The Potential of Adjusting Water Bolus Liquid Properties for Economic and Precise MR Thermometry Guided Radiofrequency Hyperthermia

Probability of Cavitation in a Custom Iron-Based Coupling Medium for Transcranial Magnetic Resonance-Guided Focused Ultrasound Procedures

OBJECTIVE

A coupling bath of circulating, chilled, degassed water is essential to safe and precise acoustic transmittance during transcranial magnetic resonance-guided focused ultrasound (tMRgFUS) procedures, but the circulating water impairs the critical real-time magnetic resonance imaging (MRI). An iron-based coupling medium (IBCM) using iron oxide nanoparticles previously developed by our group increased the relaxivity of the coupling bath such that it appears to be invisible on MRI compared with degassed water. However, the nanoparticles also reduced the pressure threshold for cavitation. To address this concern for prefocal cavitation, our group recently developed an IBCM of electrosterically stabilized and aggregation-resistant poly(methacrylic acid)-coated iron oxide nanoparticles (PMAA-FeOX) with a similar capability to reduce the MR signal of degassed water. This study examines the effect of the PMAA-FeOX IBCM on the cavitation threshold.

METHODS

Increasing concentrations of PMAA-FeOX nanoparticles in degassed, deionized water were placed at the focus of two different transducers to assess low and high duty-cycle pulsing parameters which are representative of two modes of focused ultrasound being investigated for tMRgFUS. Passive cavitation detection and high-speed optical imaging were used to measure cavitation threshold pressures.

RESULTS

The mean cavitation threshold was determined in both cases to be indistinguishable from the degassed water control, between 6-8 MPa for high duty-cycle pulsing (CW) and between 25.5-26.5 MPa for very low duty-cycle pulsing.

CONCLUSION

The findings of this study indicate that an IBCM of PMAA-FeOX nanoparticles is a possible solution to reducing MRI interference from the coupling bath without increasing the risk of prefocal cavitation.

Comparison of Microwave Hyperthermia Applicator Designs with Fora Dipole and Connected Array

In microwave hyperthermia tumor therapy, electromagnetic waves focus energy on the tumor to elevate the temperature above its normal levels with minimal injury to the surrounding healthy tissue. Microwave hyperthermia applicator design is important for the effectiveness of the therapy and the feasibility of real-time application. In this study, the potential of using fractal octagonal ring antenna elements as a dipole antenna array and as a connected array at 2.45 GHz for breast tumor hyperthermia application was investigated. Microwave hyperthermia treatment models consisting of different fractal octagonal ring antenna array designs and a breast phantom are simulated in COMSOL Multiphysics to obtain the field distributions. The antenna excitation phases and magnitudes are optimized using the global particle swarm algorithm to selectively increase the specific absorption rate at the target region while minimizing hot spots in other regions within the breast. Specific absorption rate distributions, obtained inside the phantom, are analyzed for each proposed microwave hyperthermia applicator design. The dipole fractal octagonal ring antenna arrays are comparatively assessed for three different designs: circular, linear, and Cross-array. The 16-antenna dipole array performance was superior for all three 1-layer applicator designs, and no distinct difference was found between 16-antenna circular, linear, or cross arrays. Two-layer dipole arrays have better performance in the deep-tissue targets than one-layer arrays. The performance of the connected array with a higher number of layers exceeds the performance of the dipole arrays in the superficial regions, while they are comparable for deep regions of the breast. The 1-layer 12-antenna circular FORA dipole array feasibility as a microwave hyperthermia applicator was experimentally shown.

Iron-based coupling media for MRI-guided ultrasound surgery

PURPOSE

In this study, we examine the effects of a recently developed, iron-based coupling medium (IBCM) on guidance magnetic resonance (MR) scans during transcranial, magnetic-resonance-guided, focused ultrasound surgery (tMRgFUS) procedures. More specifically, this study tests the hypotheses that the use of the IBCM will (a) not adversely affect image quality, (b) remove aliasing from small field-of-view scans, and (c) decouple image quality from the motion state of the coupling fluid.

METHODS

An IBCM, whose chemical synthesis and characterization are reported elsewhere, was used as a coupling medium during tMRgFUS procedures on gel phantoms. Guidance magnetization-prepared rapid-gradient-echo (MP-RAGE), TSE, and GRE scans were acquired with fields of view of 28 and 18 cm. Experiments were repeated with the IBCM in several distinct flow states. GRE scans were used to estimate temperature time courses as a gel target was insonated. IBCM performance was measured by computing (i) the root mean square difference (RMSD) of TSE and GRE pixel values acquired using water and the IBCM, relative to the use of water; (ii) through-time temperature uncertainty for GRE scans; and (iii) Bland-Altman analysis of the temperature time courses. Finally, guidance TSE and GRE scans of a human volunteer were acquired during a separate sham tMRgFUS procedure. As a control, all experiments were repeated using a water coupling medium.

RESULTS

Use of the IBCM reduced RMSD in TSE scans by a factor of 4 or more for all fields of view and nonstationary motion states, but did not reduce RMSD estimates in MP-RAGE scans. With the coupling media in a stationary state, the IBCM altered estimates of temperature uncertainty relative to the use of water by less than 0.2°C. However, with a high flow state, the IBCM reduced temperature uncertainties by the statistically significant amounts (at the 0.01 level) of 0.5°C (28 cm field of view) and 5°C (18 cm field of view). Bland-Altman analyses found a 0.1°C ± 0.5°C difference between temperature estimates acquired using water and the IBCM as coupling media. Finally, scans of a human volunteer using the IBCM indicate more conspicuous grey/white matter contrast, a reduction in aliasing, and a less than 0.2°C change in temperature uncertainty.

CONCLUSIONS

The use of an IBCM during tMRgFUS procedures does not adversely affect image quality for TSE and GRE scans, can decouple image quality from the motion state of the coupling fluid, and can remove aliasing from scans where the field of view is set to be much smaller than the spatial extent of the coupling fluid.

Antenna Excitation Optimization with Deep Learning for Microwave Breast Cancer Hyperthermia

Microwave hyperthermia (MH) requires the effective calibration of antenna excitations for the selective focusing of the microwave energy on the target region, with a nominal effect on the surrounding tissue. To this end, many different antenna calibration methods, such as optimization techniques and look-up tables, have been proposed in the literature. These optimization procedures, however, do not consider the whole nature of the electric field, which is a complex vector field; instead, it is simplified to a real and scalar field component. Furthermore, most of the approaches in the literature are system-specific, limiting the applicability of the proposed methods to specific configurations. In this paper, we propose an antenna excitation optimization scheme applicable to a variety of configurations and present the results of a convolutional neural network (CNN)-based approach for two different configurations. The data set for CNN training is collected by superposing the information obtained from individual antenna elements. The results of the CNN models outperform the look-up table results. The proposed approach is promising, as the phase-only optimization and phase-power-combined optimization show a 27% and 4% lower hotspot-to-target energy ratio, respectively, than the look-up table results for the linear MH applicator. The proposed deep-learning-based optimization technique can be utilized as a protocol to be applied on any MH applicator for the optimization of the antenna excitations, as well as for a comparison of MH applicators.

Experimental Validation of the MRcollar: An MR Compatible Applicator for Deep Heating in the Head and Neck Region

Clinical effectiveness of hyperthermia treatments, in which tumor tissue is artificially heated to 40-44 °C for 60-90 min, can be hampered by a lack of accurate temperature monitoring. The need for noninvasive temperature monitoring in the head and neck region (H&N) and the potential of MR thermometry prompt us to design an MR compatible hyperthermia applicator: the MRcollar. In this work, we validate the design, numerical model, and MR performance of the MRcollar. The MRcollar antennas have low reflection coefficients (<-15 dB) and the intended low interaction between the individual antenna modules (<-32 dB). A 10 °C increase in 3 min was reached in a muscle-equivalent phantom, such that the specifications from the European Society for Hyperthermic Oncology were easily reached. The MRcollar had a minimal effect on MR image quality and a five-fold improvement in SNR was achieved using the integrated coils of the MRcollar, compared to the body coil. The feasibility of using the MRcollar in an MR environment was shown by a synchronous heating experiment. The match between the predicted SAR and measured SAR using MR thermometry satisfied the gamma criteria [distance-to-agreement = 5 mm, dose-difference = 7%]. All experiments combined show that the MRcollar delivers on the needs for MR-hyperthermia in the H&N and is ready for in vivo investigation.

External Basic Hyperthermia Devices for Preclinical Studies in Small Animals

Simple Summary

The application of mild hyperthermia can be beneficial for solid tumor treatment by induction of sublethal effects on a tissue- and cellular level. When designing a hyperthermia experiment, several factors should be taken into consideration. In this review, multiple elementary hyperthermia devices are described in detail to aid standardization of treatment design.

Abstract

Preclinical studies have shown that application of mild hyperthermia (40–43 °C) is a promising adjuvant to solid tumor treatment. To improve preclinical testing, enhance reproducibility, and allow comparison of the obtained results, it is crucial to have standardization of the available methods. Reproducibility of methods in and between research groups on the same techniques is crucial to have a better prediction of the clinical outcome and to improve new treatment strategies (for instance with heat-sensitive nanoparticles). Here we provide a preclinically oriented review on the use and applicability of basic hyperthermia systems available for solid tumor thermal treatment in small animals. The complexity of these techniques ranges from a simple, low-cost water bath approach, irradiation with light or lasers, to advanced ultrasound and capacitive heating devices.