Magnetic resonance imaging (MRI) guided focused ultrasound (MRgFUS) is a promising non-invasive and non-ionizing therapy in which the acoustic energy penetrates to the target through the intact surrounding tissue without causing any significant bioeffects and without any incisions. At the target, ultrasound energy is converted to heat, causing tissue coagulation and necrosis. MRI guidance is used with FUS to provide high quality tumor margin definition as well as the ability to monitor the temperature of the tissue and assess the treatment. Among the MRgFUS applications are treatments of tumors in the prostate, breast, uterine fibroids, liver and brain. To make these applications widely acceptable and available to patients, improvement of image guidance is essential. The goal of this work was to develop novel MRI tools for visualization of the focal spot and for adaptive focusing of ultrasound. Visualization of the ultrasound focus is performed to con rm that the beam's focus is placed on the target anatomy. Currently, it is achieved by producing a small temperature rise in a test spot, which is detected using MRI temperature monitoring techniques. Focus localization often relies on multiple applications of ultrasound, the cumulative effects of which can lead to potentially irreversible changes in healthy tissue. In addition, visualization of the temperature rise with MRI is problematic in tissue with high fat content such as breast. The thesis addresses the challenges of focus visualization by introducing novel imaging methods, that image displacement of tissue due to acoustic radiation force: 2D Fourier Transform (2DFT) spin-echo and single-shot echo planar imaging (EPI) MR guided acoustic radiation force imaging (MR-ARFI). The new pulse sequences are demonstrated ex vivo and optimized for in vivo brain applications. One of the challenges of using FUS to treat brain pathology is overcoming the phase aberrations of ultrasound caused by heterogeneous acoustic properties of the skull bone. These aberrations result in partial or complete destruction of the focal spot, and therefore prevent the delivery of sufficient energy to the targeted volume, and cause heating where it was not intended. The current correction method estimates the aberrations from the thickness and density of the skull bone obtained from pre-operative computerized tomography (CT) images of the patient's head. Recently introduced alternative methods use adaptive focusing approach combined with MR-ARFI. The transducer elements' emissions are manipulated until the acoustic intensity, which is proportional to tissue displacement, is maximized. Promising, but very time consuming, these methods do not o er a practical solution. In this work, it is shown how using Zernike polynomials, actively utilized in optics, can increase the efficiency of MR-ARFI-based adaptive focusing, making it a more suitable technique for clinical applications.

Image-guided therapy (IGT) uses imaging to improve the localization and targeting of diseased tissue and to monitor and control treatments. During the past decade, image-guided surgeries and image-guided minimally invasive interventions have emerged as advances that can be used in place of traditional invasive approaches. Advanced imaging technologies such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) entered into operating rooms and interventional suites to complement already-available routine imaging devices like X-ray and ultrasound. At the same time, navigational tools, computer-assisted surgery devices, and image-guided robots also became part of the revolution in interventional radiology suites and the operating room. Intraoperative Imaging and Image-Guided Therapy explores the fundamental, technical, and clinical aspects of state-of the-art image-guided therapies. It presents the basic concepts of image guidance, the technologies involved in therapy delivery, and the special requirements for the design and construction of image-guided operating rooms and interventional suites. It also covers future developments such as molecular imaging-guided surgeries and novel innovative therapies like MRI-guided focused ultrasound surgery. IGT is a multidisciplinary and multimodality field in which teams of physicians, physicists, engineers, and computer scientists collaborate in performing these interventions, an approach that is reflected in the organization of the book. Contributing authors include members of the National Center of Image-Guided Therapy program at Brigham and Women’s Hospital and international leaders in the field of IGT. The book includes coverage of these topics: - Imaging methods, guidance technologies, and the therapy delivery systems currently used or in development. - Clinical applications for IGT in various specialties such as neurosurgery, ear-nose-and-throat surgery, cardiovascular surgery, endoscopies, and orthopedic procedures. - Review and comparison of the clinical uses for IGT with conventional methods in terms of invasiveness, effectiveness, and outcome. - Requirements for the design and construction of image-guided operating rooms and interventional suites.

MRI-Guided Focused Ultrasound Surgery will be the first publication on this new technology, and will present a variety of current and future clinical applications in tumor ablation treatment. This source helps surgeons and specialists evaluate, analyze, and utilize MRI-guided focused ultrasound surgery - bridging the gap between phase 3 clinical tr

Exciting new developments and applications of imaging techniques have emerged over the last few years, leading to many improvements in diagnosis and staging of urologic diseases. Refinements in the technology mean that imaging now is much more precise than even five years ago, and this has significantly enhanced its application within several key fields. As such, there are virtually no books currently available that cover the impact of these advances within urology leaving a major hole in the market. With its sound overview of the current state of affairs, and also its focus on highlighting future advances, this book would therefore find a significant audience within not only trainees, but also practicing clinicians too. Furthermore, the whole topic of ultrasonography is a relatively overlooked one, with very few modern books tackling any specific areas of the field. This book will be up-to-date and will pay attention to the unique applications of ultrasound within each discipline.

This book combines orthopedists’ and radiologists’ perspectives to provide a comprehensive overview of the rapidly expanding use of ultrasound in orthopedic surgery. It also highlights the growing awareness of the potential of this non-invasive and portable, real-time imaging tool, which has led to its inclusion in the minimally invasive toolkit of upper limb surgeons. The book is divided into five parts – shoulder, elbow, forearm, hand and wrist and fingers. Each part focuses on a particular anatomic region or joint, carefully analyzing the sonoanatomy of its nerves, tendons and bones. For each region, experienced experts illustrate how to perform specific techniques under ultrasound control, ranging from classic procedures, like carpal tunnel release, to the treatment of less common conditions. Covering all the basic and practical aspects of this innovative, multi-disciplinary approach, as well as future perspectives, this unique book is a must-read for all orthopedists, radiologists, sports physicians and physiotherapist wanting to gain insights into this promising field.