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Kim K, Narsinh K, Ozhinsky E. Technical advances in motion-robust MR thermometry. Magn Reson Med 2024; 92:15-27. [PMID: 38501903 PMCID: PMC11132643 DOI: 10.1002/mrm.30057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 03/20/2024]
Abstract
Proton resonance frequency shift (PRFS) MR thermometry is the most common method used in clinical thermal treatments because of its fast acquisition and high sensitivity to temperature. However, motion is the biggest obstacle in PRFS MR thermometry for monitoring thermal treatment in moving organs. This challenge arises because of the introduction of phase errors into the PRFS calculation through multiple methods, such as image misregistration, susceptibility changes in the magnetic field, and intraframe motion during MRI acquisition. Various approaches for motion correction have been developed for real-time, motion-robust, and volumetric MR thermometry. However, current technologies have inherent trade-offs among volume coverage, processing time, and temperature accuracy. These tradeoffs should be considered and chosen according to the thermal treatment application. In hyperthermia treatment, precise temperature measurements are of increased importance rather than the requirement for exceedingly high temporal resolution. In contrast, ablation procedures require robust temporal resolution to accurately capture a rapid temperature rise. This paper presents a comprehensive review of current cutting-edge MRI techniques for motion-robust MR thermometry, and recommends which techniques are better suited for each thermal treatment. We expect that this study will help discern the selection of motion-robust MR thermometry strategies and inspire the development of motion-robust volumetric MR thermometry for practical use in clinics.
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Affiliation(s)
- Kisoo Kim
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, California, USA
| | - Kazim Narsinh
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, California, USA
| | - Eugene Ozhinsky
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, California, USA
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2
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Kim K, Diederich C, Narsinh K, Ozhinsky E. Motion-robust, multi-slice, real-time MR thermometry for MR-guided thermal therapy in abdominal organs. Int J Hyperthermia 2023; 40:2151649. [PMID: 36535967 PMCID: PMC10269483 DOI: 10.1080/02656736.2022.2151649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To develop an effective and practical reconstruction pipeline to achieve motion-robust, multi-slice, real-time MR thermometry for monitoring thermal therapy in abdominal organs. METHODS The application includes a fast spiral magnetic resonance imaging (MRI) pulse sequence and a real-time reconstruction pipeline based on multi-baseline proton resonance frequency shift (PRFS) method with visualization of temperature imaging. The pipeline supports multi-slice acquisition with minimal reconstruction lag. Simulations with a virtual motion phantom were performed to investigate the influence of the number of baselines and respiratory rate on the accuracy of temperature measurement. Phantom experiments with ultrasound heating were performed using a custom-made motion phantom to evaluate the performance of the pipeline. Lastly, experiments in healthy volunteers (N = 2) without heating were performed to evaluate the accuracy and stability of MR thermometry in abdominal organs (liver and kidney). RESULTS The multi-baseline approach with greater than 25 baselines resulted in minimal temperature errors in the simulation. Phantom experiments demonstrated a 713 ms update time for 3-slice acquisitions. Temperature maps with 30 baselines showed clear temperature distributions caused by ultrasound heating in the respiratory phantom. Finally, the pipeline was evaluated with physiologic motions in healthy volunteers without heating, which demonstrated the accuracy (root mean square error [RMSE]) of 1.23 ± 0.18 °C (liver) and 1.21 ± 0.17 °C (kidney) and precision of 1.13 ± 0.11 °C (liver) and 1.16 ± 0.15 °C (kidney) using 32 baselines. CONCLUSIONS The proposed real-time acquisition and reconstruction pipeline allows motion-robust, multi-slice, real-time temperature monitoring within the abdomen during free breathing.
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Affiliation(s)
- Kisoo Kim
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, USA
| | - Chris Diederich
- Department of Radiation Oncology, University of California, San Francisco, USA
| | - Kazim Narsinh
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, USA
| | - Eugene Ozhinsky
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, USA
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3
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Boehm C, Goeger-Neff M, Mulder HT, Zilles B, Lindner LH, van Rhoon GC, Karampinos DC, Wu M. Susceptibility artifact correction in MR thermometry for monitoring of mild radiofrequency hyperthermia using total field inversion. Magn Reson Med 2022; 88:120-132. [PMID: 35313384 DOI: 10.1002/mrm.29191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE MR temperature monitoring of mild radiofrequency hyperthermia (RF-HT) of cancer exploits the linear resonance frequency shift of water with temperature. Motion-induced susceptibility distribution changes cause artifacts that we correct here using the total field inversion (TFI) approach. METHODS The performance of TFI was compared to two background field removal (BFR) methods: Laplacian boundary value (LBV) and projection onto dipole fields (PDF). Data sets with spatial susceptibility change and B 0 -drift were simulated, phantom heating experiments were performed, four volunteer data sets at thermoneutral conditions as well as data from one cervical cancer, two sarcoma, and one seroma patients undergoing mild RF-HT were corrected using the proposed methods. RESULTS Simulations and phantom heating experiments revealed that using BFR or TFI preserves temperature-induced phase change, while removing susceptibility artifacts and B 0 -drift. TFI resulted in the least cumulative error for all four volunteers. Temperature probe information from four patient data sets were best depicted by TFI-corrected data in terms of accuracy and precision. TFI also performed best in case of the sarcoma treatment without temperature probe. CONCLUSION TFI outperforms previously suggested BFR methods in terms of accuracy and robustness. While PDF consistently overestimates susceptibility contribution, and LBV removes valuable pixel information, TFI is more robust and leads to more accurate temperature estimations.
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Affiliation(s)
- Christof Boehm
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | | | | | - Benjamin Zilles
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Lars H Lindner
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | | | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Mingming Wu
- Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany
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Qiao Y, Zou C, Wen J, Long X, Cheng C, Yang W, Ye W, Liang D, Liu X, Zheng H. MARFit: An integrated software for real-time MR guided focused ultrasound neuromodulation system. IEEE Trans Neural Syst Rehabil Eng 2022; 30:264-273. [DOI: 10.1109/tnsre.2022.3146286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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5
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Payne A, Chopra R, Ellens N, Chen L, Ghanouni P, Sammet S, Diederich C, Ter Haar G, Parker D, Moonen C, Stafford J, Moros E, Schlesinger D, Benedict S, Wear K, Partanen A, Farahani K. AAPM Task Group 241: A medical physicist's guide to MRI-guided focused ultrasound body systems. Med Phys 2021; 48:e772-e806. [PMID: 34224149 DOI: 10.1002/mp.15076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 04/28/2021] [Accepted: 06/21/2021] [Indexed: 11/07/2022] Open
Abstract
Magnetic resonance-guided focused ultrasound (MRgFUS) is a completely non-invasive technology that has been approved by FDA to treat several diseases. This report, prepared by the American Association of Physicist in Medicine (AAPM) Task Group 241, provides background on MRgFUS technology with a focus on clinical body MRgFUS systems. The report addresses the issues of interest to the medical physics community, specific to the body MRgFUS system configuration, and provides recommendations on how to successfully implement and maintain a clinical MRgFUS program. The following sections describe the key features of typical MRgFUS systems and clinical workflow and provide key points and best practices for the medical physicist. Commonly used terms, metrics and physics are defined and sources of uncertainty that affect MRgFUS procedures are described. Finally, safety and quality assurance procedures are explained, the recommended role of the medical physicist in MRgFUS procedures is described, and regulatory requirements for planning clinical trials are detailed. Although this report is limited in scope to clinical body MRgFUS systems that are approved or currently undergoing clinical trials in the United States, much of the material presented is also applicable to systems designed for other applications.
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Affiliation(s)
- Allison Payne
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Rajiv Chopra
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Lili Chen
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Pejman Ghanouni
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Steffen Sammet
- Department of Radiology, University of Chicago, Chicago, IL, USA
| | - Chris Diederich
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | | | - Dennis Parker
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Chrit Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jason Stafford
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA
| | - Eduardo Moros
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - David Schlesinger
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA
| | | | - Keith Wear
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | | | - Keyvan Farahani
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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6
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Vinding MS, Aigner CS, Schmitter S, Lund TE. DeepControl: 2DRF pulses facilitating B 1 + inhomogeneity and B 0 off-resonance compensation in vivo at 7 T. Magn Reson Med 2021; 85:3308-3317. [PMID: 33480029 DOI: 10.1002/mrm.28667] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 01/26/2023]
Abstract
PURPOSE Rapid 2DRF pulse design with subject-specific B 1 + inhomogeneity and B0 off-resonance compensation at 7 T predicted from convolutional neural networks is presented. METHODS The convolution neural network was trained on half a million single-channel transmit 2DRF pulses optimized with an optimal control method using artificial 2D targets, B 1 + and B0 maps. Predicted pulses were tested in a phantom and in vivo at 7 T with measured B 1 + and B0 maps from a high-resolution gradient echo sequence. RESULTS Pulse prediction by the trained convolutional neural network was done on the fly during the MR session in approximately 9 ms for multiple hand-drawn regions of interest and the measured B 1 + and B0 maps. Compensation of B 1 + inhomogeneity and B0 off-resonances has been confirmed in the phantom and in vivo experiments. The reconstructed image data agree well with the simulations using the acquired B 1 + and B0 maps, and the 2DRF pulse predicted by the convolutional neural networks is as good as the conventional RF pulse obtained by optimal control. CONCLUSION The proposed convolutional neural network-based 2DRF pulse design method predicts 2DRF pulses with an excellent excitation pattern and compensated B 1 + and B0 variations at 7 T. The rapid 2DRF pulse prediction (9 ms) enables subject-specific high-quality 2DRF pulses without the need to run lengthy optimizations.
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Affiliation(s)
- Mads Sloth Vinding
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark
| | | | - Sebastian Schmitter
- Physikalisch-Technische Bundesanstalt, Braunschweig and Berlin, Germany.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Torben Ellegaard Lund
- Center of Functionally Integrative Neuroscience (CFIN), Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark
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de Senneville BD, Coupé P, Ries M, Facq L, Moonen CTW. Deep correction of breathing-related artifacts in real-time MR-thermometry. Comput Med Imaging Graph 2020; 87:101834. [PMID: 33352524 DOI: 10.1016/j.compmedimag.2020.101834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- B Denis de Senneville
- University of Bordeaux, IMB, UMR CNRS 5251, Talence, France, Talence Cedex, F-33405, France; INRIA Project Team Monc, Talence, France, Talence Cedex, F-33405, France; Department of Radiotherapy, UMC Utrecht, Heidelberglaan 100, 3508 GA, The Netherlands.
| | - P Coupé
- CNRS, University of Bordeaux, Bordeaux INP, "Laboratoire Bordelais de la Recherche Informatique" (LaBRI), UMR5800, Talence, F-33400, France
| | - M Ries
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - L Facq
- University of Bordeaux, IMB, UMR CNRS 5251, Talence, France, Talence Cedex, F-33405, France
| | - C T W Moonen
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
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8
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Bing C, Cheng B, Staruch RM, Nofiele J, Staruch MW, Szczepanski D, Farrow-Gillespie A, Yang A, Laetsch TW, Chopra R. Breath-hold MR-HIFU hyperthermia: phantom and in vivo feasibility. Int J Hyperthermia 2019; 36:1084-1097. [PMID: 31707872 PMCID: PMC6873809 DOI: 10.1080/02656736.2019.1679893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/04/2019] [Accepted: 10/06/2019] [Indexed: 01/01/2023] Open
Abstract
Background: The use of magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) to deliver mild hyperthermia requires stable temperature mapping for long durations. This study evaluates the effects of respiratory motion on MR thermometry precision in pediatric subjects and determines the in vivo feasibility of circumventing breathing-related motion artifacts by delivering MR thermometry-controlled HIFU mild hyperthermia during repeated forced breath holds.Materials and methods: Clinical and preclinical studies were conducted. Clinical studies were conducted without breath-holds. In phantoms, breathing motion was simulated by moving an aluminum block towards the phantom along a sinusoidal trajectory using an MR-compatible motion platform. In vivo experiments were performed in ventilated pigs. MR thermometry accuracy and stability were evaluated.Results: Clinical data confirmed acceptable MR thermometry accuracy (0.12-0.44 °C) in extremity tumors, but not in the tumors in the chest/spine and pelvis. In phantom studies, MR thermometry accuracy and stability improved to 0.37 ± 0.08 and 0.55 ± 0.18 °C during simulated breath-holds. In vivo MR thermometry accuracy and stability in porcine back muscle improved to 0.64 ± 0.22 and 0.71 ± 0.25 °C during breath-holds. MR-HIFU hyperthermia delivered during intermittent forced breath holds over 10 min duration heated an 18-mm diameter target region above 41 °C for 10.0 ± 1.0 min, without significant overheating. For a 10-min mild hyperthermia treatment, an optimal treatment effect (TIR > 9 min) could be achieved when combining 36-60 s periods of forced apnea with 60-155.5 s free-breathing.Conclusion: MR-HIFU delivery during forced breath holds enables stable control of mild hyperthermia in targets adjacent to moving anatomical structures.
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Affiliation(s)
- Chenchen Bing
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Bingbing Cheng
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Robert M. Staruch
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
- Clinical Sites Research Program, Philips Research North America, Cambridge, MA
| | - Joris Nofiele
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Debra Szczepanski
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alan Farrow-Gillespie
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX
| | - Adeline Yang
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Theodore W. Laetsch
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
- Pauline Allen Gill Center for Cancer and Blood Disorders, Children’s Health, Dallas, TX
| | - Rajiv Chopra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX
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Abstract
The unique ability of magnetic resonance imaging to measure temperature noninvasively, in vivo, makes it an attractive tool for monitoring interventional procedures, such as radiofrequency or microwave ablation in real-time. The most frequently used approach for magnetic resonance-based temperature measurement is proton resonance frequency (PRF) thermometry. Although it has many advantages, including tissue-independence and real-time capability, the main drawback is its motion sensitivity. This is likely the reason PRF thermometry in moving organs, such as the liver, is not commonly used in the clinical arena. In recent years, however, several developments suggest that motion-corrected thermometry in the liver is achievable. The present article summarizes the diverse attempts to correct thermometry in the liver. Therefore, the physical principle of PRF is introduced, with additional references for necrosis zone estimation and how to deal with fat phase modulation, and main magnetic field drifts. The primary categories of motion correction are presented, including general methods for motion compensation and library-based approaches, and referenceless thermometry and hybrid methods. Practical validation of the described methods in larger patient groups will be necessary to establish accurate motion-corrected thermometry in the clinical arena, with the goal of complete liver tumor ablation.
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10
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Celicanin Z, Manasseh G, Petrusca L, Scheffler K, Auboiroux V, Crowe LA, Hyacinthe JN, Natsuaki Y, Santini F, Becker CD, Terraz S, Bieri O, Salomir R. Hybrid ultrasound-MR guided HIFU treatment method with 3D motion compensation. Magn Reson Med 2017; 79:2511-2523. [PMID: 28944490 DOI: 10.1002/mrm.26897] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 08/10/2017] [Accepted: 08/11/2017] [Indexed: 01/16/2023]
Abstract
PURPOSE Treatments using high-intensity focused ultrasound (HIFU) in the abdominal region remain challenging as a result of respiratory organ motion. A novel method is described here to achieve 3D motion-compensated ultrasound (US) MR-guided HIFU therapy using simultaneous ultrasound and MRI. METHODS A truly hybrid US-MR-guided HIFU method was used to plan and control the treatment. Two-dimensional ultrasound was used in real time to enable tracking of the motion in the coronal plane, whereas an MR pencil-beam navigator was used to detect anterior-posterior motion. Prospective motion compensation of proton resonance frequency shift (PRFS) thermometry and HIFU electronic beam steering were achieved. RESULTS The 3D prospective motion-corrected PRFS temperature maps showed reduced intrascan ghosting artifacts, a high signal-to-noise ratio, and low geometric distortion. The k-space data yielded a consistent temperature-dependent PRFS effect, matching the gold standard thermometry within approximately 1°C. The maximum in-plane temperature elevation ex vivo was improved by a factor of 2. Baseline thermometry acquired in volunteers indicated reduction of residual motion, together with an accuracy/precision of near-harmonic referenceless PRFS thermometry on the order of 0.5/1.0°C. CONCLUSIONS Hybrid US-MR-guided HIFU ablation with 3D motion compensation was demonstrated ex vivo together with a stable referenceless PRFS thermometry baseline in healthy volunteer liver acquisitions. Magn Reson Med 79:2511-2523, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Zarko Celicanin
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Gibran Manasseh
- Image Guided Interventions Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Lorena Petrusca
- Hepatobiliary and Pancreatic Interventional Radiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Klaus Scheffler
- MRC Department, MPI for Biological Cybernetics, Tübingen, Germany.,Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Vincent Auboiroux
- Image Guided Interventions Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Clinatec/LETI/CEA, 38054, Grenoble, France
| | - Lindsey A Crowe
- Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Jean-Noel Hyacinthe
- Image Guided Interventions Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,School of Health Sciences, HES-SO, University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | | | - Francesco Santini
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Christoph D Becker
- Hepatobiliary and Pancreatic Interventional Radiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Sylvain Terraz
- Image Guided Interventions Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Oliver Bieri
- Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Rares Salomir
- Image Guided Interventions Laboratory, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Radiology Department, University Hospitals of Geneva, Geneva, Switzerland
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11
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van Breugel JMM, de Greef M, Wijlemans JW, Schubert G, van den Bosch MAAJ, Moonen CTW, Ries MG. Thermal ablation of a confluent lesion in the porcine kidney with a clinically available MR-HIFU system. Phys Med Biol 2017; 62:5312-5326. [PMID: 28557798 DOI: 10.1088/1361-6560/aa75b3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The incidence of small renal masses (SRMs) sized <4 cm has increased over the decades (as co-findings/or due to introduction of cross sectional imaging). Currently, partial nephrectomy (PN) or watchful waiting is advised in these patients. Ultimately, 80-90% of these SRMs require surgical treatment and PN is associated with a 15% complication rate. In this aging population, with possible comorbidities and poor health condition, both PN and watchful waiting are non-ideal treatment options. This resulted in an increased need for early, non-invasive treatment strategies such as MR-guided high intensity focused ultrasound (MR-HIFU). (i) To investigate the feasibility of creating a confluent lesion in the kidney using respiratory-gated MR-HIFU under clinical conditions in a pre-clinical study and (ii) to evaluate the reproducibility of the MR-HIFU ablation strategy. Healthy pigs (n = 10) under general anesthesia were positioned on a clinical MR-HIFU system with integrated cooling. A honeycomb pattern of seven overlapping ablation cells (4 × 4 × 10 mm3, 450 W, <30 s) was ablated successively in the cortex of the porcine kidney. Both MR thermometry and acoustic energy delivery were respiratory gated using a pencil beam navigator on the contralateral kidney. The non-perfused volume (NPV) was visualized after the last sonication by contrast-enhanced (CE) T 1-weighted MR (T 1 w) imaging. Cell viability staining was performed to visualize the extent of necrosis. RESULTS a median NPV of 0.62 ml was observed on CE-T 1 w images (IQR 0.58-1.57 ml, range 0.33-2.75 ml). Cell viability staining showed a median damaged volume of 0.59 ml (IQR 0.24-1.35 ml, range 0-4.1 ml). Overlooking of the false rib, shivering of the pig, and too large depth combined with a large heat-sink effect resulted in insufficient heating in 4 cases. The NPV and necrosed volume were confluent in all cases in which an ablated volume could be observed. Our results demonstrated the feasibility of creating a confluent volume of ablated kidney cortical tissue in vivo with MR-HIFU on a clinically available system using respiratory gating and near-field cooling and showed its reproducibility.
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Affiliation(s)
- J M M van Breugel
- Center for Imaging Sciences, University Medical Center Utrecht, Utrecht, Netherlands
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12
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Kuroda K. MR techniques for guiding high-intensity focused ultrasound (HIFU) treatments. J Magn Reson Imaging 2017; 47:316-331. [PMID: 28580706 DOI: 10.1002/jmri.25770] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/02/2017] [Indexed: 12/17/2022] Open
Abstract
To make full use of the ability of magnetic resonance (MR) to guide high-intensity focused ultrasound (HIFU) treatment, effort has been made to improve techniques for thermometry, motion tracking, and sound beam visualization. For monitoring rapid temperature elevation with proton resonance frequency (PRF) shift, data acquisition and processing can be accelerated with parallel imaging and/or sparse sampling in conjunction with appropriate signal processing methods. Thermometry should be robust against tissue motion, motion-induced magnetic field variation, and susceptibility change. Thus, multibaseline, referenceless, or hybrid techniques have become important. In cases with adipose or bony tissues, for which PRF shift cannot be used, thermometry with relaxation times or signal intensity may be utilized. Motion tracking is crucial not only for thermometry but also for targeting the focus of an ultrasound in moving organs such as the liver, kidney, or heart. Various techniques for motion tracking, such as those based on an anatomical image atlas with optical-flow displacement detection, a navigator echo to seize the diaphragm position, and/or rapid imaging to track vessel positions, have been proposed. Techniques for avoiding the ribcage and near-field heating have also been examined. MR acoustic radiation force imaging (MR-ARFI) is an alternative to thermometry that can identify the location and shape of the focal spot and sound beam path. This technique could be useful for treating heterogeneous tissue regions or performing transcranial therapy. All of these developments, which will be discussed further in this review, expand the applicability of HIFU treatments to a variety of clinical targets while maintaining safety and precision. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;47:316-331.
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Affiliation(s)
- Kagayaki Kuroda
- Department of Human and Information Science, School of Information Science and Technology, Tokai University, Hiratsuka, Kanagawa, Japan.,Center for Frontier Medical Engineering, Chiba University, Inage, Chiba, Japan
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Toupin S, Bour P, Lepetit-Coiffé M, Ozenne V, Denis de Senneville B, Schneider R, Vaussy A, Chaumeil A, Cochet H, Sacher F, Jaïs P, Quesson B. Feasibility of real-time MR thermal dose mapping for predicting radiofrequency ablation outcome in the myocardium in vivo. J Cardiovasc Magn Reson 2017; 19:14. [PMID: 28143574 PMCID: PMC5286737 DOI: 10.1186/s12968-017-0323-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical treatment of cardiac arrhythmia by radiofrequency ablation (RFA) currently lacks quantitative and precise visualization of lesion formation in the myocardium during the procedure. This study aims at evaluating thermal dose (TD) imaging obtained from real-time magnetic resonance (MR) thermometry on the heart as a relevant indicator of the thermal lesion extent. METHODS MR temperature mapping based on the Proton Resonance Frequency Shift (PRFS) method was performed at 1.5 T on the heart, with 4 to 5 slices acquired per heartbeat. Respiratory motion was compensated using navigator-based slice tracking. Residual in-plane motion and related magnetic susceptibility artifacts were corrected online. The standard deviation of temperature was measured on healthy volunteers (N = 5) in both ventricles. On animals, the MR-compatible catheter was positioned and visualized in the left ventricle (LV) using a bSSFP pulse sequence with active catheter tracking. Twelve MR-guided RFA were performed on three sheep in vivo at various locations in left ventricle (LV). The dimensions of the thermal lesions measured on thermal dose images, on 3D T1-weighted (T1-w) images acquired immediately after the ablation and at gross pathology were correlated. RESULTS MR thermometry uncertainty was 1.5 °C on average over more than 96% of the pixels covering the left and right ventricles, on each volunteer. On animals, catheter repositioning in the LV with active slice tracking was successfully performed and each ablation could be monitored in real-time by MR thermometry and thermal dosimetry. Thermal lesion dimensions on TD maps were found to be highly correlated with those observed on post-ablation T1-w images (R = 0.87) that also correlated (R = 0.89) with measurements at gross pathology. CONCLUSIONS Quantitative TD mapping from real-time rapid CMR thermometry during catheter-based RFA is feasible. It provides a direct assessment of the lesion extent in the myocardium with precision in the range of one millimeter. Real-time MR thermometry and thermal dosimetry may improve safety and efficacy of the RFA procedure by offering a reliable indicator of therapy outcome during the procedure.
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Affiliation(s)
- Solenn Toupin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Siemens Healthineers France, F-93210 Saint-Denis, France
| | - Pierre Bour
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Image Guided Therapy, F-33600 Pessac, France
| | | | - Valéry Ozenne
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
| | | | | | - Alexis Vaussy
- Siemens Healthineers France, F-93210 Saint-Denis, France
| | - Arnaud Chaumeil
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Hubert Cochet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Frédéric Sacher
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Pierre Jaïs
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), F-33600 Pessac, France
| | - Bruno Quesson
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France
- Centre de recherche Cardio-Thoracique de Bordeaux, INSERM, U1045, F-33000 Bordeaux, France
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Toupin S, de Senneville BD, Ozenne V, Bour P, Lepetit-Coiffe M, Boissenin M, Jais P, Quesson B. Combination of principal component analysis and optical-flow motion compensation for improved cardiac MR thermometry. Phys Med Biol 2017; 62:1208-1224. [PMID: 28114116 DOI: 10.1088/1361-6560/aa51f9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The use of magnetic resonance (MR) thermometry for the monitoring of thermal ablation is rapidly expanding. However, this technique remains challenging for the monitoring of the treatment of cardiac arrhythmia by radiofrequency ablation due to the heart displacement with respiration and contraction. Recent studies have addressed this problem by compensating in-plane motion in real-time with optical-flow based tracking technique. However, these algorithms are sensitive to local variation of signal intensity on magnitude images associated with tissue heating. In this study, an optical-flow algorithm was combined with a principal component analysis method to reduce the impact of such effects. The proposed method was integrated to a fully automatic cardiac MR thermometry pipeline, compatible with a future clinical workflow. It was evaluated on nine healthy volunteers under free breathing conditions, on a phantom and in vivo on the left ventricle of a sheep. The results showed that local intensity changes in magnitude images had lower impact on motion estimation with the proposed method. Using this strategy, the temperature mapping accuracy was significantly improved.
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Affiliation(s)
- S Toupin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux University, F-33600 Pessac-Bordeaux, France. INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000 Bordeaux, France. Siemens Healthineers France, F-93210 Saint-Denis, France
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15
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Seo J, Koizumi N, Mitsuishi M, Sugita N. Ultrasound image based visual servoing for moving target ablation by high intensity focused ultrasound. Int J Med Robot 2016; 13. [PMID: 27995752 PMCID: PMC5724706 DOI: 10.1002/rcs.1793] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/29/2016] [Accepted: 10/31/2016] [Indexed: 01/16/2023]
Abstract
Background Although high intensity focused ultrasound (HIFU) is a promising technology for tumor treatment, a moving abdominal target is still a challenge in current HIFU systems. In particular, respiratory‐induced organ motion can reduce the treatment efficiency and negatively influence the treatment result. In this research, we present: (1) a methodology for integration of ultrasound (US) image based visual servoing in a HIFU system; and (2) the experimental results obtained using the developed system. Materials and methods In the visual servoing system, target motion is monitored by biplane US imaging and tracked in real time (40 Hz) by registration with a preoperative 3D model. The distance between the target and the current HIFU focal position is calculated in every US frame and a three‐axis robot physically compensates for differences. Because simultaneous HIFU irradiation disturbs US target imaging, a sophisticated interlacing strategy was constructed. Results In the experiments, respiratory‐induced organ motion was simulated in a water tank with a linear actuator and kidney‐shaped phantom model. Motion compensation with HIFU irradiation was applied to the moving phantom model. Based on the experimental results, visual servoing exhibited a motion compensation accuracy of 1.7 mm (RMS) on average. Moreover, the integrated system could make a spherical HIFU‐ablated lesion in the desired position of the respiratory‐moving phantom model. Conclusions We have demonstrated the feasibility of our US image based visual servoing technique in a HIFU system for moving target treatment.
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Affiliation(s)
- Joonho Seo
- Korea Institute of Machinery and Materials, Daegu, South Korea
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16
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MRI-Guided HIFU Methods for the Ablation of Liver and Renal Cancers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 880:43-63. [DOI: 10.1007/978-3-319-22536-4_3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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17
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Zachiu C, Papadakis N, Ries M, Moonen C, Denis de Senneville B. An improved optical flow tracking technique for real-time MR-guided beam therapies in moving organs. Phys Med Biol 2015; 60:9003-29. [PMID: 26540256 DOI: 10.1088/0031-9155/60/23/9003] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Magnetic resonance (MR) guided high intensity focused ultrasound and external beam radiotherapy interventions, which we shall refer to as beam therapies/interventions, are promising techniques for the non-invasive ablation of tumours in abdominal organs. However, therapeutic energy delivery in these areas becomes challenging due to the continuous displacement of the organs with respiration. Previous studies have addressed this problem by coupling high-framerate MR-imaging with a tracking technique based on the algorithm proposed by Horn and Schunck (H and S), which was chosen due to its fast convergence rate and highly parallelisable numerical scheme. Such characteristics were shown to be indispensable for the real-time guidance of beam therapies. In its original form, however, the algorithm is sensitive to local grey-level intensity variations not attributed to motion such as those that occur, for example, in the proximity of pulsating arteries.In this study, an improved motion estimation strategy which reduces the impact of such effects is proposed. Displacements are estimated through the minimisation of a variation of the H and S functional for which the quadratic data fidelity term was replaced with a term based on the linear L(1)norm, resulting in what we have called an L(2)-L(1) functional.The proposed method was tested in the livers and kidneys of two healthy volunteers under free-breathing conditions, on a data set comprising 3000 images equally divided between the volunteers. The results show that, compared to the existing approaches, our method demonstrates a greater robustness to local grey-level intensity variations introduced by arterial pulsations. Additionally, the computational time required by our implementation make it compatible with the work-flow of real-time MR-guided beam interventions.To the best of our knowledge this study was the first to analyse the behaviour of an L(1)-based optical flow functional in an applicative context: real-time MR-guidance of beam therapies in moving organs.
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Affiliation(s)
- C Zachiu
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
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18
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Glide-Hurst CK, Kim JP, To D, Hu Y, Kadbi M, Nielsen T, Chetty IJ. Four dimensional magnetic resonance imaging optimization and implementation for magnetic resonance imaging simulation. Pract Radiat Oncol 2015; 5:433-42. [DOI: 10.1016/j.prro.2015.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 12/25/2022]
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19
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Nofiele J, Yuan Q, Kazem M, Tatebe K, Torres Q, Sawant A, Pedrosa I, Chopra R. An MRI-compatible platform for one-dimensional motion management studies in MRI. Magn Reson Med 2015; 76:702-12. [PMID: 26493684 DOI: 10.1002/mrm.25903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/17/2015] [Accepted: 07/30/2015] [Indexed: 01/17/2023]
Abstract
PURPOSE Abdominal MRI remains challenging because of respiratory motion. Motion compensation strategies are difficult to compare clinically because of the variability across human subjects. The goal of this study was to evaluate a programmable system for one-dimensional motion management MRI research. METHODS A system comprised of a programmable motorized linear stage and computer was assembled and tested in the MRI environment. Tests of the mutual interference between the platform and a whole-body MRI were performed. Organ trajectories generated from a high-temporal resolution scan of a healthy volunteer were used in phantom tests to evaluate the effects of motion on image quality and quantitative MRI measurements. RESULTS No interference between the motion platform and the MRI was observed, and reliable motion could be produced across a wide range of imaging conditions. Motion-related artifacts commensurate with motion amplitude, frequency, and waveform were observed. T2 measurement of a kidney lesion in an abdominal phantom showed that its value decreased by 67% with physiologic motion, but could be partially recovered with navigator-based motion-compensation. CONCLUSION The motion platform can produce reliable linear motion within a whole-body MRI. The system can serve as a foundation for a research platform to investigate and develop motion management approaches for MRI. Magn Reson Med 76:702-712, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Joris Nofiele
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Qing Yuan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Ken Tatebe
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Quinn Torres
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amit Sawant
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rajiv Chopra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Sunnybrook Research Institute, Toronto, Ontario, Canada.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Mikhail AS, Partanen A, Yarmolenko P, Venkatesan AM, Wood BJ. Magnetic Resonance-Guided Drug Delivery. Magn Reson Imaging Clin N Am 2015; 23:643-55. [PMID: 26499281 DOI: 10.1016/j.mric.2015.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The use of clinical imaging modalities for the guidance of targeted drug delivery systems, known as image-guided drug delivery (IGDD), has emerged as a promising strategy for enhancing antitumor efficacy. MR imaging is particularly well suited for IGDD applications because of its ability to acquire images and quantitative measurements with high spatiotemporal resolution. The goal of IGDD strategies is to improve treatment outcomes by facilitating planning, real-time guidance, and personalization of pharmacologic interventions. This article reviews basic principles of targeted drug delivery and highlights the current status, emerging applications, and future paradigms of MR-guided drug delivery.
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Affiliation(s)
- Andrew S Mikhail
- Center for Interventional Oncology, Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
| | - Ari Partanen
- Center for Interventional Oncology, Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA; Philips Healthcare, 3000 Minuteman Road, Andover, MA 01810, USA
| | - Pavel Yarmolenko
- The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, 111 Michigan Avenue, Washington, DC 20010, USA
| | - Aradhana M Venkatesan
- Section of Abdominal Imaging, Department of Diagnostic Radiology, M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030-4009, USA
| | - Bradford J Wood
- Center for Interventional Oncology, Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
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21
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Denis de Senneville B, El Hamidi A, Moonen C. A direct PCA-based approach for real-time description of physiological organ deformations. IEEE TRANSACTIONS ON MEDICAL IMAGING 2015; 34:974-982. [PMID: 25423649 DOI: 10.1109/tmi.2014.2371995] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Dynamic magnetic resonance (MR)-imaging can provide functional and positional information in real-time, which can be conveniently used online to control a cancer therapy, e.g., using high intensity focused ultrasound or radio therapy. However, a precise real-time correction for motion is fundamental in abdominal organs to ensure an optimal treatment dose associated with a limited toxicity in nearby organs at risk. This paper proposes a real-time direct principal component analysis (PCA)-based technique which offers a robust approach for motion estimation of abdominal organs and allows correcting motion related artifacts. The PCA was used to detect spatio-temporal coherences of the periodic organ motion in a learning step. During the interventional procedure, physiological contributions were characterized quantitatively using a small set of parameters. A coarse-to-fine resolution scheme is proposed to improve the stability of the algorithm and afford a predictable constant latency of 80 ms. The technique was evaluated on 12 free-breathing volunteers and provided an improved real-time description of motion related to both breathing and cardiac cycles. A reduced learning step of 10 s was sufficient without any need for patient-specific control parameters, rendering the method suitable for clinical use.
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22
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Pichardo S, Köhler M, Lee J, Hynnyen K. In vivo optimisation study for multi-baseline MR-based thermometry in the context of hyperthermia using MR-guided high intensity focused ultrasound for head and neck applications. Int J Hyperthermia 2014; 30:579-92. [DOI: 10.3109/02656736.2014.981299] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Kim YS. Advances in MR image-guided high-intensity focused ultrasound therapy. Int J Hyperthermia 2014; 31:225-32. [DOI: 10.3109/02656736.2014.976773] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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High-resolution dynamic MR imaging of the thorax for respiratory motion correction of PET using groupwise manifold alignment. Med Image Anal 2014; 18:939-52. [DOI: 10.1016/j.media.2014.05.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 05/21/2014] [Accepted: 05/24/2014] [Indexed: 11/20/2022]
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25
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Courivaud F, Kazaryan AM, Lund A, Orszagh VC, Svindland A, Marangos IP, Halvorsen PS, Jebsen P, Fosse E, Hol PK, Edwin B. Thermal fixation of swine liver tissue after magnetic resonance-guided high-intensity focused ultrasound ablation. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1564-1577. [PMID: 24768489 DOI: 10.1016/j.ultrasmedbio.2014.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 01/23/2014] [Accepted: 02/01/2014] [Indexed: 06/03/2023]
Abstract
The aim of this study was to investigate experimental conditions for efficient and controlled in vivo liver tissue ablation by magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) in a swine model, with the ultimate goal of improving clinical treatment outcome. Histological changes were examined both acutely (four animals) and 1 wk after treatment (five animals). Effects of acoustic power and multiple sonication cycles were investigated. There was good correlation between target size and observed ablation size by thermal dose calculation, post-procedural MR imaging and histopathology, when temperature at the focal point was kept below 90°C. Structural histopathology investigations revealed tissue thermal fixation in ablated regions. In the presence of cavitation, mechanical tissue destruction occurred, resulting in an ablation larger than the target. Complete extra-corporeal MR-guided HIFU ablation in the liver is feasible using high acoustic power. Nearby large vessels were preserved, which makes MR-guided HIFU promising for the ablation of liver tumors adjacent to large veins.
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Affiliation(s)
| | - Airazat M Kazaryan
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Alice Lund
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway; Department of Pathology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Vivian C Orszagh
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway
| | - Aud Svindland
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Irina Pavlik Marangos
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | | | - Peter Jebsen
- Department of Pathology, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Erik Fosse
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | | | - Bjørn Edwin
- The Intervention Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway; Department of Gastrointestinal and Hepatobiliary Surgery, Oslo University Hospital, Oslo, Norway
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Groupwise simultaneous manifold alignment for high-resolution dynamic MR imaging of respiratory motion. ACTA ACUST UNITED AC 2014; 23:232-43. [PMID: 24683972 DOI: 10.1007/978-3-642-38868-2_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Respiratory motion is a complicating factor for many applications in medical imaging and there is significant interest in dynamic imaging that can be used to estimate such motion. Magnetic resonance imaging (MRI) is an attractive modality for motion estimation but current techniques cannot achieve good image contrast inside the lungs. Manifold learning is a powerful tool to discover the underlying structure of high-dimensional data. Aligning the manifolds of multiple datasets can be useful to establish relationships between different types of data. However, the current state-of-the-art in manifold alignment is not robust to the wide variations in manifold structure that may occur in clinical datasets. In this work we propose a novel, fully automatic technique for the simultaneous alignment of large numbers of manifolds with varying manifold structure. We apply the technique to reconstruct high-resolution and high-contrast dynamic 3D MRI images from multiple 2D datasets for the purpose of respiratory motion estimation. The proposed method is validated on synthetic data with known ground truth and real data. We demonstrate that our approach can be applied to reconstruct significantly more accurate and consistent dynamic images of the lungs compared to the current state-of-the-art in manifold alignment.
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A historical overview of magnetic resonance imaging, focusing on technological innovations. Invest Radiol 2013; 47:725-41. [PMID: 23070095 DOI: 10.1097/rli.0b013e318272d29f] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Magnetic resonance imaging (MRI) has now been used clinically for more than 30 years. Today, MRI serves as the primary diagnostic modality for many clinical problems. In this article, historical developments in the field of MRI will be discussed with a focus on technological innovations. Topics include the initial discoveries in nuclear magnetic resonance that allowed for the advent of MRI as well as the development of whole-body, high field strength, and open MRI systems. Dedicated imaging coils, basic pulse sequences, contrast-enhanced, and functional imaging techniques will also be discussed in a historical context. This article describes important technological innovations in the field of MRI, together with their clinical applicability today, providing critical insights into future developments.
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28
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Park MJ, Kim YS, Yang J, Sun WC, Park H, Chae SY, Namgung MS, Choi KS. Pulsed high-intensity focused ultrasound therapy enhances targeted delivery of cetuximab to colon cancer xenograft model in mice. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:292-299. [PMID: 23219035 DOI: 10.1016/j.ultrasmedbio.2012.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 10/05/2012] [Accepted: 10/06/2012] [Indexed: 06/01/2023]
Abstract
Our aim was to evaluate whether pulsed high-intensity focused ultrasound (HIFU) therapy enhances the effect of an epidermal growth factor receptor-targeted chemotherapeutic drug, cetuximab, in treating human colon cancer xenografts in a mouse model. Balb/c nude mice with subcutaneous xenografts of HT-29 cells were randomly categorized into control (n = 9), pulsed HIFU alone (n = 10), cetuximab monotherapy (n = 8) or combined pulsed HIFU and cetuximab therapy (n = 9) group. Cetuximab, pulsed HIFU therapy, or both were administered three times per week starting from day 8 after tumor cell injection. Based on tumor growth curves up to 34 days, the combination therapy group showed more suppressed tumor growth than all other groups (p < 0.05). The final relative tumor volumes were 5.4 ± 2.1, 5.2 ± 1.3, 4.8 ± 1.8, and 3.1 ± 0.9 for control, pulsed HIFU alone, cetuximab monotherapy, and combination therapy groups, respectively. In conclusion, pulsed HIFU therapy appears to enhance the anti-tumor effect of epidermal growth factor receptor-targeted cetuximab on human colon cancer xenograft models in mice.
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Affiliation(s)
- Min Jung Park
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Stam MK, Crijns SPM, Zonnenberg BA, Barendrecht MM, van Vulpen M, Lagendijk JJW, Raaymakers BW. Navigators for motion detection during real-time MRI-guided radiotherapy. Phys Med Biol 2012; 57:6797-805. [PMID: 23032581 DOI: 10.1088/0031-9155/57/21/6797] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
An MRI-linac system provides direct MRI feedback and with that the possibility of adapting radiation treatments to the actual tumour position. This paper addresses the use of fast 1D MRI, pencil-beam navigators, for this feedback. The accuracy of using navigators was determined on a moving phantom. The possibility of organ tracking and breath-hold monitoring based on navigator guidance was shown for the kidney. Navigators are accurate within 0.5 mm and the analysis has a minimal time lag smaller than 30 ms as shown for the phantom measurements. The correlation of 2D kidney images and navigators shows the possibility of complete organ tracking. Furthermore the breath-hold monitoring of the kidney is accurate within 1.5 mm, allowing gated radiotherapy based on navigator feedback. Navigators are a fast and precise method for monitoring and real-time tracking of anatomical landmarks. As such, they provide direct MRI feedback on anatomical changes for more precise radiation delivery.
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Affiliation(s)
- Mette K Stam
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
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Khokhlova TD, Hwang JH. HIFU for palliative treatment of pancreatic cancer. J Gastrointest Oncol 2012; 2:175-84. [PMID: 22811848 DOI: 10.3978/j.issn.2078-6891.2011.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 07/30/2011] [Indexed: 12/15/2022] Open
Abstract
High intensity focused ultrasound (HIFU) is a novel non-invasive modality for ablation of various solid tumors including uterine fibroids, prostate cancer, hepatic, renal, breast and pancreatic tumors. HIFU therapy utilizes mechanical energy in the form of a powerful ultrasound wave that is focused inside the body to induce thermal and/or mechanical effects in tissue. Multiple preclinical and non-randomized clinical trials have been performed to evaluate the safety and efficacy of HIFU for palliative treatment of pancreatic tumors. Substantial tumor-related pain reduction was achieved in most cases after HIFU treatment, and no significant side-effects were observed. This review provides a description of different physical mechanisms underlying HIFU therapy, summarizes the clinical experience obtained to date in HIFU treatment of pancreatic tumors, and discusses the challenges, limitations and new approaches in this modality.
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Affiliation(s)
- Tatiana D Khokhlova
- Division of Gastroenterology, Department of Medicine, Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
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Nikitin SM, Khokhlova TD, Pelivanov IM. Temperature dependence of the optoacoustic transformation efficiency in ex vivo tissues for application in monitoring thermal therapies. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:061214. [PMID: 22734744 DOI: 10.1117/1.jbo.17.6.061214] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The calibration dependencies of the optoacoustic (OA) transformation efficiency on tissue temperature are obtained for the application in OA temperature monitoring during thermal therapies. Accurate measurement of the OA signal amplitude versus temperature is performed in different ex vivo tissues in the temperature range 25°C to 80°C. The investigated tissues were selected to represent different structural components: chicken breast (skeletal muscle), porcine lard (fatty tissue), and porcine liver (richly perfused tissue). Backward mode of the OA signal detection and a narrow probe laser beam were used in the experiments to avoid the influence of changes in light scattering with tissue coagulation on the OA signal amplitude. Measurements were performed in heating and cooling regimes. Characteristic behavior of the OA signal amplitude temperature dependences in different temperature ranges were described in terms of changes in different structural components of the tissue samples. The accuracy of temperature reconstruction from the obtained calibration dependencies for the investigated tissue types is evaluated.
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Affiliation(s)
- Sergey M Nikitin
- International Laser Center, M.V. Lomonosov Moscow State University, Moscow, Russia
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Crijns SPM, Kok JGM, Lagendijk JJW, Raaymakers BW. Towards MRI-guided linear accelerator control: gating on an MRI accelerator. Phys Med Biol 2011; 56:4815-25. [DOI: 10.1088/0031-9155/56/15/012] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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de Senneville BD, Ries M, Bartels LW, Moonen CTW. MRI-Guided High-Intensity Focused Ultrasound Sonication of Liver and Kidney. INTERVENTIONAL MAGNETIC RESONANCE IMAGING 2011. [DOI: 10.1007/174_2011_394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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