Temperature mapping using the water proton chemical shift: self-referenced method with echo-planar spectroscopic imaging

MR Thermometry during Transcranial MR Imaging-Guided Focused Ultrasound Procedures: A Review

Interest in transcranial MR imaging-guided focused ultrasound procedures has recently grown. These incisionless procedures enable precise focal ablation of brain tissue using real-time monitoring by MR thermometry. This article will provide an updated review on clinically applicable technical underpinnings and considerations of proton resonance frequency MR thermometry, the most common clinically used MR thermometry sequence.

Proton magnetic resonance spectroscopy thermometry: Impact of separately acquired full water or partially suppressed water data on quantification and measurement error

In proton magnetic resonance spectroscopy (¹ H MRS) thermometry, separately acquired full water and partially suppressed water are commonly used for measuring temperature. This paper compares these two approaches. Single-voxel ¹ H MRS data were collected on a 3-T GE scanner from 26 human subjects. Every subject underwent five continuous MRS sessions, each separated by a 2-min phase. Each MRS session lasted 13 min and consisted of two free induction decays (FIDs) without water suppression (with full water [FW or w]) and 64 FIDs with partial water suppression (with partially suppressed water [PW or w']). Frequency differences between the two FWs, the first two PWs, the second FW and the first PW (FW₂ , PW₁ ), or between averaged water ( wav' ) and N-acetylaspartate (NAA), were measured. Intrasubject and intersubject variations of the frequency differences were used as a metric for the error in temperature measurement. The intrasubject variations of frequency differences between FW₂ and PW₁fw2-fw1' , calculated from the five MRS sessions for each subject, were larger than those between the two FWs or between the first two PWs (p = 1.54 x 10^-4 and p = 1.72 x 10^-4 , respectively). The mean values of intrasubject variations of fw2-fw1' for all subjects were 4.7 and 4.5 times those of fw2-fw1 and fw2'-fw1' , respectively. The intrasubject variations of the temperatures based on frequency differences, fw2-fNAA or ( fw1'-fNAA ), were about 2.5 times greater than those based on averaged water and NAA frequencies (fwav'-fNAA ). The mean temperature measured from (fwav'-fNAA ) (n = 26) was 0.29°C lower than that measured from fw2-fNAA and was 0.83°C higher than that from ( fw1'-fNAA ). It was concluded that the use of separately acquired unsuppressed or partially suppressed water signals may result in large errors in frequency and, consequently, temperature measurement.

Proton resonance frequency-based thermometry for aqueous and adipose tissues

PURPOSE

The proton resonance frequency (PRF)-based thermometry uses heating-induced phase variations to reconstruct magnetic resonance (MR) temperature maps. However, the measurements of the phase differences may be corrupted by the presence of fat due to its phase being insensitive to heat. The work aims to reconstruct the PRF-based temperature maps for tissues containing fat.

METHODS

This work proposes a PRF-based method that eliminates the fat's phase contribution by estimating the temperature-insensitive fat vector. A vector in a complex domain represents a given voxel's magnetization from an acquired, complex MR image. In this method, a circle was fit to a time series of vectors acquired from a heated region during a heating experiment. The circle center served as the fat vector, which was then subtracted from the acquired vectors, leaving only the temperature-sensitive vectors for thermal mapping. This work was verified with the gel phantoms of 10%, 15%, and 20% fat content and the ex vivo phantom of porcine abdomen tissue during water-bath heating. It was also tested with an ex vivo porcine tissue during focused ultrasound (FUS) heating.

RESULTS

A good agreement was found between the temperature measurements obtained from the proposed method and the optical fiber temperature probe in the verification experiments. In the gel phantoms, the linear regression provided a slope of 0.992 and an R² of 0.994. The Bland-Altman analysis gave a bias of 0.49°C and a 95% confidence interval of ±1.60°C. In the ex vivo tissue, the results of the linear regression and Bland-Altman methods provided a slope of 0.979, an intercept of 0.353, an R² of 0.947, and a 95% confidence interval of ±3.26°C with a bias of -0.14°C. In FUS tests, a temperature discrepancy of up to 28% was observed between the proposed and conventional PRF methods in ex vivo tissues containing fat.

CONCLUSIONS

The proposed PRF-based method can improve the accuracy of the temperature measurements in tissues with fat, such as breast, abdomen, prostate, and bone marrow.

Temperature-corrected proton density fat fraction estimation using chemical shift-encoded MRI in phantoms

PURPOSE

Chemical shift-encoded MRI (CSE-MRI) is well-established to quantify proton density fat fraction (PDFF) as a quantitative biomarker of hepatic steatosis. However, temperature is known to bias PDFF estimation in phantom studies. In this study, strategies were developed and evaluated to correct for the effects of temperature on PDFF estimation through simulations, temperature-controlled experiments, and a multi-center, multi-vendor phantom study.

THEORY AND METHODS

A technical solution that assumes and automatically estimates a uniform, global temperature throughout the phantom is proposed. Computer simulations modeled the effect of temperature on PDFF estimation using magnitude-, complex-, and hybrid-based CSE-MRI methods. Phantom experiments were performed to assess the temperature correction on PDFF estimation at controlled phantom temperatures. To assess the temperature correction method on a larger scale, the proposed method was applied to data acquired as part of a nine-site multi-vendor phantom study and compared to temperature-corrected PDFF estimation using an a priori guess for ambient room temperature.

RESULTS

Simulations and temperature-controlled experiments show that as temperature deviates further from the assumed temperature, PDFF bias increases. Using the proposed correction method and a reasonable a priori guess for ambient temperature, PDFF bias and variability were reduced using magnitude-based CSE-MRI, across MRI systems, field strengths, protocols, and varying phantom temperature. Complex and hybrid methods showed little PDFF bias and variability both before and after correction.

CONCLUSION

Correction for temperature reduces temperature-related PDFF bias and variability in phantoms across MRI vendors, sites, field strengths, and protocols for magnitude-based CSE-MRI, even without a priori information about the temperature.

Proton Resonance Frequency Shift Thermometry: A Review of Modern Clinical Practices

Magnetic resonance imaging (MRI) has become a popular modality in guiding minimally invasive thermal therapies, due to its advanced, nonionizing, imaging capabilities and its ability to record changes in temperature. A variety of MR thermometry techniques have been developed over the years, and proton resonance frequency (PRF) shift thermometry is the current clinical gold standard to treat a variety of cancers. It is used extensively to guide hyperthermic thermal ablation techniques such as high-intensity focused ultrasound (HIFU) and laser-induced thermal therapy (LITT). Essential attributes of PRF shift thermometry include excellent linearity with temperature, good sensitivity, and independence from tissue type. This noninvasive temperature mapping method gives accurate quantitative measures of the temperature evolution inside biological tissues. In this review, the current status and new developments in the fields of MR-guided HIFU and LITT are presented with an emphasis on breast, prostate, bone, uterine, and brain treatments. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.

MR Thermometry in Cerebrovascular Disease: Physiologic Basis, Hemodynamic Dependence, and a New Frontier in Stroke Imaging

The remarkable temperature sensitivity of the brain is widely recognized and has been studied for its role in the potentiation of ischemic and other neurologic injuries. Pyrexia frequently complicates large-vessel acute ischemic stroke and develops commonly in critically ill neurologic patients; the profound sensitivity of the brain even to minor intraischemic temperature changes, together with the discovery of brain-to-systemic as well as intracerebral temperature gradients, has thus compelled the exploration of cerebral thermoregulation and uncovered its immutable dependence on cerebral blood flow. A lack of pragmatic and noninvasive tools for spatially and temporally resolved brain thermometry has historically restricted empiric study of cerebral temperature homeostasis; however, MR thermometry (MRT) leveraging temperature-sensitive nuclear magnetic resonance phenomena is well-suited to bridging this long-standing gap. This review aims to introduce the reader to the following: 1) fundamental aspects of cerebral thermoregulation, 2) the physical basis of noninvasive MRT, and 3) the physiologic interdependence of cerebral temperature, perfusion, metabolism, and viability.

Recent technological advancements in thermometry

Thermometry is the key factor for achieving successful thermal therapy. Although invasive thermometry with a probe has been used for more than four decades, this method can only detect the local temperature within the probing volume. Noninvasive temperature imaging using a tomographic technique is ideal for monitoring hot-spot formation in the human body. Among various techniques, such as X-ray computed tomography, microwave tomography, echo sonography, and magnetic resonance (MR) imaging, the proton resonance frequency shift method of MR thermometry is the only method currently available for clinical practice because its temperature sensitivity is consistent in most aqueous tissues and can be easily observed using common clinical scanners. New techniques are being proposed to improve the robustness of this method against tissue motion. MR techniques for fat thermometry were also developed based on relaxation times. One of the latest non-MR techniques to attract attention is photoacoustic imaging.

Magnetic resonance thermometry and its biological applications - Physical principles and practical considerations

Most parameters that influence the magnetic resonance imaging (MRI) signal experience a temperature dependence. The fact that MRI can be used for non-invasive measurements of temperature and temperature change deep inside the human body has been known for over 30 years. Today, MR temperature imaging is widely used to monitor and evaluate thermal therapies such as radio frequency, microwave, laser, and focused ultrasound therapy. In this paper we cover the physical principles underlying the biological applications of MR temperature imaging and discuss practical considerations and remaining challenges. For biological tissue, the MR signal of interest comes mostly from hydrogen protons of water molecules but also from protons in, e.g., adipose tissue and various metabolites. Most of the discussed methods, such as those using the proton resonance frequency (PRF) shift, T₁, T₂, and diffusion only measure temperature change, but measurements of absolute temperatures are also possible using spectroscopic imaging methods (taking advantage of various metabolite signals as internal references) or various types of contrast agents. Currently, the PRF method is the most used clinically due to good sensitivity, excellent linearity with temperature, and because it is largely independent of tissue type. Because the PRF method does not work in adipose tissues, T₁- and T₂-based methods have recently gained interest for monitoring temperature change in areas with high fat content such as the breast and abdomen. Absolute temperature measurement methods using spectroscopic imaging and contrast agents often offer too low spatial and temporal resolution for accurate monitoring of ablative thermal procedures, but have shown great promise in monitoring the slower and usually less spatially localized temperature change observed during hyperthermia procedures. Much of the current research effort for ablative procedures is aimed at providing faster measurements, larger field-of-view coverage, simultaneous monitoring in aqueous and adipose tissues, and more motion-insensitive acquisitions for better precision measurements in organs such as the heart, liver, and kidneys. For hyperthermia applications, larger coverage, motion insensitivity, and simultaneous aqueous and adipose monitoring are also important, but great effort is also aimed at solving the problem of long-term field drift which gets interpreted as temperature change when using the PRF method.

Calibration of methylene-referenced lipid-dissolved xenon frequency for absolute MR temperature measurements

PURPOSE

Absolute MR temperature measurements are currently difficult because they require precalibration procedures specific for tissue types and conditions. Reference of the lipid-dissolved ¹²⁹ Xe resonance frequency to temperature-insensitive methylene protons (rLDX) has been proposed to remove the effect of macro- and microscopic susceptibility gradients to obtain absolute temperature information. The scope of this work is to evaluate the rLDX chemical shift (CS) dependence on lipid composition to estimate the precision of absolute temperature measurements in lipids.

METHODS

Neat triglycerides, vegetable oils, and samples of freshly excised human and rodent adipose tissue (AT) are prepared under ¹²⁹ Xe atmosphere and studied using high-resolution NMR. The rLDX CS is measured as a function of temperature. ¹ H spectra are also acquired and the consistency of methylene-referenced water proton and rLDX CS values are compared in human AT.

RESULTS

Although rLDX CS shows a dependence on lipid composition, in human and rodent AT samples the rLDX shows consistent CS values with a similar temperature dependence (-0.2058 ± 0.0010) ppm/°C × T (°C) + (200.15 ± 0.03) ppm, enabling absolute temperature measurements with an accuracy of 0.3°C. Methylene-referenced water CS values present variations of up to 4°C, even under well-controlled conditions.

CONCLUSIONS

The rLDX can be used to obtain accurate absolute temperature measurements in AT, opening new opportunities for hyperpolarized ¹²⁹ Xe MR to measure tissue absolute temperature.

Quantitative MR thermometry based on phase-drift correction PRF shift method at 0.35 T

Background

Noninvasive magnetic resonance thermometry (MRT) at low-field using proton resonance frequency shift (PRFS) is a promising technique for monitoring ablation temperature, since low-field MR scanners with open-configuration are more suitable for interventional procedures than closed systems. In this study, phase-drift correction PRFS with first-order polynomial fitting method was proposed to investigate the feasibility and accuracy of quantitative MR thermography during hyperthermia procedures in a 0.35 T open MR scanner.

Methods

Unheated phantom and ex vivo porcine liver experiments were performed to evaluate the optimal polynomial order for phase-drift correction PRFS. The temperature estimation approach was tested in brain temperature experiments of three healthy volunteers at room temperature, and in ex vivo porcine liver microwave ablation experiments. The output power of the microwave generator was set at 40 W for 330 s. In the unheated experiments, the temperature root mean square error (RMSE) in the inner region of interest was calculated to assess the best-fitting order for polynomial fit. For ablation experiments, relative temperature difference profile measured by the phase-drift correction PRFS was compared with the temperature changes recorded by fiber optic temperature probe around the microwave ablation antenna within the target thermal region.

Results

The phase-drift correction PRFS using first-order polynomial fitting could achieve the smallest temperature RMSE in unheated phantom, ex vivo porcine liver and in vivo human brain experiments. In the ex vivo porcine liver microwave ablation procedure, the temperature error between MRT and fiber optic probe of all but six temperature points were less than 2 °C. Overall, the RMSE of all temperature points was 1.49 °C.

Conclusions

Both in vivo and ex vivo experiments showed that MR thermometry based on the phase-drift correction PRFS with first-order polynomial fitting could be applied to monitor temperature changes during microwave ablation in a low-field open-configuration whole-body MR scanner.

Referenced MR thermometry using three-echo phase-based fat water separation method

A three-point image reconstruction method for internally referenced MR thermometry was developed. The technique exploits the fact that temperature-induced changes in the water resonance frequency are small relative to the chemical shift difference between water and fat signals. This property enabled the use of small angle approximations to derive an analytic phase-based fat-water separation method for MR thermometry. Ethylene glycol and cream cool-down experiments were performed to validate measurement technique. Over a cool-down temperature range of 20 °C, maximum deviation between probe and MR measurement (averaged over 1.3 cm³ region surrounding probe) was 0.6 °C and 1.1 °C for ethylene glycol and cream samples, respectively.

Echo-planar spectroscopic imaging with dual-readout alternated gradients (DRAG-EPSI) at 7 T: Application for 2-hydroxyglutarate imaging in glioma patients

PURPOSE

To develop echo-planar spectroscopic imaging (EPSI) with large spectral width and accomplish high-resolution imaging of 2-hydroxyglutarate (2HG) at 7 T.

METHODS

We designed a new EPSI readout scheme at 7 T. Data were recorded with dual-readout alternated gradients and combined according to the gradient polarity. Following validation of its performance in phantoms, the new readout scheme, together with previously reported 2HG-optimized magnetic resonance spectroscopy (point-resolved spectroscopy echo time of 78 ms), was used for time-efficient and high-resolution imaging of 2HG and other metabolites in five glioma patients before treatment. Unsuppressed water, acquired with EPSI, was used as reference for multichannel combination, eddy-current compensation, and metabolite quantification. Spectral fitting was conducted with the LCModel using in-house calculated basis sets.

RESULTS

Using a readout gradient strength of 9.5 mT/m and slew rate of 90 mT/m/ms, dual-readout alternated gradients EPSI permitted 1638-Hz spectral width with 6 × 6 mm² in-plane resolution at 7 T. Phantom data indicated that dual-readout alternated gradients EPSI provides proper metabolite signals and induces much less frequency drifts than conventional EPSI. For a spatial resolution of 0.5 mL, 2HG was detected in tumors with precision (Cramer-Rao lower bound < 10%). The 2HG was estimated to be 2.3 to 3.3 mM in tumors of three patients with biopsy-proven isocitrate dehydrogenase (IDH) mutant gliomas. The 2HG was undetectable in an IDH wild-type glioblastoma. For a radiographically suggested glioma, the estimated 2HG of 2.3 ± 0.2 mM (Cramer-Rao lower bound < 10%) indicated that the lesion may be an IDH mutant glioma.

CONCLUSIONS

The data indicated that the dual-readout alternated gradients EPSI can provide reliable high-resolution imaging of 2HG in glioma patients at 7 T in vivo. Magn Reson Med 79:1851-1861, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

MR techniques for guiding high-intensity focused ultrasound (HIFU) treatments

To make full use of the ability of magnetic resonance (MR) to guide high-intensity focused ultrasound (HIFU) treatment, effort has been made to improve techniques for thermometry, motion tracking, and sound beam visualization. For monitoring rapid temperature elevation with proton resonance frequency (PRF) shift, data acquisition and processing can be accelerated with parallel imaging and/or sparse sampling in conjunction with appropriate signal processing methods. Thermometry should be robust against tissue motion, motion-induced magnetic field variation, and susceptibility change. Thus, multibaseline, referenceless, or hybrid techniques have become important. In cases with adipose or bony tissues, for which PRF shift cannot be used, thermometry with relaxation times or signal intensity may be utilized. Motion tracking is crucial not only for thermometry but also for targeting the focus of an ultrasound in moving organs such as the liver, kidney, or heart. Various techniques for motion tracking, such as those based on an anatomical image atlas with optical-flow displacement detection, a navigator echo to seize the diaphragm position, and/or rapid imaging to track vessel positions, have been proposed. Techniques for avoiding the ribcage and near-field heating have also been examined. MR acoustic radiation force imaging (MR-ARFI) is an alternative to thermometry that can identify the location and shape of the focal spot and sound beam path. This technique could be useful for treating heterogeneous tissue regions or performing transcranial therapy. All of these developments, which will be discussed further in this review, expand the applicability of HIFU treatments to a variety of clinical targets while maintaining safety and precision.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;47:316-331.

Image-guided thermal ablation with MR-based thermometry

Thermal ablation techniques such as radiofrequency, microwave, high intensity focused ultrasound (HIFU) and laser have been used as minimally invasive strategies for the treatment of variety of cancers. MR thermometry methods are readily available for monitoring thermal distribution and deposition in real time, leading to decrease of incidents of normal tissue damage around targeted lesion. HIFU and laser-induced thermal therapy (LITT) are the two widely accepted tumor ablation techniques because of their compatibility with MR systems. MRI provides multiple temperature dependent parameters for thermal imaging, such as signal intensity, T1, T2, diffusion coefficient, magnetization transfer, proton resonance frequency shift (PRFS, including phase imaging and spectroscopy) as well as frequency shift of temperature sensitive contrast agents. Absolute temperature mapping techniques, including both spectroscopic imaging using metabolites as a reference and phase imaging using fat as a reference, are immune to susceptibility effects and are not dependent on phase differences. These techniques are intrinsically more reliable than relative temperature measurement by phase mapping methods. If the limitation of low temporal and spatial resolution could be overcome, these methods may be preferred for MR-guided thermal ablation systems. As of today, the most popular MR thermal imaging method applied in tumor thermal ablation surgery is, however, still PRFS based phase mapping technique, which only provides relative temperature change and is prone to motion artifacts.

Human Brown Adipose Tissue Temperature and Fat Fraction Are Related to Its Metabolic Activity

BACKGROUND AND AIM

The metabolic activity of human brown adipose tissue (BAT) has been previously examined using positron emission tomography (PET). The aim of this study was to use proton magnetic resonance spectroscopy (1H MRS) to investigate whether the temperature and the fat fraction (FF) of BAT and white adipose tissue (WAT) are associated with BAT metabolic activity determined by deoxy-2-18F-fluoro-d-glucose (18F-FDG)-PET.

MATERIALS AND METHODS

Ten healthy subjects (four women, six men; 25 to 45 years of age) were studied using PET-magnetic resonance imaging during acute cold exposure and at ambient room temperature. BAT and subcutaneous WAT 1H MRS were measured. The tissue temperature and the FF were derived from the spectra. Tissue metabolic activity was studied through glucose uptake using dynamic FDG PET scanning during cold exposure. A 2-hour hyperinsulinemic euglycemic clamp was performed on eight subjects.

RESULTS

The metabolic activity of BAT associated directly with the heat production capacity and inversely with the FF of the tissue. In addition, the lipid-burning capacity of BAT associated with whole-body insulin sensitivity. During cold exposure, the FF of BAT was lower than at room temperature, and cold-induced FF of BAT associated inversely with high-density lipoprotein and directly with low-density lipoprotein cholesterol.

CONCLUSION

Both 1H MRS-derived temperature and FF are promising methods to study BAT activity noninvasively. The association between the lipid-burning capacity of BAT and whole-body insulin sensitivity emphasizes the role of BAT in glucose handling. Furthermore, the relation of FF to high-density lipoprotein and low-density lipoprotein cholesterol suggests that BAT has a role in lipid clearance, thus protecting tissues from excess lipid load.

Quantification of mass fat fraction in fish using water-fat separation MRI

Selection of fish with appropriate fat content and anatomic distribution is searched in fish industry. This necessitates fast and accurate measurements of mass fat fraction maps on a large number of fish. The objective of this work is to assess the relevance of MRI water-fat separation for this purpose. For the separation of the water and fat images we rely on a single T2(⁎) and a multiple peak fat spectrum model, the parameters of which are estimated using the "Varpro" method. The difference of proton density between fat and water and the lack of the signal from the macromolecules are taken into account to convert the obtained proton density fat fraction into mass fat fraction. We used 0.23T NMR to validate the method on 30 salmon steaks. The fat fraction values were in the range of 5% to 25%. Very good accordance was found between 1.5T MRI and NMR although MRI slightly overestimated the mass fat fraction. The R(2) of the linear regression was equal to 0.96 (P<10(-5)), the slope to 1.12 (CI.95=0.03). These results demonstrate that a good accuracy can be achieved. We also show that high throughput can be achieved since the measurements do not depend on the position and we conclude that, for example, it is feasible to quantify the mass fat fraction in fish steaks within about one minute per sample.

Improving thermal dose accuracy in magnetic resonance-guided focused ultrasound surgery: Long-term thermometry using a prior baseline as a reference

PURPOSE

To investigate thermal dose volume (TDV) and non-perfused volume (NPV) of magnetic resonance-guided focused ultrasound (MRgFUS) treatments in patients with soft tissue tumors, and describe a method for MR thermal dosimetry using a baseline reference.

MATERIALS AND METHODS

Agreement between TDV and immediate post treatment NPV was evaluated from MRgFUS treatments of five patients with biopsy-proven desmoid tumors. Thermometry data (gradient echo, 3T) were analyzed over the entire course of the treatments to discern temperature errors in the standard approach. The technique searches previously acquired baseline images for a match using 2D normalized cross-correlation and a weighted mean of phase difference images. Thermal dose maps and TDVs were recalculated using the matched baseline and compared to NPV.

RESULTS

TDV and NPV showed between 47%-91% disagreement, using the standard immediate baseline method for calculating TDV. Long-term thermometry showed a nonlinear local temperature accrual, where peak additional temperature varied between 4-13°C (mean = 7.8°C) across patients. The prior baseline method could be implemented by finding a previously acquired matching baseline 61% ± 8% (mean ± SD) of the time. We found 7%-42% of the disagreement between TDV and NPV was due to errors in thermometry caused by heat accrual. For all patients, the prior baseline method increased the estimated treatment volume and reduced the discrepancies between TDV and NPV (P = 0.023).

CONCLUSION

This study presents a mismatch between in-treatment and post treatment efficacy measures. The prior baseline approach accounts for local heating and improves the accuracy of thermal dose-predicted volume.

Sampling strategies for subsampled segmented EPI PRF thermometry in MR guided high intensity focused ultrasound

PURPOSE

To investigate k-space subsampling strategies to achieve fast, large field-of-view (FOV) temperature monitoring using segmented echo planar imaging (EPI) proton resonance frequency shift thermometry for MR guided high intensity focused ultrasound (MRgHIFU) applications.

METHODS

Five different k-space sampling approaches were investigated, varying sample spacing (equally vs nonequally spaced within the echo train), sampling density (variable sampling density in zero, one, and two dimensions), and utilizing sequential or centric sampling. Three of the schemes utilized sequential sampling with the sampling density varied in zero, one, and two dimensions, to investigate sampling the k-space center more frequently. Two of the schemes utilized centric sampling to acquire the k-space center with a longer echo time for improved phase measurements, and vary the sampling density in zero and two dimensions, respectively. Phantom experiments and a theoretical point spread function analysis were performed to investigate their performance. Variable density sampling in zero and two dimensions was also implemented in a non-EPI GRE pulse sequence for comparison. All subsampled data were reconstructed with a previously described temporally constrained reconstruction (TCR) algorithm.

RESULTS

The accuracy of each sampling strategy in measuring the temperature rise in the HIFU focal spot was measured in terms of the root-mean-square-error (RMSE) compared to fully sampled "truth." For the schemes utilizing sequential sampling, the accuracy was found to improve with the dimensionality of the variable density sampling, giving values of 0.65 °C, 0.49 °C, and 0.35 °C for density variation in zero, one, and two dimensions, respectively. The schemes utilizing centric sampling were found to underestimate the temperature rise, with RMSE values of 1.05 °C and 1.31 °C, for variable density sampling in zero and two dimensions, respectively. Similar subsampling schemes with variable density sampling implemented in zero and two dimensions in a non-EPI GRE pulse sequence both resulted in accurate temperature measurements (RMSE of 0.70 °C and 0.63 °C, respectively). With sequential sampling in the described EPI implementation, temperature monitoring over a 192×144×135 mm3 FOV with a temporal resolution of 3.6 s was achieved, while keeping the RMSE compared to fully sampled "truth" below 0.35 °C.

CONCLUSIONS

When segmented EPI readouts are used in conjunction with k-space subsampling for MR thermometry applications, sampling schemes with sequential sampling, with or without variable density sampling, obtain accurate phase and temperature measurements when using a TCR reconstruction algorithm. Improved temperature measurement accuracy can be achieved with variable density sampling. Centric sampling leads to phase bias, resulting in temperature underestimations.

Proton resonance frequency chemical shift thermometry: experimental design and validation toward high-resolution noninvasive temperature monitoring and in vivo experience in a nonhuman primate model of acute ischemic stroke

BACKGROUND AND PURPOSE

Applications for noninvasive biologic temperature monitoring are widespread in biomedicine and of particular interest in the context of brain temperature regulation, where traditionally costly and invasive monitoring schemes limit their applicability in many settings. Brain thermal regulation, therefore, remains controversial, motivating the development of noninvasive approaches such as temperature-sensitive nuclear MR phenomena. The purpose of this work was to compare the utility of competing approaches to MR thermometry by using proton resonance frequency chemical shift. We tested 3 methodologies, hypothesizing the feasibility of a fast and accurate approach to chemical shift thermometry, in a phantom study at 3T.

MATERIALS AND METHODS

A conventional, paired approach (difference [DIFF]-1), an accelerated single-scan approach (DIFF-2), and a new, further accelerated strategy (DIFF-3) were tested. Phantom temperatures were modulated during real-time fiber optic temperature monitoring, with MR thermometry derived simultaneously from temperature-sensitive changes in the water proton chemical shift (∼0.01 ppm/°C). MR thermometry was subsequently performed in a series of in vivo nonhuman primate experiments under physiologic and ischemic conditions, testing its reproducibility and overall performance.

RESULTS

Chemical shift thermometry demonstrated excellent agreement with phantom temperatures for all 3 approaches (DIFF-1: linear regression R(2) = 0.994; P < .001; acquisition time = 4 minutes 40 seconds; DIFF-2: R(2) = 0.996; P < .001; acquisition time = 4 minutes; DIFF-3: R(2) = 0.998; P < .001; acquisition time = 40 seconds).

CONCLUSIONS

These findings confirm the comparability in performance of 3 competing approaches to MR thermometry and present in vivo applications under physiologic and ischemic conditions in a primate stroke model.

Temperature-dependent MR signals in cortical bone: potential for monitoring temperature changes during high-intensity focused ultrasound treatment in bone

PURPOSE

Because existing magnetic resonance thermometry techniques do not provide temperature information within bone, high-intensity focused ultrasound (HIFU) exposures in bone are monitored using temperature changes in adjacent soft tissues. In this study, the potential to monitor temperature changes in cortical bone using a short TE gradient echo sequence is evaluated.

METHODS

The feasibility of this proposed method was initially evaluated by measuring the temperature dependence of the gradient echo signal during cooling of cortical bone samples implanted with fiber-optic temperature sensors. A subsequent experiment involved heating a cortical bone sample using a clinical MR-HIFU system.

RESULTS

A consistent relationship between temperature change and the change in magnitude signal was observed within and between cortical bone samples. For the two-dimensional gradient echo sequence implemented in this study, a least-squares linear fit determined the percentage change in signal to be (0.90 ± 0.01)%/°C. This relationship was used to estimate temperature changes observed in the HIFU experiment and these temperatures agreed well with those measured from an implanted fiber-optic sensor.

CONCLUSION

This method appears capable of displaying changes related to temperature in cortical bone and could improve the safety of MR-HIFU treatments. Further investigations into the sensitivity of the technique in vivo are warranted.

Non-invasive temperature mapping using temperature-responsive water saturation shift referencing (T-WASSR) MRI

We present a non-invasive MRI approach for assessing the water proton resonance frequency (PRF) shifts associated with changes in temperature. This method is based on water saturation shift referencing (WASSR), a method first developed for assessing B0 field inhomogeneity. Temperature-induced water PRF shifts were determined by estimating the frequency of the minimum intensity of the water direct saturation spectrum at each temperature using Lorentzian line-shape fitting. The change in temperature was then calculated from the difference in water PRF shifts between temperatures. Optimal acquisition parameters were first estimated using simulations and later confirmed experimentally. Results in vitro and in vivo showed that the temperature changes measured using the temperature-responsive WASSR (T-WASSR) were in good agreement with those obtained with MR spectroscopy or phase-mapping-based water PRF measurement methods,. In addition, the feasibility of temperature mapping in fat-containing tissue is demonstrated in vitro. In conclusion, the T-WASSR approach provides an alternative for non-invasive temperature mapping by MRI, especially suitable for temperature measurements in fat-containing tissues.

Correction of proton resonance frequency shift MR-thermometry errors caused by heat-induced magnetic susceptibility changes during high intensity focused ultrasound ablations in tissues containing fat

PURPOSE

In this study, we aim to demonstrate the sensitivity of proton resonance frequency shift (PRFS) -based thermometry to heat-induced magnetic susceptibility changes and to present and evaluate a model-based correction procedure.

THEORY AND METHODS

To demonstrate the expected temperature effect, field disturbances during high intensity focused ultrasound sonications were monitored in breast fat samples with a three-dimensional (3D) gradient echo sequence. To evaluate the correction procedure, the interface of tissue-mimicking ethylene glycol gel and fat was sonicated. During sonication, the temperature was monitored with a 2D dual flip angle multi-echo gradient echo sequence, allowing for PRFS-based relative and referenced temperature measurements in the gel and T1 -based temperature measurements in fat. The PRFS-based measurement in the gel was corrected by minimizing the discrepancy between the observed 2D temperature profile and the profile predicted by a 3D thermal model.

RESULTS

The HIFU sonications of breast fat resulted in a magnetic field disturbance which completely disappeared after cooling. For the correction method, the 5th to 95th percentile interval of the PRFS-thermometry error in the gel decreased from 3.8°C before correction to 2.0-2.3°C after correction.

CONCLUSION

This study has shown the effects of magnetic susceptibility changes induced by heating of breast fatty tissue samples. The resultant errors can be reduced by the use of a model-based correction procedure.

On the confounding effect of temperature on chemical shift-encoded fat quantification

PURPOSE

To characterize the confounding effect of temperature on chemical shift-encoded (CSE) fat quantification.

METHODS

The proton resonance frequency of water, unlike triglycerides, depends on temperature. This leads to a temperature dependence of the spectral models of fat (relative to water) that are commonly used by CSE-MRI methods. Simulation analysis was performed for 1.5 Tesla CSE fat-water signals at various temperatures and echo time combinations. Oil-water phantoms were constructed and scanned at temperatures between 0 and 40°C using spectroscopy and CSE imaging at three echo time combinations. An explanted human liver, rejected for transplantation due to steatosis, was scanned using spectroscopy and CSE imaging. Fat-water reconstructions were performed using four different techniques: magnitude and complex fitting, with standard or temperature-corrected signal modeling.

RESULTS

In all experiments, magnitude fitting with standard signal modeling resulted in large fat quantification errors. Errors were largest for echo time combinations near TEinit ≈ 1.3 ms, ΔTE ≈ 2.2 ms. Errors in fat quantification caused by temperature-related frequency shifts were smaller with complex fitting, and were avoided using a temperature-corrected signal model.

CONCLUSION

Temperature is a confounding factor for fat quantification. If not accounted for, it can result in large errors in fat quantifications in phantom and ex vivo acquisitions.

Multiparametric fat-water separation method for fast chemical-shift imaging guidance of thermal therapies

PURPOSE

A k-means-based classification algorithm is investigated to assess suitability for rapidly separating and classifying fat/water spectral peaks from a fast chemical shift imaging technique for magnetic resonance temperature imaging. Algorithm testing is performed in simulated mathematical phantoms and agar gel phantoms containing mixed fat/water regions.

METHODS

Proton resonance frequencies (PRFs), apparent spin-spin relaxation (T2*) times, and T1-weighted (T1-W) amplitude values were calculated for each voxel using a single-peak autoregressive moving average (ARMA) signal model. These parameters were then used as criteria for k-means sorting, with the results used to determine PRF ranges of each chemical species cluster for further classification. To detect the presence of secondary chemical species, spectral parameters were recalculated when needed using a two-peak ARMA signal model during the subsequent classification steps. Mathematical phantom simulations involved the modulation of signal-to-noise ratios (SNR), maximum PRF shift (MPS) values, analysis window sizes, and frequency expansion factor sizes in order to characterize the algorithm performance across a variety of conditions. In agar, images were collected on a 1.5T clinical MR scanner using acquisition parameters close to simulation, and algorithm performance was assessed by comparing classification results to manually segmented maps of the fat/water regions.

RESULTS

Performance was characterized quantitatively using the Dice Similarity Coefficient (DSC), sensitivity, and specificity. The simulated mathematical phantom experiments demonstrated good fat/water separation depending on conditions, specifically high SNR, moderate MPS value, small analysis window size, and low but nonzero frequency expansion factor size. Physical phantom results demonstrated good identification for both water (0.997 ± 0.001, 0.999 ± 0.001, and 0.986 ± 0.001 for DSC, sensitivity, and specificity, respectively) and fat (0.763 ± 0.006, 0.980 ± 0.004, and 0.941 ± 0.002 for DSC, sensitivity, and specificity, respectively). Temperature uncertainties, based on PRF uncertainties from a 5 × 5-voxel ROI, were 0.342 and 0.351°C for pure and mixed fat/water regions, respectively. Algorithm speed was tested using 25 × 25-voxel and whole image ROIs containing both fat and water, resulting in average processing times per acquisition of 2.00 ± 0.07 s and 146 ± 1 s, respectively, using uncompiled MATLAB scripts running on a shared CPU server with eight Intel Xeon(TM) E5640 quad-core processors (2.66 GHz, 12 MB cache) and 12 GB RAM.

CONCLUSIONS

Results from both the mathematical and physical phantom suggest the k-means-based classification algorithm could be useful for rapid, dynamic imaging in an ROI for thermal interventions. Successful separation of fat/water information would aid in reducing errors from the nontemperature sensitive fat PRF, as well as potentially facilitate using fat as an internal reference for PRF shift thermometry when appropriate. Additionally, the T1-W or R2* signals may be used for monitoring temperature in surrounding adipose tissue.

MRIgHIFU: a tool for image-guided therapeutics

High-intensity focused ultrasound (HIFU) provides focal delivery of mechanical energy deep into the body. This energy can be used to elevate the tissue temperature to such a degree that ablation is achieved. The elevated temperature can also be used to release drugs from temperature-sensitive carriers or activate therapeutic molecules using mechanical or thermal energy. Lower dose exposures modify the vasculature to allow large molecules to diffuse from blood in the surrounding tissue for local drug delivery. The energy delivery can be targeted and monitored using magnetic resonance imaging (MRI). The online image guidance and monitoring provides treatment delivery that is customized to each patient such that optimal, effective treatment can be achieved. This ability to localize and customize treatment delivery may further enhance the future potential of targeted drugs that are personalized for each patient. This review examines the rapid development of MRI-guided HIFU (MRIgHIFU) methods over the past few years and discuss their future potential.

Differential temporal evolution patterns in brain temperature in different ischemic tissues in a monkey model of middle cerebral artery occlusion

Brain temperature is elevated in acute ischemic stroke, especially in the ischemic penumbra (IP). We attempted to investigate the dynamic evolution of brain temperature in different ischemic regions in a monkey model of middle cerebral artery occlusion. The brain temperature of different ischemic regions was measured with proton magnetic resonance spectroscopy (¹H MRS), and the evolution processes of brain temperature were compared among different ischemic regions. We found that the normal (baseline) brain temperature of the monkey brain was 37.16°C. In the artery occlusion stage, the mean brain temperature of ischemic tissue was 1.16°C higher than the baseline; however, this increase was region dependent, with 1.72°C in the IP, 1.08°C in the infarct core, and 0.62°C in the oligemic region. After recanalization, the brain temperature of the infarct core showed a pattern of an initial decrease accompanied by a subsequent increase. However, the brain temperature of the IP and oligemic region showed a monotonously and slowly decreased pattern. Our study suggests that in vivo measurement of brain temperature could help to identify whether ischemic tissue survives.

Challenges to effective cancer nanotheranostics

Advances in nanotechnology for oncology will arise from an increased understanding of the interaction between nanomaterials and biological systems; refinement of multifunctional nanocomposites for applications such as simultaneous imaging and therapy (theranostics); and harnessing of the unique physicochemical properties arising from nanoscale effects which distinguish them from small-molecular-weight molecules in the detection and destruction of cancer cells with high selectivity and efficiency. The major challenges in successful clinical translation of tumor specific nanoparticle delivery include overcoming various biological barriers and demonstrating enhanced therapeutic efficacy over the current standard of care in the clinic. For many nanoparticle mediated theranostic applications, image guidance can play a crucial role not only in exploiting the cancer specific imaging capabilities of these novel particles, but in planning, targeting, monitoring and verifying treatment delivery, thus enhancing the safety and efficacy of these emerging procedures.

MR fluoroscopy in vascular and cardiac interventions (review)

Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image-guided surgeries that offer improved patient management and cost effectiveness.

Real-time MR thermometry for monitoring HIFU ablations of the liver

A high-resolution and high-speed pulse sequence is presented for monitoring high-intensity focused ultrasound ablations in the liver in the presence of motion. The sequence utilizes polynomial-order phase saturation bands to perform outer volume suppression, followed by spatial-spectral excitation and three readout segmented echo-planar imaging interleaves. Images are processed with referenceless thermometry to create temperature-rise images every frame. The sequence and reconstruction were implemented in RTHawk and used to image stationary and moving sonications in a polyacrylamide gel phantom (62.4 acoustic W, 50 sec, 550 kHz). Temperature-rise images were compared between moving and stationary experiments. Heating spots and corresponding temperature-rise plots matched very well. The stationary sonication had a temperature standard deviation of 0.15 degrees C compared to values of 0.28 degrees C and 0.43 degrees C measured for two manually moved sonications at different velocities. Moving the phantom (while not heating) with respect to the transducer did not cause false temperature rises, despite susceptibility changes. The system was tested on nonheated livers of five normal volunteers. The mean temperature rise was -0.05 degrees C, with a standard deviation of 1.48 degrees C. This standard deviation is acceptable for monitoring high-intensity focused ultrasound ablations, suggesting real-time imaging of moving high-intensity focused ultrasound sonications can be clinically possible.

MRI-guided focused ultrasound treatments

Focused ultrasound (FUS) allows noninvasive focal delivery of energy deep into soft tissues. The focused energy can be used to modify and eliminate tissue for therapeutic purposes while the energy delivery is targeted and monitored using magnetic resonance imaging (MRI). MRI compatible methods to deliver these exposures have undergone rapid development over the past 10 years such that clinical treatments are now routinely performed. This paper will review the current technical and clinical status of MRI-guided focused ultrasound therapy and discuss future research and development opportunities.

Accuracy of real-time MR temperature mapping in the brain: a comparison of fast sequences

PURPOSE

To compare magnetic resonance (MR) thermometry based on the proton resonance frequency (PRF) method using a single shot echoplanar imaging (ss EPI) sequence to both of the standard sequences, gradient echo (GRE) and segmented echoplanar imaging (seg EPI) in the in vivo human brain, at 1.5T and 3T.

MATERIAL AND METHODS

Repetitive MR thermometry was performed on the brain of six volunteers using GRE, seg EPI, and ss EPI sequences on whole-body 1.5T and 3T clinical systems using comparable acquisition parameters. Phase stability and temperature data precision in the human head were determined over 12 min for the three sequences at both field strengths. An ex-vivo swine skeletal muscle model was used to evaluate temperature accuracy of the ss EPI sequence during heating by high intensity focused ultrasound (HIFU).

RESULTS

In-vivo examinations of brain revealed an average temperature precision of 0.37 °C/0.39 °C/0.16 °C at 3T for the GRE/seg EPI/ss EPI sequences. At 1.5T, a precision of 0.58 °C/0.63 °C/0.21 °C was achieved. In the ex-vivo swine model, a strong correlation of temperature data derived using ss EPI and GRE sequences was found with a temperature deviation <1 °C.

CONCLUSION

The ss EPI sequence was the fastest and the most precise sequence for MR thermometry, with significantly higher accuracy compared to GRE.

An internal reference model-based PRF temperature mapping method with Cramer-Rao lower bound noise performance analysis

The conventional phase difference method for MR thermometry suffers from disturbances caused by the presence of lipid protons, motion-induced error, and field drift. A signal model is presented with multi-echo gradient echo (GRE) sequence using a fat signal as an internal reference to overcome these problems. The internal reference signal model is fit to the water and fat signals by the extended Prony algorithm and the Levenberg-Marquardt algorithm to estimate the chemical shifts between water and fat which contain temperature information. A noise analysis of the signal model was conducted using the Cramer-Rao lower bound to evaluate the noise performance of various algorithms, the effects of imaging parameters, and the influence of the water:fat signal ratio in a sample on the temperature estimate. Comparison of the calculated temperature map and thermocouple temperature measurements shows that the maximum temperature estimation error is 0.614 degrees C, with a standard deviation of 0.06 degrees C, confirming the feasibility of this model-based temperature mapping method. The influence of sample water:fat signal ratio on the accuracy of the temperature estimate is evaluated in a water-fat mixed phantom experiment with an optimal ratio of approximately 0.66:1.

Noninvasive monitoring of brain temperature during mild hypothermia

The main purpose of this study was to verify the feasibility of brain temperature mapping with high-spatial- and reduced-spectral-resolution magnetic resonance spectroscopic imaging (MRSI). A secondary goal was to determine the temperature coefficient of water chemical shift in the brain with and without internal spectral reference. The accuracy of the proposed MRSI method was verified using a water and vegetable oil phantom. Selective decrease of the brain temperature of pigs was induced by intranasal cooling. Temperature reductions between 2 degrees C and 4 degrees C were achieved within 20 min. The relative changes in temperature during the cooling process were monitored using MRSI. The reference temperature was measured with MR-compatible fiber-optic probes. Single-voxel (1)H MRS was used for measurement of absolute brain temperature at baseline and at the end of cooling. The temperature coefficient of the water chemical shift of brain tissue measured by MRSI without internal reference was -0.0192+/-0.0019 ppm/degrees C. The temperature coefficients of the water chemical shift relative to N-acetylaspartate, choline-containing compounds and creatine were -0.0096+/-0.0009, -0.0083+/-0.0007 and -0.0091+/-0.0011 ppm/degrees C, respectively. The results of this study indicate that MRSI with high spatial and reduced spectral resolutions is a reliable tool for monitoring long-term temperature changes in the brain.

Accurate temperature imaging based on intermolecular coherences in magnetic resonance

Conventional magnetic resonance methods that provide interior temperature profiles, which find use in clinical applications such as hyperthermic therapy, can develop inaccuracies caused by the inherently inhomogeneous magnetic field within tissues or by probe dynamics, and work poorly in important applications such as fatty tissues. We present a magnetic resonance method that is suitable for imaging temperature in a wide range of environments. It uses the inherently sharp resonances of intermolecular zero-quantum coherences, in this case flipping up a water spin while flipping down a nearby fat spin. We show that this method can rapidly and accurately assign temperatures in vivo on an absolute scale.

MR thermometry

Minimally invasive thermal therapy as local treatment of benign and malignant diseases has received increasing interest in recent years. Safety and efficacy of the treatment require accurate temperature measurement throughout the thermal procedure. Noninvasive temperature monitoring is feasible with magnetic resonance (MR) imaging based on temperature-sensitive MR parameters such as the proton resonance frequency (PRF), the diffusion coefficient (D), T1 and T2 relaxation times, magnetization transfer, the proton density, as well as temperature-sensitive contrast agents. In this article the principles of temperature measurements with these methods are reviewed and their usefulness for monitoring in vivo procedures is discussed. Whereas most measurements give a temperature change relative to a baseline condition, temperature-sensitive contrast agents and spectroscopic imaging can provide absolute temperature measurements. The excellent linearity and temperature dependence of the PRF and its near independence of tissue type have made PRF-based phase mapping methods the preferred choice for many in vivo applications. Accelerated MRI imaging techniques for real-time monitoring with the PRF method are discussed. Special attention is paid to acquisition and reconstruction methods for reducing temperature measurement artifacts introduced by tissue motion, which is often unavoidable during in vivo applications.

Dynamic chemical shift imaging for image-guided thermal therapy: analysis of feasibility and potential

A fast chemical shift imaging (CSI) technique based on a multiple gradient-recalled acquisition using a small number of echoes with intentional aliasing of the reference lipid peak is studied to determine its feasibility for temperature monitoring. Simulations were implemented to find parameters where the lipid and water peaks can be measured using a Fourier-based peak fitting approach as well as using an innovative autoregressive moving average technique. A phantom consisting of 50% mayonnaise/50% lemon juice was calibrated to temperature and compared to literature values. A porcine kidney was treated ex vivo with an external laser and imaged with the CSI technique with comparisons to temperature readings from a fluoroptic monitoring system and complex phase difference (CPD) calculations. To demonstrate the technique in vivo, a Balb/c mouse with a CT26 xenograft in the subcutaneous lower back was treated using gold-coated, silica-core nanoshells heated with an 808 nm interstitial laser. Compared to standard CPD techniques using a two-dimensional fast spoiled gradient recalled echo, this technique maintains spatiotemporal resolution, has high signal-to-noise ratio and accuracy over a wide range of T2* tissue values, can separate water and lipid signals, and additionally can use the lipid peak, when present, as an internal reference.

Temperature mapping considerations in the breast with line scan echo planar spectroscopic imaging

A line-scan echo planar spectroscopic imaging (LSEPSI) sequence was used to serially acquire spectra from 4,096 voxels every 6.4 s throughout the breasts of nine female subjects in vivo. Data from the serial acquisitions were analyzed to determine the potential of the technique to characterize temperature changes using either the water frequency alone or the water-methylene frequency difference. Fluctuations of the apparent temperature change under these conditions of no heating were smallest using the water-methylene frequency difference, most probably due to a substantial reduction of motion effects both within and without the imaged plane. The approach offers considerable advantages over other methods for temperature change monitoring in the breast with magnetic resonance but suffers from some limitations, including the unavailability of lipid and water resonances in some voxels as well as a surprisingly large distribution of water-methylene frequency differences, which may preclude absolute temperature measurement.

Magnetic resonance-guided high-intensity ultrasound ablation of the prostate

OBJECTIVES

This paper describes our work in developing techniques and devices for magnetic resonance (MR)-guided high-intensity ultrasound ablation of the prostate and includes review of relevant literature.

METHODS

Catheter-based high-intensity ultrasound applicators, in interstitial and transurethral configurations, were developed to be used under MR guidance. Magnetic resonance thermometry and the relevant characteristics and artifacts were evaluated during in vivo thermal ablation of the prostate in 10 animals. Contrast-enhanced MR imaging (MRI) and diffusion-weighted MRI were used to assess tissue damage and compared with histology.

RESULTS

During evaluation of these applicators, MR thermometry was used to monitor the temperature distributions in the prostate in real time. Magnetic resonance-derived maximum temperature thresholds of 52 degrees C and thermal dose thresholds of 240 minutes were used to control the extent of treatment and qualitatively correlated well with posttreatment imaging studies and histology. The directional transurethral devices are selective in their ability to target well-defined regions of the prostate gland and can be rotated in discrete steps to conform treatment to prescribed boundaries. The curvilinear applicator is the most precise of these directional techniques. Multisectored transurethral applicators, with dynamic angular control of heating and no rotation requirements, offer a fast and less complex means of treatment with less selective contouring.

CONCLUSIONS

The catheter-based ultrasound devices can produce spatially selective regions of thermal destruction in prostate. The MR thermal imaging and thermal dose maps, obtained in multiple slices through the target volume, are useful for controlling therapy delivery (rotation, power levels, duration). Contrast-enhanced T1-weighted MRI and diffusion-weighted imaging are useful tools for assessing treatment.

Correction of proton resonance frequency shift temperature maps for magnetic field disturbances using fat signal

PURPOSE

To improve the immunity of the proton resonance frequency shift (PRFS) method of MRI temperature mapping against magnetic field disturbances. Since PRFS is a phase-sensitive method, it misinterprets magnetic field disturbances as artifact temperature changes. If not corrected, the resulting temperature artifacts can completely obscure the true temperature estimation, especially if the temperature elevations are small.

MATERIALS AND METHODS

Since the fat protons experience the same magnetic field disturbances as the water protons, but no temperature-related frequency shift, the fat signal has been used for correcting PRFS temperature maps for the disturbances. A simple correction method is proposed that has either better compensation capability than the phase correction methods previously reported or higher spatial and temporal resolution than the spectroscopic correction methods previously reported. The evaluated method is based on the utilization of several gradient and spin echoes acquired within one repetition interval with water- and fat-selective scans.

RESULTS

In a series of phantom experiments, the improved method is shown to enable the reconstruction of accurate temperature maps in spite of interscan motion, suboptimal fat-water separation, and a wide range of magnetic field disturbances.

CONCLUSION

Our approach can be used for the guidance of thermal therapies involving tissues containing fat or surrounded by fat.

Near-real-time feedback control system for liver thermal ablations based on self-referenced temperature imaging

Our challenge was to design and implement a dedicated temperature imaging feedback control system to guide and assist in a thermal liver ablation procedure in a double-donut 0.5T open MR scanner. This system has near-real-time feedback capability based on a newly developed "self-referenced" temperature imaging method using "moving-slab" and complex-field-fitting techniques. Two phantom validation studies and one ex vivo experiment were performed to compare the newly developed self-referenced method with the conventional subtraction method and evaluate the ability of the feedback control system in the same MR scanner. The near-real-time feedback system was achieved by integrating the following primary functions: (1) imaging of the moving organ temperature; (2) on-line needle tip tracking; (3) automatic turn-on/off the heating devices; (4) a Windows operating system-based novel user-interfaces. In the first part of the validation studies, microwave heating was applied in an agar phantom using a fast spoiled gradient recalled echo in a steady state sequence. In the second part of the validation and ex vivo study, target visualization, treatment planning and monitoring, and temperature and thermal dose visualization with the graphical user interface of the thermal ablation software were demonstrated. Furthermore, MR imaging with the "self-referenced" temperature imaging method has the ability to localize the hot spot in the heated region and measure temperature elevation during the experiment. In conclusion, we have demonstrated an interactively controllable feedback control system that offers a new method for the guidance of liver thermal ablation procedures, as well as improving the ability to assist ablation procedures in an open MR scanner.