Magnetic resonance temperature imaging-based quantification of blood flow-related energy losses

AAPM Task Group 241: A medical physicist's guide to MRI-guided focused ultrasound body systems

Magnetic resonance-guided focused ultrasound (MRgFUS) is a completely non-invasive technology that has been approved by FDA to treat several diseases. This report, prepared by the American Association of Physicist in Medicine (AAPM) Task Group 241, provides background on MRgFUS technology with a focus on clinical body MRgFUS systems. The report addresses the issues of interest to the medical physics community, specific to the body MRgFUS system configuration, and provides recommendations on how to successfully implement and maintain a clinical MRgFUS program. The following sections describe the key features of typical MRgFUS systems and clinical workflow and provide key points and best practices for the medical physicist. Commonly used terms, metrics and physics are defined and sources of uncertainty that affect MRgFUS procedures are described. Finally, safety and quality assurance procedures are explained, the recommended role of the medical physicist in MRgFUS procedures is described, and regulatory requirements for planning clinical trials are detailed. Although this report is limited in scope to clinical body MRgFUS systems that are approved or currently undergoing clinical trials in the United States, much of the material presented is also applicable to systems designed for other applications.

Enhancement of HIFU ablation by sonosensitizer-loading liquid fluorocarbon nanoparticles with pre-targeting in a mouse model

High intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique for the treatment of benign and malignant solid masses. To improve the efficacy of HIFU ablation, we developed poly (lactide-co-glycolide) (PLGA) nanoparticles encapsulating perfluoropentane (PFP) and hematoporphyrin monomethyl ether (HMME) as synergistic agents (HMME+PFP/PLGA). Two-step biotin-avidin pre-targeting technique was applied for the HIFU ablation. We further modified the nanoparticles with streptavidin (HMME+PFP/PLGA-SA). HMME+PFP/PLGA-SA were highly dispersed with spherical morphology (477.8 ± 81.8 nm in diameter). The encapsulation efficiency of HMME and PFP were 46.6 ± 3.3% and 40.1 ± 2.6%, respectively. The binding efficiency of nanoparticles to streptavidin was 95.5 ± 2.5%. The targeting ability of the HMME+PFP/PLGA-SA nanoparticles was tested by parallel plate flow chamber in vitro. In the pre-targeting group (HMME+PFP/PLGA-SA), a large number of nanoparticles bound to the peripheral and surface of the cell. In the HIFU ablation experiment in vivo, compared with the other groups, the largest gray-scale changes and coagulation necrosis areas were observed in the pre-targeting (HMME+PFP/PLGA-SA) group, with the lowest energy efficiency factor value. Moreover, the microvessel density and proliferation index declined, while the apoptotic index increased, in the tumor tissue surrounding the coagulation necrosis area in the pre-targeting group. Meanwhile, the survival time of the tumor-bearing nude mice in the pre-targeting group was significantly longer than that in the HIFU treatment group. These results suggest that HMME+PFP/PLGA-SA have high potential to act as synergistic agents in HIFU ablation.

Characteristics of temperature changes in photothermal therapy induced by combined application of indocyanine green and laser

Photothermal therapy, a type of laser application, has the ability to eradicate tumor cells by a local thermal effect and elicit a tumor specific immune response. Indocyanine green (ICG), a photosensitizer, can effectively elevate the local temperature by absorbing energy from the laser. The present study aimed to investigate the characteristics of temperature changes during photothermal therapy with an infrared thermometer in an ICG solution and in tumor-bearing mice treated with a combination of laser and ICG. Additionally, the present study observed the morphological changes of tumor tissue by hematoxylin-eosin staining following photothermal therapy. In the solution experiment, when the laser power density was 1 W/cm² and the concentration of ICG was 0 or 0.0187 mg/ml, the temperature of the water was elevated by 3 and 28°C, respectively. In the tumor-bearing mice experiment, when the laser power density was 1 W/cm² and the concentration of ICG was 0 and 0.1 mg/ml, the temperature of the tumor-bearing mice was elevated by 6.9 and 28.5°C, respectively. With an increase in laser power density, including 0.6, 0.8 and 1.0 W/cm², the temperature was 23.3, 26.7 and 28.5°C, respectively. Pathological tissue sections demonstrated that a large number of tumor cells experienced necrosis, and the envelope of the tumor was destroyed. Numerous inflammatory cells, in particular lymphocytes, infiltrated into the tumor tissue following tumor tissue treatment with a combination of laser and ICG. These results indicated that a combination treatment with laser and ICG may significantly increase the temperature of the water solutions and in the tumor-bearing mice. The concentration of ICG and laser power density contributed to the temperature elevation, in particular to the concentration of ICG.

Analytical estimation of ultrasound properties, thermal diffusivity, and perfusion using magnetic resonance-guided focused ultrasound temperature data

For thermal modeling to play a significant role in treatment planning, monitoring, and control of magnetic resonance-guided focused ultrasound (MRgFUS) thermal therapies, accurate knowledge of ultrasound and thermal properties is essential. This study develops a new analytical solution for the temperature change observed in MRgFUS which can be used with experimental MR temperature data to provide estimates of the ultrasound initial heating rate, Gaussian beam variance, tissue thermal diffusivity, and Pennes perfusion parameter. Simulations demonstrate that this technique provides accurate and robust property estimates that are independent of the beam size, thermal diffusivity, and perfusion levels in the presence of realistic MR noise. The technique is also demonstrated in vivo using MRgFUS heating data in rabbit back muscle. Errors in property estimates are kept less than 5% by applying a third order Taylor series approximation of the perfusion term and ensuring the ratio of the fitting time (the duration of experimental data utilized for optimization) to the perfusion time constant remains less than one.