Biopsy marker localization with thermo-acoustic ultrasound for lumpectomy guidance.

PURPOSE: Almost one in four lumpectomies fails to fully remove cancerous tissue from the breast, requiring reoperation. This high failure rate suggests that existing lumpectomy guidance methods are inadequate for allowing surgeons to consistently identify the proper volume of tissue for excision. Current guidance techniques either provide little information about the tumor position or require surgeons to frequently switch between making incisions and manually probing for a marker placed at the lesion site. This article explores the feasibility of thermo-acoustic ultrasound (TAUS) to enable hands-free localization of metallic biopsy markers throughout surgery, which would allow for continuous visualization of the lesion site in the breast without the interruption of surgery. In a TAUS-based localization system, microwave excitations would be transmitted into the breast, and the amplification in microwave absorption around the metallic markers would generate acoustic signals from the marker sites through the thermo-acoustic effect. Detection and ranging of these signals by multiple acoustic receivers on the breast could then enable marker localization through acoustic multilateration. METHODS: Physics simulations were used to characterize the TAUS signals generated from different markers by microwave excitations. First, electromagnetic simulations determined the spatial pattern of the amplification in microwave absorption around the markers. Then, acoustic simulations characterized the acoustic fields generated from these markers at various acoustic frequencies. TAUS-based one-dimensional (1D) ranging of two metallic markers-including a biopsy marker that is FDA-approved for clinical use-immersed in saline was also performed using a bench-top setup. To perform TAUS acquisitions, a microwave applicator was driven by 2.66 GHz microwave signals that were amplitude-modulated by chirps at the desired acoustic excitation frequencies, and the resulting TAUS signal from the markers was detected by an ultrasonic transducer. RESULTS: The simulation results show that the geometry of the marker strongly impacts the quantity and spatial pattern of both the microwave absorption around the marker and the resulting TAUS signal generated from the marker. The simulated TAUS signal maps and acoustic frequency responses also make clear that the marker geometry plays an important role in determining the overall system response. Using the bench-top setup, TAUS detection and 1D localization of the markers were successfully demonstrated for multiple different combinations of microwave applicator and metallic marker. These initial results indicate that TAUS-based localization of biopsy markers is feasible. CONCLUSIONS: Through microwave excitations and acoustic detection, TAUS can be used to localize metallic biopsy markers. With further development, TAUS opens new avenues to enable a more intuitive lumpectomy guidance system that could help to achieve better lumpectomy outcomes.

Wireless Resonant Circuits Printed Using Aerosol Jet Deposition for MRI Catheter Tracking.

Interventional magnetic resonance imaging (MRI) could allow for diagnosis and immediate treatment of ischemic stroke; however, such endovascular catheter-based procedures under MRI guidance are inherently difficult. One major challenge is tracking the tip of the catheter, as standard fabrication methods for building inductively coupled coil markers are rigid and bulky. Here, we report a new approach that uses aerosol jet deposition to three-dimensional (3-D) print an inductively coupled RF coil marker on a polymer catheter. Our approach enables lightweight conforming markers on polymer catheters and these low-profile markers allow the catheter to be more safely navigated in small caliber vessels. Prototype markers with an inductor with the geometry of a double helix are incorporated on catheters for in vitro studies, and we show that these markers exhibit good signal amplification. We report temperature measurements and, finally, demonstrate feasibility in a preliminary in vivo experiment. We provide material properties and electromagnetic simulation performance analysis. This paper presents fully aerosol jet-deposited and functional wireless resonant markers on polymer catheters for use in 3T clinical scanners.

Thermo-acoustic ultrasound for noninvasive temperature monitoring at lead tips during MRI.

PURPOSE: We explore the use of thermo-acoustic ultrasound (TAUS) to monitor temperature at the tips of conductive device leads during MRI. THEORY: In TAUS, rapid radiofrequency (RF) power deposition excites an acoustic signal via thermoelastic expansion. Coupling of the MRI RF transmit to device leads causes SAR amplification at lead tips, allowing MRI RF transmitters to excite significant lead tip TAUS signals. Because the amplitude of the TAUS signal depends on temperature, it becomes feasible to monitor the lead tip temperature during MRI by tracking the TAUS amplitude. METHODS: The TAUS temperature dependence was characterized in a phantom and in tissue. To perform TAUS acquisitions in an MRI scanner, amplitude modulated RF chirps were transmitted by the body coil, and the lead tip TAUS signal was detected by an ultrasonic transducer. The TAUS signal level was correlated with the RF current induced on the lead and the associated B1 artifacts in MRI. TAUS signals acquired during RF-induced heating were used to estimate the lead tip temperature. RESULTS: The TAUS signal exhibited strong dependence on temperature, increasing over 30% with 10∘ C of heating both in the phantom and in tissue. A lead tip TAUS signal was observed for a 100 mA rms current induced on a lead. During RF-induced heating, the TAUS signal appeared to accurately approximate the peak lead tip temperature. CONCLUSIONS: TAUS allows for noninvasive monitoring of lead tip temperature in an MRI environment. With further development, TAUS opens new avenues to improve RF device safety during MRI scans.

Thermo-Acoustic Ultrasound for Detection of RF-Induced Device Lead Heating in MRI.

Patients who have implanted medical devices with long conductive leads are often restricted from receiving MRI scans due to the danger of RF-induced heating near the lead tips. Phantom studies have shown that this heating varies significantly on a case-by-case basis, indicating that many patients with implanted devices can receive clinically useful MRI scans without harm. However, the difficulty of predicting RF-induced lead tip heating prior to scanning prevents numerous implant recipients from being scanned. Here, we demonstrate that thermo-acoustic ultrasound (TAUS) has the potential to be utilized for a pre-scan procedure assessing the risk of RF-induced lead tip heating in MRI. A system was developed to detect TAUS signals by four different TAUS acquisition methods. We then integrated this system with an MRI scanner and detected a peak in RF power absorption near the tip of a model lead when transmitting from the scanner's body coil. We also developed and experimentally validated simulations to characterize the thermo-acoustic signal generated near lead tips. These results indicate that TAUS is a promising method for assessing RF implant safety, and with further development, a TAUS pre-scan could allow many more patients to have access to MRI scans of significant clinical value.

Optimal Broadband Noise Matching to Inductive Sensors: Application to Magnetic Particle Imaging.

Inductive sensor-based measurement techniques are useful for a wide range of biomedical applications. However, optimizing the noise performance of these sensors is challenging at broadband frequencies, owing to the frequency-dependent reactance of the sensor. In this work, we describe the fundamental limits of noise performance and bandwidth for these sensors in combination with a low-noise amplifier. We also present three equivalent methods of noise matching to inductive sensors using transformer-like network topologies. Finally, we apply these techniques to improve the noise performance in magnetic particle imaging, a new molecular imaging modality with excellent detection sensitivity. Using a custom noise-matched amplifier, we experimentally demonstrate an 11-fold improvement in noise performance in a small animal magnetic particle imaging scanner.

Depletion-Mode GaN HEMT Q-Spoil Switches for MRI Coils.

Q-spoiling is the process of decoupling an MRI receive coil to protect the equipment and patient. Conventionally, Q-spoiling is performed using a PIN diode switch that draws significant current. In this work, a Q-spoiling technique using a depletion-mode Gallium Nitride HEMT device was developed for coil detuning at both 1.5 T and 3 T MRI. The circuits with conventional PIN diode Q-spoiling and the GaN HEMT device were implemented on surface coils. SNR was measured and compared for all surfaces coils. At both 1.5 T and 3 T, comparable SNR was achieved for all coils with the proposed technique and conventional Q-spoiling. The GaN HEMT device has significantly reduced the required power for Q-spoiling. The GaN HEMT device also provides useful safety features by detuning the coil when unpowered.

A semiflexible 64-channel receive-only phased array for pediatric body MRI at 3T.

PURPOSE: To design, construct, and validate a semiflexible 64-channel receive-only phased array for pediatric body MRI at 3T. METHODS: A 64-channel receive-only phased array was developed and constructed. The designed flexible coil can easily conform to different patient sizes with nonoverlapping coil elements in the transverse plane. It can cover a field of view of up to 44 × 28 cm(2) and removes the need for coil repositioning for body MRI patients with multiple clinical concerns. The 64-channel coil was compared with a 32-channel standard coil for signal-to-noise ratio and parallel imaging performances on different phantoms. With IRB approval and informed consent/assent, the designed coil was validated on 21 consecutive pediatric patients. RESULTS: The pediatric coil provided higher signal-to-noise ratio than the standard coil on different phantoms, with the averaged signal-to-noise ratio gain at least 23% over a depth of 7 cm along the cross-section of phantoms. It also achieved better parallel imaging performance under moderate acceleration factors. Good image quality (average score 4.6 out of 5) was achieved using the developed pediatric coil in the clinical studies. CONCLUSION: A 64-channel semiflexible receive-only phased array has been developed and validated to facilitate high quality pediatric body MRI at 3T. Magn Reson Med 76:1015-1021, 2016. © 2015 Wiley Periodicals, Inc.

Offline impedance measurements for detection and mitigation of dangerous implant interactions: an RF safety prescreen.

PURPOSE: The concept of a "radiofrequency safety prescreen" is investigated, wherein dangerous interactions between radiofrequency fields used in MRI, and conductive implants in patients are detected through impedance changes in the radiofrequency coil. THEORY: The behavior of coupled oscillators is reviewed, and the resulting, observable impedance changes are discussed. METHODS: A birdcage coil is loaded with a static head phantom and a wire phantom with a wire close to its resonant length, the shape, position, and orientation of which can be changed. Interactions are probed with a current sensor and network analyzer. RESULTS: Impedance spectra show dramatic, unmistakable splitting in cases of strong coupling, and strong correlation is observed between induced current and scattering parameters. CONCLUSIONS: The feasibility of a new, low-power prescreening technique has been demonstrated in a simple phantom experiment, which can unambiguously detect resonant interactions between an implanted wire and an imaging coil. A new technique has also been presented which can detect parallel transmit null modes for the wire.

Medusa: a scalable MR console using USB.

Magnetic resonance imaging (MRI) pulse sequence consoles typically employ closed proprietary hardware, software, and interfaces, making difficult any adaptation for innovative experimental technology. Yet MRI systems research is trending to higher channel count receivers, transmitters, gradient/shims, and unique interfaces for interventional applications. Customized console designs are now feasible for researchers with modern electronic components, but high data rates, synchronization, scalability, and cost present important challenges. Implementing large multichannel MR systems with efficiency and flexibility requires a scalable modular architecture. With Medusa, we propose an open system architecture using the universal serial bus (USB) for scalability, combined with distributed processing and buffering to address the high data rates and strict synchronization required by multichannel MRI. Medusa uses a modular design concept based on digital synthesizer, receiver, and gradient blocks, in conjunction with fast programmable logic for sampling and synchronization. Medusa is a form of synthetic instrument, being reconfigurable for a variety of medical/scientific instrumentation needs. The Medusa distributed architecture, scalability, and data bandwidth limits are presented, and its flexibility is demonstrated in a variety of novel MRI applications.

Catheter tracking with phase information in a magnetic resonance scanner.

The purpose of this study is to describe a new active technique for accurately determining both the position and orientation of the tip of a catheter during magnetic resonance (MR)-guided percutaneous cardiovascular procedures. The technique utilizes phase information introduced into the MR signal from a small receive coil located on the distal tip of the catheter. Phase patterns around a small receive coil are rich in information that is directly related to position and orientation. This information can be collected over a large spherical volume with a diameter several times that of the receive coil. The high degree of redundancy yields the potential for an accurate and robust method of catheter tracking. A tracking algorithm is presented that performs catheter tip localization using phase images acquired in two orthogonal planes without any a priori knowledge of catheter position. Associated experimentation demonstrating feasibility is also presented.

Frequency-offset Cartesian feedback for MRI power amplifier linearization.

High-quality magnetic resonance imaging (MRI) requires precise control of the transmit radio-frequency (RF) field. In parallel excitation applications such as transmit SENSE, high RF power linearity is essential to cancel aliased excitations. In widely-employed class AB power amplifiers, gain compression, cross-over distortion, memory effects, and thermal drift all distort the RF field modulation and can degrade image quality. Cartesian feedback (CF) linearization can mitigate these effects in MRI, if the quadrature mismatch and dc offset imperfections inherent in the architecture can be minimized. In this paper, we present a modified Cartesian feedback technique called "frequency-offset Cartesian feedback" (FOCF) that significantly reduces these problems. In the FOCF architecture, the feedback control is performed at a low intermediate frequency rather than dc, so that quadrature ghosts and dc errors are shifted outside the control bandwidth. FOCF linearization is demonstrated with a variety of typical MRI pulses. Simulation of the magnetization obtained with the Bloch equation demonstrates that high-fidelity RF reproduction can be obtained even with inexpensive class AB amplifiers. Finally, the enhanced RF fidelity of FOCF over CF is demonstrated with actual images obtained in a 1.5 T MRI system.

Frequency-Offset Cartesian Feedback Based on Polyphase Difference Amplifiers.

A modified Cartesian feedback method called "frequency-offset Cartesian feedback" and based on polyphase difference amplifiers is described that significantly reduces the problems associated with quadrature errors and DC-offsets in classic Cartesian feedback power amplifier control systems.In this method, the reference input and feedback signals are down-converted and compared at a low intermediate frequency (IF) instead of at DC. The polyphase difference amplifiers create a complex control bandwidth centered at this low IF, which is typically offset from DC by 200-1500 kHz. Consequently, the loop gain peak does not overlap DC where voltage offsets, drift, and local oscillator leakage create errors. Moreover, quadrature mismatch errors are significantly attenuated in the control bandwidth. Since the polyphase amplifiers selectively amplify the complex signals characterized by a +90° phase relationship representing positive frequency signals, the control system operates somewhat like single sideband (SSB) modulation. However, the approach still allows the same modulation bandwidth control as classic Cartesian feedback.In this paper, the behavior of the polyphase difference amplifier is described through both the results of simulations, based on a theoretical analysis of their architecture, and experiments. We then describe our first printed circuit board prototype of a frequency-offset Cartesian feedback transmitter and its performance in open and closed loop configuration. This approach should be especially useful in magnetic resonance imaging transmit array systems.

Pyrolytic graphite foam: a passive magnetic susceptibility matching material.

PURPOSE: To evaluate a novel soft, lightweight cushion that can match the magnetic susceptibility of human tissue. The magnetic susceptibility difference between air and tissue produces field inhomogeneities in the B(0) field, which leads to susceptibility artifacts in magnetic resonance imaging (MRI) studies. MATERIALS AND METHODS: Pyrolytic graphite (PG) microparticles were uniformly embedded into a foam cushion to reduce or eliminate field inhomogeneities at accessible air and tissue interfaces. 3T MR images and field maps of an air/water/PG foam phantom were acquired. Q measurements on a 4T tuned head coil and pulse sequence heating tests at 3T were also performed. RESULTS: The PG foam improved susceptibility matching, reduced the field perturbations in phantoms, does not heat, and is nonconductive. CONCLUSION: The susceptibility matched PG foam is lightweight, safe for patient use, adds no noise or MRI artifacts, is compatible with radiofrequency coil arrays, and improves B(0) homogeneity, which enables more robust MR studies.

Ensuring safety of implanted devices under MRI using reversed RF polarization.

Patients with long-wire medical implants are currently prevented from undergoing magnetic resonance imaging (MRI) scans due to the risk of radio frequency (RF) heating. We have developed a simple technique for determining the heating potential for these implants using reversed radio frequency (RF) polarization. This technique could be used on a patient-to-patient basis as a part of the standard prescan procedure to ensure that the subject's device does not pose a heating risk. By using reversed quadrature polarization, the MR scan can be sensitized exclusively to the potentially dangerous currents in the device. Here, we derive the physical principles governing the technique and explore the primary sources of inaccuracy. These principles are verified through finite-difference simulations and through phantom scans of implant leads. These studies demonstrate the potential of the technique for sensitively detecting potentially dangerous coupling conditions before they can do any harm.

Minimum envelope roughness pulse design for reduced amplifier distortion in parallel excitation.

Parallel excitation uses multiple transmit channels and coils, each driven by independent waveforms, to afford the pulse designer an additional spatial encoding mechanism that complements gradient encoding. In contrast to parallel reception, parallel excitation requires individual power amplifiers for each transmit channel, which can be cost prohibitive. Several groups have explored the use of low-cost power amplifiers for parallel excitation; however, such amplifiers commonly exhibit nonlinear memory effects that distort radio frequency pulses. This is especially true for pulses with rapidly varying envelopes, which are common in parallel excitation. To overcome this problem, we introduce a technique for parallel excitation pulse design that yields pulses with smoother envelopes. We demonstrate experimentally that pulses designed with the new technique suffer less amplifier distortion than unregularized pulses and pulses designed with conventional regularization.

An optically coupled system for quantitative monitoring of MRI-induced RF currents into long conductors.

The currents induced in long conductors such as guidewires by the radio-frequency (RF) field in magnetic resonance imaging (MRI) are responsible for potentially dangerous heating of surrounding media, such as tissue. This paper presents an optically coupled system with the potential to quantitatively measure the RF currents induced on these conductors. The system uses a self shielded toroid transducer and active circuitry to modulate a high speed light-emitting-diode transmitter. Plastic fiber guides the light to a photodiode receiver and transimpedance amplifier. System validation included a series of experiments with bare wires that compared wire tip heating by fluoroptic thermometers with the RF current sensor response. Validations were performed on a custom whole body 64 MHz birdcage test platform and on a 1.5 T MRI scanner. With this system, a variety of phenomena were demonstrated including cable trap current attenuation, lossy dielectric Q-spoiling and even transverse electromagnetic wave node patterns. This system should find applications in studies of MRI RF safety for interventional devices such as pacemaker leads, and guidewires. In particular, variations of this device could potentially act as a realtime safety monitor during MRI guided interventions.

Narrowband magnetic particle imaging.

The magnetic particle imaging (MPI) method directly images the magnetization of super-paramagnetic iron oxide (SPIO) nanoparticles, which are contrast agents commonly used in magnetic resonance imaging (MRI). MPI, as originally envisioned, requires a high-bandwidth receiver coil and preamplifier, which are difficult to optimally noise match. This paper introduces Narrowband MPI, which dramatically reduces bandwidth requirements and increases the signal-to-noise ratio for a fixed specific absorption rate. We employ a two-tone excitation (called intermodulation) that can be tailored for a high-Q, narrowband receiver coil. We then demonstrate a new MPI instrument capable of full 3-D tomographic imaging of SPIO particles by imaging acrylic and tissue phantoms.

Feasibility of noncontact intracardiac ultrasound ablation and imaging catheter for treatment of atrial fibrillation.

Atrial fibrillation (AF) affects 1% of the population and results in a cost of 2.8 billion dollars from hospitalizations alone. Treatments that electrically isolate portions of the atria are clinically effective in curing AF. However, such minimally invasive catheter treatments face difficulties in mechanically positioning the catheter tip and visualizing the anatomy of the region. We propose a noncontact, intracardiac transducer that can ablate tissue and provide rudimentary imaging to guide therapy. Our design consists of a high-power, 20 mm by 2 mm, 128-element, transducer array placed on the side of 7-French catheter. The transducer will be used in imaging mode to locate the atrial wall; then, by focusing at that location, a lesion can be formed. Imaging of previously formed lesions could potentially guide placement of subsequent lesions. Successive rotations of the catheter will potentially enable a contiguous circular lesion to be created around the pulmonary vein. The challenge of intracardiac-sized transducers is achieving high intensities (300-5000 W/cm2) needed to raise the temperature of the tissue above 43 degrees C. In this paper, we demonstrate the feasibility of an intracardiac-sized transducer for treatment of atrial fibrillation. In simulations and proof-of-concept experiments, we show a 37 degrees C temperature rise in the lesion location and demonstrate the possibility of lesion imaging.

Three-dimensional prepolarized magnetic resonance imaging using rapid acquisition with relaxation enhancement.

Prepolarized MRI (PMRI) with pulsed electromagnets has the potential to produce diagnostic quality 0.5- to 1.0-T images with significantly reduced cost, susceptibility artifacts, specific absorption rate, and gradient noise. In PMRI, the main magnetic field cycles between a high field (B(p)) to polarize the sample and a homogeneous, low field (B(0)) for data acquisition. This architecture combines the higher SNR of the polarizing field with the imaging benefits of the lower field. However, PMRI can only achieve high SNR efficiency for volumetric imaging with 3D rapid imaging techniques, such as rapid acquisition with relaxation enhancement (RARE) (FSE, TSE), because slice-interleaved acquisition and longitudinal magnetization storage are both inefficient in PMRI. This paper demonstrates the use of three techniques necessary to achieve efficient, artifact-free RARE in PMRI: quadratic nulling of concomitant gradient fields, electromotive force cancelation during field ramping, and phase compensation of CPMG echo trains. This paper also demonstrates the use of 3D RARE in PMRI to achieve standard T(1) and fat-suppressed T(2) contrast in phantoms and in vivo wrists. These images show strong potential for future clinical application of PMRI to extremity musculoskeletal imaging and peripheral angiography.

Magnetic resonance imaging with T1 dispersion contrast.

Prepolarized MRI uses pulsed magnetic fields to produce MR images by polarizing the sample at one field strength (approximately 0.5 T) before imaging at a much lower field (approximately 50 mT). Contrast reflecting the T(1) of the sample at an intermediate field strength is achieved by polarizing the sample and then allowing the magnetization to decay at a chosen "evolution" field before imaging. For tissues whose T(1) varies with field strength (T(1) dispersion), the difference between two images collected with different evolution fields yields an image with contrast reflecting the slope of the T(1) dispersion curve between those fields. Tissues with high protein content, such as muscle, exhibit rapid changes in their T(1) dispersion curves at 49 and 65 mT due to cross-relaxation with nitrogen nuclei in protein backbones. Tissues without protein, such as fat, have fairly constant T(1) over this range; subtracting images with two different evolution fields eliminates signal from flat T(1) dispersion species. T(1) dispersion protein-content images of the human wrist and foot are presented, showing clear differentiation between muscle and fat. This technique may prove useful for delineating regions of muscle tissue in the extremities of patients with diseases affecting muscle viability, such as diabetic neuropathy, and for visualizing the protein content of tissues in vivo.