Magnetic Resonance Imaging Thermometry Research Articles

Advanced software for MRgFUS treatment planning

Background and objectivesHerein, a user-friendly software platform for 3-dimensional Focused Ultrasound treatment planning based on Magnetic Resonance Imaging (MRI) images is presented. MethodsThe software directly retrieves and loads MRI images. Various design tools can be used on the MRI images to define the treatment area and the sonication parameters. Based on the treatment plan, the software controls the robotic motion and motion pattern of Magnetic Resonance guided Focused Ultrasound (MRgFUS) robotic systems to execute the treatment procedure. Real-time treatment monitoring is achieved through MRI images and thermometry. The software's functionality and performance were evaluated in both laboratory and MRI environments. Different treatment plans were designed on MRI images and sonications were executed on agar-based phantoms and polymer films. ResultsMagnetic Resonance (MR) thermometry maps were acquired in the agar-based phantoms. An exceptional agreement was observed between the software-planned treatment area and the lesions produced on the polymer films. ConclusionsThe developed software was successfully integrated with the MRI and robotic system controls for performing accurate treatment planning and real-time monitoring during sonications. The software provides an extremely user-friendly interface, while in the future it could be enhanced by providing dynamic modulation of the ultrasonic parameters during the treatment process.

Magnetic resonance imaging-guided ultrasound ablation for prostate cancer - A contemporary review of performance.

Prostate cancer (PCa) is one of the most common malignancies in men, but patient outcomes are varied depending on extent of disease. Radical, whole-gland therapies, such as prostatectomy or radiotherapy, are definitive treatments for PCa, but they are associated with significant morbidity, including erectile dysfunction and urinary incontinence. Focal therapies for PCa, whereby the part of gland harboring disease is selectively treated, spares the normal surrounding structures, and minimizes the morbidity associated with whole gland treatment. The use of magnetic resonance imaging (MRI) guidance provides advantages over ultrasound guidance, such as better localization and targeting of clinically significant PCa (csPCa), as well as MRI thermometry which optimizes tissue ablation temperatures. This review will discuss two MRI-guided high-intensity focused ultrasound (HIFU) techniques - transrectal MR-guided focused ultrasound (MRgFUS) and TULSA (transurethral ultrasound ablation) ablation for localized PCa. Overall, recent major trials for MRgFUS and TULSA have shown promising oncological and functional results in the treatment of low- to intermediate-risk PCa. Recent Phase II MRgFUS trials have shown better oncologic outcomes than the published results for focal ultrasound guided HIFU and may justify the additional costs associated with MRI guidance. While initial studies on TULSA have focused on subtotal gland ablation, recent trials assessing oncological outcomes for focal treatment of angular sectors have shown promise.

Assessing critical temperature dose areas in the kidney by magnetic resonance imaging thermometry in an ex vivo Holmium:YAG laser lithotripsy model

PurposeWe aimed to assess critical temperature areas in the kidney parenchyma using magnetic resonance thermometry (MRT) in an ex vivo Holmium:YAG laser lithotripsy model.MethodsThermal effects of Ho:YAG laser irradiation of 14 W and 30 W were investigated in the calyx and renal pelvis of an ex vivo kidney with different laser application times (tL) followed by a delay time (tD) of tL/tD = 5/5 s, 5/10 s, 10/5 s, 10/10 s, and 20/0 s, with irrigation rates of 10, 30, 50, 70, and 100 ml/min. Using MRT, the size of the area was determined in which the thermal dose as measured by the Cumulative Equivalent Minutes (CEM43) method exceeded a value of 120 min.ResultsIn the calyx, CEM43 never exceeded 120 min for flow rates ≥ 70 ml/min at 14 W, and longer tL (10 s vs. 5 s) lead to exponentially lower thermal affection of tissue (3.6 vs. 21.9 mm2). Similarly at 30 W and ≥ 70 ml/min CEM43 was below 120 min. Interestingly, at irrigation rates of 10 ml/min, tL = 10 s and tD = 10 s CEM43 were observed > 120 min in an area of 84.4 mm2 and 49.1 mm2 at tD = 5 s. Here, tL = 5 s revealed relevant thermal affection of 29.1 mm2 at 10 ml/min.ConclusionWe demonstrate that critical temperature dose areas in the kidney parenchyma were associated with high laser power and application times, a low irrigation rate, and anatomical volume of the targeted calyx.

Analysis of cavitation artifacts in Magnetic Resonance Imaging Thermometry during laser ablation monitoring.

Magnetic Resonance Thermometry Imaging (MRTI) holds great potential in laser ablation (LA) monitoring. It provides the real-time multidimensional visualization of the treatment effect inside the body, thus enabling accurate intraoperative prediction of the thermal damage induced. Despite its great potential., thermal maps obtained with MRTI may be affected by numerous artifacts. Among the sources of error producing artifacts in the images., the cavitation phenomena which could occur in the tissue during LA induces dipole-structured artifacts. In this work., an analysis of the cavitation artifacts occurring during LA in a gelatin phantom in terms of symmetry in space and symmetry of temperature values was performed. Results of 2 Wand 4 W laser power were compared finding higher symmetry for the 2 W case in terms of both dimensions of artifact-lobes and difference in temperature values extracted in specular pixels in the image. This preliminary investigation of artifact features may provide a step forward in the identification of the best strategy to correct and avoid artifact occurrence during thermal therapy monitoring. Clinical Relevance- This work presents an analysis of cavitation artifacts in MRTI from LA which must be corrected to avoid error in the prediction of thermal damage during LA monitoring.

One-Step Preparation of Highly Stable Copper-Zinc Ferrite Nanoparticles in Water Suitable for MRI Thermometry.

Superparamagnetic ferrite nanoparticles coated with a polymer layer are widely used for biomedical applications. The objective of this work is to design nanoparticles as a magnetic resonance imaging (MRI) temperature-sensitive contrast agent. Copper–zinc ferrite nanoparticles coated with a poly(ethylene glycol) (PEG) layer are synthesized using a one-step thermal decomposition method in a polymer matrix. The resulting nanoparticles are stable in water and biocompatible. Using Mössbauer spectroscopy and magnetometry, it was determined that the grown nanoparticles exhibit superparamagnetic properties. Embedding these particles into an agarose gel resulted in significant modification of water proton relaxation times T1, T2, and T2* determined by nuclear magnetic resonance measurements. The results of the spin-echo T2-weighted MR images of an aqueous phantom with embedded Cu0.08Zn0.54Fe2.38O4 nanoparticles in the presence of a strong temperature gradient show a strong correlation between the temperature and the image intensity. The presented results support the hypothesis that CuZn ferrite nanoparticles can be used as a contrast agent for MRI thermometry.

Thermal holographic patterns for ultrasound hyperthermia

Holograms can shape wavefronts to produce arbitrary acoustic images. In this work, we experimentally demonstrate how acoustic holograms can produce controlled thermal patterns in absorbing media at ultrasonic frequencies. Magnetic resonance imaging (MRI)-compatible holographic ultrasound lenses were designed by time-reversal methods and manufactured using 3D-printing. Several thermal holographic patterns were measured using MRI thermometry and a thermographic camera in gelatin-milk phantoms and in an ex vivo liver tissue. The results show that acoustic holograms enable spatially controlled heating in arbitrary regions. Increasing the temperature using low-cost and MRI-compatible holographic transducers might be of great interest for many biomedical applications, such as ultrasound hyperthermia, where the control of specific thermal patterns is needed.

Heat-Mitigated Design and Lorentz Force-Based Steering of an MRI-Driven Microcatheter toward Minimally Invasive Surgery.

Catheters integrated with microcoils for electromagnetic steering under the high, uniform magnetic field within magnetic resonance (MR) scanners (3–7 Tesla) have enabled an alternative approach for active catheter operations. Achieving larger ranges of tip motion for Lorentz force‐based steering have previously been dependent on using high power coupled with active cooling, bulkier catheter designs, or introducing additional microcoil sets along the catheter. This work proposes an alternative approach using a heat‐mitigated design and actuation strategy for a magnetic resonance imaging (MRI)‐driven microcatheter. A quad‐configuration microcoil (QCM) design is introduced, allowing miniaturization of existing MRI‐driven, Lorentz force‐based catheters down to 1‐mm diameters with minimal power consumption (0.44 W). Heating concerns are experimentally validated using noninvasive MRI thermometry. The Cosserat model is implemented within an MR scanner and results demonstrate a desired tip range up to 110° with 4° error. The QCM is used to validate the proposed model and power‐optimized steering algorithm using an MRI‐compatible neurovascular phantom and ex vivo kidney tissue. The power‐optimized tip orientation controller conserves as much as 25% power regardless of the catheter's initial orientation. These results demonstrate the implementation of an MRI‐driven, electromagnetic catheter steering platform for minimally invasive surgical applications without the need for camera feedback or manual advancement via guidewires. The incorporation of such system in clinics using the proposed design and actuation strategy can further improve the safety and reliability of future MRI‐driven active catheter operations.

Exposure to Long Magnetic Resonance Imaging Thermometry Does Not Cause Significant DNA Double-Strand Breaks on CF-1 Mice

Exposure to Long Magnetic Resonance Imaging Thermometry Does Not Cause Significant DNA Double-Strand Breaks on CF-1 Mice

On the optimization of imaging parameters for magnetic resonance imaging thermometry using magnetic microparticles

Magnetic Resonance Imaging thermometry is an extremely useful technique which allows one to determine, noninvasively, the temperature deep in the tissue in two or three dimensions. Many methods of MR thermometry have been developed, including those that rely on the intrinsic MR properties of tissue and those which depend on the addition of contrast agents injected into the tissue to create temperature dependent MR images. One such method is to introduce magnetic particles whose magnetization’s temperature dependence influences the MR properties of the surrounding tissue and obtain temperature from calibrated intensity changes of T2* weighted MR images. One limitation of this method is the temperature resolution which is determined by the rate of change of the magnetization with temperature. One can change the MR response either through varying the particles properties or finding the MR scan parameters which maximize the image contrast due to T2* weighting of images. In this work we calculate the MR signal strength, using known values of T1 and T2* relaxation times for agarose gel phantoms with embedded magnetic particles, and compared this with the temperature dependent intensity of experimental MR images. We seek to optimize the change in signal intensity with temperature by varying the selectable MR scanner parameters: echo time, repetition time, and flip angle. Based on comparison with experimental data we find that the change in signal with temperature can be significantly increased (by as much as 100%) through the appropriate choice of MR scan parameters.

Magnetic resonance thermometry using a GdIII-based contrast agent.

The complexes described here serve as contrast agents for magnetic resonance imaging thermometry. The complexes differentially enhance contrast between 275 and 325 K. The basis of the temperature response of the fluorinated contrast complex is the modulation of water exchange caused by trifluoromethyl groups that can be chemically controlled.

Stereotactic MRI-guided laser interstitial thermal therapy for extratemporal lobe epilepsy.

Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRg-LITT) is an alternative to open epilepsy surgery. We assess safety and effectiveness of MRg-LITT for extratemporal lobe epilepsy (ETLE) in patients who are considered less favorable for open resection. We retrospectively reviewed sequential cases of patients with focal ETLE who underwent MRg-LITT between 2012 and 2019. Epileptogenic zones were determined from standard clinical and imaging data±stereoelectroencephalography (SEEG). Standard stereotactic techniques, MRI thermometry, and a commercial laser thermal therapy system were used for ablations. Anatomic MRI was used to calculate ablation volumes. Clinical outcomes were determined longitudinally. Thirty-five patients with mean epilepsy duration of 21.3±12.2years underwent MRg-LITT for focal ETLE at a mean age 36.4±12.7years. A mean 2.59±1.45 trajectories per patient were used to obtain ablation volumes of 8.8±7.5cm3 . Mean follow-up was 27.3±19.5months. Of 32 patients with >12months of follow-up, 17 (53%) achieved good outcomes (Engel class I+II) of whom 14 (44%) were Engel class I. Subgroup analysis revealed better outcomes for patients with lesional ETLE than for those who were nonlesional, multifocal, or who had failed prior interventions (P=.02). Of 13 patients showing favorable seizure-onset patterns (localized low voltage fast activity or rhythmic spiking on SEEG) prior to ablation, 9 (69%) achieved good outcomes, whereas only 3 of 11 (27%) who show other slower onset patterns achieved good outcomes. Minor adverse events included six patients with transient sensorimotor neurologic deficits and four patients with asymptomatic hemorrhages along the fiber tract. Major adverse events included one patient with a brain abscess that required stereotactic drainage and one patient with persistent hypothalamic obesity. Three deaths-two seizure-associated and one suicide-were unrelated to surgical procedures. MRI-guided laser interstitial thermal therapy (or MRg-LITT) was well-tolerated and yielded good outcomes in a heterogeneous group of ETLE patients. Lesional epilepsy and favorable seizure-onset patterns on SEEG predicted higher likelihoods of success.

An MRI-Guided Ring High-Intensity Focused Ultrasound System for Noninvasive Breast Ablation.

High-intensity focused ultrasound (HIFU) has been used for noninvasive treatment of breast tumors, but the present magnetic resonance imaging (MRI)-guided HIFU (MRI-HIFU) systems encounter skin burn. In this study, a novel MRI-HIFU breast ablation system was developed to improve the above problem. The system consisted of the ring HIFU phased-array transducer, a commercial power amplifier, the mechanical positioner, and the graphical user interface control software. MRI thermometry was also established to monitor the temperature in the HIFU-treated tissue. Ablation of pork and the in vivo rabbit leg were carried out to validate the developed system. Results of fat-surrounding pork ablation showed that the ring HIFU system reached a safe margin of 3 mm without fat burn. Moreover, precision of the positioner moving the HIFU focal zone was within 6% error under MRI circumstances. The representative MRI temperature images show that the peak temperatures among the five ablations ranged between 66 °C and 91 °C, and their thermal doses were over 10000. The system could also ablate the biceps femoris of a rabbit without skin burn to form a lesion of 2.5 mm beneath the skin. With the HIFU dose of 315 W/10 s, the MRI temperature map revealed that the maximum temperature and the thermal dose were 60 °C and 3380, respectively. The MRI-guided ring HIFU system can ablate the target tissue near subcutaneous fat without fat burn. The system prototype is a promising tool for clinical implementation.

Structural, magnetic and toxicity studies of ferrite particles employed as contrast agents for magnetic resonance imaging thermometry

We carried out comprehensive structural, magnetic and toxicity studies of Mg1−xZnxFe2O4 and Cu1−xZnxFe2O4 ferrites that we plan to use as contrast agents for magnetic resonance-imaging thermometry. Samples were prepared by a standard ceramic technique. Their structural properties were investigated with an x-ray diffraction system, and data was analyzed using the Rietveld method that allowed us to determine cations distribution. Magnetic properties of MgZn and CuZn ferrites were studied using a superconducting quantum interference device magnetometer, a vibrating sample magnetometer, and Mössbauer spectrometer. Magnetometry measurements were cross-correlated with XRD results and compared with magnetic properties determined by Mössbauer spectroscopy, allowing us to understand the magnetic structure of studied ferrites. The temperature dependent magnetic measurements were used as guidance to select the most suitable MgZn and CuZn ferrites compositions for MRI thermometry near human body temperature. The inflammation studies indicated that MgZn ferrites are more suitable from the toxicology point of view for MRI thermometry.

Applications of Focused Ultrasound in Cerebrovascular Diseases and Brain Tumors.

Oncology and cerebrovascular disease constitute two of the most common diseases afflicting the central nervous system. Standard of treatment of these pathologies is based on multidisciplinary approaches encompassing combination of interventional procedures such as open and endovascular surgeries, drugs (chemotherapies, anti-coagulants, anti-platelet therapies, thrombolytics), and radiation therapies. In this context, therapeutic ultrasound could represent a novel diagnostic/therapeutic in the armamentarium of the surgeon to treat these diseases. Ultrasound relies on mechanical energy to induce numerous physical and biological effects. The application of this technology in neurology has been limited due to the challenges with penetrating the skull, thus limiting a prompt translation as has been seen in treating pathologies in other organs, such as breast and abdomen. Thanks to pivotal adjuncts such as multiconvergent transducers, magnetic resonance imaging (MRI) guidance, MRI thermometry, implantable transducers, and acoustic windows, focused ultrasound (FUS) is ready for prime-time applications in oncology and cerebrovascular neurology. In this review, we analyze the evolution of FUS from the beginning in 1950s to current state-of-the-art. We provide an overall picture of actual and future applications of FUS in oncology and cerebrovascular neurology reporting for each application the principal existing evidences.

Simultaneous Passive Acoustic Mapping and Magnetic Resonance Thermometry for Monitoring of Cavitation-Enhanced Tumor Ablation in Rabbits Using Focused Ultrasound and Phase-Shift Nanoemulsions

Thermal ablation of solid tumors via focused ultrasound (FUS) is a non-invasive image-guided alternative to conventional surgical resection. However, the usefulness of the technique is limited in vascularized organs because of convection of heat, resulting in long sonication times and unpredictable thermal lesion formation. Acoustic cavitation has been found to enhance heating but requires use of exogenous nuclei and sufficient acoustic monitoring. In this study, we employed phase-shift nanoemulsions (PSNEs) to promote cavitation and incorporated passive acoustic mapping (PAM) alongside conventional magnetic resonance imaging (MRI) thermometry within the bore of a clinical MRI scanner. Simultaneous PAM and MRI thermometry were performed in an in vivo rabbit tumor model, with and without PSNE to promote cavitation. Vaporization and cavitation of the nanoemulsion could be detected using PAM, which led to accelerated heating, monitored with MRI thermometry. The maximum heating assessed from MRI was well correlated with the integrated acoustic emissions, illustrating cavitation-enhanced heating. Examination of tissue revealed thermal lesions that were larger in the presence of PSNE, in agreement with the thermometry data. Using fixed exposure conditions over 94 sonications in multiple animals revealed an increase in the mean amplitude of acoustic emissions and resulting temperature rise, but with significant variability between sonications, further illustrating the need for real-time monitoring. The results indicate the utility of combined PAM and MRI for monitoring of tumor ablation and provide further evidence for the ability of PSNEs to promote cavitation-enhanced lesioning.

Nano-sized ferrite particles for magnetic resonance imaging thermometry

Recently, we reported the application of magnetic particles as temperature sensors for use in magnetic resonance imaging thermometry (tMRI). In this novel method, the brightness of the magnetic resonance (MR) image changes with temperature due to a temperature-dependent local magnetic field inhomogeneity caused by the dipolar field of the magnetic particles. Ferrites are new and promising compounds for tMRI applications because of their biocompatibility and because their magnetic properties can be varied by changing composition. Earlier studies used micrometer sized ferrite particles in a proof-of-concept demonstration. However, such large particles cannot be administered intravenously for in-vivo use. In this report, we establish the use of nanoscale ferrite particles as temperature sensors for tMRI. Scanning transmission electron microscopy and X-ray diffraction demonstrate the synthesis of 210 nm Co0.3Zn0.7Fe2O4 clusters comprised of 10–30 nm crystallites. Temperature-dependent magnetization measurements reveal a Curie temperature of around 275 K. We conducted nuclear magnetic resonance (NMR) and MRI studies of samples with different concentrations of ferrite nanoparticles suspended in agar gel. The relative MR image intensity shows a near-linear temperature dependence. At concentrations as low as 0.12 g/L these ferrite nanoparticles provide sufficient image contrast to determine temperature changes with accuracy of ±1.0 K at 310 K, bolstering the potential viability of this material for bio-medical applications.

Development of Ferrite-Based Temperature Sensors for Magnetic Resonance Imaging: A Study of Cu1−xZnxFe2O4

We investigate the use of Cu1-x Zn x Fe2O4 ferrites (0.60 < x < 0.76) as potential sensors for magnetic- resonance-imaging thermometry. Samples are prepared by a standard ceramic technique. Their structural and magnetic properties are determined using x-ray diffraction, scanning electron microscopy, super-conducting quantum-interference device magnetometry, and Mossbauer and 3-T nuclear-magnetic-resonance spectroscopies. We use the mass magnetization of powdered ferrites and transverse relaxivity r*2 of water protons in Ringer's-solution-based agar gels with embedded micron-sized particles to determine the best composition for magnetic-resonance-imaging (MRI) temperature sensors in the (280-323)-K range. A preclinical 3-T MRI scanner is employed to acquire T*2 weighted temperature-dependent images. The brightness of the MRI images is cross-correlated with the temperature of the phantoms, which allows for a temperature determination with approximately 1°C accuracy. We determine that the composition of 0.65 < x < 0.70 is the most suitable for MRI thermometry near human body temperature.

Software that controls a magnetic resonance imaging compatible robotic system for guiding high-intensity focused ultrasound therapy

ABSTRACT Background and Objectives: This study describes a software application for controlling a focused ultrasound system that was guided by magnetic resonance imaging (MRI). Materials and Methods: The software's functionalities were tested using a custom-made electronic system, MRI compatible robotic systems, and a high-intensity focused ultrasound (HIFU) system. The experiments were conducted in gel phantoms to test the motion accuracy and functionality of the system. Results: The software includes the following functionalities: (a) patient database (patient identification number, age, weight, gender, etc.); (b) acquisition of MRI images; (c) transducer movement; (d) transducer coordinates; (e) ultrasound control; (f) MRI thermometry; (h) temperature measurement with thermocouple; (i) command history (command name, starting time, and remaining time); and (j) MRI compatible camera. Evaluation experiments were conducted to test the software for accuracy, functionality, and communication with MRI. Conclusions: User-friendly software was developed to control an MRI-guided HIFU system. The software was evaluated in phantom experiments and it was found to accomplish all the intended functions.

A multipurpose positioning device for magnetic resonance imaging-guided focused ultrasound surgery

ABSTRACT Background and Objectives: An magnetic resonance imaging (MRI)-guided focused ultrasound (MRgFUS) positioning device was developed with 3 identical Cartesian stages. The robotic system can be utilized to move a focused ultrasound transducer for performing various MR-guided applications. Materials and Methods: A single element spherically focused transducer of 4 cm diameter, focusing at 10 cm, and operating at 1.14 MHz was used during the evaluation of the robotic system. The propagation of ultrasound was either lateral or superior to inferior. MRI thermometry algorithms were developed to assess the thermal effects of MRgFUS. The proposed robotic system was developed using a three-dimensional printer. Results: The system was tested successfully in a gel phantom for various tasks (robot motion, functionality, and MR compatibility). Controlled thermal lesions were created in the gel phantom. The lesion creation was monitored successfully using MRI thermometry. Conclusions: The system was tested successfully for its functionality and its MR compatibility. This system has the potential to be used for focused ultrasound applications in the brain, breast, abdominal, and thyroid.

Evaluation of MR thermometry with proton resonance frequency method at 7T.

Quantitative and non-invasive temperature mapping using magnetic resonance imaging (MRI) provides a unique way to measure temperature evolution inside biological tissues. The method is widely used in thermal ablation procedures with magnetic fields at or below 3T. In this paper, the sensitivity of the MRI thermometry at 7T was studied using a proton resonance frequency (PRF)-based technique. We first used an agarose gel phantom with MR-compatible thermometry to calibrate the temperature coefficient, and then this temperature coefficient was employed to measure the internal temperature in both ex vivo (beef muscle) and in vivo (rat) experiments using focused ultrasound heating. The temperature coefficient calibrated by the phantom was 0.0095 ppm/°C, and both the ex vivo and in vivo experiments exhibited clear temperature evolution. This quantitative study confirmed the sensitivity (<1 °C) of MR temperature mapping at 7T.