BackgroundAccurate synchronization between magnetic resonance imaging data acquisition and a subject’s cardiac activity (“triggering”) is essential for reducing image artifacts but conventional, contact-based methods for this task are limited by several factors, including preparation time, patient inconvenience, and susceptibility to signal degradation. The purpose of this work is to evaluate the performance of a new contact-free triggering method developed with the aim to eventually replace conventional methods in non-cardiac imaging applications. In this study, the method’s performance is evaluated in the context of 7 Tesla non-enhanced angiography of the lower extremities.MethodsOur main contribution is a basic algorithm capable of estimating in real-time the phase of the cardiac cycle from reflection photoplethysmography signals obtained from skin color variations of the forehead recorded with a video camera. Instead of finding the algorithm’s parameters heuristically, they were optimized using videos of the forehead as well as electrocardiography and pulse oximetry signals that were recorded from eight healthy volunteers in and outside the scanner, with and without active radio frequency and gradient coils. Based on the video characteristics, synthetic signals were generated and the “best available” values of an objective function were determined using mathematical optimization. The performance of the proposed method with optimized algorithm parameters was evaluated by applying it to the recorded videos and comparing the computed triggers to those of contact-based methods. Additionally, the method was evaluated by using its triggers for acquiring images from a healthy volunteer and comparing the result to images obtained using pulse oximetry triggering.ResultsDuring evaluation of the videos recorded inside the bore with active radio frequency and gradient coils, the pulse oximeter triggers were labeled in 62.5% as “potentially usable” for cardiac triggering, the electrocardiography triggers in 12.5%, and the proposed method’s triggers in 62.5%. Evaluation of the angiography images demonstrated that under appropriate conditions the method is feasible to produce an image quality comparable to pulse oximetry.ConclusionWe conclude that cardiac triggering using the proposed method is technically feasible. However, for improved reliability the signal-to-noise ratio of the videos will have to be addressed by either replacing the camera sensor, improving the illumination, or by use of additional signal filtering techniques.

In this paper we present an approach to the problem of modelling long, flexible instruments, such as endoscopes or catheters. The idea is to recursively enumerate all possible shapes and subsequently filter them according to given mechanical and physical constraints. Although this brute-force approach has an exponential worst-case complexity, we show with a typical example that in case of tubular structures the empirical complexity is polynomial. We present two approximation methods that reduce this bound to a linear complexity. We have performed accuracy, runtime and robustness tests in preparation for first clinical studies.

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We attempt to maximize the success probability for "blind" biopsies by preoperatively estimating four parameters. These parameters well-define the procedure, given that the bronchoscope resides "somewhere" inside the target branch of the tracheobronchial tree. The calculations are based on a patient specific lung model (CT scan) and a digital model of a flexible bronchoscope. Using both models, we simulate the biopsy and derive frequency distributions for each parameter. Based on these distributions, we choose several parameter sets that together maximize the success probability. The parameters are provided to the surgeon in form of detailed step-by-step instructions (protocol) of how to handle the bronchoscope. To control the parameters in the operating room (OR) we use passive controls. First lung phantom experiments show that we could hit in worst-case 12 mm targets (average-case: 5 mm) with three aspirations.