Evaluation of MR-safe bioptomes for MR-guided endomyocardial biopsy in 
minipigs: a potential radiation-free clinical approach

Svetlove, Angelika; Ritter, C.O.; Dullin, Christian; Schmid, M.; Schauer, S.; Uihlein, J.; Uecker, M.; Mietsch, M.; Stadelmann, C.; Lotz, J.; Unterberg-Buchwald, C.

doi:10.1186/s41747-023-00391-4

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Evaluation of MR-safe bioptomes for MR-guided endomyocardial biopsy in minipigs: a potential radiation-free clinical approach

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Svetlove, Angelika
Research Group of Translational Molecular Imaging, Max Planck Institute for Multidisciplinary Sciences, Max Planck Society;

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Dullin, Christian
Research Group of Translational Molecular Imaging, Max Planck Institute for Multidisciplinary Sciences, Max Planck Society;

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引用

Svetlove, A., Ritter, C., Dullin, C., Schmid, M., Schauer, S., Uihlein, J., Uecker, M., Mietsch, M., Stadelmann, C., Lotz, J., & Unterberg-Buchwald, C. (2023). Evaluation of MR-safe bioptomes for MR-guided endomyocardial biopsy in minipigs: a potential radiation-free clinical approach. European Radiology Experimental, 7(1):. doi:10.1186/s41747-023-00391-4.

引用: https://hdl.handle.net/21.11116/0000-000E-1B79-D

要旨

Background:
Diagnostic accuracy of endomyocardial biopsy could improve if clinically safe magnetic resonance (MR)-compatible bioptomes were available. We explored two novel MR-compatible cardiac bioptomes for performance, safety, and clinical viability, employing in vivo minipig trials and phase-contrast synchrotron radiation computed microtomography (SRµCT).

Methods:
Analysis of ex vivo obtained pig endomyocardial biopsies was performed using phase-contrast SRµCT and conventional two-dimensional histology. The technical performance was evaluated by measuring volume, inner and outer integrities, compression, and histological diagnostic value in 3 sets (6 per set) of biopsies for each experimental bioptome. The bioptomes were tested in vivo in 3 healthy minipigs per bioptome. The clinical feasibility was evaluated by procedural and cutting success as well as histological diagnostic value.

Results:
The bioptome with the ‘grind-grind’ design achieved similar values to control in compression (p = 0.822), inner (p = 0.628), and outer (p = 0.507), integrities ex vivo. It showed a better performance in the in vivo real-time MRI setting demonstrating a higher cutting success (91.7%) than the ‘grind-anvil’ (86.2%) design. In both ex vivo and in vivo evaluations, the ‘grind-grind’ design displayed sufficient diagnostic value (83% and 95%). The ‘grind-anvil’ design showed adequate diagnostic value both ex vivo and in vivo (78% and 87.5%) but was not comparable to control according to the three-dimensional (3D) analysis.

Conclusion:
A novel MR-compatible bioptome was identified as plausible in a clinical setting. Additionally, SRµCT and subsequent 3D structural analysis could be valuable in the label-free investigation of myocardial tissue at a micrometer level.

Relevance statement:
Implementation of MR-guided biopsy can improve animal studies on structural myocardial changes at any point in an experimental setup. With further improvements in guiding catheters, MR-guided biopsy, using the new bioptome, has a potential to increase quality and diagnostic accuracy in patients both with structural and inflammatory cardiomyopathies.

Key points:
- Novel MR-compatible bioptomes show promise for a clinical application.
- SRµCT enabled detailed analysis of endomyocardial biopsies.
- The bioptomes showed adequate in vivo performance without major complications.