KR101603742B1 - A Magnetic Resonance Positioning Marker for Focused Ultrasound Surgery - Google Patents

Abstract

The present invention relates to a magnetic resonance image marker plate for detecting a relative location of a target area in a body to be tested in a magnetic resonance image, and to a focused ultrasound treatment system including the same. The present invention provides rapid and reliable information about a lesion location as a target in various non-invasive treatments. Particularly, the magnetic resonance image marker plate can be applied to the focused ultrasound treatment system, enables a user to accurately and rapidly identify a treatment location with the minimum magnetic resonance image photographing and location adjustment. Therefore, the magnetic resonance image marker plate enables safe and efficient treatment, which does not require acquisition of an additional image or long-time anesthesia of a patient, to be performed.

Description

A Magnetic Resonance Positioning Marker for Focused Ultrasound Surgery for Ultrasound Integrated Surgery.

The present invention relates to a magnetic resonance imaging marker for locating a lesion in an ultrasound integrated surgery.

Recently, non-invasive treatment techniques have been actively developed to replace surgery and chemotherapy. High-Intensity Focused Ultrasound Treatment System (HIFU) Is a mechanism of transferring high-intensity focused ultrasonic waves to tissues and turning them into heat energy to melt the target tissue. Magnetic resonance imaging (MR) -guided focused ultrasound surgery (MRGFUS) is a combination of magnetic resonance imaging (MRI) as an imaging device for HIFU and soft tissue tumors (uterine cancer, breast cancer, etc.) , Brain cancer, etc.) and bone canal are used to alleviate cancer pain. Particularly, the pain caused by bone metastases, which constitutes the largest proportion of cancer pain, greatly affects the quality of life of tumor patients. Systemic drug therapy (analgesics, chemotherapy, hormone therapy (MRFFUS) has recently been increasingly used because it is difficult to obtain satisfactory results with local treatment (radiotherapy, surgery, laser ablation or radiofrequency percutaneous ablation) .

For ultrasound integrated surgery (HIFU), location of pre-treatment lesion and evaluation of post-treatment response are essential. MRgFUS, which uses MRI as an imaging device, has a greater contrast contrast between tissues during lesion confirmation than ultrasonography. It can monitor the appropriate amount of sonic energy by confirming the tissue temperature during the procedure. Various MR imaging techniques (A), (b), (c), (d), and (c), respectively. In addition, the bone and deep soft tissues, which were impossible to image by ultrasonography, are the only alternative to perform ultrasonographic integration surgery for MRgFUS.

In order to achieve a successful MRgFUS, the position of the lesion should first be located on the HIFU device. At this time, if the lesion can not be found efficiently, the patient's anesthesia time will be prolonged, and the risk associated with repeatedly changing the posture of the patient in the respiratory anesthesia state is increased. Therefore, it is required to develop a method for efficiently searching the location of a lesion of a patient undergoing MRgFUS in a short time.

Numerous papers and patent documents are referenced and cited throughout this specification. The disclosures of the cited papers and patent documents are incorporated herein by reference in their entirety to better understand the state of the art to which the present invention pertains and the content of the present invention.

Korean Patent Publication No. 10-2011-0127736 (published on November 25, 2011)

The present inventors have sought to develop a technique capable of quickly and accurately detecting a lesion site to be removed in a non-invasive treatment including ultrasonic agglutination. As a result, when a standardized plate containing a contrast agent for a magnetic resonance image is placed at a predetermined position and the magnetic resonance image is taken while the lesion is positioned on the lesion of the subject, image information appearing through the contrast agent serves as a reference, So that the present invention has been completed.

It is therefore an object of the present invention to provide a magnetic resonance imaging marker plate for measuring a relative position of a target portion in a subject in a magnetic resonance imaging.

Another object of the present invention is to provide an ultrasound imaging system including the MRI marker plate.

Other objects and advantages of the present invention will become more apparent from the following detailed description of the invention, claims and drawings.

According to one aspect of the present invention, there is provided a magnetic resonance imaging marker plate for measuring a relative position of a target portion in a subject in a magnetic resonance imaging, comprising:

(a) a plate body having a circular hole at the center thereof for marking a target portion on the surface of the subject;

(b) a liquid containing member attached to the above (a) at regular intervals; And

(c) the contrast agent solution for magnetic resonance accommodated in (b) above.

The present inventors have sought to develop a technique capable of quickly and accurately detecting a lesion site to be removed in a non-invasive treatment including ultrasonic agglutination. As a result, when a standardized plate containing a contrast agent for a magnetic resonance image is placed at a predetermined position and the magnetic resonance image is taken while the lesion is positioned on the lesion of the subject, image information appearing through the contrast agent serves as a reference, It is possible to obtain the relative position information between the two.

According to the present invention, when the magnetic resonance imaging marker plate of the present invention is attached to various non-invasive treatment apparatuses including the ultrasonic direct apparatus, only one magnetic resonance imaging before the treatment is used to measure the position of the lesion site and the By calculating the positional difference of the non-invasive treatment device and performing the positional correction based on the positional difference, the position of the treatment device and the lesion site can be precisely matched.

According to the present invention, since the liquid-containing member attached to the plate body of the present invention includes the magnetic resonance contrast agent to be imaged, in order for the display on the magnetic resonance image represented by the contrast agent to serve as a scale for calculating the lesion site, The liquid containing members including the positive contrast agent solution should be positioned at regular intervals. As used herein, the term " constant spacing " means having a regular arrangement such that it is positioned at the same or a symmetrical distance from the center of the plate body to serve as a scale or reference, It may be enemy.

According to the present invention, the magnetic resonance imaging marker plate of the present invention is attached to a non-invasive treatment apparatus when imaging a magnetic resonance image for pre-treatment lesion site search, so that a non- .

According to a specific embodiment of the present invention, the plate body of the present invention has a rectangular shape, and the liquid containing member is attached to the outer periphery of the plate body. More specifically, an additional liquid receiving member is attached diagonally to the plate body of the present invention.

The contrast agent for magnetic resonance used in the present invention may be a T1 contrast agent and a T2 contrast agent, and according to a specific embodiment, a T1 contrast agent may be used.

In the present specification, the term " T1 contrast agent " refers to a material that is composed of a paramagnetic material capable of causing spin-lattice relaxation and has a bright or positive contrast effect as compared with water when a magnetic field is applied. In MRI, the T1 signal has a high signal intensity (bright signal), so the resolution between tissues is excellent and the anatomical structure can be more clearly distinguished and the signal intensity characteristic of subacute bleeding can be shown It is useful for judging the bleeding in a lesion. The T1 contrast media that can be used in the present invention include, for example, metal ions such as Gd, Tb, Dy, Ho, Er, Mn, etc., but the present invention is not limited thereto. .

According to a more specific embodiment of the present invention, the T1 contrast agent is gadolinium (Gd).

According to a specific embodiment of the present invention, the plate body of the present invention is made of a non-magnetic material.

As used herein, the term " non-magnetic material " refers to a material having a magnetic hardness of at least a certain level to maintain the appearance of the plate body without interference with MRI signals. Nonmagnetic materials constituting the plate body in the present invention include, for example, ceramics, cured silicones, polystyrenes, polyacrylics, or copolymers thereof, but not limited thereto, all of which satisfy the definition of " nonmagnetic & Materials can be used. According to a more specific embodiment, the nonmagnetic material used in the present invention is an acrylic resin.

According to another aspect of the present invention, the present invention provides an ultrasound integrated therapy (FUS) system comprising:

(a) an image acquiring unit acquiring a magnetic resonance image of a lesion of a subject;

(b) an applicator for irradiating a lesion site of the subject with a therapeutic ultrasound wave;

(b) a relative position between the lesion site (b) and the lesion site in a magnetic resonance image acquired by (a), wherein the lesion site is located between (b) The magnetic resonance imaging marker plate according to the present invention provides information on the position.

Since the magnetic resonance imaging marker plate used in the present invention has already been described above, the description thereof is omitted in order to avoid excessive duplication.

The present invention relates to a magnetic resonance (MR) -guided focused (MRI) technique that incorporates MRI technology for location of a lesion in an ultrasound cooperative operation in which high-intensity ultrasound energy is converted into heat energy by melting the tissue to absorb lesion tissue. ultrasound surgery, MRgFUS). Therefore, the configurations (a) and (b) of the present invention can use the same configurations as those employed in the conventional MRgFUS, and these configurations are well known in the art.

According to the present invention, an applicator (configuration (b)) for irradiating ultrasonic waves with the magnetic resonance imaging marker plate of the present invention is attached to the surface of the lesion of the subject before the ultrasonic integration surgery is performed. Then, when a magnetic resonance image is photographed using the magnetic resonance image acquiring unit (configuration (a)), the position image of the marker plate as well as the image of the lesion can be simultaneously obtained as one diagnostic image. The difference between the lesion position and the position of the ultrasonic assist applicator reflected by the marker plate can be measured with reference to the lesion on the diagnostic image and the position of the marker plate. When the marker plate is displaced by the measured positional difference from the skin surface, the mark is displayed on the skin along the circular hole in the central portion, and then the marker plate is removed. The ultrasound-assisted applicator may then be directed to the indicated location to aim at the correct lesion location.

As described above, the ultrasonic integrated treatment system of the present invention can accurately grasp the position of the operation even with a minimum of the MR photographing and the position adjustment, thereby greatly cost, safety and efficiency.

The features and advantages of the present invention are summarized as follows:

(a) a magnetic resonance imaging marker plate for measuring a relative position of a target portion in a subject in a magnetic resonance imaging; And an ultrasound integrated treatment system including the same.

(b) The present invention provides rapid and reliable information on target lesion location in various non-invasive treatments.

(c) It can be applied to the ultrasonic integrated treatment system of the present invention, and it is possible to accurately and quickly grasp the position of the operation even with minimal magnetic resonance imaging and position adjustment, thereby providing safe and efficient It enables the procedure.

1 is a view showing a magnetic resonance imaging marker plate according to the present invention. A transparent acrylic plate having a size of 30 x 30 x 2 cm was manufactured in accordance with the size of the MRgFUS device which is currently in commerce (Fig. 1A). The central circular hole corresponds to the size of the actual ultrasound intensifier probe, and the lesion should not deviate therefrom. FIG. 1B shows a process of acquiring a magnetic resonance image using a marker and a human phantom of the present invention.
FIG. 2 is a diagram showing a result of photographing a T2 magnetic resonance image along the axial and sagittal planes using the marker plate of the present invention on the assumption of preoperative MR images. It can be seen that the marker plate deviates 5 cm from the axial image and 8 cm from the sagittal image based on the target lesion site.
FIG. 3 shows a result of magnetic resonance imaging in which a marker is moved and relocated on the basis of the measurement result of FIG. 2, and then the human phantom is displayed and an apparatus for ultrasound therapy is placed at a marked position. As shown in FIG. 3, it can be seen that the lesion is positioned at the center of the position where the ultrasound is irradiated as intended.
FIG. 4 is a diagram showing a result of checking whether the temperature changes when acquiring a magnetic coherence image by positioning four channels between a human phantom and a marker. As shown in FIG. 4, no temperature rise was observed at all.
FIG. 5 is a diagram showing a comparison of a workflow of a conventional ultrasound integrated treatment method and a method using a magnetic resonance imaging marker of the present invention. With the marker of the present invention, it is possible to easily determine the patient position (i.e., the position of the patient to be readjusted so as to match the lesion position and the position of the ultrasonic irradiation apparatus) in lesions visible from the ultrasound, The anesthesia time of the patients can be significantly reduced.

Hereinafter, the present invention will be described in more detail with reference to Examples. It is to be understood by those skilled in the art that these embodiments are only for describing the present invention in more detail and that the scope of the present invention is not limited by these embodiments in accordance with the gist of the present invention .

Example

Experimental Method

Fabrication of Magnetic Resonance Marker Plate for Ultrasound Integrated Surgery

A 30 x 30 x 2 cm acrylic plate (magnetic resonance marker plate) having a circular hole with a diameter of 12 cm in the center was fabricated according to the size of the actual MRgFUS device (Fig. 1). Physiological saline solution of 0.1% gadolinium in the diagonal direction to the circumference of the entire acrylic plate was tube-stitched so that it could be visualized in a magnetic resonance (MR) image. The central circular hole is sized for the ultrasound intensifier (12 cm) for ultrasound intensive surgery, and the 30 x 30 cm size is the size of the film of the ultrasound intensifier. Therefore, it is possible to obtain information on the relative positional relationship between the lesion position and the position of the ultrasonic wave accumulating device through the magnetic resonance imaging before the procedure, and by repositioning the patient based on the information, the examination part of the ultrasonic wave accumulating device It can be precisely targeted to the lesion part.

Usability evaluation

Using a human phantom (Model 701, CIRS, VA, USA) for magnetic resonance imaging, the procedure was simulated assuming a target tumor located in the left hip acetabulum. First, assuming the pre-procedure MR image, a marker plate was attached and a T2 magnetic resonance image was obtained along the axial and sagittal planes. Measuring the distance between the tube at the edge of the marker plate and the diagonal tube shows the left-right position on the upper surface of the shaft and the upper-lower position on the sagittal plane. Using this, the left-right distance and the up-down distance at which the target tumor can be located in the center of the circular hole at the center of the marker plate were calculated (Fig. 2). After moving the marker plate by the calculated distance, a circular hole at the center of the marker plate was marked on the surface (skin) of the phantom of the phantom. Next, a magnetic resonance imaging was performed in an ultrasound integrated device assuming actual ultrasound integration therapy (FIG. 3). The ultrasound intensifier was placed on the surface of the phantom and the magnetic resonance imaging was performed. Through the above images, it was confirmed that the target tumor was located at the center, that is, in accordance with the position of the ultrasonic irradiation apparatus.

Stability evaluation

The temperature between the marker plate and the human phantom was monitored during magnetic resonance imaging using a real-time temperature measurement device (AccuSens, Opsens, Quebec, Canada) that can be used in a magnetic resonance imaging apparatus. Diagnostic MR images were acquired using a total of three MR sequences: T1-weighted axial images, T2-weighted axial images, and T2-weighted sagittal images.

Experiment result

 Usability evaluation

On the assumption of preoperative MR imaging, a marker plate was attached to an ultrasound intensive device, and a T2 magnetic resonance image of a phantom phantom was taken along the axial and sagittal planes. As a result, , And 8 cm from the sagittal image. This means that the ultrasound irradiating unit is axially 5 cm away from the target lesion site and 8 cm away from the sagittal image. Based on this information, the marker plate is repositioned by the distance deviated from the target lesion, and the hole at the center of the marker plate is displayed on the phantom . After the ultrasound intensive therapy was assumed, the magnetic resonance images were taken after matching the parts on the surface of the phantom with the ultrasonic integrated device. As a result, the phantom was positioned at the center of the location where the lesion was irradiated as intended. (Fig. 3). Therefore, when the marker plate of the present invention is used, it can be seen that the ultrasound irradiating device can be set to the correct position by performing the MR imaging once and the patient position adjustment once.

Stability evaluation

Four channels were placed between the human phantom and the marker, and the temperature was not changed when acquiring the MR images. As a result, no temperature rise was observed.

As described above, by using the magnetic resonance imaging marker plate of the present invention, it is possible to accurately grasp the operation position even with minimal MR imaging and patient position adjustment. Accordingly, the present invention can be used for a more safe and efficient magnetic resonance guided ultrasound intensive surgery in which additional image acquisition is unnecessary and the patient's anesthetic time is significantly reduced.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the same is by way of illustration and example only and is not to be construed as limiting the scope of the present invention. Accordingly, the actual scope of the present invention will be defined by the appended claims and their equivalents.

Claims (9)

A magnetic resonance imaging marker plate for measuring a relative position of a target portion in a subject in a magnetic resonance imaging comprising:
(a) a plate body having a circular hole at the center thereof for marking a target portion on the surface of the subject;
(b) a liquid containing member attached to the above (a) at regular intervals; And
(c) the contrast agent solution for magnetic resonance accommodated in (b) above.
The magnetic resonance imaging marker plate of claim 1, wherein the plate body has a rectangular shape, and the liquid containing member is attached to an outer periphery of the plate body.
The magnetic resonance imaging marker plate of claim 2, wherein the liquid containing member is additionally attached in a diagonal direction of the plate body.
The magnetic resonance imaging marker plate according to claim 1, wherein the contrast agent solution for magnetic resonance imaging is a T1 contrast agent.
5. The magnetic resonance imaging marker plate of claim 4, wherein the T1 contrast agent is gadolinium (Gd).
The magnetic resonance imaging marker plate according to claim 1, wherein the plate body is made of a non-magnetic material.
The magnetic resonance imaging marker plate according to claim 6, wherein the non-magnetic substance is an acrylic resin.
An ultrasound integrated therapy (HIFU) system comprising:
(a) an image acquiring unit acquiring a magnetic resonance image of a lesion of a subject;
(b) an applicator for irradiating a lesion site of the subject with a therapeutic ultrasound wave;
(b) a relative position between the lesion site (b) and the lesion site in a magnetic resonance image acquired by (a), wherein the lesion site is located between (b) The magnetic resonance imaging marker plate of any one of claims 1 to 7, which provides information about the position.
The ultrasound diagnostic apparatus according to claim 8, wherein, when (c) is attached to (b), the position where the therapeutic ultrasound is irradiated by the (b) system.

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