MRI monitoring of high -temperature ultrasound therapy.

摘要

More than fifty years ago, it was demonstrated that ultrasound could penetrate deep into tissue and induce a biological response. By focusing the ultrasound beam, localized heating in soft tissue is possible, allowing for a completely non-invasive technique to thermally ablate diseased tissue. Despite many promising results and advances in the last fifty years, widespread clinical implementation of therapeutic heating with ultrasound has not occurred because of the difficulty in guiding and monitoring the procedure. Magnetic resonance imaging (MRI) has been shown capable of monitoring thermal therapies such as focused ultrasound surgery. With MRI, the tumor can be accurately detected and targeted. Temperature-sensitive MRI techniques can be used to guide and monitor the ultrasound therapy. Thermal tissue damage induced by the ultrasound can be imaged. The purpose of this work was to test the use of MRI for guiding and monitoring high temperature ultrasound surgery. MRI-derived thermal imaging, which maps temperature-induced changes in the water proton resonant frequency, was implemented in a series of experiments. The first experiments demonstrated that MRI-derived temperature and thermal dose measurements correctly predict the onset of tissue damage in vivo, while the applied ultrasound power does not. The accuracy of the MRI-derived thermometry during long ultrasound exposures was also verified, and the limit of the technique in light of heating-induced tissue swelling was demonstrated. The accuracy of the thermometry to estimate online the extent of tissue damage was verified at the exposure time limit. Methods for using the temperature information gathered with MRI to estimate the ultrasound treatment parameters were also demonstrated experimentally. Focused ultrasound surgery in tumor models (animal and clinical breast tumor treatments) was shown feasible and demonstrated the need for image guidance. Finally, two new pulse sequences were shown capable of minimizing errors in the thermometry caused by changes in the water proton resonant frequency unrelated to changes in temperature, such as that which occurs during tissue motion and from the contributions of lipid signals.