Francesco Padormo1, Arian Beqiri1, Joseph V Hajnal1, and Shaihan Malik1
1Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
Synopsis
We propose a novel method to visualise guidewires in
interventional MRI procedures using the coupling mode of a PTx array.Introduction
Interventional procedures using X-Ray guidance have poor image/tissue
contrast and deposit ionising radiation. Interventional MRI (iMRI) is an
attractive alternative hindered by concerns about device safety, as the
transmit field (B1+) can induce currents on interventional devices which can lead
to dangerous focal energy deposition (1). Parallel Transmission (PTx)
in conjunction with current sensors has enabled successful imaging whilst
minimising induced radiofrequency (RF) current on guidewires, so reducing risk
of tissue heating (2–4). A remaining problem in iMRI
is visualisation of devices to allow guidance to the desired location. Many
hardware and sequence design solutions have been proposed; here we present a strategy
to visualise guidewires using PTx.
Methods
Consider an N element PTx system with M current sensors placed
on the exposed sections of a partially-inserted guidewire. The coupling (cm,n)
of the nth transmitter to mth current sensor is found by
measuring the induced currents whilst transmitting on each element
sequentially. Performing an SVD on the MxN coupling matrix
C generates N RF shims of unit-norm. The (N-M) shims with
zero-valued singular values (referred to as dark modes, DMs) produce no wire
current and can therefore be harnessed for safe imaging. The M remaining shims (referred
to as coupling modes, CMs) produce wire currents and are typically discarded.
It has been noted that wire currents produce a magnetic field whose magnitude
is inversely proportional to the radial distance from the wire. Consequently,
even small wire currents can produce significant B1+ adjacent to it. We propose
the use of this mechanism to enable guidewire visualisation.
Proof of principle experiments were performed on a 3T
Philips Achieva with an 8-channel TEM body coil (5) and 6-channel torso rx-array.
A guidewire (Terumo, Japan) was inserted into a meat phantom via embedded
tubing filled with doped saline (0.7g/L NaCl, 0.02% Dotarem), shaped to mimic a
3D interventional guidewire trajectory. Currents on the exposed section of the
guidewire (oriented parallel to B0) were monitored by two current sensors,
whose signals were measured by the scanner spectrometer and power meters
(Rohde&Schwarz NRP-Z11). The matrix C
was determined using spectrometer measurements and six DMs were then calculated.
B1+ maps of the modes were obtained using volumetric AFI (6,7) (transmitting in quadrature,
FOV=370x92x120mm, res=33mm, FA=40°, BW=723Hz, TR1=25ms, TR2 = 125ms,
TE=4.6ms) in conjunction with low flip angle SPGRs (8) of each mode (as AFI, except
TR=10ms and FA=1°). Four sets of shims were used for imaging: a quadrature shim,
shims comprised of the sum of the six DMs, the first CM, and the first CM reduced
to 10% amplitude. Guidewire visualisation was tested using a multi-shot TSE
(FOV = 300x150x51, res=0.75x1, dz=3mm, FA=90°, TSE factor=13, TR=4422ms,
TE=52ms) with concurrent power monitoring.
Results
Figure 1 shows maximum intensity projections (MIPS) of B1+ maps
of the CM and DM shims. The CM map exhibits large B1+ due to currents on the
wire; this is not apparent for the DM map. Figure 2 shows example coronal TSE
images. The guidewire is partially visible with quadrature shim (Fig.2A) due to
uncontrolled coupling to both transmit and receive fields. Fig.2B shows an
inherently safe imaging mode; the GW imparts an intensity modulation purely due
to receive interaction. Fig.2C shows imaging with CM; signal is generated
around the wire, but its large amplitude can cause heating and the resulting signals
from the wire are too diffuse to facilitate visualisation. Fig.2D shows the
image acquired with reduced amplitude CM – signal is restricted to immediately
adjacent to the guidewire. Fig3 shows MIPs through the TSE volumes – accurate
depiction of the guidewire location is only possible when using the reduced
amplitude CM. Fig4 shows current sensor power readings for the first 25ms
period of the TSE shot. CM produces the highest readings of 8W; reducing their amplitude to 10%
reduces the power by a factor of 100 to the power level produced by quadrature.
Discussion
Successful guidewire visualisation has been demonstrated
using the CM of a PTx array. All images exhibit receive enhancement due to the
presence of a guidewire, however this is not sufficiently restrictive to allow
visualisation. Operating with CM at low drive is vital for both safety and useful
for visualisation. The proposed method is analogous to the reverse polarisation
method (9), except with the RF field
optimally designed to couple to the wire. Further work will explore tailoring
the receive channel combination to further delineate the wire; in addition to
interleaving transmission with DM shims (to visualise tissue) and CM (to
visualise the wire) to enable real-time guidance.
Acknowledgements
We would like to thank Michelangelo Padormo for help with
phantom construction. This work was funded by MRC strategic funds.References
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