In vivo image-guided MR thermometry during laser ablation: experience in kidney and liver

This works aims at assessing the thermal outcome of laser-based hyperthermia on living animals. Temperature evolution in target organs were monitored by means of non-invasive and contactless magnetic resonance (MR) images and fiber optic based-thermometers. Through MR-guidance, an expert interventional radiologist inserted MR-compatible fiber optic laser applicator and the thermometers through percutaneous procedure into kidney and liver. MR compatible, custom-made needle-like probes relying on fiber Bragg grating (FBG) technology were use to ease the percutaneous insertion of the thermometers into the organs. The thermal dependence of proton resonance frequency (PRF) of tissue water protons was used to obtain the MR thermal mapping; phase imaging method allowed the analysis of the thermal evolution. A respiratory-gated sequence was used to synchronize the images acquisition with the breathing frequency of the animal. The thermal maps provided by MR images were compared with the thermal trends measured by FBGs. Results showed that the temperature evolution measured by the FBGs at a specific distance from laser applicator tip was in accordance with the data provided by MR images, in both organs. Especially in liver, FBGs were subjected to the breathing movements (maximum error of 7 °C). regarding MR thermometry, it was also subjected to some artifacts, mostly due to: 1) cavitation-induced phase shift in the images, and 2) breathing movements (temperature changes up to 10 °C). In conclusion, even though MR imaging is particularly useful for clinical applications, improvements still should be implemented in terms of motion compensation. The introduction of sensors in clinical practice can allows a safer evaluation of the temperature distribution, hence, of the induced thermal damage.

[1]  Alexandru Cernicanu,et al.  New horizons in MR-controlled and monitored radiofrequency ablation of liver tumours , 2007, Cancer imaging : the official publication of the International Cancer Imaging Society.

[2]  Marina Militare,et al.  Outcomes and Risk Factors for Complications of Laser Ablation for Thyroid Nodules. A Multicenter Study on 1531 Patients , 2015 .

[3]  Rares Salomir,et al.  Observation and correction of transient cavitation-induced PRFS thermometry artifacts during radiofrequency ablation, using simultaneous ultrasound/MR imaging. , 2010, Medical physics.

[4]  Allison Payne,et al.  Respiration artifact correction in three‐dimensional proton resonance frequency MR thermometry using phase navigators , 2016, Magnetic resonance in medicine.

[5]  Sergio Silvestri,et al.  Feasibility of EUS-guided Nd:YAG laser ablation of unresectable pancreatic adenocarcinoma. , 2018, Gastrointestinal endoscopy.

[6]  Kim Butts Pauly,et al.  MR thermometry , 2008, Journal of magnetic resonance imaging : JMRI.

[7]  Sébastien Roujol,et al.  Robust Adaptive Extended Kalman Filtering for Real Time MR-Thermometry Guided HIFU Interventions , 2012, IEEE Transactions on Medical Imaging.

[8]  Sergio Silvestri,et al.  Techniques for temperature monitoring during laser-induced thermotherapy: An overview , 2013, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[9]  Jürgen Hennig,et al.  Fast PRF-based MR thermometry using double-echo EPI: in vivo comparison in a clinical hyperthermia setting , 2015, Magnetic Resonance Materials in Physics, Biology and Medicine.

[10]  K. Hill,et al.  Narrow-band Bragg reflectors in optical fibers. , 1978, Optics letters.

[11]  T. H. van der Kwast,et al.  Focal laser ablation for prostate cancer followed by radical prostatectomy: validation of focal therapy and imaging accuracy. , 2010, European urology.

[12]  Guido Perrone,et al.  Laser ablation of the biliary tree: in vivo proof of concept as potential treatment of unresectable cholangiocarcinoma , 2018, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[13]  Paola Saccomandi,et al.  Endoluminal Nd:YAG laser application in ex vivo biliary porcine tissue , 2017, Lasers in Medical Science.

[14]  Guido Perrone,et al.  Novel carbon fiber probe for temperature monitoring during thermal therapies , 2017, 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

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