Developments in PET-MRI for Radiotherapy Planning Applications

The hybridization of magnetic resonance imaging (MRI) and positron emission tomography (PET) provides the benefit of soft-tissue contrast and specific molecular information in a simultaneous acquisition. The applications of PET-MRI in radiotherapy are only starting to be realised. However, quantitative accuracy of PET relies on accurate attenuation correction (AC) of, not only the patient anatomy but also MRI hardware and current methods, which are prone to artefacts caused by dense materials. Quantitative accuracy of PET also relies on full characterization of patient motion during the scan. The simultaneity of PET-MRI makes it especially suited for motion correction. However, quality assurance (QA) procedures for such corrections are lacking. Therefore, a dynamic phantom that is PET and MR compatible is required. Additionally, respiratory motion characterization is needed for conformal radiotherapy of lung. 4D-CT can provide 3D motion characterization but suffers from poor soft-tissue contrast. In this thesis, I examine these problems, and present solutions in the form of improved MR-hardware AC techniques, a PET/MRI/CT-compatible tumour respiratory motion phantom for QA measurements, and a retrospective 4D-PET-MRI technique to characterise respiratory motion. Chapter 2 presents two techniques to improve upon current AC methods that use a standard helical CT scan for MRI hardware in PET-MRI. One technique uses a dual-energy computed tomography (DECT) scan to construct virtual monoenergetic image volumes and the other uses a tomotherapy linear accelerator to create CT images at megavoltage energies (1.0 MV) of the RF coil. The DECT-based technique reduced artefacts in the images translating to improved μ-maps. The MVCT-based technique provided further improvements in artefact reduction, resulting in artefact free μ-maps. This led to more AC of the breast coil. In chapter 3, I present a PET-MR-CT motion phantom for QA of motion-correction protocols. This phantom is used to evaluate a clinically available real-time dynamic MR images and a respiratory-triggered PET-MRI protocol. The results show the protocol to perform well under motion conditions. Additionally, the phantom provided a good model for performing QA of respiratory-triggered PET-MRI. Chapter 4 presents a 4D-PET/MRI technique, using MR sequences and PET acquisition methods currently available on hybrid PET/MRI systems. This technique is validated using the motion phantom presented in chapter 3 with three motion profiles. I conclude that our 4D-PET-MRI technique provides information to characterise tumour respiratory motion while using a clinically available pulse sequence and PET acquisition method

Magnetic resonance thermometry: methodology, pitfalls and practical solutions

Clinically established thermal therapies such as thermoablative approaches or adjuvant hyperthermia treatment rely on accurate thermal dose information for the evaluation and adaptation of the thermal therapy. Intratumoural temperature measurements have been correlated successfully with clinical end points. Magnetic resonance imaging is the most suitable technique for non-invasive thermometry avoiding complications related to invasive temperature measurements. Since the advent of MR thermometry two decades ago, numerous MR thermometry techniques have been developed, continuously increasing accuracy and robustness for in vivo applications. While this progress was primarily focused on relative temperature mapping, current and future efforts will likely close the gap towards quantitative temperature readings. These efforts are essential to benchmark thermal therapy efficiency, to understand temperature-related biophysical and physiological processes and to use these insights to set new landmarks for diagnostic and therapeutic applications. With that in mind, this review summarises and discusses advances in MR thermometry, providing practical considerations, pitfalls and technical obstacles constraining temperature measurement accuracy, spatial and temporal resolution in vivo. Established approaches and current trends in thermal therapy hardware are surveyed with respect to potential benefits for MR thermometry

Entwicklung von Fluor-19 und Protonen-Magnetresonanztomographie und ihre Anwendung bei Neuroentzündung

The experimental autoimmune encephalomyelitis (EAE) is used to study multiple sclerosis (MS) pathology and develop novel technologies to quantify inflammation over time. Magnetic resonance imaging (MRI) with gadolinium-based contrast agents (GBCAs) is the state-of-the-art method to assess inflammation in MS patients and its animal model. Fluorine (19F)-MRI is one novel technology to quantify inflammatory immune cells in vivo using 19F-nanoparticles. T1 mapping of contrast-enhancing images is another method that could be implemented to quantify inflammatory lesions. Transient macroscopic changes in the EAE brain confound quantification and necessitate registration methods to spatially align images in longitudinal studies. For 19F-MRI, an additional challenge is the low signal-to-noise ratio (SNR) due to low number of 19F-labeled immune cells in vivo. Transceive surface radiofrequency (RF) probes and SNR-efficient imaging techniques such as RARE (Rapid Acquisition with Relaxation Enhancement) are combined to increase sensitivity in 19F-MRI. However, the strong spatially-varying RF field (B1 inhomogeneity) of transceive surface RF probes further hampers quantification. Retrospective B1 correction methods typically use signal intensity equations, unavailable for complex acquisition methods like RARE. The main goal of this work is to investigate novel B1 correction and registration methods to enable the study of inflammatory diseases using 1H- and 19F-MRI following GBCA and 19F-nanoparticle administration, respectively. For correcting B1 inhomogeneities in 1H- and 19F-MR transceive surface RF probes, a model-based method was developed using empirical measurements and simulations, and then validated and compared with a sensitivity method and a hybrid of both. For 19F-MRI, a workflow to measure anatomical images in vivo and a method to compute 19F-concentration uncertainty after correction using Monte Carlo simulations were developed. To overcome the challenges of EAE brain macroscopic changes, a pipeline for registering images throughout longitudinal studies was developed. The proposed B1 correction methods demonstrated dramatic improvements in signal quantification and T1 contrast on images of test phantoms and mouse brains, allowing quantitative measurement with transceive surface RF probes. For low-SNR scenarios, the model-based method yielded reliable 19F-quantifications when compared to volume resonators. Uncertainty after correction depended linearly on the SNR (≤10% with SNR≥10.1, ≤25% when SNR≥4.25). The implemented registration approach provided successful image alignment despite substantial morphological changes in the EAE brain over time. Consequently, T1 mapping was shown to objectively quantify gadolinium lesion burden as a measure of inflammatory activity in EAE. The 1H- and 19F-MRI methods proposed here are highly relevant for quantitative MR of neuroinflammatory diseases, enabling future (pre)clinical investigations.Die experimentelle Autoimmun-Enzephalomyelitis (EAE) wird zur Untersuchung Multipler Sklerose (MS) und zur Entwicklung neuer Technologien zur Entzündungsquantifizierung eingesetzt. Magnetresonanztomographie (MRT) mit Gadolinium-haltigen Kontrastmitteln (GBCAs) ist die modernste Methode zur Beurteilung von Entzündungen bei MS-Patienten und im Tiermodell. Fluor (19F)-MRT unter Verwendung von 19F-Nanopartikeln ist eine neue Technologie zur Quantifizierung entzündlicher Immunzellen in vivo. T1-Kartierung ist eine MRT-Methode, die zur Quantifizierung entzündlicher Läsionen eingesetzt werden könnte. Temporäremorphologische Veränderungen im EAE-Gehirn erschweren die Quantifizierung und erfordern Registrierungsmethoden, um MRT-Bilder in Längsschnittstudien räumlichabzugleichen. Das niedrige Signal-Rausch-Verhältnis (SNR) ist aufgrund der geringen Anzahl 19F-markierter Immunzellen in vivo eine zusätzliche Herausforderung der 19F-MRT. Um deren Empfindlichkeit zu erhöhen, werden Sende-/Empfangsoberflächen-Hochfrequenzspulen (TX/RX-HF-Spule) und SNR-effiziente MRT-Techniken wie RARE (Rapid Acquisition with Relaxation Enhancement) kombiniert. Jedoch verhindert die starke räumliche Variation des HF-Feldes (B1-Inhomogenität) dieser Spulen die Signalquantifizierung. Retrospektive B1-Korrekturmethoden verwenden in der Regel Signalintensitätsgleichungen, die für komplexe MRT-Techniken wie RARE nicht existieren. Das Hauptziel dieser Arbeit ist die Untersuchung neuartiger B1-Korrektur- und Bildregistrierungsmethoden, um in vivo 1H- und 19F-MRT Studien von Entzündungsprozessen zu ermöglichen. Zur Korrektur von B1-Inhomogenitäten wurde eine modellbasierte Methode entwickelt. Diese verwendet empirische Messungen und Simulationen, wurde in Phantomexperimenten validiert und mit Referenzmethoden verglichen. Für 19F-MRT wurden ein Protokoll zur Messung anatomischer Bilder in vivo und eine Methode zur Berechnung der 19F-Konzentrationsunsicherheit nach Korrektur mittels Monte-Carlo-Simulationen entwickelt. Um morphologische Veränderungen im EAE-Gehirn in longitudinalen Studien zu kompensieren, wurde zur Bildregistrierung eine Software-Bibliothek entwickelt. Die B1-Korrekturmethoden zeigten in Testobjekten und Mäusehirnen drastische Verbesserungen der Signal- und T1 Quantifizierung und ermöglichten so quantitative Messungen mit TX/RX-HF-Spulen. Die modellbasierte Methode lieferte für geringe SNRs zuverlässige 19F-Quantifizierungen, deren Genauigkeit mit dem SNR korrelierte. Die implementierte Registrierungsmethode ermöglichte einen erfolgreichen Abgleich von Bildserientrotz erheblicher morphologischer Veränderungen im EAE-Hirn. Folglich wurde gezeigt, dass MRT basierte T1-Kartierung die Gadolinium-Läsionslast als Maß entzündlicher Aktivität bei EAE objektiv quantifizieren kann. Die hier unterscuhten Methoden sind für quantitative 1H- und 19F-MRT neuroinflammatorischer Erkrankungen sehr relevant und ermöglichen künftige (prä)klinische Untersuchungen

Ultra-High Carrier Mobilities in Ferroelectric Domain Wall Corbino Cones at Room Temperature

Recently, electrically conducting heterointerfaces between dissimilar band-insulators (such as lanthanum aluminate and strontium titanate) have attracted considerable research interest. Charge transport has been thoroughly explored and fundamental aspects of conduction firmly established. Perhaps surprisingly, similar insights into conceptually much simpler conducting homointerfaces, such as the domain walls that separate regions of different orientations of electrical polarisation within the same ferroelectric band-insulator, are not nearly so well-developed. Addressing this disparity, we herein report magnetoresistance in approximately conical 180° charged domain walls, which occur in partially switched ferroelectric thin film single crystal lithium niobate. This system is ideal for such measurements: firstly, the conductivity difference between domains and domain walls is extremely and unusually large (a factor of at least 1013) and hence currents driven through the thin film, between planar top and bottom electrodes, are overwhelmingly channelled along the walls; secondly, when electrical contact is made to the top and bottom of the domain walls and a magnetic field is applied along their cone axes (perpendicular to the thin film surface), then the test geometry mirrors that of a Corbino disc, which is a textbook arrangement for geometric magnetoresistance measurement. Our data imply carriers at the domain walls with extremely high room temperature Hall mobilities of up to ~ 3,700cm2V-1s-1. This is an unparalleled value for oxide interfaces (and for bulk oxides too) and is most comparable to mobilities in other systems typically seen at cryogenic, rather than at room, temperature

Development of novel magnetic resonance methods for advanced parametric mapping of the right ventricle

The detection of diffuse fibrosis is of particular interest in congenital heart disease patients, including repaired Tetralogy of Fallot (rTOF), as clinical outcome is linked to the accurate identification of diffuse fibrosis. In the Left Ventricular (LV) myocardium native T1 mapping and Diffusion Tensor Cardiac Magnetic Resonance (DT-CMR) are promising approaches for detection of diffuse fibrosis. In the Right Ventricle (RV) current techniques are limited due to the thinner, mobile and complex shaped compact myocardium. This thesis describes technical development of RV tissue characterisation methods. An interleaved variable density spiral DT-CMR method was implemented on a clinical 3T scanner allowing both ex and in vivo imaging. A range of artefact corrections were implemented and tested (gradient timing delays, off-resonance and T2* corrections). The off- resonance and T2* corrections were evaluated using computational simulation demonstrating that for in vivo acquisitions, off-resonance correction is essential. For the first-time high-resolution Stimulated Echo Acquisition Mode (STEAM) DT-CMR data was acquired in both healthy and rTOF ex-vivo hearts using an interleaved spiral trajectory and was shown to outperform single-shot EPI methods. In vivo the first DT-CMR data was shown from the RV using both an EPI and an interleaved spiral sequence. Both sequences provided were reproducible in healthy volunteers. Results suggest that the RV conformation of cardiomyocytes differs from the known structure in the LV. A novel STEAM-SAturation-recovery Single-sHot Acquisition (SASHA) sequence allowed the acquisition of native T1 data in the RV. The excellent blood and fat suppression provided by STEAM is leveraged to eliminate partial fat and blood signal more effectively than Modified Look-Locker Imaging (MOLLI) sequences. STEAM-SASHA T1 was validated in a phantom showing more accurate results in the native myocardial T1 range than MOLLI. STEAM-SASHA demonstrated good reproducibility in healthy volunteers and initial promising results in a single rTOF patient.Open Acces

Holographic fermions in external magnetic fields

We study the Fermi level structure of 2+1-dimensional strongly interacting electron systems in external magnetic field using the AdS/CFT correspondence. The gravity dual of a finite density fermion system is a Dirac field in the background of the dyonic AdS-Reissner-Nordstrom black hole. In the probe limit the magnetic system can be reduced to the non-magnetic one, with Landau-quantized momenta and rescaled thermodynamical variables. We find that at strong enough magnetic fields, the Fermi surface vanishes and the quasiparticle is lost either through a crossover to conformal regime or through a phase transition to an unstable Fermi surface. In the latter case, the vanishing Fermi velocity at the critical magnetic field triggers the non-Fermi liquid regime with unstable quasiparticles and a change in transport properties of the system. We associate it with a metal-"strange metal" phase transition. Next we compute the DC Hall and longitudinal conductivities using the gravity-dressed fermion propagators. For dual fermions with a large charge, many different Fermi surfaces contribute and the Hall conductivity is quantized as expected for integer Quantum Hall Effect (QHE). At strong magnetic fields, as additional Fermi surfaces open up, new plateaus typical for the fractional QHE appear. The somewhat irregular pattern in the length of fractional QHE plateaus resemble the outcomes of experiments on thin graphite in a strong magnetic field. Finally, motivated by the absence of the sign problem in holography, we suggest a lattice approach to the AdS calculations of finite density systems.Comment: 34 pages, 14 figure

Imaging with therapeutic acoustic wavelets–short pulses enable acoustic localization when time of arrival is combined with delay and sum

—Passive acoustic mapping (PAM) is an algorithm that reconstructs the location of acoustic sources using an array of receivers. This technique can monitor therapeutic ultrasound procedures to confirm the spatial distribution and amount of microbubble activity induced. Current PAM algorithms have an excellentlateral resolution but have a poor axial resolution, making it difficult to distinguish acoustic sources within the ultrasound beams. With recent studies demonstrating that short-length and low-pressure pulses—acoustic wavelets—have the therapeutic function, we hypothesizedthat the axial resolution could be improved with a quasi-pulse-echo approach and that the resolution improvement would depend on the wavelet’s pulse length. This article describes an algorithm that resolves acoustic sources axially using time of flight and laterally using delayand-sum beamforming, which we named axial temporal position PAM (ATP-PAM). The algorithm accommodates a rapid short pulse (RaSP) sequence that can safely deliver drugs across the blood–brain barrier. We developed our algorithm with simulations (k-wave) and in vitro experiments for one-, two-, and five-cycle pulses, comparing our resolution against that of two current PAM algorithms. We then tested ATP-PAM in vivo and evaluated whether the reconstructed acoustic sources mapped to drug deliver