Proton Resonance Frequency Shift Technique Research Articles

Thermal measurements of a muscle-mimicking phantom during ultra-high field magnetic resonance imaging

Abstract At ultra-high field MRI (Bo>7T) it is crucial to predict and control the patient safety. Commonly patient safety is controlled by the power deposited in the tissue (specific absorption rate - SAR). However, temperature distributions do not always correlate directly with SAR distributions, which makes temperature control also a crucial parameter to guarantee patient safety. In this work, temperature changes were accessed by MR thermometry, specifically by the proton resonance frequency shift technique (PRF). A phantom mimicking muscle tissue was used to evaluate the temperature rise caused by the radiofrequency (RF) absorption during 7T MRI, applied through a commercial birdcage head coil. A pulse-sequence protocol was implemented for both, the generation of temperature increase and the MR thermometry. To control the temperature, a digital thermometer was used, and oil tubes were utilized to dismiss the drift effects for PRF. Measurements of the phantom’s dielectric characteristics, i.e. conductivity and permittivity, were in good agreement with the literature values for muscle. Spatio-temporal evaluations showed a temperature increase in time via RF exposure and the feasibility of measuring temperature maps using the PRF shift method. The accuracy of the PRF shift method increased when the drift effects were quantified and dismissed, indicating a PRF reading accuracy differing less than 0.5 °C from the thermometer. Results also validate our heating and temperature imaging protocol. This study is a valuable contribution to the evaluation of heating effects caused by RF absorption and demonstrates potential impact on future thermal investigations, which may use different heating sources, as well validate thermal simulations.

Referenceless magnetic resonance temperature imaging using Gaussian process modeling

During magnetic resonance (MR)-guided thermal therapies, water proton resonance frequency shift (PRFS)-based MR temperature imaging can quantitatively monitor tissue temperature changes. It is widely known that the PRFS technique is easily perturbed by tissue motion, tissue susceptibility changes, magnetic field drift, and modality-dependent applicator-induced artifacts. Here, a referenceless Gaussian process modeling (GPM)-based estimation of the PRFS is investigated as a methodology to mitigate unwanted background field changes. The GPM offers a complementary trade-off between data fitting and smoothing and allows prior information to be used. The end result being the GPM provides a full probabilistic prediction and an estimate of the uncertainty. GPM was employed to estimate the covariance between the spatial position and MR phase measurements. The mean and variance provided by the statistical model extrapolated background phase values from nonheated neighboring voxels used to train the model. MR phase predictions in the heating ROI are computed using the spatial coordinates as the test input. The method is demonstrated in ex vivo rabbit liver tissue during focused ultrasound heating with manually introduced perturbations (n = 6) and in vivo during laser-induced interstitial thermal therapy to treat the human brain (n = 1) and liver (n = 1). Temperature maps estimated using the GPM referenceless method demonstrated a RMS error of <0.8°C with artifact-induced reference-based MR thermometry during ex vivo heating using focused ultrasound. Nonheated surrounding areas were <0.5°C from the artifact-free MR measurements. The GPM referenceless MR temperature values and thermally damaged regions were within the 95% confidence interval during in vivo laser ablations. A new approach to estimation for referenceless PRFS temperature imaging is introduced that allows for an accurate probabilistic extrapolation of the background phase. The technique demonstrated reliable temperature estimates in the presence of the background phase changes and was demonstrated useful in the in vivo brain and liver ablation scenarios presented.

Cavernosal nerve functionality evaluation after magnetic resonance imaging-guided transurethral ultrasound treatment of the prostate.

To evaluate the feasibility of using therapeutic ultrasound as an alternative treatment option for organ-confined prostate cancer. In this study, a trans-urethral therapeutic ultrasound applicator in combination with 3T magnetic resonance imaging (MRI) guidance was used for real-time multi-planar MRI-based temperature monitoring and temperature feedback control of prostatic tissue thermal ablation in vivo. We evaluated the feasibility and safety of MRI-guided trans-urethral ultrasound to effectively and accurately ablate prostate tissue while minimizing the damage to surrounding tissues in eight canine prostates. MRI was used to plan sonications, monitor temperature changes during therapy, and to evaluate treatment outcome. Real-time temperature and thermal dose maps were calculated using the proton resonance frequency shift technique and were displayed as two-dimensional color-coded overlays on top of the anatomical images. After ultrasound treatment, an evaluation of the integrity of cavernosal nerves was performed during prostatectomy with a nerve stimulator that measured tumescence response quantitatively and indicated intact cavernous nerve functionality. Planned sonication volumes were visually correlated to MRI ablation volumes and corresponding histo-pathological sections after prostatectomy. A total of 16 sonications were performed in 8 canines. MR images acquired before ultrasound treatment were used to localize the prostate and to prescribe sonication targets in all canines. Temperature elevations corresponded within 1 degree of the targeted sonication angle, as well as with the width and length of the active transducer elements. The ultrasound treatment procedures were automatically interrupted when the temperature in the target zone reached 56 °C. In all canines erectile responses were evaluated with a cavernous nerve stimulator post-treatment and showed a tumescence response after stimulation with an electric current. These results indicated intact cavernous nerve functionality. In all specimens, regions of thermal ablation were limited to areas within the prostate capsule and no damage was observed in periprostatic tissues. Additionally, a visual analysis of the ablation zones on contrast-enhanced MR images acquired post ultrasound treatment correlated excellent with the ablation zones on thermal dose maps. All of the ablation zones received a consensus score of 3 (excellent) for the location and size of the correlation between the histologic ablation zone and MRI based ablation zone. During the prostatectomy and histologic examination, no damage was noted in the bladder or rectum. Trans-urethral ultrasound treatment of the prostate with MRI guidance has potential to safely, reliably, and accurately ablate prostatic regions, while minimizing the morbidities associated with conventional whole-gland resection or therapy.

Reconstruction of fully three‐dimensional high spatial and temporal resolution MR temperature maps for retrospective applications

Many areas of MR-guided thermal therapy research would benefit from temperature maps with high spatial and temporal resolution that cover a large three-dimensional volume. This article describes an approach to achieve these goals, which is suitable for research applications where retrospective reconstruction of the temperature maps is acceptable. The method acquires undersampled data from a modified three-dimensional segmented echo-planar imaging sequence and creates images using a temporally constrained reconstruction algorithm. The three-dimensional images can be zero-filled to arbitrarily small voxel spacing in all directions and then converted into temperature maps using the standard proton resonance frequency shift technique. During high intensity focused ultrasound heating experiments, the proposed method was used to obtain temperature maps with 1.5 mm × 1.5 mm × 3.0 mm resolution, 288 mm × 162 mm × 78 mm field of view, and 1.7 s temporal resolution. The approach is validated to demonstrate that it can accurately capture the spatial characteristics and time dynamics of rapidly changing high intensity focused ultrasound-induced temperature distributions. Example applications from MR-guided high intensity focused ultrasound research are shown to demonstrate the benefits of the large coverage fully three-dimensional temperature maps, including characterization of volumetric heating trajectories and near- and far-field heating.

Accuracy of real time noninvasive temperature measurements using magnetic resonance thermal imaging in patients treated for high grade extremity soft tissue sarcomas

To establish accuracy of real time noninvasive temperature measurements using magnetic resonance thermal imaging in patients treated for high grade extremity soft tissue sarcomas. Protocol patients with advanced extremity sarcomas were treated with external beam radiation therapy and hyperthermia. Invasive temperature measures were compared to noninvasive magnetic resonance thermal imaging (MRTI) at 1.5 T performed during hyperthermia. Volumetric temperature rise images were obtained using the proton resonance frequency shift (PRFS) technique during heating in a 140 MHz miniannular phased array applicator. MRTI temperature changes were compared to invasive measurements of temperature with a multisensor fiber optic probe inside a #15 g catheter in the tumor. Since the PRFS technique is sensitive to drifts in the primary imaging magnetic field, temperature change distributions were corrected automatically during treatment using temperature-stable reference materials to characterize field changes in 3D. The authors analyzed MRT images and compared, in evaluable treatments, MR-derived temperatures to invasive temperatures measured in extremity sarcomas. Small regions of interest (ROIs) were specified near each invasive sensor identified on MR images. Temperature changes in the interstitial sensors were compared to the corresponding ROI PRFS-based temperature changes over the entire treatment and over the steady-state period. Nonevaluable treatments (motion/imaging artifacts, noncorrectable drifts) were not included in the analysis. The mean difference between MRTI and interstitial probe measurements was 0.91 degrees C for the entire heating time and 0.85 degrees C for the time at steady state. These values were obtained from both tumor and normal tissue ROIs. When the analysis is done on just the tumor ROIs, the mean difference for the whole power on time was 0.74 degrees C and during the period of steady state was 0.62 degrees C. The data show that for evaluable treatments, excellent correlation (deltaT < 1 degrees C) of MRTI-ROI and invasive measurements can be achieved, but that motion and other artifacts are still serious challenges that must be overcome in future work.

WE‐C‐BRC‐02: Combined Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE‐MRI) and Magnetic Resonance Thermal Imaging (MRTI) for Optimal Hyperthermia Treatment of Advanced Extremity Sarcomas: Fifteen Patients Update

Purpose: To deliver optimal hyperthermia (HT) treatments for patients with advanced extremity sarcomas using DCE‐MRI and MRTI Method and Materials: Patients were treated on a protocol using radiotherapy consisting of 45 Gy and once a week HT for 5 weeks in a setting that allows the use of a 1.5 T GE magnet for imaging. Pre‐ and post first HT treatment DCE‐MR images were acquired and analyzed with software from iCAD Inc. (Nashua, NH) based on a full time point pharmacokinetics (PK) analysis that measures tumor's permeability (Ktrans) and extracellular volume fraction (Ve). Multi‐slice temperature rise images were obtained using the proton resonance frequency shift technique during heating in a 140 MHz phased array HT applicator and compared to invasive temperature measurements. Thermal dose metrics were calculated and correlated with response and with the PK parameters. Results: Fifteen patients were enrolled on this protocol; ten patients were heated. Permeability maps derived from DCE‐MR images were used to guide the placement of the invasive catheter to span regions varying from high to low perfusion. The MRTI images were used to steer the power, with the intent of heating the tumor uniformly while maintaining surrounding normal tissue at lower temperatures. From the evaluable HT treatments, we achieved excellent correlation (ΔT&lt;1°C) between the MRTI and invasive measurements. As a trend, patients that were either pathological complete or partial responders had a decrease in Ktrans. The Ve parameter showed no clear trend with pathological response or % necrosis. As expected, tumors that were more vascularized (higher Ktrans) heated less than tumors with a high degree of necrosis or fluid pockets. Conclusion: DCE‐MRI coupled with MRTI provides information on tumor environment that can improve planning, delivery, and evaluation of HT treatments.Supported by a grant from the NCI CA42745.

MRI temperature mapping during thermal balloon angioplasty

Knowledge on the thermal dose delivered during thermal balloon angioplasty (TBA) is desirable to understand why TBA's outcome varies widely among patients and why it is subject to high restenosis rates. In its conventional implementation, TBA involves injection of a heated medium into a balloon positioned within a stenotic blood vessel. The medium injection causes flow, motion and susceptibility-redistribution artefacts that are devastating to the proton resonance frequency shift (PRFS) technique of MRI temperature mapping. Here, we propose to separate in time medium injection and heating by first inflating a balloon with a medium at an initial temperature, and then by heating the medium up using laser light. The separation is shown to eliminate all the mentioned artefacts and to enable real-time MRI temperature mapping using the PRFS technique. Accurate and reliable temperature maps were acquired in a TBA balloon itself and in the surrounding phantom tissue during heat application.

Temperature measurement using echo-shifted FLASH at low field for interventional MRI.

We investigated the feasibility of using echo-shifted fast low-angle shot (FLASH) for temperature-monitored thermo-therapeutic procedures in a 0.2 T interventional magnetic resonance (MR) scanner. Based on the proton resonance frequency shift technique, modified echo-shifted FLASH has sufficiently high signal-to-noise ratio to provide accurate temperature maps with short scan times, i.e., 5 seconds in phantoms (TR = 20.5 msec; effective TE = 30 msec; one echo shift; NSA = 2) and ex vivo experiments (TR = 19.4 msec; effective TE = 28.9 msec; one echo shift; NSA = 2) and 3 seconds (TR = 19.4 msec; effective TE = 28.9 msec, one echo shift; NSA 1) for an in vivo case. The proton resonance frequency shifts with temperature observed in a 0.2 T MR scanner using this sequence were -0.0072 ppm/degrees C (temperature uncertainty = +/-2.5 degrees C) for polyacrylamide phantoins and -0.0086 ppm/degrees C (temperature uncertainty = +/- 1 degrees C) for ex vivo bovine liver. These experiments demonstrated that echo-shifted FLASH is a viable method for low-field temperature monitoring despite the decreased signal and decreased phase sensitivity compared with its counterpart in a 1.5 T MR imaging system. The improved temporal resolution of temperature images, now possible in low-field interventional MR systems using echo-shifted FLASH, will allow clinicians more accurate monitoring of interstitial ablation in MR-guided interventional procedures.

Optimization of spoiled gradient-echo phase imaging for in vivo localization of a focused ultrasound beam.

The parameters of a spoiled gradient-echo (SPGR) pulse sequence have been optimized for in vivo localization of a focused ultrasound beam. Temperature elevation was measured by using the proton resonance frequency shift technique, and the phase difference signal-to-noise ratio (SNR delta phi) was estimated in skeletal muscle and kidney cortex in 10 rabbits. Optimized parameters included the echo time equivalent to T2* of the tissue, the longest repetition time possible with a 20-s sonication, and the flip angle equivalent to the Ernst angle. Optimal SPGR phase imaging can detect a sonication beam with a peak phase difference of 0.55 radian, which corresponds to a temperature elevation of 7.3 degrees C. The sonication beam can be localized within one voxel (0.6 x 0.6 x 5 mm3) at power levels that are below the threshold for thermal damage of the tissue.