EP1233699A1 - Surveillance par resonance magnetique de therapie par voie thermique - Google Patents

Surveillance par resonance magnetique de therapie par voie thermique

Info

Publication number
EP1233699A1
EP1233699A1 EP99974183A EP99974183A EP1233699A1 EP 1233699 A1 EP1233699 A1 EP 1233699A1 EP 99974183 A EP99974183 A EP 99974183A EP 99974183 A EP99974183 A EP 99974183A EP 1233699 A1 EP1233699 A1 EP 1233699A1
Authority
EP
European Patent Office
Prior art keywords
tissue
heat
echo
gradient
applying
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP99974183A
Other languages
German (de)
English (en)
Other versions
EP1233699A4 (fr
Inventor
Harvey Cline
Christopher J. Hardy
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
InSightec-TxSonics Ltd
Original Assignee
InSightec-TxSonics Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by InSightec-TxSonics Ltd filed Critical InSightec-TxSonics Ltd
Publication of EP1233699A1 publication Critical patent/EP1233699A1/fr
Publication of EP1233699A4 publication Critical patent/EP1233699A4/fr
Withdrawn legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • G01R33/4804—Spatially selective measurement of temperature or pH
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • G01R33/54—Signal processing systems, e.g. using pulse sequences ; Generation or control of pulse sequences; Operator console
    • G01R33/56—Image enhancement or correction, e.g. subtraction or averaging techniques, e.g. improvement of signal-to-noise ratio and resolution
    • G01R33/563—Image enhancement or correction, e.g. subtraction or averaging techniques, e.g. improvement of signal-to-noise ratio and resolution of moving material, e.g. flow contrast angiography
    • G01R33/56308—Characterization of motion or flow; Dynamic imaging

Definitions

  • This invention is concerned with noninvasive or minimally invasive surgical procedures, and more particularly, to minimally invasive surgery using locally generated heat that is monitored and positioned by magnetic resonance imaging methods.
  • the present invention relates to surgery by necrosis caused by heat focused on tumorous tissue and guided by magnetic resonance (MR) imaging (MRI) methods.
  • MR magnetic resonance
  • MRI magnetic resonance
  • the pulsed heat means presently in use includes, among other things, coherent optical heat sources guided by laser fiber to the tissue to be destroyed.
  • Another often used heat source for such surgical use utilizes pulsed heat means that is generated by a focused ultrasound transducer dissipating ultrasonic energy at a focal point within a region of tissue to be destroyed.
  • the prior art performs thermal surgery guided by MRI procedures and systems to selectively destroy tumorous tissue in the patient with localized heating, without adversely affecting healthy tissue.
  • the heat is applied to the tumor tissue in a pulsed or oscillating fashion.
  • the pulsed energy creates a heat focus that heats either at the tip of the optical fiber, or at the focal point of the transducer, depending on the heat source.
  • the heated tumorous region may be imaged with the use of the MRI systems, employing a temperature sensitive MR pulse sequence to acquire a temperature "map" that is used basically to assure that the heat is being applied to the tumorous tissue and not to the surrounding healthy tissue. This is done by applying a quantity of heat that is insufficient to cause necrosis but is sufficient to raise the temperature of the heated tissue.
  • the MRI temperature map shows whether or not the heat is applied to the previously located tumorous tissue.
  • the imaging system is also used in a separate scan sequence to create an image of the tissue intended to be destroyed. Using the imaging system in the prior art, the operator of the apparatus adjusts the placement of the radiation on the site of the tissue to be destroyed.
  • the MR image of the tumor acquired in the separate scan determines in real time if necrosis is occurring and effectively ablating the tumorous tissue.
  • the monitoring and guiding are provided using separate two- dimensional scan sequences.
  • MRI Magnetic Resonance Med.
  • vol. 36 pp. 745-752; 1996.
  • MRI monitor in the prior art is known to display both the temperature elevation and tissues during the treatment, but the prior art uses separate two-dimensional scan sequences.
  • This non-invasive temperature monitoring is important for two reasons. First, the detection ofthe transient low-temperature elevation is crucial for localization ofthe low-power focused ultrasound beams and tissues, before the high-powered thermal therapy exposure, to accurately position the heat focus. Second, the measurement of the degree of temperature elevation is important to accurately quantify the thermal dose induced by the heat source. The measured temperature is used to verify whether enough thermal dose is delivered to necrose the targeted tissues. So, in the prior art both a temperature measuring image and a separate tissue-image acquired during different scan sequences are used.
  • MRI methods that have been used in the past for measuring temperatures using well-known MRI parameters, such as the spin-lattice relaxation time Tl, the time to repeat (TR), the time to echo TE, and the flip angle.
  • temperature maps are generated based on such procedures that provide Tl derived images i.e., proton resonance frequency shift (PRFS) sequences, evaluated with fast spoiled gradient echo sequences applied during the actual thermal therapy exposure.
  • PRFS proton resonance frequency shift
  • the parameters used are to some degree based on the tissue type and the precise evaluation of the behavior due to physiological or metabolic changes in the tissue during thermal therapy exposure.
  • TE, TR and the flip angle of the spoiled gradient echo have been used for localizing the low-temperature elevation induced by a focused ultrasound beam during both the planning and treatment.
  • the MRI equipment in the prior art is also used for viewing the volume of ablated tissue with T2 weighted fast spin echo images.
  • a plurality of images using MRI are required to properly monitor the thermal therapy.
  • a two-dimensional scan is made to locate the tumorous tissue, then another multi-dimensional scan is made to acquire an image to assure that the heat is being applied to the tumorous tissue. This is done with the temperature imaging, while the power used on the heat source is such that the temperature is kept below the necrosis value; i.e., the temperature needed for ablation or coagulation.
  • the MRI locating and monitoring of the applied heat has been accomplished using two images, each acquired with a two-dimensional scan.
  • the necessity of requiring two separate scans reduces the efficiency of the thermal therapy. It precludes monitoring both temperature and ablation simultaneously.
  • An aspect of a preferred embodiment of the present invention is to most efficiently ablate tumorous tissue while non-invasively simultaneously, continuously monitoring and controlling the ablation with MRI systems.
  • the necrosis is caused by applied heat.
  • the heat source may be generated by focused ultrasound, by microwave radiation, or by laser beams directed through laser fiber optics.
  • the heat source is preferably a pulsed source used to selectively destroy tumorous tissue of the patient with the minimum amount of surgery and without damage to su ⁇ ounding healthy tissue.
  • a system for selectively applying heat to destroy tumorous tissue while using a one-dimensional (line scan) imaging sequence to simultaneously, continuously monitor both the temperature of the tumorous tissue and the tumorous tissue itself in a time frame that is presently used to generate either the temperature or the tissue display.
  • line scans are accomplished using intersecting slices or cylindrical excitation regions such as disclosed in U.S. Patents 4,995,394, 5,307,812 and 5,327,884, the disclosures of which are hereby incorporated herein by reference.
  • the line is not rastered through space, but is instead repeatedly excited and read out from a single location to provide a time-dependent scrolling display of intensities along the line.
  • An aspect ofthe invention contemplates using a double-echo MR line scan sequence to generate two parallel scrolling displays during the heat therapy.
  • the two displays are generated in the same time period that one display is normally generated.
  • One of the displays provides a temperature map; the second display provides images of tissue damage by showing tissue intensity values.
  • the system guides or monitors thermal therapy using MRI apparatus, whereby heat is selectively applied for destroying tumorous tissue while two MRI displays are simultaneously generated.
  • One ofthe two displays may be a Tl derived temperature map used to monitor the temperature at the tumorous tissue, and the other display may be a T2 weighted display that images edematious regions for evaluating the necrosed image volume.
  • Simultaneously as used herein means during the same scan sequence, such as for example a double echo MR line scan sequence.
  • a prefe ⁇ ed aspect of the present invention is a method for performing thermal therapy on tumorous tissue using MRI apparatus and a source of radiant heat, selectively applying heat to the tumorous tissue using a 1-D scanning sequence to simultaneously monitor both the temperature ofthe tumorous tissue and the heat caused tissue damage in the tumorous tissue.
  • apparatus for guiding and monitoring thermal therapy comprising a heat source for selectively applying heat for destroying tumorous tissue, and magnetic resonance imaging (MRI) apparatus for performing a line scanning sequence to generate and monitor two displays in the same scan, one display being of temperature responsive data and the other display being an image of selected tissue.
  • MRI magnetic resonance imaging
  • a control processor for doing a double echo scan to acquire the two displays in a single scan is provided.
  • both displays are displays of the same selected tissue.
  • the display of the temperature responsive data encompasses a larger region than the display that is an image of selected tissue.
  • the MRI apparatus for performing the line scanning sequence includes a pencil beam generator for generating a pencil beam, and a read-out gradient for reading out MR signals along the pencil beam.
  • the cross-section of the pencil beam is cylindrical.
  • the cross-section of the pencil beam is non-cylindrical.
  • the MRI apparatus for performing the line scanning sequence includes an intersecting plane generator for generating intersecting planes to provide lines at the intersections of the planes, and a read-out gradient generator for reading out MR signals along the lines.
  • the pencil beam generator includes a first gradient generator for applying a first-time varying magnetic field gradient in a first direction and a second gradient generator for applying a second time varying magnetic field gradient in a second direction orthogonal to the first direction, and a synchronizer for applying both said first gradient and said second gradient substantially simultaneously with an RF excitation pulse so as to provide an elongated excitation region in said patient.
  • the apparatus includes a control processor for applying a first read-out gradient in a manner that provides a Tl weighted display; and for applying a second read-out gradient in a manner that provides a T2 weighted display.
  • the heat source for selectively applying heat for destroying tumorous tissue comprises laser means for selectively applying a laser light beam to said tumorous tissue.
  • the heat source for selectively applying heat for destroying tumorous tissue comprises means for selectively applying ultrasound energy to said tumorous tissue.
  • the apparatus includes a control processor for temperature encoding said first echo with a Tl weighted read-out gradient and for tissue intensity encoding said second echo with a T2 weighted read-out gradient.
  • the control processor temperature encodes said first echo with diffusion of magnetic gradient fields.
  • the apparatus includes an image processor for reconstructing said first and second echoes to generate magnetization profiles, the profile of the first echo indicating the temperature of tissue along the length of the excitation region and the profile of the second echo showing tissue intensity values along the length of the excitation region, said heat source applying pulsed heat at a predetermined pulse frequency, and heat source controls for controlling the heat source to adjust the frequency and position of the heated region so as to heat the specified tissue without substantial damage to adjacent tissue.
  • said image processor reconstructs using one-dimensional Fourier Transformations.
  • the heat source for applying heat comprises a focused ultrasonic heat source for focusing ultrasonic waves on an application point, and a position controller for positioning the application point at a predetermined location within the specified tissue.
  • the heat source is a phased a ⁇ ay ultrasonic transducer.
  • the heat source for applying pulsed heat comprises a generator for generating optical energy, and an optical fiber for transferring the optical energy to a predetermined application point positioned at a predetermined location within the specified tissue.
  • a magnetic resonance (MR) monitored heat system for allowing an operator to selectively heat tissue within a patient, comprising a heat producing source adopted for concentrating energy at an application point in a patient; a heat source positioner for positioning the application point of the heat producing source in a specified tissue within the patient so as to create a heated region within the specified tissue; a controller for enabling said operator to control the positioner; MR apparatus comprising: a radio- frequency (RF) transmitter for transmitting an RF excitation pulse into said patient; gradient generators for producing a time-varying magnetic field gradient in a first direction and a time- varying magnetic field gradient in a second direction orthogonal to the first direction, both gradients applied substantially simultaneously with the RF excitation pulse for exciting longitudinal magnetization of an elongated excitation region in said patient; a control processor for applying first and second read-out gradients to the elongated excitation region; an RF receiver for receiving first and second echo signals from the elongated excitation region responsive to the application of said first and second read
  • the heat source comprises: a source of pulsed optical energy; an invasive device adapted for insertion into the patient to reach the specified tissue of the patient; and an optical fiber having a first end and a second end, said first end adapted to be fitted into the invasive device, within the specified tissue, when said second end is proximate to the pulsed heat producing source, the fiber being adapted to pass the optical energy from the pulsed heat- producing source into the specified tissue.
  • the heat-producing source comprises a laser.
  • the heat-producing source comprises: an ultrasonic transducer adapted for generating pulsed ultrasonic energy concentrated at a focal point, the focal point being the application point.
  • MR monitored heat system for enabling an operator to selectively heat tissue within a patient comprising: a heat source adapted for concentrating heat at an application point; a positioner for positioning the application point of the heat in a specified tissue within the patient so as to create a heated region within the specified tissue; an operator responsive control for enabling said operator to control the positioning means; an MR imaging means comprising: a homogenous magnetic field applied to said patent to align spins in the patient; a radio frequency (RF) transmitter for applying an RF pulse for tipping said spins into a transverse plane; first and second gradient generators for transmitting a first and a second time-varying gradient during the application of the RF pulse, said first and second gradients being orthogonal to each other, said RF pulse being the two- dimensional Fourier transform of a desired excitation profile; and a third gradient generator for transmitting first and second read-out gradients to provide a first echo signal and a second echo signal, said first echo signal providing a temperature profile at the specified tissue and
  • RF radio frequency
  • the pencil beam is generated by applying a time varying magnetic field gradient in a first direction and a time varying magnetic field gradient in a second direction orthogonal to the first direction; and applying both gradients simultaneously with an RF excitation pulse so as to excite longitudinal magnetization of an elongated excitation region in said patient.
  • a first read-out gradient is supplied in a manner that provides a Tl weighted display; and a second read-out gradient is supplied in a manner that provides a T2 weighted display.
  • selectively applying heat for destroying tumorous tissue comprises selectively applying a laser light beam to said tumorous tissue.
  • selectively applying heat for destroying tumorous tissue comprises applying ultrasound energy to said tumorous tissue.
  • a method of performing thermal surgery on a patient guided by MRI comprising: creating an internal image of tissues of said patient; determining the position of a specified tissue in the patient; applying pulsed heat at a predetermined pulse frequency to the specified tissue to create a heated region within the specified tissue; monitoring the heated region with MRI by: transmitting an RF excitation pulse into said patient; applying a time varying magnetic field gradient in a first direction, and a time varying magnetic field gradient in a second direction, , both gradients applied during the RF excitation pulse so as to excite longitudinal magnetization of an elongated excitation region in said patient; applying a first read-out gradient designed to produce a first echo; applying a second read-out gradient designed to produce a second echo; and using the first echo to acquire a first display and the second echo to acquire a second display.
  • the method includes temperature encoding said first echo with a Tl weighted readout gradient and tissue intensity encoding said second echo with a T2 weighted read-out gradient.
  • temperature encoding includes temperature encoding said first echo with diffusion of magnetic gradient fields.
  • the method includes applying one-dimensional Fourier transformations to the echo signals to generate magnetization profiles, the profile of the first echo indicating the temperature of tissue along the length of the excitation region and the profile of the second echo showing tissue intensity values along the length of the excitation region and adjusting the frequency and position of the pulsed heat so as to heat the specified tissue without substantial damage to adjacent tissue.
  • applying pulsed heat comprises: focusing ultrasonic waves on an application point and positioning the application point at a predetermined location within the specified tissue.
  • applying pulsed heat comprises: creating optical energy; transferring the optical energy through an optical fiber to a predetermined application point; and positioning the application point at a predetermined location within the specified tissue.
  • Fig. 1 is a schematic block diagram of an embodiment ofthe present invention
  • Fig. 2 is a cross sectional view of a patient positioned for thermal surgery within the bore of the magnet of one embodiment of the present invention, employing a focused ultrasound heat source;
  • Fig. 3 is a partial perspective cutaway view of a patient positioned for thermal surgery within the bore of the magnet of another embodiment of the present invention employing a laser heat source and a fiber optics heat delivery system;
  • Fig. 4 is a double echo scan sequence used to simultaneously perform line scanning and temperature mapping of the tumorous and/or immediately surrounding tissue, in accordance with a preferred embodiment ofthe invention
  • Fig. 5 is a 2-D image generated during the planning stage or the post-heating stage of the present invention.
  • Fig. 1 shows a typical MRI system 11 comprising a magnet 12 for receiving a patient therein.
  • the magnet is a super-conducting magnet, but within the scope of this invention other types of magnets can be used.
  • a large static, relatively homogeneous magnetic field Bo is generated by field generator Ho indicated at 13.
  • the large static field causes certain nuclei ("spins") to align with the static field.
  • Gradient fields are generated by gradient field generators Gx indicated at 14,
  • the gradient fields are used to vary the large magnetic field in a known manner. According to convention, the gradient fields are a ⁇ anged orthogonally in X, Y and Z directions, as shown by the orthogonally directed arrows at 20.
  • the field Bo is conventionally in the Z direction.
  • Means are provided for generating radio-frequency (RF) pulses for "flipping" the aligned spins into a transverse plane such as the XY plane or to have a component in the XY plane.
  • the means for flipping the spins comprises RF coils (not shown) in the magnet and a pulse transmitter 18.
  • the pulse transmitter frequency may be supplied by synthesizer 19 and controlled by control processor or controller 21.
  • the controller 21 controls, among other things, the time and amplitude of the outputs of the various component parts making up the MRI system.
  • the transmitted pulse goes from the transmitter 18 through a transmitter-receiver selection switch 22 to an RF coil (not shown) in the magnet.
  • the synthesizer signal is coupled to the transmitter 18 when the system is in the transmitting mode through a second transmitter- receiver selection switch 23.
  • the RF coil in the magnet senses free induction decay (FID) signals, including echo signals.
  • FID free induction decay
  • the signals received at the RF coil go through switch 22 when it is switched by controller 21 into the receiving mode to connect the RF coil to the receiver.
  • Separate RF coils can be used for receiving and transmitting within the scope ofthe invention.
  • the received signal then passes through an analog-to-digital converter 25.
  • the digital output of the converter 25 is applied to an image processor 26 having an associated memory 27 to provide an image in display unit 28 using reconstruction methods such as fast Fourier Transforms.
  • the control processor 21, as shown, is connected to a surgical control unit 29 which controls a heat source 30 that generates the heat used to destroy the tumorous tissue.
  • the magnetic resonance system is used both for monitoring the temperature at the focal point of the heat, that is at the tumorous tissue, and for monitoring the necrosis at the tumorous tissue.
  • patient 31 is located on a bed or table 32, designed to accommodate a heat source such as an ultrasound transducer 33 in a water bath 34.
  • a focused ultrasound transducer is shown, however, a phased a ⁇ ay ultrasound transducer having controllable focal points can be used.
  • the focal point ofthe transducer is shown at 36.
  • the patient-table ultrasound unit and water bath are all shown mounted within the bore 38 of the magnet 12.
  • An alternative embodiment may utilize an ultrasound transducer that creates heat over a line segment instead of a point.
  • the ultrasound transducer 33 can alternatively be moved inside the bore ofthe magnet to different locations so as to focus on different locations within the patient.
  • the ultrasound unit itself can be a phased a ⁇ ay ultrasound transducer, enabling electronically moving the focal point.
  • a patient 41 lies on a table 42 that moves into the bore 43 of the magnet 12.
  • a laser fiber 44 is inserted into the patient with a hollow needle 46, guided by a mechanical positioning device indicated at 47.
  • the positioning device preferably is a hydraulic positioner. While a closed type magnet 12 is shown, the magnet can also be an open type magnet such as shown, for example, in U.S. Patent 5,119,372, the disclosure of which is hereby incorporated herein by reference.
  • a safe trajectory from the entry point to the target that does not intersect critical anatomy, such as large blood vessels is determined during the preplanning stage of the operation.
  • Heat is applied to the tumorous tissue 48 by periodically pulsing the laser through a fiber-optic material 44 and needle 46 to destroy the tumor 48, while the operator views the temperature-sensitive magnetic resonance images. While one needle 46 is shown, more than one needle may be required to remove an i ⁇ egularly shaped tumor.
  • a heat source that creates heat at a point as shown, a heat source that creates heat over a line segment instead of a point may be utilized.
  • images are acquired to locate the tumorous tissue.
  • images are acquired, according to prefe ⁇ ed aspects of the invention for example, temperature elevation during heat exposure is monitored by using scans that provide Tl weighted images such as through the diffusion of magnetic field gradients or by using proton resonance frequency shift images or with fast gradient echo sequence images.
  • tissue is imaged with T2 weighted fast spin echo images.
  • Both images are acquired using cylindrical excitation beams, also known as pencil beams for performing line scanning, rather than 2-D scanning or volume scanning. By using pencil beams, the line scanning can be readily oriented in real time along non-orthogonal lines aligned with the tumorous tissue, wherever that may be.
  • the line scanning is not necessarily limited to orthogonal axes, but can be used at any line location following the tumorous tissue.
  • the pencil beams can be individually shaped.
  • a rectangular cross-section pencil beam is acquired using crossed selective 80 and 90 degree pulses with spin echo imaging.
  • Circular cross-sections are acquired with selective 90 degree pulses in a selective spiral acquisition scan.
  • line scanning could be accomplished using intersecting slices.
  • a double echo sequence is used that involves an RF selective pulse 51 , followed by two readout gradient echo signals directed along the axis of the beam.
  • the first echo signal is used to measure the temperature, for example using the proton resonance frequency shift method.
  • the second echo measures the tissue T2 property, which images the heat treatment of the tumorous anatomy. This provides an image of the tissue when using an imaging pencil beam probe such as beam 68 of Fig. 6.
  • probe beams can be produced which excite volumes which are the Fourier Transform of the weighted trajectory through k space, with the gradient wave forms 52 and 53 following a spiral which efficiently samples k space.
  • the RF pulse 51 which can be normalized to the k space velocity serves as a weighting function for the k space trajectory so that the method can be used to produce a cylindrical excitation beam with a Gaussian profile cross-section, for example.
  • the bandwidth of the pulse is maximized by varying the rate of traversal of k space, subject to the constraint of the particular maximum gradient slew rate available in a particular MRI system.
  • two separate echoes are provided in a single scan.
  • One echo 50 is Tl weighted and is used to monitor the temperature of the tumorous tissue subjected to the heat treatment.
  • the other echo 60 is T2 weighted to enable viewing the tissue damage.
  • the T2 weighted gradient echo is provided by applying Gx gradient echo read-out pulses 63 and 64 in a well-known manner. The display of the tissue based on the T2 weighted echo highlights the edematous regions to effectively monitor the heat initiated surgery.
  • a gradient echo 50 is acquired by the application of the Gx read-out gradient pulses 54 and 56.
  • the gradient pulses 61 and 62 are well-known spoiler lobes. These de-phase the total magnetization and eliminate coherence prior to commencement ofthe next profile imaging sequence.
  • Fig. 5 shows the two-dimensional scan used in the planning phase which is used to locate diseased tissue such as tumorous tissue 66 located in the image of the patient's body part 67. This is shown to be in the X,Y plane.
  • the probe "pencil-like" beam is shown in Fig. 6 at 68 for accomplishing the line scans.
  • Beam 68 is shown intercepting the tumorous tissue so as to provide temperature readings of the tumorous tissue during the surgical procedure.
  • the beam 68 also intercepts the tumorous tissue during the same scan, to enable monitoring tissue by highlighting the edematous tissue.
  • focused or directed heat is used to selectively destroy tumor tissue of a patient in a minimum invasive procedure.
  • MRI is employed to monitor the location of the heating and the tissue destruction caused by the heating during the surgical procedure.
  • line scanning while generating both a temperature map and a tissue image during single scans efficiently monitors the thermal therapy in real time. The efficiency is further increased when pencil beams are generated during single scans to monitor the temperature map and to highlight edematous regions, and therefore tissue damage.
  • the utilization of the pencil beams to provide line data during a single scan provides a more precise guide for the surgeon during the surgery.

Abstract

Cette invention a trait à un système permettant de procéder à un apport sélectif de chaleur (30) afin de détruire des tissus tumoraux (66) et ce, en utilisant une séquence de balayages horizontaux à double écho (50, 51, 52, 53, 54, 56, 60, 61, 62, 63, 64) produisant deux affichages parallèles de défilement durant la thérapie par voie thermique. L'un de ces affichages donne une carte des température et l'autre fournit des images des dommages subis par les tissus en montrant des valeurs d'intensité du tissu.
EP99974183A 1999-11-17 1999-11-17 Surveillance par resonance magnetique de therapie par voie thermique Withdrawn EP1233699A4 (fr)

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PCT/IL1999/000618 WO2001035825A1 (fr) 1999-11-17 1999-11-17 Surveillance par resonance magnetique de therapie par voie thermique

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EP1233699A1 true EP1233699A1 (fr) 2002-08-28
EP1233699A4 EP1233699A4 (fr) 2006-04-12

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AU (1) AU1176100A (fr)
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Y.ISHIHARA ET AL.: "Evaluation of Inner Body Heating Induced by 1H Decoupling Pulses - Real-Time Temperature Mapping Using the Water Proton Chemical Shift -" PROC.SOC.MAG.RESON.MED. AND THE EUROP.SOC.MAG.RESON.MED.BIOL., 1995, page 1225, XP002365425 *

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