Magnetic Resonance Temperature Imaging Research Articles

Patient-specific temperature distribution prediction in laser interstitial thermal therapy: single-irradiation data-driven method

Laser interstitial thermal therapy (LITT) is popular for treating brain tumours and epilepsy. The strict control of tissue thermal damage extent is crucial for LITT. Temperature prediction is useful for predicting thermal damage extent. Accurately predicting in vivo brain tissue temperature is challenging due to the temperature dependence and the individual variations in tissue properties. Considering these factors is essential for improving the temperature prediction accuracy. Objective. To present a method for predicting patient-specific tissue temperature distribution within a target lesion area in the brain during LITT. Approach. A magnetic resonance temperature imaging (MRTI) data-driven estimation model was constructed and combined with a modified Pennes bioheat transfer equation (PBHE) to predict patient-specific temperature distribution. In the PBHE for temperature prediction, the individual specificity and temperature dependence of thermal tissue properties and blood perfusion, as well as the individual specificity of optical tissue properties were considered. Only MRTI data during one laser irradiation were required in the method. This enables the prediction of patient-specific temperature distribution and the resulting thermal damage region for subsequent ablations. Main results. Patient-specific temperature prediction was evaluated based on clinical data acquired during LITT in the brain, using intraoperative MRTI data as the reference standard. Our method significantly improved the prediction performance of temperature distribution and thermal damage region. The average root mean square error was decreased by 69.54%, the average intraclass correlation coefficient was increased by 37.5%, the average Dice similarity coefficient was increased by 43.14% for thermal damage region prediction. Significance. The proposed method can predict temperature distribution and thermal damage region at an individual patient level during LITT, providing a promising approach to assist in patient-specific treatment planning for LITT in the brain.

An MR-compatible fiber-optic probe for measuring focused ultrasound-induced temperature rises without viscous heating artifacts

Focused ultrasound (FUS) beam interactions with thermocouples and fiber optic (FO) probes cause a “viscous heating artifact” (VHA), which prevent accurate temperature measurements during acoustic sonication. This work demonstrates a novel fiber-optic temperature probe which is insensitive to VHA, validated in an MR-guided FUS treatment setting. The FO probe (OSENSA Innovations; PRB-140, 0.14 mm diameter) was inserted with an 18G catheter into a tissue-mimicking gelatin phantom. The FO probe tip was located with high-resolution MR images (0.25 × 0.25 × 0.5 mm3) for targeting with FUS. Continuous-wave FUS sonications (50 W, 20 s) were delivered at a distance of ∼1.5 mm from the FO probe tip using a 256 phased-array transducer (Imasonic, France; 1 MHz, 2.1 × 2.3 × 9.8 FWHM spot size) and FUS-induced heating was measured with 3D MR temperature imaging (MRTI; 0.5 × 0.5 × 1 mm3 resolution, 3.9 s acquisition). The VHA effect was not observed in the PRB-140 FO probe measurement data. The FO probe heating and cooling curves closely matched those measured by MRTI, with a root mean-squared error (RMSE) of 0.61 °C. In contrast, the RMSE of VHA-sensitive FO probe was 6.00 °C for a similar acoustic power output. This ultrasound artifact-immune FO temperature probe is highly advantageous for MR temperature sequence development and precise temperature monitoring in FUS treatment applications.

Evaluation of acoustic-thermal simulations of invivo magnetic resonance guided focused ultrasound ablative therapy.

To evaluate numerical simulations of focused ultrasound (FUS) with a rabbit model, comparing simulated heating characteristics with magnetic resonance temperature imaging (MRTI) data collected during invivo treatment. A rabbit model was treated with FUS sonications in the biceps femoris with 3D MRTI collected. Acoustic and thermal properties of the rabbit muscle were determined experimentally. Numerical models of the rabbits were created, and tissue-type-specific properties were assigned. FUS simulations were performed using both the hybrid angular spectrum (HAS) method and k-Wave. Simulated power deposition patterns were converted to temperature maps using a Pennes' bioheat equation-based thermal solver. Agreement of pressure between the simulation techniques and temperature between the simulation and experimental heating was evaluated. Contributions of scattering and absorption attenuation were considered. Simulated peak pressures derived using the HAS method exceeded the simulated peak pressures from k-Wave by 1.6 ± 2.7%. The location and FWHM of the peak pressure calculated from HAS and k-Wave showed good agreement. When muscle acoustic absorption value in the simulations was adjusted to approximately 54% of the measured attenuation, the average root-mean-squared error between simulated and experimental spatial-average temperature profiles was 0.046 ± 0.019 °C/W. Mean distance between simulated and experimental COTMs was 3.25 ± 1.37 mm. Transverse FWHMs of simulated sonications were smaller than in invivo sonications. Longitudinal FWHMs were similar. Presented results demonstrate agreement between HAS and k-Wave simulations and that FUS simulations can accurately predict focal position and heating for invivo applications in soft tissue.

Remotely detuned receiver coil for high-resolution interventional cardiac magnetic resonance imaging.

Interventional cardiac MRI in the context of the treatment of cardiac arrhythmia requires submillimeter image resolution to precisely characterize the cardiac substrate and guide the catheter-based ablation procedure in real-time. Conventional MRI receiver coils positioned on the thorax provide insufficient signal-to-noise ratio (SNR) and spatial selectivity to satisfy these constraints. A small circular MRI receiver coil was developed and evaluated under different experimental conditions, including high-resolution MRI anatomical and thermometric imaging at 1.5 T. From the perspective of developing a therapeutic MR-compatible catheter equipped with a receiver coil, we also propose alternative remote active detuning techniques of the receiver coil using one or two cables. Theoretical details are presented, as well as simulations and experimental validation. Anatomical images of the left ventricle at 170 µm in-plane resolution are provided on ex vivo beating heart from swine using a 2 cm circular receiver coil. Taking advantage of the increase of SNR at its vicinity (up to 35 fold compared to conventional receiver coils), real-time MR-temperature imaging can reach an uncertainty below 0.1°C at the submillimetric spatial resolution. Remote active detuning using two cables has similar decoupling efficiency to conventional on-site decoupling, at the cost of an acceptable decrease in the resulting SNR. This study shows the potential of small dimension surface coils for minimally invasive therapy of cardiac arrhythmia intraoperatively guided by MRI. The proposed remote decoupling approaches may simplify the construction process and reduce the cost of such single-use devices.

Development of a Treatment Planning Framework for Laser Interstitial Thermal Therapy (LITT).

Develop a treatment planning framework for neurosurgeons treating high-grade gliomas with LITT to minimize the learning curve and improve tumor thermal dose coverage. Deidentified patient images were segmented using the image segmentation software Materialize MIMICS©. Segmented images were imported into the commercial finite element analysis (FEA) software COMSOL Multiphysics© to perform bioheat transfer simulations. The laser probe was modeled as a cylindrical object with radius 0.7 mm and length 100 mm, with a constant beam diameter. A modeled laser probe was placed in the tumor in accordance with patient specific patient magnetic resonance temperature imaging (MRTi) data. The laser energy was modeled as a deposited beam heat source in the FEA software. Penne's bioheat equation was used to model heat transfer in brain tissue. The cerebrospinal fluid (CSF) was modeled as a solid with convectively enhanced conductivity to capture heat sink effects. In this study, thermal damage-dependent blood perfusion was assessed. Pulsed laser heating was modeled based on patient treatment logs. The stationary heat source and pullback heat source techniques were modeled to compare the calculated tissue damage. The developed bioheat transfer model was compared to MRTi data obtained from a laser log during LITT procedures. The application builder module in COMSOL Multiphysics© was utilized to create a Graphical User Interface (GUI) for the treatment planning framework. Simulations predicted increased thermal damage (10-15%) in the tumor for the pullback heat source approach compared with the stationary heat source. The model-predicted temperature profiles followed trends similar to those of the MRTi data. Simulations predicted partial tissue ablation in tumors proximal to the CSF ventricle. A mobile platform-based GUI for bioheat transfer simulation was developed to aid neurosurgeons in conveniently varying the simulation parameters according to a patient-specific treatment plan. The convective effects of the CSF should be modeled with heat sink effects for accurate LITT treatment planning.

Improved MR temperature imaging at 0.5T using view-sharing accelerated multiecho thermometry for MR-guided laser interstitial thermal therapy.

The aim of the current study was to improve temperature-monitoring precision using multiecho proton resonance frequency shift-based thermometry with view-sharing acceleration for MR-guided laser interstitial thermal therapy (MRgLITT) on a 0.5-T low-field MR system. Both precision and speed of the temperature measurement for clinical MRgLITT treatments suffer at low field, due to reduced image signal-to-noise ratio (SNR), decreased temperature-induced phase changes, and limited RF receiver channels. In this work, a bipolar multiecho gradient-recalled echo sequence with a temperature-to-noise ratio optimal weighted echo combination is applied to improve the temperature precision. A view-sharing-based approach is utilized to accelerate signal acquisitions while preserving image SNRs. The method was evaluated using ex vivo (pork and pig brain) LITT heating experiments and in vivo (human brain) nonheating experiments on a high-performance 0.5-T scanner. In terms of results, (1) after echo combination, multiecho thermometry (i.e., ~7.5-40.5ms, 7 TEs) provides ~1.5-1.9 times higher temperature precision than the no echo combination case (i.e., TE7 = 40.5ms) within the same readout bandwidth. Additionally, echo registration is necessary for the bipolar multiecho sequence; (2) for a threefold acceleration, the view-sharing approach with variable-density subsampling shows around 1.8 times lower temperature errors than the GRAPPA method. Particularly for view-sharing, variable-density subsampling performs better than Interleave subsampling; and (3) ex vivo heating and in vivo nonheating experiments demonstrated that the temperature accuracy was less than 0.5 and that the temperature precision was less than 0.6 using the proposed 0.5-T thermometry. It was concluded that view-sharing accelerated multiecho thermometry is a practical temperature measurement approach for MRgLITT at 0.5T.

Validation of a drift-corrected 3D MR temperature imaging sequence for breast MR-guided focused ultrasound treatments

Real-time temperature monitoring is critical to the success of thermally ablative therapies. This work validates a 3D thermometry sequence with k-space field drift correction designed for use in magnetic resonance-guided focused ultrasound treatments for breast cancer. Fiberoptic probes were embedded in tissue-mimicking phantoms, and temperature change measurements from the probes were compared with the magnetic resonance temperature imaging measurements following heating with focused ultrasound. Precision and accuracy of measurements were also evaluated in free-breathing healthy volunteers (N = 3) under a non-heating condition.MR temperature measurements agreed closely with those of fiberoptic probes, with a 95% confidence interval of measurement difference from −2.0 °C to 1.4 °C. Field drift-corrected measurements in vivo had a precision of 1.1 ± 0.7 °C and were accurate within 1.3 ± 0.9 °C across the three volunteers. The field drift correction method improved precision and accuracy by an average of 46 and 42%, respectively, when compared to the uncorrected data. This temperature imaging sequence can provide accurate measurements of temperature change in aqueous tissues in the breast and support the use of this sequence in clinical investigations of focused ultrasound treatments for breast cancer.

A k-space-based method to measure and correct for temporal B0 field variations in MR temperature imaging.

Present a method to use change in phase in repeated Cartesian k-space measurements to monitor the change in magnetic field for dynamic MR temperature imaging. The method is applied to focused ultrasound heating experiments in a gelatin phantom and an ex vivo salt pork sample, without and with simulated respiratory motion. In each experiment, phase variations due to B0 field drift and respiration were readily apparent in the measured phase difference. With correction, the SD of the temperature over time was reduced from 0.18°C to 0.14°C (no breathing) and from 0.81°C to 0.22°C (with breathing) for the gelatin phantom, and from 0.68°C to 0.13°C (no breathing) and from 1.06°C to 0.17°C (with breathing) for the pork sample. The accuracy in nonheated regions, assessed as the RMS error deviation from 0°C, improved from 1.70°C to 1.11°C (no breathing) and from 4.73°C to 1.47°C (with breathing) for the gelatin phantom, and from 5.95°C to 0.88°C (no breathing) and from 13.40°C to 1.73°C (with breathing) for the pork sample. The correction did not affect the temperature measurement accuracy in the heated regions. This work demonstrates that phase changes resulting from variations in B0 due to drift and respiration, commonly seen in MR thermometry applications, can be measured directly from 3D Cartesian acquisition methods. The correction of temporal field variations using the presented technique improved temperature accuracy, reduced variability in nonheated regions, and did not reduce accuracy in heated regions.

Magnetic resonance temperature imaging of laser-induced thermotherapy using proton resonance frequency shift: evaluation of different sequences in phantom and porcine brain at 7T.

The present study aimed to evaluate magnetic resonance (MR) thermometry using proton resonance frequency shift (PRFS) during laser-induced thermotherapy (LITT), and to compare the results of using different sequences at a field strength of 7-Tesla to identify the optimal for use in ablation so that the surrounding healthy tissues may be protected from damaging in real time. LITT was applied to agarose gel phantoms and ex-vivo porcine brains. We reconstructed both magnitude and phase images to perform MR thermometry based on PRFS methods. We tested four different sequences: a gradient-echo (GRE), a segmented gradient-echo echoplanar imaging (EPI-GRE), a fast-low angle shot (FLASH), and a true fast imaging with steady precession (TRUFI). Temperature was monitored and verified using a fiber-optic thermometry device. All sequences showed good linear correlations (R = 0.97-0.99) between the measured temperature and the calculated MR-thermometry measurements. The phantom/porcine brain experiments revealed the temperature precisions at 1.53/0.69°C (GRE), 0.61/0.43°C (EPI-GRE), 1.64/1.32°C (FLASH), and 0.58/1.52°C (TRUFI), respectively. Furthermore, we performed a Bland-Altman analysis and the temperature accuracies were found to be - 1.32/- 0.60°C (GRE), 0.42/- 0.33°C (EPI-GRE), - 1.28/- 0.98°C (FLASH), and 0.14/0.46°C (TRUFI) in the phantom/porcine brain experiments, respectively. Our experiments recommend that EPI-GRE sequence be the best of the all sequences for MR temperature imaging with PRFS in the LITT on 7T magnetic resonance imaging (MRI) systems because of its relatively higher precision and accuracy.

Design and evaluation of an open-source, conformable skin-cooling system for body magnetic resonance guided focused ultrasound treatments

Purpose Magnetic resonance guided focused ultrasound (MRgFUS) treatment of tumors uses inter-sonication delays to allow heat to dissipate from the skin and other near-field tissues. Despite inter-sonication delays, treatment of tumors close to the skin risks skin burns. This work has designed and evaluated an open-source, conformable, skin-cooling system for body MRgFUS treatments to reduce skin burns and enable ablation closer to the skin. Methods A MR-compatible skin cooling system is described that features a conformable skin-cooling pad assembly with feedback control allowing continuous flow and pressure maintenance during the procedure. System performance was evaluated with hydrophone, phantom and in vivo porcine studies. Sonications were performed 10 and 5 mm from the skin surface under both control and forced convective skin-cooling conditions. 3D MR temperature imaging was acquired in real time and the accumulated thermal dose volume was measured. Gross analysis of the skin post-sonication was further performed. Device conformability was demonstrated at several body locations. Results Hydrophone studies demonstrated no beam aberration, but a 5–12% reduction of the peak pressure due to the presence of the skin-cooling pad assembly in the acoustic near field. Phantom evaluation demonstrated there is no MR temperature imaging precision reduction or any other artifacts present due to the coolant flow during MRgFUS sonication. The porcine studies demonstrated skin burns were reduced in size or eliminated when compared to the control condition. Conclusion An open-source design of an MRgFUS active skin cooling system demonstrates device conformability with a reduction of skin burns while ablating superficial tissues.

MRI-based thermal dosimetry based on single-slice imaging during focused ultrasound thalamotomy

Transcranial MRI-guided focused ultrasound (MRgFUS) is a noninvasive thermal ablation method approved for the treatment of essential tremor and tremor-dominant Parkinson’s disease. This method uses MR temperature imaging (MRTI) to monitor the treatment. Accurately tracking the accumulated thermal dose is important for both safety and efficacy. Currently, MRTI is obtained in a single plane that varies between sonications, preventing direct tracking of the accumulated dose. In this work, we tested a method to estimate this dose during 120 MRgFUS treatments. This method used the MRTI to create simulated thermal images for sonications when the imaging plane was changed. This approach accurately predicted the lesion shapes. The mean Sørensen-Dice similarity coefficient between the lesion segmentations and dose regions at the 17 cumulative min at 43 °C (CEM43) threshold used by the device software was 0.82 but varied among different treatments (range: 0.34–0.95). Tissue swelling appeared to explain when mismatch occurred, although other errors probably contributed. Overall, the mean distance between the lesion segmentations and the 17 CEM43 dose contours was 0.37 ± 0.57 mm. The probability for thermal damage was estimated to be 50% at 13.6 CEM43 and a maximum temperature of 48.6 °C. Due to large thermal gradients, which exceeded 99 CEM43/mm on average, the area where the probability for thermal damage was uncertain was narrow. Overall these results show that the 17 CEM43 threshold is on average a good predictor for thermal lesions, although there will always be a narrow margin where the fate of the tissue is uncertain.

Using Phase Data From MR Temperature Imaging to Visualize Anatomy During MRI-Guided Focused Ultrasound Neurosurgery.

Neurosurgery targets in the thalamus can be challenging to identify during transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation due to poor image quality. They also neighbor structures that can result in side effects if damaged. Here we demonstrate that the phase data obtained during MRgFUS for MR temperature imaging (MRTI) contains anatomic information that could be useful in guiding this procedure. This approach was evaluated in 68 thalamotomies for essential tremor (ET). We found that we could readily visualize the red nucleus and subthalamic nucleus, and those nuclei were consistently aligned with the sonication target coordinates. We also could consistently visualize the internal capsule, which needs to be protected from thermal damage to prevent side effects. Preliminary results from four pallidotomies in Parkinson's disease patients suggest that this approach might also be useful in visualizing the optic tract in addition to the internal capsule. Overall, this approach can visualize anatomic landmarks that may be useful to refine atlas-based targeting for MRgFUS. Since the same data is used for MRTI and anatomic visualization, there are no errors induced by registration to previously obtained planning images or image distortion, and no additional time is needed.

Accurate and Real-Time Temperature Monitoring during MR Imaging Guided PTT.

Photothermal therapy (PTT) is an efficient approach for cancer treatment. However, accurately monitoring the spatial distribution of photothermal transducing agents (PTAs) and mapping the real-time temperature change in tumor and peritumoral normal tissue remain a huge challenge. Here, we propose an innovative strategy to integrate T1-MRI for precisely tracking PTAs with magnetic resonance temperature imaging (MRTI) for real-time monitoring temperature change in vivo during PTT. NaBiF4: Gd@PDA@PEG nanomaterials were synthesized with favorable T1-weighted performance to target tumor and localize PTAs. The extremely weak susceptibility (1.04 × 10-6 emu g-1 Oe1-) of NaBiF4: Gd@PDA@PEG interferes with the local phase marginally, which maintains the capability of MRTI to dynamically record real-time temperature change in tumor and peritumoral normal tissue. The time resolution is 19 s per frame, and the detection precision of temperature change is approximately 0.1 K. The approach achieving PTT guided by multimode MRI holds significant potential for the clinical application.

Elementwise approach for simulating transcranial MRI-guided focused ultrasound thermal ablation.

This work explored an elementwise approach to model transcranial MRI-guided focused ultrasound (TcMRgFUS) thermal ablation, a noninvasive approach to neurosurgery. Each element of the phased array transducer was simulated individually and could be simultaneously loaded into computer memory, allowing for rapid (~2.5 s) calculation of the pressure field for different phase offsets used for beam steering and aberration correction. We simulated the pressure distribution for 431 sonications in 32 patients, applied the phase and magnitude values used during treatment, and estimated the resulting temperature rise. We systematically varied the relationship between CT (computerized tomography)-derived skull density and the acoustic attenuation and sound speed to obtain the best agreement between the predictions and MR temperature imaging (MRTI). The optimization was validated with simulations of 396 sonications from 40 additional treatments. After optimization, the predicted and measured heating agreed well (R2: 0.74 patients 1–32; 0.71 patients 33–72). The dimensions and obliquity of the heating in the simulated temperature maps were correlated with the MRTI (R2: 0.62, 0.74, respectively), but the measured heating was more spatially diffuse. The energy needed to achieve ablation varied by an order of magnitude (3.3–36.1 kJ). While this elementwise approach required more computation time up front (the combined simulation matrices were approximately 4.6 times higher than a single large simulation), it could be performed in parallel on a computing cluster. It allows for rapid calculation of the three-dimensional heating at the focus for different phase and magnitude values on the array. We also show how this approach can be used to optimize the relationship between CT-derived skull density and acoustic properties. While the relationships found here need further validation in a larger patient population, these results demonstrate the promise of this approach to model TcMRgFUS.

Low-rank plus sparse compressed sensing for accelerated proton resonance frequency shift MR temperature imaging.

To improve multichannel compressed sensing (CS) reconstruction for MR proton resonance frequency (PRF) shift thermography, with application to MRI-induced RF heating evaluation and MR guided high intensity focused ultrasound (MRgFUS) temperature monitoring. A new compressed sensing reconstruction is proposed that enforces joint low rank and sparsity of complex difference domain PRF data between post heating and baseline images. Validations were performed on 4 retrospectively undersampled dynamic data sets in PRF applications, by comparing the proposed method to a previously described L1 and total variation- (TV-) based CS approach that also operates on complex difference domain data, and to a conventional low rank plus sparse (L+S) separation-based CS reconstruction applied to the original domain data. In all 4 retrospective validations, the proposed reconstruction method outperformed the conventional L+S and L1 +TV CS reconstruction methods with a 3.6× acceleration ratio in terms of temperature accuracy with respect to fully sampled data. For RF heating evaluation, the proposed method achieved RMS error of 12%, compared to 19% for the L+S method and 17% for the L1 +TV method. For in vivo MRgFUS thalamotomy, the peak temperature reconstruction errors were 19%, 31%, and 35%, respectively. The complex difference-based low rank and sparse model enhances compressibility for dynamic PRF temperature imaging applications. The proposed multichannel CS reconstruction method enables high acceleration factors for PRF applications including RF heating evaluation and MRgFUS sonication.

Improved MR thermometry for laser interstitial thermotherapy.

To develop, test and evaluate improved 2D and 3D protocols for proton resonance frequency shift magnetic resonance temperature imaging (MRTI) of laser interstitial thermal therapy (LITT). The objective was to develop improved MRTI protocols in terms of temperature measurement precision and volume coverage compared to the 2D MRTI protocol currently used with a commercially available LITT system. Four different 2D protocols and four different 3D protocols were investigated. The 2D protocols used multi-echo readouts to prolong the total MR sampling time and hence the MRTI precision, without prolonging the total acquisition time. The 3D protocols provided volumetric thermometry by acquiring a slab of 12 contiguous slices in the same acquisition time as the 2D protocols. The study only considered readily available pulse sequences (Cartesian 2D and 3D gradient recalled echo and echo planar imaging [EPI]) and methods (partial Fourier and parallel imaging) to ensure wide availability and rapid clinical implementation across vendors and field strengths. In vivo volunteer studies were performed to investigate and compare MRTI precision and image quality. Phantom experiments with LITT heating were performed to investigate and compare MRTI precision and accuracy. Different coil setups were used in the in vivo studies to assess precision differences between using local (such as flex and head coils) and non-local (i.e., body coil) receive coils. Studies were performed at both 1.5 T and 3 T. The improved 2D protocols provide up to a factor of two improvement in the MRTI precision in the same acquisition time, compared to the currently used clinical protocol. The 3D echo planar imaging protocols provide comparable precision as the currently used 2D clinical protocol, but over a substantially larger field of view, without increasing the acquisition time. As expected, local receive coils perform substantially better than the body coil, and 3 T provides better MRTI accuracy and precision than 1.5 T. 3D data can be zero-filled interpolated in all three dimensions (as opposed to just two dimensions for 2D data), reducing partial volume effects and measuring higher maximum temperature rises. With the presented protocols substantially improved MRTI precision (for 2D imaging) or greatly improved field of view coverage (for 3D imaging) can be achieved in the same acquisition time as the currently used protocol. Only widely available pulse sequences and acquisition methods were investigated, which should ensure quick translation to the clinic. Lasers Surg. Med. 51:286-300, 2019. © 2019 Wiley Periodicals, Inc.

Temperature mapping of exothermic in situ chemistry: imaging of thermoembolization via MR

Purpose: MR temperature imaging (MRTI) was employed for visualizing the spatiotemporal evolution of the exotherm of thermoembolization, an investigative transarterial treatment for solid tumors.Materials and methods: Five explanted kidneys were injected with thermoembolic solutions, and monitored by MRTI. In three nonselective experiments, 5 ml of 4 mol/l dichloroacetyl chloride (DCA-Cl) solution in a hydrocarbon vehicle was injected via the main renal artery. For two of these three, MRTI temperature data were compared to fiber optic thermal probes. Another two kidneys received selective injections, treating only portions of the kidneys with 1 ml of 2 mol/l DCA-Cl. MRTI data were acquired and compared to changes in pre- and post-injection CT. Specimens were bisected and photographed for gross pathology 24 h post-procedure.Results: MRTI temperature estimates were within ±1 °C of the probes. In experiments without probes, MRTI measured increases of 30 °C. Some regions had not reached peak temperature by the end of the >18 min acquisition. MRTI indicated the initial heating occurred in the renal cortex, gradually spreading more proximally toward the main renal artery. Gross pathology showed the nonselective injection denatured the entire kidney whereas in the selective injections, only the treated territory was coagulated.Conclusion: The spatiotemporal evolution of thermoembolization was visualized for the first time using noninvasive MRTI, providing unique insight into the thermodynamics of thermoembolization.PrécisThermoembolization is being investigated as a novel transarterial treatment. In order to begin to characterize delivery of this novel treatment modality and aid translation from the laboratory to patients, we employ MR temperature imaging to visualize the spatiotemporal distribution of temperature from thermoembolization in ex vivo tissue.

Real-time mapping of heat generation and distribution in a laser irradiated agar phantom loaded with gold nanoparticles using MR temperature imaging.

Gold nanoparticles (AuNPs) have shown potential strength in photothermal therapy of cancer. Several techniques have been developed to investigate local heat generation by AuNPs. However, a sensitive thermal imaging technology with high temporal resolution, minimum invasiveness and high spatial resolution is still lacking. In this research study, by using magnetic resonance thermal imaging (MRTI), we reported a technique for monitoring of heat generation and distribution in an AuNPs loaded agar phantom irradiated by laser. Three different agar phantoms with various AuNPs concentrations (0, 8 and 16 μg/ml) were produced and studied. The phantoms were exposed to an external laser [532 nm; 4 min] under MRTI. For real-time temperature monitoring, we employed the theory of proton resonance frequency (PRF) shift. Infrared (IR) camera was employed to measure the actual temperature of each point on the surface of irradiated agar gel. Finally, the correlation between the temperatures obtained by IR camera and MRTI was evaluated. We observed that temperature of the gels loaded by AuNPs at concentration of 0, 8 and 16 μg/ml reached 27.2, 37.8, 45 °C with a total area of heat distribution of 94.98, 452.16, and 907.34 mm2 (from the point of irradiation). During the process of laser irradiation, we observed: (i) a significant rise in temperature, (ii) a dependency between the rate of temperature rise and concentration of AuNPs, and (iii) a direct correlation between temperature change and MR image phase. In addition, statistical analysis showed that the variation of temperatures measured by IR camera and temperatures computed by MRTI had acceptable correlation (R > 0.9). In conclusion, MRTI has a good sensitivity and precision that can be employed for nano-photothermal therapy planning and may be considered for real-time mapping of heat generation and distribution in a laser irradiated tissue loaded by AuNPs.

Systematic quality assurance of the BSD2000-3D MR-compatible hyperthermia applicator performance using MR temperature imaging

Background: Radiofrequency (RF) mild hyperthermia (40 °C–44 °C for 60 minutes) is an effective adjuvant treatment for several types of cancer. To ensure treatment efficacy, quality assurance (QA) is necessary. This study presents the first systematic 3D characterisation of the heating performance of the commonly used Pyrexar BSD2000-3D MR-compatible hyperthermia applicator using magnetic resonance temperature imaging (MRTI).Methods: A reproducibly positioned phantom was heated with a power of 1000 watts during the 12.4 min needed to measure eight temperature distributions using MRTI. The target heating location was systematically varied between experiments. We analysed focus shape characteristics, steering accuracy, focus deformation due to steering, presence of off-target heating and reproducibility.Results: The mean maximum temperature increase was 5.9 ± 0.4 °C. The mean full width half maximum (FWHM) was 14.4 ± 0.5 cm in the XY plane and 24.5 ± 0.8 cm in Z-direction. The mean steering error was 0.4 ± 0.2 cm. The focus shape slightly varied between experiments, depending on steering distance in Y-direction. Off-target heating was not detected. Reproducibility of the focus amplitude and shape was determined by comparing the mean deviation from the mean temperature in the central slice was 0.3 ± 0.2 °C.Conclusion: The Pyrexar BSD2000-3D MR-compatible applicator provides robust and reproducible heating. The upper boundary of the 95% confidence interval of the spatial steering accuracy is 0.9 cm, i.e. sufficient to fulfil the criterion of ≤0.2 °C temperature variation due to positioning errors as defined by Canters et al.

MR thermometry-guided ultrasound hyperthermia of user-defined regions using the ExAblate prostate ablation array

BackgroundHyperthermia therapy (HT) has shown to be an effective adjuvant to radiation, chemotherapy, and immunotherapy. In order to be safe and effective, delivery of HT requires maintenance of target tissue temperature within a narrow range (40–44 °C) for 30–60 min, which necessitates conformal heat delivery and accurate temperature monitoring. The goal of this project was to develop an MR thermometry-guided hyperthermia delivery platform based upon the ExAblate prostate array that would achieve uniform stable heating over large volumes within the prostate, while allowing the user to precisely control the power deposition patterns and shape of the region of treatment (ROT).MethodsThe HT platform incorporates an accelerated multi-slice real time MR thermometry pulse sequence and reconstruction pipeline. Temperature uniformity over a large contiguous area was achieved by multi-point temperature sampling with multi-focal feedback power control. The hyperthermia delivery system was based on an InSightec ExAblate 2100 prostate focused ultrasound ablation system, and HeartVista’s RTHawk real-time MRI system integrated with a 3 T MRI scanner. The integrated system was evaluated in experiments with a tissue-mimicking phantom for prolonged exposures with a target temperature increase of 7 °C from baseline.ResultsFive various shapes of the region of treatment, defined on a 5 × 5 grid (35 × 35 mm, 11–25 focal spots per shape), were implemented to evaluate the performance of the system. MR temperature images, acquired after steady state was reached, showed different patterns of heating that closely matched the prescribed regions. Temperature uncertainty of the thermometry acquisition was 0.5 °C. The time to reach the target temperature (2:58–7:44 min) depended on the chosen ROT shape and on the distance from transducer to focal plane. Pre-cooling with circulating water helped to reduce near-field heating.ConclusionsWe have implemented a real-time MR thermometry-guided system for hyperthermia delivery within user-defined regions with the ExAblate prostate array and evaluated it in phantom experiments for different shapes and focal depths. Our results demonstrate the feasibility of using a commercially available endorectal FUS transducer to perform spatially-conformal hyperthermia therapy and could lead to a new set of exciting applications for these devices.