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Real-time Active MR-tracking of Metallic Stylets in MR-guided Radiation Therapy

1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Radiation Oncology, Brigham and Women's Hospital, Harvard medical School, Boston, MA, USA.
3Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
4College of Engineering, University of Georgia, Athens, GA, USA.
5MR R&D, Siemens Healthcare, Boston, MA, USA.
John Wiley & Sons, Inc.
Publication Date:
Magn Reson Med.
Volume Number:
Issue Number:
Magn Reson Med. 2015 May;73(5):1803-11.
PubMed ID:
Active MR-tracking, metallic device, radiation therapy, phase-field dithering
Appears in Collections:
P41 RR019703/RR/NCRR NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
R21 CA158987/CA/NCI NIH HHS/United States
R21 CA167800/CA/NCI NIH HHS/United States
Generated Citation:
Wang W., Dumoulin C.L., Viswanathan A.N., Tse Z.T.H., Mehrtash A., Loew W., Norton I., Tokuda J., Seethamraju R.T., Kapur T., Damato A.L., Cormack R.A., Schmidt E.J. Real-time Active MR-tracking of Metallic Stylets in MR-guided Radiation Therapy. Magn Reson Med. 2015 May;73(5):1803-11. PMID: 24903165. PMCID: PMC4257908.
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Purpose: To develop an active MR-tracking system to guide placement of metallic devices for radiation therapy. Methods: An actively tracked metallic stylet for brachytherapy was constructed by adding printed-circuit micro-coils to a commercial stylet. The coil design was optimized by electromagnetic simulation, and has a radio-frequency lobe pattern extending ~5 mm beyond the strong B0 inhomogeneity region near the metal surface. An MR-tracking sequence with phase-field dithering was used to overcome residual effects of B0 and B1 inhomogeneities caused by the metal, as well as from inductive coupling to surrounding metallic stylets. The tracking system was integrated with a graphical workstation for real-time visualization. 3T MRI catheter-insertion procedures were tested in phantoms and ex-vivo animal tissue, and then performed in three patients during interstitial brachytherapy. Results: The tracking system provided high-resolution (0.6 × 0.6 × 0.6 mm3) and rapid (16 to 40 frames per second, with three to one phase-field dithering directions) catheter localization in phantoms, animals, and three gynecologic cancer patients. Conclusion: This is the first demonstration of active tracking of the shaft of metallic stylet in MR-guided brachytherapy. It holds the promise of assisting physicians to achieve better targeting and improving outcomes in interstitial brachytherapy.

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