Pencil-beam Navigator Research Articles

Design of a Patient-Specific Respiratory-Motion-Simulating Platform for In Vitro 4D Flow MRI.

Four-dimensional (4D) flow magnetic resonance imaging (MRI) is a leading-edge imaging technique and has numerous medicinal applications. In vitro 4D flow MRI can offer some advantages over in vivo ones, especially in accurately controlling flow rate (gold standard), removing patient and user-specific variations, and minimizing animal testing. Here, a complete testing method and a respiratory-motion-simulating platform are proposed for in vitro validation of 4D flow MRI. A silicon phantom based on the hepatic arteries of a living pig is made. Under the free-breathing, a human volunteer's liver motion (inferior-superior direction) is tracked using a pencil-beam MRI navigator and is extracted and converted into velocity-distance pairs to program the respiratory-motion-simulating platform. With the magnitude displacement of about 1.3cm, the difference between the motions obtained from the volunteer and our platform is ≤ 1mm which is within the positioning error of the MRI navigator. The influence of the platform on the MRI signal-to-noise ratio can be eliminated even if the actuator is placed in the MRI room. The 4D flow measurement errors are respectively 0.4% (stationary phantom), 9.4% (gating window = 3mm), 27.3% (gating window = 4mm) and 33.1% (gating window = 7mm). The vessel resolutions decreased with the increase of the gating window. The low-cost simulation system, assembled from commercially available components, is easy to be duplicated.

Hybrid ultrasound-MR guided HIFU treatment method with 3D motion compensation.

Treatments using high-intensity focused ultrasound (HIFU) in the abdominal region remain challenging as a result of respiratory organ motion. A novel method is described here to achieve 3D motion-compensated ultrasound (US) MR-guided HIFU therapy using simultaneous ultrasound and MRI. A truly hybrid US-MR-guided HIFU method was used to plan and control the treatment. Two-dimensional ultrasound was used in real time to enable tracking of the motion in the coronal plane, whereas an MR pencil-beam navigator was used to detect anterior-posterior motion. Prospective motion compensation of proton resonance frequency shift (PRFS) thermometry and HIFU electronic beam steering were achieved. The 3D prospective motion-corrected PRFS temperature maps showed reduced intrascan ghosting artifacts, a high signal-to-noise ratio, and low geometric distortion. The k-space data yielded a consistent temperature-dependent PRFS effect, matching the gold standard thermometry within approximately 1°C. The maximum in-plane temperature elevation ex vivo was improved by a factor of 2. Baseline thermometry acquired in volunteers indicated reduction of residual motion, together with an accuracy/precision of near-harmonic referenceless PRFS thermometry on the order of 0.5/1.0°C. Hybrid US-MR-guided HIFU ablation with 3D motion compensation was demonstrated ex vivo together with a stable referenceless PRFS thermometry baseline in healthy volunteer liver acquisitions. Magn Reson Med 79:2511-2523, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Thermal ablation of a confluent lesion in the porcine kidney with a clinically available MR-HIFU system

The incidence of small renal masses (SRMs) sized <4 cm has increased over the decades (as co-findings/or due to introduction of cross sectional imaging). Currently, partial nephrectomy (PN) or watchful waiting is advised in these patients. Ultimately, 80–90% of these SRMs require surgical treatment and PN is associated with a 15% complication rate. In this aging population, with possible comorbidities and poor health condition, both PN and watchful waiting are non-ideal treatment options. This resulted in an increased need for early, non-invasive treatment strategies such as MR-guided high intensity focused ultrasound (MR-HIFU). (i) To investigate the feasibility of creating a confluent lesion in the kidney using respiratory-gated MR-HIFU under clinical conditions in a pre-clinical study and (ii) to evaluate the reproducibility of the MR-HIFU ablation strategy. Healthy pigs (n = 10) under general anesthesia were positioned on a clinical MR-HIFU system with integrated cooling. A honeycomb pattern of seven overlapping ablation cells (4 × 4 × 10 mm3, 450 W, <30 s) was ablated successively in the cortex of the porcine kidney. Both MR thermometry and acoustic energy delivery were respiratory gated using a pencil beam navigator on the contralateral kidney. The non-perfused volume (NPV) was visualized after the last sonication by contrast-enhanced (CE) T1-weighted MR (T1w) imaging. Cell viability staining was performed to visualize the extent of necrosis. Results: a median NPV of 0.62 ml was observed on CE-T1w images (IQR 0.58–1.57 ml, range 0.33–2.75 ml). Cell viability staining showed a median damaged volume of 0.59 ml (IQR 0.24–1.35 ml, range 0–4.1 ml). Overlooking of the false rib, shivering of the pig, and too large depth combined with a large heat-sink effect resulted in insufficient heating in 4 cases. The NPV and necrosed volume were confluent in all cases in which an ablated volume could be observed. Our results demonstrated the feasibility of creating a confluent volume of ablated kidney cortical tissue in vivo with MR-HIFU on a clinically available system using respiratory gating and near-field cooling and showed its reproducibility.

Spontaneous breathing vs. mechanical ventilation for respiratory-gated MR-HIFU ablation in the liver

Magnetic resonance-guided High Intensity Focused Ultrasound (MR-HIFU) ablation in the liver is complicated by the continuous motion of the target due to the respiratory cycle. Several motion compensation strategies have been proposed in the past, such as breath-holding, respiratory gating and dynamic beam steering. Respiratory gating for sonication and MR thermometry uses a pencil beam navigator on the diaphragm to limit power output and image acquisition to the resting phase of the diaphragm. Previously, we have used General Anesthesia with mechanical ventilation (GA) to obtain a long and reproducible resting phase of the diaphragm. From a patient’s perspective however, Procedural Sedation and Analgesia (PSA) has several advantages over GA such as a lower risk of complications and shorter recovery. In addition, it has lower associated costs and can be performed by non-anesthesiologists. The purpose of this animal study was to investigate the feasibility of respiratory-gated MR-HIFU ablation in the liver under PSA with spontaneous breathing.

Motion detection improvement of a pencil-beam navigator echo using a gradient reversal technique

PurposeTo develop and demonstrate the feasibility of a pencil-beam navigator using a gradient reversal technique for reducing signal contamination from undesired excitation for precise motion detection and correction. Materials and methodsThe navigator echo was obtained using normal and reversed gradient waveforms sequentially in three-dimensional spoiled gradient-recalled echo imaging. These two signals were combined in the complex domain for generating the final navigator data, which were used for detecting the diaphragm motion to nullify the side lobe effects with the smallest radius from the beam center. The navigator signals were compared with and without the proposed technique in phantom and human scans. In addition, navigator-gated imaging was performed in the human scans. ResultsIn a phantom experiment, the proposed technique diminished signals from a phantom placed outside the beam’s area. In human scans, the proposed technique reduced undesired signals in the navigator data for all subjects. The resultant images had fewer motion-induced ghosts than the images from the conventional technique for 8 subjects out of 10. ConclusionsWe have demonstrated that the gradient reversal technique reduced undesired signals in a pencil-beam navigator. This technique can be an alternative for free-breathing abdominal scan when the conventional navigator technique cannot detect the patient’s respiratory motion precisely.

Practical PET Respiratory Motion Correction in Clinical PET/MR.

Respiratory motion during PET acquisition may lead to blurring in resulting images and underestimation of uptake parameters. The advent of integrated PET/MR scanners allows us to exploit the integration of modalities, using high spatial resolution and high-contrast MR images to monitor and correct PET images degraded by motion. We proposed a practical, anatomy-independent MR-based correction strategy for PET data affected by respiratory motion and showed that it can improve image quality both for PET acquired simultaneously to the motion-capturing MR and for PET acquired up to 1 h earlier during a clinical scan. To estimate the respiratory motion, our method needs only an extra 1-min dynamic MR scan, acquired at the end of the clinical PET/MR protocol. A respiratory signal was extracted directly from the PET list-mode data. This signal was used to gate the PET data and to construct a motion model built from the dynamic MR data. The estimated motion was then incorporated into the PET image reconstruction to obtain a single motion-corrected PET image. We evaluated our method in 2 steps. The PET-derived respiratory signal was compared with an MR measure of diaphragmatic displacement via a pencil-beam navigator. The motion-corrected images were compared with uncorrected images with visual inspection, line profiles, and standardized uptake value (SUV) in focally avid lesions. We showed a strong correlation between the PET-derived and MR-derived respiratory signals for 9 patients, with a mean correlation of 0.89. We then showed 4 clinical case study examples ((18)F-FDG and (68)Ga-DOTATATE) using the motion-correction technique, demonstrating improvements in image sharpness and reduction of respiratory artifacts in scans containing pancreatic, liver, and lung lesions as well as cardiac scans. The mean increase in peak SUV (SUV(peak)) and maximum SUV (SUV(max)) in a patient with 4 pancreatic lesions was 23.1% and 34.5% in PET acquired simultaneously with motion-capturing MR, and 17.6% and 24.7% in PET acquired 50 min before as part of the clinical scan. We showed that a respiratory signal can be obtained from raw PET data and that the clinical PET image quality can be improved using only a short additional PET/MR acquisition. Our method does not need external respiratory hardware or modification of the normal clinical MR sequences.

In vivo optimisation study for multi-baseline MR-based thermometry in the context of hyperthermia using MR-guided high intensity focused ultrasound for head and neck applications

Purpose: In this in vivo study, the feasibility to perform hyperthermia treatments in the head and neck using magnetic resonance image-guided high intensity focused ultrasound (MRgHIFU) was established using a porcine acute model.Materials and methods: Porcine specimens with a weight between 17 and 18 kg were treated in the omohyoid muscle in the neck. Hyperthermia was applied with a target temperature of 41 °C for 30 min using a Sonalleve MRgHIFU system. MR-based thermometry was calculated using water-proton resonance frequency shift and multi-baseline look-up tables indexed by peak-to-peak displacement (Dpp) measurements using a pencil-beam navigator. Three hyperthermia experiments were conducted at different Dpp values of 0.2, 1.0 and 3.0 mm. An optimisation study was carried out to establish the optimal parameters controlling the multi-baseline method that ensured a minimisation of spatial-average peak-to-peak temperature (TSA-pp) and temperature direct current bias (TSA-DC).Results: The multi-baseline technique reduced considerably the noise on both TSA-pp and TSA-DC. The reduction of noise was more important when Dpp was higher. For Dpp = 3 mm the average (±standard deviation (SD)) of TSA-pp and TSA-DC was reduced from 4.5 (± 2.5) and 2.5 (±0.6) °C, respectively, to 0.8 (± 0.7) and 0.09 (± 0.2) °C.Conclusions: This in vivo study showed the level of noise in PRFS-based thermometry introduced by respiratory motion in the context of MRgHIFU hyperthermia treatment for head and neck and the feasibility of reducing this noise using a multi-baseline technique.

Free-breathing, zero-TE MR lung imaging.

The investigation of three-dimensional radial, zero-echo time (TE) imaging for high-resolution, free-breathing magnetic resonance (MR) lung imaging using prospective and retrospective motion correction. Zero-TE was implemented similarly to the rotating-ultra-fast-imaging-sequence, providing 3D, isotropic, radial imaging with proton density contrast. Respiratory motion was addressed using prospective triggering (PT), prospective gating (PG) and retrospective gating (RG) with physiological signals obtained from a respiratory belt and interleaved pencil beam and DC navigators. The methods were demonstrated on four healthy volunteers at 3T. 3D, radial zero-TE imaging with high imaging bandwidth and nominally zero echo-time enables efficient capture of short-lived signals from the lung parenchyma and the vessels. Compared to Cartesian encoding, unaccounted for free-breathing respiration resulted in only benign blurring artifacts confined to the origin of motion. Breath holding froze respiration but achieved only limited image resolution (~1.8 mm, 30 s). PT and PG obtained similar quality expiratory-phase images at 1.2 mm resolution in ~6 min scan time. RG allowed multi-phase imaging in ~15 min, derived from eight individually stored averages. Zero-TE appears to be an attractive pulse sequence for 3D isotropic lung imaging. Prospective and retrospective approaches provide high-quality, free-breathing MR lung imaging within reasonable scan time.

Manifold learning based ECG-free free-breathing cardiac CINE MRI.

To present and validate a manifold learning (ML)-based method that can estimate both cardiac and respiratory navigator signals from electrocardiogram (ECG)-free free-breathing cardiac magnetic resonance imaging (MRI) data to achieve self-gated retrospective CINE reconstruction. In this work the use of the ML method is demonstrated for 2D cardiac CINE to achieve both cardiac and respiratory self-gating without the need of an external navigator or ECG signal. This is achieved by sequentially applying ML to two sets of retrospectively reconstructed real-time images with differing temporal resolutions. A 1D cardiac signal is estimated by applying ML to high temporal resolution real-time images reconstructed from the acquired data. Using the estimated cardiac signal, a 1D respiratory signal was obtained by applying the ML method to low temporal resolution images reconstructed from the same acquired data for each cardiac cycle. Data were acquired in five volunteers with a 2D golden angle radial trajectory in a balanced steady-state free precession (b-SSFP) acquisition. The accuracy of the estimated cardiac signal was calculated as the standard deviation of the temporal difference between the estimated signal and the recorded ECG. The correlation between the estimated respiratory signal and standard pencil beam navigator signal was evaluated. Gated CINE reconstructions (20 cardiac phases per cycle, temporal resolution ∼30 msec) using the estimated cardiac and respiratory signals were qualitatively compared against conventional ECG-gated breath-hold CINE acquisitions. Accurate cardiac signals were estimated with the proposed method, with an error standard deviation in comparison to ECG lower than 20 msec. Respiratory signals estimated with the proposed method achieved a mean cross-correlation of 94% with respect to standard pencil beam navigator signals. Good quality visual scores of 2.80 ± 0.45 (scores from 0, bad, to 4, excellent quality) were observed for the proposed approach in comparison with the conventional ECG-gated breath-hold images (visual score: 3.00 ± 0.71). Accurate respiratory and cardiac navigator signals can be estimated using the proposed framework from the acquired data itself, resulting in retrospective self-gated CINE reconstruction with high spatial and temporal quality.

High-resolution dynamic MR imaging of the thorax for respiratory motion correction of PET using groupwise manifold alignment.

Respiratory motion is a complicating factor in PET imaging as it leads to blurring of the reconstructed images which adversely affects disease diagnosis and staging. Existing motion correction techniques are often based on 1D navigators which cannot capture the inter- and intra-cycle variabilities that may occur in respiration. MR imaging is an attractive modality for estimating such motion more accurately, and the recent emergence of hybrid PET/MR systems allows the combination of the high molecular sensitivity of PET with the versatility of MR. However, current MR imaging techniques cannot achieve good image contrast inside the lungs in 3D. 2D slices, on the other hand, have excellent contrast properties inside the lungs due to the in-flow of previously unexcited blood, but lack the coverage of 3D volumes. In this work we propose an approach for the robust, navigator-less reconstruction of dynamic 3D volumes from 2D slice data. Our technique relies on the fact that data acquired at different slice positions have similar low-dimensional representations which can be extracted using manifold learning. By aligning these manifolds we are able to obtain accurate matchings of slices with regard to respiratory position. The approach naturally models all respiratory variabilities. We compare our method against two recently proposed MR slice stacking methods for the correction of PET data: a technique based on a 1D pencil beam navigator, and an image-based technique. On synthetic data with a known ground truth our proposed technique produces significantly better reconstructions than all other examined techniques. On real data without a known ground truth the method gives the most plausible reconstructions and high consistency of reconstruction. Lastly, we demonstrate how our method can be applied for the respiratory motion correction of simulated PET/MR data.

Relative role of motion and PSF compensation in whole‐body oncologic PET‐MR imaging

Respiratory motion and partial-volume effects are the two main sources of image degradation in whole-body PET imaging. Simultaneous PET-MR allows measurement of respiratory motion using MRI while collecting PET events. Improved PET images may be obtained by modeling respiratory motion and point spread function (PSF) within the PET iterative reconstruction process. In this study, the authors assessed the relative impact of PSF modeling and MR-based respiratory motion correction in phantoms and patient studies using a whole-body PET-MR scanner. An asymmetric exponential PSF model accounting for radially varying and axial detector blurring effects was obtained from point source acquisitions performed in the PET-MR scanner. A dedicated MRI acquisition protocol using single-slice steady state free-precession MR acquisitions interleaved with pencil-beam navigator echoes was developed to track respiratory motion during PET-MR studies. An iterative ordinary Poisson fully 3D OSEM PET reconstruction algorithm modeling all the physical effects of the acquisition (attenuation, scatters, random events, detectors efficiencies, PSF), as well as MR-based nonrigid respiratory deformations of tissues (in both emission and attenuation maps) was developed. Phantom and(18)F-FDG PET-MR patient studies were performed to evaluate the proposed quantitative PET-MR methods. The phantom experiment results showed that PSF modeling significantly improved contrast recovery while limiting noise propagation in the reconstruction process. In patients with soft-tissue static lesions, PSF modeling improved lesion contrast by 19.7%-109%, enhancing the detectability and assessment of small tumor foci. In a patient study with small moving hepatic lesions, the proposed reconstruction technique improved lesion contrast by 54.4%-98.1% and reduced apparent lesion size by 21.8%-34.2%. Improvements were particularly important for the smallest lesion undergoing large motion at the lung-liver interface. Heterogeneous tumor structures delineation was substantially improved. Enhancements offered by PSF modeling were more important when correcting for motion at the same time. The results suggest that the proposed quantitative PET-MR methods can significantly enhance the performance of tumor diagnosis and staging as compared to conventional methods. This approach may enable utilization of the full potential of the scanner in oncologic studies of both the lower abdomen, with moving lesions, as well as other parts of the body unaffected by motion.

Real-time method for motion-compensated MR thermometry and MRgHIFU treatment in abdominal organs

Magnetic resonance-guided high-intensity focused ultrasound is considered to be a promising treatment for localized cancer in abdominal organs such as liver, pancreas, or kidney. Abdominal motion, anatomical arrangement, and required sustained sonication are the main challenges. MR acquisition consisted of thermometry performed with segmented gradient-recalled echo echo-planar imaging, and a segment-based one-dimensional MR navigator parallel to the main axis of motion to track the organ motion. This tracking information was used in real-time for: (i) prospective motion correction of MR thermometry and (ii) HIFU focal point position lock-on target. Ex vivo experiments were performed on a sheep liver and a turkey pectoral muscle using a motion demonstrator, while in vivo experiments were conducted on two sheep liver. Prospective motion correction of MR thermometry yielded good signal-to-noise ratio (range, 25 to 35) and low geometric distortion due to the use of segmented EPI. HIFU focal point lock-on target yielded isotropic in-plane thermal build-up. The feasibility of in vivo intercostal liver treatment was demonstrated in sheep. The presented method demonstrated in moving phantoms and breathing sheep accurate motion-compensated MR thermometry and precise HIFU focal point lock-on target using only real-time pencil-beam navigator tracking information, making it applicable without any pretreatment data acquisition or organ motion modeling.

Navigators for motion detection during real-time MRI-guided radiotherapy

An MRI-linac system provides direct MRI feedback and with that the possibility of adapting radiation treatments to the actual tumour position. This paper addresses the use of fast 1D MRI, pencil-beam navigators, for this feedback. The accuracy of using navigators was determined on a moving phantom. The possibility of organ tracking and breath-hold monitoring based on navigator guidance was shown for the kidney. Navigators are accurate within 0.5 mm and the analysis has a minimal time lag smaller than 30 ms as shown for the phantom measurements. The correlation of 2D kidney images and navigators shows the possibility of complete organ tracking. Furthermore the breath-hold monitoring of the kidney is accurate within 1.5 mm, allowing gated radiotherapy based on navigator feedback. Navigators are a fast and precise method for monitoring and real-time tracking of anatomical landmarks. As such, they provide direct MRI feedback on anatomical changes for more precise radiation delivery.

Navigators for Motion Detection in the 1.5T MRI-linac

Navigators for Motion Detection in the 1.5T MRI-linac

Whole‐heart coronary MR angiography with 2D self‐navigated image reconstruction

Several self-navigation techniques have been proposed to improve respiratory motion compensation in coronary MR angiography. In this work, we implemented a 2D self-navigation method by using the startup profiles of a whole-heart balanced Steady-state free precession sequence, which are primarily used to catalyze the magnetization towards the steady-state. To create 2D self-navigation images (2DSN), we added phase encoding gradients to the startup profiles. With this approach we calculated foot-head and left-right motion and performed retrospective translational motion correction. The 2DSN images were reconstructed from 10 startup profiles acquired at the beginning of each shot. Nine healthy subjects were scanned, and the proposed method was compared to a 1D self-navigation (1DSN) method with foot-head correction only. Foot-head correction was also performed with the diaphragmatic 1D pencil beam navigator (1Dnav) using a tracking factor of 0.6. 2DSN shows improved motion correction compared to 1DSN and 1Dnav for all coronary arteries and all subjects for the investigated diaphragmatic gating window of 10 mm. The visualized vessel length of the right coronary artery could be significantly improved with a multiple targeted 2D self-navigation approach, compared to 2DSN method.

New respiratory gating technique for whole heart cine imaging: Integration of a navigator slice in steady state free precession sequences

To evaluate the performance of a slice navigator sequence integrated into a b-SSFP sequence for obtaining real time respiratory self-gated whole heart cine imaging. In this work, we present a novel and robust approach for respiratory motion detection by integrating a slice navigator sequence into a balanced steady state free precession (b-SSFP) sequence, while maintaining the steady state. The slice navigator sequence is integrated into consecutive repetition times (TRs) of a b-SSFP sequence to excite and read out a navigator slice. We performed several phantom experiments to test the performance of the slice navigator sequence. Additionally, the method was evaluated in five volunteers and compared with breathing signals obtained from conventional pencil beam navigator sequence. Finally, the navigator slice was used to obtain whole heart MR cine images. The breathing signals detected by the proposed method showed an excellent agreement with those obtained from pencil beam navigators. Moreover, the technique was capable of removing respiratory motion artifacts with minimal distortion of the steady state. Image quality comparison showed a statistical significant improvement from a quality score of 2.1 obtained by the nonrespiratory gated images, compared to a quality score of 3.4 obtained by the respiratory gated images. This novel method represents a robust approach to estimate breathing motion during SSFP imaging. The technique was successfully applied to acquire whole heart artifact-free cine images.

Pulmonary vein inflow artifact reduction for free‐breathing left atrium late gadolinium enhancement

Two-dimensional "pencil-beam" navigator, placed on the right hemidiaphragm, is used for free-breathing late gadolinium enhancement of the left atrium in patients with atrial fibrillation. The pencil-beam navigator creates an inflow artifact in the right pulmonary veins and atrial wall that may obscure local pulmonary vein and left atrium scars. To reduce this artifact, we propose a large slab right hemidiaphragm projection navigator that measures the respiratory motion while reducing the associated inflow artifact. Eighteen subjects underwent pulmonary vein late gadolinium enhancement using the pencil-beam and projection navigator. Subjective inflow and respiratory motion artifact scores (1 = severe, 2 = moderate, 3 = mild, and 4 = none) from two blinded readers were compared. The artifact scores were 3.8 ± 0.4 and 2.1 ± 0.7 for the projection and pencil-beam navigators, respectively (P < 0.001). Respiratory motion artifact scores were similar between the two techniques (3.0 ± 0.5 vs. 3.1 ± 0.5 for projection vs. pencil-beam navigator). The proposed method greatly reduces the inflow artifact in free-breathing pulmonary vein late gadolinium enhancement while allowing adequate respiratory motion compensation.

Spectrally selective pencil‐beam navigator for motion compensation of MR‐guided high‐intensity focused ultrasound therapy of abdominal organs

MR-guided high-intensity focused ultrasound (MR-HIFU) is a noninvasive technique for depositing thermal energy in a controlled manner deep within the body. However, the MR-HIFU treatment of mobile abdominal organs is problematic as motion-related thermometry artifacts need to be corrected and the focal point position must be updated in order to follow the moving organ to avoid damaging healthy tissue. In this article, a fat-selective pencil-beam navigator is proposed for real-time monitoring and compensation of through-plane motion. As opposed to the conventional spectrally nonselective navigator, the fat-selective navigator does not perturb the water-proton magnetization used for proton resonance frequency shift thermometry. This allows the proposed navigator to be placed directly on the target organ for improved motion estimation accuracy. The spectral and spatial selectivity of the proposed navigator pulse is evaluated through simulations and experiments, and the improved slice tracking performance is demonstrated in vivo by tracking experiments on a human kidney and on a human liver. The direct motion estimation provided by the fat-selective navigator is also shown to enable accurate motion compensated MR-HIFU therapy of in vivo porcine kidney, including motion compensation of thermometry and beam steering based on the observed three-dimensional kidney motion.

Real‐time 3D target tracking in MRI guided focused ultrasound ablations in moving tissues

Magnetic resonance imaging-guided high intensity focused ultrasound is a promising method for the noninvasive ablation of pathological tissue in abdominal organs such as liver and kidney. Due to the high perfusion rates of these organs, sustained sonications are required to achieve a sufficiently high temperature elevation to induce necrosis. However, the constant displacement of the target due to the respiratory cycle render continuous ablations challenging, since dynamic repositioning of the focal point is required. This study demonstrates subsecond 3D high intensity focused ultrasound-beam steering under magnetic resonance-guidance for the real-time compensation of respiratory motion. The target is observed in 3D space by coupling rapid 2D magnetic resonance-imaging with prospective slice tracking based on pencil-beam navigator echoes. The magnetic resonance-data is processed in real-time by a computationally efficient reconstruction pipeline, which provides the position, the temperature and the thermal dose on-the-fly, and which feeds corrections into the high intensity focused ultrasound-ablator. The effect of the residual update latency is reduced by using a 3D Kalman-predictor for trajectory anticipation. The suggested method is characterized with phantom experiments and verified in vivo on porcine kidney. The results show that for update frequencies of more than 10 Hz and latencies of less then 114 msec, temperature elevations can be achieved, which are comparable to static experiments.

Respiratory self-gated coronary MRI: A comparison between 2D spiral pencil beam and projection navigators

Background Respiratory self-gated navigator techniques have been introduced to directly measure the respiratory induced heart motion from a single projection data. The estimated motion is used to retrospectively eliminate the respiratory motion artifact of the acquired images[1,2]. In this study, we have implemented and evaluated a prospectively gate self-gating coronary MRI, and compared the acquired images with the ones reconstructed by the diaphragmatic navigator.