Real‐time adaptive methods for treatment of mobile organs by MRI‐controlled high‐intensity focused ultrasound

Focused ultrasound (US) is a unique and noninvasive technique for local deposition of thermal energy deep inside the body. MRI guidance offers the additional benefits of excellent target visualization and continuous temperature mapping. However, treating a moving target poses severe problems because 1) motion‐related thermometry artifacts must be corrected, 2) the US focal point must be relocated according to the target displacement. In this paper a complete MRI‐compatible, high‐intensity focused US (HIFU) system is described together with adaptive methods that allow continuous MR thermometry and therapeutic US with real‐time tracking of a moving target, online motion correction of the thermometry maps, and regional temperature control based on the proportional, integral, and derivative method. The hardware is based on a 256‐element phased‐array transducer with rapid electronic displacement of the focal point. The exact location of the target during US firing is anticipated using automatic analysis of periodic motions. The methods were tested with moving phantoms undergoing either rigid body or elastic periodical motions. The results show accurate tracking of the focal point. Focal and regional temperature control is demonstrated with a performance similar to that obtained with stationary phantoms. Magn Reson Med 57:319–330, 2007. © 2007 Wiley‐Liss, Inc.

[1]  Elizabeth A Stewart,et al.  Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. , 2006, Fertility and sterility.

[2]  K. Kuroda,et al.  A precise and fast temperature mapping using water proton chemical shift , 1995, Magnetic resonance in medicine.

[3]  P. P. Lele,et al.  Production of deep focal lesions by focused ultrasound--current status. , 1967, Ultrasonics.

[4]  Vincent Schmithorst,et al.  Simultaneous correction of ghost and geometric distortion artifacts in EPI using a multiecho reference scan , 2001, IEEE Transactions on Medical Imaging.

[5]  F C Vimeux,et al.  Real-time control of focused ultrasound heating based on rapid MR thermometry. , 1999, Investigative radiology.

[6]  Sharon Thomsen,et al.  Magnetic resonance-guided focused ultrasound surgery of breast cancer: reliability and effectiveness. , 2006, Journal of the American College of Surgeons.

[7]  Kullervo Hynynen,et al.  Pre-clinical testing of a phased array ultrasound system for MRI-guided noninvasive surgery of the brain--a primate study. , 2006, European journal of radiology.

[8]  Karl J. Friston,et al.  Spatial registration and normalization of images , 1995 .

[9]  Rares Salomir,et al.  Automatic spatial and temporal temperature control for MR‐guided focused ultrasound using fast 3D MR thermometry and multispiral trajectory of the focal point , 2004, Magnetic resonance in medicine.

[10]  P. P. Lele,et al.  Induction of deep, local hyperthermia by ultrasound and electromagnetic fields , 1980, Radiation and environmental biophysics.

[11]  J B Pond,et al.  The role of heat in the production of ultrasonic focal lesions. , 1970, The Journal of the Acoustical Society of America.

[12]  L. Gavrilov,et al.  A theoretical assessment of the relative performance of spherical phased arrays for ultrasound surgery , 2000, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[13]  Max A. Viergever,et al.  A survey of medical image registration , 1998, Medical Image Anal..

[14]  Natalia Vykhodtseva,et al.  Heat-activated liposomal MR contrast agent: initial in vivo results in rabbit liver and kidney. , 2004, Radiology.

[15]  W. Dewey,et al.  Thermal dose determination in cancer therapy. , 1984, International journal of radiation oncology, biology, physics.

[16]  J. Poorter,et al.  Noninvasive MRI Thermometry with the Proton Resonance Frequency (PRF) Method: In Vivo Results in Human Muscle , 1995, Magnetic resonance in medicine.

[17]  David J. Fleet,et al.  Performance of optical flow techniques , 1994, International Journal of Computer Vision.

[18]  R. Stafford,et al.  Magnetic resonance imaging‐guided focused ultrasound thermal therapy in experimental animal models: Correlation of ablation volumes with pathology in rabbit muscle and VX2 tumors , 2002, Journal of magnetic resonance imaging : JMRI.

[19]  F A Jolesz,et al.  MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: a feasibility study. , 2001, Radiology.

[20]  C. Moonen,et al.  A fast calculation method for magnetic field inhomogeneity due to an arbitrary distribution of bulk susceptibility , 2003 .

[21]  J. Hindman,et al.  Proton Resonance Shift of Water in the Gas and Liquid States , 1966 .

[22]  Pascal Desbarats,et al.  Atlas-based motion correction for online MR temperature mapping , 2004, 2004 International Conference on Image Processing, 2004. ICIP '04..

[23]  Kullervo Hynynen,et al.  MR imaging-guided focused ultrasound surgery of uterine leiomyomas: a feasibility study. , 2003, Radiology.

[24]  D. Cranston,et al.  High intensity focused ultrasound: surgery of the future? , 2003, The British journal of radiology.

[25]  J A de Zwart,et al.  Hyperthermia by MR‐guided focused ultrasound: Accurate temperature control based on fast MRI and a physical model of local energy deposition and heat conduction , 2000, Magnetic resonance in medicine.

[26]  W. Fry,et al.  Physical Factors Involved in Ultrasonically Induced Changes in Living Systems: II. Amplitude Duration Relations and the Effect of Hydrostatic Pressure for Nerve Tissue , 1951 .

[27]  M. Papa,et al.  The use of MR imaging guided focused ultrasound in breast cancer patients; a preliminary phase one study and review , 2005, Breast cancer.

[28]  J A de Zwart,et al.  On‐line correction and visualization of motion during MRI‐controlled hyperthermia , 2001, Magnetic resonance in medicine.

[29]  Rares Salomir,et al.  Automatic control of hyperthermic therapy based on real‐time Fourier analysis of MR temperature maps , 2002, Magnetic resonance in medicine.

[30]  M Pernot,et al.  High power transcranial beam steering for ultrasonic brain therapy. , 2003, Physics in medicine and biology.

[31]  George Wolberg,et al.  Robust image registration using log-polar transform , 2000, Proceedings 2000 International Conference on Image Processing (Cat. No.00CH37101).

[32]  Takeo Kanade,et al.  An Iterative Image Registration Technique with an Application to Stereo Vision , 1981, IJCAI.

[33]  C. Moonen,et al.  Image-guided Control of Transgene Expression Based on Local Hyperthermia , 2003, Molecular imaging.

[34]  F DUNN Physical mechanisms of the action of intense ultrasound on tissue. , 1958, American journal of physical medicine.

[35]  Berthold K. P. Horn,et al.  Determining Optical Flow , 1981, Other Conferences.

[36]  R Lufkin,et al.  Phase imaging on a .2‐T MR scanner: Application to temperature monitoring during ablation procedures , 1997, Journal of magnetic resonance imaging : JMRI.

[37]  Kullervo Hynynen,et al.  MR temperature mapping of focused ultrasound surgery , 1994, Magnetic resonance in medicine.

[38]  Mathieu Pernot,et al.  3-D real-time motion correction in high-intensity focused ultrasound therapy. , 2004, Ultrasound in medicine & biology.

[39]  P Wust,et al.  Three‐dimensional monitoring of small temperature changes for therapeutic hyperthermia using MR , 1998, Journal of magnetic resonance imaging : JMRI.

[40]  Pascal Desbarats,et al.  Image processing for on-line reduction of thermometry artifacts , 2006 .