First-in-Human Intratumoral Temperature Monitoring During Standard 3 T MRI Demonstrates RF-Induced Tissue Heating...

Magnetic resonance imaging (MRI) uses radiofrequency (RF) energy to generate diagnostic images. RF-tissue interactions lead to energy absorption and tissue heating, quantified by the specific absorption rate (SAR). Although SAR limits are strictly regulated for patient safety, actual in vivo tissue temperature changes during clinical MRI examinations in humans have not been directly measured. A patient with a histologically confirmed soft tissue sarcoma of the thigh underwent a clinically indicated 3 T MRI examination 24 h prior to resection. During imaging with whole-body SAR of 2.27 W/kg, direct temperature measurements (invasive and on the skin) were obtained. Temperatures increased by 2.0 °C within the tumor and at the skin surface was 3.4 °C at the skin surface. No technical difficulties or adverse events were observed, and the patient tolerated the examination well. This first-in-human case demonstrates the feasibility and safety of direct intratumoral temperature measurement during standard 3T MRI. While MRI was performed within safety limits of SAR as a surrogate for true tissue temperature, non-invasive temperature monitoring during MRI needs improvement. Controlled RF-induced heating during MRI may open new therapeutic possibilities, including MR-guided hyperthermia for sarcomas and other solid tumors or modulation of blood-brain barrier through transient RF-induced temperature elevations facilitating drug delivery.