Fusion of Real-time US with CT Images to Guide Sacroiliac Joint Injection in Vitro and in Vivo

Klauser, Andrea; Zordo, Tobias De; Feuchtner, Gudrun; Djedovic, Gabriel; Bellmann‐Weiler, Rosa; Faschingbauer, R; Schirmer, Michael; Moriggl, Bernhard

doi:10.1148/radiol.10090968

Cited by 64 publications

(51 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our experience confirms previous reports on the efficacy of image fusion as a guide for sacroiliac joint injections [12] and provides the first data on the feasibility of US-MR image fusion for this purpose. Aside from the advantages of three-dimensional imaging, the use of MRI also eliminates the problem of radiation exposure, and in some cases the images can also be useful for assessing joint inflammation.…”

Section: Image Fusionsupporting

confidence: 89%

“…The limits of our study lie mainly in the small number of cases examined, which is, however, fairly similar to that of other studies reported in the literature [12]. In addition, the efficacy of the technique was documented radiologically on the basis of the registration errors, but correct intra-articular placement of the needle tip was not verified with another imaging modality.…”

Section: Image Fusionsupporting

confidence: 75%

“…The most important contribution in optimization of the technique has been made by Klauser et al who demonstrated the fundamental importance of precisely defined anatomical landmarks in facilitating intra-articular injections and reducing the incidence of incorrectly placed (i.e., extra-articular) drug delivery. They reported a success rate of 100 % with a mean procedure time of approximately 3 min [12].…”

Section: Discussionmentioning

confidence: 99%

“…The overall success rate was high, also in terms of the clinical outcome (pain relief based on pre-and post-procedure scores). The mean overall procedure time was approximately 20 min with a mean image registration time of around 15 min [12].…”

Section: Image Fusionmentioning

confidence: 99%

See 3 more Smart Citations

Use of ultrasound–magnetic resonance image fusion to guide sacroiliac joint injections: a preliminary assessment

et al. 2013

View full text Add to dashboard Cite

Background The sacroiliac joint is one of the sources of chronic lower back pain. Intra-articular injections of anesthetic drugs and/or steroids are currently used in these cases for diagnostic and therapeutic purposes. However, given the anatomic and functional complexity of the joint, imaging guidance is mandatory during such procedures. In this context, the technique of fusing images obtained with two different modalities can often overcome the limitations and enhance the advantages of single-modality guidance. Aim The aim of this study was to evaluate the technique of ultrasound (US)-magnetic resonance (MR) image fusion to guide intra-articular injections of drugs into the sacroiliac joint. Materials and methods We evaluated seven sacroiliac joints in six patients with sacroiliac pain syndrome (four females, two males; mean age 59 years; range 46-76 years). Five were candidates for radiofrequency thermolysis, and a therapeutic nerve block was performed in the sixth. Using the volume navigation system, we fused three-dimensional MR images with simultaneously acquired real-time ultrasound images and used them to guide the intra-articular injections. Results In all patients, spatial accuracy was considered excellent, with definition of registration errors of less than 3 mm. The diagnostic blocks produced positive results in all patients with 80 % reductions in pain (measured with a Numerical Rating Scale, NRS) relative to baseline. The patient who underwent the therapeutic nerve block experienced complete resolution of symptoms that has been maintained over time. There were no complications. Conclusions US-MR imaging fusion guidance of sacroiliac joint injections is feasible and effective, in accordance with the data in the literature. The use of the MR for threedimensional imaging eliminates the risk of radiation exposure. Keywords Image fusion technique Á Sacroiliac joints Á Ultrasound RiassuntoBackground il dolore sacro-iliaco è una delle cause di dolore lombare cronico. L'infiltrazione intra-articolare di farmaci anestetici e/o steroidi, costituisce uno strumento correntemente utilizzato a scopo diagnostico e terapeutico. Tuttavia, la complessità anatomo-funzionale dell'articolazione impone l'utilizzo della guida imaging all'infiltrazione. La fusion imaging si pone in questo contesto come strumento che risolve i limiti delle singole metodiche e ne amplifica i vantaggi. Scopo l'obiettivo del nostro lavoro è valutare la fusion imaging come strumento per la guida della somministrazione farmacologica intra-articolare dell'articolazione sacro-iliaca, utilizzando la co-registrazione di immagini ecografiche e di risonanza magnetica. Materiali e Metodi sono state valutate 7 articolazioni sacro-iliache in 6 pazienti (4 femmine, 2 maschi; età media 59 anni; range 46-76 anni) con sindrome dolorosa sacroiliaca; 5 candidati al trattamento di termolesione, 1 sottoposto a blocco terapeutico. L'iniezione intra-articolare è stata condotta con la guida della fusion imaging ottenuta con i dati tridimensionali RM visua...

show abstract

Section: Image Fusionsupporting

confidence: 89%

Section: Image Fusionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Image Fusionmentioning

confidence: 99%

See 2 more Smart Citations

Use of ultrasound–magnetic resonance image fusion to guide sacroiliac joint injections: a preliminary assessment

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The use of US fusion in the diagnosis or treatment of musculoskeletal conditions has been limited. Klauser et al [15] reported on a series of sacroiliac joint injections and showed that US and CT fusion allowed reliable injection of the target area.…”

Section: Introductionmentioning

confidence: 99%

2011 Mid-America Orthopaedic Association Dallas B. Phemister Physician in Training Award: Can Musculoskeletal Tumors be Diagnosed with Ultrasound Fusion-Guided Biopsy?

Khalil

Mott

Parsons

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Percutaneous biopsy for musculoskeletal tumors commonly relies on imaging adjuncts including ultrasound (US), CT, or MRI. These modalities however have disadvantages (US) or are cumbersome, not universally available, and costly (CT and MRI). US fusion is a novel technique that fuses previously obtained CT or MRI data with real-time US, which allows biopsies to be performed in an US suite. It has proven useful in various body systems but musculoskeletal applications remain scarce. Our goal is to evaluate the fusion technology and determine its ability to diagnose musculoskeletal tumors. Questions/Purposes We determined whether biopsies performed via US fusion compared with CT guidance provide equivalent diagnostic yield and accuracy and allow quicker biopsy scheduling and procedure times. Methods Forty-seven patients were assigned to undergo either US fusion (with MR, n = 16 or CT, n = 15) or CTguided biopsies (n = 16). We evaluated adequacy of the histologic specimen (diagnostic yield) and correlation with surgical pathology (diagnostic accuracy). We determined scheduling times and lengths of the biopsy. Results US fusion and CT-guided biopsy groups had comparable diagnostic yields (CT = 94%; US/MRI = 94%; US/CT = 93%) and accuracy (CT = 83%; US/ MRI = 90%; US/CT = 100%). US fusion biopsies were faster to schedule and perform. All procedures were safe with minimal complications.Conclusions US fusion provides a high diagnostic yield and accuracy comparable to CT-guided biopsy while performed in the convenience of an US suite. This may have resulted in the observed faster scheduling and biopsy times. Level of Evidence Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

Educational benefits of fusing magnetic resonance imaging with sonograms

Vollman

Hulen

Dulchavsky

et al. 2014

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

Fusion of Real-time US with CT Images to Guide Sacroiliac Joint Injection in Vitro and in Vivo

Abstract: Image fusion of real-time US and previously obtained CT scans is feasible to guide needle insertion into the SI joint.

Cited by 64 publications

References 27 publications

Use of ultrasound–magnetic resonance image fusion to guide sacroiliac joint injections: a preliminary assessment

Use of ultrasound–magnetic resonance image fusion to guide sacroiliac joint injections: a preliminary assessment

2011 Mid-America Orthopaedic Association Dallas B. Phemister Physician in Training Award: Can Musculoskeletal Tumors be Diagnosed with Ultrasound Fusion-Guided Biopsy?

Educational benefits of fusing magnetic resonance imaging with sonograms

Contact Info

Product

Resources

About