RSNA 2016

Abstract Archives of the RSNA, 2016


SSA24-05

MR-iGuide TIPS: MRI-Angio Fusion Image Guided TIPS (Pre-Clinical Study)

Sunday, Nov. 27 11:25AM - 11:35AM Room: E350



Edward W. Lee, MD, PhD, Los Angeles, CA (Presenter) Nothing to Disclose
Jonathan K. Park, MD, Los Angeles, CA (Abstract Co-Author) Nothing to Disclose
Bashir A. Tafti, MD, Los Angeles, CA (Abstract Co-Author) Nothing to Disclose
Justin P. McWilliams, MD, Los Angeles, CA (Abstract Co-Author) Nothing to Disclose
Stephen T. Kee, MD, Stanford, CA (Abstract Co-Author) Nothing to Disclose
PURPOSE

To evaluate the feasibility, safety and reproducibility of performing MRI-Angio fusion image guided TIPS

METHOD AND MATERIALS

Upon ARC approval, twelve Yorkshire swine underwent TIPS procedure using an iGuide software (Siemens) and Rosch-Uchida TIPS set. 3D images were prepared using non-contrast MRI images fused with cone-beam CT images.  The following data were evaluated: a time to create 3D images, a total procedure time, a total fluoro time and the number of punctures needed to cannulate portal vein.  Any procedure related complications were also noted.

RESULTS

A technical success rate of creating TIPS was 100% in all 12 animals.  Of 12, 11 animals had a “single puncture” TIPS with a mean fluoro time of 7 minutes.  A mean time of creating 3D image map was 10 minutes.  MRI-Angio fusion images were successfully created in all 12 animals.  A mean total procedure time for the entire TIPS procedure was 25 minutes.  No immediate complications were noted. 

CONCLUSION

Using MR-iGuide, a safe, “single puncture” TIPS is possible. MR-iGuide TIPS is feasible and reproducible with a minimal radiation exposure.

CLINICAL RELEVANCE/APPLICATION

One of the most challenging part of performing TIPS procedure is to identifying intrahepatic portal vein blindly.  With our results, we may be able to improve and change the way we perform TIPS currently by providing a direct guidance to the portal vein safely and effectively.