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Slotman DJ, Bartels MMTJ, Ferrer CJ, Bos C, Bartels LW, Boomsma MF, Phernambucq ECJ, Nijholt IM, Morganti AG, Siepe G, Buwenge M, Grüll H, Bratke G, Yeo SY, Blanco Sequeiros R, Minn H, Huhtala M, Napoli A, De Felice F, Catalano C, Bazzocchi A, Gasperini C, Campanacci L, Simões Corrêa Galendi J, Müller D, Braat MNGJA, Moonen C, Verkooijen HM. Focused Ultrasound and RadioTHERapy for non-invasive palliative pain treatment in patients with bone metastasis: a study protocol for the three armed randomized controlled FURTHER trial. Trials 2022; 23:1061. [PMID: 36582001 PMCID: PMC9798627 DOI: 10.1186/s13063-022-06942-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cancer-induced bone pain (CIBP), caused by bone metastases, is a common complication of cancer and strongly impairs quality of life (QoL). External beam radiotherapy (EBRT) is the current standard of care for treatment of CIBP. However, approximately 45% of patients have no adequate pain response after EBRT. Magnetic resonance image-guided high-intensity focused ultrasound (MR-HIFU) may improve pain palliation in this patient population. The main objective of this trial was to compare MR-HIFU, EBRT, and MR-HIFU + EBRT for the palliative treatment of bone metastases. METHODS/DESIGN The FURTHER trial is an international multicenter, three-armed randomized controlled trial. A total of 216 patients with painful bone metastases will be randomized in a 1:1:1 ratio to receive EBRT only, MR-HIFU only, or combined treatment with EBRT followed by MR-HIFU. During a follow-up period of 6 months, patients will be contacted at eight time points to retrieve information about their level of pain, QoL, and the occurrence of (serious) adverse events. The primary outcome of the trial is pain response at 14 days after start of treatment. Secondary outcomes include pain response at 14 days after trial enrolment, pain scores (daily until the 21st day and at 4, 6, 12 and 24 weeks), toxicity, adverse events, QoL, and survival. Cost-effectiveness and cost-utility analysis will be conducted. DISCUSSION The FURTHER trial aims to evaluate the effectiveness and cost-effectiveness of MR-HIFU-alone or in combination with EBRT-compared to EBRT to relieve CIBP. The trial will be performed in six hospitals in four European countries, all of which are partners in the FURTHER consortium. TRIAL REGISTRATION The FURTHER trial is registered under the Netherlands Trials Register number NL71303.041.19 and ClinicalTrials.gov registration number NCT04307914. Date of trial registration is 13-01-2020.
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Affiliation(s)
- Derk J. Slotman
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Marcia M. T. J. Bartels
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cyril J. Ferrer
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Clemens Bos
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lambertus W. Bartels
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Martijn F. Boomsma
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Erik C. J. Phernambucq
- grid.452600.50000 0001 0547 5927Department of Radiation Oncology, Isala Hospital, Zwolle, The Netherlands
| | - Ingrid M. Nijholt
- grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Alessio G. Morganti
- grid.6292.f0000 0004 1757 1758DIMES, Alma Mater Studiorum - Bologna University, Bologna, Italy ,grid.6292.f0000 0004 1757 1758Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giambattista Siepe
- grid.6292.f0000 0004 1757 1758Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Milly Buwenge
- grid.6292.f0000 0004 1757 1758DIMES, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Holger Grüll
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Grischa Bratke
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sin Yuin Yeo
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roberto Blanco Sequeiros
- grid.410552.70000 0004 0628 215XDepartment of Radiology, Turku University Hospital, Turku, Finland
| | - Heikki Minn
- grid.1374.10000 0001 2097 1371Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Mira Huhtala
- grid.1374.10000 0001 2097 1371Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Alessandro Napoli
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca De Felice
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alberto Bazzocchi
- grid.419038.70000 0001 2154 6641Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- grid.419038.70000 0001 2154 6641Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Laura Campanacci
- grid.419038.70000 0001 2154 66413Rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Julia Simões Corrêa Galendi
- grid.6190.e0000 0000 8580 3777Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Dirk Müller
- grid.6190.e0000 0000 8580 3777Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Manon N. G. J. A. Braat
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Chrit Moonen
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Helena M. Verkooijen
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
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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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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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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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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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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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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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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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Vera R, Ferrández A, Ferrer CJ, Flores C, Joaquín C, López S, Martín T, Martín E, Marzo M, Sarrión A, Vaquero E, Zapatero A, Aparicio J. Procedures and recommended times in the care process of the patient with pancreatic cancer: PAN-TIME consensus between scientific societies. Clin Transl Oncol 2017; 19:834-843. [PMID: 28105537 PMCID: PMC5486521 DOI: 10.1007/s12094-016-1609-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 12/29/2016] [Indexed: 01/20/2023]
Abstract
PURPOSE Pancreatic cancer (PC) is a disease with bad prognosis. It is usually diagnosed at advanced stages and its treatment is complex. The aim of this consensus document was to provide recommendations by experts that would ameliorate PC diagnosis, reduce the time to treatment, and optimize PC management by interdisciplinary teams. METHODS As a consensus method, we followed the modified Delphi methodology. A scientific committee of experts provided 40 statements that were submitted in two rounds to a panel of 87 specialists of 12 scientific societies. RESULTS Agreement was reached for 39 of the 40 proposed statements (97.5%). CONCLUSIONS Although a screening of the asymptomatic population is not a feasible option, special attention to potential symptoms during primary care could ameliorate early diagnostic. It is especially important to decrease the period until diagnostic tests are performed. This consensus could improve survival in PC patients by decreasing the time to diagnose and time to treatment and by the implementation of multidisciplinary teams.
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Affiliation(s)
- R Vera
- Spanish Society of Medical Oncology, Madrid, Spain.
| | - A Ferrández
- Spanish Society of Pathological Anatomy, Madrid, Spain
| | - C J Ferrer
- Spanish Society of Radiation Oncology, Madrid, Spain
| | - C Flores
- Spanish Society of General and Family Physicians, Madrid, Spain
| | - C Joaquín
- Spanish Society of Endocrinology and Nutrition, Madrid, Spain
| | - S López
- Spanish Society of Surgical Oncology, Madrid, Spain
| | - T Martín
- Spanish Society of Medical Radiology/Spanish Society of Abdominal Radiology, Madrid, Spain
| | - E Martín
- Spanish Association of Surgeons, Madrid, Spain
| | - M Marzo
- Spanish Society of Family and Community Medicine, Madrid, Spain
| | - A Sarrión
- Spanish Society of Primary Care Physicians, Madrid, Spain
| | - E Vaquero
- Spanish Association of Gastroenterology, Madrid, Spain
| | - A Zapatero
- Spanish Society of Internal Medicine, Madrid, Spain
| | - J Aparicio
- Spanish Society of Medical Oncology, Madrid, Spain
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