Interventional Magnetic Resonance Imaging (2005)

Magnetic resonance imaging (MRI) provides unique information for the guidance of interventional procedures. Foremost is the ability to see soft tissue pathologies that are not visible on other imaging methods. In addition, MRI has a diverse array of contrast mechanisms that offer additional information for intraprocedural guidance. In the past, MRI has been difficult to use in guiding interventions because of cost and limited patient access. However, the increasing recognition of MRI's unique contrast mechanisms and capabilities is leading to the development and application of interventional MR in many new exciting areas. Interventional MRI encompasses many diverse areas from the treatment of heart disease, to neurosurgery, to body applications. In this edition of Topics in MRI, we have assembled 4 articles from 4 very different areas, all focusing on clinical applications. In the first article, Wady Gedroyc describes his experience with several thermal ablation technologies applied to a range of different applications. His experiences provide insight to the technologies, both in thermal ablation devices and in monitoring capabilities. Additionally, he provides examples of the emerging applications for thermal ablation. The group at the Brigham and Women's Hospital in Boston has extensive experience with MR-guided brachytherapy in the prostate. Steven Haker has provided an excellent review article on prostate imaging from diagnosis, to staging, to planning, to treatment. This overview of the role of thermal ablation and monitoring technologies and how they can be used clinically is a valuable guide to developing prostate treatment. Cengizhan Ozturk at the National Institutes of Health provides an overview of the state of MRI-guided vascular interventions. He describes the current clinical applications and the areas of research and development. One particularly critical issue in all areas of interventional MRI is that of MR-compatible devices. An active community is developing MR-compatible devices, but greatly expanded commercialization of these devices will be essential for the success of the field. Tom Moriarty provides an overview on the neurosurgical use of intraprocedural MRI. This review article covers the use of MRI for guiding brain tumor resection; it also covers other neurosurgical applications. One innovative example is the use of high-intensity focused ultrasound to treat brain pathologies. This is a snapshot of a portion of the field as it stands in the spring of 2006. However, interventional MR technologies are rapidly evolving. For example, MR-compatible devices are being developed for many applications, including vascular interventions, thermal therapies, and even robotic placement of devices. Improvements in imaging methods include ways to reduce motion sensitivity of thermal therapy monitoring and methods for evaluating thermal therapy immediately after treatment. Finally, new, more open MRI systems suitable for interventions are now becoming widely available. This is especially important for the broader application of interventional MRI in the future. This is clearly a very exciting area. I would like to thank Scott Atlas for giving us this opportunity to put together an issue dedicated to interventional MRI topics and the journal staff. I also would like to thank the authors for their hard work to prepare these excellent review articles.