1
|
Wu Q, Xia Y, Xiong X, Duan X, Pang X, Zhang F, Tang S, Su J, Wen S, Mei L, Cannon RD, Ji P, Ou Z. Focused ultrasound-mediated small-molecule delivery to potentiate immune checkpoint blockade in solid tumors. Front Pharmacol 2023; 14:1169608. [PMID: 37180717 PMCID: PMC10173311 DOI: 10.3389/fphar.2023.1169608] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
In the last decade, immune checkpoint blockade (ICB) has revolutionized the standard of treatment for solid tumors. Despite success in several immunogenic tumor types evidenced by improved survival, ICB remains largely unresponsive, especially in "cold tumors" with poor lymphocyte infiltration. In addition, side effects such as immune-related adverse events (irAEs) are also obstacles for the clinical translation of ICB. Recent studies have shown that focused ultrasound (FUS), a non-invasive technology proven to be effective and safe for tumor treatment in clinical settings, could boost the therapeutic effect of ICB while alleviating the potential side effects. Most importantly, the application of FUS to ultrasound-sensitive small particles, such as microbubbles (MBs) or nanoparticles (NPs), allows for precise delivery and release of genetic materials, catalysts and chemotherapeutic agents to tumor sites, thus enhancing the anti-tumor effects of ICB while minimizing toxicity. In this review, we provide an updated overview of the progress made in recent years concerning ICB therapy assisted by FUS-controlled small-molecule delivery systems. We highlight the value of different FUS-augmented small-molecules delivery systems to ICB and describe the synergetic effects and underlying mechanisms of these combination strategies. Furthermore, we discuss the limitations of the current strategies and the possible ways that FUS-mediated small-molecule delivery systems could boost novel personalized ICB treatments for solid tumors.
Collapse
Affiliation(s)
- Qiuyu Wu
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
| | - Yuanhang Xia
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
| | - Xiaohe Xiong
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
| | - Xinxing Duan
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xiaoxiao Pang
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Fugui Zhang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Song Tang
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
| | - Junlei Su
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
| | - Shuqiong Wen
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
| | - Li Mei
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Richard D. Cannon
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ping Ji
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Ping Ji, Zhanpeng Ou,
| | - Zhanpeng Ou
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Ping Ji, Zhanpeng Ou,
| |
Collapse
|
2
|
VilasBoas-Ribeiro I, Nouwens SAN, Curto S, Jager BD, Franckena M, van Rhoon GC, Heemels WPMH, Paulides MM. POD-Kalman filtering for improving noninvasive 3D temperature monitoring in MR-guided hyperthermia. Med Phys 2022; 49:4955-4970. [PMID: 35717578 PMCID: PMC9545729 DOI: 10.1002/mp.15811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 12/21/2022] Open
Abstract
Background During resonance frequency (RF) hyperthermia treatment, the temperature of the tumor tissue is elevated to the range of 39–44°C. Accurate temperature monitoring is essential to guide treatments and ensure precise heat delivery and treatment quality. Magnetic resonance (MR) thermometry is currently the only clinical method to measure temperature noninvasively in a volume during treatment. However, several studies have shown that this approach is not always sufficiently accurate for thermal dosimetry in areas with motion, such as the pelvic region. Model‐based temperature estimation is a promising approach to correct and supplement 3D online temperature estimation in regions where MR thermometry is unreliable or cannot be measured. However, complete 3D temperature modeling of the pelvic region is too complex for online usage. Purpose This study aimed to evaluate the use of proper orthogonal decomposition (POD) model reduction combined with Kalman filtering to improve temperature estimation using MR thermometry. Furthermore, we assessed the benefit of this method using data from hyperthermia treatment where there were limited and unreliable MR thermometry measurements. Methods The performance of POD–Kalman filtering was evaluated in several heating experiments and for data from patients treated for locally advanced cervical cancer. For each method, we evaluated the mean absolute error (MAE) concerning the temperature measurements acquired by the thermal probes, and we assessed the reproducibility and consistency using the standard deviation of error (SDE). Furthermore, three patient groups were defined according to susceptibility artifacts caused by the level of intestinal gas motion to assess if the POD–Kalman filtering could compensate for missing and unreliable MR thermometry measurements. Results First, we showed that this method is beneficial and reproducible in phantom experiments. Second, we demonstrated that the combined method improved the match between temperature prediction and temperature acquired by intraluminal thermometry for patients treated for locally advanced cervical cancer. Considering all patients, the POD–Kalman filter improved MAE by 43% (filtered MR thermometry = 1.29°C, POD–Kalman filtered temperature = 0.74°C). Moreover, the SDE was improved by 47% (filtered MR thermometry = 1.16°C, POD–Kalman filtered temperature = 0.61°C). Specifically, the POD–Kalman filter reduced the MAE by approximately 60% in patients whose MR thermometry was unreliable because of the great amount of susceptibilities caused by the high level of intestinal gas motion. Conclusions We showed that the POD–Kalman filter significantly improved the accuracy of temperature monitoring compared to MR thermometry in heating experiments and hyperthermia treatments. The results demonstrated that POD–Kalman filtering can improve thermal dosimetry during RF hyperthermia treatment, especially when MR thermometry is inaccurate.
Collapse
Affiliation(s)
- Iva VilasBoas-Ribeiro
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sven A N Nouwens
- Control System Technology Group, Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Bram de Jager
- Control System Technology Group, Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Martine Franckena
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Gerard C van Rhoon
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Radiation Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - W P M H Heemels
- Control System Technology Group, Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Margarethus M Paulides
- Department of Radiotherapy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Care and Cure Research Lab (EM-4C&C) of the Electromagnetics Group, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| |
Collapse
|
3
|
Le Guevelou J, Chirila ME, Achard V, Guillemin PC, Lorton O, Uiterwijk JWE, Dipasquale G, Salomir R, Zilli T. Combined hyperthermia and radiotherapy for prostate cancer: a systematic review. Int J Hyperthermia 2022; 39:547-556. [PMID: 35313781 DOI: 10.1080/02656736.2022.2053212] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Optimization of treatment strategies for prostate cancer patients treated with curative radiation therapy (RT) represents one of the major challenges for the radiation oncologist. Dose escalation or combination of RT with systemic therapies is used to improve tumor control in patients with unfavorable prostate cancer, at the risk of increasing rates and severity of treatment-related toxicities. Elevation of temperature to a supra-physiological level has been shown to both increase tumor oxygenation and reduce DNA repair capabilities. Thus, hyperthermia (HT) combined with RT represents a compelling treatment strategy to improve the therapeutic ratio in prostate cancer patients. The aim of the present systematic review is to report on preclinical and clinical evidence supporting the combination of HT and RT for prostate cancer, discussing future applications and developments of this combined treatment.
Collapse
Affiliation(s)
- Jennifer Le Guevelou
- Division of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Monica Emilia Chirila
- Division of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.,Amethyst Radiotherapy Centre, Cluj-Napoca, Romania
| | - Vérane Achard
- Division of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | | | - Orane Lorton
- Department of Radiology and Medical Informatics, Geneva University Hospital, Geneva, Switzerland
| | | | - Giovanna Dipasquale
- Division of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Rares Salomir
- Faculty of Medicine, Geneva University, Geneva, Switzerland.,Department of Radiology and Medical Informatics, Geneva University Hospital, Geneva, Switzerland
| | - Thomas Zilli
- Division of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| |
Collapse
|
4
|
Chen J, Nan Z, Zhao Y, Zhang L, Zhu H, Wu D, Zong Y, Lu M, Ilovitsh T, Wan M, Yan K, Feng Y. Enhanced HIFU Theranostics with Dual-Frequency-Ring Focused Ultrasound and Activatable Perfluoropentane-Loaded Polymer Nanoparticles. MICROMACHINES 2021; 12:mi12111324. [PMID: 34832737 PMCID: PMC8621746 DOI: 10.3390/mi12111324] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023]
Abstract
High-intensity focused ultrasound (HIFU) has been widely used in tumor ablation in clinical settings. Meanwhile, there is great potential to increase the therapeutic efficiency of temporary cavitation due to enhanced thermal effects and combined mechanical effects from nonlinear vibration and collapse of the microbubbles. In this study, dual-frequency (1.1 and 5 MHz) HIFU was used to produce acoustic droplet vaporization (ADV) microbubbles from activatable perfluoropentane-loaded polymer nanoparticles (PFP@Polymer NPs), which increased the therapeutic outcome of the HIFU and helped realize tumor theranostics with ultrasound contrast imaging. Combined with PFP@Polymer NPs, dual-frequency HIFU changed the shape of the damage lesion and reduced the acoustic intensity threshold of thermal damage significantly, from 216.86 to 62.38 W/cm2. It produced a nearly 20 °C temperature increase in half the irradiation time and exhibited a higher tumor inhibition rate (84.5% ± 3.4%) at a low acoustic intensity (1.1 MHz: 23.77 W/cm2; 5 MHz: 0.35 W/cm2) in vitro than the single-frequency HIFU (60.2% ± 11.9%). Moreover, compared with the traditional PFP@BSA NDs, PFP@Polymer NPs showed higher anti-tumor efficacy (81.13% vs. 69.34%; * p < 0.05) and better contrast-enhanced ultrasound (CEUS) imaging ability (gray value of 57.53 vs. 30.67; **** p < 0.0001), probably benefitting from its uniform and stable structure. It showed potential as a highly efficient tumor theranostics approach based on dual-frequency HIFU and activatable PFP@Polymer NPs.
Collapse
Affiliation(s)
- Junjie Chen
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Zhezhu Nan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Yubo Zhao
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Lei Zhang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Hongrui Zhu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Daocheng Wu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Yujin Zong
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Mingzhu Lu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Tali Ilovitsh
- Department of Biomedical Engineering, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Mingxi Wan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
| | - Kai Yan
- College of Bioresources Chemical and Materials Engineering, Shaanxi University of Science and Technology, Xi’an 710021, China
- Correspondence: (K.Y.); (Y.F.)
| | - Yi Feng
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi′an Jiaotong University, Xi′an 710049, China; (J.C.); (Z.N.); (Y.Z.); (L.Z.); (H.Z.); (D.W.); (Y.Z.); (M.L.); (M.W.)
- Correspondence: (K.Y.); (Y.F.)
| |
Collapse
|
5
|
Wu M, Mulder HT, Baron P, Coello E, Menzel MI, van Rhoon GC, Haase A. Correction of motion-induced susceptibility artifacts and B 0 drift during proton resonance frequency shift-based MR thermometry in the pelvis with background field removal methods. Magn Reson Med 2020; 84:2495-2511. [PMID: 32367530 PMCID: PMC7402020 DOI: 10.1002/mrm.28302] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022]
Abstract
Purpose The linear change of the water proton resonance frequency shift (PRFS) with temperature is used to monitor temperature change based on the temporal difference of image phase. Here, the effect of motion‐induced susceptibility artifacts on the phase difference was studied in the context of mild radio frequency hyperthermia in the pelvis. Methods First, the respiratory‐induced field variations were disentangled from digestive gas motion in the pelvis. The projection onto dipole fields (PDF) as well as the Laplacian boundary value (LBV) algorithm were applied on the phase difference data to eliminate motion‐induced susceptibility artifacts. Both background field removal (BFR) algorithms were studied using simulations of susceptibility artifacts, a phantom heating experiment, and volunteer and patient heating data. Results Respiratory‐induced field variations were negligible in the presence of the filled water bolus. Even though LBV and PDF showed comparable results for most data, LBV seemed more robust in our data sets. Some data sets suggested that PDF tends to overestimate the background field, thus removing phase attributed to temperature. The BFR methods even corrected for susceptibility variations induced by a subvoxel displacement of the phantom. The method yielded successful artifact correction in 2 out of 4 patient treatment data sets during the entire treatment duration of mild RF heating of cervical cancer. The heating pattern corresponded well with temperature probe data. Conclusion The application of background field removal methods in PRFS‐based MR thermometry has great potential in various heating applications and body regions to reduce motion‐induced susceptibility artifacts that originate outside the region of interest, while conserving temperature‐induced PRFS. In addition, BFR automatically removes up to a first‐order spatial B0 drift.
Collapse
Affiliation(s)
- Mingming Wu
- Munich School of Bioengineering, TUM Department of Physics, Technical University of Munich, Garching, Germany
| | | | - Paul Baron
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Eduardo Coello
- Munich School of Bioengineering, TUM Department of Physics, Technical University of Munich, Garching, Germany.,GE Healthcare, Munich, Germany
| | | | | | - Axel Haase
- Munich School of Bioengineering, TUM Department of Physics, Technical University of Munich, Garching, Germany
| |
Collapse
|
6
|
Bing C, Cheng B, Staruch RM, Nofiele J, Wodzak Staruch M, Szczepanski D, Farrow-Gillespie A, Yang A, Laetsch TW, Chopra R. Breath-hold MR-HIFU hyperthermia: phantom and in vivo feasibility. Int J Hyperthermia 2020; 36:1084-1097. [PMID: 31707872 DOI: 10.1080/02656736.2019.1679893] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [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.
Collapse
Affiliation(s)
- Chenchen Bing
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bingbing Cheng
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robert M Staruch
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Clinical Sites Research Program, Philips Research North America, Cambridge, MA, USA
| | - Joris Nofiele
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Debra Szczepanski
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alan Farrow-Gillespie
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Adeline Yang
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Theodore W Laetsch
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Pauline Allen Gill Center for Cancer and Blood Disorders, Children's Health, Dallas, TX, USA
| | - Rajiv Chopra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
7
|
Mougenot C, Moonen C. Magnetic Resonance-guided High Intensity Focused Ultrasound in the presence of biopsy markers. J Ther Ultrasound 2017; 5:25. [PMID: 28944056 PMCID: PMC5607585 DOI: 10.1186/s40349-017-0103-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/08/2017] [Indexed: 01/31/2023] Open
Abstract
Background Magnetic Resonance guided High Intensity Focused ultrasound (MR-HIFU) offers precise non-invasive thermotherapy for clinical applications such as the treatment of breast lesions. However, patients with a biopsy marker are usually not eligible for MR-HIFU treatment. This study investigates the interaction of some MR-compatible markers with MR-HIFU thermotherapy. Methods The MR-HIFU compatibility of 14 markers (6 Gold Anchor and 4 Visicoil markers in gold, 1 Visicoil marker in brass, 3 BiomarC markers in carbon coated) were tested using the Sonalleve breast MR-HIFU platform at 1.5 T. The impact of these markers was assessed by counting the number of voxels with low signal intensity on MR thermal maps and by comparing temperature increases induced by the HIFU beam. Results Most markers were visible on thermal maps with an apparent size 4.2 ± 3.1 and 2 ± 1.8 times larger than their respective actual width and length. The volume of masked voxels was for most of the markers much larger than the actual volume of the marker (up to a factor 65.1). However, it represents only a small fraction of the 12 mm diameter targeted region (up to 8.8 voxels which represents 19% of this targeted region). Some differences in the maximal temperature increase were observed especially for BiomarC 1 × 3 and BiomarC 2 × 4 markers enhancing the heating. These differences were less pronounced at the edge of the targeted region. Conclusion All markers had a minimal impact on the volume above the thermal dose threshold of 240 EM since the differences measured were smaller than the in-plane image resolution of 1.56 mm.
Collapse
Affiliation(s)
- Charles Mougenot
- University Medical Center Utrecht, Heidelberglaan 100, Room Q03.4.21, 3584 CX Utrecht, The Netherlands
| | - Chrit Moonen
- University Medical Center Utrecht, Heidelberglaan 100, Room Q03.4.21, 3584 CX Utrecht, The Netherlands
| |
Collapse
|
8
|
Dillon CR, Rieke V, Ghanouni P, Payne A. Thermal diffusivity and perfusion constants from in vivo MR-guided focussed ultrasound treatments: a feasibility study. Int J Hyperthermia 2017; 34:352-362. [DOI: 10.1080/02656736.2017.1340677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Christopher R. Dillon
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Viola Rieke
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA
| | - Pejman Ghanouni
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Allison Payne
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
9
|
Zhang Y, Chen S, Deng K, Chen B, Wei X, Yang J, Wang S, Ying K. Kalman Filtered Bio Heat Transfer Model Based Self-adaptive Hybrid Magnetic Resonance Thermometry. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:194-202. [PMID: 27552745 DOI: 10.1109/tmi.2016.2601440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
To develop a self-adaptive and fast thermometry method by combining the original hybrid magnetic resonance thermometry method and the bio heat transfer equation (BHTE) model. The proposed Kalman filtered Bio Heat Transfer Model Based Self-adaptive Hybrid Magnetic Resonance Thermometry, abbreviated as KalBHT hybrid method, introduced the BHTE model to synthesize a window on the regularization term of the hybrid algorithm, which leads to a self-adaptive regularization both spatially and temporally with change of temperature. Further, to decrease the sensitivity to accuracy of the BHTE model, Kalman filter is utilized to update the window at each iteration time. To investigate the effect of the proposed model, computer heating simulation, phantom microwave heating experiment and dynamic in-vivo model validation of liver and thoracic tumor were conducted in this study. The heating simulation indicates that the KalBHT hybrid algorithm achieves more accurate results without adjusting λ to a proper value in comparison to the hybrid algorithm. The results of the phantom heating experiment illustrate that the proposed model is able to follow temperature changes in the presence of motion and the temperature estimated also shows less noise in the background and surrounding the hot spot. The dynamic in-vivo model validation with heating simulation demonstrates that the proposed model has a higher convergence rate, more robustness to susceptibility problem surrounding the hot spot and more accuracy of temperature estimation. In the healthy liver experiment with heating simulation, the RMSE of the hot spot of the proposed model is reduced to about 50% compared to the RMSE of the original hybrid model and the convergence time becomes only about one fifth of the hybrid model. The proposed model is able to improve the accuracy of the original hybrid algorithm and accelerate the convergence rate of MR temperature estimation.
Collapse
|
10
|
Schooneveldt G, Bakker A, Balidemaj E, Chopra R, Crezee J, Geijsen ED, Hartmann J, Hulshof MC, Kok HP, Paulides MM, Sousa-Escandon A, Stauffer PR, Maccarini PF. Thermal dosimetry for bladder hyperthermia treatment. An overview. Int J Hyperthermia 2016; 32:417-33. [DOI: 10.3109/02656736.2016.1156170] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
11
|
Zachiu C, Denis de Senneville B, Moonen C, Ries M. A framework for the correction of slow physiological drifts during MR-guided HIFU therapies: Proof of concept. Med Phys 2016; 42:4137-48. [PMID: 26133614 DOI: 10.1118/1.4922403] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE While respiratory motion compensation for magnetic resonance (MR)-guided high intensity focused ultrasound (HIFU) interventions has been extensively studied, the influence of slow physiological motion due to, for example, peristaltic activity, has so far been largely neglected. During lengthy interventions, the magnitude of the latter can exceed acceptable therapeutic margins. The goal of the present study is to exploit the episodic workflow of these therapies to implement a motion correction strategy for slow varying drifts of the target area and organs at risk over the entire duration of the intervention. METHODS The therapeutic workflow of a MR-guided HIFU intervention is in practice often episodic: Bursts of energy delivery are interleaved with periods of inactivity, allowing the effects of the beam on healthy tissues to recede and/or during which the plan of the intervention is reoptimized. These periods usually last for at least several minutes. It is at this time scale that organ drifts due to slow physiological motion become significant. In order to capture these drifts, the authors propose the integration of 3D MR scans in the therapy workflow during the inactivity intervals. Displacements were estimated using an optical flow algorithm applied on the 3D acquired images. A preliminary study was conducted on ten healthy volunteers. For each volunteer, 3D MR images of the abdomen were acquired at regular intervals of 10 min over a total duration of 80 min. Motion analysis was restricted to the liver and kidneys. For validating the compatibility of the proposed motion correction strategy with the workflow of a MR-guided HIFU therapy, an in vivo experiment on a porcine liver was conducted. A volumetric HIFU ablation was completed over a time span of 2 h. A 3D image was acquired before the first sonication, as well as after each sonication. RESULTS Following the volunteer study, drifts larger than 8 mm for the liver and 5 mm for the kidneys prove that slow physiological motion can exceed acceptable therapeutic margins. In the animal experiment, motion tracking revealed an initial shift of up to 4 mm during the first 10 min and a subsequent continuous shift of ∼2 mm/h until the end of the intervention. This leads to a continuously increasing mismatch of the initial shot planning, the thermal dose measurements, and the true underlying anatomy. The estimated displacements allowed correcting the planned sonication cell cluster positions to the true target position, as well as the thermal dose estimates during the entire intervention and to correct the nonperfused volume measurement. A spatial coherence of all three is particularly important to assure a confluent ablation volume and to prevent remaining islets of viable malignant tissue. CONCLUSIONS This study proposes a motion correction strategy for displacements resulting from slowly varying physiological motion that might occur during a MR-guided HIFU intervention. The authors have shown that such drifts can lead to a misalignment between interventional planning, energy delivery, and therapeutic validation. The presented volunteer study and in vivo experiment demonstrate both the relevance of the problem for HIFU therapies and the compatibility of the proposed motion compensation framework with the workflow of a HIFU intervention under clinical conditions.
Collapse
Affiliation(s)
- Cornel Zachiu
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, Netherlands
| | - Baudouin Denis de Senneville
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, NetherlandsMathematical Institute of Bordeaux, University of Bordeaux, Talence Cedex 33405, France
| | - Chrit Moonen
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, Netherlands
| | - Mario Ries
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht 3584 CX, Netherlands
| |
Collapse
|
12
|
Lam MK, Huisman M, Nijenhuis RJ, van den Bosch MAAJ, Viergever MA, Moonen CTW, Bartels LW. Quality of MR thermometry during palliative MR-guided high-intensity focused ultrasound (MR-HIFU) treatment of bone metastases. J Ther Ultrasound 2015; 3:5. [PMID: 25874113 PMCID: PMC4396149 DOI: 10.1186/s40349-015-0026-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/07/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Magnetic resonance (MR)-guided high-intensity focused ultrasound has emerged as a clinical option for palliative treatment of painful bone metastases, with MR thermometry (MRT) used for treatment monitoring. In this study, the general image quality of the MRT was assessed in terms of signal-to-noise ratio (SNR) and apparent temperature variation. Also, MRT artifacts were scored for their occurrence and hampering of the treatment monitoring. METHODS Analyses were performed on 224 MRT datasets retrieved from 13 treatments. The SNR was measured per voxel over time in magnitude images, in the target lesion and surrounding muscle, and was averaged per treatment. The standard deviation over time of the measured temperature per voxel in MRT images, in the muscle outside the heated region, was defined as the apparent temperature variation and was averaged per treatment. The scored MRT artifacts originated from the following sources: respiratory and non-respiratory time-varying field inhomogeneities, arterial ghosting, and patient motion by muscle contraction and by gross body movement. Distinction was made between lesion type, location, and procedural sedation and analgesic (PSA). RESULTS The average SNR was highest in and around osteolytic lesions (21 in lesions, 27 in surrounding muscle, n = 4) and lowest in the upper body (9 in lesions, 16 in surrounding muscle, n = 4). The average apparent temperature variation was lowest in osteolytic lesions (1.2°C, n = 4) and the highest in the upper body (1.7°C, n = 4). Respiratory time-varying field inhomogeneity MRT artifacts occurred in 85% of the datasets and hampered treatment monitoring in 81%. Non-respiratory time-varying field inhomogeneities and arterial ghosting MRT artifacts were most frequent (94% and 95%) but occurred only locally. Patient motion artifacts were highly variable and occurred less in treatments of osteolytic lesions and using propofol and esketamine as PSA. CONCLUSIONS In this study, the general image quality of MRT was observed to be higher in osteolytic lesions and lower in the upper body. Respiratory time-varying field inhomogeneity was the most prominent MRT artifact. Patient motion occurrence varied between treatments and seemed to be related to lesion type and type of PSA. Clinicians should be aware of these observed characteristics when interpreting MRT images.
Collapse
Affiliation(s)
- Mie K Lam
- />Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Merel Huisman
- />Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robbert J Nijenhuis
- />Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Max A Viergever
- />Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chrit TW Moonen
- />Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lambertus W Bartels
- />Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
13
|
Salgaonkar VA, Diederich CJ. Catheter-based ultrasound technology for image-guided thermal therapy: current technology and applications. Int J Hyperthermia 2015; 31:203-15. [PMID: 25799287 DOI: 10.3109/02656736.2015.1006269] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Catheter-based ultrasound (CBUS) is applied to deliver minimally invasive thermal therapy to solid cancer tumours, benign tissue growth, vascular disease, and tissue remodelling. Compared to other energy modalities used in catheter-based surgical interventions, unique features of ultrasound result in conformable and precise energy delivery with high selectivity, fast treatment times, and larger treatment volumes. We present a concise review of CBUS technology being currently utilized in animal and clinical studies or being developed for future applications. CBUS devices have been categorised into interstitial, endoluminal and endovascular/cardiac applications. Basic applicator designs, site-specific evaluations and possible treatment applications have been discussed in brief. Particular emphasis has been given to ablation studies that incorporate image guidance for applicator placement, therapy monitoring, feedback control, and post-procedure assessment. Examples of devices included here span the entire spectrum of the development cycle from preliminary simulation-based design studies to implementation in clinical investigations. The use of CBUS under image guidance has the potential for significantly improving precision and applicability of thermal therapy delivery.
Collapse
Affiliation(s)
- Vasant A Salgaonkar
- Department of Radiation Oncology, University of California , San Francisco, California , USA
| | | |
Collapse
|