Technical challenges and clinical research applications of ultrahigh field MRI A.G.Webb Professor,...

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Technical challenges and clinical research applications of ultrahigh field MRI

A.G.Webb

Professor, Director C.J.Gorter Center for High Field MRI

Department of Radiology

Leiden University Medical Center

Leiden, The Netherlands

2

Outline

Why a very high field scanner? What can it do?

Why doesn’t it work and give nice images automatically?

How do we address the major challenges?

Why do we need the input of medical physicists?

Clinical applications and future input into radiotherapy

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Philosophy

Σα βγεις στον πηγαιμό για την Ιθάκη,

να εύχεσαι νάναι μακρύς ο δρόμος,

γεμάτος περιπέτειες, γεμάτος γνώσεις.

7T system~50 worldwide

Why ultra-high field MRI?

Image quality is proportional to magnetic field strength

Signal to noise at 7 tesla 2.3 times higher than 3 tesla

Higher resolution and faster (for patients) MRI

Improved sensitivity to diffuse iron deposition (neurodegeneration)Intrinsically better angiography to visualize small vessels

Increased spectral resolution for metabolic studies

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Congratulations on purchasing your new Philips 7T- a bargain at €8,500,000

Compared to your old 3 Tesla Philips is delighted to offer significant increases in……..

Image non-uniformities

Potential for heating the patient

Questions about safety/implants/dental wires

Motion sensitivity

Difficulties in image segmentation

Complexity of cardiac triggering

But also significant decreases in

Number of RF coils commercially available

The first technical challenge – design of customized detectors

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Image non-uniformities

Potential for heating the patient

Questions about safety/implants/dental wires

Motion sensitivity

Difficulties in image segmentation

Complexity of cardiac triggering

Image non-uniformities at high field

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3T 4T 5T 6T 7T 8T 10T 12T

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General observations at high fields

1tissue

rf

• Overall, RF wavelength in tissue decreases with B0 field strength

Dielectric constant

Relative dielectric constant

100

150

200

250

300

350

400

450

500

45

50

55

60

65

70

75

frequency (MHz)

MuscleWavelength (cm)

frequency (MHz)

100

150

200

250

300

350

400

450

500

10

20

30

40

50

60

RF inhomogeneityconstructive/destructive interference

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l~12 cm

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General observations at high fields Solution 1 - multiple transmit channels

RF waveformgenerator 1

Power amplifier

Tx/Rx switch 1 Coil element 1

Digital receiver 1

RF waveformgenerator 2

Power amplifier

Tx/Rx switch 2 Coil element 2

Digital receiver 2

RF waveformgenerator 3

Power amplifier

Tx/Rx switch 3 Coil element 3

Digital receiver 3

RF waveformgenerator N

Power amplifier

Tx/Rx switch N Coil element N

Digital receiver N

The alternative and slightly cheaper method

New, high permittivity materials

How do dielectric materials work?

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Displacement currents in the dielectric material produce a secondary local RF field which increases the total B1+

Dielectric pads in imaging

FLAIR TSE

normal

with pads

Abdominal imaging at 3 Tesla

(a) (b) (c)

(d) (e) (f)

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Image non-uniformities

Potential for heating the patient

Questions about safety/implants

Motion sensitivity

Difficulties in image segmentation

Complexity of cardiac triggering

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General observations at high fields

Conductivity increases with frequency

0Imeff ion r

Conductivity

100 150 200 250 300 350 400

0.35

0.40

0.45

0.50

0.55

Conductivity of gray matter (S/m)

frequency (MHz)

P=1/2 sE2

RF inhomogeneityconstructive/destructive interference

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l~12 cm

Increased SAR and heating at 7T

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7T 300 MHz3T 128 MHz

SAR (W/kg)

300 MHz128 MHz

Temperature rise (oC)

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General observations at high fields How do you ensure safety?

The RF engineer is the first personto be tested!

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General observations at high fields Call upon the medical physics specialists

Requires flexibility

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General observations at high fields

lack of self-awareness

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General observations at high fields

Attention to detail

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General observations at high fields

Rigorous safety testing procedures

Electromagnetic simulationsPhantom heating tests

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1

0.1

SARpoint (W/kg)

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Image non-uniformities

Potential for heating the patient

Questions about safety/implants/dental wires

Motion sensitivity

Difficulties in image segmentation

Complexity of cardiac triggering

Reduction in image quality in patients

High quality obtained in volunteers is typically not reproduced

in AD patients

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Healthy volunteer AD patient

50 100 150

-10

0

10

20

time (s)

freq

(H

z) /

A.U

.

resp. beltnav. phase

250 300 350

-10

0

10

20

time (s)

freq

uenc

y (H

z)

Normal volunteer

AD patient

0 50 150

0 50 150

In vivo results of f0 fluctuations

before correction

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On-line monitoring of frequency variations

Some examples

Image quality is significantlyimproved

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Image non-uniformities

Potential for heating the patient

Questions about safety/implants/dental wires

Motion sensitivity

Difficulties in image segmentation

Complexity of cardiac triggering

Reduced contrast makes segmentation difficult

T2*-magnitude T2*- phase T1

Specialized image segmentation algorithm

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Image non-uniformities

Potential for heating the patient

Questions about safety/implants/dental wires

Motion sensitivity

Difficulties in image segmentation

Complexity of cardiac triggering

Problems with cardiac triggering

Overwhelming magnetohydrodynamic effect

Develop acoustic triggering

Principle developed by Niendorf group on Siemens 7T platformCommercially available for mildly ridiculous price

Develop an open-source Arduino-based system for continuousImprovement amongst users

Develop acoustic triggering

Technical “solutions”

High permittivity materials

Accurate SAR modelling

On-line “motion” monitoring

Acoustic cardiac triggering

Phase/magnitude image segmentation

7T Cardiovascular MRCoronary MRA

7T Cardiovascular MRCoronary MRA

van Elderen et al., Radiology 2010;257:254-259

7T Cardiovascular MRCoronary MRA, 7T versus 3T

7T Cardiovascular MRCoronary MRA, 7T versus 3T

S.G.C.van Elderen, M.J.Versluis, J.J.M.Westenberg, H.Agarwal, N.B.Smith, M.Stuber, A.de Roos and A.G.Webb, In vivo coronary magnetic resonance angiography at 7 Tesla: a direct quantitative comparison with 3 Tesla,

Radiology, 257, 254-259, 2010.

7T Cardiovascular MRIschemic Cardiomyopathy, RCA

7T Cardiovascular MRIschemic Cardiomyopathy, RCA

General observations at high fields Carotid artery vessel wall imaging

T1

T2

TOF

Cochlear imaging

MIP

Inner ear imaging – cochlear implants

3T 7T

Musculoskeletal applications of 7 Tesla

High resolution imaging of the human vertebra

• Inflammation in spine and sacroiliac joints

Ankylosing Spondylitis

Water/fat images of sacroiliac (SI) joint

High resolution imaging of the eye

High resolution imaging of the eye

Uveal melanoma patients

ultrasound

Proton beam therapy planning

Acknowledgements

Itamar RonenHermien KanMaarten VersluisThijs van OschSanneke van RoodenEce ArcanFrancesca BranzoliSebastian AussenhoferEidrees GhariqWouter TeeuwisseMark van BuchemWyger BrinkPaul de HeerJeroen van der Grond

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