Nandita Saha1,2, Andre Kuehne3,4, and Thoralf Niendorf1,2,4
1Berlin Ultra High Field Facility, Max-Delbrück-Centrum für Molekulare Medizin, Berlin, Germany, 2Experimental and Clinical Research Center (ECRC), a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany, 3Brightmind.AI GmbH, Vienna, Austria, 4MRI.TOOLS GmbH, Berlin, Germany
Synopsis
Keywords: Interventional Devices, MR-Guided Interventions, ThermalMR Brain Tumor
Motivation: Thermal magnetic resonance theranostics combines diagnostic MRI with targeted thermal therapy with an integrated radiofrequency applicator. Precise RF dosimetry is crucial for real-time treatment planning.
Goal(s): Our goal is to evaluate a time-frequency multiplexing wideband RF beamforming method for precise targeting of small and large deep-seated brain tumors for Thermal Magnetic Resonance theranostics.
Approach: We employed a multi-vector field shaping algorithm for optimizing RF channel settings of the RF applicator.
Results: With time-frequency multiplex excitations, we achieved precise SAR10g targeting in the tumor volume while minimizing RF exposure to healthy tissues. Our study advances thermal magnetic resonance theranostics efficacy promising improved outcomes.
Impact: Our approach of utilizing
horse-shoe shaped RF applicator comprised of wideband SGBT dipole antenna can
be conveniently adapted to individual patient's tumor position and geometry
while maintaining the efficiency and quality of RF heating for ThermalMR theranostics
of brain tumors.
PURPOSE
Thermal Magnetic Resonance (ThermalMR) is a
theranostic approach that combines diagnostic magnetic resonance imaging (MRI)
with targeted thermal therapy in the hyperthermia range using an integrated
radiofrequency (RF) applicator1-3. ThermalMR’s efficacy encompasses uniform transmission B1+ field for MRI and focal RF heating in the target volume (TV) for thermal therapy.
Both criteria govern by RF applicator design and constructive E-field focusing
optimization for targeted heating. RF hyperthermia of brain tissue benefits from
wideband RF beam-forming6. In this work, we examine the performance of the time-frequency multiplexing beam-forming approach and use this excitation
vector optimization approach for targeting small and large deep-seated brain
tumors for ThermalMR theranostics at 7.0T, 9.4T and 10.5T.METHODS
The ThermalMR RF applicator comprises eight
compact SGBT4 dipole antennas (size:
42.3x46.3x2.5mm3) arranged in a horse-shoe shaped (arc= 2700)
annular array and ensures ample brain coverage while sparing the high conductive
regions of the eyes from RF exposure during targeted heating (Fig. 1a,b). The
RF applicator supports MRI at 300MHz (B0=7.0T), 400MHz (B0=9.4T) and 450MHz (B0=10.5T) and targeted RF heating at multiple
discrete frequencies (f=250, 300, 350, 400, 450MHz). EMF simulations (CST
Studio Suite 2020) were performed on the human voxel model ‘Duke' (IT'IS
Foundation Zürich). To emulate a
real clinical scenario, two patient models were created including a (i) intracranial
large irregular shape tumor TVL (volume=500ml, σtumor=1.15S/m, εrtumor=66.5)
and (ii) a small spheroid tumor TVS (radius=2cm, volume=33.5ml, σtumor=1.15
S/m, εrtumor=66.5)1 in the
right parietal region of Duke’s brain (Fig. 1c,d).
A Multiplexed Vector Field Shaping (MVFS)5
(Fig. 2) algorithm was used to provide globally optimal excitation vectors defining
phase and amplitude setting for RF channels of RF applicator to focus SAR10g
in TV and to reduce RF exposure to the healthy tissues by selecting appropriate
intervention frequencies and time-interleaved excitations. For targeted RF
heating, time-multiplex (TM) excitation (at 300MHz) and
time-frequency multiplex (TFM) excitation of above mentioned
multiple discrete frequencies are used to focus SAR10g in the TVL
and TVS. The focusing ability of the RF applicator was evaluated
using the metrics SAR10g in TV and tumor coverage TCx as local SAR
typically used as a representation for tissue heating1,5-6.
Tumor coverage TC25, TC50, and TC80 detail the fraction of tumor enclosed in
the 25%, 50%, and 80% isolines of peak SAR10g1,5-6.
Postprocessing was conducted in MATLAB 2020 to calculate B1+,
SAR10g and targeted heating optimization.RESULTS
EMF simulations showed that the RF applicator
provides B1+ that facilitates brain MRI at 7.0T,9.4T, 10.5T (Fig. 3a,b) with
maximum local SAR10g within the IEC limits (Fig. 3a-c). For targeted RF heating, MVFS algorithm derived single
excitation in TM mode for both patient models, TVL and TVS,
and yielded similar SAR10g(mean~max)=(19~33)W/kg inside the TV (Fig.
4a,b). However, TM mode induced undesired RF power deposition,
causing hotspots in peripheral healthy tissues surrounding the head. In TFM
mode, MVFS algorithm employed four excitations at frequencies of 300MHz,
350MHz, and 450MHz for TVL patient, and two excitations at 350MHz and 450MHz
for TVS patient to focus RF power inside TV (Fig. 4c,d). Patients with TVL
demonstrated 8%, 25%, and 15% higher TC25, TC50, and TC80 values in TM mode
compared to TFM mode (Fig. 4,5). Conversely, patients with TVS
exhibited 11%, 39%, and 64% lower TC25, TC50, and TC80 values in TM mode
compared to TFM mode (Fig. 4,5). The TFM mode results
showed stronger SAR10g (mean~max)=(31~40)W/kg focus inside TVS, while TVL
achieved less TC with SAR10g focus inside full TVL despite
the use of four excitation modes. This result is due to the uniformity
criterion used for RF power optimization. This constraint limits the maximization
of RF power deposition in large volume. The diameter of the spheroid TVS
is one-third of the wavelength in brain tissue at ~300MHz which permits surpassing
of RF focusing limits and results in excellent tumor coverage. For TVL
this problem can be addressed by setting higher target SAR.TFM
facilitates significant improvements in protecting healthy tissues from
unintended RF power deposition for small and large TV when compared to the TM
mode.DISCUSSION & CONCLUSION
This study
demonstrates the benefits of time-frequency multiplexing to enhance RF
beam-forming for targeted RF heating for ThermalMR of small and large
deep-seated brain tumors. The
MVFS TFM approach provides numerous degrees of freedom to best
deliver RF power at the desired tumor location with an arbitrarily complex
target tumor shape. Our simulations provide a framework for ThermalMR
treatment planning, allowing for the pre-determination of hotspots for more
precise and real-time RF dosimetry. Our work provides a technical foundation for ThermalMR theranostics of
brain tumors. Acknowledgements
This project is funded by an advanced ERC grant (EU project Thermal MR: 743077).References
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