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Respiration based steering for high intensity focused ultrasound liver ablation
Author(s) -
Holbrook Andrew B.,
Ghanouni Pejman,
Santos Juan M.,
Dumoulin Charles,
Medan Yoav,
Pauly Kim Butts
Publication year - 2014
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.24695
Subject(s) - respiration , ablation , intensity (physics) , ultrasound , high intensity focused ultrasound , ultrasound imaging , biomedical engineering , chemistry , computer science , medicine , radiology , cardiology , physics , anatomy , optics
Purpose Respiratory motion makes hepatic ablation using high intensity focused ultrasound (HIFO) challenging. Previous HIFU liver treatment had required apnea induced during general anesthesia. We describe and test a system that allows treatment of the liver in the presence of breathing motion. Methods Mapping a signal from an external respiratory bellow to treatment locations within the liver allows the ultrasound transducer to be steered in real time to the target location. Using a moving phantom, three metrics were used to compare static, steered, and unsteered sonications: the area of sonications once a temperature rise of 15°C was achieved, the energy deposition required to reach that temperature, and the average rate of temperature rise during the first 10 s of sonication. Steered HIFU in vivo ablations of the porcine liver were also performed and compared to breath‐hold ablations. Results For the last phantom metric, all groups were found to be statistically significantly different ( P ≤ 0.003). However, in the other two metrics, the static and unsteered sonications were not statistically different ( P > 0.9999). Steered in vivo HIFU ablations were not statistically significantly different from ablations during breath‐holding. Conclusions A system for performing HIFU steering during ablation of the liver with breathing motion is presented and shown to achieve results equivalent to ablation performed with breath‐holding. Magn Reson Med 71:797–806, 2014. © 2012 Wiley Periodicals, Inc.