Automatic model-based evaluation of magnetic resonance-guided radio frequency ablation lesions with histological correlation

PURPOSE

To develop a model-based method for automatic evaluation of radio frequency (RF) ablation treatment using magnetic resonance (MR) images.

MATERIALS AND METHODS

RF current lesions were generated in a rabbit thigh model using MR imaging (MRI) guidance. We created a 12-parameter, three-dimensional, globally deformable model with quadric surfaces that delineates lesion boundaries and is automatically fitted to MR grayscale data. We applied this method to in vivo T2- and contrast-enhanced (CE) T1-weighted MR images acquired immediately post-ablation and four days later. We then compared results to manually segmented MR and three-dimensional registered corresponding histological boundaries of cellular damage.

RESULTS

Resulting lesions featured a two-boundary appearance with an inner region and an outer hyperintense margin on MR images. For automated vs. manual MR boundaries, the mean errors over all specimens were 0.19 +/- 0.51 mm and 0.27 +/- 0.52 mm for the inner surface, and -0.29 +/- 0.40 mm and -0.12 +/- 0.17 mm for the outer surface, for T2- and CE T1-weighted images, respectively. For automated vs. histological boundaries, mean errors over all specimens were 0.07 +/- 0.64 mm and 0.33 +/- 0.71 mm for the inner surface, and -0.27 +/- 0.69 mm and 0.02 +/- 0.43 mm for the outer surface, for T2- and CE T1-weighted images, respectively. All boundary errors compared favorably to MR voxel dimensions, which were 0.7 mm in-plane and 3.0 mm thick.

CONCLUSION

The method is accurate both in describing MR-apparent boundaries and in predicting histological response and has applications in lesion visualization, volume estimation, and treatment evaluation.

Fast Spiral two-point Dixon technique using block regional off-resonance correction

The Spiral two-point Dixon (Spiral 2PD) technique has recently been proposed as a method for unambiguous water-fat decomposition in spiral imaging. It also corrects for off-resonance blurring artifacts using only two data sets. In the Spiral 2PD technique, several predetermined off-resonance frequencies are tested to both separate water and fat signals and deblur the decomposed images. Unfortunately, the algorithm is computationally quite intensive since the range of tested frequencies must be set sufficiently large to span the full range of anticipated B(0) variation over the scanned objects. The block regional off-resonance correction (BRORC) algorithm corrects for off-resonance blurring artifacts block by block through the reconstructed image and usually provides several times higher computational efficiency than the conventional frequency-segmented off-resonance correction algorithm. This work shows that both water-fat decomposition and blurring artifact correction can be performed block by block using two spiral images with different TEs and that this new technique (BRORC-Spiral2PD technique) significantly improves the computational efficiency of other Spiral 2PD algorithms, opening new opportunities for spiral imaging.

Radial alternating TE sequence for faster fat suppression

This study describes a steady-state sequence that uses a radial k-space trajectory and alternating echo times (TEs) between even and odd k-space views. The sequence generated a single data set that was used to reconstruct images with inherent fat suppression. This fat suppression results from the fat phase variation in alternate echoes giving rise to cancellation in the central portion of k-space. This new fat-suppression method provides inherent fat suppression in half the acquisition time relative to the radial two-point Dixon method. The improvement in k-space sampling efficiency is demonstrated in phantom and clinical images, and through measured point-spread functions (PSFs). As a result, the radial alternating TE sequence offers improved temporal resolution over a radial version of the two-point Dixon sequence by requiring fewer total projections to obtain the same effective resolution in water-based tissues.

Dixon techniques in spiral trajectories with off-resonance correction: A new approach for fat signal suppression without spatial-spectral RF pulses

Spiral imaging has recently gained acceptance in MR applications requiring rapid data acquisition. One of the main disadvantages of spiral imaging, however, is blurring artifacts that result from off-resonance effects. Spatial-spectral (SPSP) pulses are commonly used to suppress those spins that are chemically shifted from water and lead to off-resonance artifacts. However, SPSP pulses may produce nonuniform fat signal suppression or unwanted water signal suppression when applied in the presence of B(0) field inhomogeneities. Dixon techniques have been developed as methods for water-fat signal decomposition in rectilinear sampling schemes since they can produce unequivocal water-fat signal decomposition even in the presence of B(0) inhomogeneities. This article demonstrates that three-point and two-point Dixon techniques can be extended to conventional spiral and variable-density spiral data acquisitions for unambiguous water-fat decomposition with off-resonance blurring correction. In the spiral three-point Dixon technique, water-fat signal decomposition and image deblurring are performed based on the frequency maps that are directly derived from the acquired images. In the spiral two-point Dixon technique, several predetermined frequencies are tested to create a frequency map. The newly proposed techniques can achieve more effective and more uniform fat signal suppression when compared to the conventional spiral acquisition method with SPSP pulses.

Determining and optimizing the precision of quantitative measurements of perfusion from dynamic contrast enhanced MRI

PURPOSE

To examine the sensitivity of quantitative dynamic contrast enhanced MRI (DCE-MRI) perfusion maps to errors in the various source images and to determine optimal imaging parameters for reducing this sensitivity.

MATERIALS AND METHODS

A detailed analysis of the precision of a DCE-MRI protocol was performed using the "propagation of errors" technique to investigate the effect of errors in the source images on errors in K(trans). Optimal parameter values and interactions between parameters were examined. The propagation of errors analysis was validated by Monte-Carlo simulations.

RESULTS

The precision of K(trans) was found to be most sensitive to artifacts in the tissue portion of the baseline images and least sensitive to noise in the arterial portion of the dynamic images. The tip-angle strongly affected the precision, with the optimum being a function of tissue T1(0).

CONCLUSION

Protocol optimization requires matching the tip-angle to the anticipated T1(0) of the tissue of interest; however such optimization yields a relatively small improvement. Future developmental efforts would be most productively focused on minimizing the artifact level.

Targeted overexpression of luteinizing hormone causes ovary-dependent functional adenomas restricted to cells of the Pit-1 lineage

The majority of pituitary adenomas in humans are nonmetastasizing, monoclonal neoplasms that occur in approximately 20% of the general population. Their development has been linked to a combination of extrinsic factors and intrinsic defects. We now demonstrate with transgenic mice that targeted and chronic overexpression of LH causes ovarian hyperstimulation and subsequent hyperproliferation of Pit-1-positive cells that culminates in the appearance of functional pituitary adenomas ranging from focal to multifocal expansion of lactotropes, somatotropes, and thyrotropes. Tumors fail to develop in ovariectomized mice, indicating that contributions from the ovary are necessary for adenoma development. Although the link between chronic ovarian hyperstimulation and PRL-secreting adenomas was expected, the involvement of somatotropes and thyrotropes was surprising and suggests that multiple ovarian hormones may contribute to this unusual pathological consequence. In support of this idea, we have found that ovariectomy followed by estrogen replacement results in the expansion of lactotropes selectively in LH overexpressing mice, but not somatotropes and thyrotropes. Collectively, these data indicate that estrogen is sufficient for the formation of lactotrope adenomas only in animals with a hyperstimulated ovary, whereas the appearance of GH- and TSH-secreting adenomas depends on multiple ovarian hormones. Together, our data expand current models of pituitary tumorigenesis by suggesting that chronic ovarian hyperstimulation may underlie the formation of a subset of pituitary adenomas containing lactotropes, somatotropes, and thyrotropes.

Radio-frequency-induced thermal lesions: Subacute magnetic resonance appearance and histological correlation

PURPOSE

To investigate the relationship between subacute magnetic resonance (MR) images of radio-frequency (RF) ablation lesions and tissue viability as determined from histological tissue samples.

MATERIALS AND METHODS

We generated lesions (N = 5) in a rabbit thigh model. Four days later, we obtained in vivo T(2)- and contrast-enhanced (CE) T(1)-weighted images and ex vivo histological samples approximately perpendicular to the electrode path. Using three-dimensional registration and warping, we spatially compared manually segmented boundaries apparent on MR images to boundaries separating distinct histological zones determined from hematoxylin and eosin (H&E) and Masson trichrome (MT) stains, as well as birefringence studies.

RESULTS

Lesions have a characteristic MR appearance: an outer hyperintense margin (M2) separating background tissue (M3) from an inner core (M1), in both T(2) and CE T(1) images. Histologically, there are two zones of damage: an outer zone of likely nonviable cells (H2) separating background tissue (H3) from an inner core of coagulated nonviable cells (H1). We measured distances between automatically computed correspondence points along histological and MR boundaries. For T(2) and CE T(1) images, respectively, M1 vs. H1 distances were 0.72 +/- 0.99 mm (mean +/- SD) and 0.10 +/- 0.95 mm, while outer M2 vs. H2 boundary distances were 0.26 +/- 1.16 mm and 0.05 +/- 1.08 mm. The discrepancy between histological and MR boundaries was larger than the variability in segmenting MR images, but probably within registration error. There were no significant differences between T(2) and CE T(1) boundaries.

CONCLUSION

Lesion boundaries apparent in both T(2)- and CE T(1)-weighted MR scans, performed several days postablation, similarly predict the histological response. That is, the lesion core (M1) corresponds to nonviable coagulated cells (H1), while the hyperintense margin (M2) corresponds to likely nonviable cells undergoing necrotic changes (H2).

Sub-acute changes in lesion conspicuity and geometry following MR-guided radiofrequency ablation

PURPOSE

To evaluate MR signal and lesion zone volume evolution through the sub-acute phase following image-guided radiofrequency (RF) thermal ablation.

MATERIALS AND METHODS

For many tissues, including muscle and liver, thermal lesions that result from RF heating have a characteristic two-boundary appearance featuring an inner core (zone I) surrounded by a hyper-intense margin (zone II) and normal tissue (zone III), found in both T(2) and contrast enhanced (CE) T(1)-weighted MR images, both immediately post-ablation and four days later. First, we compared corresponding points between manually segmented zone boundaries apparent in T(2)- and CE T(1)-weighted images. Second, we examined the contrast-to-noise ratio (CNR) between all zone combinations. Third, we quantified the volume of zone I, zone II, and the entire lesion using a three-dimensional lesion geometry model fitted to segmented images.

RESULTS

On a slice-by-slice basis, no statistically significant differences were found between zone boundaries apparent in T(2) and CE T(1)-weighted images. The contrast to noise ratio (CNR) of zone I vs. zone II, zone I vs. background muscle, and zone II vs. background muscle was always equal or greater for T(2)-weighted images than for CE T(1)-weighted images. In addition, by day four, zone II significantly increased in intensity compared to background muscle. The median Zone I volume increase was 44.2% (42.6%) using T(2) weighted images and 55.5% (68.7% interquartile range) using CE T(1)- weighted images. This expansion likely corresponds to an enlargement of the ablated, coagulative necrosis, region. The median Zone II volume increase was 15.0% (42.6%) using T(2)- weighted images 1.5% (38.8%) using CE T(1)-weighted images.

CONCLUSIONS

1) There are no significant differences between the apparent zone boundaries in T(2)- and CE T(1)-weighted images; 2) CNR is equal or greater for T(2)-weighted images as compared to CE T(1)-images; and 3) both the inner and outer lesion zone volumes typically increase several days post-ablation.

Block regional off-resonance correction (BRORC): a fast and effective deblurring method for spiral imaging

One primary disadvantage of spiral imaging is blurring artifact due to off-resonance effects. The conventional frequency segmented off-resonance correction method that is performed over the entire image is computationally intense due to the large number of fast Fourier transforms (FFTs) required. Here, a new fast off-resonance correction method, block regional off-resonance correction (BRORC), is presented. In this method, off-resonance correction proceeds block-by-block through the reconstructed image with FFTs performed on matrices that are smaller than the full image matrix. The BRORC algorithm is typically several times more computationally efficient than the conventional off-resonance correction algorithm. Additional computational reductions can be expected for the BRORC if only specific image regions require deblurring. The newly proposed off-resonance correction method offers significant speed advantages and equivalent image quality when compared to conventional off-resonance correction methods.

MR imaging-guided vascular procedures using CO2 as a contrast agent

OBJECTIVE

The purpose of this study was to test the use of CO(2) as a black blood contrast agent for MR imaging-guided vascular procedures in an animal model.

MATERIALS AND METHODS

Repeated intraarterial CO(2) injections were performed through a catheter located in the aorta and the renal arteries of three fully anesthetized pigs. Real-time images were acquired using a steady-state free precession sequence.

RESULTS

During the CO(2) injections, the bright blood in the aorta and the main renal artery was totally replaced, and this procedure resulted in an immediate, statistically significant signal loss in the vessel lumen. In more peripheral vessels, CO(2) improved the vessel conspicuity substantially. Confirmation of vessel patency distal to the catheter tip position was possible.

CONCLUSION

The use of carbon dioxide in combination with a bright blood MR imaging sequence improves vessel conspicuity and provides immediate information about blood flow distal to the catheter. This technique may be used to facilitate MR imaging-guided intravascular procedures.

Novel interleaved spiral imaging motion correction technique using orbital navigators

Although spiral imaging seldom produces apparent artifacts related to flow, it remains sensitive to rapid object motion. In this article, a new correction method is presented for rapid rigid body motion in interleaved spiral imaging. With this technique, an identical circular navigator k-space trajectory is linked to each spiral trajectory. Data inconsistency due to both rotation and translation among spiral interleaves can be corrected by evaluating the magnitudes and phases of the data contained in the navigator "ring." Further, it is difficult to create a frequency field map for off-resonance correction when an object moves during a scan, because there is motion-dependent misregistration between the two images acquired with different TEs. However, this difficulty can be overcome by combining the motion-correction method with a recently proposed technique (off-resonance correction using variable-density spirals (ORC-VDS)), thereby enabling both motion compensation and off-resonance correction with no additional scanning.

Three-dimensional method for comparing in vivo interventional MR images of thermally ablated tissue with tissue response

PURPOSE

To investigate the ability of magnetic resonance (MR) to monitor radio-frequency (RF) ablation treatments by comparing MR images of thermal lesions to histologically assayed cellular damage. We developed a new methodology using three-dimensional registration for making spatial correlations.

MATERIALS AND METHODS

A low-field, open MRI system was used to guide an ablation probe into rabbit thigh muscle and acquire MR volumes after ablation. After fixation, we sliced and photographed the tissue at 3-mm intervals, using a specially designed apparatus, to obtain a volume of tissue images. Histologic samples were digitized using a video microscopy system. For our three-dimensional registration method, we used the tissue images as the reference, and registered histology and MR images to them using two different computer alignment steps. First, the MR volume was aligned to the volume of tissue images by registering needle fiducials placed near the tissue of interest. Second, we registered the histology images with the tissue images using a two-dimensional warping technique that aligned internal features and the outside boundary of histology and tissue images.

RESULTS

The MR and histology images were very well aligned, and registration accuracy, determined from displacement of needle fiducials, was 1.32 +/- 0.39 mm (mean +/- SD), which compared favorably to the MR voxel dimensions (0.70 mm in-plane and 3.0 mm thick). A preliminary comparison of MR and tissue response showed that the region inside the elliptical hyperintense rim in MR closely corresponds to the region of necrosis as established by histology, with a mean absolute distance between MR and histology boundaries of 1.17 mm, slightly smaller than the mean registration error. The MR region slightly overestimated the region of necrosis, with a mean signed distance between boundaries of 0.85 mm.

CONCLUSION

Our results suggest that our methodology can be used to achieve three-dimensional registration of histology and in vivo MR images. In MR lesion images, the inner border of the hyperintense region corresponds to the border of irreversible cell damage. This is good evidence that during RF ablation treatments, iMRI lesion images can be used for real-time feedback.

Keyhole Dixon method for faster, perceptually equivalent fat suppression

PURPOSE

To reduce the acquisition time associated with the two-point Dixon fat suppression technique by combining a keyhole in-phase (Water + Fat) k-space data set with a full out-of-phase (Water - Fat) k-space data set and optimizing the keyhole size with a perceptual difference model.

MATERIALS AND METHODS

A set of keyhole Dixon images was created by varying the number of lines in the keyhole data set. Off-resonance correction was incorporated into the image reconstruction process to improve the homogeneity of the fat suppression. A perceptual difference model (PDM) was validated with human observer experiments and used to compare the keyhole images to images from a full two-point Dixon acquisition. The PDM was used to determine the smallest keyhole width required to obtain perceptual equivalence to images obtained from the full two-point Dixon method.

RESULTS

In experimental phantom studies, the keyhole Dixon image reconstructed from 96 of 192 Water + Fat k-space lines and 192 Water - Fat k-space lines was perceptually equivalent to the full (192 + 192) two-point Dixon images, resulting in a 25% reduction in scan time. Clinical images of a volunteer's knee, orbits, and abdomen created from the smallest, perceptually equivalent keyhole width resulted in a 27%-38% reduction in total scan time.

CONCLUSION

This method improves the temporal efficiency of the conventional two-point Dixon technique and may prove especially useful for high-field systems where specific absorption rate (SAR) limits will constrain radiofrequency (RF)-based fat suppression techniques.

Do surgical clips interfere with radiofrequency thermal ablation?

OBJECTIVE

This study sought to evaluate whether surgical clips affect tissue conductivity and thereby alter the induction of radiofrequency ablation lesions and to determine whether therapy is safe after previous placement of clips in the liver.

MATERIALS AND METHODS

An ex vivo porcine hepatic model was used. Three clips were placed around a radiofrequency electrode at 10, 20, and 30 mm from the point of insertion. Clips were arranged in a plane either perpendicular or parallel to the electrode track. After placement of the liver specimen on a grounding pad, radiofrequency energy was applied in a standardized manner for 5 min. Lesion growth and morphology were documented for each minute.

RESULTS

Radiofrequency lesions appeared circular and homogeneous after 5 min. Lesion diameter perpendicular to the radiofrequency electrode averaged 30 mm. However, lesion formation was irregular during the early phase of the radiofrequency ablation. The lesion extended irregularly toward the 1-cm clip after 60 sec of ablation. During the second minute, a distinct lesion was observed around the clip 1 cm from the electrode; the primary lesion had not yet reached the clip. During the final 3 min, the primary lesion reached the 1-cm clip and ultimately incorporated the satellite lesion. No lesions were detected surrounding the more distant clips.

CONCLUSION

Our data suggest that with the parameters applied in our study, radiofrequency ablation can be safely performed in patients with implanted clips. No aberrant conduction is observed around surgical clips that are located 20 mm and further from the radiofrequency electrode.

Volume registration using needle paths and point landmarks for evaluation of interventional MRI treatments

We created a method for three-dimensional (3-D) registration of medical images (e.g., magnetic resonance imaging (MRI) or computed tomography) to images of physical tissue sections or to other medical images and evaluated its accuracy. Our method proved valuable for evaluation of animal model experiments on interventional-MRI guided thermal ablation and on a new localized drug delivery system. The method computes an optimum set of rigid body registration parameters by minimization of the Euclidean distances between automatically chosen correspondence points, along manually selected fiducial needle paths, and optional point landmarks, using the iterative closest point algorithm. For numerically simulated experiments, using two needle paths over a range of needle orientations, mean voxel displacement errors depended mostly on needle localization error when the angle between needles was at least 20 degrees. For parameters typical of our in vivo experiments, the mean voxel displacement error was < 0.35 mm. In addition, we determined that the distance objective function was a useful diagnostic for predicting registration quality. To evaluate the registration quality of physical specimens, we computed the misregistration for a needle not considered during the optimization procedure. We registered an ex vivo sheep brain MR volume with another MR volume and tissue section photographs, using various combinations of needle and point landmarks. Mean registration error was always < or = 0.54 mm for MR-to-MR registrations and < or = 0.52 mm for MR to tissue section registrations. We also applied the method to correlate MR volumes of radio-frequency induced thermal ablation lesions with actual tissue destruction. In this case, in vivo rabbit thigh volumes were registered to photographs of ex vivo tissue sections using two needle paths. Mean registration errors were between 0.7 and 1.36 mm over all rabbits, the largest error less than two MR voxel widths. We conclude that our method provides sufficient spatial correspondence to facilitate comparison of 3-D image data with data from gross pathology tissue sections and histology.

Slice-to-volume registration and its potential application to interventional MRI-guided radio-frequency thermal ablation of prostate cancer

In this study, we registered live-time interventional magnetic resonance imaging (iMRI) slices with a previously obtained high-resolution MRI volume that in turn can be registered with a variety of functional images, e.g., PET, SPECT, for tumor targeting. We created and evaluated a slice-to-volume (SV) registration algorithm with special features for its potential use in iMRI-guided radio-frequency (RF) thermal ablation of prostate cancer. The algorithm features included a multiresolution approach, two similarity measures, and automatic restarting to avoid local minima. Imaging experiments were performed on volunteers using a conventional 1.5-T MR scanner and a clinical 0.2-T C-arm iMRI system under realistic conditions. Both high-resolution MR volumes and actual iMRI image slices were acquired from the same volunteers. Actual and simulated iMRI images were used to test the dependence of SV registration on image noise, receive coil inhomogeneity, and RF needle artifacts. To quantitatively assess registration, we calculated the mean voxel displacement over a volume of interest between SV registration and volume-to-volume registration, which was previously shown to be quite accurate. More than 800 registration experiments were performed. For transverse image slices covering the prostate, the SV registration algorithm was 100% successful with an error of <2 mm, and the average and standard deviation was only 0.4 mm +/- 0.2 mm. Visualizations such as combined sector display and contour overlay showed excellent registration of the prostate and other organs throughout the pelvis. Error was greater when an image slice was obtained at other orientations and positions, mostly because of inconsistent image content such as that from variable rectal and bladder filling. These preliminary experiments indicate that MR SV registration is sufficiently accurate to aid image-guided therapy.

Variation correction algorithm: analysis of phase suppression and thermal profile fidelity for proton resonance frequency magnetic resonance thermometry at 0.2 T

PURPOSE

To develop and analyze the performance of the variation correction algorithm (VCA), a phase correction technique that mitigates the contribution of background phase variations by combining accurate alignment of echoes, K-space-based phase correction (as opposed to spatial polynomials), and extraction of alias-free phase difference images.

MATERIALS AND METHODS

A series of echo-shifted gradient-recalled echo (GRE) images was processed with K-space alignment and phase corrected with increasing sizes of M x M masks of central K-space coefficients. The extent of background phase variation suppression due to magnet field drift was assessed. Further, a simulated thermal profile was superimposed on the same data in a related experiment. Residual errors in reconstructed simulated thermal profiles were quantitatively characterized to estimate algorithm performance.

RESULTS

Using a 3 x 3 K-space mask, the VCA was able to 1) maintain the typical mean background error in a 35 x 35 pixel region of interest (ROI) at -0.1 degrees C; and 2) reconstruct, relative to the applied thermal profile, a phase-corrected profile that typically contains a 1.7 degrees C underestimation of peak temperature difference and a mean error along the 60 degrees C line of -0.8 degrees C.

CONCLUSION

The results suggest that thermal profiles can be accurately reconstructed at 0.2 T using the VCA, even in the presence of over 1 ppm spatially and temporally dependent field drift over a 1-hour time frame.

MR image-guided endovascular procedures with the ultrasmall superparamagnetic iron oxide SH U 555 C as an intravascular contrast agent: study in pigs

PURPOSE

To evaluate the feasibility of using the ultrasmall superparamagnetic iron oxide (USPIO) SH U 555 C as an intravascular contrast agent for magnetic resonance (MR) image-guided vascular procedures with an open MR imaging system.

MATERIALS AND METHODS

All experiments were performed with MR imaging at 0.2 T. MR image-guided interventions were performed in USPIO-enhanced vessels in four pigs. With near real-time MR image guidance (acquisition time, 0.64 second per section), the splenic and renal arteries were consecutively catheterized by using a susceptibility artifact-based catheter-guide wire combination. Angioplasty and stent implantation were performed four times in the renal artery and twice in the iliac artery. Intraaortal signal intensity (SI) was measured during the interventions.

RESULTS

After administration of SH U 555 C (40 micromol of iron per kilogram of body weight), a three-dimensional MR angiographic sequence was performed that allowed visualization of the abdominal and pelvic vessels that were as small as 2 mm in diameter. Catheterization, angioplasty, and stent implantation were successfully guided in the USPIO-enhanced vasculature. Sixty minutes after contrast agent injection, the mean aortic SI was 70% of the maximum measured enhancement levels.

CONCLUSION

One intravenous injection of SH U 555 C enabled long, continuous intravascular SI enhancement at MR angiography, and, in combination with susceptibility artifact-based device tracking, the injection allowed the performance of MR imaging-guided intravascular interventions in an open MR imaging system.

Selective missing pulse steady state free precession (MP-SSFP): Inner volume and chemical shift selective imaging in a steady state sequence

PURPOSE

To examine new sequences that restrict acquisition of spins to those excited by both of the RF pulses in missing pulse steady state free precession (MP-SSFP) MRI.

MATERIALS AND METHODS

New MP-SSFP sequences were created by replacing one of the slice selective pulses (SSPs) with an orthogonal SSP for inner volume imaging, and with a chemical shift selective (CHESS) pulse for chemical shift imaging. The inner volume sequence was applied to a reduced field of view at the center of a resolution phantom; resulting images were evaluated for differences in the aliased signal. The CHESS sequence was applied to volunteers, as well as to and fat, water, and acetic acid phantoms. Results were evaluated with SNR measurements.

RESULTS

The inner volume sequence eliminated the aliased signal, while nonselected fat and water levels were suppressed to that of noise by the CHESS sequence.

CONCLUSION

Results suggest a novel steady state technique for rapid inner volume or chemical shift imaging.

Endoscopically inserted endoluminal receiver coil for high-resolution magnetic resonance imaging of the pancreas: Initial results in an animal model

BACKGROUND

This study assessed the feasibility of high-resolution magnetic resonance imaging of the pancreas by means of an endoscopically inserted endoluminal magnetic resonance receiver coil.

METHOD

A 0.032-inch diameter internal magnetic resonance imaging receiver coil was endoscopically inserted into the pancreatic duct in 4 pigs through the accessory channel of a standard duodenoscope to obtain high-resolution magnetic resonance images by using T1- and T2-weighted sequences.

RESULTS

The pig anatomy precluded the usual transoral approach; however, transgastric access allowed endoscopic transpapillary insertion of a receiver coil into the pancreatic duct in all animals without the need for sphincterotomy. The small swine pancreas could then be visualized by magnetic resonance imaging with a 0.3 x 0.3-mm in-plane resolution.

CONCLUSION

High-resolution pancreas magnetic resonance imaging is feasible by using an endoscopically inserted endoluminal receiver coil. The smaller stomach and larger pancreatic duct diameter in humans will facilitate clinical application of the imaging procedure.

Magnetic resonance-guided biliary drainage in a patient with malignant obstructive jaundice and thrombocytopenia

In a patient suffering from malignant obstructive jaundice and thrombocytopenia, magnetic resonance imaging (MRI) was used to guide percutaneous transhepatic biliary drainage, to avoid blind puncture of the bile ducts using fluoroscopy. The first puncture approach was successful, and an MRI-visible guide wire and drainage catheter were inserted successfully within 35 min. The course after the intervention was uneventful, and the patient's fever and itching improved. MRI guidance facilitated optimal procedure planning and high puncture accuracy.

Femur: MR imaging-guided radio-frequency ablation in a porcine model-feasibility study

PURPOSE

To determine the feasibility of magnetic resonance (MR) imaging-guided and -monitored radio-frequency (RF) ablation of bone.

MATERIALS AND METHODS

Seven femurs were treated in five pigs with use of a 0.2-T open MR imager. An 11-gauge bone marrow needle was percutaneously inserted into the distal femur metaphysis with MR fluoroscopy (fast imaging with steady-state precession, or FISP, sequences) to introduce an RF electrode into the bone with further image guidance. Thermal ablation was performed for 10 minutes (90 degrees C +/- 2 [mean +/- SD]). MR follow-up was performed immediately after ablation and again at 7 and 14 days after the procedure (with contrast material-enhanced T1-weighted, T2-weighted, and fast short inversion time inversion-recovery, or STIR, sequences). The animals were sacrificed at day 14. The femurs were sliced, decalcified, and stained. Image analysis was performed to measure lesion diameter and contrast-to-noise ratio (CNR) and to evaluate complications.

RESULTS

Technical success was obtained in all animals. The lesion diameter perpendicular to the electrode was 15.4 mm +/- 2.7. No significant complications were noted. The thermal lesions displayed low signal intensity with a sharp rim of high signal intensity. T2-weighted images demonstrated the highest CNR and the lowest error in predicting the lesion size immediately after ablation (2.7 mm +/- 1.3). Contrast-enhanced T1-weighted images demonstrated the highest accuracy at day 14 (1.0 mm +/- 1.0).

CONCLUSION

RF ablation of bone with MR imaging as the sole imaging modality is feasible and allows monitoring of the ablation.

Use of a blood-pool contrast agent for MR-guided vascular procedures: feasibility of ultrasmall superparamagnetic iron oxide particles

RATIONALE AND OBJECTIVES

The purpose of this study was to examine the dose dependency of the intravascular signal intensity after injection of ultrasmall superparamagnetic iron oxide (USPIO) particles (SH U 555 C) in a rabbit model studied with a low-field-strength magnetic resonance (MR) imaging system. The results were used to facilitate MR-guided vascular procedures in a pig.

MATERIALS AND METHODS

All experiments were performed at 0.2 T. To determine the optimum USPIO (or SH U 555 C) dose for intravascular interventions, the authors acquired coronal three-dimensional MR angiographic images in 12 rabbits after injection of four dose levels (10, 20, 30, and 40 micromol of iron per kilogram body weight). The intraaortic signal intensities were measured in user-defined regions of interest. For numerical analysis, signal intensity enhancement was computed. Subsequently MR image-guided procedures were performed in USPIO-enhanced vessels in one pig.

RESULTS

The signal intensity evaluation shows a clear-cut dose dependence in both early and late phases after administration of SH U 555 C. A high-spatial-resolution MR angiogram acquired 20 minutes after injection yielded the best results with the highest dose (40 micromol of iron per kilogram); at that dose, intravascular enhancement was sufficient for vascular procedures for 60 minutes after injection.

CONCLUSION

SH U 555 C is a promising contrast agent for MR angiography and MR-guided vascular procedures in an open low-field-strength MR imager.

Three-dimensional model of lesion geometry for evaluation of MR-guided thermal ablation therapy

RATIONALE AND OBJECTIVES

High-radiofrequency energy is used clinically to ablate pathologic tissue with interventional magnetic resonance (MR) imaging. For many tissues, resulting lesions have a characteristic appearance on contrast-enhanced T1- and T2-weighted MR images, with two boundaries enclosing an inner hypointense region and an outer hyperintense margin. Geometric modeling of three-dimensional thermal lesions in animal experiments and patient treatments would improve analyses and visualization.

MATERIALS AND METHODS

The authors created a model with two quadric surfaces and 12 parameters to describe both lesion surfaces. Parameters were estimated with iterative optimization to minimize the sum of the squared shortest distances from segmented points to the model surface. The authors validated the estimation process with digital lesion phantoms that simulated varying levels of segmentation error and missing surface information. They also applied their method to in vivo images of lesions in a rabbit model.

RESULTS

For simulated phantom lesions, the lesion geometry was accurate despite manual segmentation error and incomplete surface data. Even when 50% of the surface was missing, the median error was less than 0.5 mm. For all in vivo lesions, the median distance from the model surface to data was no more than 0.58 mm for both inner and outer surfaces, less than a voxel width (0.7 mm). The interquartile range was 0.89 mm or less for all data.

CONCLUSION

The authors' model provides a good approximation of actual lesion geometry and is highly resistant to missing segmentation information. It should prove useful for three-dimensional lesion visualization, volume estimation, automated segmentation, and volume registration.