Deckers R, Merckel L G, Denis de Senneville B, Schubert G, Köhler M, Knuttel F M, Mali W P Th M, Moonen C T W, van den Bosch M A A J, Bartels L W
Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands.
Phys Med Biol. 2015 Jul 21;60(14):5527-42. doi: 10.1088/0031-9155/60/14/5527. Epub 2015 Jul 2.
MR-guided HIFU ablation is a promising technique for the non-invasive treatment of breast cancer. A phase I study was performed to assess the safety and treatment accuracy and precision of MR-HIFU ablation in breast cancer patients (n=10) using a newly developed MR-HIFU platform dedicated to applications in the breast. In this paper a technical analysis of the performance of the dedicated breast MR-HIFU system during breast tumors ablation is described. The main points of investigation were the spatial targeting accuracy and precision of the system and the performance of real-time respiration-corrected MR thermometry.The mean targeting accuracy was in the range of 2.4-2.6 mm, whereas the mean targeting precision was in the range of 1.5-1.8 mm. To correct for respiration-induced magnetic field fluctuations during MR temperature mapping a look-up-table (LUT)-based correction method was used. An optimized procedural sedation protocol in combination with the LUT-based correction method allowed for precise MR thermometry during the ablation procedure (temperature standard deviation <3 °C). No unwanted heating in the near field (i.e. skin) nor in the far field (pectoral muscle) was detected.The newly developed dedicated breast MR-HIFU system allows for safe, accurate and precise ablation of breast tumors.
磁共振引导高强度聚焦超声消融术是一种很有前景的乳腺癌非侵入性治疗技术。开展了一项I期研究,以评估使用新开发的专门用于乳腺应用的磁共振引导高强度聚焦超声消融平台,对乳腺癌患者(n = 10)进行磁共振引导高强度聚焦超声消融的安全性、治疗准确性和精确性。本文描述了专用乳腺磁共振引导高强度聚焦超声系统在乳腺肿瘤消融过程中的性能技术分析。主要研究要点是该系统的空间靶向准确性和精确性以及实时呼吸校正磁共振测温的性能。平均靶向准确性在2.4 - 2.6毫米范围内,而平均靶向精确性在1.5 - 1.8毫米范围内。为了校正磁共振温度映射期间呼吸引起的磁场波动,使用了基于查找表(LUT)的校正方法。优化的程序镇静方案与基于LUT的校正方法相结合,使得在消融过程中能够进行精确的磁共振测温(温度标准差<3°C)。未检测到近场(即皮肤)和远场(胸肌)出现不必要的加热。新开发的专用乳腺磁共振引导高强度聚焦超声系统能够安全、准确且精确地消融乳腺肿瘤。
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