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From the RSNA Refresher Courses

MR Imaging in Hyperthermia¹

¹ From the Department of Radiology, Duke University Medical Center, Box 3808, Erwin Road, Durham, NC 27710. Presented as a refresher course at the 2007 RSNA Annual Meeting. Received May 4, 2007; revision requested May 16 and received June 21; accepted June 25. Supported by grant P01-CA42745 from the National Institutes of Health. All authors have no financial relationships to disclose. Address correspondence to J.R.M. (e-mail: james.macfall{at}duke.edu).

There is growing clinical evidence that the combination of radiation therapy and hyperthermia, when delivered at moderate temperatures (40°–45°C) for sustained times (30–90 minutes), is of benefit with regard to palliative relief of cancer, tumor response, local control, and survival. Adequate measurement of the temperature distribution achieved with the hyperthermia is a key element in successful therapy. Thermal dosimetry, even invasive dosimetry, is a complex topic when applied to the heterogeneous tissue of a tumor and associated organ systems. Imaging in hyperthermia therapy is performed primarily for estimation and control of temperature. Magnetic resonance (MR) imaging has unique parameter dependences that make it possible to monitor hyperthermia therapy by detection of proton resonant frequency changes or diffusion coefficient changes. In addition, MR imaging can be used to assess vascular parameters that not only allow selection of suitable patients for therapy but may also allow demonstration of response to therapy. Finally, as the use of thermally sensitive liposomes for delivery of chemotherapeutic agents is developed, MR imaging may allow determination of local drug dose.

© RSNA, 2007