Local specific absorption rate in brain tumors at 7 tesla.

PURPOSE: MR safety at 7 Tesla relies on accurate numerical simulations of transmit electromagnetic fields to fully assess local specific absorption rate (SAR) safety. Numerical simulations for SAR safety are currently performed using models of healthy patients. These simulations might not be useful for estimating SAR in patients who have large lesions with potentially abnormal dielectric properties, e.g., brain tumors. THEORY AND METHODS: In this study, brain tumor patient models are constructed based on scans of four patients with high grade brain tumors. Dielectric properties for the modeled tumors are assigned based on electrical properties tomography data for the same patients. Simulations were performed to determine SAR. RESULTS: Local SAR increases in the tumors by as much as 30%. However, the location of the maximum 10-gram averaged SAR typically occurs outside of the tumor, and thus does not increase. In the worst case, if the tumor model is moved to the location of maximum electric field intensity, then we do observe an increase in the estimated peak 10-gram SAR directly related to the tumor. CONCLUSION: Peak local SAR estimation made on the results of a healthy patient model simulation may underestimate the true peak local SAR in a brain tumor patient.

Establishing implantation uncertainties for focal brachytherapy with I-125 seeds for the treatment of localized prostate cancer.

BACKGROUND: The efficacy of focal continuous low dose-rate brachytherapy (CLDR-BT) for prostate cancer requires that appropriate margins are applied to ensure robust target coverage. In this study we propose a method to establish such margins by emulating a focal treatment in patients treated with CLDR-BT to the entire gland. MATERIAL AND METHODS: In 15 patients with localized prostate cancer, prostate volumes and dominant intra-prostatic lesions were delineated on pre-treatment magnetic resonance imaging (MRI). Delineations and MRI were registered to trans-rectal ultrasound images in the operating theater. The patients received CLDR-BT treatment to the total prostate volume. The implantation consisted of two parts: an experimental focal plan covering the dominant intra-prostatic lesion (F-GTV), followed by a plan containing additional seeds to achieve entire prostate coverage. Isodose surfaces were reconstructed using follow-up computed tomography (CT). The focal dose was emulated by reconstructing seeds from the focal plan only. The distance to agreement between planned and delivered isodose surfaces and F-GTV coverage was determined to calculate the margin required for robust treatment. RESULTS: If patients had been treated only focally, the target volume would have been reduced from an average of 40.9 cm3 for the entire prostate to 5.8 cm3 for the focal plan. The D90 for the F-GTV in the focal plan was 195±60 Gy, the V100 was 94% [range 71-100%]. The maximum distance (cd95) between the planned and delivered isodose contours was 0.48 cm. CONCLUSIONS: This study provides an estimate of 0.5 cm for the margin required for robust coverage of a focal target volume prior to actually implementing a focal treatment protocol.

Multimodal tract-based analysis in ALS patients at 7T: a specific white matter profile?

Our objective was to explore the value of additional MR contrasts in elucidating the decrease in fractional anisotropy (FA) as has been observed in the corticospinal tracts (CST) of patients with amyotrophic lateral sclerosis (ALS). Eleven patients and nine healthy control subjects were scanned at 3T and 7T MRI. Whole brain and tract specific comparison was performed of both diffusion weighted (3T), quantitative T1 (qT1), magnetization transfer ratio (MTR) and amide proton transfer weighted (APTw) imaging (7T). Results of whole brain comparison using histogram analyses showed no significant differences between patients and controls. Measures along the CST showed a significantly reduced FA together with a significantly increased diffusivity perpendicular to the tract direction in patients compared to controls. In addition, patients showed a small but significant increase in MTR values within the right CST. No significant changes were observed in qT1 and APTw values. In conclusion, our findings, based on a multimodal approach, revealed that the decrease in FA is most probably caused by an increased diffusivity perpendicular to the CST. This diffusivity profile, together with the increase in MTR is inconsistent with demyelination but consistent with an increase of free liquid spins in the white matter tissue.

Uncertainty estimations for quantitative in vivo MRI T1 mapping.

Mapping the longitudinal relaxation time (T(1)) of brain tissue is of great interest for both clinical research and MRI sequence development. For an unambiguous interpretation of in vivo variations in T(1) images, it is important to understand the degree of variability that is associated with the quantitative T(1) parameter. This paper presents a general framework for estimating the uncertainty in quantitative T(1) mapping by combining a slice-shifted multi-slice inversion recovery EPI technique with the statistical wild-bootstrap approach. Both simulations and experimental analyses were performed to validate this novel approach and to evaluate the estimated T(1) uncertainty in several brain regions across four healthy volunteers. By estimating the T(1) uncertainty, it is shown that the variation in T(1) within anatomic regions for similar tissue types is larger than the uncertainty in the measurement. This indicates that heterogeneity of the inspected tissue and/or partial volume effects can be the main determinants for the observed variability in the estimated T(1) values. The proposed approach to estimate T(1) and its uncertainty without the need for repeated measurements may also prove to be useful for calculating effect sizes that are deemed significant when comparing group differences.

Signal to noise ratio and uncertainty in diffusion tensor imaging at 1.5, 3.0, and 7.0 Tesla.

PURPOSE: To compare diffusion tensor imaging (DTI) measurements at ultra high field strength (7 Tesla [T]) in human volunteers with DTI measurements performed at 1.5 and 3 Tesla. MATERIALS AND METHODS: The signal to noise ratio (SNR) and the uncertainty in fitted DTI parameters fractional anisotropy and primary eigenvector are assessed with tractography based regions of interest, measured in nine volunteers at 1.5T, 3T, and 7T with clinically available hardware configurations. RESULTS: An increase in SNR is observed on the 7T system compared with the 1.5 or 3T system. The measured increase in SNR at 7T is larger than expected from field strength alone, indicating the large influence of improved receive coil hardware. Additionally, while the average fractional anisotropy remains relatively constant across field strengths, a decrease in uncertainty in the fitted values for fractional anisotropy and the principal eigenvector of the DTI tensor was found. Increased spatial heterogeneity of signal intensities is observed at 7T. CONCLUSION: Given the current hardware constraints, DTI at ultra-high field strengths is possible with improved performance in selected regions of interest.