J Korean Med Sci.  2011 Jun;26(6):839-843. 10.3346/jkms.2011.26.6.839.

Clinical Application of 7.0 T Magnetic Resonance Images in Gamma Knife Radiosurgery for a Patient with Brain Metastases

• Paek SH
• Son YD
• Chung HT
• Kim DG
• Cho ZH

• KMID: 1785975
• DOI: http://doi.org/10.3346/jkms.2011.26.6.839

Abstract

In the study we assessed the distortion of 7.0 T magnetic resonance (MR) images in reference to 1.5 T MR images in the radiosurgery of metastatic brain tumors. Radiosurgery with Gamma Knife Perfexion(R) was performed for the treatment of a 54-yr-old female patient with multiple brain metastases by the co-registered images of the 7.0 T and 1.5 T magnetic resonance images (MRI). There was no significant discrepancy in the positions of anterior and posterior commissures as well as the locations of four metastatic brain tumors in the co-registered images between 7.0 T and 1.5 T MRI with better visualization of the anatomical details in 7.0 T MR images. This study demonstrates for the first time that 7.0 T MR images can be safely utilized in Perfexion(R) Gamma Knife radiosurgery for the treatment of metastatic brain tumors. Furthermore 7.0 T MR images provide better visualization of brain tumors without image distortion in comparison to 1.5 T MR images.

Keyword

1.5 T MRI; 7.0 T MRI; Co-registered Images; Radiosurgery

MeSH Terms

Adenocarcinoma/pathology/radiography
Brain Neoplasms/pathology/secondary/*surgery
Female
Humans
Lung Neoplasms/pathology/radiography
*Magnetic Resonance Imaging
Middle Aged
*Radiosurgery
Tomography, X-Ray Computed

Figure

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  Fig. 1 Axial, coronal, and sagittal images of the anterior commissure (▽) and the posterior commissure (△) in 1.5T and 7.0 T magnetic resonance images (MRI). In the coregistered images of the 7.0T MRI and 1.5T MRI, there is no significant difference in the location of the AC and PC between 1.5T (A-C) and 7.0T MRI (D-F) whereas enhanced anatomical details of the metastatic brain tumors are provided by 7.0T MRI.

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  Fig. 2 Axial images of four metastatic brain tumors in the co-registered images of 1.5 T and 7.0 T magnetic resonance images (MRI). Upper panel shows 1.5 T MRI (A-D) and lower panel shows 7.0 T MRI (E-H). Total four metastastic brain tumors are found; three lesions in the left parietal (A, E) and temporal lobe (B, C, F, G) and one in the right side of the pons (D, H).

• 

  Fig. 3 Axial, coronal, and sagittal images of a metastatic lesion in the left parietal lobe in the co-registered images of 1.5 T and 7.0 T magnetic resonance images (MRI). The tumor is demarcated in blue line and its 50%-isodose volume of 22 Gy is marked with yellow line in the left parietal lobe in the axial, coronal, and sagittal view of the coregistered images of 1.5 T (A-C) and 7.0 T MRI (D-F).

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  Fig. 4 Sagittal and coronal images of metastatic lesions (arrow) in the left temporal lobe and the right side of the pons in the co-registered images of 1.5 T and 7.0 T magnetic resonance images (MRI). While only high signal intensity regions in 1.5 T MRI (A, B), blood vessels connected to the tumors are clearly identified in high resolution images of 7.0 T MRI (C, D).

Reference

1. Abduljalil AM, Schmalbrock P, Novak V, Chakeres DW. Enhanced gray and white matter contrast of phase susceptibility-weighted images in ultra-high-field magnetic resonance imaging. J Magn Reson Imaging. 2003. 18:284–290.

2. Thomas DL, De Vita E, Roberts S, Turner R, Yousry TA, Ordidge RJ. High-resolution fast spin echo imaging of the human brain at 4.7 T: implementation and sequence characteristics. Magn Reson Med. 2004. 51:1254–1264.

3. Abduljalil AM, Kangarlu A, Yu Y, Robitaille PM. Macroscopic susceptibility in ultra high field MRI. II: acquisition of spin echo images from human head. J Comput Assist Tomogr. 1999. 23:842–844.

4. Abduljalil AM, Robitaille PM. Macroscopic susceptibility in ultra high field MRI. J Comput Assist Tomogr. 1999. 23:832–841.

5. Kollia K, Maderwald S, Putzki N, Schlamann M, Theysohn JM, Kraff O, Ladd ME, Forsting M, Wanke I. First clinical study on ultra-high-field MR imaging in patients with multiple sclerosis: comparison of 1.5T and 7T. AJNR Am J Neuroradiol. 2009. 30:699–702.

6. Novak V, Abduljalil AM, Novak P, Robitaille PM. High-resolution ultra-high-field MRI of stroke. Magn Reson Imaging. 2005. 23:539–548.

7. Novak V, Chowdhary A, Abduljalil A, Novak P, Chakeres D. Venous cavernoma at 8 Tesla MRI. Magn Reson Imaging. 2003. 21:1087–1089.

8. Shmuel A, Yacoub E, Chaimow D, Logothetis NK, Ugurbil K. Spatio-temporal point-spread function of fMRI signal in human gray matter at 7 Tesla. Neuroimage. 2007. 35:539–552.

9. Thomas BP, Welch EB, Niederhauser BD, Whetsell WO Jr, Anderson AW, Gore JC, Avison MJ, Creasy JL. High-resolution 7T MRI of the human hippocampus in vivo. J Magn Reson Imaging. 2008. 28:1266–1272.

10. Wiesinger F, Van de Moortele PF, Adriany G, De Zanche N, Ugurbil K, Pruessmann KP. Parallel imaging performance as a function of field strength-an experimental investigation using electrodynamic scaling. Magn Reson Med. 2004. 52:953–964.

11. Cha S, Johnson G, Wadghiri YZ, Jin O, Babb J, Zagzag D, Turnbull DH. Dynamic, contrast-enhanced perfusion MRI in mouse gliomas: correlation with histopathology. Magn Reson Med. 2003. 49:848–855.

12. Norris DG. High field human imaging. J Magn Reson Imaging. 2003. 18:519–529.

13. Runge VM, Kirsch JE, Thomas GS, Mugler JP 3rd. Clinical comparison of three-dimensional MP-RAGE and FLASH techniques for MR imaging of the head. J Magn Reson Imaging. 1991. 1:493–500.

14. Takeda T, Takeda A, Nagaoka T, Kunieda E, Takemasa K, Watanabe M, Hatous T, Oguro S, Katayama M. Gadolinium-enhanced three-dimensional magnetization-prepared rapid gradient-echo (3D MP-RAGE) imaging is superior to spin-echo imaging in delineating brain metastases. Acta Radiol. 2008. 49:1167–1173.