passage; withdrawing the first inner sheath from the bodily passage; withdrawing the second inner sheath from the bodily passage; advancing a treatment device through the outer sheath and to the tissue; manipulating the tissue using the treatment device; withdrawing the treatment device from the outer sheath; scanning a first portion of the patient using the magnetic resonance scanner; advancing a tissue removal device through the outer sheath and to the tissue; manipulating the tissue using the tissue removal device; withdrawing the tissue removal device from the outer sheath; withdrawing the outer sheath from the bodily passage. 
     Another example method of performing an interventional medical treatment under MRI comprises: positioning a patient within a magnetic resonance scanner; scanning a first portion of the patient using the magnetic resonance scanner; obtaining a magnetic resonance image of the first portion of the patient; identifying a tissue that has predefined characteristics using the magnetic resonance image; while the patient remains positioned within the magnetic resonance scanner used to scan a portion of the patient, advancing a medical device into a bodily passage and to the tissue while scanning a second portion of the patient that includes the medical device using the magnetic resonance scanner; obtaining a magnetic resonance image of the second portion of the patient that includes the medical device; confirming the position of the medical device within the bodily passage; advancing an anchor member through the medical device and to the tissue while the patient remains positioned within the magnetic resonance scanner; securing the anchor member to the tissue to retain the position of the anchor member relative to the tissue; withdrawing the medical device from the bodily passage; advancing a first inner sheath over the anchor member and toward the tissue to dilate the bodily passage; advancing a second inner sheath over the first inner sheath and toward the tissue to dilate the bodily passage; advancing an outer sheath over the second inner sheath and toward the tissue to dilate the bodily passage; withdrawing the first inner sheath from the bodily passage; withdrawing the second inner sheath from the bodily passage; removing the anchor member from the tissue; withdrawing the anchor member from the bodily passage; advancing a biopsy device through the outer sheath and to the tissue while scanning a third portion of the patient that includes the biopsy device using the magnetic resonance scanner; obtaining a magnetic resonance image of the third portion of the patient that includes the biopsy device; confirming the position of the biopsy device; collecting a tissue sample from the tissue using the biopsy device while scanning a fourth portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner; obtaining a magnetic resonance image of the fourth portion of the patient that includes the biopsy device; confirming the tissue sample has been collected; withdrawing the biopsy device and the tissue sample through the outer sheath; determining whether the tissue sample meets a predefined criterion; if the tissue sample does not meet the predefined criterion, withdrawing the outer sheath from the bodily passage and removing the patient from the magnetic resonance scanner; if the tissue sample meets the predefined criterion, advancing a treatment device through the outer sheath and to the tissue; manipulating the tissue using the treatment device; withdrawing the treatment device from the outer sheath; scanning a first portion of the patient using the magnetic resonance scanner; advancing a tissue removal device through the outer sheath and to the tissue; manipulating the tissue using the tissue removal device; withdrawing the tissue removal device from the outer sheath; withdrawing the outer sheath from the bodily passage; removing the patient from the magnetic resonance scanner. 
     An example method of performing treatment on a prostate under MRI comprises: positioning a patient within a magnetic resonance scanner; scanning a prostate and surrounding tissue of the patient using the magnetic resonance scanner; obtaining a magnetic resonance image of the prostate and surrounding tissue of the patient; identifying a tissue within the magnetic resonance image that has predefined characteristics; while the patient remains positioned within the magnetic resonance scanner used to scan the prostate and surrounding tissue, advancing a medical device into a bodily passage and to the tissue while scanning a first portion of the patient that includes the medical device using the magnetic resonance scanner; obtaining a magnetic resonance image of the second portion of the patient that includes the medical device; confirming the position of the medical device within the bodily passage; advancing a biopsy device through the medical device and to the tissue while scanning a third portion of the patient that includes the biopsy device using the magnetic resonance scanner; obtaining a magnetic resonance image of the third portion of the patient that includes the biopsy device; confirming the position of the biopsy device; collecting a tissue sample from the tissue using the biopsy device while scanning a fourth portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner; obtaining a magnetic resonance image of the fourth portion of the patient that includes the biopsy device; confirming the tissue sample has been collected; withdrawing the biopsy device and the tissue sample through the medical device; determining whether the tissue sample meets a predefined criterion; if the tissue sample does not meet the predefined criterion, withdrawing the medical device from the bodily passage and removing the patient from the magnetic resonance scanner; if the tissue sample meets the predefined criterion, advancing an anchor member through the medical device through which the biopsy device was advanced and to the tissue while the patient remains positioned within the magnetic resonance scanner; securing the anchor member to the tissue to retain the position of the medical device relative to the tissue; advancing a first inner sheath over the medical device and toward the tissue to dilate the bodily passage; advancing a second inner sheath over the first inner sheath and toward the tissue to dilate the bodily passage; advancing an outer sheath over the second inner sheath and toward the tissue to dilate the bodily passage; removing the anchor member from the tissue; withdrawing the anchor member from the bodily passage; withdrawing the medical device from the bodily passage; withdrawing the first inner sheath from the bodily passage; withdrawing the second inner sheath from the bodily passage; advancing a treatment device through the outer sheath and to the tissue; manipulating the tissue using the treatment device; withdrawing the treatment device from the outer sheath; advancing a tissue removal device through the outer sheath and to the tissue; manipulating the tissue using the tissue removal device; withdrawing the tissue removal device from the outer sheath; withdrawing the outer sheath from the bodily passage. 
     Additional understanding of these example tissue removal devices, kits, and methods can be obtained by review of the detailed description, below, and the appended drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a partial perspective view of a first example tissue removal device. 
         FIG. 2  is a partial perspective view of a second example tissue removal device. 
         FIG. 3  is a partial perspective view of a third example tissue removal device. 
         FIG. 4  is another partial perspective view of the tissue removal device illustrated in  FIG. 3 . 
         FIG. 5  is a top view of the tissue removal device illustrated in  FIG. 3 . 
         FIG. 6  is a partial elevation view of a fourth example tissue removal device. 
         FIG. 6A  is a partial elevation view of an alternative tissue removal device. 
         FIG. 6B  is a partial elevation view of another alternative tissue removal device. 
         FIG. 7  is a partial elevation view of a fifth example tissue removal device. 
         FIG. 8  is a partial elevation view of a sixth example tissue removal device. 
         FIG. 9  is a partial perspective view of an example system for use with a tissue removal device. 
         FIGS. 10A and 10B  show a schematic illustration of an example method of performing treatment under MRI. 
         FIGS. 11A and 11B  show another schematic illustration of an example method of performing treatment under MRI. 
         FIGS. 12A and 12B  show another schematic illustration of an example method of performing treatment under MRI. 
         FIG. 13  illustrates an example kit that includes example tissue removal devices and an example system for use with a tissue removal device. 
     
    
    
     DETAILED DESCRIPTION OF SELECTED EXAMPLES 
     The following detailed description and the appended drawings describe and illustrate various example tissue removal devices useful in performing treatment under MRI, kits useful in performing treatment under MRI, and methods of performing interventional medical treatment under MRI. The description and illustration of these examples are provided to enable one skilled in the art to make and use a tissue removal device, a kit, and to practice a method of performing an interventional medical treatment under MRI. They are not intended to limit the scope of the invention, or the protection sought, in any manner. The invention is capable of being practiced or carried out in various ways and the examples described and illustrated herein are merely selected examples of the various ways of practicing or carrying out the invention and are not considered exhaustive. 
     As used herein, the term “attached” refers to one member being secured to another member such that the members do not completely separate from each other during use performed in accordance with the intended use of an item that includes the members in their attached form. 
     As used herein, the term “circumference” refers an external enclosing boundary of a body, element, or feature and does not impart any structural configuration on the body, element, or feature. 
       FIG. 1  illustrates a first example tissue removal device  10 . In this example, the tissue removal device  10  is an elongate member  12  attached to a handle  80 . 
     The elongate member  12  has a lengthwise axis  13 , a proximal end  20 , a distal end  22 , and a main body  24  that defines a lumen  26 , a distal tapered tip  28 , a wall  30 , an inner surface  32 , an outer surface  34 , a slot  36 , a first cutting edge  38 , and a second cutting edge  40 . The lumen  26  extends from the proximal end  20  to the distal end  22  such that one or more devices can be passed into, and through, the elongate member  12  and/or such that the lumen  26  can be used for suction and/or flushing a portion of a bodily passage. The distal tapered tip  28  extends from a location  42  disposed between the proximal end  20  and the distal end  22  to the distal end  22  and tapers from the location  42  to the distal end  22 . However, alternative embodiments can include a distal tapered portion that tapers from a location disposed between a proximal end and a distal end and toward, but not to, the distal end. 
     In the illustrated embodiment, the slot  36  extends from the distal end  22  toward the proximal end  20 , from the inner surface  32  to the outer surface  34 , around a portion of the circumference of the main body  24  and has a first end  44 , a second end  46 , a length  45 , and a width  47 . The first end  44  is disposed on the distal tapered tip  28  and the second end  46  is disposed between the distal tapered tip  28  and the proximal end  20  of the elongate member  12 . The length  45  of the slot  36  extends from the first end  44  to the second end  46  and is greater than the width  47  of the slot  36 . While the slot  36  has been illustrated as extending around a portion of the circumference of the main body  24 , as having a first end  44  disposed on the distal tapered tip  28 , as having a second end  46  disposed between the distal tapered tip  28  and the proximal end  20 , and as having a length  45  that is greater than the width  47 , a slot can have any suitable configuration. Selection of a suitable configuration for a slot can be based on various considerations, including the intended use of the tissue removal device. Examples of configurations considered suitable for a slot included in a tissue removal device include those in which a slot extends around the entire circumference of a main body of an elongate member, a slot extends linearly and parallel to a lengthwise axis of an elongate main body, a slot has a first end disposed between a distal tapered tip and a proximal end, a slot has a second end disposed on a distal tapered tip, a slot has a length that is less than or equal to a width of the slot, combinations of the configurations described herein, and any other configuration considered suitable for a particular embodiment. 
     The first cutting edge  38  extends from the first end  44  of the slot  36  to the second end  46  of the slot  36  and is defined on the outer surface  34 . The second cutting edge  40  extends from the first end  44  of the slot  36  to the second end  46  of the slot  36  and is defined on the inner surface  32 . This structural arrangement provides a mechanism for allowing the first cutting edge  38  to cut tissue when a torque is applied to the elongate member  12  and it is rotated in a clockwise direction and prevents additional tissue from being cut when a torque is applied to the elongate member  12  and it is rotated in a counterclockwise direction. When the elongate member  12  is rotated in a clockwise direction, tissue is cut and enters the slot  36  such that when the elongate member  12  is rotated in a counterclockwise direction the cut tissue can be separated and removed from the body. An elongate member can also include a structural arrangement in which rotation in directions opposite to those described will achieve the results described. While the cutting edges  38 ,  40  have been illustrated as extending from the first end  44  of the slot  36  to the second end  46  of the slot  36 , a cutting edge can extend along any suitable portion of a slot. For example, a cutting edge can extend from a first end of a slot to a second end of a slot, a location between a first end and a second end of a slot to the second end of the slot, a location between a first end and a second end of a slot to the first end of the slot, or from a first location between a first end and a second end of a slot to a second location between the first location and the first end of the slot. In addition, while the first cutting edge  38  has been illustrated on the outer surface  34  and the second cutting edge  40  has been illustrated on the inner surface  32 , a cutting edge can be defined on an inner surface, an outer surface, or between an inner surface and outer surface. A cutting edge defined by an elongate member can optionally be sharpened and electropolished to provide a sharp cutting surface. 
     The handle  80  is attached to the proximal end  20  of the elongate member  12  and is adapted to move the elongate member  12  is first and second directions. The handle  80  can include any suitable features, structures, and/or components capable of accomplishing rotation of the elongate member  12  in first and second directions. For example, rotation of an elongate member can be accomplished using a pneumatic or hydraulic actuation of gears (e.g., driven manually by the operator or otherwise). Alternately, a handle can be omitted from a tissue removal device and rotation of the tissue removal device can be accomplished manually. 
     In the illustrated embodiment, the elongate member  12  and handle  80  can be formed of any suitable MRI compatible material and can include any suitable type and/or number of markers. Selection of a suitable material to form an elongate member and/or handle can be based on various considerations, including the intended use of the elongate member. Examples of MRI compatible materials considered suitable to form an elongate member and/or a handle include biocompatible materials, materials that can be made biocompatible, metals, electrically insulating materials, electrically non-conducting materials, non-magnetic materials, shape memory alloys, including nickel-titanium alloys such as Nitinol, stainless steel, including Austenitic stainless steel, stainless steel containing Iron, stainless steel including Inconel, cobalt chromium, cobalt chromium alloys, Inconel, titanium, thermoplastics, polymers, PEEK, carbon-filled PEEK, ceramics, the materials described herein, combinations of the described herein, and any other material considered suitable for a particular embodiment. In the illustrated embodiment, the elongate member  12  is formed of a non-magnetic material and the handle  80  is formed of a thermoplastic. In embodiments in which a cutting or sharp edge is included in a device, a first portion of the device that extends from a proximal end toward the distal end can be formed of a first material (e.g., PEEK, Inconel) and a second portion on which the cutting or sharp edge is disposed can be attached to the first portion and formed of a second material that is different than the first material (e.g., Inconel, PEEK). The marker  50  comprises a magnetically susceptible material incorporated into the material forming the main body  14 . For example, a ferromagnetic or paramagnetic compound can be incorporated into the material that forms the main body  14  during manufacture and at a desired location on the main body  14 . Examples of materials considered suitable for marker or markers include magnetically susceptible material, such as ferromagnetic or paramagnetic compounds, including those in powder form, Tantalum powder, Barium Sulfate, Bismuth Oxychloride, Tungsten, Iron Oxide nanoparticles, functionalized magnetite, Gadolinium, Stainless Steel, Ferritic Stainless Steel, Ferritic Stainless Steel powders, 316 Stainless Steel, and any other material considered suitable for a particular embodiment. A marker can be incorporated into the material of the main body or disposed on a surface of the main body. Examples of markers considered suitable to include in a medical device are described in U.S. Patent Application No. 63/135,801, filed on Jan. 11, 2021, which is hereby incorporated by reference in its entirety for the purpose of describing markers considered suitable to include in a medical device. Optionally, a cutting edge, a tip, a sharp edge, a sharp cutting edge, a spiral member, and/or a barb can include one or more markers that can visualized using an image obtained by MRI or identified by a unique pattern recognized and transformed into a virtual instrument within a program and displayed on a screen. 
       FIG. 2  illustrates a second example tissue removal device  110 . In this example, the tissue removal device  110  is an elongate member  112 . The elongate member  112  is similar to the elongate member  12  illustrated in FIG. and described above, except as detailed below. In the illustrated embodiment, the elongate member  112  has a lengthwise axis  113 , a proximal end  120 , a distal end  122 , and a main body  124  that defines a lumen  126 , a wall  130 , an inner surface  132 , an outer surface  134 , and a plurality of cutting teeth  136 . The lumen  126  extends from the proximal end  120  to the distal end  122  such that one or more devices can be passed into, and through, the elongate member  112  and/or such that the lumen  126  can be used for suction and/or flushing a portion of a bodily passage. 
     Each tooth of the plurality of cutting teeth  136  has a lengthwise axis  137 , a first end  138 , a second end  140 , a length  141 , a tip  142 , and a width  143 . The first end  138  is disposed between the proximal end  120  and the distal end  122  of the elongate member  112  and the second end  140  is disposed at the distal end  122  of the elongate member  112 . The length  141  extends from the first end  138  to the second end  140 . The tip  142  is disposed at the distal end  122  of the elongate member  112  and defines a sharp cutting edge  144 . The tip  142  of each tooth of the plurality of cutting teeth  136  can optionally be sharpened and electropolished to provide the sharp cutting edge  144 . The width  143  tapers from the first end  138  to the second end  140 . The lengthwise axis  137  of each tooth of the plurality of cutting teeth  136  is disposed at an angle  145  relative to an axis  147  that is parallel to the lengthwise axis  113  of the elongate member  112  and disposed within the wall  130  of the elongate member  112 . The angle  145  is the same for each tooth of the plurality of cutting teeth  136 . However, alternative embodiments can include a plurality of teeth of which only a portion have a lengthwise disposed at the same angle relative to an axis disposed parallel to a lengthwise axis of an elongate member. Optionally, an elongate member can include one or more markers, such as at, or near, the distal end of the elongate member, along the length of the elongate member, and any other location considered suitable for a particular embodiment. 
     The structural arrangement of the elongate member  112  provides a mechanism for allowing the plurality of cutting teeth  136  to cut tissue when a torque is applied to the elongate member  112  and it is rotated in a clockwise direction. When the elongate member  112  is rotated in a clockwise direction, tissue is cut and can enter the lumen  126  such that when suction is applied to the lumen  126  the cut tissue can be removed from the body. An elongate member can also include a structural arrangement in which rotation in directions opposite to those described will achieve the results described. The application of toque on the elongate member  112  to accomplish rotation can be accomplished using any suitable method or technique. In the embodiment illustrated, torque is applied manually by a user. Alternatively, a handle can be attached to an elongate member to accomplish rotation of the elongate member as described herein. 
       FIGS. 3, 4, and 5  illustrate a third example tissue removal device  210 . In this example, the tissue removal device  210  is an elongate member  212  partially disposed within a tubular member  214 . The elongate member  212  is similar to the elongate member  12  illustrated in  FIG. 1  and described above, except as detailed below. In the illustrated embodiment, the elongate member  212  has a lengthwise axis  213 , a proximal end  220 , a distal end  222 , and a main body  224  that defines a lumen  226 , a wall  230 , an inner surface  232 , an outer surface  234 , a proximal portion  236 , a coil member  238 , and a sharp edge  240 . The lumen  226  extends from the proximal end  220  to the distal end  222  such that one or more devices can be passed into, and through, the elongate member  212  and/or such that the lumen  226  can be used for suction and/or flushing a portion of a bodily passage. 
     In the illustrated embodiment, the coil member  238  is moveable between a first, compressed configuration and a second, uncompressed configuration. The proximal portion  236  has an outside diameter  237  and extends from the proximal end  220  to the coil member  238 . The coil member  238  has a first outside diameter  239  in the first, compressed configuration and a second outside diameter  241  in the second, uncompressed configuration that is greater than the first outside diameter  239 . The coil member  238  extends from the proximal portion  236  to the distal end  222 . The coil member  238  has a first end  242  and a second end  244 . The first end  242  is attached to the proximal portion  236  and the second end  244  is free of attachment to the proximal portion. In the second, uncompressed configuration, the coil member  238  extends from the first end  242  around a portion of the lengthwise axis  213  of the elongate member  212  in a first direction to the second end  244 . However, in alternative embodiments, a coil member can extend from a first end around the entirety of a lengthwise axis of an elongate member, or around a lengthwise axis of an elongate member more than a single revolution. In addition, in the second, uncompressed configuration, the coil member  238  extends from the first end  242  and away from the lengthwise axis  213  of the elongate member  212  to the second end  244  and from the first end  242  and away from the proximal portion  236  to the second end  244 . This structural arrangement results in the coil member  238  having a second outside diameter  241  that is greater than the outside diameter  237  of the proximal portion  236 . In addition, this structural arrangement results in the first end  242  being disposed a first distance  243  from the proximal end  220  of the elongate member  212  and the second end  244  being disposed a second distance  245  from the proximal end  220  of the elongate member  212  that is greater than the first distance  243 . The sharp edge  240  is defined on the second end  244  of the coil member  238 . The sharp edge  240  can optionally be sharpened and electropolished to provide a sharp cutting surface. Optionally, an elongate member can include one or more markers, such as at, or near, the distal end of the elongate member, along the length of the elongate member, and any other location considered suitable for a particular embodiment. 
     The tubular member  214  disposed over the elongate member  212  and has a proximal end  250 , a distal end  252 , and a main body  254  that defines a lumen  256  and a slot  258 . The lumen  256  extends from the proximal end  250  to the distal end  252  and is sized to receive the elongate member  212 . The slot  258  extends from the distal end  252  toward the proximal end  250  and is sized to receive a portion of the coil member  238 . Optionally, a tubular member can include one or more markers, such as at, or near, the distal end of the tubular member, along the length of the tubular member, and any other location considered suitable for a particular embodiment. 
     In the first, compressed configuration, the coil member  238  is disposed within the lumen  256  defined by the tubular member  214 . To move the coil member  238  from the first, compressed configuration to the second, uncompressed configuration, torque is applied to the elongate member  212  in a first direction, as shown by arrow  259  in  FIG. 5 , while the position of the tubular member  214  is maintained such that the elongate member  212  is rotated relative to the tubular member  214 . Alternatively, torque can be applied to the elongate member  212  in a second direction  261  while applying torque to the tubular member  214  in a first, different direction  259 , or maintaining the position of the elongate member  212  while applying torque to the elongate member  214  in a second direction  261 . This results in the coil member  238  being advanced out of the lumen  256  defined by the tubular member  214  through the slot  258 . Torque is applied to the elongate member  212  and/or tubular member  214 , as described above until a desired amount of the coil member  238  is advanced out of the tubular member  214 . Subsequently, torque can be applied to the elongate member  212  in the first direction  259  until a desired amount of tissue has been cut, or removed (e.g., by applying suction to the lumen  226 ), from the treatment area. 
     Once a desired amount of tissue has been cut, or removed, from the treatment area, the coil member  238  can be moved from the second, uncompressed configuration to the first, compressed configuration. This can be accomplished by applying torque to the elongate member  212  in a second direction  261 , opposite that shown by arrow  259 , while maintaining the position of the tubular member  214  such that the elongate member  212  is rotated relative to the tubular member  214 . Alternatively, torque can be applied to the elongate member  212  in a first direction  259  while applying torque to the tubular member  214  in a second, different direction  261 , or maintaining the position of the elongate member  212  while applying torque to the elongate member  214  in a first direction  259 . This results in the coil member  238  being introduced into the lumen  256  defined by the tubular member  214  through the slot  258 . Torque is applied to the elongate member  212  and/or tubular member  214 , as described above until a desired amount of the coil member  238  is introduced into the tubular member  214  (e.g., a portion of the coil member  238 , the entirety if the coil member  238 ). In embodiments in which the coil member  238  is not disposed adjacent to the slot  258  subsequent to cutting, or removing tissue, the elongate member  212  can be advanced toward the tubular member  214  by applying a proximally-directed force on the elongate member  212  while maintaining the position of the tubular member  214 , applying a proximally-directed force on the elongate member  212  while applying a distally-directed force on the tubular member  214 , or by maintaining the position of the elongate member  212  while applying a distally-directed force on the tubular member  214 . The application of toque on the elongate member  212  to accomplish rotation can be accomplished using any suitable method or technique. In the embodiment illustrated, torque is applied manually by a user. Alternatively, a handle can be attached to an elongate member to accomplish rotation of the elongate member as described herein. Furthermore, an elongate member can include a structural arrangement in which rotation in directions opposite to those described will achieve the results described. 
       FIG. 6  illustrates a fourth example tissue removal device  310 . In this example, the tissue removal device  310  is an elongate member  312 . The elongate member  312  is similar to the elongate member  12  illustrated in FIG. and described above, except as detailed below. In the illustrated embodiment, the elongate member  312  has a lengthwise axis  313 , a proximal end  320 , a distal end  322 , and a main body  324  that defines a central shaft  326 , a blunted distal tip  328 , and a spiral member  330 . The central shaft  326  extends from the proximal end  320  to the distal end  322 . The spiral member  330  extends from the central shaft  326  and away from the lengthwise axis  313  of the elongate member  312 . The spiral member  330  has a first end  332 , a second end  334 , and extends around the lengthwise axis  313  of the elongate member  312  from the first end  332  to the second end  334 . Optionally, an elongate member can include one or more markers, such as at, or near, the distal end of the elongate member, along the length of the elongate member, and any other location considered suitable for a particular embodiment. The tissue removal device  310  can include one or more markers. For example, a first marker  350  can be disposed on the proximal end  320  and a second marker  352  on the central shaft  326  at or at a location orthogonal to the first end  332  of the spiral member  330 . Alternatively, a second marker  352  can be disposed on the first end  332  of the spiral member  330 . Also alternatively, a marker can be disposed along the entire length of the spiral member  330 . For example, the external side of the spiral member  330  can be coated with a magnetically susceptible material, such as a paramagnetic material or a ferromagnetic material, such as Nickel or a Nickel-containing alloy. 
     To remove tissue from a bodily passage, the elongate member  312  is positioned adjacent, or within, the tissue and a torque is applied to the elongate member  312  in a first direction, illustrated by arrow  335 . Optionally, a distally-directed force can be applied to the elongate member  312  while applying a torque in the first direction  335  to remove tissue. The application of toque on the elongate member  312  to accomplish rotation can be accomplished using any suitable method or technique. In the embodiment illustrated, torque is applied manually by a user. Alternatively, a handle can be attached to an elongate member to accomplish rotation of the elongate member as described herein. Furthermore, an elongate member can include a structural arrangement in which rotation in directions opposite to those described will achieve the results described. 
     Each of  FIGS. 6A and 6B  illustrate alternative structures for the main body  324  of the fourth example tissue removal device  310 . In  FIG. 6A , the main body  324 ′ of the tissue removal device  310 ′ defines a ship auger, eliminating the central shaft  326  and spiral member  330  disposed on the central shaft  326  illustrated in  FIG. 6 . In  FIG. 6B , the main body  324 ″ of the tissue removal device  310 ″ defines a twisted ribbon structure, also eliminating the central shaft  326  and spiral member  330  disposed on the central shaft  326  illustrated in  FIG. 6 . Each of these alternative structures may be advantageous for certain applications, and a skilled artisan will be able to select a desirable structure for a tissue removal device according to a particular embodiment based on various considerations, including the nature of the tissue with which the tissue removal device is intended to be used. Each of these alternative structures can include a marker or markers as described above for the embodiment illustrated in  FIG. 6 . For example, a first marker  350 ′ and  350 ″ can be disposed on the proximal end  320 ′ and  320 ″ and a second marker  352 ′ and  352 ″ on the main body  324 ′  324 ″ at or at a location orthogonal to the first end  332 ′ and  332 ″ of the auger portion of the main body  320 ′ and  320 ″. Alternatively, a marker can be disposed along the entire length of the auger portion of the main body  320 ′ and  320 ″. For example, the external side of the auger portion of the main body  320 ′ and  320 ″ can be coated with a magnetically susceptible material, such as a paramagnetic material or a ferromagnetic material, such as Nickel or a Nickel-containing alloy. 
       FIG. 7  illustrate a fifth example tissue removal device  410 . In this example, the tissue removal device  410  is an elongate member  412 . The elongate member  412  is similar to the elongate member  12  illustrated in FIG. and described above, except as detailed below. In the illustrated embodiment, the elongate member  412  has a central lengthwise axis  413 , a proximal end  420 , a distal end  422 , and a main body  424  that defines a lumen  426 , a wall  430 , an inner surface  432 , an outer surface  434 , and a plurality of cutting teeth  436 . The lumen  426  extends from the proximal end  420  to the distal end  422  such that one or more devices or tissue can be passed into, and through, the elongate member  412  and/or such that the lumen  426  can be used for suction and/or flushing a portion of a bodily passage. 
     In the illustrated embodiment, each tooth of the plurality of cutting teeth  436  extends from the inner surface  432  toward the central lengthwise  413  of the elongate member  412 , around the entire central lengthwise axis  413 , has as a first end  438 , a second end  440 , a length  441 , a tip  442 , and a width  443 . Each tooth of the plurality of cutting teeth  436  can optionally be sharpened and electropolished to provide a sharp cutting surface. Alternative embodiments, however, can include a plurality of cutting teeth in which each cutting tooth of the plurality of cutting teeth extends around a portion of a central lengthwise axis of the elongate member. The first end  438  is disposed between the outer surface  434  and the lumen  426  of the elongate member  412  and the second end  440  is disposed within the lumen  426  of the elongate member  412 . The length extends from the first end  438  to the second end  440 . The tip  442  is disposed at the second end  440  and defines a sharp cutting edge  444 . The width  443  tapers from the first end  438  to the second end  440 . Each tooth of the plurality of cutting teeth  436  is disposed at an angle  445  relative to an axis  447  that is parallel to the lengthwise axis  413  of the elongate member  412  and disposed within the wall  430  of the elongate member  412 . The angle  445  is the same for each tooth of the plurality of cutting teeth  436 . However, alternative embodiments can include a plurality of teeth of which only a portion have a lengthwise disposed at the same angle relative to an axis disposed parallel to a lengthwise axis of an elongate member. Optionally, an elongate member can include one or more markers, such as at, or near, the distal end of the elongate member, along the length of the elongate member, and any other location considered suitable for a particular embodiment. 
     To remove tissue from a bodily passage, the elongate member  412  is positioned adjacent, or within, the tissue and an oscillating or vibrating force is applied to the elongate member  412  while applying a distally-directed force on the elongate member  412  such that tissue advances into the lumen  426  and the plurality of cutting teeth  436  mechanically disrupt the tissue. The disrupted tissue can then be removed from the bodily passage by aspiration or suction through the lumen  426  or through a lumen defined by a device through which the elongate member  412  is disposed. Alternatively, a basket and/or grasping device can be positioned distal to the elongate member  412  and through the lumen  426  or a lumen defined by a device through which the elongate member  412  is disposed and used to remove tissue. The application of an oscillating or vibrating force on the elongate member  412  can be accomplished using any suitable method or technique. In the embodiment illustrated, an oscillating or vibrating force can be applied using the system  570  illustrated in  FIG. 9 , as described in more detail herein. Alternatively, an oscillating or vibrating force can be applied manually by a user. 
       FIG. 8  illustrates a sixth example tissue removal device  510 . In this example, the tissue removal device  510  is an elongate member  512  partially disposed within a tubular member  514 . The elongate member  512  is similar to the elongate member  12  illustrated in  FIG. 1  and described above, except as detailed below. In the illustrated embodiment, the elongate member  512  has a lengthwise axis  513 , a proximal end  520 , a distal end  522 , and a main body  524  that defines a central shaft  526 , a blunted distal tip  528 , and a plurality of barbs  530 . The central shaft  526  extends from the proximal end  520  to the distal end  522 . In the illustrated embodiment, each barb of the plurality of barbs  530  extends from the central shaft  526  and away from the lengthwise axis  513  of the elongate member  512 . Each barb of the plurality of barbs  530  can optionally be sharpened and electropolished to provide a sharp cutting surface. In an alternative embodiment, an elongate member can include a roughened surface along a portion of the elongate member that extends from the distal end toward the proximal end, or from a location between the distal end and the proximal end toward the proximal end. This alternative embodiment can include the barbs described herein, or omits the barbs described herein. 
     The tubular member  514  disposed over the elongate member  512  and has a proximal end  550 , a distal end  552 , and a main body  554  that defines a lumen  556 , a tapered wall portion  558 , and a sharp distal tip  560 . The lumen  556  extends from the proximal end  550  to the distal end  552  and is sized to receive the elongate member  512 . The tapered wall portion  558  extends from a location  559  disposed between the proximal end  550  and the distal end  552  to the distal end  552  and tapers from the location  559  to the distal end  552 . The sharp distal tip  560  is disposed on the distal end  552 . Optionally, an elongate member and/or tubular member can include one or more markers, such as at, or near, the distal end of the elongate member or tubular member, along the length of the elongate member or tubular member, and any other location considered suitable for a particular embodiment. 
     To remove tissue from a bodily passage, the elongate member  512  and tubular member  514  are positioned adjacent, or within, the tissue and the elongate member  512  is advanced distal to the distal end  552  of the tubular member  514 . This can be accomplished by applying a distally-directed force on the elongate member  512  while maintaining the position of the tubular member  514 , applying a proximally-directed force on the tubular member  514  while maintaining the position of the elongate member  512 , or applying a distally-directed force on the elongate member  512  while applying a proximally-directed force on the tubular member  514 . Once the elongate member  512  is disposed distal to the distal end  552  of the tubular member  514 , an oscillating or vibrating force is applied to the elongate member  512  while applying a distally-directed force on the elongate member  512 , applying a distally-directed force on the elongate member  512  and a distally-directed force on the tubular member  514 , applying a distally-directed force on the elongate member  512  while applying a proximally-directed force on the tubular member  514  such that tissue advances into the lumen  556  defined by the tubular member  514  and is mechanically disrupted. Alternatively, the application of an oscillating or vibrating force can be omitted and other steps completed to remove tissue. The sharp distal tip  560  cuts the tissue as it is pulled into the lumen  556 , which can then be removed from the bodily passage by aspiration or suction through the lumen  556  or through a lumen defined by a device through which the tubular member  514  and elongate member  512  are disposed. The application of an oscillating or vibrating force on the elongate member  512  can be accomplished using any suitable method or technique. In the embodiment illustrated, an oscillating or vibrating force can be applied using the system  570  illustrated in  FIG. 9 , as described in more detail herein. Alternatively, an oscillating or vibrating force can be applied manually by a user. 
     Use of the tissue removal devices described herein provide a mechanism for removing tissue, such as the edges of an abnormal growth being removed from a body (e.g., edges of a tumor) if other techniques (e.g., ablative techniques) have been attempted but were not successful in removing all of the abnormal growth. 
     Oscillation or vibration forces can be applied to an elongate member using any suitable device or system and selection of a suitable device or system can be based on various considerations, including the structural arrangement of a tissue removal device being oscillated or vibrated.  FIG. 9  illustrates an example system  570  for applying an oscillating force or a vibrating force on an elongate member  572  attached to a handle  580 . The system is configured to resonate the elongate member  572  at a frequency of 15-25 kHz using any suitable method or technique. For example, an elongate member of a tissue removal device can be driven (e.g., oscillated, vibrated) using piezoelectric crystals (e.g., lead zirconium titanate) on which an electric field is applied. The resulting mechanical forces imparted on the tissue by the elongate member cause shearing and cavitation to ablate the target tissue. Any heating and devitalization of tissue can be monitored by MRI scanning. While 15-25 kHz has been described, other frequencies are considered suitable. Alternatively, oscillation or vibration of an elongate member can be accomplished using a pneumatic or hydraulic actuation of gears (e.g., driven manually by the operator or otherwise) positioned within a handle to which an elongate member is attached, or by using materials that naturally vibrate under MRI. Alternately, a handle can be omitted from a tissue removal device and oscillation or vibration of the elongate member can be accomplished manually. 
     Various methods of performing interventional medical treatment under MRI are described herein. While the methods described herein are shown and described as a series of acts, it is to be understood and appreciated that the methods are not limited by the order of acts, as some acts may in accordance with these methods may be omitted, occur in the order shown and/or described, occur in different orders, and/or occur concurrently with other acts described herein. 
       FIGS. 10A and 10B  illustrate a schematic illustration of an example method  600  of performing treatment under MRI. 
     An initial step  602  comprises positioning a patient within a magnetic resonance scanner. Another step  604  comprises scanning a first portion of the patient using the magnetic resonance scanner. Another step  606  comprises obtaining a magnetic resonance image of the first portion of the patient. Another step  608  comprises identifying a tissue that has predefined characteristics using the magnetic resonance image. While the patient remains positioned within the magnetic resonance scanner used to scan a portion of the patient, another step  610  comprises advancing a medical device into a bodily passage and to, within, or adjacent to, the tissue while scanning a second portion of the patient that includes the medical device using the magnetic resonance scanner. Another step  612  comprises obtaining a magnetic resonance image of the second portion of the patient that includes the medical device. Another step  614  comprises confirming the position of the medical device within the bodily passage. Another step  616  comprises advancing a biopsy device through the medical device and to the tissue while scanning a third portion of the patient that includes the biopsy device using the magnetic resonance scanner. Another step  618  comprises obtaining a magnetic resonance image of the third portion of the patient that includes the biopsy device. Another step  620  comprises confirming the position of the biopsy device. Another step  622  comprises collecting a tissue sample from the tissue using the biopsy device while scanning a fourth portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner. Another step  624  comprises obtaining a magnetic resonance image of the fourth portion of the patient that includes the biopsy device. Another step  626  comprises confirming the tissue sample has been collected. Another step  628  comprises withdrawing the biopsy device and the tissue sample through the medical device. Another step  630  comprises determining whether the tissue sample meets a predefined criterion. If the tissue sample does not meet the predefined criterion, additional steps comprise  632  withdrawing the medical device from the bodily passage and  634  removing the patient from the magnetic resonance scanner. If the tissue sample meets the predefined criterion, another step  636  comprises advancing an anchor member through the medical device through which the biopsy device was advanced and to the tissue while the patient remains positioned within the magnetic resonance scanner. Another step  638  comprises securing the anchor member to the tissue to retain the position of the medical device relative to the tissue. Another step  640  comprises advancing a first inner sheath over the medical device and toward the tissue to dilate the bodily passage. Another step  642  comprises advancing a second inner sheath over the first inner sheath and toward the tissue to dilate the bodily passage. Another step  644  comprises advancing an outer sheath over the second inner sheath and toward the tissue to dilate the bodily passage. Another step  646  comprises removing the anchor member from the tissue. Another step  648  comprises withdrawing the anchor member from the bodily passage. Another step  650  comprises withdrawing the medical device from the bodily passage. Another step  652  comprises withdrawing the first inner sheath from the bodily passage. Another step  654  comprises withdrawing the second inner sheath from the bodily passage. Another step  656  comprises advancing a treatment device through the outer sheath and to the tissue. Another step  658  comprises manipulating the tissue using the treatment device. Another step  660  comprises withdrawing the treatment device from the outer sheath. Another step  662  comprises scanning a first portion of the patient using the magnetic resonance scanner. Another step  664  comprises advancing a tissue removal device through the outer sheath and to the tissue. Another step  666  comprises manipulating the tissue using the tissue removal device. Another step  668  comprises withdrawing the tissue removal device from the outer sheath. Another step  670  comprises withdrawing the outer sheath from the bodily passage. 
     Step  602  can be accomplished by positioning a patient within any suitable magnetic resonance scanner, such as conventional magnetic resonance scanners, magnetic resonance scanners that utilize 0.55 T fields, 1.5 T fields, 3 T fields, fields between about 0.055 T and 1.5 T, fields less than 1 T, and any other magnetic resonance scanner considered suitable for a particular embodiment. 
     Step  604  can be accomplished by scanning any suitable portion of a patient and selection of a suitable portion of a patient to scan can be based on various considerations, including the treatment intended to be performed. Examples of portions of a patient considered suitable to scan include the extremities (e.g., arms, legs), chest, breast, spine, neck, head, abdomen, pelvis, prostate, peri-prostatic structures, tissue surrounding the portions described herein, and/or any other portion of the patient considered suitable for a particular embodiment. 
     Step  606  can be accomplished by obtaining the magnetic resonance image from the magnetic resonance scanner used in step  602 . 
     Step  608  can be accomplished by reviewing the magnetic resonance image obtained in step  606  and utilizing conventional techniques and/or methods to determine whether tissue has predefined characteristics (e.g., tissue has characteristics indicative of cancer, is a lesion, abnormal mass). Furthermore, the margins (e.g., borders) of any tissue (e.g., abnormal mass, lesions) can be identified and used in further steps, as described herein, to remove and/or treat the tissue. 
     Step  610  can be accomplished using any suitable medical device, such as the medical devices and/or cannulas described in U.S. Patent Application No. 63/135,801, filed on Jan. 11, 2021, which is hereby incorporated by reference in its entirety for the purpose of describing medical devices considered suitable to complete a step within a method of treatment. Step  610  can be accomplished by applying a distally-directed force on the medical device such that a distal end of the medical device is advanced into a bodily passage and to, within, or adjacent to, the tissue that has been identified as having the predefined characteristics. A bodily passage can include any suitable portion of a body, including existing bodily passages, bodily lumens, and/or bodily passages created through tissues layers and/or fascia using a device described herein. Step  610  can be accomplished by scanning any suitable portion of a patient and selection of a suitable portion of a patient to scan can be based on various considerations, including the location of the tissue that has predefined characteristics. Examples of portions of a patient considered suitable to scan include portions that include the tissue that has predefined characteristics, portions that include the medical device, portions that include the tissue that has predefined characteristics and the medical device, and any other portion of the patient considered suitable for a particular embodiment. For example, a second portion of the patient can be the same as, or different than, the first portion of the patient. 
     Step  612  can be accomplished by obtaining the magnetic resonance image from the magnetic resonance scanner used in step  602 . 
     Step  614  can be accomplished by reviewing the magnetic resonance image obtained in step  612  and confirming the medical device is positioned at a desired location within the bodily passage (e.g., at, within, or adjacent to, the tissue that has been identified as having the predefined characteristics). This can be accomplished by visualizing one or more markers included on the medical device, as described herein. If the medical device is not positioned at a desired location, an optional step comprises manipulating the position of the medical device. 
     Step  616  can be accomplished by applying a distally-directed force on the biopsy device such that a distal end of the biopsy device is advanced into a lumen defined by the medical device, through the lumen defined by the medical device, and to the tissue that has been identified as having the predefined characteristics. Step  616  can be accomplished by scanning any suitable portion of a patient and selection of a suitable portion of a patient to scan can be based on various considerations, including the location of the tissue that has predefined characteristics. Examples of portions of a patient considered suitable to scan include portions that include the tissue that has predefined characteristics, portions that include the biopsy device, portions that include the tissue that has predefined characteristics and the biopsy device, and any other portion of the patient considered suitable for a particular embodiment. For example, a third portion of the patient can be the same as, or different than, the first portion of the patient and/or the second portion of the patient. 
     Step  616 , step  622 , and step  628  can be accomplished using any suitable biopsy device, such as MRI compatible biopsy devices, the Echotip ProCore provided by Cook Medical, the Echotip Ultra provided by Cook Medical, and any other biopsy device considered suitable for a particular embodiment. Alternatively, step  616 , step  622 , and step  628  can be completed using a biopsy device that is not MRI compatible. This alternative step can comprise advancing the biopsy device through the medical device and to the tissue without scanning a portion of the patient that includes the biopsy device using the magnetic resonance scanner. An alternative to step  628  can comprise collecting a tissue sample using the biopsy device without scanning a portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner. 
     Step  618  can be accomplished by obtaining the magnetic resonance image from the magnetic resonance scanner used in step  602 . 
     Step  620  can be accomplished by reviewing the magnetic resonance image obtained in step  618  and confirming the biopsy device is positioned at a desired location within the bodily passage (.e.g., at, within, or adjacent to, the tissue that has been identified as having the predefined characteristics). If the biopsy device is not positioned at a desired location, an optional step comprises manipulating the position of the biopsy device. 
     Step  622  can be accomplished using the biopsy device and conventional methods of obtaining a tissue sample using a biopsy device. Step  622  can be accomplished by scanning any suitable portion of a patient and selection of a suitable portion of a patient to scan can be based on various considerations, including the location of the tissue that has predefined characteristics. Examples of portions of a patient considered suitable to scan include portions that include the tissue that has predefined characteristics, portions that include the biopsy device, portions that include the tissue that has predefined characteristics and the biopsy device, and any other portion of the patient considered suitable for a particular embodiment. For example, a fourth portion of the patient can be the same as, or different than, the first portion of the patient, the second portion of the patient, and/or the third portion of the patient. 
     Step  610 , step  616 , and/or step  622  can optionally be conducted in combination with performing an ultrasound on the portion of the patient that includes the medical device and/or biopsy device. In embodiments in which an ultrasound image is obtained, the magnetic resonance image obtained can be electronically fused with a real-time ultrasound image (e.g., transrectal ultrasound image of a prostate). 
     Step  624  can be accomplished by obtaining the magnetic resonance image from the magnetic resonance scanner used in step  602 . 
     Step  626  can be accomplished by reviewing the magnetic resonance image obtained in step  624  and confirming the biopsy device has collected the tissue sample (e.g., the tissue that has been identified as having the predefined characteristics). If the biopsy device has not collected the tissue sample, optional steps comprise repeating step  616 , step  618 , step  620 , step  622 , step  624 , and/or step  626 . 
     Step  606 , step  612 , step  618 , and/or step  624  can comprise obtaining a single still image. Alternatively, step  604 , step  610 , step  616 , and/or step  622  can be repeated any desired number of times such that step  606 , step  612 , step  618 , and/or step  624  comprises obtaining multiple magnetic resonance images of a portion that can be grouped as a cine to show motion. 
     Step  628  can be accomplished by applying a proximally-directed force on the biopsy device such that it is withdrawn from the lumen defined by the medical device. In an alternative embodiment, step  616 , step  618 , step  620 , step  622 , step  624 , step  626 , and step  628  can be omitted from method  600 , and other methods described herein, and the medical device advanced in step  610  can be utilized to obtain a biopsy and steps similar to those described with respect to a biopsy device can be completed utilizing the medical device. In another alternative embodiment, an anchor can be placed, as described herein, the medical device withdrawn, and the anchor used to track a biopsy device to the tissue. 
     Step  630  can be accomplished using any technique or method considered suitable to determine whether tissue meets predefined criterion. For example, step  630  can utilize conventional techniques and methods for determining whether a tissue sample is malignant, such as frozen section and/or other cytological methods. 
     Each of step  606 , step  608 , step  610 , step  612 , step  614 , step  616 , step  618 , step  620 , step  622 , step  624 , step  626 , step  628 , and/or step  630  can be accomplished without removing the patient from the magnetic resonance scanner within which the patient is positioned in step  602 . 
     Step  632  can be accomplished by applying a proximally-directed force on the medical device until it is withdrawn from the bodily passage. Step  634  can be accomplished by withdrawing the patient from the magnetic resonance scanner such that the patient is free of the magnetic resonance scanner. 
     Step  636  can be accomplished using any suitable anchor member, such as the anchor members described in U.S. Patent Application No. 63/135,801, filed on Jan. 11, 2021, which is hereby incorporated by reference in its entirety for the purpose of describing anchors considered suitable to complete a step in a method of treatment. Step  636  can be accomplished by applying a distally-directed force on the anchor member such that a distal end of the anchor member is advanced into a lumen defined by the medical device, through the lumen defined by the medical device, and to the tissue, within, or adjacent to the tissue. Optionally, step  636  can be completed while scanning a fifth portion of the patient that includes the anchor member using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the fifth portion of the patient that includes the anchor member, and confirming the position of the anchor member. In embodiments in which it is desired to utilize the magnetic resonance scanner on a second patient that is different from the patient, optional steps that can be completed subsequent to step  638  include removing the patient from the magnetic resonance scanner while maintaining the position of the patient on a surface, positioning a second patient within the magnetic resonance scanner, scanning a portion of the second patient using the magnetic resonance scanner, obtaining a magnetic resonance image of the portion of the second patient, removing the second patient from the magnetic resonance scanner, and repositioning the patient within the magnetic resonance scanner. 
     Completion of step  638  of securing the anchor member into the tissue will depend on the structural configuration of the anchor member. Examples of suitable actions that can be performed for this step include, but are not limited to, axially advancing the anchoring member through a lumen defined by a medical device until a portion of the anchor member (e.g., barb) becomes disposed within the tissue, or applying torque on the anchoring member until a portion of the anchor member becomes disposed within the tissue. Alternatively, step  638  can comprise anchoring the anchor member into a second, different tissue disposed adjacent to or within the tissue. Step  638  allows for the medical device to be utilized as a guide rail to a target site such that one or more other devices can be advanced over the medical device to a treatment site. Optionally, step  638  can be completed while scanning a sixth portion of the patient that includes the anchor member using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the sixth portion of the patient that includes the anchor member, and confirming the position of the anchor member. Step  638  allows for site retention such that the medical device and/or anchor member stays positioned relative to the tissue after biopsy and prior to treatment and can be used to direct a treatment device to the tissue, as described in more detail herein. 
     Step  640  can be accomplished by applying a distally-directed force on the first inner sheath such that a distal end of the first inner sheath is advanced over the medical device and to the tissue. Optionally, step  640  can be completed while scanning a seventh portion of the patient that includes the first inner sheath using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the seventh portion of the patient that includes the first inner sheath, and confirming the position of the first inner sheath. 
     Step  642  can be accomplished by applying a distally-directed force on the second inner sheath such that a distal end of the second inner sheath is advanced over the first inner sheath and to the tissue. Optionally, step  642  can be completed while scanning an eighth portion of the patient that includes the second inner sheath using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the eighth portion of the patient that includes the second inner sheath, and confirming the position of the second inner sheath. 
     Step  644  can be accomplished by applying a distally-directed force on the outer sheath such that a distal end of the outer sheath is advanced over the second inner sheath and to the tissue. Optionally, step  644  can be completed while scanning a ninth portion of the patient that includes the outer sheath using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the ninth portion of the patient that includes the outer sheath, and confirming the position of the outer sheath. 
     Completion of step  640 , step  642 , and  644  results in sequential dilation of the bodily passage under MRI. While only first and second inner sheaths and a single outer sheath has been described as accomplishing sequential dilation, any suitable number of inner sheaths and/or outer sheaths can be used to complete sequential dilation of a bodily passage. Examples of numbers of inner sheaths and/or outer sheaths considered suitable to accomplish sequential dilation includes one, two, a plurality, three, four, and any other number considered suitable for a particular embodiment. In embodiment in which sequential dilation is not desired, step  640  can alternatively comprise advancing a dilator over the medical device and toward the tissue to dilate the bodily passage and step  642  and step  644  can be omitted from method  600 . In this alternative step, step  640  can be accomplished using any suitable dilator, such as conventional dilators, and/or the dilators described herein. 
     Completion of step  646  of removing the anchor member from the tissue will depend on the structural configuration of the anchor member. Examples of suitable actions that can be performed for this step include, but are not limited to, applying a proximally-directed force on the anchor member such that it is withdrawn through the lumen defined by a medical device until a portion of the anchor member (e.g., barb) becomes free of the tissue, applying torque to the anchoring member until the portion of the anchor member disposed within the tissue becomes free of the tissue, or applying a distally-directed force on the anchor member such that it is advanced within the lumen defined by a medical device until a portion of the anchor member (e.g., barb) becomes free of the tissue. Alternatively, step  646  can comprise removing the anchor member from a tissue disposed adjacent to or within the tissue. Optionally, step  646  can be completed while scanning a tenth portion of the patient that includes the anchor member using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the tenth portion of the patient that includes the anchor member, and confirming the position of the anchor member. 
     Step  648  can be accomplished by applying a proximally-directed force on the anchor member such that it is withdrawn from the lumen defined by the medical device. In an alternative embodiment, step  636 , step  638 , step  646 , and step  648  can be omitted from method  600  and similar steps can be omitted from other methods described herein. 
     Step  650  can be accomplished by applying a proximally-directed force on the medical device until it is withdrawn from the bodily passage. 
     In an alternative embodiment, step  640  can comprise withdrawing the medical device from the bodily passage, step  642  can comprise advancing a dilator over the anchor member and toward the tissue to dilate the bodily passage, step  644  can comprise removing the anchor member from the tissue, and step  646  can comprise withdrawing the anchor member from the bodily passage. In this alternative embodiment, dilation is accomplished over the anchor member. Sequential dilation can also be accomplished over the anchor member and be completed as described herein utilizing original step  640 , step  642 , and step  644 . 
     Step  652  can be accomplished by applying a proximally-directed force on the first inner sheath until it is withdrawn from the bodily passage. 
     Step  654  can be accomplished by applying a proximally-directed force on the second inner sheath until it is withdrawn from the bodily passage. 
     Step  656  can be accomplished by applying a distally-directed force on the treatment device such that a distal end of the treatment device is advanced into a lumen defined by the outer sheath, or dilator, through the lumen defined by the outer sheath, or dilator, and to the tissue. Any suitable treatment device can be utilized in method  600  and selection of a suitable treatment device can be based on various considerations, such as the intended use of the treatment device. Examples of treatment devices considered suitable to treat tissue for which a tissue sample meets a predefined criterion include dissection tools, optical fibers, optical fibers formed of a material selected from the group consisting of argon, dye, erbium, excimer, Nd:YAG, and CO 2 , optical fibers that include control cables (e.g., ultra-high molecular weight polyethylene, Dyneema) to direct the fibers toward tissue intended to be treated, needles, cannulas, such as those described herein or incorporated by reference, and any other treatment device considered suitable for a particular embodiment. Optionally, step  656  can be completed while scanning an eleventh portion of the patient that includes the treatment device using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the eleventh portion of the patient that includes the treatment device, and confirming the position of the treatment device. 
     Step  658  can be accomplished by physically manipulating the tissue using the treatment device, which can include removing of all or a portion of the tissue, introducing a material into the tissue, applying a treatment to the tissue, and performing any other suitable treatment on the tissue. Examples of treatments considered suitable include laser direct therapy, photodynamic therapy (PDT), chemotherapy, a focal treatment, a radical prostatectomy, infusion of ablative agents, such as acetic acid, ethanol, sclerosants (e.g., sodium tetradecyl sulfate), chemotherapeutic agents, and any other treatment considered suitable for a particular embodiment. Optionally, step  658  can be completed while scanning a twelfth portion of the patient that includes the treatment device using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the twelfth portion of the patient that includes the treatment device, and confirming the position of the treatment device. For example, a magnetic resonance scanner can be utilized to determine areas of tissue that become devitalized during ablative therapies. The heating and devitalization of tissue can be monitored such that it occurs in real time and can be used to guide the targeted treatment of the tissue (e.g., prostate). 
     Step  660  can be accomplished by applying a proximally-directed force on the treatment device until it is withdrawn from the lumen defined by the outer sheath, or dilator. 
     Step  662  can be accomplished by scanning any suitable portion of a patient and selection of a suitable portion of a patient to scan can be based on various considerations, including the location of the tissue that has predefined characteristics. Examples of portions of a patient considered suitable to scan include portions that include the tissue that has predefined characteristics, the margins of the tissue that has predefined characteristics, and any other portion of the patient considered suitable for a particular embodiment. 
     Step  664  can be accomplished using any suitable tissue removal device, such as the tissue removal devices described herein, or incorporated by reference. Step  664  can be accomplished by applying a distally-directed force on a tissue removal device such that a distal end of the tissue removal device is advanced into a lumen defined by the outer sheath, or dilator, through the lumen defined by the outer sheath, or dilator, and to the tissue, or margins of the tissue. Optionally, step  664  can be completed while scanning a portion of the patient that includes the tissue removal device using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the portion of the patient that includes the tissue removal device, and confirming the position of the tissue removal device. 
     Step  666  can be accomplished by physically manipulating the tissue using the tissue removal device, which can include removing of all or a portion of the tissue, introducing a material into the tissue, applying a treatment to the tissue, and performing any other suitable treatment on the tissue. For example, step  666  can be accomplished by applying torque to an elongate member of a tissue removal device, as described herein, applying an oscillating or vibrating force on an elongate member of a tissue removal device, as described herein, applying a suction force to lumen defined by an elongate member of a tissue removal device or a lumen through which the tissue removal device is disposed, introducing a flushing fluid or cooling fluid through the lumen defined by an elongate member of a tissue removal device or a lumen through which the tissue removal device is disposed, and/or utilizing a tissue removal device, as described herein. Optionally, step  666  can be completed while scanning a portion of the patient that includes the tissue removal device using the magnetic resonance scanner and additional steps that can be completed subsequent to this optional step include obtaining a magnetic resonance image of the portion of the patient that includes the tissue removal device, and confirming the position of the tissue removal device. 
     Optionally, step  666  can be repeated. For example, as the space within the body enlarges as step  666  is being completed, more of the tissue removal device (e.g., elongate member) can be introduced into the space created in initial step  666  to increase the area of disruption. Once the space has been maximally enlarged, the tissue removal device and outer sheath are removed and can then be inserted into different locations of the tissue until the entire tissue that has predefined characteristics is removed. 
     Step  668  can be accomplished by applying a proximally-directed force on the tissue removal device until it is withdrawn from the lumen defined by the outer sheath, or dilator. 
     In an alternative embodiment, step  656 , step  658 , and step  660  can be omitted and step  662 , step  664 , step  666 , and step  668  can be utilized to treat the tissue. 
     Step  670  can be accomplished by applying a proximally-directed force on the outer sheath, or dilator, until it is withdrawn from the bodily passage. 
       FIGS. 11A and 11B  illustrate another schematic illustration of an example method  700  of performing treatment under MRI. 
     An initial step  702  comprises positioning a patient within a magnetic resonance scanner. Another step  704  comprises scanning a first portion of the patient using the magnetic resonance scanner. Another step  706  comprises obtaining a magnetic resonance image of the first portion of the patient. Another step  708  comprises identifying a tissue that has predefined characteristics using the magnetic resonance image. While the patient remains positioned within the magnetic resonance scanner used to scan a portion of the patient, another step  710  comprises advancing a medical device into a bodily passage and to, within, or adjacent to, the tissue while scanning a second portion of the patient that includes the medical device using the magnetic resonance scanner. Another step  712  comprises obtaining a magnetic resonance image of the second portion of the patient that includes the medical device. Another step  714  comprises confirming the position of the medical device within the bodily passage. Another step  716  comprises advancing an anchor member through the medical device and to the tissue while the patient remains positioned within the magnetic resonance scanner. Another step  718  comprises securing the anchor member to the tissue to retain the position of the anchor member relative to the tissue. Another step  720  comprises withdrawing the medical device from the bodily passage. Another step  722  comprises advancing a first inner sheath over the anchor member and toward the tissue to dilate the bodily passage. Another step  724  comprises advancing a second inner sheath over the first inner sheath and toward the tissue to dilate the bodily passage. Another step  726  comprises advancing an outer sheath over the second inner sheath and toward the tissue to dilate the bodily passage. Another step  728  comprises withdrawing the first inner sheath from the bodily passage. Another step  730  comprises withdrawing the second inner sheath from the bodily passage. Another step  732  comprises removing the anchor member from the tissue. Another step  734  comprises withdrawing the anchor member from the bodily passage. Another step  736  comprises advancing a biopsy device through the outer sheath and to the tissue while scanning a third portion of the patient that includes the biopsy device using the magnetic resonance scanner. Another step  738  comprises obtaining a magnetic resonance image of the third portion of the patient that includes the biopsy device. Another step  740  comprises confirming the position of the biopsy device. Another step  742  comprises collecting a tissue sample from the tissue using the biopsy device while scanning a fourth portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner. Another step  744  comprises obtaining a magnetic resonance image of the fourth portion of the patient that includes the biopsy device. Another step  746  comprises confirming the tissue sample has been collected. Another step  748  comprises withdrawing the biopsy device and the tissue sample through the outer sheath. Another step  750  comprises determining whether the tissue sample meets a predefined criterion. If the tissue sample does not meet the predefined criterion, additional steps comprise  752  withdrawing the outer sheath from the bodily passage and  754  removing the patient from the magnetic resonance scanner. If the tissue sample meets the predefined criterion, another step  756  comprises advancing a treatment device through the outer sheath and to the tissue. Another step  758  comprises manipulating the tissue using the treatment device. Another step  760  comprises withdrawing the treatment device from the outer sheath. Another step  762  comprises scanning a first portion of the patient using the magnetic resonance scanner. Another step  764  comprises advancing a tissue removal device through the outer sheath and to the tissue. Another step  766  comprises manipulating the tissue using the tissue removal device. Another step  768  comprises withdrawing the tissue removal device from the outer sheath. Another step  770  comprises withdrawing the outer sheath from the bodily passage. Another step  772  comprises removing the patient from the magnetic resonance scanner. 
       FIGS. 12A and 12B  illustrate another schematic illustration of an example method  800  of performing treatment on a prostate under MRI. 
     An initial step  802  comprises positioning a patient within a magnetic resonance scanner. Another step  804  comprises scanning a prostate and surrounding tissue of the patient using the magnetic resonance scanner. Another step  806  comprises obtaining a magnetic resonance image of the prostate and surrounding tissue of the patient. Another step  808  comprises identifying a tissue within the magnetic resonance image that has predefined characteristics. While the patient remains positioned within the magnetic resonance scanner used to scan the prostate and surrounding tissue, another step  810  comprises advancing a medical device into a bodily passage and to the tissue while scanning a first portion of the patient that includes the medical device using the magnetic resonance scanner. Another step  812  comprises obtaining a magnetic resonance image of the second portion of the patient that includes the medical device. Another step  814  comprises confirming the position of the medical device within the bodily passage. Another step  816  comprises advancing a biopsy device through the medical device and to the tissue while scanning a third portion of the patient that includes the biopsy device using the magnetic resonance scanner. Another step  818  comprises obtaining a magnetic resonance image of the third portion of the patient that includes the biopsy device. Another step  820  comprises confirming the position of the biopsy device. Another step  822  comprises collecting a tissue sample from the tissue using the biopsy device while scanning a fourth portion of the patient that includes the biopsy device and the tissue using the magnetic resonance scanner. Another step  824  comprises obtaining a magnetic resonance image of the fourth portion of the patient that includes the biopsy device. Another step  826  comprises confirming the tissue sample has been collected. Another step  828  comprises withdrawing the biopsy device and the tissue sample through the medical device. Another step  830  comprises determining whether the tissue sample meets a predefined criterion. If the tissue sample does not meet the predefined criterion, additional steps comprise  832  withdrawing the medical device from the bodily passage and  834  removing the patient from the magnetic resonance scanner. If the tissue sample meets the predefined criterion, another step  836  comprises advancing an anchor member through the medical device through which the biopsy device was advanced and to the tissue while the patient remains positioned within the magnetic resonance scanner. Another step  838  comprises securing the anchor member to the tissue to retain the position of the medical device relative to the tissue. Another step  840  comprises advancing a first inner sheath over the medical device and toward the tissue to dilate the bodily passage. Another step  842  comprises advancing a second inner sheath over the first inner sheath and toward the tissue to dilate the bodily passage. Another step  844  comprises advancing an outer sheath over the second inner sheath and toward the tissue to dilate the bodily passage. Another step  846  comprises removing the anchor member from the tissue. Another step  848  comprises withdrawing the anchor member from the bodily passage. Another step  850  comprises withdrawing the medical device from the bodily passage. Another step  852  comprises withdrawing the first inner sheath from the bodily passage. Another step  854  comprises withdrawing the second inner sheath from the bodily passage. Another step  856  comprises advancing a treatment device through the outer sheath and to the tissue. Another step  858  comprises manipulating the tissue using the treatment device. Another step  860  comprises withdrawing the treatment device from the outer sheath. Another step  862  comprises advancing a tissue removal device through the outer sheath and to the tissue. Another step  864  comprises manipulating the tissue using the tissue removal device. Another step  866  comprises withdrawing the tissue removal device from the outer sheath. Another step  868  comprises withdrawing the outer sheath from the bodily passage. 
     Method  600 , method  700 , and method  800  are considered advantageous at least because each step of method  600 , method  700 , and method  800  can be performed during a single patient visit and using the same magnetic resonance scanner, which increases efficiency and reduces the number of patient visits and procedures performed. This results in a set of procedures in which a physician can visualize, diagnose, and treat a patient in a single patient visit. Furthermore, these methods are considered advantageous at least because they provide methods for removing margins of abnormal tissue (e.g., tumor) if other treatment techniques have been unsuccessful or cannot properly remove the margins. For example, MR offers high spatial and temporal resolution in real time that can image tissue (e.g., prostate) and assess it both from a functional aspect as well as morphologically. The methods described herein provide for non-invasive abnormal tissue (e.g., tumor) detection, staging, and consequent direction of biopsy and interventional therapies. They can be used to guide physicians to the desired treatment strategies for an individual patient since the imaging quality of MRI is superior as compared to ultrasound. The higher resolution procedures described herein lead to a better outcome for the patient, faster recovery time, less perioperative pain, and less blood loss as compared to open surgical techniques allowing a patient to return to normal activity in a shorter period of time. While some steps have been described as being completed while scanning a portion of the patient using a magnetic resonance scanner and other steps have not been described as being performed while scanning a portion of the patient using a magnetic resonance scanner, any step described herein can be completed while scanning a portion of a patient using the magnetic resonance scanner, and/or an ultrasound device or without scanning a portion of a patient using a magnetic resonance scanner. In embodiments in which an ultrasound image is obtained, the magnetic resonance image obtained can be electronically fused with a real-time ultrasound image (e.g., transrectal ultrasound image of a prostate). While some steps have been described as being completed while scanning a portion of the patient using a magnetic resonance scanner, this step can be broken into two separate steps such that a subsequent step of scanning a portion of a patient using the magnetic resonance scanner can be accomplished. Furthermore, any step which is completed while scanning a portion of the patient using the magnetic resonance scanner can comprise obtaining a single still image and be repeated any desired number of times to obtain multiple magnetic resonance images that can be grouped as a cine to show motion and/or any step which is completed while scanning a portion of the patient using the magnetic resonance scanner can comprise obtaining a live image, such as being completed under live real-time MRI visualization. 
     While a number of methods have been described herein, it will be appreciated that the method may be a non-invasive method that does not require an invasive intervention by a medical professional. For example, a method may be carried out within a body lumen or passageway, such as the ear canal or a nasal passage, for example in order to place a device within such a passageway. Equally, methods may be implemented on a cadaver or artificial body parts for example for training purposes. Moreover, the skilled person will appreciate that the methods described herein may not be used on the human or animal body at all, but may be used in order to view other types of devices using MRI imaging techniques, for example in an industrial setting. 
       FIG. 13  illustrates an exemplary kit  900  comprising a first tissue removal device  902  according to an embodiment, such as tissue removal device  10  illustrated in  FIG. 1 ; a tissue removal device  904  according to an embodiment, such as tissue removal device  110  illustrated in  FIG. 2 ; a third tissue removal device  906  according to an embodiment, such as tissue removal device  210  illustrated in  FIGS. 3, 4, and 5 ; a fourth tissue removal device  908  according to an embodiment, such as tissue removal device  310  illustrated in  FIG. 6 ; a fifth tissue removal device  910  according to an embodiment, such as tissue removal device  410  illustrated in  FIG. 7 ; a sixth tissue removal device  912  according to an embodiment, such as tissue removal device  510  illustrated in  FIG. 8 ; a system for use with a tissue removal device  914  according to an embodiment, such as system  570  illustrated in  FIG. 9 ; a seventh tissue removal device  916  according to an embodiment, such as tissue removal device  572 ,  580  illustrated in  FIG. 9 ; and instructions for use  918 . 
     While kit  900  has been illustrated as including seven tissue removal devices  902 ,  904 ,  906 ,  908 ,  910 ,  912 ,  914 , and a system for use with a tissue removal device, any suitable number, and type, of tissue removal devices and/or systems for use with a tissue removal device can be included in a kit. Selection of a suitable number of tissue removal devices and/or systems for use with a tissue removal device to include in a kit according to a particular embodiment can be based on various considerations, such as the treatment intended to be performed. Examples of numbers of tissue removal devices and/or systems for use with a tissue removal device considered suitable to include in a kit include at least one, one, two, a plurality, three, four, five, six, seven, eight, nine, ten, more than ten, and any other number considered suitable for a particular embodiment. 
     Furthermore, while tissue removal device  10 , tissue removal device  110 , tissue removal device  210 , tissue removal device  310 , tissue removal device  410 , tissue removal device  510 , system for use with a tissue removal device  570 , and tissue removal device  572 ,  580  have been illustrated as included in kit  900 , any suitable tissue removal device and/or system can be included in a kit. Selection of a suitable tissue removal device and/or system to include in a kit according to a particular embodiment can be based on various considerations, such as the treatment intended to be performed. Examples of tissue removal devices and systems considered suitable to include in a kit include tissue removal device  10 , tissue removal device  110 , tissue removal device  210 , tissue removal device  310 , tissue removal device  410 , tissue removal device  510 , system  570 , tissue removal device  572 ,  580 , and/or any other tissue removal device and/or system considered suitable for a particular embodiment. 
     Those with ordinary skill in the art will appreciate that various modifications and alternatives for the described and illustrated examples can be developed in light of the overall teachings of the disclosure, and that the various elements and features of one example described and illustrated herein can be combined with various elements and features of another example without departing from the scope of the invention. Accordingly, the particular arrangement of elements and steps disclosed herein have been selected by the inventor(s) simply to describe and illustrate examples of the invention and are not intended to limit the scope of the invention or its protection, which is to be given the full breadth of the appended claims and any and all equivalents thereof.