Termal Terapilerin Yönlendirilmesinde Çift Yollu Sekanslar Kullanarak Manyetik Rezonans Termometrisinin Sıcaklık-Gürültü Oranını Artırmak için 1.5T, 3T ve 7T’de Organa Özgü Öneriler

Amaç: Termal tedaviler, cerrahi müdahaleye minimal invaziv alternatifler sağlar. Güvenlik ve etkinlikleri, doğru sıcaklık izleme gerektirir. Manyetik rezonans (MR) termometrisinin sıcaklık/ gürültü oranının (TNR), çift yollu sekanslarla 3T manyetik alan değerinde dokuya özgü parametreler kullanılarak artırılabileceği daha önce gösterilmiştir. Bu çalışma, daha fazla dokuda 1.5T, 3T ve 7T manyetik alan güçlerinde, doğruluk ve hız artırabilmek için, kapsamlı öneriler sunar. Gereç ve Yöntemler: Çift yollu bir ‘Kararlı-Hal-Serbest-Devinim-Hızlı-Görüntüleme’ (FISP)-‘ters FISP’(PSIF) sekansının TNR’si, daha geleneksel bir çift FISP ile karşılaştırıldı. Analitik çözümler, TNR hesaplamaları ve Monte Carlo simülasyonları ile yazılım doğrulandı. Öneriler, 1.5T ve 3T’de meme glandüler ve yağ dokusu, miyometriyum, endometriyum, serviks, karaciğer, prostat, pankreas, dalak, miyokard, optik sinir ve omurilik; 1.5T, 3T ve 7T’de gri madde, beyaz madde, böbrek medulla ve korteks, iskelet kası, yağ, kıkırdak ve kemik iliği için, geliştirildi. Bulgular: PSIF-FISP kullanımı, TR azaldıkça TNR’yi büyük ölçüde artırırken, sapma-açısı arttıkça ise TNR’yi hafifçe artırmıştır. Özellikle, böbrek, uterus, prostat, dalak, optik sinir ve omurilikte çoğu parametre ayarında ve alan değerinde iyileşme görülmüştür. Ek olarak, karaciğer, pankreas, kıkırdak, iskelet kası, miyokard ve memede yalnızca kısa tekrar-süresi (TR) ayarlarında iyileşme görülmüştür. Beyinde 1.5T ve 3T’de çoğu parametre ayarlarında iyileşme görülürken, iyileşme 7T’de azalmıştır. Yağ ve kemik iliğinde 1.5T’de çoğu parametre ayarında iyileşme görülürken, iyileşme 3T ve 7T’de azalmıştır. Servikste ise 3T’de çoğu parametre ayarlarında yaygın iyileşme görülürken, 1.5T’de yalnızca kısa TR ayarlarında iyileşme görülmüştür. Sonuç: MR termometrisi TNR ve görüntü elde etme hızı, çift yollu dizinlerle hedef dokuya ve manyetik alan değerine göre seçilen parametreler kullanılarak, önemli ölçüde artırılabilir.

Organ-Specific Recommendations for Increasing Temperature- To-Noise Ratio of Magnetic Resonance Thermometry Using Dual-Pathway Sequences at 1.5T, 3T, and 7T during Guidance of Thermal Therapies

Objective: Thermal therapies provide minimally-invasive alternatives to surgery. Their safety andefficacy require accurate temperature monitoring. Dual-pathway sequences were shown to improvemagnetic resonance (MR) thermometry temperature-to-noise-ratio (TNR) using tissue specificparameters at 3T. This study provides expanded guidance for increasing accuracy and speed, across awider range of tissue types at magnetic field strengths 1.5T, 3T and 7T.Material and Methods: TNR of a dual-pathway ‘Fast-Imaging-with-Steady-state-free-Precession’(FISP)-‘inverted-FISP’ (PSIF) sequence was compared to a more conventional dual-FISP. Softwarewas validated against analytical solutions, TNR calculations and Monte Carlo simulations.Recommendations were developed for breast glandular tissue and fat, myometrium, endometrium,cervix, liver, prostate, pancreas, spleen, myocardium, optic nerve and spinal cord at 1.5T and 3T; andfor gray matter, white matter, kidney medulla and cortex, skeletal muscle, fat, cartilage, bone marrowat 1.5T, 3T, and 7T.Results: TNR improved using PSIF-FISP: in the kidney, uterus, prostate, spleen, optic nerve andspinal cord at most parameters and fields; in the liver, pancreas, cartilage, skeletal muscle, myocardium,and breast at only short repetition-times (TR); in the brain at 1.5T and 3T across most parameters, butthe benefits decreased at 7T; in fat and bone marrow at 1.5T across most parameters, but the benefitsdecreased at 3T and 7T; and in the cervix at 1.5T at only short TRs, and at 3T with widespreadbenefits at most parameters. In all cases, PSIF-FISP improved TNR greatly as TR decreased, andslightly as the flip-angle increased.Conclusion: MR thermometry TNR and speed can increase considerably using dual-pathwaysequences with parameters selected based on target tissue and magnetic field strength.

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