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MR-guided minimally-invasive surgery
 Humans
can make mistakes, so it is important that their involvement is minimal and
hence minimally invasive surgery is vital for the medical fraternity. It helps
in reducing medical errors to a great extent.
Non-real time, low resolution, non-3D, ionisation, localisation
in accuracy, no real time treatment monitoring are some of the disadvantages
of such surgeries. This surgery is used for interventional MRI in console, navigation,
and life support by vital signs monitor.
Localisation, targeting, navigation, monitoring and control,
are all included in intra-operative monitoring. Also, diagnostic imaging, surgical
planning, interactive planning, validation and assessment are a part of image
guided minimally invasive surgery.
Image guided minimally invasive surgery is used in open surgery,
integrated navigation system, laser therapy and 3D visualisation, real time
temperature monitoring, brachytherapy, robotic assisted for MR guided prostate
brachytherapy, focussed ultrasound (FUS) treatment, targeting by MR guidance,
cardio vascular intervention, coronary artery intervention and multi-therapeutic
techniques.
Commonly referred minimally invasive or non-invasive procedures
include cryotherapy, focused ultrasound (FUS), interstitial radio frequency
(RF), brachytherapy, laser, microwave and others. Minimally invasive procedures,
with much less complication and very promising treatment outcome, are presumed
to be preferred alternatives to conventional open surgeries.
These approaches, however, are not commonly applied clinically
mostly owing to its limitation in targeting guidance and treatment process monitoring
when using imaging equipment such as ultrasound (US), fluoroscopy, and computed
tomography (CT).
There imaging modalities offer some specific advantages,
but their drawbacks in terms of spatial resolution, real-time guidance and monitoring
capability, tissue contrast differentiation, radiation, and 3D localisation
inadequacy limit their applications.
Magnetic resonance imaging (MRI) offers excellent soft-tissue
discrimination and 3D high spatial and temporal resolution imaging ability,
showing great potential for guidance and monitoring of minimally invasive procedures.
(Dr Dr Lei Zhao spoke during IRIA)
The writer is with Brigham and Women's Hospital, Harvard Medical School
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