[The significance of skin thermometry in the evaluation of peripheral blood circulation].
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Magnetic resonance image-guidance for interstitial thermal therapy has proven to be a valuable tool in its traditional role in device localization and, more recently, in monitoring heat deposition within tissue. However, a quantitative understanding of how temperature-time exposure relates to thermal damage is crucial if the predictive value of real-time MR thermal-monitoring is to be fully realized. Results are presented on interstitial laser coagulation of two canine prostate models which are shown to provide an opportunity to evaluate three models of thermal damage based on a threshold maximum temperature, an Arrhenius damage integral, and a temperature-time product. These models were compared to the resultant lesion margin as derived from post-treatment T(1)- and T(2)-weighted MR images, as well as from direct histological evaluation of the excised canine prostate. Histological evaluation shows that the thermal-injury boundary can be predicted from a threshold-maximum temperature of approximately 51 degrees C or an equivalent Arrhenius t(43) period of 200 minutes, but it is not reliably predicted using the temperature-time product. The methods described in this study are expected to have implications for the treatment of benign prostatic hyperplasia and prostate cancer with interstitial laser coagulation, which will be the focus of future human studies.
The potential use of multiple-frequency-band radiometry as a means of noninvasive sensing of one-dimensional temperature profiles is presented in this communication. The radiative energy transfer equation is solved numerically. Ideal-condition thermal noise spectra and distributions of received energy, associated with specific temperature-depth profiles, are presented. Performance characteristics are discussed.
BACKGROUND: The objective of this study was to evaluate noninvasive magnetic resonance (MR) thermography for the monitoring of regional hyperthermia (RHT) in patients with soft tissue sarcomas of the lower extremities and pelvis. METHODS: Noninvasive MR monitoring during RHT was performed in 9 patients who had high-risk soft tissue sarcomas of the lower extremities or pelvis during neoadjuvant chemotherapy plus RHT in the scope of the European Organization for Research and Treatment of Cancer 62961/European Society for Hyperthermic Oncology RHT-95 study. Anatomic and temperature-sensitive data sets were acquired every 10 minutes before and during RHT (using gradient-echo-sequences with variable echo times). MR temperature distributions were derived from the phase differences by using the proton-resonance frequency shift method. A phase convolution setting phase shifts to zero in the fat tissue was performed as a drift correction. The mean MR temperatures in the tumor and muscles and the index temperatures (e.g., T90, which covers 90% of the target volume) and thermal doses were determined and compared with pathohistologic responses and direct temperature measurements if available. RESULTS: Thirty of 72 MR-thermography data sets (>40% of heat sessions) were evaluable. A significant correlation was observed between pathohistologic response (defined as a necrosis rate >or=90%) and standardized thermal parameters, such as thermal dose cumulative equivalent minutes at 43 degrees C to 90% of the target volume (T90) (P = .050), mean T90 (P = .048), or T50 (P = .050). The correlation of 13 conventional temperature measurements performed in selected patients and sessions invasively in the tumor or noninvasively in rectum and bladder revealed an excellent correlation with MR temperatures (R2 = .96). CONCLUSIONS: Noninvasive MR thermography of soft tissue sarcoma was feasible and suitable for validating the quality of heating during RHT.
PURPOSE: To investigate the peak temperature and thermal dose (T(43)) as tissue damage indicators for thermal therapy. MATERIALS AND METHODS: The proton resonant frequency (PRF) shift thermal coefficient was calibrated on six in vivo rabbit brains during interstitial laser ablation. The peak temperature and T(43) were correlated with the lesion boundary observed on T2-weighted spin-echo (SE) MRI at 4 hours post-heating in seven thermal lesions using direct MR measurement and analysis based on a binary discriminate model. RESULTS: The peak temperature and T(43) were 48.3 +/- 1.7 degrees C and 191 +/- 219 minutes, respectively, from the direct MR measurement. The values derived by the binary discriminate analysis were 47.8 +/- 2.2 degrees C and 28 +/- 41 minutes, respectively. CONCLUSION: Our results suggest that tissue damage in rabbit brain 4 hours after thermal ablation can be predicted reliably from a threshold temperature of approximately 48 degrees C.
PURPOSE: To develop and analyze the performance of the variation correction algorithm (VCA), a phase correction technique that mitigates the contribution of background phase variations by combining accurate alignment of echoes, K-space-based phase correction (as opposed to spatial polynomials), and extraction of alias-free phase difference images. MATERIALS AND METHODS: A series of echo-shifted gradient-recalled echo (GRE) images was processed with K-space alignment and phase corrected with increasing sizes of M x M masks of central K-space coefficients. The extent of background phase variation suppression due to magnet field drift was assessed. Further, a simulated thermal profile was superimposed on the same data in a related experiment. Residual errors in reconstructed simulated thermal profiles were quantitatively characterized to estimate algorithm performance. RESULTS: Using a 3 x 3 K-space mask, the VCA was able to 1) maintain the typical mean background error in a 35 x 35 pixel region of interest (ROI) at -0.1 degrees C; and 2) reconstruct, relative to the applied thermal profile, a phase-corrected profile that typically contains a 1.7 degrees C underestimation of peak temperature difference and a mean error along the 60 degrees C line of -0.8 degrees C. CONCLUSION: The results suggest that thermal profiles can be accurately reconstructed at 0.2 T using the VCA, even in the presence of over 1 ppm spatially and temporally dependent field drift over a 1-hour time frame.
The purpose of this study was the application of the proton-resonance-frequency method to monitor laser-induced interstitial thermotherapy (LITT) in a patient with an astrocytoma WHO II. A phase-sensitive two-dimensional (2D) fast low-angle shot (FLASH) sequence was used to determine the temperature-related phase shifts during LITT. Temperature maps were displayed during therapy with a temporal resolution of 20 seconds. Irradiation was discontinued as soon as the 60 to 65 degrees C isotherm reached the margin of the tumor. A contrast-enhanced MRI study performed immediately after therapy showed a good correlation of the size of an enhancing rim around the lesion with the 60 to 65 degrees C isotherm. The preliminary results of our study indicate that MRI guidance of LITT may be improved by temperature quantification based on the proton-resonance-frequency method.
BACKGROUND AND OBJECTIVES: The goal of this study was to explore the feasibility of magnetic resonance thermal imaging (MRTI)-based feedback control of intracerebral laser interstitial thermal therapy (LITT), using a computer workstation and 980-nm diode laser interfaced to an MR scanner. STUDY DESIGN/MATERIALS AND METHODS: A computer-controlled laser thermal therapy system was used to produce 12 ex vivo lesions in 3 canine and porcine brains and 16 in vivo lesions in 6 canines with diffusing tip fiberoptic applicators and energies from 54 to 900 J. MRTI predictions of thermal damage were correlated with histopathologic analysis. RESULTS: Under feedback control, no carbonization, vaporization, or applicator damage was observed. MRTI-based prediction of thermal dose was not significantly different from histological evaluation of achieved thermal necrosis. CONCLUSIONS: The computer-controlled thermal therapy system was effective at regulating heating, eliminating carbonization and vaporization, and protecting fiberoptic applicators. MRTI estimation of thermal dose accurately predicted achieved thermal necrosis.
The temperature sensitivity of the proton-resonance frequency (PRF) has proven valuable for the monitoring of MR image-guided thermal coagulation therapy. However, there is significant inconsistency in reported values of the PRF-thermal coefficient, as measured from experiments encompassing a range of in vivo and ex vivo tissue types and experimental conditions. A method of calibrating the temperature dependence of the PRF is described and results are presented that indicate a tissue-type independence. To this end, other possible mechanisms for variations in the PRF-thermal coefficient are suggested, including physiological perturbations and volume magnetic susceptibility effects from geometry and orientation.
A method is presented for the rapid acquisition of frequency maps based on multiecho balanced steady-state free precession (balanced SSFP, fast imaging with steady precession (True FISP), fast imaging employing steady-state excitation (FIESTA), or balanced fast field echo (FFE)). This technique was applied to measure temperature changes within a gel phantom based on the temperature-sensitive water proton-resonance frequency. The frequency was determined as the slope of a linear fit of the phases measured at different TEs along the echo train. The signal-to-noise ratio (SNR) of multiecho SSFP was analyzed for different parameters, such as relaxation times and flip angle, as well as for different local field inhomogeneities. The theoretical and experimental results were compared with results from the established multiecho fast low-angle shot (FLASH) method. Depending on the given tissue parameters, a significant increase in the accuracy of the frequency/temperature shift estimation compared to FLASH was observed. Furthermore, balanced SSFP can be used with very short TRs without generating a saturation-related signal loss, which is essential for real-time temperature mapping.
Of the various techniques employed to quantify temperature changes by MR, proton resonance frequency (PRF) shift-based phase-difference imaging (PDI) is the most accurate and widely used. However, PDI is associated with various artifacts. Motivated by these limitations, we developed a new method to monitor temperature changes by MRI using the balanced steady-state free precession (balanced-SSFP) pulse sequence. Magnitude images obtained with the SSFP pulse sequence were used to find the PRF shift, which is proportional to temperature change. Spatiotemporal temperature maps were successfully reconstructed with this technique in gel phantom experiments and a rabbit model. The results show that the balanced-SSFP-based method is a promising new technique for monitoring temperature.