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Slotman DJ, Bartels LW, Nijholt IM, Froeling M, Huirne JAF, Moonen CTW, Boomsma MF. Intravoxel incoherent motion (IVIM)-derived perfusion fraction mapping for the visual evaluation of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. Int J Hyperthermia 2024; 41:2321980. [PMID: 38616245 DOI: 10.1080/02656736.2024.2321980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/19/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND A method for periprocedural contrast agent-free visualization of uterine fibroid perfusion could potentially shorten magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) treatment times and improve outcomes. Our goal was to test feasibility of perfusion fraction mapping by intravoxel incoherent motion (IVIM) modeling using diffusion-weighted MRI as method for visual evaluation of MR-HIFU treatment progression. METHODS Conventional and T2-corrected IVIM-derived perfusion fraction maps were retrospectively calculated by applying two fitting methods to diffusion-weighted MRI data (b = 0, 50, 100, 200, 400, 600 and 800 s/mm2 at 1.5 T) from forty-four premenopausal women who underwent MR-HIFU ablation treatment of uterine fibroids. Contrast in perfusion fraction maps between areas with low perfusion fraction and surrounding tissue in the target uterine fibroid immediately following MR-HIFU treatment was evaluated. Additionally, the Dice similarity coefficient (DSC) was calculated between delineated areas with low IVIM-derived perfusion fraction and hypoperfusion based on CE-T1w. RESULTS Average perfusion fraction ranged between 0.068 and 0.083 in areas with low perfusion fraction based on visual assessment, and between 0.256 and 0.335 in surrounding tissues (all p < 0.001). DSCs ranged from 0.714 to 0.734 between areas with low perfusion fraction and the CE-T1w derived non-perfused areas, with excellent intraobserver reliability of the delineated areas (ICC 0.97). CONCLUSION The MR-HIFU treatment effect in uterine fibroids can be visualized using IVIM perfusion fraction mapping, in moderate concordance with contrast enhanced MRI. IVIM perfusion fraction mapping has therefore the potential to serve as a contrast agent-free imaging method to visualize the MR-HIFU treatment progression in uterine fibroids.
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Affiliation(s)
- Derk J Slotman
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn Froeling
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam UMC, Amsterdam, The Netherlands
| | - Chrit T W Moonen
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
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de Maar JS, Zandvliet MMJM, Veraa S, Tobón Restrepo M, Moonen CTW, Deckers R. Ultrasound and Microbubbles Mediated Bleomycin Delivery in Feline Oral Squamous Cell Carcinoma—An In Vivo Veterinary Study. Pharmaceutics 2023; 15:pharmaceutics15041166. [PMID: 37111651 PMCID: PMC10142092 DOI: 10.3390/pharmaceutics15041166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
To investigate the feasibility and tolerability of ultrasound and microbubbles (USMB)-enhanced chemotherapy delivery for head and neck cancer, we performed a veterinary trial in feline companion animals with oral squamous cell carcinomas. Six cats were treated with a combination of bleomycin and USMB therapy three times, using the Pulse Wave Doppler mode on a clinical ultrasound system and EMA/FDA approved microbubbles. They were evaluated for adverse events, quality of life, tumour response and survival. Furthermore, tumour perfusion was monitored before and after USMB therapy using contrast-enhanced ultrasound (CEUS). USMB treatments were feasible and well tolerated. Among 5 cats treated with optimized US settings, 3 had stable disease at first, but showed disease progression 5 or 11 weeks after first treatment. One cat had progressive disease one week after the first treatment session, maintaining a stable disease thereafter. Eventually, all cats except one showed progressive disease, but each survived longer than the median overall survival time of 44 days reported in literature. CEUS performed immediately before and after USMB therapy suggested an increase in tumour perfusion based on an increase in median area under the curve (AUC) in 6 out of 12 evaluated treatment sessions. In this small hypothesis-generating study, USMB plus chemotherapy was feasible and well-tolerated in a feline companion animal model and showed potential for enhancing tumour perfusion in order to increase drug delivery. This could be a forward step toward clinical translation of USMB therapy to human patients with a clinical need for locally enhanced treatment.
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Affiliation(s)
- Josanne S. de Maar
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands
| | - Maurice M. J. M. Zandvliet
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Stefanie Veraa
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Mauricio Tobón Restrepo
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Chrit T. W. Moonen
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands
| | - Roel Deckers
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands
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3
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Lena B, Florkow MC, Ferrer CJ, van Stralen M, Seevinck PR, Vonken EJPA, Boomsma MF, Slotman DJ, Viergever MA, Moonen CTW, Bos C, Bartels LW. Synthetic CT for the planning of MR-HIFU treatment of bone metastases in pelvic and femoral bones: a feasibility study. Eur Radiol 2022; 32:4537-4546. [PMID: 35190891 PMCID: PMC9213310 DOI: 10.1007/s00330-022-08568-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 12/12/2022]
Abstract
Objectives Visualization of the bone distribution is an important prerequisite for MRI-guided high-intensity focused ultrasound (MRI-HIFU) treatment planning of bone metastases. In this context, we evaluated MRI-based synthetic CT (sCT) imaging for the visualization of cortical bone. Methods MR and CT images of nine patients with pelvic and femoral metastases were retrospectively analyzed in this study. The metastatic lesions were osteolytic, osteoblastic or mixed. sCT were generated from pre-treatment or treatment MR images using a UNet-like neural network. sCT was qualitatively and quantitatively compared to CT in the bone (pelvis or femur) containing the metastasis and in a region of interest placed on the metastasis itself, through mean absolute difference (MAD), mean difference (MD), Dice similarity coefficient (DSC), and root mean square surface distance (RMSD). Results The dataset consisted of 3 osteolytic, 4 osteoblastic and 2 mixed metastases. For most patients, the general morphology of the bone was well represented in the sCT images and osteolytic, osteoblastic and mixed lesions could be discriminated. Despite an average timespan between MR and CT acquisitions of 61 days, in bone, the average (± standard deviation) MAD was 116 ± 26 HU, MD − 14 ± 66 HU, DSC 0.85 ± 0.05, and RMSD 2.05 ± 0.48 mm and, in the lesion, MAD was 132 ± 62 HU, MD − 31 ± 106 HU, DSC 0.75 ± 0.2, and RMSD 2.73 ± 2.28 mm. Conclusions Synthetic CT images adequately depicted the cancellous and cortical bone distribution in the different lesion types, which shows its potential for MRI-HIFU treatment planning. Key Points • Synthetic computed tomography was able to depict bone distribution in metastatic lesions. • Synthetic computed tomography images intrinsically aligned with treatment MR images may have the potential to facilitate MR-HIFU treatment planning of bone metastases, by combining visualization of soft tissues and cancellous and cortical bone. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-022-08568-y.
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Affiliation(s)
- Beatrice Lena
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.
| | - Mateusz C Florkow
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.
| | - Cyril J Ferrer
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Marijn van Stralen
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.,MRIguidance BV, Gildstraat 91-A, 3572, EL, Utrecht, The Netherlands
| | - Peter R Seevinck
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.,MRIguidance BV, Gildstraat 91-A, 3572, EL, Utrecht, The Netherlands
| | - Evert-Jan P A Vonken
- Division of Imaging and Oncology, Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, AB, Zwolle, The Netherlands
| | - Derk J Slotman
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, AB, Zwolle, The Netherlands
| | - Max A Viergever
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Clemens Bos
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands
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de Maar JS, Rousou C, van Elburg B, Vos HJ, Lajoinie GPR, Bos C, Moonen CTW, Deckers R. Ultrasound-Mediated Drug Delivery With a Clinical Ultrasound System: In Vitro Evaluation. Front Pharmacol 2021; 12:768436. [PMID: 34737709 PMCID: PMC8560689 DOI: 10.3389/fphar.2021.768436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/05/2021] [Indexed: 12/22/2022] Open
Abstract
Chemotherapy efficacy is often reduced by insufficient drug uptake in tumor cells. The combination of ultrasound and microbubbles (USMB) has been shown to improve drug delivery and to enhance the efficacy of several drugs in vitro and in vivo, through effects collectively known as sonopermeation. However, clinical translation of USMB therapy is hampered by the large variety of (non-clinical) US set-ups and US parameters that are used in these studies, which are not easily translated to clinical practice. In order to facilitate clinical translation, the aim of this study was to prove that USMB therapy using a clinical ultrasound system (Philips iU22) in combination with clinically approved microbubbles (SonoVue) leads to efficient in vitro sonopermeation. To this end, we measured the efficacy of USMB therapy for different US probes (S5-1, C5-1 and C9-4) and US parameters in FaDu cells. The US probe with the lowest central frequency (i.e. 1.6 MHz for S5-1) showed the highest USMB-induced intracellular uptake of the fluorescent dye SYTOX™ Green (SG). These SG uptake levels were comparable to or even higher than those obtained with a custom-built US system with optimized US parameters. Moreover, USMB therapy with both the clinical and the custom-built US system increased the cytotoxicity of the hydrophilic drug bleomycin. Our results demonstrate that a clinical US system can be used to perform USMB therapy as efficiently as a single-element transducer set-up with optimized US parameters. Therefore, future trials could be based on these clinical US systems, including validated US parameters, in order to accelerate successful translation of USMB therapy.
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Affiliation(s)
- Josanne S de Maar
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Charis Rousou
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, Netherlands
| | - Benjamin van Elburg
- Physics of Fluids Group, MIRA Institute of Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Hendrik J Vos
- Laboratory of Acoustical Wavefield Imaging, Faculty of Applied Sciences, Delft University of Technology, Delft, Netherlands
| | - Guillaume P R Lajoinie
- Physics of Fluids Group, MIRA Institute of Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Clemens Bos
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Chrit T W Moonen
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Roel Deckers
- Imaging and Oncology Division, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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5
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Lena B, Bartels LW, Ferrer CJ, Moonen CTW, Viergever MA, Bos C. Interleaved water and fat MR thermometry for monitoring high intensity focused ultrasound ablation of bone lesions. Magn Reson Med 2021; 86:2647-2655. [PMID: 34061390 PMCID: PMC8596687 DOI: 10.1002/mrm.28877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE To demonstrate that interleaved MR thermometry can monitor temperature in water and fat with adequate temporal resolution. This is relevant for high intensity focused uUltrasounds (HIFU) treatment of bone lesions, which are often found near aqueous tissues, as muscle, or embedded in adipose tissues, as subcutaneous fat and bone marrow. METHODS Proton resonance frequency shift (PRFS)-based thermometry scans and T1 -based 2D variable flip angle (2D-VFA) thermometry scans were acquired alternatingly over time. Temperature in water was monitored using PRFS thermometry, and in fat by 2D-VFA thermometry with slice profile effect correction. The feasibility of interleaved water/fat temperature monitoring was studied ex vivo in porcine bone during MR-HIFU sonication. Precision and stability of measurements in vivo were evaluated in a healthy volunteer under non-heating conditions. RESULTS The method allowed observing temperature change over time in muscle and fat, including bone marrow, during MR-HIFU sonication, with a temporal resolution of 6.1 s. In vivo, the apparent temperature change was stable on the time scale of the experiment: In 7 min the systematic drift was <0.042°C/min in muscle (PRFS after drift correction) and <0.096°C/min in bone marrow (2D-VFA). The SD of the temperature change averaged over time was 0.98°C (PRFS) and 2.7°C (2D-VFA). CONCLUSIONS Interleaved MR thermometry allows temperature measurements in water and fat with a temporal resolution high enough for monitoring HIFU ablation. Specifically, combined fat and water thermometry provides uninterrupted information on temperature changes in tissue close to the bone cortex.
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Affiliation(s)
- Beatrice Lena
- Image Sciences InstituteUniversity Medical Center UtrechtUtrechtthe Netherlands
| | | | - Cyril J. Ferrer
- Imaging DivisionUniversity Medical Center UtrechtUtrechtthe Netherlands
| | | | - Max A. Viergever
- Image Sciences InstituteUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Clemens Bos
- Imaging DivisionUniversity Medical Center UtrechtUtrechtthe Netherlands
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6
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Lena B, Bos C, Ferrer CJ, Moonen CTW, Viergever MA, Bartels LW. Rapid 2D variable flip angle method for accurate and precise T 1 measurements over a wide range of T 1 values. NMR Biomed 2021; 34:e4542. [PMID: 34031938 PMCID: PMC8365751 DOI: 10.1002/nbm.4542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 05/07/2023]
Abstract
PURPOSE To perform dynamic T1 mapping using a 2D variable flip angle (VFA) method, a correction for the slice profile effect is needed. In this work we investigated the impact of flip angle selection and excitation RF pulse profile on the performance of slice profile correction when applied to T1 mapping over a range of T1 values. METHODS A correction of the slice profile effect is proposed, based on Bloch simulation of steady-state signals. With this correction, Monte Carlo simulations were performed to assess the accuracy and precision of 2D VFA T1 mapping in the presence of noise, for RF pulses with time-bandwidth products of 2, 3 and 10 and with flip angle pairs in the range [1°-90°]. To evaluate its performance over a wide range of T1 , maximum errors were calculated for six T1 values between 50 ms and 1250 ms. The method was demonstrated using in vitro and in vivo experiments. RESULTS Without corrections, 2D VFA severely underestimates T1 . Slice profile errors were effectively reduced with the correction based on simulations, both in vitro and in vivo. The precision and accuracy of the method depend on the nominal T1 values, the FA pair, and the RF pulse shape. FA pairs leading to <5% errors in T1 can be identified for the common RF shapes, for T1 values between 50 ms and 1250 ms. CONCLUSIONS 2D VFA T1 mapping with Bloch-simulation-based correction can deliver T1 estimates that are accurate and precise to within 5% over a wide T1 range.
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Affiliation(s)
- Beatrice Lena
- Image Sciences Institute, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
- Image Guided Molecular Interventions Group, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Clemens Bos
- Image Guided Molecular Interventions Group, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Cyril J. Ferrer
- Image Guided Molecular Interventions Group, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Chrit T. W. Moonen
- Image Guided Molecular Interventions Group, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Max A. Viergever
- Image Sciences Institute, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Lambertus W. Bartels
- Image Sciences Institute, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
- Image Guided Molecular Interventions Group, Imaging and Oncology DivisionUniversity Medical Center UtrechtUtrechtThe Netherlands
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7
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Bartels MMTJ, Verpalen IM, Ferrer CJ, Slotman DJ, Phernambucq ECJ, Verhoeff JJC, Eppinga WSC, Braat MNGJA, van den Hoed RD, van 't Veer-Ten Kate M, de Boer E, Naber HR, Nijholt IM, Bartels LW, Bos C, Moonen CTW, Boomsma MF, Verkooijen HM. Combining radiotherapy and focused ultrasound for pain palliation of cancer induced bone pain; a stage I/IIa study according to the IDEAL framework. Clin Transl Radiat Oncol 2021; 27:57-63. [PMID: 33532631 PMCID: PMC7822778 DOI: 10.1016/j.ctro.2021.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
Combined treatment of EBRT and MR-HIFU is feasible and well tolerated by patients. Clinical outcomes of combined treatment of EBRT and MR-HIFU are promising. Superiority of combined treatment over standard EBRT needs to be evaluated in a comparative study.
Background Cancer induced bone pain (CIBP) strongly interferes with patient’s quality of life. Currently, the standard of care includes external beam radiotherapy (EBRT), resulting in pain relief in approximately 60% of patients. Magnetic Resonance guided High Intensity Focused Ultrasound (MR-HIFU) is a promising treatment modality for CIBP. Methods A single arm, R-IDEAL stage I/IIa study was conducted. Patients presenting at the department of radiation oncology with symptomatic bone metastases in the appendicular skeleton, as well as in the sacrum and sternum were eligible for inclusion. All participants underwent EBRT, followed by MR-HIFU within 4 days. Safety and feasibility were assessed, and pain scores were monitored for 4 weeks after completing the combined treatment. Results Six patients were enrolled. Median age was 67 years, median lesion diameter was 56,5 mm. In all patients it was logistically possible to plan and perform the MR-HIFU treatment within 4 days after EBRT. All patients tolerated the combined procedure well. Pain response was reported by 5 out of 6 patients at 7 days after completion of the combined treatment, and stabilized on 60% at 4 weeks follow up. No treatment related serious adverse events occurred. Conclusion This is the first study to combine EBRT with MR-HIFU. Our results show that combined EBRT and MR-HIFU in first-line treatment of CIBP is safe and feasible, and is well tolerated by patients. Superiority over standard EBRT, in terms of (time to) pain relief and quality of life need to be evaluated in comparative (randomized) study.
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Affiliation(s)
- Marcia M T J Bartels
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.,University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Inez M Verpalen
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Cyril J Ferrer
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Derk J Slotman
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Erik C J Phernambucq
- Isala Hospital, Department of Radiation Oncology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Joost J C Verhoeff
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Wietse S C Eppinga
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Manon N G J A Braat
- University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Rolf D van den Hoed
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | | | - Erwin de Boer
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Harry R Naber
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Ingrid M Nijholt
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Lambertus W Bartels
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Clemens Bos
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Chrit T W Moonen
- University Medical Center Utrecht, Image Sciences Institute, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Martijn F Boomsma
- Isala Hospital, Department of Radiology, Dokter van Heesweg 2, 8025 AB Zwolle, The Netherlands
| | - Helena M Verkooijen
- University Medical Center Utrecht, Department of Radiation Oncology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.,University Medical Center Utrecht, Department of Radiology, Division of Imaging and Oncology, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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de Senneville BD, Coupé P, Ries M, Facq L, Moonen CTW. Deep correction of breathing-related artifacts in real-time MR-thermometry. Comput Med Imaging Graph 2020; 87:101834. [PMID: 33352524 DOI: 10.1016/j.compmedimag.2020.101834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
Real-time MR-imaging has been clinically adapted for monitoring thermal therapies since it can provide on-the-fly temperature maps simultaneously with anatomical information. However, proton resonance frequency based thermometry of moving targets remains challenging since temperature artifacts are induced by the respiratory as well as physiological motion. If left uncorrected, these artifacts lead to severe errors in temperature estimates and impair therapy guidance. In this study, we evaluated deep learning for on-line correction of motion related errors in abdominal MR-thermometry. For this, a convolutional neural network (CNN) was designed to learn the apparent temperature perturbation from images acquired during a preparative learning stage prior to hyperthermia. The input of the designed CNN is the most recent magnitude image and no surrogate of motion is needed. During the subsequent hyperthermia procedure, the recent magnitude image is used as an input for the CNN-model in order to generate an on-line correction for the current temperature map. The method's artifact suppression performance was evaluated on 12 free breathing volunteers and was found robust and artifact-free in all examined cases. Furthermore, thermometric precision and accuracy was assessed for in vivo ablation using high intensity focused ultrasound. All calculations involved at the different stages of the proposed workflow were designed to be compatible with the clinical time constraints of a therapeutic procedure.
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Affiliation(s)
- B Denis de Senneville
- University of Bordeaux, IMB, UMR CNRS 5251, Talence, France, Talence Cedex, F-33405, France; INRIA Project Team Monc, Talence, France, Talence Cedex, F-33405, France; Department of Radiotherapy, UMC Utrecht, Heidelberglaan 100, 3508 GA, The Netherlands.
| | - P Coupé
- CNRS, University of Bordeaux, Bordeaux INP, "Laboratoire Bordelais de la Recherche Informatique" (LaBRI), UMR5800, Talence, F-33400, France
| | - M Ries
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
| | - L Facq
- University of Bordeaux, IMB, UMR CNRS 5251, Talence, France, Talence Cedex, F-33405, France
| | - C T W Moonen
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands
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de Maar JS, Suelmann BBM, Braat MNGJA, van Diest PJ, Vaessen HHB, Witkamp AJ, Linn SC, Moonen CTW, van der Wall E, Deckers R. Phase I feasibility study of Magnetic Resonance guided High Intensity Focused Ultrasound-induced hyperthermia, Lyso-Thermosensitive Liposomal Doxorubicin and cyclophosphamide in de novo stage IV breast cancer patients: study protocol of the i-GO study. BMJ Open 2020; 10:e040162. [PMID: 33243800 PMCID: PMC7692846 DOI: 10.1136/bmjopen-2020-040162] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/21/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION In breast cancer, local tumour control is thought to be optimised by administering higher local levels of cytotoxic chemotherapy, in particular doxorubicin. However, systemic administration of higher dosages of doxorubicin is hampered by its toxic side effects. In this study, we aim to increase doxorubicin deposition in the primary breast tumour without changing systemic doxorubicin concentration and thus without interfering with systemic efficacy and toxicity. This is to be achieved by combining Lyso-Thermosensitive Liposomal Doxorubicin (LTLD, ThermoDox, Celsion Corporation, Lawrenceville, NJ, USA) with mild local hyperthermia, induced by Magnetic Resonance guided High Intensity Focused Ultrasound (MR-HIFU). When heated above 39.5°C, LTLD releases a high concentration of doxorubicin intravascularly within seconds. In the absence of hyperthermia, LTLD leads to a similar biodistribution and antitumour efficacy compared with conventional doxorubicin. METHODS AND ANALYSIS This is a single-arm phase I study in 12 chemotherapy-naïve patients with de novo stage IV HER2-negative breast cancer. Previous endocrine treatment is allowed. Study treatment consists of up to six cycles of LTLD at 21-day intervals, administered during MR-HIFU-induced hyperthermia to the primary tumour. We will aim for 60 min of hyperthermia at 40°C-42°C using a dedicated MR-HIFU breast system (Profound Medical, Mississauga, Canada). Afterwards, intravenous cyclophosphamide will be administered. Primary endpoints are safety, tolerability and feasibility. The secondary endpoint is efficacy, assessed by radiological response.This approach could lead to optimal loco-regional control with less extensive or even no surgery, in de novo stage IV patients and in stage II/III patients allocated to receive neoadjuvant chemotherapy. ETHICS AND DISSEMINATION This study has obtained ethical approval by the Medical Research Ethics Committee Utrecht (Protocol NL67422.041.18, METC number 18-702). Informed consent will be obtained from all patients before study participation. Results will be published in an academic peer-reviewed journal. TRIAL REGISTRATION NUMBERS NCT03749850, EudraCT 2015-005582-23.
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Affiliation(s)
- Josanne S de Maar
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Britt B M Suelmann
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Manon N G J A Braat
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - P J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H H B Vaessen
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arjen J Witkamp
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S C Linn
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elsken van der Wall
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Roel Deckers
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Besse HC, Chen Y, Scheeren HW, Metselaar JM, Lammers T, Moonen CTW, Hennink WE, Deckers R. A Doxorubicin-Glucuronide Prodrug Released from Nanogels Activated by High-Intensity Focused Ultrasound Liberated β-Glucuronidase. Pharmaceutics 2020; 12:E536. [PMID: 32532061 PMCID: PMC7355552 DOI: 10.3390/pharmaceutics12060536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/16/2022] Open
Abstract
The poor pharmacokinetics and selectivity of low-molecular-weight anticancer drugs contribute to the relatively low effectiveness of chemotherapy treatments. To improve the pharmacokinetics and selectivity of these treatments, the combination of a doxorubicin-glucuronide prodrug (DOX-propGA3) nanogel formulation and the liberation of endogenous β-glucuronidase from cells exposed to high-intensity focused ultrasound (HIFU) were investigated in vitro. First, a DOX-propGA3-polymer was synthesized. Subsequently, DOX-propGA3-nanogels were formed from this polymer dissolved in water using inverse mini-emulsion photopolymerization. In the presence of bovine β-glucuronidase, the DOX-propGA3 in the nanogels was quantitatively converted into the chemotherapeutic drug doxorubicin. Exposure of cells to HIFU efficiently induced liberation of endogenous β-glucuronidase, which in turn converted the prodrug released from the DOX-propGA3-nanogels into doxorubicin. β-glucuronidase liberated from cells exposed to HIFU increased the cytotoxicity of DOX-propGA3-nanogels to a similar extend as bovine β-glucuronidase, whereas in the absence of either bovine β-glucuronidase or β-glucuronidase liberated from cells exposed to HIFU, the DOX-propGA3-nanogels hardly showed cytotoxicity. Overall, DOX-propGA3-nanogels systems might help to further improve the outcome of HIFU-related anticancer therapy.
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Affiliation(s)
- Helena C. Besse
- Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (H.C.B.); (C.T.W.M.)
| | - Yinan Chen
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (Y.C.); (T.L.); (W.E.H.)
| | - Hans W. Scheeren
- Cluster for Molecular Chemistry, Radboud University, 6525 XZ Nijmegen, The Netherlands;
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, 52074 Aachen, Germany;
| | - Josbert M. Metselaar
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, 52074 Aachen, Germany;
- Department of Targeted Therapeutics, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands
| | - Twan Lammers
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (Y.C.); (T.L.); (W.E.H.)
- Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH Aachen University Clinic, 52074 Aachen, Germany;
- Department of Targeted Therapeutics, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands
| | - Chrit T. W. Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (H.C.B.); (C.T.W.M.)
| | - Wim E. Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (Y.C.); (T.L.); (W.E.H.)
| | - Roel Deckers
- Division of Imaging and Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (H.C.B.); (C.T.W.M.)
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11
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Verpalen IM, Anneveldt KJ, Vos PC, Edens MA, Heijman E, Nijholt IM, Dijkstra JR, Schutte JM, Franx A, Bartels LW, Moonen CTW, Boomsma MF. Use of multiparametric MRI to characterize uterine fibroid tissue types. MAGMA 2020; 33:689-700. [PMID: 32219676 DOI: 10.1007/s10334-020-00841-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/02/2020] [Accepted: 03/10/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although the biological characteristics of uterine fibroids (UF) have implications for therapy choice and effectiveness, there is limited MRI data about these characteristics. Currently, the Funaki classification and Scaled Signal Intensity (SSI) are used to predict treatment outcome but both screening-tools appear to be suboptimal. Therefore, multiparametric and quantitative MRI was studied to evaluate various biological characteristics of UF. METHODS 87 patients with UF underwent an MRI-examination. Differences between UF tissues and myometrium were investigated using T2-mapping, Apparent Diffusion Coefficient (ADC) maps with different b-value combinations, contrast-enhanced T1-weighted and T2-weighted imaging. Additionally, the Funaki classification and SSI were calculated. RESULTS Significant differences between myometrium and UF tissue in T2-mapping (p = 0.001), long-TE ADC low b-values (p = 0.002), ADC all b-values (p < 0.001) and high b-values (p < 0.001) were found. Significant differences between Funaki type 3 versus type 1 and 2 were observed in SSI (p < 0.001) and T2-values (p < 0.001). Significant correlations were found between SSI and T2-mapping (p < 0.001; ρs = 0.82), ADC all b-values (p = 0.004; ρs = 0.31), ADC high b-values (p < 0.001; ρs = 0.44) and long-TE ADC low b-values (p = 0.004; ρs = 0.31). CONCLUSIONS Quantitative MR-data allowed us to distinguish UF tissue from myometrium and to discriminate different UF tissue types and may, therefore, be a useful tool to predict treatment outcome/determine optimal treatment modality.
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Affiliation(s)
- Inez M Verpalen
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands.
| | - Kimberley J Anneveldt
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands
- Department of Gynecology, Isala, Zwolle, The Netherlands
| | - Pieter C Vos
- Oncology Solutions, Philips Research, Eindhoven, The Netherlands
| | - Mireille A Edens
- Department of Innovation and Science, Isala, Zwolle, The Netherlands
| | - Edwin Heijman
- Oncology Solutions, Philips Research, Eindhoven, The Netherlands
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands
| | | | - Joke M Schutte
- Department of Gynecology, Isala, Zwolle, The Netherlands
| | - Arie Franx
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Lambertus W Bartels
- Imaging Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, Zwolle, The Netherlands
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12
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Besse HC, Barten-van Rijbroek AD, van der Wurff-Jacobs KMG, Bos C, Moonen CTW, Deckers R. Tumor Drug Distribution after Local Drug Delivery by Hyperthermia, In Vivo. Cancers (Basel) 2019; 11:cancers11101512. [PMID: 31600958 PMCID: PMC6826934 DOI: 10.3390/cancers11101512] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/27/2019] [Accepted: 10/02/2019] [Indexed: 02/02/2023] Open
Abstract
Tumor drug distribution and concentration are important factors for effective tumor treatment. A promising method to enhance the distribution and the concentration of the drug in the tumor is to encapsulate the drug in a temperature sensitive liposome. The aim of this study was to investigate the tumor drug distribution after treatment with various injected doses of different liposomal formulations of doxorubicin, ThermoDox (temperature sensitive liposomes) and DOXIL (non-temperature sensitive liposomes), and free doxorubicin at macroscopic and microscopic levels. Only ThermoDox treatment was combined with hyperthermia. Experiments were performed in mice bearing a human fibrosarcoma. At low and intermediate doses, the largest growth delay was obtained with ThermoDox, and at the largest dose, the largest growth delay was obtained with DOXIL. On histology, tumor areas with increased doxorubicin concentration correlated with decreased cell proliferation, and substantial variations in doxorubicin heterogeneity were observed. ThermoDox treatment resulted in higher tissue drug levels than DOXIL and free doxorubicin for the same dose. A relation with the distance to the vasculature was shown, but vessel perfusion was not always sufficient to determine doxorubicin delivery. Our results indicate that tumor drug distribution is an important factor for effective tumor treatment and that its dependence on delivery formulation merits further systemic investigation.
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Affiliation(s)
- Helena C Besse
- Center of Imaging Sciences, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | | | - Kim M G van der Wurff-Jacobs
- Center of Imaging Sciences, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Clemens Bos
- Center of Imaging Sciences, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Chrit T W Moonen
- Center of Imaging Sciences, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Roel Deckers
- Center of Imaging Sciences, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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13
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Ferrer CJ, Bartels LW, van der Velden TA, Grüll H, Heijman E, Moonen CTW, Bos C. Field drift correction of proton resonance frequency shift temperature mapping with multichannel fast alternating nonselective free induction decay readouts. Magn Reson Med 2019; 83:962-973. [PMID: 31544289 PMCID: PMC6899537 DOI: 10.1002/mrm.27985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE To demonstrate that proton resonance frequency shift MR thermometry (PRFS-MRT) acquisition with nonselective free induction decay (FID), combined with coil sensitivity profiles, allows spatially resolved B0 drift-corrected thermometry. METHODS Phantom experiments were performed at 1.5T and 3T. Acquisition of PRFS-MRT and FID were performed during MR-guided high-intensity focused ultrasound heating. The phase of the FIDs was used to estimate the change in angular frequency δωdrift per coil element. Two correction methods were investigated: (1) using the average δωdrift over all coil elements (0th-order) and (2) using coil sensitivity profiles for spatially resolved correction. Optical probes were used for independent temperature verification. In-vivo feasibility of the methods was evaluated in the leg of 1 healthy volunteer at 1.5T. RESULTS In 30 minutes, B0 drift led to an apparent temperature change of up to -18°C and -98°C at 1.5T and 3T, respectively. In the sonicated area, both corrections had a median error of 0.19°C at 1.5T and -0.54°C at 3T. At 1.5T, the measured median error with respect to the optical probe was -1.28°C with the 0th-order correction and improved to 0.43°C with the spatially resolved correction. In vivo, without correction the spatiotemporal median of the apparent temperature was at -4.3°C and interquartile range (IQR) of 9.31°C. The 0th-order correction had a median of 0.75°C and IQR of 0.96°C. The spatially resolved method had the lowest median at 0.33°C and IQR of 0.80°C. CONCLUSION FID phase information from individual receive coil elements allows spatially resolved B0 drift correction in PRFS-based MRT.
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Affiliation(s)
- Cyril J Ferrer
- Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
| | | | | | - Holger Grüll
- Faculty of Medicine and University Hospital of Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Edwin Heijman
- Faculty of Medicine and University Hospital of Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany.,Oncology Solutions, Philips Research, Aachen, Germany
| | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
| | - Clemens Bos
- Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
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14
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Shcherbakova Y, Bartels LW, Mandija S, Beld E, Seevinck PR, van der Voort van Zyp JRN, Kerkmeijer LGW, Moonen CTW, Lagendijk JJW, van den Berg CAT. Visualization of gold fiducial markers in the prostate using phase-cycled bSSFP imaging for MRI-only radiotherapy. ACTA ACUST UNITED AC 2019; 64:185001. [DOI: 10.1088/1361-6560/ab35c3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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15
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Shcherbakova Y, van den Berg CAT, Moonen CTW, Bartels LW. Investigation of the influence of B 0 drift on the performance of the PLANET method and an algorithm for drift correction. Magn Reson Med 2019; 82:1725-1740. [PMID: 31317584 PMCID: PMC6772029 DOI: 10.1002/mrm.27860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/26/2019] [Accepted: 05/23/2019] [Indexed: 01/03/2023]
Abstract
Purpose The PLANET method was designed to simultaneously reconstruct maps of T1 and T2, the off‐resonance, the RF phase, and the banding free signal magnitude. The method requires a stationary B0 field over the course of a phase‐cycled balanced SSFP acquisition. In this work we investigated the influence of B0 drift on the performance of the PLANET method for single‐component and two‐component signal models, and we propose a strategy for drift correction. Methods The complex phase‐cycled balanced SSFP signal was modeled with and without frequency drift. The behavior of the signal influenced by drift was mathematically interpreted as a sum of drift‐dependent displacement of the data points along an ellipse and drift‐dependent rotation around the origin. The influence of drift on parameter estimates was investigated experimentally on a phantom and on the brain of healthy volunteers and was verified by numerical simulations. A drift correction algorithm was proposed and tested on a phantom and in vivo. Results Drift can be assumed to be linear over the typical duration of a PLANET acquisition. In a phantom (a single‐component signal model), drift induced errors of 4% and 8% in the estimated T1 and T2 values. In the brain, where multiple components are present, drift only had a minor effect. For both single‐component and two‐component signal models, drift‐induced errors were successfully corrected by applying the proposed drift correction algorithm. Conclusion We have demonstrated theoretically and experimentally the sensitivity of the PLANET method to B0 drift and have proposed a drift correction method.
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Affiliation(s)
- Yulia Shcherbakova
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
| | - Cornelis A T van den Berg
- Department of Radiotherapy, Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
| | - Chrit T W Moonen
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
| | - Lambertus W Bartels
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, Netherlands
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Sadeghi N, Kok RJ, Bos C, Zandvliet M, Geerts WJC, Storm G, Moonen CTW, Lammers T, Deckers R. Hyperthermia-triggered release of hypoxic cell radiosensitizers from temperature-sensitive liposomes improves radiotherapy efficacy in vitro. Nanotechnology 2019; 30:264001. [PMID: 30836341 DOI: 10.1088/1361-6528/ab0ce6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Hypoxia is a characteristic feature of solid tumors and an important cause of resistance to radiotherapy. Hypoxic cell radiosensitizers have been shown to increase radiotherapy efficacy, but dose-limiting side effects prevent their widespread use in the clinic. We propose the encapsulation of hypoxic cell radiosensitizers in temperature-sensitive liposomes (TSL) to target the radiosensitizers specifically to tumors and to avoid unwanted accumulation in healthy tissues. The main objective of the present study is to develop and characterize TSL loaded with the radiosensitizer pimonidazole (PMZ) and to evaluate the in vitro efficacy of free PMZ and PMZ encapsulated in TSL in combination with hyperthermia and radiotherapy. PMZ was actively loaded into TSL at different drug/lipid ratios, and the physicochemical characteristics and the stability of the resulting TSL-PMZ were evaluated. PMZ release was determined at 37 °C and 42 °C in HEPES buffer saline and fetal bovine serum. The concentration-dependent radiosensitizing effect of PMZ was investigated by exposing FaDu cells to different PMZ concentrations under hypoxic conditions followed by exposure to ionizing irradiation. The efficacy of TSL-PMZ in combination with hyperthermia and radiotherapy was determined in vitro, assessing cell survival and DNA damage by means of the clonogenic assay and histone H2AX phosphorylation, respectively. All TSL-PMZ formulations showed high encapsulation efficiencies and were stable for 30 d upon storage at 4 °C and 20 °C. Fast PMZ release was observed at 42 °C, regardless of the drug/lipid ratio. Increasing the PMZ concentration significantly enhanced the effect of ionizing irradiation. Pre-heated TSL-PMZ in combination with radiotherapy caused a 14.3-fold increase in cell death as compared to radiotherapy treatment alone. In conclusion, our results indicate that TSL-PMZ in combination with hyperthermia can assist in improving the efficacy of radiotherapy under hypoxic conditions.
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Affiliation(s)
- Negar Sadeghi
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands. Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, University Clinic and Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
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Borman PTS, Bos C, Stemkens B, Moonen CTW, Raaymakers BW, Tijssen RHN. Assessment of 3D motion modeling performance for dose accumulation mapping on the MR-linac by simultaneous multislice MRI. Phys Med Biol 2019; 64:095004. [PMID: 30917353 DOI: 10.1088/1361-6560/ab13e3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hybrid MR-linac systems enable intrafraction motion monitoring during radiation therapy. Since time-resolved 3D MRI is still challenging, various motion models have been developed that rely on time-resolved 2D imaging. Continuous validation of these models is important for accurate dose accumulation mapping. In this study we used 2D simultaneous multislice (SMS) imaging to improve the PCA-based motion modeling method developed previously (Stemkens et al 2016 Phys. Med. Biol. 61 5335-55). From the additional simultaneously acquired slices, several independent motion models could be generated, which allowed for an assessment of the sensitivity of the motion model to the location of the time-resolved 2D slices. Additionally, the best model could be chosen at every time-point, increasing the method's robustness. Imaging experiments were performed in six healthy volunteers using three simultaneous slices, which generated three independent models per volunteer. For each model the motion traces of the liver tip and both kidneys were estimated. We found that the location of the 2D slices influenced the model's error in five volunteers significantly with a p -value <0.05, and that selecting the best model at every time-point can improve the method. This allows for more accurate and robust motion characterization in MR-guided radiotherapy.
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Affiliation(s)
- P T S Borman
- Department of Radiotherapy, University Medical Center Utrecht. Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. Imaging Division, University Medical Center Utrecht. Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. Author to whom any correspondence should be addressed
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18
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Ferrer CJ, Bos C, Yoneyama M, Obara M, Kok L, van Leeuwen MS, Bleys RLAW, Moonen CTW, Bartels LW. Respiratory- and cardiac-triggered three-dimensional sheath inked rapid acquisition with refocused echoes imaging (SHINKEI) of the abdomen for magnetic resonance neurography of the celiac plexus. Eur Radiol Exp 2019; 3:14. [PMID: 30923930 PMCID: PMC6439132 DOI: 10.1186/s41747-019-0095-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022] Open
Abstract
The visualisation of the celiac plexus using respiratory- and cardiac-triggered three-dimensional (3D) sheath inked rapid acquisition with refocused echoes imaging (SHINKEI) was evaluated. After ethical approval and written informed consent, eight volunteers (age 27 ± 5 years, mean ± standard deviation) were scanned at 1.5 and 3 T. Displacement of the celiac ganglia due to aortic pulsatility was studied on axial single-slice breath-hold balanced turbo field-echo cine sequences in five volunteers and found to be 3.0 ± 0.5 mm (left) and 3.1 ± 0.4 mm (right). Respiratory- and cardiac-triggered 3D SHINKEI images were compared to respiratory- and cardiac-triggered fat-suppressed 3D T2-weighted turbo spin-echo and respiratory-triggered 3D SHINKEI in all volunteers. Visibility of the celiac ganglia was rated by three radiologists as visible or non-visible. On 3D SHINKEI with double-triggering at 1.5 T, the left and right ganglia were seen by all observers in 7/8 and 8/8 volunteers, respectively. At 3 T, this was the case for 6/8 and 7/8 volunteers, respectively. The nerve-to-muscle signal ratio increased from 1.9 ± 0.5 on fat-suppressed 3D T2-weighted turbo spin-echo to 4.7 ± 0.8 with 3D SHINKEI. Anatomical validation was performed in a human cadaver. An expert in anatomy confirmed that the hyperintense structure visible on ex vivo 3D SHINKEI scans was the celiac plexus. In conclusion, double-triggering allowed visualisation of the celiac plexus using 3D SHINKEI at both 1.5 T and 3 T.
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Affiliation(s)
- Cyril J Ferrer
- Imaging Division, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Clemens Bos
- Imaging Division, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Masami Yoneyama
- Philips Japan, 3-37 Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Makoto Obara
- Philips Japan, 3-37 Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan
| | - Lisanne Kok
- Imaging Division, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Maarten S van Leeuwen
- Department of Radiology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Ronald L A W Bleys
- Department of Anatomy, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Utrecht University, Domplein 29, 3512 JE, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Imaging Division, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Bones IK, Harteveld AA, Franklin SL, van Osch MJP, Hendrikse J, Moonen CTW, Bos C, van Stralen M. Enabling free-breathing background suppressed renal pCASL using fat imaging and retrospective motion correction. Magn Reson Med 2019; 82:276-288. [PMID: 30883873 PMCID: PMC6593735 DOI: 10.1002/mrm.27723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/24/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
Abstract
Purpose For free‐breathing renal perfusion imaging using arterial spin labeling (ASL), retrospective image realignment has been found essential to reduce subtraction artifacts and, independently, background suppression has been demonstrated to reduce physiologic noise. However, negative results on ASL precision and accuracy have been reported for the combination of both. In this study, the effect of background suppression ‐level in combination with image registration on free‐breathing renal ASL signal quality, with registration either on ASL‐images themselves or guided by additionally acquired fat‐images, was investigated. The results from free‐breathing acquisitions were compared with the reference paced‐breathing motion compensation strategy. Methods Pseudocontinuous ASL (pCASL) data with additional fat‐images were acquired from 10 subjects at 1.5T with varying background suppression levels during free‐breathing and paced‐breathing. Images were registered using the ASL‐images themselves (ASLReg) or using their corresponding fat‐images (FatReg). Temporal signal‐to‐noise ratio (tSNR) served to evaluate precision and perfusion weighted signal (PWS) to assess accuracy. Results In combination with image registration, background suppression significantly improved tSNR by 50% (P < .05). For heavy suppression, ASLReg and FatReg showed similar performance in terms of tSNR and PWS. Background suppression with two inversion pulses induced a small, nonsignificant (P > .05) PWS reduction, but increased PWS accuracy. When applying heavy background suppression, free‐breathing acquisitions resulted in similar ASL‐quality to paced‐breathing acquisitions. Conclusion Background suppression was found beneficial for free‐breathing renal pCASL precision without compromising accuracy, despite motion challenges. In combination with ASLReg or FatReg, background suppression enabled clinically viable free‐breathing renal pCASL.
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Affiliation(s)
- Isabell K. Bones
- Center for Image SciencesUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Anita A. Harteveld
- Center for Image SciencesUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Suzanne L. Franklin
- Center for Image SciencesUniversity Medical Center UtrechtUtrechtthe Netherlands
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Matthias J. P. van Osch
- C. J. Gorter Center for High Field MRI, Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Jeroen Hendrikse
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Chrit T. W. Moonen
- Center for Image SciencesUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Clemens Bos
- Center for Image SciencesUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Marijn van Stralen
- Center for Image SciencesUniversity Medical Center UtrechtUtrechtthe Netherlands
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Shcherbakova Y, van den Berg CAT, Moonen CTW, Bartels LW. On the accuracy and precision of PLANET for multiparametric MRI using phase-cycled bSSFP imaging. Magn Reson Med 2018; 81:1534-1552. [PMID: 30303562 PMCID: PMC6585657 DOI: 10.1002/mrm.27491] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 11/09/2022]
Abstract
Purpose In this work we demonstrate how sequence parameter settings influence the accuracy and precision in T1, T2, and off‐resonance maps obtained with the PLANET method for a single‐component signal model. In addition, the performance of the method for the particular case of a two‐component relaxation model for white matter tissue was assessed. Methods Numerical simulations were performed to investigate the influence of sequence parameter settings on the accuracy and precision in the estimated parameters for a single‐component model, as well as for a two‐component white matter model. Phantom and in vivo experiments were performed for validation. In addition, the effects of Gibbs ringing were investigated. Results By making a proper choice for sequence parameter settings, accurate and precise parameter estimation can be achieved for a single‐component signal model over a wide range of relaxation times at realistic SNR levels. Due to the presence of a second myelin‐related signal component in white matter, an underestimation of approximately 30% in T1 and T2 was observed, predicted by simulations and confirmed by measurements. Gibbs ringing artifacts correction improved the precision and accuracy of the parameter estimates. Conclusion For a single‐component signal model there is a broad “sweet spot” of sequence parameter combinations for which a high accuracy and precision in the parameter estimates is achieved over a wide range of relaxation times. For a multicomponent signal model, the single‐component PLANET reconstruction results in systematic errors in the parameter estimates as expected.
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Affiliation(s)
- Yulia Shcherbakova
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Cornelis A T van den Berg
- 2Department of Radiotherapy, Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Chrit T W Moonen
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lambertus W Bartels
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
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Borman PTS, Tijssen RHN, Bos C, Moonen CTW, Raaymakers BW, Glitzner M. Characterization of imaging latency for real-time MRI-guided radiotherapy. ACTA ACUST UNITED AC 2018; 63:155023. [DOI: 10.1088/1361-6560/aad2b7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zachiu C, de Senneville BD, Moonen CTW, Raaymakers BW, Ries M. Anatomically plausible models and quality assurance criteria for online mono- and multi-modal medical image registration. Phys Med Biol 2018; 63:155016. [PMID: 29972147 DOI: 10.1088/1361-6560/aad109] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Medical imaging is currently employed in the diagnosis, planning, delivery and response monitoring of cancer treatments. Due to physiological motion and/or treatment response, the shape and location of the pathology and organs-at-risk may change over time. Establishing their location within the acquired images is therefore paramount for an accurate treatment delivery and monitoring. A feasible solution for tracking anatomical changes during an image-guided cancer treatment is provided by image registration algorithms. Such methods are, however, often built upon elements originating from the computer vision/graphics domain. Since the original design of such elements did not take into consideration the material properties of particular biological tissues, the anatomical plausibility of the estimated deformations may not be guaranteed. In the current work we adapt two existing variational registration algorithms, namely Horn-Schunck and EVolution, to online soft tissue tracking. This is achieved by enforcing an incompressibility constraint on the estimated deformations during the registration process. The existing and the modified registration methods were comparatively tested against several quality assurance criteria on abdominal in vivo MR and CT data. These criteria included: the Dice similarity coefficient (DSC), the Jaccard index, the target registration error (TRE) and three additional criteria evaluating the anatomical plausibility of the estimated deformations. Results demonstrated that both the original and the modified registration methods have similar registration capabilities in high-contrast areas, with DSC and Jaccard index values predominantly in the 0.8-0.9 range and an average TRE of 1.6-2.0 mm. In contrast-devoid regions of the liver and kidneys, however, the three additional quality assurance criteria have indicated a considerable improvement of the anatomical plausibility of the deformations estimated by the incompressibility-constrained methods. Moreover, the proposed registration models maintain the potential of the original methods for online image-based guidance of cancer treatments.
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Affiliation(s)
- C Zachiu
- Department of Radiotherapy, UMC Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, Netherlands
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Zachiu C, de Senneville BD, Tijssen RHN, Kotte ANTJ, Houweling AC, Kerkmeijer LGW, Lagendijk JJW, Moonen CTW, Ries M. Non-rigid CT/CBCT to CBCT registration for online external beam radiotherapy guidance. ACTA ACUST UNITED AC 2017; 63:015027. [DOI: 10.1088/1361-6560/aa990e] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Zachiu C, Denis de Senneville B, Dmitriev ID, Moonen CTW, Ries M. A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen. J Ther Ultrasound 2017; 5:27. [PMID: 29043083 PMCID: PMC5632838 DOI: 10.1186/s40349-017-0106-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/28/2017] [Indexed: 01/20/2023] Open
Abstract
Background During lengthy magnetic resonance-guided high intensity focused ultrasound (MRg-HIFU) thermal ablations in abdominal organs, the therapeutic work-flow is frequently hampered by various types of physiological motion occurring at different time-scales. If left un-addressed this can lead to an incomplete therapy and/or to tissue damage of organs-at-risk. While previous studies focus on correction schemes for displacements occurring at a particular time-scale within the work-flow of an MRg-HIFU therapy, in the current work we propose a motion correction strategy encompassing the entire work-flow. Methods The proposed motion compensation framework consists of several linked components, each being adapted to motion occurring at a particular time-scale. While respiration was addressed through a fast correction scheme, long term organ drifts were compensated using a strategy operating on time-scales of several minutes. The framework relies on a periodic examination of the treated area via MR scans which are then registered to a reference scan acquired at the beginning of the therapy. The resulting displacements were used for both on-the-fly re-optimization of the interventional plan and to ensure the spatial fidelity between the different steps of the therapeutic work-flow. The approach was validated in three complementary studies: an experiment conducted on a phantom undergoing a known motion pattern, a study performed on the abdomen of 10 healthy volunteers and during 3 in-vivo MRg-HIFU ablations on porcine liver. Results Results have shown that, during lengthy MRg-HIFU thermal therapies, the human liver and kidney can manifest displacements that exceed acceptable therapeutic margins. Also, it was demonstrated that the proposed framework is capable of providing motion estimates with sub-voxel precision and accuracy. Finally, the 3 successful animal studies demonstrate the compatibility of the proposed approach with the work-flow of an MRg-HIFU intervention under clinical conditions. Conclusions In the current study we proposed an image-based motion compensation framework dedicated to MRg-HIFU thermal ablations in the abdomen, providing the possibility to re-optimize the therapy plan on-the-fly with the patient on the interventional table. Moreover, we have demonstrated that even under clinical conditions, the proposed approach is fully capable of continuously ensuring the spatial fidelity between the different phases of the therapeutic work-flow.
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Affiliation(s)
- Cornel Zachiu
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA Netherlands
| | - Baudouin Denis de Senneville
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA Netherlands.,Institut de Mathématiques de Bordeaux, CNRS UMR5251/Université de Bordeaux, Talence Cedex, Bordeaux, 33405 France
| | - Ivan D Dmitriev
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA Netherlands
| | - Chrit T W Moonen
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA Netherlands
| | - Mario Ries
- Imaging Division, UMC Utrecht, Heidelberglaan 100, Utrecht, 3508 GA Netherlands
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Zachiu C, Ries M, Ramaekers P, Guey JL, Moonen CTW, de Senneville BD. Real-time non-rigid target tracking for ultrasound-guided clinical interventions. ACTA ACUST UNITED AC 2017; 62:8154-8177. [DOI: 10.1088/1361-6560/aa8c66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lammertink BHA, Deckers R, Derieppe M, De Cock I, Lentacker I, Storm G, Moonen CTW, Bos C. Dynamic Fluorescence Microscopy of Cellular Uptake of Intercalating Model Drugs by Ultrasound-Activated Microbubbles. Mol Imaging Biol 2017; 19:683-693. [PMID: 28213832 PMCID: PMC5574961 DOI: 10.1007/s11307-016-1042-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE The combination of ultrasound and microbubbles can facilitate cellular uptake of (model) drugs via transient permeabilization of the cell membrane. By using fluorescent molecules, this process can be studied conveniently with confocal fluorescence microscopy. This study aimed to investigate the relation between cellular uptake and fluorescence intensity increase of intercalating model drugs. PROCEDURES SYTOX Green, an intercalating fluorescent dye that displays >500-fold fluorescence enhancement upon binding to nucleic acids, was used as a model drug for ultrasound-induced cellular uptake. SYTOX Green uptake was monitored in high spatiotemporal resolution to qualitatively assess the relation between uptake and fluorescence intensity in individual cells. In addition, the kinetics of fluorescence enhancement were studied as a function of experimental parameters, in particular, laser duty cycle (DC), SYTOX Green concentration and cell line. RESULTS Ultrasound-induced intracellular SYTOX Green uptake resulted in local fluorescence enhancement, spreading throughout the cell and ultimately accumulating in the nucleus during the 9-min acquisition. The temporal evolution of SYTOX Green fluorescence was substantially influenced by laser duty cycle: continuous laser (100 % DC) induced a 6.4-fold higher photobleaching compared to pulsed laser (3.3 % DC), thus overestimating the fluorescence kinetics. A positive correlation of fluorescence kinetics and SYTOX Green concentration was found, increasing from 0.6 × 10-3 to 2.2 × 10-3 s-1 for 1 and 20 μM, respectively. Finally, C6 cells displayed a 2.4-fold higher fluorescence rate constant than FaDu cells. CONCLUSIONS These data show that the temporal behavior of intracellular SYTOX Green fluorescence enhancement depends substantially on nuclear accumulation and not just on cellular uptake. In addition, it is strongly influenced by the experimental conditions, such as the laser duty cycle, SYTOX Green concentration, and cell line.
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Affiliation(s)
- B H A Lammertink
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - R Deckers
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M Derieppe
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - I De Cock
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - I Lentacker
- Department of Pharmaceutics, Ghent University, Ghent, Belgium
| | - G Storm
- Pharmaceutics Department, Utrecht University, Utrecht, The Netherlands
- Targeted Therapeutics, MIRA Institute, University of Twente, Enschede, The Netherlands
| | - C T W Moonen
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - C Bos
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
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Ojha T, Pathak V, Shi Y, Hennink WE, Moonen CTW, Storm G, Kiessling F, Lammers T. Pharmacological and physical vessel modulation strategies to improve EPR-mediated drug targeting to tumors. Adv Drug Deliv Rev 2017; 119:44-60. [PMID: 28697952 PMCID: PMC5919100 DOI: 10.1016/j.addr.2017.07.007] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 02/08/2023]
Abstract
The performance of nanomedicine formulations depends on the Enhanced Permeability and Retention (EPR) effect. Prototypic nanomedicine-based drug delivery systems, such as liposomes, polymers and micelles, aim to exploit the EPR effect to accumulate at pathological sites, to thereby improve the balance between drug efficacy and toxicity. Thus far, however, tumor-targeted nanomedicines have not yet managed to achieve convincing therapeutic results, at least not in large cohorts of patients. This is likely mostly due to high inter- and intra-patient heterogeneity in EPR. Besides developing (imaging) biomarkers to monitor and predict EPR, another strategy to address this heterogeneity is the establishment of vessel modulation strategies to homogenize and improve EPR. Over the years, several pharmacological and physical co-treatments have been evaluated to improve EPR-mediated tumor targeting. These include pharmacological strategies, such as vessel permeabilization, normalization, disruption and promotion, as well as physical EPR enhancement via hyperthermia, radiotherapy, sonoporation and phototherapy. In the present manuscript, we summarize exemplary studies showing that pharmacological and physical vessel modulation strategies can be used to improve tumor-targeted drug delivery, and we discuss how these advanced combination regimens can be optimally employed to enhance the (pre-) clinical performance of tumor-targeted nanomedicines.
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Affiliation(s)
- Tarun Ojha
- Department of Nanomedicines and Theranostics, Institute for Experimental Molecular Imaging (ExMI), RWTH Aachen University Clinic, 52074 Aachen, Germany; Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CG, Utrecht, The Netherlands
| | - Vertika Pathak
- Department of Nanomedicines and Theranostics, Institute for Experimental Molecular Imaging (ExMI), RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Yang Shi
- Department of Nanomedicines and Theranostics, Institute for Experimental Molecular Imaging (ExMI), RWTH Aachen University Clinic, 52074 Aachen, Germany
| | - Wim E Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CG, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Imaging division, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Gert Storm
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CG, Utrecht, The Netherlands; Department of Targeted Therapeutics, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands
| | - Fabian Kiessling
- Department of Nanomedicines and Theranostics, Institute for Experimental Molecular Imaging (ExMI), RWTH Aachen University Clinic, 52074 Aachen, Germany.
| | - Twan Lammers
- Department of Nanomedicines and Theranostics, Institute for Experimental Molecular Imaging (ExMI), RWTH Aachen University Clinic, 52074 Aachen, Germany; Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584 CG, Utrecht, The Netherlands; Department of Targeted Therapeutics, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, 7500 AE Enschede, The Netherlands.
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Knuttel FM, Huijsse SEM, Feenstra TL, Moonen CTW, van den Bosch MAAJ, Buskens E, Greuter MJW, de Bock GH. Early health technology assessment of magnetic resonance-guided high intensity focused ultrasound ablation for the treatment of early-stage breast cancer. J Ther Ultrasound 2017; 5:23. [PMID: 28781881 PMCID: PMC5537939 DOI: 10.1186/s40349-017-0101-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 07/03/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) ablation is in development for minimally invasive treatment of breast cancer. Cost-effectiveness has not been assessed yet. An early health technology assessment was performed to estimate costs of MR-HIFU ablation, compared to breast conserving treatment (BCT). METHODS An MR-HIFU treatment model using the dedicated MR-HIFU breast system (Sonalleve, Philips Healthcare) was developed. Input parameters (treatment steps and duration) were based on the analysis of questionnaire data from an expert panel. MR-HIFU experts assessed face validity of the model. Data collected by questionnaires were compared to published data of an MR-HIFU breast feasibility study. Treatment costs for tumours of 1 to 3 cm were calculated. RESULTS The model structure was considered of acceptable face validity by consulted experts, and questionnaire data and published data were comparable. Costs of MR-HIFU ablation were higher than BCT costs. MR-HIFU best-case scenario costs exceeded BCT costs with approximately €1000. Cooling times and breathing correction contributed most to treatment costs. CONCLUSIONS MR-HIFU ablation is currently not a cost-effective alternative for BCT. MR-HIFU experience is limited, increasing uncertainty of estimations. The potential for cost-effectiveness increases if future research reduces treatment durations and might substantiate equal or improved results.
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Affiliation(s)
- Floortje M Knuttel
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Sèvrin E M Huijsse
- Department of Radiology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB Groningen, The Netherlands
| | - Talitha L Feenstra
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB Groningen, The Netherlands
| | - Chrit T W Moonen
- Center of Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maurice A A J van den Bosch
- Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB Groningen, The Netherlands
| | - Marcel J W Greuter
- Department of Radiology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB Groningen, The Netherlands
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van Breugel JMM, de Greef M, Wijlemans JW, Schubert G, van den Bosch MAAJ, Moonen CTW, Ries MG. Thermal ablation of a confluent lesion in the porcine kidney with a clinically available MR-HIFU system. Phys Med Biol 2017; 62:5312-5326. [PMID: 28557798 DOI: 10.1088/1361-6560/aa75b3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The incidence of small renal masses (SRMs) sized <4 cm has increased over the decades (as co-findings/or due to introduction of cross sectional imaging). Currently, partial nephrectomy (PN) or watchful waiting is advised in these patients. Ultimately, 80-90% of these SRMs require surgical treatment and PN is associated with a 15% complication rate. In this aging population, with possible comorbidities and poor health condition, both PN and watchful waiting are non-ideal treatment options. This resulted in an increased need for early, non-invasive treatment strategies such as MR-guided high intensity focused ultrasound (MR-HIFU). (i) To investigate the feasibility of creating a confluent lesion in the kidney using respiratory-gated MR-HIFU under clinical conditions in a pre-clinical study and (ii) to evaluate the reproducibility of the MR-HIFU ablation strategy. Healthy pigs (n = 10) under general anesthesia were positioned on a clinical MR-HIFU system with integrated cooling. A honeycomb pattern of seven overlapping ablation cells (4 × 4 × 10 mm3, 450 W, <30 s) was ablated successively in the cortex of the porcine kidney. Both MR thermometry and acoustic energy delivery were respiratory gated using a pencil beam navigator on the contralateral kidney. The non-perfused volume (NPV) was visualized after the last sonication by contrast-enhanced (CE) T 1-weighted MR (T 1 w) imaging. Cell viability staining was performed to visualize the extent of necrosis. RESULTS a median NPV of 0.62 ml was observed on CE-T 1 w images (IQR 0.58-1.57 ml, range 0.33-2.75 ml). Cell viability staining showed a median damaged volume of 0.59 ml (IQR 0.24-1.35 ml, range 0-4.1 ml). Overlooking of the false rib, shivering of the pig, and too large depth combined with a large heat-sink effect resulted in insufficient heating in 4 cases. The NPV and necrosed volume were confluent in all cases in which an ablated volume could be observed. Our results demonstrated the feasibility of creating a confluent volume of ablated kidney cortical tissue in vivo with MR-HIFU on a clinically available system using respiratory gating and near-field cooling and showed its reproducibility.
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Affiliation(s)
- J M M van Breugel
- Center for Imaging Sciences, University Medical Center Utrecht, Utrecht, Netherlands
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Ferrer CJ, Bartels LW, van Stralen M, Denis de Senneville B, Moonen CTW, Bos C. Fluid filling of the digestive tract for improved proton resonance frequency shift-based MR thermometry in the pancreas. J Magn Reson Imaging 2017. [PMID: 28646608 DOI: 10.1002/jmri.25800] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To demonstrate that fluid filling of the digestive tract improves the performance of respiratory motion-compensated proton resonance frequency shift (PRFS)-based magnetic resonance (MR) thermometry in the pancreas. MATERIALS AND METHODS In seven volunteers (without heating), we evaluated PRFS thermometry in the pancreas with and without filling of the surrounding digestive tract. All data acquisition was performed at 1.5T, then all datasets were analyzed and compared with three different PRFS respiratory motion-compensated thermometry methods: gating, multibaseline, and referenceless. The temperature precision of the different methods was evaluated by assessing temperature standard deviation over time, while a simulation experiment was used to study the accuracy of the methods. RESULTS Without fluid intake, errors in temperature precision in the pancreas up to 10°C were observed for all evaluated methods. After liquid intake, temperature precision improved to median values between 1.8 and 2.9°C. The simulations showed that gating had the lowest accuracy, with errors up to 7°C. Multibaseline and referenceless thermometry performed better, with a median error in the pancreas between -3 and +3°C after fluid intake, for all volunteers. CONCLUSION Preparation of the digestive tract near the pancreas by filling it with fluid improved MR thermometry precision and accuracy for all common respiratory motion-compensated methods evaluated. These improvements are attributed to reducing field inhomogeneity in the pancreas. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:692-701.
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Affiliation(s)
- Cyril J Ferrer
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lambertus W Bartels
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marijn van Stralen
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Clemens Bos
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
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Shcherbakova Y, van den Berg CAT, Moonen CTW, Bartels LW. PLANET: An ellipse fitting approach for simultaneous T 1 and T 2 mapping using phase-cycled balanced steady-state free precession. Magn Reson Med 2017; 79:711-722. [PMID: 28543430 PMCID: PMC5811804 DOI: 10.1002/mrm.26717] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 03/23/2017] [Accepted: 03/26/2017] [Indexed: 11/09/2022]
Abstract
Purpose To demonstrate the feasibility of a novel, ellipse fitting approach, named PLANET, for simultaneous estimation of relaxation times T1 and T2 from a single 3D phase‐cycled balanced steady‐state free precession (bSSFP) sequence. Methods A method is presented in which the elliptical signal model is used to describe the phase‐cycled bSSFP steady‐state signal. The fitting of the model to the acquired data is reformulated into a linear convex problem, which is solved directly by a linear least squares method, specific to ellipses. Subsequently, the relaxation times T1 and T2, the banding free magnitude, and the off‐resonance are calculated from the fitting results. Results Maps of T1 and T2, as well as an off‐resonance and a banding free magnitude can be simultaneously, quickly, and robustly estimated from a single 3D phase‐cycled bSSFP sequence. The feasibility of the method was demonstrated in a phantom and in the brain of healthy volunteers on a clinical MR scanner. The results were in good agreement for the phantom, but a systematic underestimation of T1 was observed in the brain. Conclusion The presented method allows for accurate mapping of relaxation times and off‐resonance, and for the reconstruction of banding free magnitude images at realistic signal‐to‐noise ratios. Magn Reson Med 79:711–722, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
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Affiliation(s)
- Yulia Shcherbakova
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis A T van den Berg
- Department of Radiotherapy, Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Center for Image Sciences, Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
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Ramaekers P, de Greef M, Berriet R, Moonen CTW, Ries M. Evaluation of a novel therapeutic focused ultrasound transducer based on Fermat’s spiral. Phys Med Biol 2017; 62:5021-5045. [DOI: 10.1088/1361-6560/aa716c] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Lam MK, Bakker CJG, Moonen CTW, Viergever MA, Bartels LW. Short and long time MR signal behavior of randomly distributed water and fat-numerical simulations. NMR Biomed 2016; 29:1634-1643. [PMID: 27687017 DOI: 10.1002/nbm.3615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 07/29/2016] [Accepted: 08/07/2016] [Indexed: 06/06/2023]
Abstract
The MR time-signal behavior of water has been reported to be different on short and long time scales for systems of randomly distributed perturbers in water in the static dephasing regime. Up to now, the signal of the perturbers in such systems has not been taken into consideration. Water-fat emulsions are macroscopically homogeneous systems and can be considered as microscopically randomly distributed perturbing fat spheres embedded in water. In such water-fat systems, the signal of the perturber, fat, cannot be ignored. Since water and fat are within the same system, the fat signal behavior may show similarities with water, with differences in short and long time scales. This could complicate fat-referenced MR thermometry (MRT) methods such as multi-gradient echo-based (MGE) MRT. Simulations were performed using a numerical phantom comprising spherical fat objects embedded in a spherical water medium. To characterize the fat signal, the theoretical signal description of water was fitted to the simulated fat signal. The simulated signals were sampled as an MGE signal and MGE MRT was used to calculate temperatures. The sampling was done with and without delay, to investigate the effect on the temperature error of the time ranges in which the signal was sampled. It was confirmed that the fat signal behavior was similar to that of water and consisted of two regimes. The separation between the short and long time scales was approximately at 55 ms for fat, as compared with 8.9 ms for water. Without delayed signal sampling, the MGE MRT temperature error was about 2.5°C. With delayed sampling such that both the water and the fat signals were either in the short or in the long time scale the error was reduced to 0.2°C.
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Affiliation(s)
- Mie K Lam
- Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, Room Q.02.445, CX, Utrecht, The Netherlands.
| | - Chris J G Bakker
- Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, Room Q.02.445, CX, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, Room Q.02.445, CX, Utrecht, The Netherlands
| | - Max A Viergever
- Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, Room Q.02.445, CX, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, Room Q.02.445, CX, Utrecht, The Netherlands
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Borman PTS, Bos C, de Boorder T, Raaymakers BW, Moonen CTW, Crijns SPM. Towards real-time thermometry using simultaneous multislice MRI. Phys Med Biol 2016; 61:N461-77. [DOI: 10.1088/0031-9155/61/17/n461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Fortin PY, Lepetit-Coiffé M, Genevois C, Debeissat C, Quesson B, Moonen CTW, Konsman JP, Couillaud F. Spatiotemporal control of gene expression in bone-marrow derived cells of the tumor microenvironment induced by MRI guided focused ultrasound. Oncotarget 2016; 6:23417-26. [PMID: 26299614 PMCID: PMC4695127 DOI: 10.18632/oncotarget.4288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 06/02/2015] [Indexed: 11/25/2022] Open
Abstract
The tumor microenvironment is an interesting target for anticancer therapies but modifying this compartment is challenging. Here, we demonstrate the feasibility of a gene therapy strategy that combined targeting to bone marrow-derived tumor microenvironment using genetically modified bone-marrow derived cells and control of transgene expression by local hyperthermia through a thermo-inducible promoter. Chimera were obtained by engraftment of bone marrow from transgenic mice expressing reporter genes under transcriptional control of heat shock promoter and inoculated sub-cutaneously with tumors cells. Heat shocks were applied at the tumor site using a water bath or magnetic resonance guided high intensity focused ultrasound device. Reporter gene expression was followed by bioluminescence and fluorescence imaging and immunohistochemistry. Bone marrow-derived cells expressing reporter genes were identified to be mainly tumor-associated macrophages. We thus provide the proof of concept for a gene therapy strategy that allows for spatiotemporal control of transgenes expression by macrophages targeted to the tumor microenvironment.
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Affiliation(s)
- Pierre-Yves Fortin
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France.,Institut de Bio-Imagerie (IBIO), CNRS/UMS 3428, Université de Bordeaux, Bordeaux, France
| | - Matthieu Lepetit-Coiffé
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France
| | - Coralie Genevois
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France.,Institut de Bio-Imagerie (IBIO), CNRS/UMS 3428, Université de Bordeaux, Bordeaux, France
| | - Christelle Debeissat
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France
| | - Bruno Quesson
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France
| | - Chrit T W Moonen
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France
| | - Jan Pieter Konsman
- Centre de Résonance Magnétique des Systèmes Biologiques (RMSB), CNRS/UMR 5536, Université de Bordeaux, Bordeaux, France
| | - Franck Couillaud
- Laboratoire d'Imagerie Moléculaire et Fonctionnelle (IMF), CNRS/UMR 5231, Université de Bordeaux, Bordeaux, France.,Centre de Résonance Magnétique des Systèmes Biologiques (RMSB), CNRS/UMR 5536, Université de Bordeaux, Bordeaux, France
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van Breugel JMM, Wijlemans JW, Vaessen HHB, de Greef M, Moonen CTW, van den Bosch MAAJ, Ries MG. Procedural sedation and analgesia for respiratory-gated MR-HIFU in the liver: a feasibility study. J Ther Ultrasound 2016; 4:19. [PMID: 27478615 PMCID: PMC4966712 DOI: 10.1186/s40349-016-0063-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 07/08/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies demonstrated both pre-clinically and clinically the feasibility of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablations in the liver. To overcome the associated problem of respiratory motion of the ablation area, general anesthesia (GA) and mechanical ventilation was used in conjunction with either respiratory-gated energy delivery or energy delivery during induced apnea. However, clinical procedures requiring GA are generally associated with increased mortality, morbidity, and complication rate compared to procedural sedation and analgesia (PSA). Furthermore, PSA is associated with faster recovery and an increased eligibility for non- and mini-invasive interventions. METHODS In this study, we investigate both in an animal model and on a small patient group the kinetics of the diaphragm during free-breathing, when a tailored remifentanil/propofol-based PSA protocol inducing partial respiratory depression is used. Subsequently, we demonstrate in an animal study the compatibility of the resulting respiratory pattern of the PSA protocol with a gated HIFU ablation in the liver by direct comparison with gated ablations conducted under GA. Wilcoxon signed-rank tests were performed for statistical analysis of non-perfused and necrosed tissue volumes. Duty cycles (ratio or percentage of the breathing cycle with the diaphragm in its resting position, such that acoustic energy delivery with MR-HIFU was allowed) were statistically compared for both GA and PSA using student's t tests. RESULTS In both animal and human experiments, the breathing frequency was decreased below 9/min, while maintaining stable vital functions. Furthermore an end-exhalation resting phase was induced by this PSA protocol during which the diaphragm is virtually immobile. Median non-perfused volumes, non-viable volumes based on NADH staining, and duty cycles were larger under PSA than under GA or equal. CONCLUSIONS We conclude that MR-HIFU ablations of the liver under PSA are feasible and potentially increase the non-invasive nature of this type of intervention.
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Affiliation(s)
- Johanna M. M. van Breugel
- Division of Imaging, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Radiology, University Medical Center Utrecht, Postbox: 85500, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands
| | - Joost W. Wijlemans
- Division of Imaging, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Martijn de Greef
- Division of Imaging, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chrit T. W. Moonen
- Division of Imaging, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Mario G. Ries
- Division of Imaging, University Medical Center Utrecht, Utrecht, The Netherlands
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Lam MK, Oerlemans C, Froeling M, Deckers R, Barten-Van Rijbroek AD, Viergever MA, Moonen CTW, Bos C, Bartels LW. DCE-MRI and IVIM-MRI of rabbit Vx2 tumors treated with MR-HIFU-induced mild hyperthermia. J Ther Ultrasound 2016; 4:9. [PMID: 26981241 PMCID: PMC4791929 DOI: 10.1186/s40349-016-0052-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 02/29/2016] [Indexed: 02/03/2023] Open
Abstract
Background The purpose of this study is to investigate whether changes could be detected in dynamic contrast-enhanced (DCE) and intra-voxel incoherent motion (IVIM) MR parameters upon MR-guided high-intensity focused ultrasound (MR-HIFU)-induced hyperthermia in a rabbit Vx2 tumor model. Methods Five Vx2 tumor-bearing New Zealand white rabbits were treated with hyperthermia using a clinical MR-HIFU system. Data were acquired before and after hyperthermia. For the DCE analysis, the extended Tofts model was used. For the IVIM analysis, a Bayesian approach was used. Maps were reconstructed of the DCE parameters (Ktrans, kep, and vp) and IVIM parameters (Dt, fp, and Dp). Individual parameter histograms and two-dimensional cross-correlation histograms were constructed to analyze changes in the parameters after hyperthermia. Changes in median values were tested for statistical significance with the Mann-Whitney U test. Results The MR temperature measurements confirmed that mild hyperthermia (40 to 42 °C) was successfully achieved in all rabbits. One rabbit died during treatment and was excluded from the analysis. In the remaining four rabbits, an increase in Dt was observed. In three rabbits, an increase in Ktrans was observed, while in the other rabbits, all three DCE parameter values decreased. Mixed changes were seen for vp and fp. Conclusions Changes in DCE and IVIM parameters were detected after hyperthermia and were variable between the rabbits. DCE- and IVIM-MRI may be promising tools to assess tumor responses to hyperthermia. Further research in a larger number of subjects is necessary in order to assess their value for treatment response monitoring.
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Affiliation(s)
- Mie K Lam
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chris Oerlemans
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn Froeling
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roel Deckers
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Max A Viergever
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Clemens Bos
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
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Ramaekers P, de Greef M, van Breugel JMM, Moonen CTW, Ries M. Increasing the HIFU ablation rate through an MRI-guided sonication strategy using shock waves: feasibility in thein vivoporcine liver. Phys Med Biol 2016; 61:1057-77. [DOI: 10.1088/0031-9155/61/3/1057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Lam MK, de Greef M, Bouwman JG, Moonen CTW, Viergever MA, Bartels LW. Multi-gradient echo MR thermometry for monitoring of the near-field area during MR-guided high intensity focused ultrasound heating. Phys Med Biol 2015; 60:7729-45. [DOI: 10.1088/0031-9155/60/19/7729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
The combination of microbubbles and ultrasound has emerged as a promising method for local drug delivery. Microbubbles can be locally activated by a targeted ultrasound beam, which can result in several bio-effects. For drug delivery, microbubble-assisted ultrasound is used to increase vascular- and plasma membrane permeability for facilitating drug extravasation and the cellular uptake of drugs in the treated region, respectively. In the case of drug-loaded microbubbles, these two mechanisms can be combined with local release of the drug following destruction of the microbubble. The use of microbubble-assisted ultrasound to deliver chemotherapeutic agents is also referred to as sonochemotherapy. In this review, the basic principles of sonochemotherapy are discussed, including aspects such as the type of (drug-loaded) microbubbles used, the routes of administration used in vivo, ultrasound devices and parameters, treatment schedules and safety issues. Finally, the clinical translation of sonochemotherapy is discussed, including the first clinical study using sonochemotherapy.
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Affiliation(s)
- Bart H A Lammertink
- Image Guided Therapy, Imaging Division, University Medical Center Utrecht Utrecht, Netherlands
| | - Clemens Bos
- Image Guided Therapy, Imaging Division, University Medical Center Utrecht Utrecht, Netherlands
| | - Roel Deckers
- Image Guided Therapy, Imaging Division, University Medical Center Utrecht Utrecht, Netherlands
| | - Gert Storm
- Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University Utrecht, Netherlands ; Targeted Therapeutics, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente Enschede, Netherlands
| | - Chrit T W Moonen
- Image Guided Therapy, Imaging Division, University Medical Center Utrecht Utrecht, Netherlands
| | - Jean-Michel Escoffre
- Image Guided Therapy, Imaging Division, University Medical Center Utrecht Utrecht, Netherlands
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41
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Deckers R, Merckel LG, Denis de Senneville B, Schubert G, Köhler M, Knuttel FM, Mali WPTM, Moonen CTW, van den Bosch MAAJ, Bartels LW. Performance analysis of a dedicated breast MR-HIFU system for tumor ablation in breast cancer patients. Phys Med Biol 2015; 60:5527-42. [DOI: 10.1088/0031-9155/60/14/5527] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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42
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Hectors SJCG, Jacobs I, Moonen CTW, Strijkers GJ, Nicolay K. MRI methods for the evaluation of high intensity focused ultrasound tumor treatment: Current status and future needs. Magn Reson Med 2015; 75:302-17. [PMID: 26096859 DOI: 10.1002/mrm.25758] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/14/2015] [Accepted: 04/10/2015] [Indexed: 01/17/2023]
Abstract
Thermal ablation with high intensity focused ultrasound (HIFU) is an emerging noninvasive technique for the treatment of solid tumors. HIFU treatment of malignant tumors requires accurate treatment planning, monitoring and evaluation, which can be facilitated by performing the procedure in an MR-guided HIFU system. The MR-based evaluation of HIFU treatment is most often restricted to contrast-enhanced T1 -weighted imaging, while it has been shown that the non-perfused volume may not reflect the extent of nonviable tumor tissue after HIFU treatment. There are multiple studies in which more advanced MRI methods were assessed for their suitability for the evaluation of HIFU treatment. While several of these methods seem promising regarding their sensitivity to HIFU-induced tissue changes, there is still ample room for improvement of MRI protocols for HIFU treatment evaluation. In this review article, we describe the major acute and delayed effects of HIFU treatment. For each effect, the MRI methods that have been-or could be-used to detect the associated tissue changes are described. In addition, the potential value of multiparametric MRI for the evaluation of HIFU treatment is discussed. The review ends with a discussion on future directions for the MRI-based evaluation of HIFU treatment.
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Affiliation(s)
- Stefanie J C G Hectors
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Department of Radiology, Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Igor Jacobs
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gustav J Strijkers
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Ramaekers P, de Greef M, Moonen CTW, Ries MG. Cavitation-enhanced back projection for acoustic rib detection and attenuation mapping. Ultrasound Med Biol 2015; 41:1726-1736. [PMID: 25843516 DOI: 10.1016/j.ultrasmedbio.2015.01.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 01/19/2015] [Accepted: 01/25/2015] [Indexed: 06/04/2023]
Abstract
High-intensity focused ultrasound allows for minimally invasive, highly localized cancer therapies that can complement surgical procedures or chemotherapy. For high-intensity focused ultrasound interventions in the upper abdomen, the thoracic cage obstructs and aberrates the ultrasonic beam, causing undesired heating of healthy tissue. When a phased array therapeutic transducer is used, such complications can be minimized by applying an apodization law based on analysis of beam path obstructions. In this work, a rib detection method based on cavitation-enhanced ultrasonic reflections is introduced and validated on a porcine tissue sample containing ribs. Apodization laws obtained for different transducer positions were approximately 90% similar to those obtained using image analysis. Additionally, the proposed method provides information on attenuation between transducer elements and the focus. This principle was confirmed experimentally on a polymer phantom. The proposed methods could, in principle, be implemented in real time for determination of the optimal shot position in intercostal high-intensity focused ultrasound therapy.
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Affiliation(s)
- Pascal Ramaekers
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Martijn de Greef
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Mario G Ries
- Imaging Division, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Baron P, Deckers R, Bouwman JG, Bakker CJG, de Greef M, Viergever MA, Moonen CTW, Bartels LW. Influence of water and fat heterogeneity on fat-referenced MR thermometry. Magn Reson Med 2015; 75:1187-97. [PMID: 25940426 DOI: 10.1002/mrm.25727] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/19/2015] [Accepted: 03/20/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate the effect of the aqueous and fatty tissue magnetic susceptibility distribution on absolute and relative temperature measurements as obtained directly from the water/fat (w/f) frequency difference. METHODS Absolute thermometry was investigated using spherical phantoms filled with pork and margarine, which were scanned in three orthogonal orientations. To evaluate relative fat referencing, multigradient echo scans were acquired before and after heating pork tissue via high-intensity focused ultrasound (HIFU). Simulations were performed to estimate the errors that can be expected in human breast tissue. RESULTS The sphere experiment showed susceptibility-related errors of 8.4 °C and 0.2 °C for pork and margarine, respectively. For relative fat referencing measurements, fat showed pronounced phase changes of opposite polarity to aqueous tissue. The apparent mean temperature for a numerical breast model assumed to be 37 °C was 47.2 ± 21.6 °C. Simulations of relative fat referencing for a HIFU sonication (ΔT = 29.7 °C) yielded a maximum temperature error of 6.6 °C compared with 2.5 °C without fat referencing. CONCLUSION Variations in the observed frequency difference between water and fat are largely due to variations in the w/f spatial distribution. This effect may lead to considerable errors in absolute MR thermometry. Additionally, fat referencing may exacerbate rather than correct for proton resonance frequency shift-temperature measurement errors.
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Affiliation(s)
- Paul Baron
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Roel Deckers
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Job G Bouwman
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Chris J G Bakker
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Martijn de Greef
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Max A Viergever
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Chrit T W Moonen
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
| | - Lambertus W Bartels
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
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45
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Lentacker I, De Cock I, Deckers R, De Smedt SC, Moonen CTW. Understanding ultrasound induced sonoporation: definitions and underlying mechanisms. Adv Drug Deliv Rev 2014; 72:49-64. [PMID: 24270006 DOI: 10.1016/j.addr.2013.11.008] [Citation(s) in RCA: 467] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/13/2013] [Indexed: 01/01/2023]
Abstract
In the past two decades, research has underlined the potential of ultrasound and microbubbles to enhance drug delivery. However, there is less consensus on the biophysical and biological mechanisms leading to this enhanced delivery. Sonoporation, i.e. the formation of temporary pores in the cell membrane, as well as enhanced endocytosis is reported. Because of the variety of ultrasound settings used and corresponding microbubble behavior, a clear overview is missing. Therefore, in this review, the mechanisms contributing to sonoporation are categorized according to three ultrasound settings: i) low intensity ultrasound leading to stable cavitation of microbubbles, ii) high intensity ultrasound leading to inertial cavitation with microbubble collapse, and iii) ultrasound application in the absence of microbubbles. Using low intensity ultrasound, the endocytotic uptake of several drugs could be stimulated, while short but intense ultrasound pulses can be applied to induce pore formation and the direct cytoplasmic uptake of drugs. Ultrasound intensities may be adapted to create pore sizes correlating with drug size. Small molecules are able to diffuse passively through small pores created by low intensity ultrasound treatment. However, delivery of larger drugs such as nanoparticles and gene complexes, will require higher ultrasound intensities in order to allow direct cytoplasmic entry.
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Affiliation(s)
- I Lentacker
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Harelbekestraat 72, 9000 Ghent, Belgium
| | - I De Cock
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Harelbekestraat 72, 9000 Ghent, Belgium
| | - R Deckers
- Imaging Division, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - S C De Smedt
- Ghent Research Group on Nanomedicines, Department of Pharmaceutics, Ghent University, Harelbekestraat 72, 9000 Ghent, Belgium.
| | - C T W Moonen
- Imaging Division, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
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Baron P, Ries M, Deckers R, de Greef M, Tanttu J, Köhler M, Viergever MA, Moonen CTW, Bartels LW. In vivo T2
-based MR thermometry in adipose tissue layers for high-intensity focused ultrasound near-field monitoring. Magn Reson Med 2013; 72:1057-64. [DOI: 10.1002/mrm.25025] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 10/11/2013] [Accepted: 10/11/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Paul Baron
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Mario Ries
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Roel Deckers
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Martijn de Greef
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Jukka Tanttu
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Max Köhler
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Max A. Viergever
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Chrit T. W. Moonen
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
| | - Lambertus W. Bartels
- Image Sciences Institute; University Medical Center Utrecht; Utrecht The Netherlands
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Lepetit-Coiffé M, Yudina A, Poujol C, de Oliveira PL, Couillaud F, Moonen CTW. Quantitative Evaluation of Ultrasound-Mediated Cellular Uptake of a Fluorescent Model Drug. Mol Imaging Biol 2013; 15:523-33. [DOI: 10.1007/s11307-013-0615-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Wijlemans JW, Bartels LW, Deckers R, Ries M, Mali WPTM, Moonen CTW, van den Bosch MAAJ. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation of liver tumours. Cancer Imaging 2012; 12:387-94. [PMID: 23022541 PMCID: PMC3460556 DOI: 10.1102/1470-7330.2012.9038] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Recent decades have seen a paradigm shift in the treatment of liver tumours from invasive surgical procedures to minimally invasive image-guided ablation techniques. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a novel, completely non-invasive ablation technique that has the potential to change the field of liver tumour ablation. The image guidance, using MR imaging and MR temperature mapping, provides excellent planning images and real-time temperature information during the ablation procedure. However, before clinical implementation of MR-HIFU for liver tumour ablation is feasible, several organ-specific challenges have to be addressed. In this review we discuss the MR-HIFU ablation technique, the liver-specific challenges for MR-HIFU tumour ablation, and the proposed solutions for clinical translation.
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Affiliation(s)
- J W Wijlemans
- Department of Radiology, University Medical Center Utrecht, The Netherlands.
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49
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de Senneville BD, Roujol S, Jaïs P, Moonen CTW, Herigault G, Quesson B. Feasibility of fast MR-thermometry during cardiac radiofrequency ablation. NMR Biomed 2012; 25:556-562. [PMID: 22553824 DOI: 10.1002/nbm.1771] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Online MR temperature monitoring during radiofrequency (RF) ablation of cardiac arrhythmias may improve the efficacy and safety of the treatment. MR thermometry at 1.5 T using the proton resonance frequency (PRF) method was assessed in 10 healthy volunteers under normal breathing conditions, using a multi-slice, ECG-gated, echo planar imaging (EPI) sequence in combination with slice tracking. Temperature images were post-processed to remove residual motion-related artifacts. Using an MR-compatible steerable catheter and electromagnetic noise filter, RF ablation was performed in the ventricles of two sheep in vivo. The standard deviation of the temperature evolution in time (TSD) was computed. Temperature mapping of the left ventricle was achieved at an update rate of approximately 1 Hz with a mean TSD of 3.6 ± 0.9 °C. TSD measurements at the septum showed a higher precision (2.8 ± 0.9 °C) than at the myocardial regions at the heart-lung and heart-liver interfaces (4.1 ± 0.9 °C). Temperature rose maximally by 9 °C and 16 °C during 5 W and 10 W RF applications, respectively, for 60 s each. Tissue temperature can be monitored at an update rate of approximately 1 Hz in five slices. Typical temperature changes observed during clinical RF application can be monitored with an acceptable level of precision.
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Affiliation(s)
- Baudouin Denis de Senneville
- Laboratory for Molecular and Functional Imaging: From Physiology to Therapy, FRE 3313 CNRS/Université Bordeaux 2, Bordeaux, France.
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Roujol S, Benois-Pineau J, de Senneville BD, Ries M, Quesson B, Moonen CTW. Robust real-time-constrained estimation of respiratory motion for interventional MRI on mobile organs. ACTA ACUST UNITED AC 2012; 16:365-74. [PMID: 22411045 DOI: 10.1109/titb.2012.2190366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Real-time magnetic resonance imaging is a promising tool for image-guided interventions. For applications such as thermotherapy on moving organs, a precise image-based compensation of motion is required in real time to allow quantitative analysis, retrocontrol of the interventional device, or determination of the therapy endpoint. Reduced field-of-view imaging represents a promising way to improve spatial and/or temporal resolution. However, it introduces new challenges for target motion estimation, since structures near the target may appear transiently due to the respiratory motion and the limited spatial coverage. In this paper, a new image-based motion estimation method is proposed combining a global motion estimation with a novel optical flow approach extending the initial Horn and Schunck (H&S) method by an additional regularization term. This term integrates the displacement of physiological landmarks into the variational formulation of the optical flow problem. This allowed for a better control of the optical flow in presence of transient structures. The method was compared to the same registration pipeline employing the H&S approach on a synthetic dataset and in vivo image sequences. Compared to the H&S approach, a significant improvement (p<0.05) of the Dice's similarity criterion computed between the reference and the registered organ positions was achieved.
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Affiliation(s)
- Sébastien Roujol
- Laboratory for Molecular and Functional Imaging: From Physiology to Therapy, CNRS, University of Bordeaux 2, Bordeaux, France.
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