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Specialized volumetric thermometry for improved guidance of MRgFUS in brain.

Authors: Marx M, Ghanouni P, Butts Pauly K

MR thermometry is critical for safe and effective transcranial focused ultrasound. The current single-slice MR thermometry sequence cannot achieve all desired treatment monitoring requirements. We propose an approach in which the imaging requirements of different aspects of treatment monitoring are met by optimizing multiple sequences. Imaging requirements were determined for three stages of MR-guided focused ultrasound brain treatment: 1) focal spot localization, 2) focal spot monitoring, and 3) background monitoring. Multiple-echo spiral thermometry sequences were optimized for each set of requirements and then validated with in vivo signal-to-noise ratio measurements and with phantom heating experiments. Each of the proposed sequences obtained better precision than the current two-dimensional Fourier transform (2DFT) thermometry sequence. Five-slice focal spot localization achieved two-fold better resolution with 1.9-fold better precision but two-fold longer acquisition compared to 2DFT. Five-slice focal monitoring achieved 2.1-fold better precision with similar speed but 12% larger voxels than 2DFT. Full-brain background monitoring was demonstrated in both axial (7.1 s) and sagittal (11.4 s) orientations. Phantom heating time curves were consistent across all sequences after correcting for resolution. Multiple-echo spiral imaging significantly improves MR thermometry efficiency, enabling multiple-slice monitoring. Optimizing multiple specialized sequences provides better performance than can be achieved by any single sequence. Magn Reson Med 78:508-517, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Introduction

Purpose Thermal ablation
Study Objective To improve MR thermometry for transcranial focused ultrasound by optimizing and validating multiple specialized multiple-echo spiral imaging sequences tailored to different treatment-monitoring stages.
MRI or image guidance method MR-guided (MRI thermometry)

Outcomes and Safety

Summary of Outcomes Multiple-echo spiral MR thermometry sequences optimized for focal spot localization, focal spot monitoring, and background monitoring outperformed standard 2DFT, giving ~2× better resolution and ~1.9–2.1× better precision for five-slice localization and monitoring (localization required ~2× longer acquisition; monitoring had ~12% larger voxels). Full-brain background monitoring was achieved in axial (7.1 s) and sagittal (11.4 s) orientations, and phantom heating curves were consistent across sequences after resolution correction.
Duration of biological effect 7.1 s, 11.4 s
Safety-related matter The authors state that MR thermometry is critical for safe and effective transcranial focused ultrasound; no adverse effects are reported, and validation was limited to in vivo SNR measurements and phantom heating experiments without mention of safety incidents.

Brain Region

Visualization unavailable

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None

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