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Interventional MRI is a technique that is strongly promoted and that aims to reach several important clinical goals: improved guidance of therapy, the establishment of non-ionizing and less invasive interventional methods and the progressive replacement of surgical procedures by transcatheter techniques. This complex technology is, however, still evolving and requires a close multidisciplinary cooperation between different fields of basic and clinical science. Several important clinical studies were realized in the past years but its total number still remains limited. This review presents the current situation in this field of research.