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Mooiweer R, Rogers C, Vidya Shankar R, Razavi R, Neji R, Roujol S. Feasibility of cardiac MR thermometry at 0.55 T. Front Cardiovasc Med 2023; 10:1233065. [PMID: 37859681 PMCID: PMC10584305 DOI: 10.3389/fcvm.2023.1233065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
Radiofrequency catheter ablation is an established treatment strategy for ventricular tachycardia, but remains associated with a low success rate. MR guidance of ventricular tachycardia shows promises to improve the success rate of these procedures, especially due to its potential to provide real-time information on lesion formation using cardiac MR thermometry. Modern low field MRI scanners (<1 T) are of major interest for MR-guided ablations as the potential benefits include lower costs, increased patient access and device compatibility through reduced device-induced imaging artefacts and safety constraints. However, the feasibility of cardiac MR thermometry at low field remains unknown. In this study, we demonstrate the feasibility of cardiac MR thermometry at 0.55 T and characterized its in vivo stability (i.e., precision) using state-of-the-art techniques based on the proton resonance frequency shift method. Nine healthy volunteers were scanned using a cardiac MR thermometry protocol based on single-shot EPI imaging (3 slices in the left ventricle, 150 dynamics, TE = 41 ms). The reconstruction pipeline included image registration to align all the images, multi-baseline approach (look-up-table length = 30) to correct for respiration-induced phase variations, and temporal filtering to reduce noise in temperature maps. The stability of thermometry was defined as the pixel-wise standard deviation of temperature changes over time. Cardiac MR thermometry was successfully acquired in all subjects and the stability averaged across all subjects was 1.8 ± 1.0°C. Without multi-baseline correction, the overall stability was 2.8 ± 1.6°C. In conclusion, cardiac MR thermometry is feasible at 0.55 T and further studies on MR-guided catheter ablations at low field are warranted.
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Affiliation(s)
- Ronald Mooiweer
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | - Charlotte Rogers
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Rohini Vidya Shankar
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
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2
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Mooiweer R, Schneider R, Krafft AJ, Empanger K, Stroup J, Neofytou AP, Mukherjee RK, Williams SE, Lloyd T, O'Neill M, Razavi R, Schaeffter T, Neji R, Roujol S. Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle. Front Cardiovasc Med 2022; 9:971869. [PMID: 36093156 PMCID: PMC9453599 DOI: 10.3389/fcvm.2022.971869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Cardiac MR thermometry shows promise for real-time guidance of radiofrequency ablation of cardiac arrhythmias. This technique uses ECG triggering, which can be unreliable in this situation. A prospective cardiac triggering method was developed for MR thermometry using the active tracking (AT) signal measured from catheter microcoils. In the proposed AT-based cardiac triggering (AT-trig) sequence, AT modules were repeatedly acquired to measure the catheter motion until a cardiac trigger was identified to start cardiac MR thermometry using single-shot echo-planar imaging. The AT signal was bandpass filtered to extract the motion induced by the beating heart, and cardiac triggers were defined as the extremum (peak or valley) of the filtered AT signal. AT-trig was evaluated in a beating heart phantom and in vivo in the left ventricle of a swine during temperature stability experiments (6 locations) and during one ablation. Stability was defined as the standard deviation over time. In the phantom, AT-trig enabled triggering of MR thermometry and resulted in higher temperature stability than an untriggered sequence. In all in vivo experiments, AT-trig intervals matched ECG-derived RR intervals. Mis-triggers were observed in 1/12 AT-trig stability experiments. Comparable stability of MR thermometry was achieved using peak AT-trig (1.0 ± 0.4°C), valley AT-trig (1.1 ± 0.5°C), and ECG triggering (0.9 ± 0.4°C). These experiments show that continuously acquired AT signal for prospective cardiac triggering is feasible. MR thermometry with AT-trig leads to comparable temperature stability as with conventional ECG triggering. AT-trig could serve as an alternative cardiac triggering strategy in situations where ECG triggering is not effective.
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Affiliation(s)
- Ronald Mooiweer
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | | | | | - Katy Empanger
- Imricor Medical Systems, Burnsville, MN, United States
| | - Jason Stroup
- Imricor Medical Systems, Burnsville, MN, United States
| | - Alexander Paul Neofytou
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Rahul K. Mukherjee
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Steven E. Williams
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Tom Lloyd
- Imricor Medical Systems, Burnsville, MN, United States
| | - Mark O'Neill
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Tobias Schaeffter
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig, Germany
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Camberley, United Kingdom
| | - Sébastien Roujol
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
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Zaltieri M, Massaroni C, Cauti FM, Schena E. Techniques for Temperature Monitoring of Myocardial Tissue Undergoing Radiofrequency Ablation Treatments: An Overview. SENSORS (BASEL, SWITZERLAND) 2021; 21:1453. [PMID: 33669692 PMCID: PMC7922285 DOI: 10.3390/s21041453] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 12/18/2022]
Abstract
Cardiac radiofrequency ablation (RFA) has received substantial attention for the treatment of multiple arrhythmias. In this scenario, there is an ever-growing demand for monitoring the temperature trend inside the tissue as it may allow an accurate control of the treatment effects, with a consequent improvement of the clinical outcomes. There are many methods for monitoring temperature in tissues undergoing RFA, which can be divided into invasive and non-invasive. This paper aims to provide an overview of the currently available techniques for temperature detection in this clinical scenario. Firstly, we describe the heat generation during RFA, then we report the principle of work of the most popular thermometric techniques and their features. Finally, we introduce their main applications in the field of cardiac RFA to explore the applicability in clinical settings of each method.
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Affiliation(s)
- Martina Zaltieri
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.)
| | - Carlo Massaroni
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.)
| | - Filippo Maria Cauti
- Arrhythmology Unit, Cardiology Division, S. Giovanni Calibita Hospital, Isola Tiberina, 00186 Rome, Italy;
| | - Emiliano Schena
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Rome, Italy; (M.Z.); (C.M.)
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Kokuryo D, Kumamoto E, Kuroda K. Recent technological advancements in thermometry. Adv Drug Deliv Rev 2020; 163-164:19-39. [PMID: 33217482 DOI: 10.1016/j.addr.2020.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/25/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Thermometry is the key factor for achieving successful thermal therapy. Although invasive thermometry with a probe has been used for more than four decades, this method can only detect the local temperature within the probing volume. Noninvasive temperature imaging using a tomographic technique is ideal for monitoring hot-spot formation in the human body. Among various techniques, such as X-ray computed tomography, microwave tomography, echo sonography, and magnetic resonance (MR) imaging, the proton resonance frequency shift method of MR thermometry is the only method currently available for clinical practice because its temperature sensitivity is consistent in most aqueous tissues and can be easily observed using common clinical scanners. New techniques are being proposed to improve the robustness of this method against tissue motion. MR techniques for fat thermometry were also developed based on relaxation times. One of the latest non-MR techniques to attract attention is photoacoustic imaging.
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Affiliation(s)
- Daisuke Kokuryo
- Graduate School of System Informatics, Kobe University, Japan
| | - Etsuko Kumamoto
- Information Science and Technology Center, Kobe University, Japan
| | - Kagayaki Kuroda
- School of Information Science and Technology, Tokai University, Japan; Center for Frontier Medical Engineering, Chiba University, Japan.
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5
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Ozenne V, Bour P, de Senneville BD, Toupin S, Vaussy A, Lepetit-Coiffé M, Jaïs P, Cochet H, Quesson B. Assessment of left ventricle magnetic resonance temperature stability in patients in the presence of arrhythmias. NMR IN BIOMEDICINE 2019; 32:e4160. [PMID: 31397942 DOI: 10.1002/nbm.4160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Magnetic resonance (MR) thermometry allows visualization of lesion formation in real-time during cardiac radiofrequency (RF) ablation. The present study was performed to evaluate the precision of MR thermometry without RF heating in patients exhibiting cardiac arrhythmia in a clinical setting. The evaluation relied on quantification of changes in temperature measurements caused by noise and physiological motion. METHODS Fourteen patients referred for cardiovascular magnetic resonance imaging underwent an extra sequence to test the temperature mapping stability during free-breathing acquisition. Phase images were acquired using a multi-slice, cardiac-triggered, single-shot echo planar imaging sequence. Temperature maps were calculated and displayed in real-time while the electrocardiogram (ECG) was recorded. The precision of temperature measurement was assessed by measuring the temporal standard deviation and temporal mean of consecutive temperature maps over a period of three minutes. The cardiac cycle was analyzed from ECG recordings to quantify the impact of arrhythmia events on the precision of temperature measurement. Finally, two retrospective strategies were tested to remove acquisition dynamics related either to arrhythmia events or sudden breathing motion. RESULTS ECG synchronization allowed categorization of inter-beat intervals (RR) into distinct beat morphologies. Five patients were in stable sinus rhythm, while nine patients showed irregular RR intervals due to ectopic beats. An average temporal standard deviation of temperature of 1.6°C was observed in patients under sinus rhythm with a frame rate corresponding to the heart rate of the patient. The temporal standard deviation rose to 2.5°C in patients with arrhythmia. The retrospective rejection strategies increased the temperature precision measurement while maintaining a sufficient frame rate. CONCLUSIONS Our results indicated that real-time cardiac MR thermometry shows good precision in patients under clinical conditions, even in the presence of arrhythmia. By providing real-time visualization of temperature distribution within the myocardium during RF delivery, MR thermometry could prevent insufficient or excessive heating and thus improve safety and efficacy.
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Affiliation(s)
- Valéry Ozenne
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Univ. Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | - Pierre Bour
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Univ. Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
| | | | - Solenn Toupin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Univ. Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- Siemens Healthcare France, Saint Denis, France
| | - Alexis Vaussy
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Univ. Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- Siemens Healthcare France, Saint Denis, France
| | | | - Pierre Jaïs
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Hubert Cochet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Bruno Quesson
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France
- Univ. Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, Bordeaux, France
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Schmidt EJ, Halperin HR. MRI use for atrial tissue characterization in arrhythmias and for EP procedure guidance. Int J Cardiovasc Imaging 2018; 34:81-95. [PMID: 28593399 PMCID: PMC5889521 DOI: 10.1007/s10554-017-1179-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/24/2017] [Indexed: 12/19/2022]
Abstract
We review the utilization of magnetic resonance imaging methods for classifying atrial tissue properties that act as a substrate for common cardiac arrhythmias, such as atrial fibrillation. We then review state-of-the-art methods for mapping this substrate as a predicate for treatment, as well as methods used to ablate the electrical pathways that cause arrhythmia and restore patients to sinus rhythm.
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Affiliation(s)
- Ehud J Schmidt
- Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Henry R Halperin
- Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
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Abstract
Quantitative and non-invasive temperature mapping using magnetic resonance imaging (MRI) provides a unique way to measure temperature evolution inside biological tissues. The method is widely used in thermal ablation procedures with magnetic fields at or below 3T. In this paper, the sensitivity of the MRI thermometry at 7T was studied using a proton resonance frequency (PRF)-based technique. We first used an agarose gel phantom with MR-compatible thermometry to calibrate the temperature coefficient, and then this temperature coefficient was employed to measure the internal temperature in both ex vivo (beef muscle) and in vivo (rat) experiments using focused ultrasound heating. The temperature coefficient calibrated by the phantom was 0.0095 ppm/°C, and both the ex vivo and in vivo experiments exhibited clear temperature evolution. This quantitative study confirmed the sensitivity (<1 °C) of MR temperature mapping at 7T.
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Affiliation(s)
- Ping Wang
- Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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8
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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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Ozenne V, Toupin S, Bour P, de Senneville BD, Lepetit-Coiffé M, Boissenin M, Benois-Pineau J, Hansen MS, Inati SJ, Govari A, Jaïs P, Quesson B. Improved cardiac magnetic resonance thermometry and dosimetry for monitoring lesion formation during catheter ablation. Magn Reson Med 2016; 77:673-683. [PMID: 26899165 DOI: 10.1002/mrm.26158] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 01/14/2016] [Accepted: 01/18/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE A new real-time MR-thermometry pipeline was developed to measure multiple temperature images per heartbeat with 1.6×1.6×3 mm3 spatial resolution. The method was evaluated on 10 healthy volunteers and during radiofrequency ablation (RFA) in sheep. METHODS Multislice, electrocardiogram-triggered, echo-planar imaging was combined with parallel imaging, under free breathing conditions. In-plane respiratory motion was corrected on magnitude images by an optical flow algorithm. Motion-related susceptibility artifacts were compensated on phase images by an algorithm based on Principal Component Analysis. Correction of phase drift and temporal filter were included in the pipeline implemented in the Gadgetron framework. Contact electrograms were recorded simultaneously with MR thermometry by an MR-compatible ablation catheter. RESULTS The temporal standard deviation of temperature in the left ventricle remained below 2 °C on each volunteer. In sheep, focal heated regions near the catheter tip were observed on temperature images (maximal temperature increase of 38 °C) during RFA, with contact electrograms of acceptable quality. Thermal lesion dimensions at gross pathology were in agreement with those observed on thermal dose images. CONCLUSION This fully automated MR thermometry pipeline (five images/heartbeat) provides direct assessment of lesion formation in the heart during catheter-based RFA, which may improve treatment of cardiac arrhythmia by ablation. Magn Reson Med 77:673-683, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Valéry Ozenne
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.,Inserm U1045 Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Solenn Toupin
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.,Inserm U1045 Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France.,Siemens Healthcare France, Saint Denis, France
| | - Pierre Bour
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.,Inserm U1045 Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | | | - Manuel Boissenin
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.,Inserm U1045 Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | - Michael S Hansen
- Magnetic Resonance Technology Program, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Souheil J Inati
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pierre Jaïs
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.,Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Bruno Quesson
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.,Inserm U1045 Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
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10
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Carias M, Hynynen K. Combined Therapeutic and Monitoring Ultrasonic Catheter for Cardiac Ablation Therapies. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:196-207. [PMID: 26431798 DOI: 10.1016/j.ultrasmedbio.2015.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/13/2015] [Accepted: 08/19/2015] [Indexed: 06/05/2023]
Abstract
This study evaluated the feasibility of a combined therapeutic and diagnostic ultrasonic catheter for cardiac ablation therapies. Ultrasound can be used to determine when diseased cardiac tissues have become fully coagulated through a method known as local harmonic motion imaging (LHMI). LHMI is an imaging modality for treatment monitoring that uses acoustic radiation force, displacement tracking and the different mechanical properties of viable and ablated tissues. In this study, we developed catheters that are capable of LHMI measurements. Experiments were conducted in phantoms, ex vivo cardiac samples and the in vivo beating hearts of healthy porcine subjects. In vivo experiments revealed that four of four epicardial sonications revealed a decrease in measured displacements from LHMI experiments and that when lower power was used, no lesions formed and there was no corresponding decrease in measured displacement amplitudes. In addition, two of three endocardial lesions were confirmed and corresponded to a decrease in the measured displacement amplitude.
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Affiliation(s)
- Mathew Carias
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
| | - Kullervo Hynynen
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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Volland NA, Kholmovski EG, Parker DL, Hadley JR. Initial feasibility testing of limited field of view magnetic resonance thermometry using a local cardiac radiofrequency coil. Magn Reson Med 2012; 70:994-1004. [PMID: 23165722 DOI: 10.1002/mrm.24534] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 09/27/2012] [Accepted: 09/27/2012] [Indexed: 01/28/2023]
Abstract
The visualization of lesion formation in real time is one potential benefit of carrying out radiofrequency ablation under magnetic resonance (MR) guidance in the treatment of atrial fibrillation. MR thermometry has the potential to detect such lesions. However, performing MR thermometry during cardiac radiofrequency ablation requires high temporal and spatial resolution and a high signal-to-noise ratio. In this study, a local MR coil (2-cm diameter) was developed to investigate the feasibility of performing limited field of view MR thermometry with high accuracy and speed. The local MR coil allowed high-resolution (1 × 1 × 3 mm(3)) image acquisitions in 76.3 ms with a field of view 64 × 32 mm(2) during an open-chest animal experiment. This represents a 4-fold image acquisition acceleration and an 18-fold field of view reduction compared to that achieved using external MR coils. The signal sensitivity achieved using the local coil was over 20 times greater than that achievable using external coils with the same scan parameters. The local coil configuration provided fewer artifacts and sharper and more stable images. These results demonstrate that MR thermometry can be performed in the heart wall and that lesion formation can be observed during radiofrequency ablation procedures in a canine model.
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Affiliation(s)
- Nelly A Volland
- Utah Center for Advanced Imaging Research, Department of Radiology, University of Utah, Salt Lake City, Utah, USA; Comprehensive Arrhythmia Research and Management Center, University of Utah, Salt Lake City, Utah, USA
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