Thermal ablation of benign and malignant tumours

Temporally constrained reconstruction applied to MRI temperature data

The monitoring of thermal ablation procedures would benefit from an acceleration in the rate at which MRI temperature maps are acquired. Constrained reconstruction techniques have been shown to be capable of generating high quality images using only a fraction of the k-space data. Here, we present a temporally constrained reconstruction (TCR) algorithm applied to proton resonance frequency shift (PRF) data. The algorithm generates images from undersampled data by iteratively minimizing a cost function. The unique challenges of using an iterative constrained reconstruction technique to generate real-time images were addressed. For a set of eight heating experiments on ex vivo porcine tissue, a maximum reduction factor of 4 was achieved while keeping the root mean square error (RMSE) of the temperature below 0.5 degrees C. For a set of three heating experiments on in vivo canine muscle tissue, the maximum reduction factor achieved was 3 while keeping the temperature RMSE below 1.0 degrees C. At these reduction factors, the TCR algorithm underpredicted the thermal dose by an average of 6% for the ex vivo data and 28% for the in vivo data. Compared with sliding window and low resolution reconstructions, the RMSE of the TCR algorithm was significantly lower (P < 0.05 in all cases).

High intensity focused ultrasound: physical principles and devices

High intensity focused ultrasound (HIFU) is gaining rapid clinical acceptance as a treatment modality enabling non-invasive tissue heating and ablation for numerous applications. HIFU treatments are usually carried out in a single session, often as a day case procedure, with the patient either fully conscious, lightly sedated or under light general anaesthesia. A major advantage of HIFU over other thermal ablation techniques is that there is no necessity for the transcutaneous insertion of probes into the target tissue. The high powered focused beams employed are generated from sources placed either outside the body (for treatment of tumours of the liver, kidney, breast, uterus, pancreas and bone) or in the rectum (for treatment of the prostate), and are designed to enable rapid heating of a target tissue volume, while leaving tissue in the ultrasound propagation path relatively unaffected. Given the wide-ranging applicability of HIFU, numerous extra-corporeal, transrectal and interstitial devices have been designed to optimise application-specific treatment delivery. Their principle of operation is described here, alongside an overview of the physical mechanisms governing HIFU propagation and HIFU-induced heating. Present methods of characterising HIFU fields and of quantifying HIFU exposure and its associated effects are also addressed.