Magnetic Resonance Imaging as a Technique for Assessing Noninvasive Tissue Ablation Using High-Intensity Ultrasound An Experimental Study.

Background and PurposeAs a form of noninvasive extracorporeal application, acoustic energy offers an alternative to nephron-sparing surgery for renal masses smaller than 4 cm. The availability of a reliable tool for monitoring the therapy is a prerequisite for safe and successful high-intensity focused ultrasound (HIFU) application. The aim of this study was to evaluate the morphologic visualization of HIFU lesions using MRI.Materials and MethodsWe used the ex vivomodel of the isolated perfused porcine kidney. Treatment was performed using an experimental HIFU system. Complex lesions were induced in 10 kidneys. MRI was performed under constant perfusion of the kidneys. To determine the exact lesion size, we performed a fat-saturated, T1-weighted, volumetric interpolated breath-hold MRI sequence. For perfusion imaging, we used a three-dimensional fast low-angle shot sequence. Subsequently, the lesions were evaluated macroscopically. The width of the complex lesions was defined as x, the length as y, and the depth as z.ResultsThe MRI scans showed good soft tissue contrast in all sequences. The mean difference for the width of the lesions was 0.2 ± 1.1 mm; for lesion length and depth, it was 1.7 ± 1.8 mm and 1.1 ± 1.3 mm for lesion width, respectively. Statistical evaluation of the x values showed no significant difference between the macroscopic and the MRI data (P 0.85). The y and z values, however, showed a statistically significant difference (P 0.071).ConclusionMRI could be a diagnostic tool for monitoring HIFU. Before this modality can be used under clinical conditions, further technical development is indispensable, especially with respect to reducing the measuring times. [ABSTRACT FROM AUTHOR]