Alexander J.E. Raaijmakers

Integrating a 1.5 T MRI scanner with a 6 MV accelerator: proof of concept

At the UMC Utrecht, The Netherlands, we have constructed a prototype MRI accelerator. The prototype is a modified 6 MV Elekta (Crawley, UK) accelerator next to a modified 1.5 T Philips Achieva (Best, The Netherlands) MRI system. From the initial design onwards, modifications to both systems were aimed to yield simultaneous and unhampered operation of the MRI and the accelerator. Indeed, the simultaneous operation is shown by performing diagnostic quality 1.5 T MRI with the radiation beam on. No degradation of the performance of either system was found. The integrated 1.5 T MRI system and radiotherapy accelerator allow simultaneous irradiation and MR imaging. The full diagnostic imaging capacities of the MRI can be used; dedicated sequences for MRI-guided radiotherapy treatments will be developed. This proof of concept opens the door towards a clinical prototype to start testing MRI-guided radiation therapy (MRIgRT) in the clinic.

Design of a radiative surface coil array element at 7 T:the single-side adapted dipole antenna

Ultra high field MR imaging (≥7 T) of deeply located targets in the body is facing some radiofrequency‐field related challenges: interference patterns, reduced penetration depth, and higher Specific Absorbtion Ratio (SAR) levels. These can be alleviated by redesigning the elements of the transmit or transceive array. This is because at these high excitation field (B1) frequencies, conventional array element designs may have become suboptimal. In this work, an alternative design approach is presented, regarding coil array elements as antennas. Following this approach, the Poynting vector of the element should be oriented towards the imaging target region. The single‐side adapted dipole antenna is a novel design that fulfills this requirement. The performance of this design as a transmit coil array element has been characterized by comparison with three other, more conventional designs using finite difference time domain (FDTD) simulations and B  +1 measurements on a phantom. Results show that the B  +1 level at the deeper regions is higher while maintaining relatively low SAR levels. Also, the B  +1 field distribution is more symmetrical and more uniform, promising better image homogeneity. Eight radiative antennas have been combined into a belt‐like surface array for prostate imaging. T1‐weighted (T1W) and T2‐weighted (T2W) volunteer images are presented along with B  +1 measurements to demonstrate the improved efficiency. Magn Reson Med, 2011.

31P MRSI and 1H MRS at 7 T: initial results in human breast cancer

This study demonstrates the feasibility of the noninvasive determination of important biomarkers of human (breast) tumor metabolism using high‐field (7‐T) MRI and MRS. 31P MRSI at this field strength was used to provide a direct method for the in vivo detection and quantification of endogenous biomarkers. These encompass phospholipid metabolism, phosphate energy metabolism and intracellular pH. A double‐tuned, dual‐element transceiver was designed with focused radiofrequency fields for unilateral breast imaging and spectroscopy tuned for optimized sensitivity at 7 T. T1‐weighted three‐dimensional MRI and 1H MRS were applied for the localization and quantification of total choline compounds. 31P MRSI was obtained within 20 min per subject and mapped in three dimensions over the breast with pixel volumes of 10 mL. The feasibility of monitoring in vivo metabolism was demonstrated in two patients with breast cancer during neoadjuvant chemotherapy, validated by ex vivo high‐resolution magic angle spinning NMR and compared with data from an age‐matched healthy volunteer. Concentrations of total choline down to 0.4 mM could be detected in the human breast in vivo. Levels of adenosine and other nucleoside triphosphates, inorganic phosphate, phosphocholine, phosphoethanolamine and their glycerol diesters detected in glandular tissue, as well as in tumor, were mapped over the entire breast. Altered levels of these compounds were observed in patients compared with an age‐matched healthy volunteer; modulation of these levels occurred in breast tumors during neoadjuvant chemotherapy. To our knowledge, this is the first comprehensive MRI and MRS study in patients with breast cancer, which reveals detailed information on the morphology and phospholipid metabolism from volumes as small as 10 mL. This endogenous metabolic information may provide a new method for the noninvasive assessment of prognostic and predictive biomarkers in breast cancer treatment. Copyright

Integrating a MRI scanner with a 6 MV radiotherapy accelerator: impact of the surface orientation on the entrance and exit dose due to the transverse magnetic field

At the UMC Utrecht, in collaboration with Elekta and Philips Research Hamburg, we are developing a radiotherapy accelerator with integrated MRI functionality. The radiation dose will be delivered in the presence of a lateral 1.5 T field. Although the photon beam is not affected by the magnetic field, the actual dose deposition is done by a cascade of secondary electrons and these electrons are affected by the Lorentz force. The magnetic field causes a reduced build-up distance: because the trajectory of the electrons between collisions is curved, the entrance depth in tissue decreases. Also, at tissue-air interfaces an increased dose occurs due to the so-called electron return effect (ERE): electrons leaving tissue will describe a circular path in air and re-enter the tissue yielding a local dose increase. In this paper the impact of a 1.5 T magnetic field on both the build-up distance and the dose increase due to the ERE will be investigated as a function of the angle between the surface and the incident beam. Monte Carlo simulations demonstrate that in the presence of a 1.5 T magnetic field, the surface dose, the build-up distance and the exit dose depend more heavily on the surface orientation than in the case without magnetic field. This is caused by the asymmetrical pointspread kernel in the presence of 1.5 T and the directional behaviour of the re-entering electrons. Simulations on geometrical phantoms show that ERE dose increase at air cavities can be avoided using opposing beams, also when the air-tissue boundary is not perpendicular to the beam. For the more general case in patient anatomies, more problems may arise. Future work will address the possibilities and limitations of opposing beams in combination with IMRT in a magnetic field.

The fractionated dipole antenna: A new antenna for body imaging at 7 Tesla.

Dipole antennas in ultrahigh field MRI have demonstrated advantages over more conventional designs. In this study, the fractionated dipole antenna is presented: a dipole where the legs are split into segments that are interconnected by capacitors or inductors.

Electrical Properties Tomography in the Human Brain at 1.5, 3, and 7T: A Comparison Study

To investigate the effect of magnetic field strength on the validity of two assumptions (namely, the “transceive phase assumption” and the “phase‐only reconstruction”) for electrical properties tomography (EPT) at 1.5, 3, and 7T.

Enhancement of Magnetic Resonance Imaging with Metasurfaces

It is revealed that the unique properties of ultrathin metasurface resonators can improve magnetic resonance imaging dramatically. A metasurface formed when an array of metallic wires is placed inside a scanner under the studied object and a substantial enhancement of the radio-frequency magnetic field is achieved by means of subwavelength manipulation with the metasurface, also allowing improved image resolution.

Feasibility of MRI guided proton therapy: magnetic field dose effects

Many methods exist to improve treatment outcome in radiotherapy. Two of these are image-guided radiotherapy (IGRT) and proton therapy. IGRT aims at a more precise delivery of the radiation, while proton therapy is able to achieve more conformal dose distributions. In order to maximally exploit the sharp dose gradients from proton therapy it has to be combined with soft-tissue based IGRT. MRI-guided photon therapy (currently under development) offers unequalled soft-tissue contrast and real-time image guidance. A hybrid MRI proton therapy system would combine these advantages with the advantageous dose steering capacity of proton therapy. This paper addresses a first technical feasibility issue of this concept, namely the impact of a 0.5 T magnetic field on the dose distribution from a 90 MeV proton beam. In contrast to photon therapy, for MR-guided proton therapy the impact of the magnetic field on the dose distribution is very small. At tissue-air interfaces no effect of the magnetic field on the dose distribution can be detected. This is due to the low-energy of the secondary electrons released by the heavy protons.

Specific absorption rate intersubject variability in 7T parallel transmit MRI of the head

Patient‐specific radiofrequency shimming in high‐field MRI strengthens the need for online, patient‐specific specific absorption rate (SAR) monitoring. Numerical simulation is currently most effective for this purpose but may require a patient‐specific dielectric model. To investigate whether a generic model may be combined with a safety factor to account for variation within the population, generic SAR behavior is studied for 7T MRI of the head. For six detailed head models, radiofrequency fields were simulated for an eight‐channel parallel transmit array. SAR behavior is studied through comparison of the eigenvalues/eigenvectors of the local Q‐matrices. Furthermore, numerical radiofrequency shimming experiments without and with SAR constraints were performed where SAR during optimization was evaluated on a generic model. In both cases, the ability of different generic models to predict actual SAR levels was evaluated. The largest eigenvalue distribution is comparable between models. Radiofrequency shimming without constraints improves the |B  +1 | homogeneity while the SAR increases substantially. Imposing constraints on SAR during optimization, estimating SAR on a generic model, was effective. A safety factor of 1.4 was found to be sufficient. Generic SAR behavior makes a generic head model a practical alternative to patient‐specific models and allows effective |B  +1 | shimming with SAR constraints. Magn Reson Med, 2013.

A 16-channel combined loop-dipole transceiver array for 7 Tesla body MRI

To develop a 16‐channel transceive body imaging array at 7.0 T with improved transmit, receive, and specific absorption rate (SAR) performance by combining both loop and dipole elements and using their respective and complementary near and far field characteristics.