Breath-hold MR-HIFU hyperthermia: phantom and in vivo feasibility

Chenchen Bing, Bingbing Cheng, Robert M. Staruch, Joris Nofiele, Michelle Wodzak Staruch, Debra Szczepanski, Alan Farrow-Gillespie, Adeline Yang, Theodore W. Laetsch, Rajiv Chopra

Research output: Contribution to journalArticle

Abstract

Background: The use of magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) to deliver mild hyperthermia requires stable temperature mapping for long durations. This study evaluates the effects of respiratory motion on MR thermometry precision in pediatric subjects and determines the in vivo feasibility of circumventing breathing-related motion artifacts by delivering MR thermometry-controlled HIFU mild hyperthermia during repeated forced breath holds. Materials and methods: Clinical and preclinical studies were conducted. Clinical studies were conducted without breath-holds. In phantoms, breathing motion was simulated by moving an aluminum block towards the phantom along a sinusoidal trajectory using an MR-compatible motion platform. In vivo experiments were performed in ventilated pigs. MR thermometry accuracy and stability were evaluated. Results: Clinical data confirmed acceptable MR thermometry accuracy (0.12–0.44 °C) in extremity tumors, but not in the tumors in the chest/spine and pelvis. In phantom studies, MR thermometry accuracy and stability improved to 0.37 ± 0.08 and 0.55 ± 0.18 °C during simulated breath-holds. In vivo MR thermometry accuracy and stability in porcine back muscle improved to 0.64 ± 0.22 and 0.71 ± 0.25 °C during breath-holds. MR-HIFU hyperthermia delivered during intermittent forced breath holds over 10 min duration heated an 18-mm diameter target region above 41 °C for 10.0 ± 1.0 min, without significant overheating. For a 10-min mild hyperthermia treatment, an optimal treatment effect (TIR > 9 min) could be achieved when combining 36–60 s periods of forced apnea with 60–155.5 s free-breathing. Conclusion: MR-HIFU delivery during forced breath holds enables stable control of mild hyperthermia in targets adjacent to moving anatomical structures.

Original languageEnglish (US)
Pages (from-to)1084-1097
Number of pages14
JournalInternational Journal of Hyperthermia
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Thermometry
Fever
Magnetic Resonance Imaging
Respiration
Swine
Back Muscles
Apnea
Aluminum
Pelvis
Artifacts
Neoplasms
Spine
Thorax
Extremities
Pediatrics

Keywords

  • high intensity focused ultrasound
  • mild hyperthermia
  • MR-HIFU
  • noninvasive thermometry
  • respiratory motion

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Cancer Research

Cite this

Bing, C., Cheng, B., Staruch, R. M., Nofiele, J., Wodzak Staruch, M., Szczepanski, D., ... Chopra, R. (2019). Breath-hold MR-HIFU hyperthermia: phantom and in vivo feasibility. International Journal of Hyperthermia, 36(1), 1084-1097. https://doi.org/10.1080/02656736.2019.1679893

Breath-hold MR-HIFU hyperthermia : phantom and in vivo feasibility. / Bing, Chenchen; Cheng, Bingbing; Staruch, Robert M.; Nofiele, Joris; Wodzak Staruch, Michelle; Szczepanski, Debra; Farrow-Gillespie, Alan; Yang, Adeline; Laetsch, Theodore W.; Chopra, Rajiv.

In: International Journal of Hyperthermia, Vol. 36, No. 1, 01.01.2019, p. 1084-1097.

Research output: Contribution to journalArticle

Bing, C, Cheng, B, Staruch, RM, Nofiele, J, Wodzak Staruch, M, Szczepanski, D, Farrow-Gillespie, A, Yang, A, Laetsch, TW & Chopra, R 2019, 'Breath-hold MR-HIFU hyperthermia: phantom and in vivo feasibility', International Journal of Hyperthermia, vol. 36, no. 1, pp. 1084-1097. https://doi.org/10.1080/02656736.2019.1679893
Bing C, Cheng B, Staruch RM, Nofiele J, Wodzak Staruch M, Szczepanski D et al. Breath-hold MR-HIFU hyperthermia: phantom and in vivo feasibility. International Journal of Hyperthermia. 2019 Jan 1;36(1):1084-1097. https://doi.org/10.1080/02656736.2019.1679893
Bing, Chenchen ; Cheng, Bingbing ; Staruch, Robert M. ; Nofiele, Joris ; Wodzak Staruch, Michelle ; Szczepanski, Debra ; Farrow-Gillespie, Alan ; Yang, Adeline ; Laetsch, Theodore W. ; Chopra, Rajiv. / Breath-hold MR-HIFU hyperthermia : phantom and in vivo feasibility. In: International Journal of Hyperthermia. 2019 ; Vol. 36, No. 1. pp. 1084-1097.
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AU - Bing, Chenchen

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AU - Staruch, Robert M.

AU - Nofiele, Joris

AU - Wodzak Staruch, Michelle

AU - Szczepanski, Debra

AU - Farrow-Gillespie, Alan

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N2 - Background: The use of magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) to deliver mild hyperthermia requires stable temperature mapping for long durations. This study evaluates the effects of respiratory motion on MR thermometry precision in pediatric subjects and determines the in vivo feasibility of circumventing breathing-related motion artifacts by delivering MR thermometry-controlled HIFU mild hyperthermia during repeated forced breath holds. Materials and methods: Clinical and preclinical studies were conducted. Clinical studies were conducted without breath-holds. In phantoms, breathing motion was simulated by moving an aluminum block towards the phantom along a sinusoidal trajectory using an MR-compatible motion platform. In vivo experiments were performed in ventilated pigs. MR thermometry accuracy and stability were evaluated. Results: Clinical data confirmed acceptable MR thermometry accuracy (0.12–0.44 °C) in extremity tumors, but not in the tumors in the chest/spine and pelvis. In phantom studies, MR thermometry accuracy and stability improved to 0.37 ± 0.08 and 0.55 ± 0.18 °C during simulated breath-holds. In vivo MR thermometry accuracy and stability in porcine back muscle improved to 0.64 ± 0.22 and 0.71 ± 0.25 °C during breath-holds. MR-HIFU hyperthermia delivered during intermittent forced breath holds over 10 min duration heated an 18-mm diameter target region above 41 °C for 10.0 ± 1.0 min, without significant overheating. For a 10-min mild hyperthermia treatment, an optimal treatment effect (TIR > 9 min) could be achieved when combining 36–60 s periods of forced apnea with 60–155.5 s free-breathing. Conclusion: MR-HIFU delivery during forced breath holds enables stable control of mild hyperthermia in targets adjacent to moving anatomical structures.

AB - Background: The use of magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) to deliver mild hyperthermia requires stable temperature mapping for long durations. This study evaluates the effects of respiratory motion on MR thermometry precision in pediatric subjects and determines the in vivo feasibility of circumventing breathing-related motion artifacts by delivering MR thermometry-controlled HIFU mild hyperthermia during repeated forced breath holds. Materials and methods: Clinical and preclinical studies were conducted. Clinical studies were conducted without breath-holds. In phantoms, breathing motion was simulated by moving an aluminum block towards the phantom along a sinusoidal trajectory using an MR-compatible motion platform. In vivo experiments were performed in ventilated pigs. MR thermometry accuracy and stability were evaluated. Results: Clinical data confirmed acceptable MR thermometry accuracy (0.12–0.44 °C) in extremity tumors, but not in the tumors in the chest/spine and pelvis. In phantom studies, MR thermometry accuracy and stability improved to 0.37 ± 0.08 and 0.55 ± 0.18 °C during simulated breath-holds. In vivo MR thermometry accuracy and stability in porcine back muscle improved to 0.64 ± 0.22 and 0.71 ± 0.25 °C during breath-holds. MR-HIFU hyperthermia delivered during intermittent forced breath holds over 10 min duration heated an 18-mm diameter target region above 41 °C for 10.0 ± 1.0 min, without significant overheating. For a 10-min mild hyperthermia treatment, an optimal treatment effect (TIR > 9 min) could be achieved when combining 36–60 s periods of forced apnea with 60–155.5 s free-breathing. Conclusion: MR-HIFU delivery during forced breath holds enables stable control of mild hyperthermia in targets adjacent to moving anatomical structures.

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