Three dimensional motion compensation for real-time MRI guided focused ultrasound treatment of abdominal organs

MR-guided high intensity focused ultrasound (HIFU) has evolved into a promising non-invasive technique for the ablation of pathological tissue in abdominal organs. However, since the high perfusion rates of these organs lead to effective cooling, sustained sonications of 30-90 s are required to achieve a sufficiently high temperature elevation to induce necrosis. This is complicated by the constant displacement of the target due to the respiratory cycle. This study proposes sub-second 3D HIFU-beam steering under MR-guidance for the near real-time compensation of respiratory motion as a possible solution. The target position is observed in 3D space by coupling rapid 2D MR-imaging with prospective slice tracking (PST) based on pencil-beam navigator echoes. Continuous real-time image processing provides temperature maps, thermal dose estimates and the target position at a frequency of 10 Hz and an update latency of less than 120 ms. The suggested method is evaluated with phantom experiments and its feasibility is verified in-vivo with an ablation experiment on a porcine kidney where it allows to achieve a thermal energy deposition which is comparable to static control experiments.