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Magnetic resonance imaging (MRI) has become a popular modality in guiding minimally invasive thermal therapies, due to its advanced, nonionizing, imaging capabilities and its ability to record changes in temperature. A variety of MR thermometry techniques have been developed over the years, and proton resonance frequency (PRF) shift thermometry is the current clinical gold standard to treat a variety of cancers. It is used extensively to guide hyperthermic thermal ablation techniques such as high-intensity focused ultrasound (HIFU) and laser-induced thermal therapy (LITT). Essential attributes of PRF shift thermometry include excellent linearity with temperature, good sensitivity, and independence from tissue type. This noninvasive temperature mapping method gives accurate quantitative measures of the temperature evolution inside biological tissues. In this review, the current status and new developments in the fields of MR-guided HIFU and LITT are presented with an emphasis on breast, prostate, bone, uterine, and brain treatments.Level of Evidence 5Technical Efficacy Stage 3 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. peer-reviewed 2021-11-20

[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).

Thermometry is the key factor for achieving successful thermal therapy. Although invasive thermometry with a probe has been used for more than four decades, this method can only detect the local temperature within the probing volume. Noninvasive temperature imaging using a tomographic technique is ideal for monitoring hot-spot formation in the human body. Among various techniques, such as X-ray computed tomography, microwave tomography, echo sonography, and magnetic resonance (MR) imaging, the proton resonance frequency shift method of MR thermometry is the only method currently available for clinical practice because its temperature sensitivity is consistent in most aqueous tissues and can be easily observed using common clinical scanners. New techniques are being proposed to improve the robustness of this method against tissue motion. MR techniques for fat thermometry were also developed based on relaxation times. One of the latest non-MR techniques to attract attention is photoacoustic imaging.

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

Real-time MR-imaging has been clinically adapted for monitoring thermal therapies since it can provide on-the-fly temperature maps simultaneously with anatomical information. However, proton resonance frequency based thermometry of moving targets remains challenging since temperature artifacts are induced by the respiratory as well as physiological motion. If left uncorrected, these artifacts lead to severe errors in temperature estimates and impair therapy guidance. In this study, we evaluated deep learning for on-line correction of motion related errors in abdominal MR-thermometry. For this, a convolutional neural network (CNN) was designed to learn the apparent temperature perturbation from images acquired during a preparative learning stage prior to hyperthermia. The input of the designed CNN is the most recent magnitude image and no surrogate of motion is needed. During the subsequent hyperthermia procedure, the recent magnitude image is used as an input for the CNN-model in order to generate an on-line correction for the current temperature map. The method's artifact suppression performance was evaluated on 12 free breathing volunteers and was found robust and artifact-free in all examined cases. Furthermore, thermometric precision and accuracy was assessed for in vivo ablation using high intensity focused ultrasound. All calculations involved at the different stages of the proposed workflow were designed to be compatible with the clinical time constraints of a therapeutic procedure., 21 pages, 9 figures, 1 table

A computer implemented method for measuring T1 in an anatomical region of interest during a dynamic procedure includes acquiring a reference MR image of the anatomical region of interest using a first flip angle. A first set of dynamic MR images of the anatomical region of interest are acquired using a second flip angle. The reference MR image and the first set are used to calculate a reference T1 value for tissue in the anatomical region of interest. During an intervention where the T1 value may change, a second set of dynamic MR images of the anatomical region of interest is acquired using the second flip angle. The reference MR image and the second set are used to calculate an estimated T1 value. The reference T1 value, the estimated T1 value, and the first and second flip angles may then be used to correct the estimated T1 value.

PURPOSE: To perform multi-echo water/fat separated proton resonance frequency (PRF)-shift temperature mapping. METHODS: State-of-the-art, iterative multi-echo water/fat separation algorithms produce high-quality water and fat images in the absence of heating but are not suitable for real-time imaging due to their long compute times and potential errors in heated regions. Existing fat-referenced PRF-shift temperature reconstruction methods partially address these limitations but do not address motion or large time-varying and spatially inhomogeneous B(0) shifts. We describe a model-based temperature reconstruction method that overcomes these limitations by fitting a library of separated water and fat images measured before heating directly to multi-echo data measured during heating, while accounting for the PRF shift with temperature. RESULTS: Simulations in a mixed water/fat phantom with focal heating showed that the proposed algorithm reconstructed more accurate temperature maps in mixed tissues compared to a fat-referenced thermometry method. In a porcine phantom experiment with focused ultrasound heating at 1.5 Tesla, temperature maps were accurate to within 1°C of fiber optic probe temperature measurements and were calculated in 0.47 s per time point. Free-breathing breast and liver imaging experiments demonstrated motion and off-resonance compensation. The algorithm can also accurately reconstruct water/fat separated temperature maps from a single echo during heating. CONCLUSIONS: The proposed model-based water/fat separated algorithm produces accurate PRF-shift temperature maps in mixed water and fat tissues in the presence of spatiotemporally varying off-resonance and motion.

Purpose To demonstrate that fluid filling of the digestive tract improves the performance of respiratory motion-compensated proton resonance frequency shift (PRFS)-based magnetic resonance (MR) thermometry in the pancreas. Materials and Methods In seven volunteers (without heating), we evaluated PRFS thermometry in the pancreas with and without filling of the surrounding digestive tract. All data acquisition was performed at 1.5T, then all datasets were analyzed and compared with three different PRFS respiratory motion-compensated thermometry methods: gating, multibaseline, and referenceless. The temperature precision of the different methods was evaluated by assessing temperature standard deviation over time, while a simulation experiment was used to study the accuracy of the methods. Results Without fluid intake, errors in temperature precision in the pancreas up to 10°C were observed for all evaluated methods. After liquid intake, temperature precision improved to median values between 1.8 and 2.9°C. The simulations showed that gating had the lowest accuracy, with errors up to 7°C. Multibaseline and referenceless thermometry performed better, with a median error in the pancreas between –3 and +3°C after fluid intake, for all volunteers. Conclusion Preparation of the digestive tract near the pancreas by filling it with fluid improved MR thermometry precision and accuracy for all common respiratory motion-compensated methods evaluated. These improvements are attributed to reducing field inhomogeneity in the pancreas. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017.

Laser Immunotherapy is a recently-developed treatment for metastatic cancers that synergistically applies photothermal laser irradiation in conjunction with a local immunoadjuvant to induce a host anti-cancer immune response. We have used laser immunotherapy to treat orthotopic pancreatic tumors in mice. In this study, we used magnetic resonance imaging to guide laser immunotherapy for interstitial treatment of metastatic pancreatic tumors in mice. Furthermore, we used MRI to investigate tumor location, guide laser treatment, and monitor the photothermal effects using proton resonance frequency shift thermometry. Our results indicate that laser immunotherapy could be an effective modality for late-stage pancreatic cancer patients, and that MRI thermometry can effectively monitor treatment for guidance.

When magnetic resonance (MR) thermometry is performed for temperature monitoring during time-consuming thermal therapy like hyperthermia, tiny main magnetic field (B0) drifts may cause significant errors in temperature readings inside the human subject. We propose a correction method of B0 drift effects in MR thermometry, which is based on temperature-dependent proton resonance frequency shift (PRFS) of water molecules. We placed magnetic field monitoring (MFM) probes around the subject and we read the center frequency of MFM signals. By interpolating the center frequencies of MFM signals on the imaging slice, we computed phase correction maps for MR thermometry. We intermittently acquired MFM signals with performing MR thermometry at 3 Tesla during radiofrequency (RF) heating of a tissue-mimicking phantom. With the B0 drift effect correction, the temperature readings of MR thermometry maps became similar to the temperature readings of an optic fiber temperature sensor embedded at the center of the phantom. We believe the proposed correction method can be used for MRI-guided thermal therapy in which precise temperature monitoring is critical.

Applications for noninvasive biologic temperature monitoring are widespread in biomedicine and of particular interest in the context of brain temperature regulation, where traditionally costly and invasive monitoring schemes limit their applicability in many settings. Brain thermal regulation, therefore, remains controversial, motivating the development of noninvasive approaches such as temperature-sensitive nuclear MR phenomena. The purpose of this work was to compare the utility of competing approaches to MR thermometry by using proton resonance frequency chemical shift. We tested 3 methodologies, hypothesizing the feasibility of a fast and accurate approach to chemical shift thermometry, in a phantom study at 3T.A conventional, paired approach (difference [DIFF]-1), an accelerated single-scan approach (DIFF-2), and a new, further accelerated strategy (DIFF-3) were tested. Phantom temperatures were modulated during real-time fiber optic temperature monitoring, with MR thermometry derived simultaneously from temperature-sensitive changes in the water proton chemical shift (∼0.01 ppm/°C). MR thermometry was subsequently performed in a series of in vivo nonhuman primate experiments under physiologic and ischemic conditions, testing its reproducibility and overall performance.Chemical shift thermometry demonstrated excellent agreement with phantom temperatures for all 3 approaches (DIFF-1: linear regression R(2) = 0.994; P.001; acquisition time = 4 minutes 40 seconds; DIFF-2: R(2) = 0.996; P.001; acquisition time = 4 minutes; DIFF-3: R(2) = 0.998; P.001; acquisition time = 40 seconds).These findings confirm the comparability in performance of 3 competing approaches to MR thermometry and present in vivo applications under physiologic and ischemic conditions in a primate stroke model.

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 (

Purpose To describe how B0 inhomogeneities can cause errors in proton resonance frequency (PRF) shift thermometry, and to correct for these errors. Methods With PRF thermometry, measured phase shifts are converted into temperature measurements through the use of a scaling factor proportional to the echo time, TE. However, B0 inhomogeneities can deform, spread, and translate MR echoes, potentially making the “true” echo time vary spatially within the imaged object and take on values that differ from the prescribed TE value. Acquisition and reconstruction methods able to avoid or correct for such errors are presented. Results Tests were performed in a gel phantom during sonication, and temperature measurements were made with proper shimming as well as with intentionally introduced B0 inhomogeneities. Errors caused by B0 inhomogeneities were observed, described, and corrected by the proposed methods. No statistical difference was found between the corrected results and the reference results obtained with proper shimming, while errors by more than 10% in temperature elevation were corrected for. The approach was also applied to an abdominal in vivo dataset. Conclusion Field variations induce errors in measured field values, which can be detected and corrected. The approach was validated for a PRF thermometry application. Magn Reson Med 73:2142–2151, 2015. © 2014 Wiley Periodicals, Inc.

Object This work aimed at evaluating the accuracy of MR-guided high-intensity focused ultrasound (MRgHIFU) brain therapy in human cadaver heads. Methods Eighteen heads of fresh human cadavers were removed with a dedicated protocol preventing intracerebral air penetration. The MR images allowed determination of the ultrasonic target: a part of the thalamic nucleus ventralis intermedius implicated in essential tremor. Osseous aberrations were corrected with simulation-based time reversal by using CT data from the heads. The ultrasonic session was performed with a 512-element phased-array transducer system operating at 1 MHz under stereotactic conditions with thermometric real-time MR monitoring performed using a 1.5-T imager. Results Dissection, imaging, targeting, and planning have validated the feasibility of this human cadaver model. The average temperature elevation measured by proton resonance frequency shift was 7.9°C ± 3°C. Based on MRI data, the accuracy of MRgHIFU is 0.4 ± 1 mm along the right/left axis, 0.7 ± 1.2 mm along the dorsal/ventral axis, and 0.5 ± 2.4 mm in the rostral/caudal axis. Conclusions Despite its limits (temperature, vascularization), the human cadaver model is effective for studying the accuracy of MRgHIFU brain therapy. With the 1-MHz system investigated here, there is millimetric accuracy.

Among many methods in tumor treatment, ultrasound hyperthermia is characterized by non-invasiveness, and it has been proven very effective for clinical treatment. But the problem of monitoring temperature limits its development. MRI-based temperature mapping techniques are safe compared with invasive methods and have been applied to detect temperature changes for a variety of applications. Among these techniques, the proton resonance frequency (PRF) method is relatively advanced. With a temperature measuring experiment and experiment conducted on tumors inside rabbit legs, the effectiveness of PRF method has been proved. This paper is to introduce an MRI guided ultrasound superficial tumor hyperthermia instrument based on PRF method.

Proton resonance frequency (PRF) change is used to measure tissue heating, but also distorts the image and causes geometric distortions in temperature estimates in the same manner as other chemical shift distortions if left uncompensated. We propose an algorithm that produces PRF temperature maps free of these distortions by fitting a signal model directly to acquired k-space data that accounts for PRF-induced phase both up to and during the readout. We also introduce a faster method compatible with Cartesian data that corrects distortions from image-domain temperature maps. Gel heating experiments show the proposed CS compensation algorithms correct magnitude image artifacts and hotspot distortions. Without CS compensation, thermal dose values are overestimated in spiral data, and are spatially offset in 2DFT and EPI data. Compensating for heat-induced CS distortions improves the accuracy of temperature change and thermal dose measurements, and can have a significant positive impact on clinical and resea...

The bioheat transfer models conventionally employed in etiology of human thermal infrared (TIR) emittance rely upon two assumptions: universal graybody emissivity and significant transmission of heat from subsurface tissue layers. In this study, a series of clinical and laboratory experiments were designed and carried out to conclusively evaluate the validity of the two assumptions. Results obtained from the objective analyses of TIR images of human facial and tibial regions demonstrated significant variations in spectral thermophysical properties at different anatomic locations on human body. The limited validity of the two assumptions signifies need for quantitative deconvolution of human TIR emittance in clinical, psychophysiological, and critical applications. A novel approach to joint inversion of the bioheat transfer model is also introduced, exploiting the deterministic temperature dependence of proton resonance frequency (PRF) in low-lipid human soft tissue for characterisation of the relationship between subsurface 3-D tissue temperature profiles and corresponding TIR emittance.

Determining the MR compatibility of medical implants and devices is becoming increasingly relevant. In most cases, the heating of conductive implants due to radiefrequency (RF) excitation pulses is measured by fluoroptic temperature sensors in relevant tests for approval. Another common method to determine these heating effects is MR thermometry using the proton resonance frequency. This method gives good results in homogeneous phantoms. However in many cases, technical shortcomings such as susceptibility artifacts prohibit exact proton resonance frequency thermometry near medical implants. Therefore, this work aimed at developing a fast T₁-based method which allows controlled MR-related heating of a medical implant while simultaneously quantifying the spatial and temporal temperature distribution. To this end, an inversion recovery snapshot Fast Low-Angle Shot (FLASH) sequence was modified with additional off-resonant heating pulses. With an accelerated imaging method and a sliding-window technique, every 7.6 s a new temperature map could be generated with a spatial in-plane resolution of 2 mm. The temperature deviation from calculated temperature values to reference fluoroptic probe was found to be smaller than 1 K.

Online MR temperature monitoring during radiofrequency (RF) ablation of cardiac arrhythmias may improve the efficacy and safety of the treatment. MR thermometry at 1.5 T using the proton resonance frequency (PRF) method was assessed in 10 healthy volunteers under normal breathing conditions, using a multi-slice, ECG-gated, echo planar imaging (EPI) sequence in combination with slice tracking. Temperature images were post-processed to remove residual motion-related artifacts. Using an MR-compatible steerable catheter and electromagnetic noise filter, RF ablation was performed in the ventricles of two sheep in vivo. The standard deviation of the temperature evolution in time (TSD) was computed. Temperature mapping of the left ventricle was achieved at an update rate of approximately 1 Hz with a mean TSD of 3.6 ± 0.9 °C. TSD measurements at the septum showed a higher precision (2.8 ± 0.9 °C) than at the myocardial regions at the heart–lung and heart–liver interfaces (4.1 ± 0.9 °C). Temperature rose maximally by 9 °C and 16 °C during 5 W and 10 W RF applications, respectively, for 60 s each. Tissue temperature can be monitored at an update rate of approximately 1 Hz in five slices. Typical temperature changes observed during clinical RF application can be monitored with an acceptable level of precision. Copyright © 2011 John Wiley & Sons, Ltd.

Purpose: To assess the feasibility, precision, and accuracy of real-time temperature mapping (TMap) during laser-induced thermotherapy (LITT) for clinical practice in patients liver with a gradient echo (GRE) sequence using the proton resonance frequency (PRF) method. Materials and Methods: LITT was performed on 34 lesions in 18 patients with simultaneous real-time visualization of relative temperature changes. Correlative contrast-enhanced T1-weighted magnetic resonance (MR) images of the liver were acquired after treatment using the same slice positions and angulations as TMap images acquired during LITT. For each slice, TMap and follow-up images were registered for comparison. Afterwards, segmentation based on temperature (T) >52°C on TMap and based on necrosis seen on follow-up images was performed. These segmented structures were overlaid and divided into zones where the TMap was found to either over- or underestimate necrosis on the postcontrast images. Regions with T>52°C after 20 minutes were defined as necrotic tissue based on data received from two different thermal dose models. Results: The average intersecting region of TMap and necrotic zone was 87% ± 5%, the overestimated 13% ± 4%, and the underestimated 13% ± 5%. Conclusion: This study demonstrates that MR temperature mapping appears reasonably capable of predicting tissue necrosis on the basis of indicating regions having greater temperatures than 52°C and could be used to monitor and adjust the thermal therapy appropriately during treatment. J. Magn. Reson. Imaging 2011;33:704–712. © 2011 Wiley-Liss, Inc.

Ultrasound hyperthermia is one of the most important methods in tumor treatment and characterized by non-invasiveness. Magnetic resonance imaging (MRI)-based temperature mapping techniques are safe compared with invasive methods and have been applied to detect temperature changes for a variety of applications. Among these techniques, the proton resonance frequency (PRF) method is relatively advanced. With a temperature measuring experiment, the effectiveness of PRF method has been proved, because the outcome temperature curve and the real temperature curve fit well. After that, an experiment has been conducted on tumors inside rabbit legs and the result indicates that this system is able to performance hyperthermia at targets based on PRF method in temperature mapping.

Conventional spectral-spatial pulses used for water-selective excitation in proton resonance frequency-shift MR thermometry require increased sequence length compared to shorter wideband pulses. This is because spectral-spatial pulses are longer than wideband pulses, and the echo time period starts midway through them. Therefore, for a fixed echo time, one must increase sequence length to accommodate conventional spectral-spatial pulses in proton resonance frequency-shift thermometry. We introduce improved water-selective spectral-spatial pulses for which the echo time period starts near the beginning of excitation. Instead of requiring increased sequence length, these pulses extend into the long echo time periods common to PRF sequences. The new pulses therefore alleviate the traditional tradeoff between sequence length and fat suppression. We experimentally demonstrate an 11% improvement in frame rate in a proton resonance frequency imaging sequence compared to conventional spectral-spatial excitation. We also introduce a novel spectral-spatial pulse design technique that is a hybrid of previous model- and filter-based techniques and that inherits advantages from both. We experimentally validate the pulses' performance in suppressing lipid signal and in reducing sequence length compared to conventional spectral-spatial pulses.

Purpose To validate echo combination as a means to reduce errors caused by fat in temperature measurements with the proton resonance frequency (PRF) shift method. Materials and Methods Computer simulations were performed to study the behavior of temperature measurement errors introduced by fat as a function of echo time. Error reduction by combining temperature images acquired at different echo times was investigated. For experimental verification, three echoes were acquired in a refocused gradient echo acquisition. Temperature images were reconstructed with the PRF shift method for the three echoes and then combined in a weighted average. Temperature measurement errors in the combined image and the individual echoes were compared for pure water and different fractions of fat in a computer simulation and for a phantom containing a homogenous mixture with 20% fat in an MR experiment. Results In both simulation and MR measurement, the presence of fat caused severe temperature underestimation or overestimation in the individual echoes. The errors were substantially reduced after echo combination. Residual errors were about 0.3°C for 10% fat and 1°C for 20% fat. Conclusion Echo combination substantially reduces temperature measurement errors caused by small fractions of fat. This technique then eliminates the need for fat suppression in tissues such as the liver. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc.

PURPOSE To demonstrate the potential of quantitative MRI-assisted thermometry for the treatment of tumor patients with regional hyperthermia (RHT) and interstitial laser thermotherapy (ILTT). METHODS Two patients and seven tissue samples were investigated using the T1-relaxation time and the chemical shift of the proton resonance frequency (PRF) as temperature sensitive MRI-parameters at 0.2 and 1.5 T. Thermotherapy was applied using either a dedicated MRI-hyperthermia hybrid system or a temperature controlled laser with 830 nm. RESULTS Both patients were treated successfully showing clinical benefit. T1 and PRF are depending on the applied thermotherapy method and on the MR-system suitable for MRI-assisted thermometry. The clinical application based on phantom results is not necessarily adequate. CONCLUSION Clinical application and phantom experiments of RHT and ILTT show the potential of MRI-assisted thermometry for further improvement of both minimal invasive thermotherapy methods. Further investigations concerning optimization of the MRI-techniques, the influence of perfusion or the determination of threshold values are necessary.

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.

The clinical role of magnetic resonance image-guided high-intensity focused ultrasound (MR-HIFU) is rapidly expanding due to its merit of non-invasiveness. MR thermometry based on a proton resonance frequency shift technique is able to accurately measure HIFU-induced temperature changes, which provides considerable advantages over ultrasonography-guided HIFU in terms of safety and therapeutic efficacy. Recent studies and the resulting technological advances in MR-HIFU such as MR thermometry for moving organs, MR-acoustic radiation force imaging, and a volumetric mild hyperthermia technique further will expand its clinical roles from mere ablation therapy to targeted drug delivery and chemo- or radio-sensitisation for cancer treatment. In this article, MR-HIFU therapy is comprehensively reviewed with an emphasis on the roles of MR imaging in HIFU therapy, techniques of MR monitoring, recent advances in clinical MR-HIFU systems, and potential future applications of MR-HIFU therapy. In addition, the pros and cons of MR-HIFU when compared with ultrasonography-guided HIFU are discussed.

The purpose of this work was to determine the accuracy of Proton Resonance Frequency (PRF) thermometry during MR-guided Focused Ultrasound (MRgFUS) ablation on explanted Thiel embalmed human and animal liver, fresh animal liver, and compared to gel phantom.PRF thermometry during MRgFUS was conducted using a 1.5T MRI system. The phantom and the organs were sonicated with the following energies: 300J, 600J, 1000J and 1400J. The temperature increase which was measured using PRF thermometry during sonication was compared to actual temperature rise in the same conditions measured by fibre optic thermocouple.Sonication of fresh animal liver showed temperature differences varying between 0.27°C and 0.40°C, whereas the phantom results showed temperature differences from 0.23°C to 0.40°C. For the Thiel embalmed organs, the temperature difference varied from 1.17 °C to 3.13°C for the ovine liver, and from 1.3°C to 3.10°C for the human liver.The temperature differences measured in the fresh liver were small and similar to those found for the gel phantom. However, the temperature differences calculated for the Thiel embalmed organs were higher compared to the fresh organ. This indicates that the PRF-based temperature calibration of the Focused Ultrasound machine for Thiel embalmed tissue is necessary.

High energy management in nuclear system and refractory metals productions are equipped with challenging procedures in terms of precise and remote controlling. In order to predict occurrence of contamination and avoidance of huge damages, there are often difficulties to access the equipment during their operation. In addition, estimating the precise and remote nucleation critical temperature of decay and growth of radioactive materials in the nuclear system has also proven to be a great challenge. Other than that, the eutectic crystallization temperature of the refractory metals during production also need to provide a precise estimation. However, it has been understood that the conventional temperature sensors are yet to be applicable to work precisely in such harsh environments. On the other hand, proton resonance frequency thermometry phenomenon have not been utilized or developed to serve as temperature sensors; despite the fact that they are capable to measure temperature in quantum level. Therefore, this article provides a review of the prior art on proton resonance frequency thermometry with its application and reliability, and elaborates on the trajectory of ultra-precise temperature measurement as the latest development.

Selective photothermal interaction using dye-assisted non-invasive laser irradiation has limitations when treating deeper tumors or when the overlying skin is heavily pigmented. We developed an interstitial laser irradiation method to induce the desired photothermal effects. An 805-nm near-infrared laser with a cylindrical diffuser was used to treat rat mammary tumors by placing the active tip of the fiber inside the target tumors. Three different power settings (1.0 to 1.5 watts) were applied to treat animal tumors with an irradiation duration of 10 minutes. The temperature distributions of the treated tumors were measured by a 7.1-Tesla magnetic resonance imager using proton resonance frequency (PRF) method. Three-dimensional temperature profiles were reconstructed and assessed using PRF. This is the first time a 7.1-Tesla magnetic resonance imager has been used to monitor interstitial laser irradiation via PRF. This study provides a basic understanding of the photothermal interaction needed to control the thermal damage inside tumor using interstitial laser irradiation. It also shows that PRF can be used effectively in monitoring photothermal interaction. Our long-term goal is to develop a PRF-guided laser therapy for cancer treatment.

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.

The ultrafast echo-planar magnetic resonance imaging technology, developed and built in Nottingham, has been used to produce the first snapshot images of the human fetus in utero. The imager, operating at a proton resonance frequency of 22 MHz, produces transaxial views in 64 or 128 milliseconds. These images comprise either 64 x 128 or 128 x 128 pixels with an in-plane resolution of 3 x 3 mm2. The slice thickness is 10 mm. Fetal scans of up to 32 contiguous slices are produced in a few minutes. These have been used to study the internal structure of the uterus and the fetus in a range of cases with gestations ranging from 26 weeks to term. Echo-planar imaging seems particularly suitable as an imaging modality since its high speed obviates image blurring arising from fetal motion.

Purpose To improve the immunity of the proton resonance frequency shift (PRFS) method of MRI temperature mapping against magnetic field disturbances. Since PRFS is a phase-sensitive method, it misinterprets magnetic field disturbances as artifact temperature changes. If not corrected, the resulting temperature artifacts can completely obscure the true temperature estimation, especially if the temperature elevations are small. Materials and Methods Since the fat protons experience the same magnetic field disturbances as the water protons, but no temperature-related frequency shift, the fat signal has been used for correcting PRFS temperature maps for the disturbances. A simple correction method is proposed that has either better compensation capability than the phase correction methods previously reported or higher spatial and temporal resolution than the spectroscopic correction methods previously reported. The evaluated method is based on the utilization of several gradient and spin echoes acquired within one repetition interval with water- and fat-selective scans. Results In a series of phantom experiments, the improved method is shown to enable the reconstruction of accurate temperature maps in spite of interscan motion, suboptimal fat–water separation, and a wide range of magnetic field disturbances. Conclusion Our approach can be used for the guidance of thermal therapies involving tissues containing fat or surrounded by fat. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc.

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.

MRI is a unique tool for minimally invasive thermal ablation in that it can provide both targeting, monitoring and control during the procedure. Monitoring is achieved by using MRI temperature mapping. In this review the relevant physics is explained as a background to the state-of-the-art methods for computing temperature maps as well as the more cutting edge methods. The review covers both methods to monitor heating and cooling of tissue and explains temperature mapping using Proton Resonance Frequency shift, T1 mapping, diffusion mapping, R2* mapping and thermal models.

tive imaging technique because both the local chemical environment and relaxation properties of the nuclear spin system are intimately tied to Brownian motion and molecular tumbling, both directly affected by temperature. Several MRI parameters have been found useful for monitoring temperature changes. The 3 most studied parameters are the spin-lattice relaxation time, the apparent diffusion constant of water, and water’s proton resonance frequency (PRF). The temperature sensitivities asso

Techniques and instrumentation are now widely available that enable interventional MR-guided preoperative needle localization and lesion marking. Minimally invasive MR-guided core biopsy techniques have been demonstrated but remain limited for small lesions and will be facilitated by the development of biopsy instruments that can be directly visualized using MR imaging. MR-guided tumor ablation is beginning to be evaluated in a few centers. It holds promise as new treatment modality in the continuing trend toward greater breast conservation in the local therapy of breast cancer. Further studies are needed to document the ability of MR-guided ablation to control the margins of a tumor as effectively as surgery. Patients with an extensive in situ intra-ductal component may pose a significant hurdle because the extent of ductal carcinoma in situ maybe underestimated on breast MR images. Ultimately, the success of MR-guided thermal ablation depends on the ability of MR imaging to map the extent of heating during the procedure so that the procedure can be performed to achieve complete control of the tumor margins. It is unfortunate that the conventional method for MR thermometry--the proton resonance frequency shift method--does not work in fat or in voxels with a mix of fat and glandular tissue and, hence, has limited applicability in the breast. Other methods, including measurement of T1 and T2, are being investigated as alternatives.

We obtained clear and reproducible MR fluoroscopic images and temperature maps for MR image-guided microwave ablation of liver tumors under general anesthesia without suspending the artificial ventilation. Respiratory information was directly obtained from air-way pressure without a sensor on the chest wall. The trigger signal started scanning of one whole image with a spoiled gradient echo sequence. The delay time before the start of scanning was adjusted to acquire the data corresponding to the k-space center at the maximal expiratory phase. The triggered images were apparently clearer than the nontriggered ones and the location of the liver was consistent, which made targeting of the tumor easy. MR temperature images, which were highly susceptible to the movement of the liver, during microwave ablation using a proton resonance frequency method, could be obtained without suspending the artificial ventilation. Respiratory triggering technique was found to be useful for MR fluoroscopic images and MR temperature monitoring in MR-guided microwave ablation of liver tumors under general anesthesia.

Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90 degrees sectored tubular (3.5 mm OD x 10 mm) or planar transducers (3.5 mm x 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n = 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the 90 degrees tubular applicator (9-15 W, 12 min, 8 MHz) produced coagulated zones covering an 80 degrees wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, approximately 8 MHz) generated thermal lesions of approximately 30 degrees extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30 degrees each) demonstrated controllable coagulation of a 270 degrees contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

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.

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.

PURPOSE: To study the feasibility of an interleaved gradient-echo, echo-planar imaging (iGE-EPI) sequence for multiplanar magnetic resonance temperature imaging (MRTI) to monitor intracerebral thermal treatment three-dimensionally using multielement ultrasound applicators.MATERIALS AND METHODS: Transmissible venereal tumor (TVT) fragments were injected into the right cerebral hemisphere of five dogs. Guided by MRI, an interstitial ultrasound applicator was inserted into the tumor or normal brain tissue. The iGE-EPI sequence was used to estimate temperature changes by computing the complex phase-difference induced by temperature-dependent shifts in the proton resonance frequency of water. The thermal dose maps were updated every 6-8 seconds for five to seven image planes during treatment. The results of MRTI were compared with those of post-treatment MRI and histologic analysis.RESULTS: The multiplanar MRTI monitored temperature and thermal dose distributions in tumor and normal brain tissue over the entire user-defined treatment volume. The ultrasound applicators produced contiguous areas of coagulative necrosis, resulting in 1.5-4.0 cm(3) volumes of tissue necrosis. MRTI-based assessments of thermal-dose distributions were consistent with the results of post-treatment MRI and histologic analysis.CONCLUSION: Multiplanar MRTI is feasible for measuring necrosing thermal doses during intracerebral thermal delivery by interstitial ultrasound applicators. (Less)

A noninvasive method of tissue ablation that is guided and monitored with magnetic resonance (MR) imaging has been developed. The method uses sharply focused ultrasound transducers of different focal lengths to induce a localized temperature elevation during a short exposure (1-20 seconds). A hydraulic, computer-controlled positioning device moves the transducer in an MR imager. The positioner is built into a standard cradle in the imager. The system includes cavitation detection and power monitoring circuitry for patient safety. The target volume is outlined with cross-sectional MR images obtained immediately before sonication. By means of the software, the focus is moved to ablate the volume defined with the images. The temperature elevation during the exposure is monitored by means of the proton resonance frequency shift with fast gradient-echo sequences, and the necrosed volume is demonstrated with T2-weighted fast spin-echo images. This method has been extensively tested in in vivo animal experiments and is now undergoing clinical trial.

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.

The use of NMR imaging as a quantitative research tool requires insight into the relationship between various imaging techniques and their resultant images. Work was undertaken to elucidate this relationship by using the following procedure. First, a theoretical model of NMR imaging under various pulse sequences was elaborated. Subsequently, a series of inversion recovery and saturation recovery images of a particular object slice was generated by varying the sequence parameters. Finally, pure rho, T1 and T2 images of that slice were obtained by solving the corresponding model equations. This procedure was applied to a test phantom containing tubes with suitable reference substances, including aqueous solutions of agar, manganese chloride and deuterium, and water-fat mixtures. The concentration of various samples was chosen such as to yield rho, T1 and T2 values usually encountered in clinical NMR imaging. Experiments were carried out with a prototype resistive NMR imager with a static magnetic field of 0.14 T, corresponding to a hydrogen proton resonance frequency of 5.9 MHz. For most samples a weighted non-linear regression analysis showed the theoretical model to produce an adequate parametrisation of the data at the 5% significance level, given the number of data points and the experimental accuracy. The quantitative information extracted from the NMR imaging experiments, i.e. rho, T1 and T2, appeared to be in good agreement with the results of conventional methods, including NMR spectroscopy. The clinical efficacy of the proposed methods is currently being investigated.