Transceive phase corrected 2D contrast source inversion-electrical properties tomography.

PURPOSE: To remove the necessity of the tranceive phase assumption for CSI-EPT and show electrical properties maps reconstructed from measured data obtained using a standard 3T birdcage body coil setup. METHODS: The existing CSI-EPT algorithm is reformulated to use the transceive phase rather than relying on the transceive phase assumption. Furthermore, the radio frequency (RF)-shield is numerically implemented to accurately model the RF fields inside the MRI scanner. We verify that the reformulated two-dimensional (2D) CSI-EPT algorithm can reconstruct electrical properties maps given 2D electromagnetic simulations. Afterward, the algorithm is tested with three-dimensional (3D) FDTD simulations to investigate if the 2D CSI-EPT can retrieve the electrical properties for 3D RF fields. Finally, an MR experiment at 3T with a phantom is performed. RESULTS: From the results of the 2D simulations, it is seen that CSI-EPT can reconstruct the electrical properties using MRI accessible quantities. For 3D simulations, it is observed that the electrical properties are underestimated, nonetheless, CSI-EPT has a lower standard deviation than the standard Helmholtz based methods. Finally, the first CSI-EPT reconstructions based on measured data are presented showing comparable accuracy and precision to reconstructions based on simulated data, and demonstrating the feasibility of CSI-EPT. CONCLUSIONS: The CSI-EPT algorithm was rewritten to use MRI accessible quantities. This allows for CSI-EPT to fully exploit the benefits of the higher static magnetic field strengths with a standard quadrature birdcage coil setup.

A single setup approach for the MRI-based measurement and validation of the transfer function of elongated medical implants.

PURPOSE: To propose a single setup using the MRI to both measure and validate the transfer function (TF) of linear implants. Conventionally, the TF of an implant is measured in one bench setup and validated using another. METHODS: It has been shown that the TF can be measured using MRI. To validate this measurement, the implant is exposed to different incident electric fields, while the temperature increase at the tip is monitored. For a good validation, the incident electric fields that the implant is exposed to should be orthogonal. We perform a simulation study on six different methods that change the incident electric field. Afterward, a TF measurement and validation study using the best method from the simulations is performed. This is done with fiberoptic temperature probes at 1.5 T for four linear implant structures using the proposed single setup. RESULTS: The simulation study showed that positioning local transmit coils at different locations along the lead trajectory has a similar validation quality compared with changing the implant trajectory (ie, the conventional validation method). For the validation study that was performed, an R2 ≥ 0.91 was found for the four investigated leads. CONCLUSION: A single setup to both measure and validate the transfer function using local transmit coils has been shown to work. The benefits of using the proposed validation method are that there is only one setup required instead of two and the implant trajectory is not varied; therefore, the relative distance between the leap tip and the temperature probe is constant.

Accelerating implant RF safety assessment using a low-rank inverse update method.

PURPOSE: Patients who have medical metallic implants, e.g. orthopaedic implants and pacemakers, often cannot undergo an MRI exam. One of the largest risks is tissue heating due to the radio frequency (RF) fields. The RF safety assessment of implants is computationally demanding. This is due to the large dimensions of the transmit coil compared to the very detailed geometry of an implant. METHODS: In this work, we explore a faster computational method for the RF safety assessment of implants that exploits the small geometry. The method requires the RF field without an implant as a basis and calculates the perturbation that the implant induces. The inputs for this method are the incident fields and a library matrix that contains the RF field response of every edge an implant can occupy. Through a low-rank inverse update, using the Sherman-Woodbury-Morrison matrix identity, the EM response of arbitrary implants can be computed within seconds. We compare the solution from full-wave simulations with the results from the presented method, for two implant geometries. RESULTS: From the comparison, we found that the resulting electric and magnetic fields are numerically equivalent (maximum error of 1.35%). However, the computation was between 171 to 2478 times faster than the corresponding GPU accelerated full-wave simulation. CONCLUSIONS: The presented method enables for rapid and efficient evaluation of the RF fields near implants and might enable situation-specific scanning conditions.

Detectability and intra-fraction motion of individual elective lymph nodes in head and neck cancer patients on the Magnetic Resonance Image guided linear accelerator.

Background and purpose: Individual elective lymph node irradiation instead of elective neck irradiation is a new concept for head-and-neck cancer (HNC) patients developed for the Magnetic Resonance Image guided linear accelerator (MR-linac). To prepare this, the detectability, volume changes and intra-fraction motion of elective lymph nodes on the MR-linac was assessed. Materials and methods: A total of 15 HNC patients underwent diagnostic pre-treatment MRI. Additionally, two MR-linac scans were obtained with a 10-minute time difference in the first week of radiation treatment. Elective lymph node contours inside lymph node levels (Ib-V) were segmented on the pre-treatment MRI and the MR-linac scans and compared on number and maximal transversal diameter. Intra-fraction motion of elective lymph nodes on the MR-linac was estimated using Center of Mass (COM) distances and incremental isotropic expansion of lymph node segmentations. Results: Of all 679 detected lymph nodes on the pre-treatment MRI, eight lymph nodes were not detectable on the first MR-linac scan and 16 new lymph nodes were detected. Lymph node diameters between the pre-treatment MRI scan and the MR-linac scan varied from -0.19 to + 0.13 mm. COM distances varied from 1.2 to 1.7 mm and lymph node contours had to be expanded with 3 mm. Conclusions: Nearly all elective lymph nodes were detectable on the 1.5T MR-linac scan with no major changes in target volumes compared to the pre-treatment MRI. Simulated intra-fraction motion during the MR-linac scans was smaller than the 5-mm margin that will be used in the first elective lymph node radiation treatment.

A perturbation approach for ultrafast calculation of RF field enhancements near medical implants in MRI.

Patients with medical implants often are deprived of magnetic resonance imaging examination because of safety risks. One specific risk is the enhancement of the radiofrequency fields around the medical implant potentially resulting in significant tissue heating and damage. The assessment of this enhancement is a computationally demanding task, with simulations taking hours or days to converge. Conventionally the source of the radiofrequency fields, patient anatomy, and the medical implant are simulated concurrently. To alleviate the computational burden, we reformulate a fast simulation method that views the medical implant as a small perturbation of the simulation domain without the medical implant and calculates the radiofrequency fields associated with this perturbation. Previously, this method required an extensive offline stage where the result is intractable for large simulation domains. Currently, this offline stage is no longer required and the method is completely online. The proposed method results in comparable radiofrequency fields but is orders of magnitude faster compared to standard simulation technique; the finite-difference time-domain, the finite-sums, and the finite element methods. This acceleration could enable patient-specific and potentially online radiofrequency safety assessment.

MRI visibility and displacement of elective lymph nodes during radiotherapy in head and neck cancer patients.

Background and purpose: To decrease the impact of radiotherapy to healthy tissues in the head and neck region, we propose to restrict the elective neck irradiation to elective lymph nodes at risk of containing micro metastases instead of the larger lymph node volumes. To assess whether this new concept is achievable in the clinic, we determined the number, volume changes and displacement of elective lymph nodes during the course of radiotherapy. Materials and methods: MRI scans of 10 head and neck cancer (HNC) patients were acquired before radiotherapy and in week 2, 3, 4 and 5 during radiotherapy. The weekly delineations of elective lymph nodes inside the lymph node levels (Ib/II/III/IVa/V) were rigidly registered and analyzed regarding number and volume. The displacement of elective lymph nodes was determined by center of mass (COM) distances, vector-based analysis and the isotropic contour expansion of the lymph nodes of the pre-treatment scan or the scan of the previous week in order to geographically cover 95% of the lymph nodes in the scans of the other weeks. Results: On average, 31 elective lymph nodes in levels Ib-V on each side of the neck were determined. This number remained constant throughout radiotherapy in most lymph node levels. The volume of the elective lymph nodes reduced significantly in all weeks, up to 50% in week 5, compared to the pre-treatment scan. The largest median COM displacements were seen in level V, for example 5.2 mm in week 5 compared to the pre-treatment scan. The displacement of elective lymph nodes was mainly in cranial direction. Geographical coverage was obtained when the lymph node volumes were expanded with 7 mm in case the pre-treatment scan was used and 6.5 mm in case the scan of the previous week was used. Conclusion: Elective lymph nodes of HNC patients remained visible on MRI and decreased in size during radiotherapy. The displacement of elective lymph nodes differ per lymph node level and were mainly directed cranially. Weekly adaptation does not seem to improve coverage of elective lymph nodes. Based on our findings we expect elective lymph node irradiation is achievable in the clinic.