MRI Magnetic Navigation Catheter for Percutaneous Biliary Stricture Treatment

Avi Hari, Nathan Liu, and Zachary Lieske

Background

Cather Based Interventions

Catheter-based interventions are pervasive throughout medicine and important in treatment within tubular structures of the human body like the cardiovascular system and bile duct. Endovascular treatments include the repair of arteries that have been damaged and the widening of narrowed arteries [1].

Biliary Stricture Pathophysiology

Treatments within the bile duct for diseases like biliary stricture (bile duct narrowing) similarly require catheters to open the tubes, with other interventions like biliary ablation therapies currently being researched [2].

The market for biliary stricture catheter interventions is the highest incidence in patients with cancerous tumors as well as those who have undergone liver transplant or laparoscopic cholecystectomy and those who have chronic pancreatitis, at rates of about 10-40%, 0.5%, and 13-21%, respectively [3]. Given the large population of biliary stricture patients, there is widespread opportunity for advancing treatments.

X-Ray vs. MRI imaging

Standard catheter control techniques involve using guidewires to structure the flexible catheters as they advance through vessels. Physicians have difficulty navigating tortuous vessels within the body using these standard techniques. In addition, catheter control must be done under x-ray fluoroscopy, despite magnetic resonance imaging (MRI) systems giving better visualization the soft tissue of blood vessels and the bile duct as guidewires are generally metallic and incompatible with MRI [4]. X-ray fluoroscopy not only exposes patients and providers to ionizing radiation but also requires contrast agents for visualization of soft vessels and the use of heavy lead protective equipment by providers. Although there are risks associated with any invasive procedure, specific risks posed by current catheter interventions include negative reactions to contrast dyes, damage to vessel walls caused by catheterization, and side effects from x-ray exposure [5].

Defining our problem

Medical professionals need a magnetically controlled catheter system with more efficient and precise catheter control. A cost-effective magnetically controlled catheter will enable more precise navigation during operations, particularly in MRI settings, allowing for safer and more efficient procedures. This is especially beneficial for treating patients with biliary stricture, as it can reduce the complexity of catheter navigation, decrease operation time, and ultimately save lives. For navigation within a bile duct in the MRI environment, the device will need a diameter of less than 7 mm and the ability to deflect up to angles of 160° while within a constant magnetic field of 1.25-1.75 Teslas. The proof-of-concept device will be tested by navigating within the branches of a simplified physiological phantom. Group 7 will deliver a magnetically controlled catheter system, the physiological phantom, along with the circuit diagrams, hardware plans, and software to UN&UP by April 28, 2025.

Text References

  1. “Catheter Interventions.” Msmc.Com, Mount Sinai Medical Center, www.msmc.com/medical_care/cardiovascular-care/catheter-interventions/#:~:text=We%20call%20these%20catheter%2Dbased,without%20incisions%20in%20the%20chest. 
  2. Fang, A., Kim, I. K., Ukeh, I., Etezadi, V., & Kim, H. S. (2021). Percutaneous Management of Benign Biliary Strictures. Seminars in interventional radiology, 38(3), 291–299. https://doi.org/10.1055/s-0041-1731087 
  3. Ma, M. X., Jayasekeran, V., & Chong, A. K. (2019). Benign biliary strictures: prevalence, impact, and management strategies. Clinical and experimental gastroenterology, 12, 83–92. https://doi.org/10.2147/CEG.S165016
  4. Catania, R., Dasyam, A. K., Miller, F. H., & Borhani, A. A. (2021). Noninvasive Imaging Prior to Biliary Interventions. Seminars in interventional radiology, 38(3), 263–272. https://doi.org/10.1055/s-0041-1731268
  5. “Cardiac Catheterization.” www.heart.org, American Heart Association, 18 Aug. 2023, www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/cardiac-catheterization. 

Image References

  1. McKay T, Franklin P, Steliga MA, Betzold RD, Kalkwarf KJ. Percutaneous Catheter for Spontaneous Pneumothorax. October 2022. doi:10.25373/ctsnet.21397425
  2. “What Is Bile Duct Cancer (Cholangiocarcinoma)?” NCI, National Cancer Institute, www.cancer.gov/types/liver/bile-duct-cancer.
  3. Hapugoda S, Abdomen x-ray (annotated). Case study, Radiopaedia.org (Accessed on 26 Sep 2024) https://doi.org/10.53347/rID-56646
  4. “Body MRI.” Body MRI – Siemens Healthineers, www.siemens-healthineers.com/magnetic-resonance-imaging/clinical-specialities/body-mri. Accessed 26 Sept. 2024.