Department of Bioengineering, Stanford University, Stanford, CA, USA.
Focused Ultrasound Foundation, Charlottesville, VA, USA.
Sci Rep. 2022 Aug 4;12(1):13407. doi: 10.1038/s41598-022-17319-4.
Transcranial focused ultrasound with the InSightec Exablate system uses thermal ablation for the treatment of movement and mood disorders and blood brain barrier disruption for tumor therapy. The system uses computed tomography (CT) images to calculate phase corrections that account for aberrations caused by the human skull. This work investigates whether magnetic resonance (MR) images can be used as an alternative to CT images to calculate phase corrections. Phase corrections were calculated using the gold standard hydrophone method and the standard of care InSightec ray tracing method. MR binary image mask, MR-simulated-CT (MRsimCT), and CT images of three ex vivo human skulls were supplied as inputs to the InSightec ray tracing method. The degassed ex vivo human skulls were sonicated with a 670 kHz hemispherical phased array transducer (InSightec Exablate 4000). 3D raster scans of the beam profiles were acquired using a hydrophone mounted on a 3-axis positioner system. Focal spots were evaluated using six metrics: pressure at the target, peak pressure, intensity at the target, peak intensity, positioning error, and focal spot volume. Targets at the geometric focus and 5 mm lateral to the geometric focus were investigated. There was no statistical difference between any of the metrics at either target using either MRsimCT or CT for phase aberration correction. As opposed to the MRsimCT, the use of CT images for aberration correction requires registration to the treatment day MR images; CT misregistration within a range of ± 2 degrees of rotation error along three dimensions was shown to reduce focal spot intensity by up to 9.4%. MRsimCT images used for phase aberration correction for the skull produce similar results as CT-based correction, while avoiding both CT to MR registration errors and unnecessary patient exposure to ionizing radiation.
经颅聚焦超声联合 InSightec Exablate 系统利用热消融治疗运动和情绪障碍,利用血脑屏障破坏治疗肿瘤。该系统采用计算机断层扫描(CT)图像来计算相位校正,以弥补颅骨引起的像差。本研究旨在探讨磁共振(MR)图像是否可以替代 CT 图像来计算相位校正。相位校正分别采用金标准水听器法和标准的 InSightec 光线追踪法进行计算。MR 二进制掩模图像、MR 模拟 CT(MRsimCT)和 3 例离体人头 CT 图像被输入至 InSightec 光线追踪法。脱气的离体人头采用 670 kHz 半球形相控阵换能器(InSightec Exablate 4000)进行超声处理。采用安装在三轴定位器系统上的水听器采集光束轮廓的 3D 光栅扫描。使用 6 个指标评估焦点:靶区压力、峰值压力、靶区强度、峰值强度、定位误差和焦点体积。在几何焦点和偏离几何焦点 5mm 处的靶点进行研究。采用 MRsimCT 或 CT 进行相位像差校正时,在任一个靶点的任意指标均无统计学差异。与 MRsimCT 不同,CT 图像的像差校正需要与治疗当天的 MR 图像进行配准;研究表明,CT 配准在三个维度上的旋转误差范围为±2 度以内,会导致焦点强度降低最高达 9.4%。用于颅骨相位像差校正的 MRsimCT 图像产生的结果与基于 CT 的校正相似,同时避免了 CT 到 MR 配准误差和不必要的患者电离辐射暴露。