Zero TE MRI applications to transcranial MR-guided focused ultrasound: Patient screening and treatment efficiency estimation.
Acoustics
Aged
Feasibility Studies
Female
Humans
Image Processing, Computer-Assisted
Linear Models
Magnetic Resonance Imaging
Male
Middle Aged
Nonlinear Dynamics
Skull
/ diagnostic imaging
Temperature
Thalamus
/ diagnostic imaging
Tomography, X-Ray Computed
Tremor
/ diagnostic imaging
Ultrasonic Therapy
CT
SDR
ZTE
focused ultrasound
thalamotomy
Journal
Journal of magnetic resonance imaging : JMRI
ISSN: 1522-2586
Titre abrégé: J Magn Reson Imaging
Pays: United States
ID NLM: 9105850
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
17
01
2019
accepted:
29
03
2019
pubmed:
17
4
2019
medline:
24
11
2020
entrez:
17
4
2019
Statut:
ppublish
Résumé
The high acoustic impedance of the skull limits the performance of transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) therapy. Subject suitability screening is based on skull parameters estimated from computed tomography (CT) scans. To assess the feasibility of screening for tcMRgFUS based on zero echo time (ZTE) MRI, and to explore the influence of measurable skull parameters in treatment performance. Retrospective. Sixteen patients treated with tcMRgFUS thalamotomy for tremor. ZTE on a 3.0T GE scanner. Baseline CT and ZTE images were processed to extract skull measures associated with treatment success: skull density ratio (SDR), skull thickness, and angle of incidence. Eight new metrics were proposed. CT and ZTE-based measures were compared. Each subject's energy-temperature curve was processed to extract a global estimate of efficiency and a measure of nonlinearity. These parameters were then correlated with the skull measures. Linear regression analysis to compare ZTE vs. CT-based measures, measures vs. efficiency, and measures vs. nonlinearity. Paired t-test to assess nonlinearity. CT and ZTE-based measures were significantly correlated (P < 0.01). In particular, classical metrics were robustly replicated (P < 0.001). The energy-temperature curves showed a nonlinear (logarithmic) relationship (P < 0.01). This nonlinearity was greater for thicker skulls (P < 0.01). Efficiency was correlated with skull thickness (P < 0.001) and SDR (P < 0.05). The feasibility of ZTE-based screening has been proven, potentially making it possible to avoid ionizing radiation and the extra imaging session required for CT. The characterization of the influence that skull properties have on tcMRgFUS may serve to develop patient-specific heating models, potentially improving control over the treatment outcome. The relationship of skull thickness with efficiency and nonlinearity empowers the role of this metric in the definition of such models. In addition, the lower association of SDR with the energy-temperature curves emphasizes the need of revisiting this metric. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1583-1592.
Sections du résumé
BACKGROUND
The high acoustic impedance of the skull limits the performance of transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) therapy. Subject suitability screening is based on skull parameters estimated from computed tomography (CT) scans.
PURPOSE
To assess the feasibility of screening for tcMRgFUS based on zero echo time (ZTE) MRI, and to explore the influence of measurable skull parameters in treatment performance.
STUDY TYPE
Retrospective.
POPULATION
Sixteen patients treated with tcMRgFUS thalamotomy for tremor.
SEQUENCE
ZTE on a 3.0T GE scanner.
ASSESSMENT
Baseline CT and ZTE images were processed to extract skull measures associated with treatment success: skull density ratio (SDR), skull thickness, and angle of incidence. Eight new metrics were proposed. CT and ZTE-based measures were compared. Each subject's energy-temperature curve was processed to extract a global estimate of efficiency and a measure of nonlinearity. These parameters were then correlated with the skull measures.
STATISTICAL TESTS
Linear regression analysis to compare ZTE vs. CT-based measures, measures vs. efficiency, and measures vs. nonlinearity. Paired t-test to assess nonlinearity.
RESULTS
CT and ZTE-based measures were significantly correlated (P < 0.01). In particular, classical metrics were robustly replicated (P < 0.001). The energy-temperature curves showed a nonlinear (logarithmic) relationship (P < 0.01). This nonlinearity was greater for thicker skulls (P < 0.01). Efficiency was correlated with skull thickness (P < 0.001) and SDR (P < 0.05).
DATA CONCLUSION
The feasibility of ZTE-based screening has been proven, potentially making it possible to avoid ionizing radiation and the extra imaging session required for CT. The characterization of the influence that skull properties have on tcMRgFUS may serve to develop patient-specific heating models, potentially improving control over the treatment outcome. The relationship of skull thickness with efficiency and nonlinearity empowers the role of this metric in the definition of such models. In addition, the lower association of SDR with the energy-temperature curves emphasizes the need of revisiting this metric.
LEVEL OF EVIDENCE
3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1583-1592.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1583-1592Informations de copyright
© 2019 International Society for Magnetic Resonance in Medicine.
Références
Jolesz FA, Mcdannold NJ. Magnetic resonance-guided focused ultrasound. A new technology for clinical neurosciences. Neurol Clin NA 2014;32:253-269.
Krishna V, Sammartino F, Rezai A. A review of the current therapies, challenges, and future directions of transcranial focused ultrasound technology: Advances in diagnosis and treatment. JAMA Neurol 2017:1-9.
Jeanmonod D, Werner B, Morel A, et al. Transcranial magnetic resonance imaging-guided focused ultrasound: Noninvasive central lateral thalamotomy for chronic neuropathic pain. Neurosurg Focus 2012;32:E1.
Elias WJ, Lipsman N, Ondo WG, et al. A randomized trial of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2016;375:730-739.
Martínez-Fernández R, Rodríguez-Rojas R, del Álamo M, et al. Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: A pilot study. Lancet Neurol 2018;17:54-63.
Jung HH, Kim SJ, Roh D, et al. Bilateral thermal capsulotomy with MR-guided focused ultrasound for patients with treatment-refractory obsessive-compulsive disorder: A proof-of-concept study. Mol Psychiatry 2015;20:1205-1211.
Fry FJ, Barger JE. Acoustical properties of the human skull. J Acoust Soc Am 1978;63:1576-1590.
Chang WS, Jung HH, Zadicario E, et al. Factors associated with successful magnetic resonance-guided focused ultrasound treatment: Efficiency of acoustic energy delivery through the skull. J Neurosurg 2015;124:1-6.
McDannold N, King RL, Hynynen K. MRI monitoring of heating produced by ultrasound absorption in the skull: in vivo study in pigs. Magn Reson Med 2004;51:1061-1065.
Schwartz ML, Yeung R, Huang Y, et al. Skull bone marrow injury caused by MR-guided focused ultrasound for cerebral functional procedures. J Neurosurg 2018:1-5.
Wintermark M, Tustison NJ, Elias WJ, et al. T1-weighted MRI as a substitute to CT for refocusing planning in MR-guided focused ultrasound. Phys Med Biol 2014;59:3599-3614.
Miller GW, Eames M, Snell J, Aubry JF. Ultrashort echo-time MRI versus CT for skull aberration correction in MR-guided transcranial focused ultrasound: in vitro comparison on human calvaria. Med Phys 2015;42:2223-2233.
Weiger M, Pruessmann KP. MRI with zero echo time. In: Encyclopedia of Magnetic Resonance. Vol. 1. 2012:311-322.
Wiesinger F, Sacolick LI, Menini A, et al. Zero TE MR bone imaging in the head. Magn Reson Med 2016;75:107-114.
Wiesinger F, Bylund M, Yang J, et al. Zero TE-based pseudo-CT image conversion in the head and its application in PET/MR attenuation correction and MR-guided radiation therapy planning. Magn Reson Med 2018;80:1440-1451.
Pineda-Pardo JA, Martínez-Fernández R, Rodríguez-Rojas R, et al. Microstructural changes of the dentato-rubro-thalamic tract after transcranial MR guided focused ultrasound ablation of the posteroventral VIM in essential tremor. Hum Brain Mapp 2019;:1-10.
Sled JG, Zijdenbos AP, Evans AC. A nonparametric method for automatic correction of intensity nonuniformity in MRI data. IEEE Trans Med Imaging 1998;17:87-97.
Bresenham JE. Algorithm for computer control of a digital plotter. IBM Syst J 1965;4:25-30.
Hughes A, Huang Y, Schwartz ML, Hynynen K. The reduction in treatment efficiency at high acoustic powers during MR-guided transcranial focused ultrasound thalamotomy for essential tremor. Med Phys 2018;45:2925-2936.
Nicholson PHF, Bouxsein ML. Effect of temperature on ultrasonic properties of the calcaneus in situ. Osteoporos Int 2002;13:888-892.
McCarthy RN, Jeffcott LB, McCartney RN. Ultrasound speed in equine cortical bone: Effects of orientation, density, porosity and temperature. J Biomech 1990;23:1139-1143.