Feasibility of stereotactic MRI-based image guidance for the treatment of vascular malformations: a phantom study.

Schwalbe, Marius; Haine, Axel; Schindewolf, Marc; von Tengg-Kobligk, Hendrik; Williamson, Tom; Weber, Stefan; Baumgartner, Iris; Fuss, Torsten (2016). Feasibility of stereotactic MRI-based image guidance for the treatment of vascular malformations: a phantom study. International Journal of Computer Assisted Radiology and Surgery, 11(12), pp. 2207-2215. Springer 10.1007/s11548-016-1417-0

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Treatment of vascular malformations requires the placement of a needle within vessels which may be as small as 1 mm, with the current state of the art relying exclusively on two-dimensional fluoroscopy images for guidance. We hypothesize that the combination of stereotactic image guidance with existing targeting methods will result in faster and more reproducible needle placements, as well as reduced radiationexposure, when compared to standard methods based on fluoroscopy alone.


The proposed navigation approach was evaluated in a phantom experiment designed to allow direct comparison with the conventional method. An anatomical phantom of the left forearm was constructed, including an independent control mechanism to indicate the attainment of the target position. Three interventionalists (one inexperienced, two of them frequently practice the conventional fluoroscopic technique) performed 45 targeting attempts utilizing the combined and 45 targeting attempts utilizing the standard approaches.


In all 45 attempts, the users were able to reach the target when utilizing the combined approach. In two cases, targeting was stopped after 15 min without reaching the target when utilizing only the C-arm. The inexperienced user was faster when utilizing the combined approach and applied significantly less radiation than when utilizing the conventional approach. Conversely, both experienced users were faster when using the conventional approach, in one case significantly so, with no significant difference in radiation dose when compared to the combined approach.


This work presents an initial evaluation of a combined navigation fluoroscopy targeting technique in a phantom study. The results suggest that, especially for inexperienced interventionalists, navigation may help to reduce the time and the radiation dose. Future work will focus on the improvement and clinical evaluation of the proposed method.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Schwalbe, Marius, Haine, Axel, Schindewolf, Marc, von Tengg-Kobligk, Hendrik, Williamson, Tom, Weber, Stefan (B), Baumgartner, Iris, Fuss, Torsten


600 Technology > 610 Medicine & health








Lars Marius Schwalbe

Date Deposited:

16 Jun 2016 16:52

Last Modified:

29 Mar 2023 23:34

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

MR imaging, Percutaneous needle insertions, Stereotactic image guidance, Vascular malformations





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