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Baker RR, Payne C, Yu Y, Mohseni M, Connell JJ, Lin F, Harrison IF, Southern P, Rudrapatna US, Stuckey DJ, Kalber TL, Siow B, Thorne L, Punwani S, Jones DK, Emberton M, Pankhurst QA, Lythgoe MF. Image-Guided Magnetic Thermoseed Navigation and Tumor Ablation Using a Magnetic Resonance Imaging System. Adv Sci (Weinh) 2022; 9:e2105333. [PMID: 35106965 PMCID: PMC9036015 DOI: 10.1002/advs.202105333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Medical therapies achieve their control at expense to the patient in the form of a range of toxicities, which incur costs and diminish quality of life. Magnetic resonance navigation is an emergent technique that enables image-guided remote-control of magnetically labeled therapies and devices in the body, using a magnetic resonance imaging (MRI) system. Minimally INvasive IMage-guided Ablation (MINIMA), a novel, minimally invasive, MRI-guided ablation technique, which has the potential to avoid traditional toxicities, is presented. It comprises a thermoseed navigated to a target site using magnetic propulsion gradients generated by an MRI scanner, before inducing localized cell death using an MR-compatible thermoablative device. The authors demonstrate precise thermoseed imaging and navigation through brain tissue using an MRI system (0.3 mm), and they perform thermoablation in vitro and in vivo within subcutaneous tumors, with the focal ablation volume finely controlled by heating duration. MINIMA is a novel theranostic platform, combining imaging, navigation, and heating to deliver diagnosis and therapy in a single device.
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Affiliation(s)
- Rebecca R. Baker
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Christopher Payne
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Yichao Yu
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Matin Mohseni
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - John J. Connell
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Fangyu Lin
- Resonant Circuits Limited21 Albemarle StreetLondonW1S 4BSUK
| | - Ian F. Harrison
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Paul Southern
- Resonant Circuits Limited21 Albemarle StreetLondonW1S 4BSUK
| | - Umesh S. Rudrapatna
- Cardiff University Brain Research Imaging CentreMaindy RoadCardiffCF24 4HQUK
| | - Daniel J. Stuckey
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Tammy L. Kalber
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Bernard Siow
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
| | - Lewis Thorne
- Victor Horsley Department of NeurosurgeryThe National Hospital for Neurology and NeurosurgeryQueen SquareLondonWC1N 3BGUK
| | - Shonit Punwani
- Centre for Medical ImagingUniversity College LondonCharles Bell House, 43‐45 Foley StreetLondonW1W 7TSUK
| | - Derek K. Jones
- Cardiff University Brain Research Imaging CentreMaindy RoadCardiffCF24 4HQUK
| | - Mark Emberton
- Division of Surgery and Interventional ScienceUniversity College LondonCharles Bell House, 43–45 Foley StreetLondonW1W 7JNUK
| | - Quentin A. Pankhurst
- Resonant Circuits Limited21 Albemarle StreetLondonW1S 4BSUK
- UCL Healthcare Biomagnetics LaboratoryUniversity College London21 Albemarle StreetLondonW1S 4BSUK
| | - Mark F. Lythgoe
- Centre for Advanced Biomedical ImagingDivision of MedicineUniversity College London72 Huntley StreetLondonWC1E 6DDUK
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Michaud F, Li N, Plantefève R, Nosrati Z, Tremblay C, Saatchi K, Moran G, Bigot A, Häfeli UO, Kadoury S, Tang A, Perreault P, Martel S, Soulez G. Selective embolization with magnetized microbeads using magnetic resonance navigation in a controlled-flow liver model. Med Phys 2018; 46:789-799. [PMID: 30451303 DOI: 10.1002/mp.13298] [Citation(s) in RCA: 13] [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: 07/16/2018] [Revised: 10/18/2018] [Accepted: 11/04/2018] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The purpose of this study was to demonstrate the feasibility of using a custom gradient sequence on an unmodified 3T magnetic resonance imaging (MRI) scanner to perform magnetic resonance navigation (MRN) by investigating the blood flow control method in vivo, reproducing the obtained rheology in a phantom mimicking porcine hepatic arterial anatomy, injecting magnetized microbead aggregates through an implantable catheter, and steering the aggregates across arterial bifurcations for selective tumor embolization. MATERIALS AND METHODS In the first phase, arterial hepatic velocity was measured using cine phase-contrast imaging in seven pigs under free-flow conditions and controlled-flow conditions, whereby a balloon catheter is used to occlude arterial flow and saline is injected at different rates. Three of the seven pigs previously underwent selective lobe embolization to simulate a chemoembolization procedure. In the second phase, the measured in vivo controlled-flow velocities were approximately reproduced in a Y-shaped vascular bifurcation phantom by injecting saline at an average rate of 0.6 mL/s with a pulsatile component. Aggregates of 200-μm magnetized particles were steered toward the right or left hepatic branch using a 20-mT/m MRN gradient. The phantom was oriented at 0°, 45°, and 90° with respect to the B0 magnetic field. The steering differences between left-right gradient and baseline were calculated using Fisher's exact test. A theoretical model of the trajectory of the aggregate within the main phantom branch taking into account gravity, magnetic force, and hydrodynamic drag was also designed, solved, and validated against the experimental results to characterize the physical limitations of the method. RESULTS At an injection rate of 0.5 mL/s, the average flow velocity decreased from 20 ± 15 to 8.4 ± 5.0 cm/s after occlusion in nonembolized pigs and from 13.6 ± 2.0 to 5.4 ± 3.0 cm/s in previously embolized pigs. The pulsatility index measured to be 1.7 ± 1.8 and 1.1 ± 0.1 for nonembolized and embolized pigs, respectively, decreased to 0.6 ± 0.4 and 0.7 ± 0.3 after occlusion. For MRN performed at each orientation, the left-right distribution of aggregates was 55%, 25%, and 75% on baseline and 100%, 100%, and 100% (P < 0.001, P = 0.003, P = 0.003) after the application of MRN, respectively. According to the theoretical model, the aggregate reaches a stable transverse position located toward the direction of the gradient at a distance equal to 5.8% of the radius away from the centerline within 0.11 s, at which point the aggregate will have transited through a longitudinal distance of 1.0 mm from its release position. CONCLUSION In this study, we showed that the use of a balloon catheter reduces arterial hepatic flow magnitude and variation with the aim to reduce steering failures caused by fast blood flow rates and low magnetic steering forces. A mathematical model confirmed that the reduced flow rate is low enough to maximize steering ratio. After reproducing the flow rate in a vascular bifurcation phantom, we demonstrated the feasibility of MRN after injection of microparticle aggregates through a dedicated injector. This work is an important step leading to MRN-based selective embolization techniques in humans.
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Affiliation(s)
- François Michaud
- Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Ning Li
- Polytechnique Montréal, 2500 Chemin de Polytechnique, Montréal, Québec, H3T 1J4, Canada
| | - Rosalie Plantefève
- Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Zeynab Nosrati
- University of British Columbia, 2405 Wesbrook Mall, Vancouver, British-Columbia, V6T 1Z3, Canada
| | - Charles Tremblay
- Polytechnique Montréal, 2500 Chemin de Polytechnique, Montréal, Québec, H3T 1J4, Canada
| | - Katayoun Saatchi
- University of British Columbia, 2405 Wesbrook Mall, Vancouver, British-Columbia, V6T 1Z3, Canada
| | - Gerald Moran
- Siemens Healthcare Limited, 1577 North Service Road East, Oakville, Ontario, L6H 0H6, Canada
| | - Alexandre Bigot
- Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Urs O Häfeli
- University of British Columbia, 2405 Wesbrook Mall, Vancouver, British-Columbia, V6T 1Z3, Canada
| | - Samuel Kadoury
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.,Polytechnique Montréal, 2500 Chemin de Polytechnique, Montréal, Québec, H3T 1J4, Canada
| | - An Tang
- Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Pierre Perreault
- Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Sylvain Martel
- Polytechnique Montréal, 2500 Chemin de Polytechnique, Montréal, Québec, H3T 1J4, Canada
| | - Gilles Soulez
- Université de Montréal, 2900 Boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
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