Magnetic Resonance Thermometry at 7T for Real-Time Monitoring and Correction of Ultrasound Induced Mild Hyperthermia

While Magnetic Resonance Thermometry (MRT) has been extensively utilized for non-invasive temperature measurement, there is limited data on the use of high field (≥7T) scanners for this purpose. MR-guided Focused Ultrasound (MRgFUS) is a promising non-invasive method for localized hyperthermia and drug delivery. MRT based on the temperature sensitivity of the proton resonance frequency (PRF) has been implemented in both a tissue phantom and in vivo in a mouse Met-1 tumor model, using partial parallel imaging (PPI) to speed acquisition. An MRgFUS system capable of delivering a controlled 3D acoustic dose during real time MRT with proportional, integral, and derivative (PID) feedback control was developed and validated. Real-time MRT was validated in a tofu phantom with fluoroptic temperature measurements, and acoustic heating simulations were in good agreement with MR temperature maps. In an in vivo Met-1 mouse tumor, the real-time PID feedback control is capable of maintaining the desired temperature with high accuracy. We found that real time MR control of hyperthermia is feasible at high field, and k-space based PPI techniques may be implemented for increasing temporal resolution while maintaining temperature accuracy on the order of 1°C

MRI for Noninvasive Thermometry

MRI was recognized for its potential use as a noninvasive in vivo thermometer 30 years ago. Today, the most popular application of MR thermometry is the guidance of thermal therapies for the treatment of cancer and other pathologies. These minimally invasive operations are routinely performed on patients who are not eligible for surgery in approximately 40 medical centers globally. The aim is to deliver or abduct thermal energy in order to cause local tissue necrosis or to sensitize a lesion to chemotherapy or radiotherapy without causing harm to the surrounding healthy tissue. Here we explain the principles of operation of MR thermometry and provide a critical review of the proposed methods, highlighting remaining fundamental and technical issues as well as recent progress. Emphasis is placed on hardware advances (RF receivers) for improved signal-to-noise ratio (SNR) which would lead to better accuracy, spatiotemporal resolution, and precise calibration. We conclude with a general outlook for the field

Correction of susceptibility-induced GRE phase shift for accurate PRFS thermometry proximal to cryoablation iceball

The susceptibility contrast between frozen and unfrozen tissue disturbs the local magnetic field in the proximity of the ice-ball during cryotherapy. This effect should be corrected for in real time to allow PRFS-based monitoring of near-zero temperatures during intervention

Online improvement of the reliability of PRF based temperature maps displayed during laser-induced thermotherapy of liver lesions

The proton-resonance frequency (PRF) shift technique exploits the phase of the MR signal that is proportional to the temperature of the observed tissue. That is, temperature changes are derived relative to a reference image acquired before the thermotherapy. However, the phase of the MR signal is also altered by motion of the observed tissue in imperfect magnetic fields and susceptibilit

A pilot study for clinical feasibility of the near-harmonic 2D referenceless PRFS thermometry in liver under free breathing using MR-guided LITT ablation data

The conventional implementations of proton resonance frequency shift (PRFS) magnetic resonance thermometry (MRT) require the subtraction of single or multiple temporal references, a motion sensitive critical feature. A pilot study was conducted here to investigate the clinical feasibility of near-harmonic two-dimensional (2D) referenceless PRFS MRT, using patient data from MR-guided laser ablation of liver malignancies

PRFS-Based MR Thermometry Versus an Alternative T1 Magnitude Method – Comparative Performance Predicting Thermally Induced Necrosis in Hepatic Tumor Ablation

<div><p>Objective</p><p>To compare the accuracy of a semi-quantitative proton resonance frequency shift (PRFS) thermal mapping interface and an alternative qualitative T1 thermometry model in predicting tissue necrosis in an established routine setting of MRI-guided laser ablation in the human liver.</p> <p>Materials and Methods</p><p>34 cases of PRFS-guided (GRE) laser ablation were retrospectively matched with 34 cases from an earlier patient population of 73 individuals being monitored through T1 magnitude image evaluation (FLASH 2D). The model-specific real-time estimation of necrotizing thermal impact (above 54 °C zone and T1 signal loss, respectively) was correlated in size with the resulting necrosis as shown by lack of enhancement on the first-day contrast exam (T1). Matched groups were compared using the Mann-Whitney test.</p> <p>Results</p><p>Online PRFS guidance was available in 33 of 34 cases. Positive size correlation between calculated impact zone and contrast defect at first day was evident in both groups (p < 0.0004). The predictive error estimating necrosis was median 21 % (range 1 % - 52 %) in the PRFS group and 61 % (range 22 - 84 %) in the T1 magnitude group. Differences in estimating lethal impact were significant (p = 0.004), whereas the real extent of therapy-induced necrosis showed no significant difference (p > 0.28) between the two groups.</p> <p>Conclusion</p><p>PRFS thermometry is feasible in a clinical setting of thermal hepatic tumor ablation. As an interference-free MR-tool for online therapy monitoring its accuracy to predict tissue necrosis is superior to a competing model of thermally induced alteration of the T1 magnitude signal.</p> </div