Search

[EN] In this work we numerically and experimentally study the performance of large-volume hyperthermia induced by acoustic holographic-modulated high-intensity focused ultrasound (AHmHIFU) in gelatin phantoms. Excellent agreement was found between thermal simulations of the AHmHIFU system and temperature maps characterized with Proton Resonance Frequency Shift MR-thermometry at 1.5 T. ROIs inside which experimental temperature elevation was greater than 4 degrees were 11 mm by 16 mm and 7 mm by 30 mm with and without the holographic lens, respectively. Most importantly, standard deviation inside these ROIs were equal to 12% and 40% of the maximum temperature with and without the lens. This demonstrates that a wider and more uniform heated region can be generated using the holographic lens, showing the capabilities of acoustic holograms to be used as a low-cost alternative for large-volume hyperthermia treatments, This research has been supported by the Spanish Ministry of Science, Innovation and Universities (MICINN) through grants IJC2018-037897-I, FPU19/00601 and PID2019-111436RBC22, by the Agencia Valenciana de la Innovaci o through grants INNCON/2021/8 and INNVA1/2020/92, by Generalitat Valenciana through grant AICO/2020/268. Action co-financed by the European Union through the Programa Operativo del Fondo Europeo de Desarrollo Regional (FEDER) of the Comunitat Valenciana 2014-2020 (IDIFEDER/2018/022) and (IDIFEDER/2021/004).

Structural and metabolic imaging are fundamental for diagnosis, treatment and follow-up in oncology. Beyond the well-established diagnostic imaging applications, ultrasounds are currently emerging in the clinical practice as a noninvasive technology for therapy. Indeed, the sound waves can be used to increase the temperature inside the target solid tumors, leading to apoptosis or necrosis of neoplastic tissues. The Magnetic resonance-guided focused ultrasound surgery (MRgFUS) technology represents a valid application of this ultrasound property, mainly used in oncology and neurology. In this paper, patient safety during MRgFUS treatments was investigated by a series of experiments in a tissue-mimicking phantom and performing ex vivo skin samples, to promptly identify unwanted temperature rises. The acquired MR images, used to evaluate the temperature in the treated areas, were analyzed to compare classical proton resonance frequency (PRF) shift techniques and referenceless thermometry methods to accurately assess the temperature variations. We exploited radial basis function (RBF) neural networks for referenceless thermometry and compared the results against interferometric optical fiber measurements. The experimental measurements were obtained using a set of interferometric optical fibers aimed at quantifying temperature variations directly in the sonication areas. The temperature increases during the treatment were not accurately detected by MRI-based referenceless thermometry methods, and more sensitive measurement systems, such as optical fibers, would be required. In-depth studies about these aspects are needed to monitor temperature and improve safety during MRgFUS treatments.

Accurate estimation of SAR is critical to safeguarding vulnerable patients who require an MRI procedure. The increased static field strength and RF duty cycle capabilities in modern MRI scanners mean that systems can easily exceed safe SAR levels for patients. Advisory protocols routinely used to establish quality assurance protocols are not required to advise on the testing of MRI SAR levels and is not routinely measured in annual medical physics quality assurance checks. This study aims to develop a head phantom and protocol that can independently verify global SAR for MRI clinical scanners. A four-channel birdcage head coil was used for RF transmission and signal reception. Proton resonance shift thermometry was used to estimate SAR. The SAR estimates were verified by comparing results against two other independent measures, then applied to a further four scanners at field strengths of 1.5¿T and 3¿T. Scanner output SAR values ranged from 0.42 to 1.52¿W/kg. Percentage SAR differences between independently estimated values and those calculated by the scanners differed by 0-2.3%. We have developed a quality assurance protocol to independently verify the SAR output of MRI scanners. The project was co-financed by the European Regional Development Fund (ERDF) under Ireland’s European Structural, Investment Funds Programme 2014–2020 and Enterprise Ireland; Grant agreement: CF-2017-0826-P, Irish Research Council postgraduate scholarship GOIPG/2018/82 and the NUI Galway College of Science. Thank you to the NUI Galway Microbiology and physics department for their help creating the phantom. Authors would like to thank Maja Drapiewska and David Connolly from the NUI Galway College of Engineering and Informatics and Eileen Smith from Netzsch for help with DSC measurements. peer-reviewed 2020-10-05

Purpose Simultaneous fat-referenced proton resonance frequency shift (FRPRFS) thermometry combined with MR elastography (MRE) is proposed, to continuously monitor thermal ablations for all types of soft tissues, including fat-containing tissues. Fat-referenced proton resonance frequency shift thermometry makes it possible to measure temperature even in the water fraction of fat-containing tissues while enabling local field-drift correction. Magnetic resonance elastography allows measuring the mechanical properties of tissues that are related to tissue structural damage. Methods A gradient-echo MR sequence framework was proposed that combines the need for multiple TE acquisitions for the water-fat separation of FRPRFS, and the need for multiple MRE phase offsets for elastogram reconstructions. Feasibility was first assessed in a fat-containing gelatin phantom undergoing moderate heating by a hot water circulation system. Subsequently, high intensity focused ultrasound heating was conducted in porcine muscle tissue ex vivo (N = 4; 2 samples, 2 locations/sample). Results Both FRPRFS temperature maps and elastograms were updated every 4.1 seconds. In the gelatin phantom, FRPRFS was in good agreement with optical fiber thermometry (average difference 1.2 ± 1°C). In ex vivo high-intensity focused ultrasound experiments on muscle tissue, the shear modulus was found to decrease significantly by 34.3% ± 7.7% (experiment 1, sample 1), 17.9% ± 10.0% (experiment 2, sample 1), 55.1% ± 8.7% (experiment 3, sample 2), and 34.7% ± 8.4% (experiment 4, sample 2) as a result of temperature increase (ΔT = 22.5°C ± 4.2°C, 14.0°C ± 2.8°C, 14.7°C ± 3.7°C, and 14.5°C ± 3.0°C, respectively). Conclusion This study demonstrated the feasibility of monitoring thermal ablations with FRPRFS thermometry together with MRE, even in fat-containing tissues. The acquisition time is similar to non-FRPRFS thermometry combined with MRE.

Purpose To demonstrate that proton resonance frequency shift MR thermometry (PRFS-MRT) acquisition with nonselective free induction decay (FID), combined with coil sensitivity profiles, allows spatially resolved B0 drift-corrected thermometry. Methods Phantom experiments were performed at 1.5T and 3T. Acquisition of PRFS-MRT and FID were performed during MR-guided high-intensity focused ultrasound heating. The phase of the FIDs was used to estimate the change in angular frequency δωdrift per coil element. Two correction methods were investigated: (1) using the average δωdrift over all coil elements (0th-order) and (2) using coil sensitivity profiles for spatially resolved correction. Optical probes were used for independent temperature verification. In-vivo feasibility of the methods was evaluated in the leg of 1 healthy volunteer at 1.5T. Results In 30 minutes, B0 drift led to an apparent temperature change of up to -18°C and -98°C at 1.5T and 3T, respectively. In the sonicated area, both corrections had a median error of 0.19°C at 1.5T and -0.54°C at 3T. At 1.5T, the measured median error with respect to the optical probe was -1.28°C with the 0th-order correction and improved to 0.43°C with the spatially resolved correction. In vivo, without correction the spatiotemporal median of the apparent temperature was at -4.3°C and interquartile range (IQR) of 9.31°C. The 0th-order correction had a median of 0.75°C and IQR of 0.96°C. The spatially resolved method had the lowest median at 0.33°C and IQR of 0.80°C. Conclusion FID phase information from individual receive coil elements allows spatially resolved B0 drift correction in PRFS-based MRT.

Quantitative and non-invasive temperature mapping using magnetic resonance imaging (MRI) provides a unique way to measure temperature evolution inside biological tissues. The method is widely used in thermal ablation procedures with magnetic fields at or below 3T. In this paper, the sensitivity of the MRI thermometry at 7T was studied using a proton resonance frequency (PRF)-based technique. We first used an agarose gel phantom with MR-compatible thermometry to calibrate the temperature coefficient, and then this temperature coefficient was employed to measure the internal temperature in both ex vivo (beef muscle) and in vivo (rat) experiments using focused ultrasound heating. The temperature coefficient calibrated by the phantom was 0.0095 ppm/°C, and both the ex vivo and in vivo experiments exhibited clear temperature evolution. This quantitative study confirmed the sensitivity (

The temperature dependence of the proton resonance frequency (PRF) is often used in MR thermometry. However, this method is prone to even very small changes in local magnetic field strength. Here, we report on the effects of susceptibility changes of surrounding air on the magnetic field inside an object and their inferred effect on the measured MR temperature. MR phase thermometry was performed on spherical agar phantoms enclosed in cylindrical containers at 7 T. The air susceptibility inside the cylindrical container was changed by both heating the air and changing the gas composition. Changing the temperature of surrounding air from 23 to 69°C caused an apparent MR temperature error of 2 K. When ambient air was displaced by 100% oxygen, the MR temperature error increased to 40 K. The magnetic field shift and therefore error in inferred MR temperature scales linearly with volume susceptibility change and has a strong and nontrivial dependence on the experimental configuration. Air susceptibility changes associated with oxygen concentration changes greatly affect PRF MR thermometry measurements. Air temperature changes can also affect these measurements, but to a smaller degree. For uncalibrated MR thermometry, air susceptibility changes may be a significant source of error.

In MRI-guided high-intensity focused ultrasound (MR-HIFU) therapy, temperature-dependent proton resonance frequency (PRF) shift is a key factor to quantify and visualize the spatial heating pattern in treated and surrounding tissue. However, during treatment, multiple scanner-related changes can impact the accuracy of the temperature measurements obtained with the PRF shift method and cause an over/under estimation of temperature, which can be a major safety issue for treatments involving real-time temperature control. Hence, it is necessary to apply corrections to ensure accurate temperature measurements during heating. Prior to image acquisition, the central MR frequency F0 can be measured to adjust the F0 of next image acquisition. After acquisition, corrections can be applied to the acquired images to remove scanner-related influences, most importantly phase drift. Different phase drift correction algorithms such as conventional and polynomial adaptive drift correction estimate the background phase by fitting a linear or polynomial to the image phase outside the treatment area and perform the correction accordingly. The goal of this study was to understand the performance of these algorithms for long heating durations as would be experienced during hyperthermia or transurethral HIFU (>20 minutes).

MRgFUS (Magnetic Resonance guided Focused UltraSound) is a new and non-invasive technique to treat different diseases in the oncology field, that uses Focused Ultrasound (FUS) to induce necrosis in the lesion. Temperature change measurements during ultrasound thermo-therapies can be performed through magnetic resonance monitoring by using Proton Resonance Frequency (PRF) thermometry. It measures the phase variation resulting from the temperature-dependent changes in resonance frequency by subtracting one phase baseline image from actual phase. Referenceless thermometry aims to re-duce artefacts caused by tissue motion and frequency drift, fitting the back-ground phase outside the heated region. The aim of this contribution is to pro-pose a novel background phase reconstruction method using Radial Basis Func-tion (RBF) interpolation. The effectiveness of the method has been demonstrat-ed by comparing it against the classical PRF shift and polynomial referenceless approach. The comparison evaluates temperature rises in uterine fibroids during MRgFUS treatments on a set of 10 patients.

A method is presented which allows precise temperature and longitudinal (T1) relaxation time measurements with high spatial and temporal resolution. This is achieved by combining dynamic variable flip angle based T1 relaxation mapping with proton resonance frequency shift based thermometry. Herein, dynamic T1 mapping is either used as a complementary measure of temperature or for the detection of T1 contrast agent release. For the first application, the temperature evolution during a high-intensity focused ultrasound tissue ablation experiment was measured in both, porcine fat and muscle, simultaneously. In this application, temperature accuracies of 2.5 K for T1-based thermometry in fat and 1.2 K for proton resonance frequency shift-based thermometry in muscle were observed. The second application relates to MR-guidance of high-intensity focused ultrasound-induced local drug delivery by means of thermo-sensitive liposomes labeled with a T1 contrast agent (Gd-HPDO3A). When the measured temperature exceeded the phase transition temperature of the liposomes, T1 was observed to decrease with a good temporal and spatial correlation due to the release of Gd-HPDO3A. The presented results demonstrate the feasibility of the proposed method for two important applications in MR-guided noninvasive therapy. It offers a high temporal resolution when compared with interleaved Look-Locker based T1 mapping techniques and thus represents an interesting candidate for simultaneous real-time monitoring of T1 and temperature changes. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.

The conventional implementations of proton resonance frequency shift (PRFS) magnetic resonance thermometry (MRT) require the subtraction of single or multiple temporal references, a motion sensitive critical feature. A pilot study was conducted here to investigate the clinical feasibility of near-harmonic two-dimensional (2D) referenceless PRFS MRT, using patient data from MR-guided laser ablation of liver malignancies.PRFS MRT with respiratory-triggered multi-slice gradient-recalled (GRE) acquisition was performed under free breathing in six patients. The precision of the novel referenceless MRT was compared with the reference phase subtraction. Coupling the referenceless MRT with a model-based, real-time compatible regularisation algorithm was also investigated.The precision of MRT was improved by a factor of 3.3 when using the referenceless method as compared to the reference phase subtraction. The approach combining referenceless PRFS MRT and model-based regularisation yielded an estimated precision of 0.7° to 2.1°C, resulting in millimetre-range agreement between the calculated thermal dose and the 24 h post-treatment unperfused regions in liver.The application of the near-harmonic 2D referenceless MRT method was feasible in a clinical scenario of MR-guided laser-induced thermal therapy (LITT) ablation in liver and permitted accurate prediction of the thermal lesion under free breathing in conscious patients, obviating the need for a controlled breathing under general anaesthesia.

A new approach to MRI thermometry using encapsulated hyperpolarized xenon is demonstrated. The method is based on the temperature dependent chemical shift of hyperpolarized xenon in a cryptophane-A cage. This shift is linear with a slope of 0.29 ppm °C(-1) which is perceptibly higher than the shift of the proton resonance frequency of water (ca. 0.01 ppm °C(-1)) that is currently used for MRI thermometry. Using spectroscopic imaging techniques, we collected temperature maps of a phantom sample that could discriminate by direct NMR detection between temperature differences of 0.1 °C at a sensor concentration of 150 μM. Alternatively, the xenon-in-cage chemical shift was determined by indirect detection using saturation transfer techniques (Hyper-CEST) that allow detection of nanomolar agent concentrations. Thermometry based on hyperpolarized xenon sensors improves the accuracy of currently available MRI thermometry methods, potentially giving rise to biomedical applications of biosensors functionalized for binding to specific target molecules.

MR-guided high-intensity focused ultrasound (HIFU) ablation is a promising, noninvasive method for treatment of bone tumors and palliation of pain. During thermal therapy, temperature mapping is necessary to ensure proper heat deposition in targeted tumors as well as to prevent undesired heating in healthy tissues. However, conventional proton resonance frequency-based MR thermometry cannot be applied in cortical bone due to its short T2* relaxation time. Recently, it was shown that ultrashort echo-time MRI can be used to assess T1 change in cortical bone due to temperature change (Han M, ISMRM 2014, P262). This work focused on characterization of temperature dependence of T1 in cortical bone by performing a calibration experiment.

To determine the stability and quality of MR temperature mapping using the proton resonance frequency (PRF) method in the liver of hepatic tumor patients.The standard deviation (SD) of a series of temperature maps was determined in 30 patients (21 patients with cirrhotic livers with carcinoma, and nine patients with noncirrhotic livers with metastasis or angioma) and in five volunteers at normal body temperature under free breathing. A respiratory-gated segmented echo-planar imaging (EPI) sequence (three slices in one expiration phase) was performed with sensitivity encoding (SENSE) acceleration on a 1.5 T scanner. Motion-corrupted images were identified by calculation of the cross-correlation coefficient, and discarded.A T2* range of 10-33 msec was found, with especially low values in advanced cirrhotic livers. The mean temperature SD in patients was 2.3 degrees C (range = 1.5-5.0 degrees C). The stability in healthy livers was slightly better than that in cirrhotic livers, and it was higher in the right liver than in the left liver. The gating failed in 4% of the images when the respiratory cycle was irregular, leading to motion artifacts and errors in the temperature maps.The achieved temperature stability and image quality makes real-time quantitative monitoring of thermal ablation of liver tumors feasible on a clinical scanner.

Of the various techniques employed to quantify temperature changes by MR, proton resonance frequency (PRF) shift-based phase-difference imaging (PDI) is the most accurate and widely used. However, PDI is associated with various artifacts. Motivated by these limitations, we developed a new method to monitor temperature changes by MRI using the balanced steady-state free precession (balanced-SSFP) pulse sequence. Magnitude images obtained with the SSFP pulse sequence were used to find the PRF shift, which is proportional to temperature change. Spatiotemporal temperature maps were successfully reconstructed with this technique in gel phantom experiments and a rabbit model. The results show that the balanced-SSFP-based method is a promising new technique for monitoring temperature.

Magnetic resonance (MR) temperature mapping can be used to monitor temperature changes in minimally invasive thermal therapies during the procedure. However, organs displacements due to physiological activity (heart and respiration) may induce important artifacts on apparent temperature maps. This paper presents a new method for motion quantification and correction in such MR images, in order to improve the precision of temperature estimation using the proton resonance frequency (PRF) shift. The PRF shift technique gives an estimate of the relative temperature variation, comparing contrast between dynamically acquired images and a reference data sets. The correction method described in this paper consists of two steps: a motion atlas is initially computed in a preparation phase; during the intervention, the appropriate reference image is chosen from the atlas, allowing correct computation of the temperature map despite tissue motion. This method can be applied to any type of image sequences and is not restricted to MR images.

Object Proton resonance frequency shift (PRFS)-based MR thermometry (MRT) is hampered by heat-induced susceptibility changes when applied in tissues containing fat, e.g., the human breast. In order to assess the impact of fat susceptibility changes on PRFS-based MRT during thermal therapy in the human breast, reliable knowledge of the temperature dependence of the magnetic volume susceptibility of fat, dχfat/dT , is a prerequisite. In this work we have measured dχfat/dT of human breast fat tissue, using a double-reference method to ensure invariance to temperature-induced changes in the proton electron screening constant. Materials and methods Ex vivo measurements were taken on a 14.1 T five mm narrow bore NMR spectrometer. Breast fat tissue samples were collected from six subjects, directly postmortem. The susceptibility was measured over a temperature range from 24 ◦ Ct o 65 ◦ C. Results A linear behavior of the susceptibility over temperature was observed for all samples. The resulting dχfat/dT of human breast fat ranged between 0.0039 and 0.0076 ppm/ ◦ C. Conclusion It is concluded that the impact of heat-induced susceptibility changes of fat during thermal therapy in the breast may not be neglected.