Validation of single reference variable flip angle (SR-VFA) dynamic T1 mapping with T2 * correction using a novel rotating phantom.

PURPOSE: To validate single reference variable flip angle (SR-VFA) dynamic T1 mapping with and without T2 * correction against inversion recovery (IR) T1 measurements. METHODS: A custom cylindrical phantom with three concentric compartments was filled with variably doped agar to produce a smooth spatial gradient of the T1 relaxation rate as a function of angle across each compartment. IR T1 , VFA T1 , and B1 + measurements were made on the phantom before rotation, and multi-echo stack-of-radial dynamic images were acquired during rotation via an MRI-compatible motor. B1 + -corrected SR-VFA and SR-VFA-T2 * T1 maps were computed from the sliding window reconstructed images and compared against rotationally registered IR and VFA T1 maps to determine the percentage error. RESULTS: Both VFA and SR-VFA-T2 * T1 maps fell within 10% of IR T1 measurements for a low rotational speed, with a mean accuracy of 2.3% ± 2.6% and 2.8% ± 2.6%, respectively. Increasing rotational speed was found to decrease the accuracy due to increasing temporal smoothing over ranges where the T1 change had a nonconstant slope. SR-VFA T1 mapping was found to have similar accuracy as the SR-VFA-T2 * and VFA methods at low TEs (˜<2 ms), whereas accuracy degraded strongly with later TEs. T2 * correction of the SR-VFA T1 maps was found to consistently improve accuracy and precision, especially at later TEs. CONCLUSION: SR-VFA-T2 * dynamic T1 mapping was found to be accurate against reference IR T1 measurements within 10% in an agar phantom. Further validation is needed in mixed fat-water phantoms and in vivo.

Simultaneous proton resonance frequency T1 - MR shear wave elastography for MR-guided focused ultrasound multiparametric treatment monitoring.

PURPOSE: To develop an efficient MRI pulse sequence to simultaneously measure multiple parameters that have been shown to correlate with tissue nonviability following thermal therapies. METHODS: A 3D segmented EPI pulse sequence was used to simultaneously measure proton resonance frequency shift (PRFS) MR thermometry (MRT), T1 relaxation time, and shear wave velocity induced by focused ultrasound (FUS) push pulses. Experiments were performed in tissue mimicking gelatin phantoms and ex vivo bovine liver. Using a carefully designed FUS triggering scheme, a heating duty cycle of approximately 65% was achieved by interleaving FUS ablation pulses with FUS push pulses to induce shear waves in the tissue. RESULTS: In phantom studies, temperature increases measured with PRFS MRT and increases in T1 correlated with decreased shear wave velocity, consistent with material softening with increasing temperature. During ablation in ex vivo liver, temperature increase measured with PRFS MRT initially correlated with increasing T1 and decreasing shear wave velocity, and after tissue coagulation with decreasing T1 and increasing shear wave velocity. This is consistent with a previously described hysteresis in T1 versus PRFS curves and increased tissue stiffness with tissue coagulation. CONCLUSION: An efficient approach for simultaneous and dynamic measurements of PRSF, T1 , and shear wave velocity during treatment is presented. This approach holds promise for providing co-registered dynamic measures of multiple parameters, which correlates to tissue nonviability during and following thermal therapies, such as FUS.

MRI-compatible electromagnetic servomotor for image-guided medical robotics.

The soft-tissue imaging capabilities of magnetic resonance imaging (MRI) combined with high precision robotics has the potential to improve the precision and safety of a wide range of image-guided medical procedures. However, functional MRI-compatible robotics have not yet been realized in part because conventional electromagnetic servomotors can become dangerous projectiles near the strong magnetic field of an MRI scanner. Here we report an electromagnetic servomotor constructed from non-magnetic components, where high-torque and controlled rotary actuation is produced via interaction between electrical current in the servomotor armature and the magnetic field generated by the superconducting magnet of the MRI scanner itself. Using this servomotor design, we then build and test an MRI-compatible robot which can achieve the linear forces required to insert a large-diameter biopsy instrument in tissue during simultaneous MRI. Our electromagnetic servomotor can be safely operated (while imaging) in the patient area of a 3 Tesla clinical MRI scanner.

Magnetic resonance shear wave elastography using transient acoustic radiation force excitations and sinusoidal displacement encoding.

A magnetic resonance (MR) shear wave elastography technique that uses transient acoustic radiation force impulses from a focused ultrasound (FUS) transducer and a sinusoidal-shaped MR displacement encoding strategy is presented. Using this encoding strategy, an analytic expression for calculating the shear wave speed in a heterogeneous medium was derived. Green's function-based simulations were used to evaluate the feasibility of calculating shear wave speed maps using the analytic expression. Accuracy of simulation technique was confirmed experimentally in a homogeneous gelatin phantom. The elastography measurement was compared to harmonic MR elastography in a homogeneous phantom experiment and the measured shear wave speed values differed by less than 14%. This new transient elastography approach was able to map the position and shape of inclusions sized from 8.5 to 14 mm in an inclusion phantom experiment. These preliminary results demonstrate the feasibility of using a straightforward analytic expression to generate shear wave speed maps from MR images where sinusoidal-shaped motion encoding gradients are used to encode the displacement-time history of a transiently propagating wave-packet. This new measurement technique may be particularly well suited for performing elastography before, during, and after MR-guided FUS therapies since the same device used for therapy is also used as an excitation source for elastography.

A Breast-Specific MR Guided Focused Ultrasound Platform and Treatment Protocol: First-in-Human Technical Evaluation.

OBJECTIVE: This paper presents and evaluates a breast-specific magnetic resonance guided focused ultrasound (MRgFUS) system. A first-in-human evaluation demonstrates the novel hardware, a sophisticated tumor targeting algorithm and a volumetric magnetic resonance imaging (MRI) protocol. METHODS: At the time of submission, N = 10 patients with non-palpable T0 stage breast cancer have been treated with the breast MRgFUS system. The described tumor targeting algorithm is evaluated both with a phantom test and in vivo during the breast MRgFUS treatments. Treatments were planned and monitored using volumetric MR-acoustic radiation force imaging (MR-ARFI) and temperature imaging (MRTI). RESULTS: Successful technical treatments were achieved in 80 % of the patients. All patients underwent the treatment with no sedation and 60 % of participants had analgesic support. The total MR treatment time ranged from 73 to 114 minutes. Mean error between desired and achieved targeting in a phantom was 2.9 ±1.8 mm while 6.2 ±1.9 mm was achieved in patient studies, assessed either with MRTI or MR-ARFI measurements. MRTI and MR-ARFI were successful in 60 % and 70 % of patients, respectively. CONCLUSION: The targeting accuracy allows the accurate placement of the focal spot using electronic steering capabilities of the transducer. The use of both volumetric MRTI and MR-ARFI provides complementary treatment planning and monitoring information during the treatment, allowing the treatment of all breast anatomies, including homogeneously fatty breasts.

Development and characterization of a tissue mimicking psyllium husk gelatin phantom for ultrasound and magnetic resonance imaging.

Purpose: To develop and characterize a tissue-mimicking phantom that enables the direct comparison of magnetic resonance (MR) and ultrasound (US) imaging techniques useful for monitoring high-intensity focused ultrasound (HIFU) treatments. With no additions, gelatin phantoms produce little if any scattering required for US imaging. This study characterizes the MR and US image characteristics as a function of psyllium husk concentration, which was added to increase US scattering.Methods: Gelatin phantoms were constructed with varying concentrations of psyllium husk. The effects of psyllium husk concentration on US B-mode and MR imaging were evaluated at nine different concentrations. T1, T2, and T2* MR maps were acquired. Acoustic properties (attenuation and speed of sound) were measured at frequencies of 0.6, 1.0, 1.8, and 3.0 MHz using a through-transmission technique. Phantom elastic properties were evaluated for both time and temperature dependence.Results: Ultrasound image echogenicity increased with increasing psyllium husk concentration while quality of gradient-recalled echo MR images decreased with increasing concentration. For all phantoms, the measured speed of sound ranged between 1567-1569 m/s and the attenuation ranged between 0.42-0.44 dB/(cm·MHz). Measured T1 ranged from 974-1051 ms. The T2 and T2* values ranged from 97-108 ms and 48-88 ms, respectively, with both showing a decreasing trend with increased psyllium husk concentration. Phantom stiffness, measured using US shear-wave speed measurements, increased with age and decreased with increasing temperature.Conclusions: The presented dual-use tissue-mimicking phantom is easy to manufacture and can be used to compare and evaluate US-guided and MR-guided HIFU imaging protocols.

Corrections to "The Role of Viscosity in the Impulse Diffraction Field of Elastic Waves Induced by the Acoustic Radiation Force" and "Supersonic Shear Imaging: A New Technique for Soft Tissue Elasticity Mapping".

This article presents corrections to J. Bercoff et al., "The role of viscosity in the impulse diffraction field of elastic waves induced by the acoustic radiation force," IEEE Trans. Ultrason., Ferroelectr., Freq. Control, vol. 51, no. 11, pp. 1523-1536, Nov. 2004, and J. Bercoff et al., "Supersonic shear imaging: A new technique for soft tissue elasticity mapping," IEEE Trans. Ultrason., Ferroelectr., Freq. Control, vol. 51, no. 4, pp. 396-409, Apr. 2004.

Efficient shear wave elastography using transient acoustic radiation force excitations and MR displacement encoding.

PURPOSE: To present a novel MR shear wave elastography (MR-SWE) method that efficiently measures the speed of propagating wave packets generated using acoustic radiation force (ARF) impulses. METHODS: ARF impulses from a focused ultrasound (FUS) transducer were applied sequentially to a preselected set of positions and motion encoded MRI was used to acquire volumetric images of the propagating shear wavefront emanating from each point. The wavefront position at multiple propagation times was encoded in the MR phase image using a train of motion encoding gradient lobes. Generating a transient propagating wavefront at multiple spatial positions and sampling each at multiple time-points allowed for shear wave speed maps to be efficiently created. MR-SWE was evaluated in tissue mimicking phantoms and ex vivo bovine liver tissue before and after ablation. RESULTS: MR-SWE maps, covering an in-plane area of ~5 × 5 cm, were acquired in 12 s for a single slice and 144 s for a volumetric scan. MR-SWE detected inclusions of differing stiffness in a phantom experiment. In bovine liver, mean shear wave speed significantly increased from 1.65 ± 0.18 m/s in normal to 2.52 ± 0.18 m/s in ablated region (n = 581 pixels; P-value < 0.001). CONCLUSION: MR-SWE is an elastography technique that enables precise targeting and excitation of the desired tissue of interest. MR-SWE may be particularly well suited for treatment planning and endpoint assessment of MR-guided FUS procedures because the same device used for therapy can be used as an excitation source for tissue stiffness quantification.

Multiple-point magnetic resonance acoustic radiation force imaging.

PURPOSE: To implement and evaluate an efficient multiple-point MR acoustic radiation force imaging pulse sequence that can volumetrically measure tissue displacement and evaluate tissue stiffness using focused ultrasound (FUS) radiation force. METHODS: Bipolar motion-encoding gradients were added to a gradient-recalled echo segmented EPI pulse sequence with both 2D and 3D acquisition modes. Multiple FUS-ON images (FUS power > 0 W) were interleaved with a single FUS-OFF image (FUS power = 0 W) on the TR level, enabling simultaneous measurements of volumetric tissue displacement (by complex subtraction of the FUS-OFF image from the FUS-ON images) and proton resonance frequency shift MR thermometry (from the OFF image). Efficiency improvements included partial Fourier acquisition, parallel imaging, and encoding up to 4 different displacement positions into a single image. Experiments were performed in homogenous and dual-stiffness phantoms, and in ex vivo porcine brain. RESULTS: In phantoms, 16-point multiple-point magnetic resonance acoustic radiation force imaging maps could be acquired in 5 s to 10 s for a 2D slice, and 60 s for a 3D volume, using parallel imaging and encoding 2 displacement positions/image. In ex vivo porcine brain, 16-point multiple-point magnetic resonance acoustic radiation force imaging maps could be acquired in 20 s for a 3D volume, using partial Fourier and parallel imaging and encoding 4 displacement positions/image. In 1 experiment it was observed that tissue displacement in ex vivo brain decreased by approximately 22% following FUS ablation. CONCLUSION: With the described efficiency improvements it is possible to acquire volumetric multiple-point magnetic resonance acoustic radiation force imaging maps, with simultaneous proton resonance frequency shift MR thermometry maps, in clinically acceptable times.

Referenced MR thermometry using three-echo phase-based fat water separation method.

A three-point image reconstruction method for internally referenced MR thermometry was developed. The technique exploits the fact that temperature-induced changes in the water resonance frequency are small relative to the chemical shift difference between water and fat signals. This property enabled the use of small angle approximations to derive an analytic phase-based fat-water separation method for MR thermometry. Ethylene glycol and cream cool-down experiments were performed to validate measurement technique. Over a cool-down temperature range of 20 °C, maximum deviation between probe and MR measurement (averaged over 1.3 cm3 region surrounding probe) was 0.6 °C and 1.1 °C for ethylene glycol and cream samples, respectively.

Simultaneous MR thermometry and acoustic radiation force imaging using interleaved acquisition.

PURPOSE: A novel and practical method for simultaneously performing MR acoustic radiation force imaging (ARFI) and proton resonance frequency (PRF)-shift thermometry has been developed and tested. This could be an important tool for evaluating the success of MR-guided focused ultrasound procedures for which MR-thermometry measures temperature and thermal dose and MR-ARFI detects changes in tissue mechanical properties. METHODS: MR imaging was performed using a gradient recalled echo segmented echo-planar imaging pulse sequence with bipolar motion encoding gradients (MEG). Images with ultrasound pulses (ON) and without ultrasound pulses (OFF) during the MEG were interleaved at the repetition time (TR) level. ARFI displacements were calculated by complex subtraction of ON-OFF images, and PRF temperature maps were calculated by baseline subtraction. Evaluations in tissue-mimicking phantoms and ex vivo porcine brain tissue were performed. Constrained reconstruction improved the temporal resolution of dynamic measurements. RESULTS: Simultaneous maps of displacement and temperature were acquired in 2D and 3D while keeping tissue heating < 1°C. Accuracy of the temperature maps was comparable to the standard PRF sequence. Using constrained reconstruction and subsampled k-space (R = 4.33), 3D simultaneous temperature and displacement maps can be acquired every 4.7 s. CONCLUSION: This new sequence acquires simultaneous temperature and displacement maps with minimal tissue heating, and can be applied dynamically for monitoring tissue mechanical properties during ablation procedures. Magn Reson Med 79:1515-1524, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

T2* Measurement bias due to concomitant gradient fields.

PURPOSE: To demonstrate that concomitant magnetic fields can cause significant spatially dependent biases in T2* relaxometry measurements with implications for clinical applications such as BOLD and dynamic susceptibility contrast-enhanced MRI. THEORY AND METHODS: After developing a theoretical framework for intravoxel dephasing and signal loss from concomitant magnetic fields, this framework and the effect of concomitant fields on T2* are validated with phantom experiments and numerical simulation. In lower leg and renal T2* mapping, we quantify measurement bias for imaging protocols with high gradient amplitude multiecho readouts, comparable to those used in clinical applications. RESULTS: Concordance between phantom experiment and numerical simulation validate the theoretical framework. Changes in T2* measured in the lower leg and kidney varied by up to 15% and 35%, respectively, as a result of concomitant gradient effects when compared with the control measurements. CONCLUSION: Concomitant magnetic fields produced by imaging gradient coils can cause clinically significant T2* mapping errors when high amplitude, long duration gradient waveforms are used. While we have shown that measurement biases can be quite large, modification of imaging parameters can potentially reduce concomitant field-induced measurement errors to acceptable levels. Magn Reson Med 77:1562-1572, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Exploration of MR-guided head and neck hyperthermia by phantom testing of a modified prototype applicator for use with proton resonance frequency shift thermometry.

Magnetic resonance thermometry (MRT) offers non-invasive temperature imaging and can greatly contribute to the effectiveness of head and neck hyperthermia. We therefore wish to redesign the HYPERcollar head and neck hyperthermia applicator for simultaneous radio frequency (RF) heating and magnetic resonance thermometry. In this work we tested the feasibility of this goal through an exploratory experiment, in which we used a minimally modified applicator prototype to heat a neck model phantom and used an MR scanner to measure its temperature distribution. We identified several distorting factors of our current applicator design and experimental methods to be addressed during development of a fully MR compatible applicator. To allow MR imaging of the electromagnetically shielded inside of the applicator, only the lower half of the HYPERcollar prototype was used. Two of its antennas radiated a microwave signal (150 W, 434 MHz) for 11 min into the phantom, creating a high gradient temperature profile (ΔTmax = 5.35 °C). Thermal distributions were measured sequentially, using drift corrected proton resonance frequency shift-based MRT. Measurement accuracy was assessed using optical probe thermometry and found to be about 0.4 °C (0.1-0.7 °C). Thermal distribution size and shape were verified by thermal simulations and found to have a good correlation (r(2 )= 0.76).

Validation of MR thermometry: method for temperature probe sensor registration accuracy in head and neck phantoms.

PURPOSE: Magnetic resonance thermometry (MRT) is an attractive means to non-invasively monitor in vivo temperature during head and neck hyperthermia treatments because it can provide multi-dimensional temperature information with high spatial resolution over large regions of interest. However, validation of MRT measurements in a head and neck clinical set-up is crucial to ensure the temperature maps are accurate. Here we demonstrate a unique approach for temperature probe sensor localisation in head and neck hyperthermia test phantoms. METHODS: We characterise the proton resonance frequency shift temperature coefficient and validate MRT measurements in an oil-gel phantom by applying a combination of MR imaging and 3D spline fitting for accurate probe localisation. We also investigate how uncertainties in both the probe localisation and the proton resonance frequency shift (PRFS) thermal coefficient affect the registration of fibre-optic reference temperature probe and MRT readings. RESULTS: The method provides a two-fold advantage of sensor localisation and PRFS thermal coefficient calibration. We provide experimental data for two distinct head and neck phantoms showing the significance of this method as it mitigates temperature probe localisation errors and thereby increases accuracy of MRT validation results. CONCLUSIONS: The techniques presented here may be used to simplify calibration experiments that use an interstitial heating device, or any heating method that provides rapid and spatially localised heat distributions. Overall, the experimental verification of the data registration and PRFS thermal coefficient calibration technique provides a useful benchmarking method to maximise MRT accuracy in any similar context.

Fat-referenced MR thermometry in the breast and prostate using IDEAL.

PURPOSE: To demonstrate a three-echo fat-referenced MR thermometry technique that estimates and corrects for time-varying phase disturbances in heterogeneous tissues. MATERIALS AND METHODS: Fat protons do not exhibit a temperature-dependent frequency shift. Fat-referenced thermometry methods exploit this insensitivity and use the signal from fat to measure and correct for magnetic field disturbances. In this study, we present a fat-referenced method that uses interpolation of the fat signal to correct for phase disturbances in fat free regions. Phantom and ex vivo tissue cool-down experiments were performed to evaluate the accuracy of this method in the absence of motion. Non-heated in vivo imaging of the breast and prostate was performed to demonstrate measurement robustness in the presence of systemic and motion-induced field disturbances. Measurement accuracy of the method was compared to conventional proton resonance frequency shift MR thermometry. RESULTS: In the ex vivo porcine tissue experiment, maximum measurement error of the fat-referenced method was reduced 42% from 3.3 to 1.9°C when compared to conventional MR thermometry. In the breasts, measurement errors were reduced by up to 70% from 6.4 to 1.9°C. CONCLUSION: Ex vivo and in vivo results show that the proposed method reduces measurement errors in the heterogeneous tissue experiments when compared to conventional MR thermometry.