title: Radiofrequency Ablation, MR Thermometry, and High-Spatial-Resolution MR Parametric Imaging with a Single, Minimally Invasive Device.
abstract: Purpose To develop and demonstrate in vitro and in vivo a single interventional magnetic resonance (MR)-active device that integrates the functions of precise identification of a tissue site with the delivery of radiofrequency (RF) energy for ablation, high-spatial-resolution thermal mapping to monitor thermal dose, and quantitative MR imaging relaxometry to document ablation-induced tissue changes for characterizing ablated tissue. Materials and Methods All animal studies were approved by the institutional animal care and use committee. A loopless MR imaging antenna composed of a tuned microcable either 0.8 or 2.2 mm in diameter with an extended central conductor was switched between a 3-T MR imaging unit and an RF power source to monitor and perform RF ablation in bovine muscle and human artery samples in vitro and in rabbits in vivo. High-spatial-resolution (250-300-μm) proton resonance frequency shift MR thermometry was interleaved with ablations. Quantitative spin-lattice (T1) and spin-spin (T2) relaxation time MR imaging mapping was performed before and after ablation. These maps were compared with findings from gross tissue examination of the region of ablated tissue after MR imaging. Results High-spatial-resolution MR imaging afforded temperature mapping in less than 8 seconds for monitoring ablation temperatures in excess of 85°C delivered by the same device. This produced irreversible thermal injury and necrosis. Quantitative MR imaging relaxation time maps demonstrated up to a twofold variation in mean regional T1 and T2 after ablation versus before ablation. Conclusion A simple, integrated, minimally invasive interventional probe that provides image-guided therapy delivery, thermal mapping of dose, and detection of ablation-associated MR imaging parametric changes was developed and demonstrated. With this single-device approach, coupling-related safety concerns associated with multiple conductor approaches were avoided.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Park 310, Baltimore, MD 21287.
authors.forename: M Arcan
authors.initials: MA
authors.lastname: Ertürk
authors.affiliation: From the Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Park 310, Baltimore, MD 21287.
authors.forename: Shashank
authors.initials: S
authors.lastname: Sathyanarayana Hegde
authors.affiliation: From the Department of Radiology, Johns Hopkins University, 600 N Wolfe St, Park 310, Baltimore, MD 21287.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Bottomley
mesh_terms: D000818:Animals; D001011:Aorta / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D017115:Catheter Ablation / Q000295:instrumentation*; D002417:Cattle; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D006358:Hot Temperature; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D011817:Rabbits; D012077:Renal Artery / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D013552:Swine; D013817:Thermography / Q000295:instrumentation*