Real-time 3D target tracking in MRI guided focused ultrasound ablations in moving tissues

Magnetic resonance imaging-guided high intensity focused ultrasound is a promising method for the noninvasive ablation of pathological tissue in abdominal organs such as liver and kidney. Due to the high perfusion rates of these organs, sustained sonications are required to achieve a sufficiently high temperature elevation to induce necrosis. However, the constant displacement of the target due to the respiratory cycle render continuous ablations challenging, since dynamic repositioning of the focal point is required. This study demonstrates subsecond 3D high intensity focused ultrasound-beam steering under magnetic resonance-guidance for the real-time compensation of respiratory motion. The target is observed in 3D space by coupling rapid 2D magnetic resonance-imaging with prospective slice tracking based on pencil-beam navigator echoes. The magnetic resonance-data is processed in real-time by a computationally efficient reconstruction pipeline, which provides the position, the temperature and the thermal dose on-the-fly, and which feeds corrections into the high intensity focused ultrasound-ablator. The effect of the residual update latency is reduced by using a 3D Kalman-predictor for trajectory anticipation. The suggested method is characterized with phantom experiments and verified in vivo on porcine kidney. The results show that for update frequencies of more than 10 Hz and latencies of less then 114 msec, temperature elevations can be achieved, which are comparable to static experiments.