Treating Aneurysm with MR Coagulation

Ouri Cohen, first author of a paper describing the new MR coagulation method, with Jerry Ackerman after receiving an award in recognition of the work

A team of investigators in the MGH Martinos Center for Biomedical Imaging, in collaboration with medical device company Robin Medical, has developed a new method that could help to address cerebral aneurysm while adding therapeutic capabilities to magnetic resonance imaging.

Cerebral aneurysm, a dangerous ballooning of a brain artery under the pulsating pressure of blood flow, afflicts an estimated 1 to 6 percent of the population. Rupture of an aneurysm frequently results in death. Aneurysms are most commonly repaired by using a catheter to fill the aneurysm with tiny coils of wire that promote thrombus (clot), or with a polymeric substance, mechanically stabilizing the aneurysm and reducing its chances of rupturing. Though effective, these methods may cause foreign body reactions and don’t offer the possibility of “sculpting” the shape of the bolus – that is, the plug of material that fills the aneurysm.

The new method could help to overcome these limitations.

“We developed a novel approach to aneurysm repair in which a biomaterial that can be coagulated with heat – a protein solution, for example – is introduced into the aneurysm via a catheter,” said Ouri Cohen, a postdoctoral fellow in the Center. Cohen works in the lab of Jerry Ackerman, the Martinos investigator who spearheaded the work. “The intrinsic radiofrequency heating effect of MRI scanning is used to heat and coagulate the biomaterial to stabilize the aneurysm by means of a wire that gets hot during the scanning. The location of the wire tip controls precisely where the heating occurs. And importantly, because the procedure takes place within an MRI scanner, the scanner can be used to guide catheter placement, monitor the procedure, and provide images of both the temperature of the tissue and the state of coagulation, simultaneously and in real time.”

Cohen, Ackerman and colleagues, including PhD student Ming Zhao from the University of Massachusetts Lowell and Robin Medical CEO Erez Nevo, described the method in a paper published last year in the Journal of Vascular and Interventional Radiology. In recognition of the work, the journal recently honored Cohen with a 2017 Editor’s Award for Distinguished Laboratory Investigation.

The MR coagulation method is just one example of a more general platform technology that the Martinos team is developing in collaboration with Robin Medical. “The technology will bring inherent therapeutic energy delivery capability to MRI scanners, heralding a new role for the scanners, which have long been viewed as diagnostic devices only,” Ackerman said. “To this end, we plan to improve the coagulatable biomaterials and delivery systems, test the technology in animals, and ultimately conduct human trials.”