Purpose: To investigate Gd-DTPA kinetics as predictors of histopathological changes following focused ultrasound (FUS) thermal ablation for improved planning and assessment.
Materials and Methods:Twenty-nine FUS lesions were created in the thigh muscle of eight rabbits under MRguidance at 1.5 Tesla. Three rabbits were killed at four hours; and 11 lesions were analyzed with histopathology. Temperature-sensitive MRI using proton-resonant frequency-shift was used for time-dependent temperature measurements. Analysis of the uptake kinetics of Gd-DTPA was performed after Gd-DTPA injection, within 20 minutes after heating and again at two hours after heating. The resulting kinetic maps, permeability (K trans ) and leakage space (v e ), were correlated to peak temperatures, T 2 -weighted MR, and histopathology.Results: Images of K trans and v e reveal regions of histopathological change not visible on conventional posttherapy MR. At early times after heating, v e predicts the area of injury more accurately than T 2 (7 Ϯ 2% vs. 25 Ϯ 6% underestimation). A circular region of extensive structural/ vascular disruption is indicated only on K trans maps. The sharp decrease in K trans at the boundary of this region occurs at 47.5 Ϯ 0.5°C, and may be a better estimate of cell death than the conventional method of temperature threshold (55°C for coagulation) used in therapy planning.
Conclusion:Our results suggest Gd-DTPA kinetics can predict different histopathological changes following FUS ablation and may be valuable for early prediction.