Abstract
The focused ultrasound power required for successful ablation of uterine fibroid tissue varies substantially between patients and within single treatments.[1,2] Fibroids with high signal intensity in pretreatment T2-weighted MR images have been shown to require increased power to achieve adequate temperature elevation for ablation;[2,4] thus, T2-weighted signal intensity has been suggested as a predictor of MRgFUS treatment response.[2,3] Physiologically, the high intensity of T2-weighted MR images of uterine fibroids may represent vascularization, fluid-rich tissues, or degeneration.[4,6] By quantifying perfusion-related energy losses (Qb) during MRgFUS treatments, this study is the first step in linking perfusion-related energy losses with MR perfusion imaging. This knowledge could be used to improve biothermal modeling of MRgFUS fibroid treatments and as a potential independent predictor of treatment response and outcome.
Highlights
Heating was achieved by electronically steering a phased-array ultrasound transducer (256 elements, f=1 MHz) in an 8 mm-radius circle for 120 s (Figure 2)
Uniform perfusion values ranged from -0.7–0.1, 1.6–3.9, and 3.4–4.4 kg/m3/s for 0, 20, and 40 mL/min flow rates, respectively, following anticipated trends with perfusion approximately zero for the no flow case and increasing from 3D MR temperature data during MRgFUS is feasible and has the potential to improve biothermal models of MRgFUS fibroid treatments
This study demonstrates that obtaining perfusion estimates
Summary
Background/introduction The focused ultrasound power required for successful ablation of uterine fibroid tissue varies substantially between patients and within single treatments.[1,2] Fibroids with high signal intensity in pretreatment T2-weighted MR images have been shown to require increased power to achieve adequate temperature elevation for ablation;[2,4] T2-weighted signal intensity has been suggested as a predictor of MRgFUS treatment response.[2,3] Physiologically, the high intensity of T2weighted MR images of uterine fibroids may represent vascularization, fluid-rich tissues, or degeneration.[4,6] By quantifying perfusion-related energy losses (Qb) during MRgFUS treatments, this study is the first step in linking perfusion-related energy losses with MR perfusion imaging. Methods Experiments were performed in ex vivo porcine kidneys perfused with a heparin- H2O solution in variable flow (0, 20, 40 mL/min) situations and embedded in a gelatin phantom (Figure 1).
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