Waqas Majeed1, Axel J. Krafft2, Sunil Patil1, Henrik Odéen3, John Roberts3, Florian Maier2, Dennis L. Parker3, and Himanshu Bhat1
1Siemens Medical Solutions USA Inc., Malvern, PA, United States, 2Siemens Healthcare GmbH, Erlangen, Germany, 3Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States
Synopsis
Low
field MRI offers advantages such as reduced cost and improved safety of implantable
and interventional devices, and reduced RF energy deposition over high field
alternatives. However, the accuracy of proton resonance frequency (PRF) thermometry suffers at low field due
to reduced signal to noise ratio as well as lower temperature-sensitivity of MR
phase. In this study we demonstrate that reduced off-resonance effects,
increased T2* and shorter T1 associated with low field can be leveraged to
achieve high quality MR thermometry in the brain and prostate at 0.55T.
Introduction
Proton
Resonance Frequency (PRF) thermometry is a widely used MR-based technique to
monitor changes in tissue temperature in response to thermal therapy1,2.
It is used in clinic to guide thermal ablation procedures, for example high intensity
focused ultrasound and laser ablation in the brain, and ultrasound ablation in
the prostate2. Recent research has demonstrated the feasibility of low
field MRI at 0.55T for diagnostic imaging and also suggested its tremendous
potential for MR-guided interventions due to significantly reduced device and
implant heating, radio-frequency (RF) energy deposition and susceptibility
artifacts3. However, PRF thermometry is challenging at 0.55T, due to
linear B0 dependence of temperature-induced phase shifts. In this
abstract we investigate the feasibility of PRF thermometry in the brain and
prostate on a 0.55T whole body prototype system.Methods
PRF
thermometry is challenging at 0.55T because both SNR and temperature-induced
phase shifts (temperature sensitivity ~0.01 ppm/°C) are inversely proportional
to B
0. However, low B
0 is also associated with longer
T2*, reduced susceptibility effects / B0 inhomogeneity, and shorter
T1, which can be used to partially compensate for these challenges
3.
Reduced susceptibility effects enable readouts with higher SNR efficiency, such
as segmented EPI, along with reduced receiver bandwidths, to partially compensate
for SNR reduction. Longer T2* allows using longer TEs to compensate for reduced
temperature sensitivity. Thus, segmented EPI with its ability to enable longer
TRs to achieve long TEs without increasing scan time is particularly well
suited to benefit from reduced B
0 inhomogeneity and long T2* in PRF
thermometry at low field. Its combination with 3D acquisition further improves SNR
and expands spatial coverage
4. The resulting improvement in quality of
PRF thermometry is complemented by quicker recovery of longitudinal
magnetization due to associated T1 shortening. We have therefore chosen to utilize
segmented EPI as the sequence of choice for this study.
Data
acquisition:Four healthy volunteers were
imaged on a 0.55T MAGNETOM Free.Max prototype (*) (Siemens Shenzhen Magnetic
Resonance Ltd., Shenzhen, China). All human measurements were performed
according to institutional volunteer scanning policies. The following
parameters were used to acquire a dynamic series of 80-100 repetitions for
assessment of temperature uncertainty:
Brain:
-
2D segmented EPI: TR 75ms, TE
38ms, water excitation, 1.08x2.18x3.5mm3 spatial resolution,
256x128 matrix, echo train length (ETL) 5, readout bandwidth (BW) 130Hz/pixel,
temporal resolution 1.95s/slice, flip angle (FA) 40°
- 2D GRE: TR 27ms, TE 12.6ms,
1.08x2.18x3.5mm3 spatial resolution, 256x128 matrix, BW 60Hz/pixel,
temporal resolution 3.46s/slice, FA 30°
- 3D segmented EPI: TR 160ms, TE
64ms or 81ms, water excitation, 1.25x2.5x2.5mm3 spatial resolution,
192x96x12 matrix, ETL 33 or 49, BW 130Hz/pixel, temporal resolution 5.8 or
3.8s/volume, FA 40°-55°
Prostate:- 3D segmented EPI: TR 100ms or
110ms, TE 45ms or 56ms, water excitation, 2x3x3mm3 spatial
resolution, 128x128x12 matrix, ETL 23 or 25, BW 398 or 340 Hz/pixel, temporal
resolution 7.2 or 6.6s/volume, FA 25°-30°
Processing:Images or volumes with significant subject motion were removed from each
dynamic series using an automatic image similarity-based MATLAB routine.
Baseline phase was removed using a Principal Component Analysis based approach
5,6,
and average phase measured within an SNR-thresholded mask was removed after
baseline correction to eliminate global phase drift. Resultant phase difference
images were scaled by -1/(γB0 TE×0.01ppm/°C) to estimate
temperature difference relative to the first acquisition. Since a temperature
change of 0°C is expected in absence of external heating, the temporal standard
deviation (σ
T) of the ΔT series was used to assess estimation uncertainty.
Results
2D and 3D
segmented EPI brain protocols resulted in excellent temperature precision
(Figs. 1-4), with average σT of less than 1.1°C and 0.8°C
respectively. 2D segmented EPI outperformed 2D single-echo GRE in terms of
acquisition time as well as precision (Fig. 1). Average σT values
ranging between 1.4°C and 1.6°C were observed in prostate across different subjects
and protocols (Figs. 1 and 5).Discussion
The results
presented in this abstract suggest that it is feasible to perform PRF
thermometry in the brain and prostate at 0.55T, with σT within acceptable
thresholds to monitor irreversible tissue damage. Frame rates achieved by our
protocols are comparable with those used clinically at higher fields. In
particular, the tested brain protocols provide a range of options in terms of
scan time, spatial coverage, and acquisition strategy. Although the results of
this initial investigation are encouraging, some key questions remain. First, it
needs to be investigated whether B0 distortion resulting from longer
EPI readouts is acceptable from a clinical perspective. Additionally, the
possibility of exacerbated device-related artifacts in longer TE and ETL EPI
acquisitions warrants further research. Future research will also focus on the
investigation of other acquisition schemes such as spiral and multi-echo EPI
for their use in MR thermometry.
Low field MR-guided interventions offer some key advantages over high-field
alternatives, such as reduced cost and improved safety of implantable and interventional
devices, and reduced RF energy deposition. The application of 0.55T MRI for
anatomical guidance is comparatively straightforward. The addition of PRF thermometry
to the interventional MRI tools available at low field can help to expand the
use of MRI as a modality for interventional guidance.Acknowledgements
No acknowledgement found.References
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thermometry." Journal of Magnetic Resonance Imaging 27.2
(2008): 376-390
2) Blackwell, James, et al. "Proton Resonance Frequency Shift Thermometry: A Review of Modern Clinical Practices." Journal of Magnetic Resonance Imaging (2020). doi: jmri.27446
3) Campbell-Washburn, Adrienne E., et al. "Opportunities in interventional and diagnostic imaging by using high-performance low-field-strength MRI." Radiology 293.2 (2019): 384-393
4) Odéen, Henrik, et al. "Sampling strategies for
subsampled segmented EPI PRF thermometry in MR guided high intensity focused
ultrasound." Medical physics 41.9 (2014).doi: 10.1118/1.4892171
5) Majeed, Waqas, et al. “A Principal Component Analysis based Multi-baseline Phase Correction Method for PRF Thermometry.” Proceedings of ISMRM 27th Annual Meeting & Exhibition (2019): 3818
6) Tan, Jeremy, et al. "Motion compensation using principal component analysis and projection onto dipole fields for abdominal magnetic resonance thermometry." Magnetic Resonance in Medicine 81.1 (2019): 195-207
(*) MAGNETOM Free.Max is still
under development and not yet commercially available. Its future availability
cannot be guaranteed.