Development of MRI methods for guidance of focused ultrasound treatment of pancreatic tumors

Abstract

MR guided High Intensity Focused Ultrasound (MR-HIFU) is a promising non-invasive therapeutic modality. It makes use of ultrasound waves to cause localized heating of a target volume, e.g. a tumor, deep inside the patient’s body. MRI is used to plan, monitor and evaluate the treatment procedure, by means of high-resolution imaging and MR thermometry techniques that allow real-time temperature mapping. Currently, pancreatic cancer patients have a poor prognosis. While MR-HIFU holds potential to enable fully non-invasive treatment of these patients, more technical work is needed to develop a routinely used treatment modality. MR Imaging and energy delivery in the pancreas is challenging because it is located in the upper abdominal area, is subject to respiratory motion and air in the digestive tract leads to artifacts in the images. In this dissertation, new MRI methods were introduced and investigated to improve MRI temperature monitoring and MRI planning of the treatment procedure. In addition, near the pancreas, major vessels and nerves are present, that can be visualized using MRI techniques developed in this thesis. The celiac plexus, for example, a nerve structure that plays a major role in pain generation in these patients, and is therefore a target in pain management. While the work presented in this manuscript introduces promising solutions, future step should be carried towards real time implementation and clinical evaluation of these solutions.