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Open AccessArticle

Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound with a 1.5 Tesla Scanner: A Prospective Intraindividual Comparison Study of Intraoperative Imaging

1
Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy
2
Neuroradiology Unit, S. Chiara Hospital, 38122 Trento, Italy
3
Department of Physics and Chemistry, University of Palermo, 90133 Palermo, Italy
4
Section of Neurosurgery, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90133 Palermo, Italy
5
Section of Neurology, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90133 Palermo, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Brain Sci. 2021, 11(1), 46; https://doi.org/10.3390/brainsci11010046
Received: 17 November 2020 / Revised: 16 December 2020 / Accepted: 28 December 2020 / Published: 4 January 2021
(This article belongs to the Special Issue Biochemical Biomarkers and Neurodegenerative Diseases)
Background: High-quality intraoperative imaging is needed for optimal monitoring of patients undergoing transcranial MR-guided Focused Ultrasound (tcMRgFUS) thalamotomy. In this paper, we compare the intraoperative imaging obtained with dedicated FUS-Head coil and standard body radiofrequency coil in tcMRgFUS thalamotomy using 1.5-T MR scanner. Methods: This prospective study included adult patients undergoing tcMRgFUS for treatment of essential tremor. Intraoperative T2-weighted FRFSE sequences were acquired after the last high-energy sonication using a dedicated two-channel FUS-Head (2ch-FUS) coil and body radiofrequency (body-RF) coil. Postoperative follow-ups were performed at 48 h using an eight-channel phased-array (8ch-HEAD) coil. Two readers independently assessed the signal-to-noise ratio (SNR) and evaluated the presence of concentric lesional zones (zone I, II and III). Intraindividual differences in SNR and lesional findings were compared using the Wilcoxon signed rank sum test and McNemar test. Results: Eight patients underwent tcMRgFUS thalamotomy. Intraoperative T2-weighted FRFSE images acquired using the 2ch-FUS coil demonstrated significantly higher SNR (R1 median SNR: 10.54; R2: 9.52) compared to the body-RF coil (R1: 2.96, p < 0.001; R2: 2.99, p < 0.001). The SNR was lower compared to the 48-h follow-up (p < 0.001 for both readers). Intraoperative zone I and zone II were more commonly visualized using the 2ch-FUS coil (R1, p = 0.031 and p = 0.008, R2, p = 0.016, p = 0.008), without significant differences with 48-h follow-up (p ≥ 0.063). The inter-reader agreement was almost perfect for both SNR (ICC: 0.85) and lesional findings (k: 0.82–0.91). Conclusions: In the study population, the dedicated 2ch-FUS coil significantly improved the SNR and visualization of lesional zones on intraoperative imaging during tcMRgFUS performed with a 1.5-T MR scanner. View Full-Text
Keywords: focused ultrasound; MR-guided focused ultrasound; high-intensity focused ultrasound ablation; magnetic resonance imaging; image quality; stereotaxic techniques; essential tremor focused ultrasound; MR-guided focused ultrasound; high-intensity focused ultrasound ablation; magnetic resonance imaging; image quality; stereotaxic techniques; essential tremor
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MDPI and ACS Style

Gagliardo, C.; Cannella, R.; D’Angelo, C.; Toia, P.; Salvaggio, G.; Feraco, P.; Marrale, M.; Iacopino, D.G.; D’Amelio, M.; La Tona, G.; La Grutta, L.; Midiri, M. Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound with a 1.5 Tesla Scanner: A Prospective Intraindividual Comparison Study of Intraoperative Imaging. Brain Sci. 2021, 11, 46. https://doi.org/10.3390/brainsci11010046

AMA Style

Gagliardo C, Cannella R, D’Angelo C, Toia P, Salvaggio G, Feraco P, Marrale M, Iacopino DG, D’Amelio M, La Tona G, La Grutta L, Midiri M. Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound with a 1.5 Tesla Scanner: A Prospective Intraindividual Comparison Study of Intraoperative Imaging. Brain Sciences. 2021; 11(1):46. https://doi.org/10.3390/brainsci11010046

Chicago/Turabian Style

Gagliardo, Cesare; Cannella, Roberto; D’Angelo, Costanza; Toia, Patrizia; Salvaggio, Giuseppe; Feraco, Paola; Marrale, Maurizio; Iacopino, Domenico G.; D’Amelio, Marco; La Tona, Giuseppe; La Grutta, Ludovico; Midiri, Massimo. 2021. "Transcranial Magnetic Resonance Imaging-Guided Focused Ultrasound with a 1.5 Tesla Scanner: A Prospective Intraindividual Comparison Study of Intraoperative Imaging" Brain Sci. 11, no. 1: 46. https://doi.org/10.3390/brainsci11010046

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