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Proton resonance frequency shift-based magnetic resonance thermometry is a currently used technique for monitoring temperature during targeted thermal therapies. However, in order to provide temperature updates with very short latency times, fast MR acquisition schemes are usually employed, which in turn might lead to noisy temperature measurements. This will, in general, have a direct impact on therapy control and endpoint detection. In this paper, we address this problem through an improved non-local filtering technique applied on the temperature images. Compared with previous non-local filtering methods, the proposed approach considers not only spatial information but also exploits temporal redundancies. The method is fully automatic and designed to improve the precision of the temperature measurements while at the same time maintaining output accuracy. In addition, the implementation was optimized in order to ensure real-time availability of the temperature measurements while having a minimal impact on latency. The method was validated in three complementary experiments: a simulation, an ex-vivo and an in-vivo study. Compared to the original non-local means filter and two other previously employed temperature filtering methods, the proposed approach shows considerable improvement in both accuracy and precision of the filtered data. Together with the low computational demands of the numerical scheme, the proposed filtering technique shows great potential for improving temperature measurements during real-time MR thermometry dedicated to targeted thermal therapies.

Real-time magnetic resonance imaging is a promising tool for image-guided interventions. For applications such as thermotherapy on moving organs, a precise image-based compensation of motion is required in real time to allow quantitative analysis, retrocontrol of the interventional device, or determination of the therapy endpoint. Reduced field-of-view imaging represents a promising way to improve spatial and/or temporal resolution. However, it introduces new challenges for target motion estimation, since structures near the target may appear transiently due to the respiratory motion and the limited spatial coverage. In this paper, a new image-based motion estimation method is proposed combining a global motion estimation with a novel optical flow approach extending the initial Horn and Schunck (H&S) method by an additional regularization term. This term integrates the displacement of physiological landmarks into the variational formulation of the optical flow problem. This allowed for a better control of the optical flow in presence of transient structures. The method was compared to the same registration pipeline employing the H&S approach on a synthetic dataset and in vivo image sequences. Compared to the H&S approach, a significant improvement (p<0.05) of the Dice's similarity criterion computed between the reference and the registered organ positions was achieved.

Real time magnetic resonance (MR) thermometry is gaining clinical importance for monitoring and guiding high intensity focused ultrasound (HIFU) ablations of tumorous tissue. The temperature information can be employed to adjust the position and the power of the HIFU system in real time and to determine the therapy endpoint. The requirement to resolve both physiological motion of mobile organs and the rapid temperature variations induced by state-of-the-art high-power HIFU systems require fast MRI-acquisition schemes, which are generally hampered by low signal-to-noise ratios (SNRs). This directly limits the precision of real time MR-thermometry and thus in many cases the feasibility of sophisticated control algorithms. To overcome these limitations, temporal filtering of the temperature has been suggested in the past, which has generally an adverse impact on the accuracy and latency of the filtered data. Here, we propose a novel filter that aims to improve the precision of MR-thermometry while monitoring and adapting its impact on the accuracy. For this, an adaptive extended Kalman filter using a model describing the heat transfer for acoustic heating in biological tissues was employed together with an additional outlier rejection to address the problem of sparse artifacted temperature points. The filter was compared to an efficient matched FIR filter and outperformed the latter in all tested cases. The filter was first evaluated on simulated data and provided in the worst case (with an approximate configuration of the model) a substantial improvement of the accuracy by a factor 3 and 15 during heat up and cool down periods, respectively. The robustness of the filter was then evaluated during HIFU experiments on a phantom and in vivo in porcine kidney. The presence of strong temperature artifacts did not affect the thermal dose measurement using our filter whereas a high measurement variation of 70% was observed with the FIR filter.

Thermotherapies can now be guided in real-time using magnetic resonance imaging (MRI). This technique is rapidly gaining importance in interventional therapies for abdominal organs such as liver and kidney. An accurate online estimation and characterization of organ displacement is mandatory to prevent misregistration and correct for motion related thermometry artifacts. In addition, when the ablation is performed with an extracorporal heating device such as high intensity focused ultrasound (HIFU), the continuous estimation of the organ displacement is the basis for the dynamic adjustment of the focal point position to track the targeted pathological tissue. In this paper, we describe the use of an optimized principal component analysis (PCA)-based motion descriptor to characterize in real-time the complex organ deformation during the therapy. The PCA was used to detect, in a preparative learning step, spatio-temporal coherences in the motion of the targeted organ. During hyperthermia, incoherent motion patterns could be discarded, which enabled improvements in motion estimation robustness, the compensation of motion related errors in thermal maps, and the adjustment of the beam position. The suggested method was evaluated for a moving phantom, and tested in vivo in the kidney and the liver of 12 healthy volunteers under free breathing conditions. The ability to perform a MR-guided thermotherapy in vivo during HIFU intervention was finally demonstrated on a porcine kidney.

Real time magnetic resonance imaging (MRI) is rapidly gaining importance in interventional therapies. An accurate motion estimation is required for mobile targets and can be conveniently addressed using an image registration algorithm. Since the adaptation of the control parameters of the algorithm depends on the application (targeted organ, location of the tumor, slice orientation, etc.), typically an individual calibration is required. However, the assessment of the estimated motion accuracy is difficult since the real target motion is unknown. In this paper, existing criteria based only on anatomical image similarity are demonstrated to be inadequate. A new criterion is introduced, which is based on the local magnetic field distribution. The proposed criterion was used to assess, during a preparative calibration step, the optimal configuration of an image registration algorithm derived from the Horn and Schunck method. The accuracy of the proposed method was evaluated in a moving phantom experiment, which allows the comparison with the known motion pattern and to an established criterion based on anatomical images. The usefulness of the method for the calibration of optical-flow based algorithms was also demonstrated in vivo under conditions similar to thermo-ablation for the abdomen of twelve volunteers. In average over all volunteers, a resulting displacement error of 1.5 mm was obtained (largest observed error equal to 4-5 mm) using a criterion based on anatomical image similarity. A better average accuracy of 1 mm was achieved using the proposed criterion (largest observed error equal to 2 mm). In both kidney and liver, the proposed criterion was shown to provide motion field accuracy in the range of the best achievable., (© 2011 IEEE)