Image guided irreversible electroporation of cancerous tissue in a MRI environment

Minimal invasive Image-guided Interventions (MII) is a new discipline in medicine. To date, no single specialist area has the necessary competencies to deliver MII. These interventions are combined with sophisticated imaging technologies, primarily to perform minimally invasive surgery. MII can be characterized by the following key steps: target location, target verification (lesion volume), target destruction, treatment monitoring and verification. CT, X-ray and ultrasound imaging are the most commonly used modalities in interventional procedures, but these have major disadvantages: the ionizing X-rays are potentially dangerous for both patient and physician, and their contrast is limited to bone or iodine-containing contrast agents. Ultrasound hardly penetrates bone, is reflected at tissue-air interfaces and is operator dependent. Due to these limitations, magnetic resonance (MR) imaging can be used for MII as well the possibility to measure temperature differences during tumor ablation.

The implementation of tumor ablative techniques within the MRI environment will expand the range of its application field to the organs (e.g. prostate, pancreas or liver) where the treatment under guidance of other techniques such as CT or US reaches its limits. The MRI environment poses a number of specific requirements such as high sensibility to external electromagnetic disturbances, strong magnetic and radiofrequency fields, relatively long scan times, limited access to the patient placed in the MRI scanner and the need of MR-compatible material.

The next stage is to find and use a compatible robot with MRI and to conduct in-vivo IRE experiments for animal tissues under the MRI (eg. prostate, pancreas, liver). MRI sequences and data acquisition parameters are very important issues that can be considered before conducting the in-vivo experiments. The injury evaluation can be monitored in real time intraoperatively (i.e. MRI) and postoperatively (i.e. histology).

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