Author + information
- S1936879815022219-bb7d56defc47dfa50850f194a4d010d0Toby Rogers,
- S1936879815022219-5363ddbf4866d8adf900bdc11170a9e9Kanishka Ratnayaka,
- S1936879815022219-e030eb14cdaa278aa3aee5b71fbf3e72William H. Schenke,
- S1936879815022219-9f7a27c28d9706af99d62e7617c7ead1Jonathan R. Mazal,
- S1936879815022219-2d7cad494ed981a10f4f2ed495e30084Adrienne Campbell-Washburn,
- S1936879815022219-89ba3d1a5b3b5bedb1d49c1f2d964b80Ozgur Kocaturk,
- S1936879815022219-2dcf421b8180b7d61b78b40d5a429b8eAnthony Z. Faranesh and
- S1936879815022219-43bfd91ee102850980352bac646e2258Robert J. Lederman
The diagnostic yield of endomyocardial biopsy is low because X-ray fluoroscopy cannot distinguish abnormal from normal myocardium. We hypothesized real-time MRI guidance could improve the yield.
Under X-ray fluoroscopy guidance, 3mL of fluorescent microspheres (NuFlow Hydrocoat, 15μm diameter, 5 million spheres/mL) was infused to a branch coronary artery followed by 2mL of 100% ethanol to create a single focal endomyocardial lesion. Animals were survived for minimum 14days, before undergoing in the same procedure MRI guided biopsy using a custom-built active visualization MR-conditional bioptome (Figure 1) and X-ray guided biopsy using a commercial steel bioptome. Specimens were analysed using a dissecting microscope under ultraviolet light with a 400-480nm band pass filter to determine the proportion of ‘on-target’ specimens containing fluorescent microspheres.
5 swine with mean bodyweight 51kg underwent both MRI and X-ray guided biopsy. After administration of systemic gadolinium contrast, the lesion was visible using late gadolinium enhancement MRI. A total of 77 specimens were collected in MRI, and 87 in X-ray. Examination of the specimens under ultraviolet light revealed fluorescent microspheres in 63/77 (81.8%) specimens obtained under MRI guidance compared with 49/87 (56.3%) specimens obtained under X-ray fluoroscopy guidance (Figure 2).
Real-time MRI guidance can improve the diagnostic yield of endomyocardial biopsy in an animal model of focal myocardial disease.