Interventional procedures under MR guidance require the images to be acquired with a fast acquisition strategy, a rapid reconstruction algorithm for "real-time" imaging (ie, high temporal resolution), acquisition of at least three adjacent slices to track a tool reliably, and high tissue contrast to ensure safe positioning of interventional devices. Often times, the field strength for interventional MR-imaging units is limited by the open magnet design. This complicates the trade-off between scan time and image quality, particularly when applied during low field interventional MRI procedures. To minimize the impact of some of these trade-offs, a combination of keyhole techniques or modified k-space trajectories, in conjunction with a fluoroscopic (ie, continuous acquisition) mode and a real time reconstruction, permits rapid imaging in a low field system using standard (speed optimized) reconstruction hardware and standard gradient electronics. The purpose of this study was to design and describe different keyhole strategies that can be used in a real time mode to increase the image frame rate by a factor of up to 16. By updating the entire raw data space with our strategies, even small changes of the object could be recognized. Our results using these new strategies on two commercially available open magnet MR-imaging units (Siemens Magnetom Open 0.2T resistive magnet, Toshiba Access 0.064T permanent magnet) and a 1.5T superconductive solenoidal magnet design imager (Siemens SP) are presented to show the potential of these acquisition strategies in interventional MRI. Furthermore, these strategies may also be helpful for several other medical applications requiring high temporal resolution like contrast-enhanced breast imaging or functional brain imaging.
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