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Marhabaie S, Delcey M, El Hamrani D, Vaillant F, Ginefri JC, Ozenne V, Abell E, Poirier-Quinot M, Quesson B. Remotely detuned receiver coil for high-resolution interventional cardiac magnetic resonance imaging. Front Cardiovasc Med 2023; 10:1249572. [PMID: 38028485 PMCID: PMC10643167 DOI: 10.3389/fcvm.2023.1249572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Interventional cardiac MRI in the context of the treatment of cardiac arrhythmia requires submillimeter image resolution to precisely characterize the cardiac substrate and guide the catheter-based ablation procedure in real-time. Conventional MRI receiver coils positioned on the thorax provide insufficient signal-to-noise ratio (SNR) and spatial selectivity to satisfy these constraints. Methods A small circular MRI receiver coil was developed and evaluated under different experimental conditions, including high-resolution MRI anatomical and thermometric imaging at 1.5 T. From the perspective of developing a therapeutic MR-compatible catheter equipped with a receiver coil, we also propose alternative remote active detuning techniques of the receiver coil using one or two cables. Theoretical details are presented, as well as simulations and experimental validation. Results Anatomical images of the left ventricle at 170 µm in-plane resolution are provided on ex vivo beating heart from swine using a 2 cm circular receiver coil. Taking advantage of the increase of SNR at its vicinity (up to 35 fold compared to conventional receiver coils), real-time MR-temperature imaging can reach an uncertainty below 0.1°C at the submillimetric spatial resolution. Remote active detuning using two cables has similar decoupling efficiency to conventional on-site decoupling, at the cost of an acceptable decrease in the resulting SNR. Discussion This study shows the potential of small dimension surface coils for minimally invasive therapy of cardiac arrhythmia intraoperatively guided by MRI. The proposed remote decoupling approaches may simplify the construction process and reduce the cost of such single-use devices.
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Affiliation(s)
- Sina Marhabaie
- Laboratoire D'Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CNRS, Inserm, Orsay, France
| | - Marylène Delcey
- Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux, France
- Siemens Healthineers, Saint-Denis, France
| | | | - Fanny Vaillant
- Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux, France
| | - Jean-Christophe Ginefri
- Laboratoire D'Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CNRS, Inserm, Orsay, France
| | - Valéry Ozenne
- Univ. Bordeaux, CNRS, CRMSB, UMR 5536, IHU Liryc, Bordeaux, France
| | - Emma Abell
- Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux, France
| | - Marie Poirier-Quinot
- Laboratoire D'Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CNRS, Inserm, Orsay, France
| | - Bruno Quesson
- Univ. Bordeaux, CNRS, CRMSB, UMR 5536, IHU Liryc, Bordeaux, France
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2
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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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3
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Real-time automatic temperature regulation during in vivo MRI-guided laser-induced thermotherapy (MR-LITT). Sci Rep 2023; 13:3279. [PMID: 36841878 PMCID: PMC9968334 DOI: 10.1038/s41598-023-29818-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/10/2023] [Indexed: 02/27/2023] Open
Abstract
Precise control of tissue temperature during Laser-Induced Thermotherapy (LITT) procedures has the potential to improve the clinical efficiency and safety of such minimally invasive therapies. We present a method to automatically regulate in vivo the temperature increase during LITT using real-time rapid volumetric Magnetic Resonance thermometry (8 slices acquired every second, with an in-plane resolution of 1.4 mmx1.4 mm and a slice thickness of 3 mm) using the proton-resonance frequency (PRF) shift technique. The laser output power is adjusted every second using a feedback control algorithm (proportional-integral-derivative controller) to force maximal tissue temperature in the targeted region to follow a predefined temperature-time profile. The root-mean-square of the difference between the target temperature and the measured temperature ranged between 0.5 °C and 1.4 °C, for temperature increases between + 5 °C to + 30 °C above body temperature and a long heating duration (up to 15 min), showing excellent accuracy and stability of the method. These results were obtained on a 1.5 T clinical MRI scanner, showing a potential immediate clinical application of such a temperature controller during MR-guided LITT.
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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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5
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Continuous cardiac thermometry via simultaneous catheter tracking and undersampled radial golden angle acquisition for radiofrequency ablation monitoring. Sci Rep 2022; 12:4006. [PMID: 35256627 PMCID: PMC8901729 DOI: 10.1038/s41598-022-06927-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/24/2022] [Indexed: 01/18/2023] Open
Abstract
The complexity of the MRI protocol is one of the factors limiting the clinical adoption of MR temperature mapping for real-time monitoring of cardiac ablation procedures and a push-button solution would ease its use. Continuous gradient echo golden angle radial acquisition combined with intra-scan motion correction and undersampled temperature determination could be a robust and more user-friendly alternative than the ultrafast GRE-EPI sequence which suffers from sensitivity to magnetic field susceptibility artifacts and requires ECG-gating. The goal of this proof-of-concept work is to establish the temperature uncertainty as well as the spatial and temporal resolutions achievable in an Agar-gel phantom and in vivo using this method. GRE radial golden angle acquisitions were used to monitor RF ablations in a phantom and in vivo in two sheep hearts with different slice orientations. In each case, 2D rigid motion correction based on catheter micro-coil signal, tracking its motion, was performed and its impact on the temperature imaging was assessed. The temperature uncertainty was determined for three spatial resolutions (1 × 1 × 3 mm3, 2 × 2 × 3 mm3, and 3 × 3 × 3 mm3) and three temporal resolutions (0.48, 0.72, and 0.97 s) with undersampling acceleration factors ranging from 2 to 17. The combination of radial golden angle GRE acquisition, simultaneous catheter tracking, intra-scan 2D motion correction, and undersampled thermometry enabled temperature monitoring in the myocardium in vivo during RF ablations with high temporal (< 1 s) and high spatial resolution. The temperature uncertainty ranged from 0.2 ± 0.1 to 1.8 ± 0.2 °C for the various temporal and spatial resolutions and, on average, remained superior to the uncertainty of an EPI acquisition while still allowing clinical monitoring of the RF ablation process. The proposed method is a robust and promising alternative to EPI acquisition to monitor in vivo RF cardiac ablations. Further studies remain required to improve the temperature uncertainty and establish its clinical applicability.
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Blackwell J, Kraśny MJ, O'Brien A, Ashkan K, Galligan J, Destrade M, Colgan N. Proton Resonance Frequency Shift Thermometry: A Review of Modern Clinical Practices. J Magn Reson Imaging 2020; 55:389-403. [PMID: 33217099 DOI: 10.1002/jmri.27446] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 12/22/2022] Open
Abstract
Magnetic resonance imaging (MRI) has become a popular modality in guiding minimally invasive thermal therapies, due to its advanced, nonionizing, imaging capabilities and its ability to record changes in temperature. A variety of MR thermometry techniques have been developed over the years, and proton resonance frequency (PRF) shift thermometry is the current clinical gold standard to treat a variety of cancers. It is used extensively to guide hyperthermic thermal ablation techniques such as high-intensity focused ultrasound (HIFU) and laser-induced thermal therapy (LITT). Essential attributes of PRF shift thermometry include excellent linearity with temperature, good sensitivity, and independence from tissue type. This noninvasive temperature mapping method gives accurate quantitative measures of the temperature evolution inside biological tissues. In this review, the current status and new developments in the fields of MR-guided HIFU and LITT are presented with an emphasis on breast, prostate, bone, uterine, and brain treatments. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- James Blackwell
- Advanced Biological Imaging Laboratory, School of Physics, National University of Ireland Galway, Galway, Ireland.,School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Marcin J Kraśny
- Advanced Biological Imaging Laboratory, School of Physics, National University of Ireland Galway, Galway, Ireland
| | - Aoife O'Brien
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Keyoumars Ashkan
- Neurosurgical Department, King's College Hospital Foundation Trust, London, UK.,Harley Street Clinic, London Neurosurgery Partnership, London, UK
| | - Josette Galligan
- Department of Medical Physics and Bioengineering, St. James' Hospital, Dublin, Ireland
| | - Michel Destrade
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Niall Colgan
- Advanced Biological Imaging Laboratory, School of Physics, National University of Ireland Galway, Galway, Ireland
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7
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De Landro M, Ianniello J, Yon M, Wolf A, Quesson B, Schena E, Saccomandi P. Fiber Bragg Grating Sensors for Performance Evaluation of Fast Magnetic Resonance Thermometry on Synthetic Phantom. SENSORS 2020; 20:s20226468. [PMID: 33198326 PMCID: PMC7696215 DOI: 10.3390/s20226468] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/07/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022]
Abstract
The increasing recognition of minimally invasive thermal treatment of tumors motivate the development of accurate thermometry approaches for guaranteeing the therapeutic efficacy and safety. Magnetic Resonance Thermometry Imaging (MRTI) is nowadays considered the gold-standard in thermometry for tumor thermal therapy, and assessment of its performances is required for clinical applications. This study evaluates the accuracy of fast MRTI on a synthetic phantom, using dense ultra-short Fiber Bragg Grating (FBG) array, as a reference. Fast MRTI is achieved with a multi-slice gradient-echo echo-planar imaging (GRE-EPI) sequence, allowing monitoring the temperature increase induced with a 980 nm laser source. The temperature distributions measured with 1 mm-spatial resolution with both FBGs and MRTI were compared. The root mean squared error (RMSE) value obtained by comparing temperature profiles showed a maximum error of 1.2 °C. The Bland-Altman analysis revealed a mean of difference of 0.1 °C and limits of agreement 1.5/−1.3 °C. FBG sensors allowed to extensively assess the performances of the GRE-EPI sequence, in addition to the information on the MRTI precision estimated by considering the signal-to-noise ratio of the images (0.4 °C). Overall, the results obtained for the GRE-EPI fully satisfy the accuracy (~2 °C) required for proper temperature monitoring during thermal therapies.
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Affiliation(s)
- Martina De Landro
- Department of Mechanical Engineering, Politecnico di Milano, via Giuseppe La Masa 1, 20156 Milan, Italy;
- Correspondence: ; Tel.: +39-02-2399-8571
| | - Jacopo Ianniello
- Unit of Measurements and Biomedical Instrumentation, Departmental Faculty of Engineering, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy; (J.I.); (E.S.)
| | - Maxime Yon
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Avenue du Haut Lévêque, 33600 Pessac, France; (M.Y.); (B.Q.)
| | - Alexey Wolf
- Laboratory of Fiber Optics, Institute of Automation and Electrometry of the SB RAS, 1 Acad. Koptyug Ave., 630090 Novosibirsk, Russia;
| | - Bruno Quesson
- Institut Hospitalo-Universitaire, Liryc Institut de Rythmologie et Modélisation Cardiaque, Avenue du Haut Lévêque, 33600 Pessac, France; (M.Y.); (B.Q.)
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Departmental Faculty of Engineering, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy; (J.I.); (E.S.)
| | - Paola Saccomandi
- Department of Mechanical Engineering, Politecnico di Milano, via Giuseppe La Masa 1, 20156 Milan, Italy;
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