H. Kroeze

Simultaneous B 1+ homogenization and specific absorption rate hotspot suppression using a magnetic resonance phased array transmit coil

In high‐field MRI severe problems with respect to B  1+ uniformity and specific absorption rate (SAR) deposition pose a great challenge to whole‐body imaging. In this study the potential of a phased array transmit coil is investigated to simultaneously reduce B  1+ nonuniformity and SAR deposition. This was tested by performing electromagnetic simulations of a phased array TEM coil operating at 128 MHz loaded with two different homogeneous elliptical phantoms and four dielectric patient models. It was shown that the wave interference of a circularly polarized RF field with an ellipse and a pelvis produces largely identical B  1+ and electric field patterns. Especially for obese patients, this results in large B  1+ nonuniformity and global areas with elevated SAR deposition. It is demonstrated that a phased array transmit coil can reduce these phenomena. The technique was especially successful in suppressing SAR hotspots with a decrease up to 50%. The application of optimized settings for an ellipse to the patient models leads to comparable results as obtained with the patient‐specific optimizations. This suggests that generic phase/amplitude port settings are possible, requiring no preinformation about patient‐specific RF fields. Such a scheme would, due to its simultaneous B  1+ homogenization and extra SAR margin, have many benefits for whole‐body imaging at 3 T. Magn Reson Med 57:577–586, 2007.

Development of a regional hyperthermia treatment planning system

A flexible and fast regional hyperthermia treatment planning system for the Coaxial TEM System has been devised and is presented. Using Hounsfield Unit based thresholding and manually outlining of the tumour, a 40 cm CT data set (slice thickness 5 mm) is segmented and down scaled to a resolution of 1 cm, requiring only 30 min. The SAR model is based on the finite-difference time-domain (FDTD) method. The number of time steps to achieve numerical stability has been determined and was found to be 7000. Various optimizations of the SAR model have been applied, resulting in a relatively short computation time of 3.7 h (memory requirements 121 MB) on a Pentium III, 450 MHz standard personal computer, running GNU/Linux. The model has been validated using absolute value(Ez) measurements in a standard phantom inserted in the Coaxial TEM Applicator under different conditions and a good agreement was found. Hyperthermia treatment planning in combination with the homemade visualization tools have provided much insight in the regional hyperthermia treatment with the Coaxial TEM Applicator.A flexible and fast regional hyperthermia treatment planning system for the Coaxial TEM System has been devised and is presented. Using Hounsfield Unit based thresholding and manually outlining of the tumour, a 40cm CT data set (slice thickness 5mm) is segmented and down scaled to a resolution of 1cm, requiring only 30min. The SAR model is based on the finite-difference time-domain (FDTD) method. The number of time steps to achieve numerical stability has been determined and was found to be 7000. Various optimizations of the SAR model have been applied, resulting in a relatively short computation time of 3.7h (memory requirements 121MB) on a Pentium III, 450MHz standard personal computer, running GNU/Linux. The model has been validated using |Ez| measurements in a standard phantom inserted in the Coaxial TEM Applicator under different conditions and a good agreement was found. Hyperthermia treatment planning in combination with the homemade visualization tools have provided much insight in the regional hyperthermia treatment with the Coaxial TEM Applicator.

Regional hyperthermia applicator design using FDTD modelling

Recently published results confirm the positive effect of regional hyperthermia combined with external radiotherapy on pelvic tumours. Several studies have been published on the improvement of RF annular array applicator systems with dipoles and a closed water bolus. This study investigates the performance of a next-generation applicator system for regional hyperthermia with a multi-ring annular array of antennas and an open water bolus. A cavity slot antenna is introduced to enhance the directivity and reduce mutual coupling between the antennas. Several design parameters, i.e. dimensions, number of antennas and operating frequency, have been evaluated using several patient models. Performance indices have been defined to evaluate the effect of parameter variation on the specific absorption rate (SAR) distribution. The performance of the new applicator type is compared with the Coaxial TEM. Operating frequency appears to be the main parameter with a positive influence on the performance. A SAR increase in tumour of 1.7 relative to the Coaxial TEM system can be obtained with a three-ring, six-antenna per ring cavity slot applicator operating at 150 MHz.

Treatment planning for capacitive regional hyperthermia

Capacitively coupled hyperthermia devices are widely in use, mainly in Asian countries. In this paper, a comprehensive treatment planning system, including a Specific Absorption Rate (SAR) and thermal model for capacitively coupled hyperthermia, is described and demonstrated using a heterogeneous patient model. In order to accurately model a hyperthermia treatment, simulation at high resolution is mandatory. Using the quasi-static approximation, the electromagnetic problem can be solved at high resolution with acceptable computational effort. The validity of the quasi-static approximation is demonstrated by comparing the Maxwell solution of a phantom problem to the quasi-static approximation. Modelling of capacitive hyperthermia of the prostate reveals the difficulty of heating deep-seated tumours in the pelvic area. Comparison of the SAR distribution in the heterogeneous patient model and a patient shaped agar phantom shows a shielding effect of the pelvic bone and the influence of the fat-muscle distribution. It is shown that evaluation of capacitive hyperthermia with agar phantoms leads to overly optimistic conclusions. Therapeutic relevant tumour temperatures can only be obtained by permitting temperature extrema in normal tissue. This concurs with clinical practice, where treatment-limiting hot spots restrict the tumour temperature. It is demonstrated that the use of very cold overlay bolus bags has only a very superficial effect. The presented model can be used for individual treatment planning and optimization, for the evaluation of capacitive applicator modifications and comparison with other devices.

Calculation of SAR and temperature rise in a high-resolution vascularized model of the human eye and orbit when exposed to a dipole antenna at 900, 1500 and 1800 MHz

The eye is considered to be a critical organ when determining safety standards for radiofrequency radiation. With a detailed anatomy of the human eye and orbit inserted in a whole-head model, the specific absorption rates (SARs) and thermal effects were determined under exposure to a dipole antenna representing a mobile phone operating at 900, 1500 and 1800 MHz with an output power of 1 W. The temperature rise was calculated by taking the blood flow into account either by the Pennes bioheat model or by including the discrete vasculature (DIVA). In addition, a simple spherical model using constant heat transfer coefficients was used. Peak SARs in the humour are 4.5, 7.7 and 8.4 W kg(-1) for 900, 1500 and 1800 MHz respectively. Averaged over the whole eyeball, the SARs are 1.7, 2.5 and 2.2 W kg(-1). The maximum temperature rises in the eye due to the exposure are 0.22, 0.27 and 0.25 degrees C for exposure of 900, 1500 and 1800 MHz, respectively, calculated with DIVA. For the Pennes bioheat model, the temperature rises are slightly lower: 0.19, 0.24, 0.22 degrees C respectively. For the simple spherical model, the maximum temperature rises are 0.15, 0.22 and 0.20 degrees C. The peak temperature is located in the anterior part of the lens for 900 MHz and deeper in the eye for higher frequencies, and in the posterior part of the lens for 1500 MHz and close to the centre of the eyeball for 1800 MHz. For these RF safety applications, both DIVA and the Pennes bioheat model could be used to relate the SAR distributions to the resulting temperature distributions. Even though, for these artificial exposure conditions, the SAR values are not in compliance with safety guidelines, the maximum temperature rises in the eye are too small to give harmful effects. The temperature in the eye also remains below body core temperature.

Uniform prostate imaging and spectroscopy at 7 T: comparison between a microstrip array and an endorectal coil

An endorectal coil and an eight‐element microstrip array were compared for prostate imaging at 7 T. An extensive radiofrequency safety assessment was performed with the use of finite difference time domain simulations to determine safe scan parameters. These simulations showed that the endorectal coil can deliver substantially more B  1+ to the prostate than can the microstrip array within the specific absorption rate safety guidelines. However, the B  1+ field of the endorectal coil is very inhomogeneous, which makes the use of adiabatic pulses compulsory for T1‐ or T2‐weighted imaging. As a consequence, a full prostate examination is only possible in a feasible amount of time when the microstrip array is used for T1‐ and T2‐weighted imaging, whereas the endorectal coil is required for spectroscopic imaging. The pulse parameters were optimised within the specific absorption rate guidelines and thereafter used to provide a good illustration of the possibilities of prostate imaging at 7 T. Copyright

The use of MR B+1 imaging for validation of FDTD electromagnetic simulations of human anatomies

In this study, MR B(+)(1) imaging is employed to experimentally verify the validity of FDTD simulations of electromagnetic field patterns in human anatomies. Measurements and FDTD simulations of the B(+)(1) field induced by a 3 T MR body coil in a human corpse were performed. It was found that MR B(+)(1) imaging is a sensitive method to measure the radiofrequency (RF) magnetic field inside a human anatomy with a precision of approximately 3.5%. A good correlation was found between the B(+)(1) measurements and FDTD simulations. The measured B(+)(1) pattern for a human pelvis consisted of a global, diagonal modulation pattern plus local B(+)(1) heterogeneties. It is believed that these local B(+)(1) field variations are the result of peaks in the induced electric currents, which could not be resolved by the FDTD simulations on a 5 mm(3) simulation grid. The findings from this study demonstrate that B(+)(1) imaging is a valuable experimental technique to gain more knowledge about the dielectric interaction of RF fields with the human anatomy.

Comparison of intra-luminal versus intra-tumoural temperature measurements in patients with locally advanced prostate cancer treated with the coaxial TEM system: report of a feasibility study

A study was performed on regional hyperthermia for patients with locally advanced prostate carcinoma. The primary objective was to analyse the thermometry data with an emphasis on the possibility of replacing invasive thermometry by tumour-related intra-luminal thermometry. Fourteen patients were treated with a combination of conformal external beam radiotherapy (70 Gy) and hyperthermia. Hyperthermia was delivered using the Coaxial TEM system, one treatment per week, to a total of five treatments. Thermometry was performed in bladder, urethra, rectum and esophagus. Invasive thermometry in the prostate was carried out during one or two treatments for each patient by placing transperineally a central and a peripheral catheter. Heterogeneous temperature distributions were measured in the prostate. The mean average invasive temperature range was 1.1°C. Due to the temperature heterogeneity and a limited number of thermometry sensors (mean 7, range 2-13), large variability between treatments and patients existed regarding achieved temperatures and dose. The mean invasive T 90 was 40.2 - 0.6°C and T 50 was 40.8 - 0.6°C. The mean Cum min T 90 >40.5°C per treatment was 22 (range 0-50). Importantly, intra-luminal temperatures did not reliably predict invasively measured temperatures. Invasive thermometry, therefore, remains compulsory to calculate a thermal dose for an individual patient. Changes in temperature during treatment, measured by the urethral sensors, corresponded well with changes in temperature measured by the individual invasive sensors. Similar comparison of rectal temperature changes with intra-prostatic temperature changes was not as predictive. The similarity in temperature changes between the urethral and interstial sites, suggests that urethral temperatures are sufficient for treatment optimization. The SAR profile did not correspond with the temperature profile indicating heterogeneous perfusion. Although regional hyperthermia in combination with external beam radiotherapy for locally advanced prostate carcinoma is clinically feasible, the question on the importance of invasive thermometry remains.

Coaxial waveguide for travelling wave MRI at ultrahigh fields

At high magnetic fields the performance of a volume‐type body coil inside a human sized MR‐scanner is influenced by the waveguide action of the scanners bore. This can result in undesirable strong radio frequency fields B1+ ) outside the coils target volume. A radio frequency (RF) transmit system, exploiting this waveguide action of the bore, is proposed in this work. A coaxial waveguide section is introduced between the antenna and the imaging region. It is shown that the coaxial waveguide has several advantages over the initially proposed travelling wave setup based on the cylindrical waveguide. First, a novel radio frequency matching principle (based on the transmission line impedance matching) is feasible with the coaxial waveguide achieving better radio frequency transmission characteristics, such as homogeneity and power efficiency of B1+ field. In case of body torso imaging, the coaxial waveguide prevents unwanted specific absorptive rate (SAR) deposition outside the target region and thus, effectively decreases local peak SAR values by factor of 5. A 3‐fold B1+ gain in the prostate can be achieved with the coaxial waveguide in comparison with the initially proposed travelling wave setup. Magn Reson Med 70:875–884, 2013.

Quasistatic zooming for regional hyperthermia treatment planning

Due to current computer limitations, specific absorption rate (SAR) distributions in regional hyperthermia treatment planning (HTP) are limited to centimetre resolution. However, since patient anatomy is highly structured on a millimetre scale, millimetre-resolution SAR modelling is required. A method called quasistatic zooming has been developed to obtain a high-resolution SAR distribution within a volume of interest (VOI): using the low-resolution E-field distribution and the high-resolution patient anatomy, the high-resolution SAR distribution is computed within a small zoom volume Q (small compared with the wavelength in water (lambda(w))). Repeating this procedure yields the zoomed-resolution SAR distribution in an arbitrary VOI. To validate this method for a VOI that is not small compared with lambda(w), high-resolution finite-difference time-domain (FDTD) modelling is needed. Since this is impractical for a clinical applicator, a computer model of a small applicator has been created. A partial patient anatomy is inserted into the applicator and both high- and low-resolution SAR distributions are computed for this geometry. For the same geometry, zoomed-resolution SAR distributions are computed with different sizes of Q. To compare the low- and zoomed-resolution SAR distributions with the high-resolution one, the correlation and averaged absolute difference are computed. These numbers are improved considerably using zooming (correlation 58% to 92%; averaged absolute difference 43% to 20%). These results appear to be independent of the size of Q, up to 0.3 lambda(w). Quasistatic zooming is a valuable tool in high-resolution regional HTP.