Fast and accurate localization of multiple RF markers for tracking in MRI-guided interventions

Geometrical accuracy of magnetic resonance imaging for ocular proton therapy planning

Background & purpose

Magnetic resonance imaging (MRI) is increasingly used in treatment preparation of ocular proton therapy, but its spatial accuracy might be limited by geometric distortions due to susceptibility artefacts. A correct geometry of the MR images is paramount since it defines where the dose will be delivered. In this study, we assessed the geometrical accuracy of ocular MRI.

Materials & methods

A dedicated ocular 3 T MRI protocol, with localized shimming and increased gradients, was compared to computed tomography (CT) and X-ray images in a phantom and in 15 uveal melanoma patients. The MRI protocol contained three-dimensional T2-weighted and T1-weighted sequences with an isotropic reconstruction resolution of 0.3-0.4 mm. Tantalum clips were identified by three observers and clip-clip distances were compared between T2-weighted and T1-weighted MRI, CT and X-ray images for the phantom and between MRI and X-ray images for the patients.

Results

Interobserver variability was below 0.35 mm for the phantom and 0.30(T1)/0.61(T2) mm in patients. Mean absolute differences between MRI and reference were below 0.27 ± 0.16 mm and 0.32 ± 0.23 mm for the phantom and in patients, respectively. In patients, clip-clip distances were slightly larger on MRI than on X-ray images (mean difference T1: 0.11 ± 0.38 mm, T2: 0.10 ± 0.44 mm). Differences did not increase at larger distances and did not correlate to interobserver variability.

Conclusions

A dedicated ocular MRI protocol can produce images of the eye with a geometrical accuracy below half the MRI acquisition voxel (<0.4 mm). Therefore, these images can be used for ocular proton therapy planning, both in the current model-based workflow and in proposed three-dimensional MR-based workflows.

State of the Art and Future Opportunities in MRI-Guided Robot-Assisted Surgery and Interventions

Magnetic resonance imaging (MRI) can provide high-quality 3-D visualization of target anatomy, surrounding tissue, and instrumentation, but there are significant challenges in harnessing it for effectively guiding interventional procedures. Challenges include the strong static magnetic field, rapidly switching magnetic field gradients, high-power radio frequency pulses, sensitivity to electrical noise, and constrained space to operate within the bore of the scanner. MRI has a number of advantages over other medical imaging modalities, including no ionizing radiation, excellent soft-tissue contrast that allows for visualization of tumors and other features that are not readily visible by other modalities, true 3-D imaging capabilities, including the ability to image arbitrary scan plane geometry or perform volumetric imaging, and capability for multimodality sensing, including diffusion, dynamic contrast, blood flow, blood oxygenation, temperature, and tracking of biomarkers. The use of robotic assistants within the MRI bore, alongside the patient during imaging, enables intraoperative MR imaging (iMRI) to guide a surgical intervention in a closed-loop fashion that can include tracking of tissue deformation and target motion, localization of instrumentation, and monitoring of therapy delivery. With the ever-expanding clinical use of MRI, MRI-compatible robotic systems have been heralded as a new approach to assist interventional procedures to allow physicians to treat patients more accurately and effectively. Deploying robotic systems inside the bore synergizes the visual capability of MRI and the manipulation capability of robotic assistance, resulting in a closed-loop surgery architecture. This article details the challenges and history of robotic systems intended to operate in an MRI environment and outlines promising clinical applications and associated state-of-the-art MRI-compatible robotic systems and technology for making this possible.

Accuracy of collagen fibre estimation under noise using directional MR imaging

In tissues containing significant amounts of organised collagen, such as tendons, ligaments, menisci and articular cartilage, MR imaging exhibits a strong signal intensity variation caused by the angle between the collagen fibres and the magnetic field. By obtaining scans at different field orientations it is possible to determine the unknown fibre orientations and to deduce the underlying tissue microstructure. Our previous work demonstrated how this method can detect ligament injuries and maturity-related changes in collagen fibre structures. Practical application in human diagnostics will demand minimisation of scanning time and likely use of open low-field scanners that can allow re-orienting of the main field. This paper analyses the performance of collage fibre estimation for various image SNR values, and in relation to key parameters including number of scanning directions and parameters of the reconstruction algorithm. The analysis involved Monte Carlo simulation studies which provided benchmark performance measures, and studies using MR images of caprine knee samples with increasing levels of synthetic added noise. Tractography plots in the form of streamlines were performed, and an Alignment Index (AI) was employed as a measure of the detected orientation distribution. The results are highly encouraging, showing high accuracy and robustness even for low image SNR values.

55 Mn-based fiducial markers for rapid and automated RF coil localization for hyperpolarized 13 C MRI

PURPOSE

To use fiducial markers containing manganese 55 to rapidly localize carbon 13 (¹³ C) RF coils for correcting images for B₁ variation.

METHODS

Hollow high-density polyethylene spheres were filled with 3M sodium permanganate and affixed to a rectangular ¹³ C-tuned RF coil. The relative positions of the markers and coil conductors were mapped using CT. Marker positions were measured by MRI using a series of 1D projections and automated peak detection. Once the coil location was determined, coil sensitivity was estimated using a quasi-static calculation. Simulations were performed to determine the minimum number of projections required for robust localization. Phantom experiments were used to confirm the accuracy of marker localization as well as the calculated coil sensitivity. Finally, in vivo validation was performed using hyperpolarized ¹³ C pyruvate in a rat model.

RESULTS

In simulations, our algorithm was accurate in determining marker positions when at least 6 projections were used (RMSE 1.4 ± 0.9 mm). These estimates were verified in phantom experiments, where markers locations were determined with an RMS accuracy of 1.3 mm. A minimum SNR of 4 was required for automated detection to perform accurately. Computed coil sensitivity had a median error of 17% when taken over the entire measured area and 5.7% over a central region. In a rat, correction for nonuniform reception and flip angle was able to normalize the signals arising from asymmetrically positioned kidneys.

CONCLUSION

Manganese 55 fiducial markers are an inexpensive and reliable method for rapidly localizing ¹³ C RF coils and correcting ¹³ C images for B₁ variation without user intervention.

Detection of maturity and ligament injury using magic angle directional imaging

PURPOSE

To investigate whether magnetic field-related anisotropies of collagen may be correlated with postmortem findings in animal models.

METHODS

Optimized scan planning and new MRI data-processing methods were proposed and analyzed using Monte Carlo simulations. Six caprine and 10 canine knees were scanned at various orientations to the main magnetic field. Image intensities in segmented voxels were used to compute the orientation vectors of the collagen fibers. Vector field and tractography plots were computed. The Alignment Index was defined as a measure of orientation distribution. The knees were subsequently assessed by a specialist orthopedic veterinarian, who gave a pathological diagnosis after having dissected and photographed the joints.

RESULTS

Using 50% less scans than reported previously can lead to robust calculation of fiber orientations in the presence of noise, with much higher accuracy. The 6 caprine knees were found to range from very immature (< 3 months) to very mature (> 3 years). Mature specimens exhibited significantly more aligned collagen fibers in their patella tendons compared with the immature ones. In 2 of the 10 canine knees scanned, partial cranial caudal ligament tears were identified from MRI and subsequently confirmed with encouragingly high consistency of tractography, Alignment Index, and dissection results.

CONCLUSION

This method can be used to detect injury such as partial ligament tears, and to visualize maturity-related changes in the collagen structure of tendons. It can provide the basis for new, noninvasive diagnostic tools in combination with new scanner configurations that allow less-restricted field orientations.

Effect of coating thickness of iron oxide nanoparticles on their relaxivity in the MRI

OBJECTIVES

Iron oxide nanoparticles have found prevalent applications in various fields including drug delivery, cell separation and as contrast agents. Super paramagnetic iron oxide (SPIO) nanoparticles allow researchers and clinicians to enhance the tissue contrast of an area of interest by increasing the relaxation rate of water. In this study, we evaluate the dependency of hydrodynamic size of iron oxide nanoparticles coated with Polyethylene glycol (PEG) on their relativities with 3 Tesla clinical MRI.

MATERIALS AND METHODS

We used three groups of nanoparticles with nominal sizes 20, 50 and 100 nm with a core size of 8.86 nm, 8.69 nm and 10.4 nm that they were covered with PEG 300 and 600 Da. A clinical magnetic resonance scanner determines the T1 and T2 relaxation times for various concentrations of PEG-coated nanoparticles.

RESULTS

The size measurement by photon correlation spectroscopy showed the hydrodynamic sizes of MNPs with nominal 20, 50 and 100 nm with 70, 82 and 116 nm for particles with PEG 600 coating and 74, 93 and 100 nm for particles with PEG 300 coating, respectively. We foud that the relaxivity decreased with increasing overall particle size (via coating thickness). Magnetic resonance imaging showed that by increasing the size of the nanoparticles, r2/r1 increases linearly.

CONCLUSION

According to the data obtained from this study it can be concluded that increments in coating thickness have more influence on relaxivities compared to the changes in core size of magnetic nanoparticles.