Imaging of pancreatic neoplasms: comparison of MR and CT

Thirty-two patients with pathologically proved pancreatic carcinomas or cystadenomas were evaluated with MR images obtained with T1-weighted spin echo (short TR/short TE), inversion recovery, and T2-weighted spin-echo (long TR/long TE) pulse sequences. CT was used as the reference standard to determine the ability of MR to delineate normal and abnormal pancreatic anatomy and thereby to exclude or detect pancreatic malignancy. Short TR/short TE spin-echo sequences were significantly better (p less than .05) than inversion recovery or T2-weighted spin-echo sequences in resolution of both normal and abnormal anatomy. Resolution of pancreatic anatomy correlated (r = .9) with the image signal-to-noise ratio. In seven (22%) of 32 cases, MR visualized pancreatic tumors better than CT did because it showed a signal intensity difference between the tumor and normal pancreatic tissue. Overall, the slight superiority of MR over CT for tumor visualization tended to occur in larger tumors and was not statistically significant. On T1-weighted images, 63% (20 of 32) of pancreatic tumors studied had lower signal intensities than normal pancreatic tissue, whereas on T2-weighted sequences (TE = 60, 120, and 180 msec) only 41% (13 of 32) of tumors had increased signal intensities. Currently available MR imaging techniques offer no significant advantages over CT for evaluating the pancreas for neoplasia.     

MR of visual pathways in patients with neurofibromatosis

MR was performed on six patients clinically diagnosed as having neurofibromatosis. Owing to its multiplanar capability, MR greatly helped determine the extent of visual pathway disease. We attempted to find specific optimal pulse sequences for evaluating the prechiasmatic, chiasmatic, and retrochiasmatic visual system at 0.35 T. Using spin-echo techniques, we evaluated a T1-weighted sequence (TR 300 msec/TE 35 msec), an intermediate T2-weighted sequence (TR 1500 msec/TE 35 msec), and a T2-weighted sequence (TR 1500 msec/TR 70 msec). We found that the orbital and intracanalicular optic nerves were most accurately and easily seen with the T1-weighted sequence axially and coronally; the chiasm was best seen with the intermediate T2-weighted coronal sequence; and the retrochiasmatic visual pathway was optimally evaluated with T2-weighted spin-echo technique.     

MR imaging of the female pelvis at 3 Tesla: evaluation of image homogeneity using different dielectric pads

PURPOSE: To evaluate improvements in image homogeneity in pelvic MR imaging at 3 Tesla (T) using two different dielectric pads. MATERIALS AND METHODS: A total of eight healthy females were scanned using a 3T MR scanner equipped with a body-array coil. Axial and sagittal fast spin-echo T2-weighted images (T2WI) (TR/TE = 3200 msec/94 msec), axial fast spin-echo T1-weighted images (T1WI) (TR/TE = 700 msec/11 msec), and sagittal half-Fourier acquisition single-shot turbo spin-echo (HASTE) images (TR/TE = 3000 msec/100 msec) were performed for pelvic imaging. Sequences were repeated with dielectric pads (consisting of either ultrasound [US] gel or water), and without pads. Three or four regions of interest (ROIs) were placed on fatty tissues and the ratio of minimum to maximum signal intensity (RSI) was calculated as a marker of image homogeneity. RESULTS: RSI was significantly higher on T2WI and T1WI when using dielectric pads than when no pad was used. A similar tendency was observed in RSI on HASTE. No significant difference was found between images with US gel pads and those with water pads. CONCLUSION: Dielectric pads consisting of either US gel or water are effective in improving image homogeneity of the pelvis on 3T MRI.     

Hepatic metastases studied with MR and CT

Examinations of the liver using magnetic resonance (MR) and computed tomography (CT) were performed on 50 patients with hepatic metastases. MR and CT were comparable in their ability to detect metastases, which generally appeared hypointense compared with normal liver parenchyma on T1-weighted MR images and hyperintense on T2-weighted images. The MR imaging techniques that were most reliable in detecting metastases were inversion recovery and a relatively T2-weighted, spin-echo technique (TR = 1,500 msec, TE = 60 msec). We conclude that CT, because of its shorter imaging time, greater spatial resolution, and lower cost, should remain the preferred screening test for hepatic metastases. MR imaging should be reserved for patients with equivocal CT findings and for patients in whom there is persistent clinical suspicion of hepatic metastases despite a negative CT examination.     

Low flip angle spin-echo MR imaging to obtain better Gd-DTPA enhanced imaging with ECG gating]

ECG-gated spin-echo imaging (ECG-SE) can reduce physiological motion artifacts. However, ECG-SE does not provide strong T1-weighted images because repetition time (TR) depends on heart rate (HR). We investigated the usefulness of low flip angle spin-echo imaging (LFSE) in obtaining more T1-dependent contrast with ECG gating. in computer simulation, the predicted image contrast and signal-to-noise ratio (SNR) obtained for each flip angle (0-180 degrees) and each TR (300 msec-1200 msec) were compared with those obtained by conventional T1-weighted spin-echo imaging (CSE: TR = 500 msec, TE = 20 msec). In clinical evaluation, tissue contrast [contrast index (CI): (SI of lesion-SI of muscle)2*100/SI of muscle] obtained by CSE and LFSE were compared in 17 patients. At a TR of 1,000 msec, T1-dependent contrast increased with decreasing flip angle and that at 38 degrees was identical to that with T1-weighted spin-echo. SNR increased with the flip angle until 100 degrees, and that at 53 degrees was identical to that with T1-weighted spin-echo. CI on LFSE (74.0 +/- 52.0) was significantly higher than CI on CSE (40.9 +/- 35.9). ECG-gated LFSE imaging provides better T1-dependent contrast than conventional ECG-SE. This method was especially useful for Gd-DTPA enhanced MR imaging.     

Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients

OBJECTIVE: The purpose of this study was to assess the accuracy of routine T2-weighted MR imaging in detecting and grading articular cartilage lesions in the knee compared with arthroscopy. SUBJECTS AND METHODS: We examined 130 consecutive patients who underwent MR imaging and arthroscopy of the knee for suspected internal derangement. MR imaging consisted of axial and coronal T2-weighted fast spin-echo sequences with fat saturation and sagittal T2-weighted spin-echo sequences. Each single plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. RESULTS: Of the 86 arthroscopically proven abnormalities, 81 were detected on MR imaging. Sensitivity of the T2-weighted fast spin-echo sequence with fat saturation was 61% for the coronal plane alone and 59% for the axial plane alone. Specificity for each plane was 99%. Sensitivity for the sagittal T2-weighted spin-echo sequence was 40%, and specificity was 100%. Sensitivity of the combination of axial and coronal T2-weighted fast spin-echo sequences with fat saturation and sagittal T2-weighted spin-echo sequence compared with arthroscopy for revealing cartilage lesions was 94%, specificity was 99%, and accuracy was 98%. Sensitivity of coronal and axial T2-weighted fast spin-echo sequences with fat saturation was 93%, and specificity was 99%. Fifty-five lesions (64%) were identically graded on MR imaging and arthroscopy. Seventy-eight lesions (90%) were within one grade using MR imaging and arthroscopy, and 84 lesions (97%) were within two grades using MR imaging and arthroscopy. CONCLUSION: T2-weighted fast spin-echo MR imaging with fat saturation is an accurate and fast technique for detecting and grading articular cartilage defects in the knee. The combination of the axial and coronal planes offers sufficient coverage of articular surfaces to provide a high sensitivity and specificity for chondral defects.     

Gradient-echo MR imaging of the cervical spine: evaluation of extradural disease

A prospective study was undertaken on 204 consecutive patients comparing low flip angle gradient-echo and T1-weighted spin-echo techniques in the MR evaluation of cervical extradural disease. Four patient groups were studied with varying gradient-echo TEs (6 or 13 msec) and flip angles (10 degrees or 60 degrees). Images were evaluated independently for contrast behavior and anatomy, then directly compared for conspicuity of lesions. The FLASH sequences (especially with a 10 degrees flip angle) produced better conspicuity of disease in half the imaging time. T1-weighted spin-echo sequences were more sensitive to marrow changes and intradural disease. The short TE sequence (6 msec) did not produce any diagnostic advantage over the longer TE sequence (13 msec). A fast and sensitive MR examination for cervical extradural disease combines a sagittal T1-weighted spin-echo acquisition with sagittal and axial FLASH 10 degrees sequences.     

Phase imaging on a .2-T MR scanner: Application to temperature monitoring during ablation procedures

Proton phase shift imaging methods with keyholing were developed to rapidly monitor temperature during MR-guided radiofrequency (RF) interventional procedures on a .2-T open configuration scanner. Temperature calibration was performed on thermally controlled gel phantom and ex vivo bovine liver samples. Keyholing methods were implemented for rapid imaging and tested both in simulation experiments and in the gel phantom. Phase drifts from extraneous sources were monitored and compensated for using reference phantoms. Sequence parameters TE, TR, and flip angle (FA) were optimized for maximum temperature sensitivity and minimum noise. Reduction of phase noise from coupling of the magnetic field to external perturbations using navigator-echo-based correction schemes were also investigated. The extraneous phase drifts from the magnet could be minimized by keeping the electromagnet on continuously. Navigator echo corrected keyholed FLASH sequences (TE = 30 msec, TR = 60 msec, FA = 40°, 64 × 128 matrix) were used to monitor the RF lesioning process in gel phantoms yielding images every 4 seconds with a temperature sensitivity of .015 ppm/°C. RF ablation in the bovine tissue was monitored using navigator-echo-corrected keyholed fast low angle shot (FLASH) sequences (TE = 30 msec, TR = 100 msec, FA = 40°, 128 × 256 matrix) with a temporal resolution of 13 seconds and a temperature sensitivity of .007 ppm/°C. The results indicate that monitoring of an RF ablation procedure by mapping temperature with sufficient temporal resolution is possible using phase images of FLASH sequences on a .2-T open scanner.     

Quantifying tissue damage due to focused ultrasound heating observed by MRI.

Focused ultrasound heating of ex vivo bovine kidney and liver was monitored using magnetic resonance imaging (MRI) to investigate the quantitative relationship between time-dependent temperature elevations and altered contrast in MR images due to thermal coagulation. Proton resonance frequency shift MR thermometry was performed during heating at 10 sec intervals (single-slice fast spoiled GRASS [FSPGR], theta/TE/TR 30 degrees/11/39 msec, field of view 8 cm, 256 x 256, 3 mm slice thickness, 1 NEX); post-heating MR images were T1-weighted (3D-FSPGR, theta/TE/TR 60 degrees/25/200 msec, 1 mm slice thickness, 3 NEX). Analysis of the resulting temperature versus time data using the Arrhenius relationship and a simple binary discrimination model showed that thermal coagulation occurred with heating at approximately 54 degrees C for 10 sec in both tissues and could be predicted with approximately 625 microm spatial resolution. These results suggest that quantitative MR guidance of thermal coagulation therapy is feasible, and they provide information useful for designing future investigations in vivo.     

Contrast optimization for the detection of focal hepatic lesions by MR imaging at 1.5 T

The relative efficacies of different spin-echo pulse sequences at 1.5 T were evaluated in the detection of focal hepatic disease. Pulse sequences compared were spin-echo with a repetition time (TR) of 200 msec and echo time (TE) of 20 msec, with six excitations; TR = 300 msec, TE = 20 msec, with 16 excitations (T1-weighted sequences); and a double spin-echo with TR = 2500 and TE = 25 and 70, with two excitations (proton-density-weighted and T2-weighted pulse sequences, respectively). Respiratory-motion compensation, which involved a recording of the phase-encoding gradients (Exorcist), was used for the last two sequences. Spin-echo with TR = 2500 msec and TE = 70 msec was superior in lesion detection and contrast-to-noise ratio. The proton-density-weighted and T2-weighted sequences with respiratory compensation produced better artifact suppression than did the short TR, short TE T1-weighted sequence with temporal averaging. In contradistinction to prior results at 0.6 T, T2-weighted pulse sequences appear superior to T1-weighted pulse sequences with multiple excitations for both lesion detection and artifact suppression at 1.5 T.     

Fast MR imaging of liver metastasis using FLASH and FISP--optimal sequences for T1- and T2*-weighted images

This paper deals with a study to obtain the optimal sequence of gradient echo (GE) for T1- and T2*-weighted images similar to T1- and T2-weighted images of spin echo (SE). Two GE sequences, fast low angle shot (FLASH) and fast imaging with steady-state precession (FISP), were performed in 15 cases of liver metastasis in various combination of flip angle (FA), repetition time (TR), and echo time (TE). The optimal combinations were summarized as follows: 1) T1-weighted FLASH image with FA of 40 degrees, TR of 22 msec and TE of 10 msec, 2) T1-weighted FISP image with FA of 70 degrees, TR of 100 msec, TE of 10 msec, 3) both T2*-weighted FLASH and FISP images with FA of 10 degrees, TR of 100 msec and TE of 30 msec. Not only to provide the adequate T1- and T2*-weighted images but also to enable breath-holding MR imaging, GE sequences can optionally take place SE in cases of deteriorated images caused by moving artifacts. Other applications support the re-examination and further detailing when required, conveniently rather in short time.     

Sequence optimization in mangafodipir trisodium-enhanced liver and pancreas MRI

To find an optimal magnetic resonance (MR) sequence for mangafodipir trisodium-enhanced liver and pancreas imaging, six healthy volunteers were studied using a 1.5 T MR system with different T1-weighted abdominal imaging sequences. These were turbo field (gradient)-echo (TFE), fast field (gradient)-echo (FFE), and spin-echo sequences before and after mangafodipir trisodium administration. Various parameter combinations were investigated within each sequence type, and then the best combination was found and compared with those of the other sequences. Signal intensity (SI) measurements were made in regions of interest in the liver, pancreas, and a reference marker with a known T1 value. Contrast index (CI, SItissue/SImarker) and contrast-to-noise ratio (CNR, [SItissue/SImarker]/SDbackground) were calculated, and percentage CI increase and CNR in the postcontrast images were used for the best sequence evaluation. Regarding CI, the TFE sequence with a TR/TE/flip angle of 15 msec/4.6 msec/20 degrees and inversion time of 300 msec had the largest pre- to postcontrast percentage increase. The FFE sequence with a TR/TE/flip angle of 140 msec/4.6 msec/90 degrees had the highest postcontrast CNR and is considered to be the optimal sequence for mangafodipir trisodium-enhanced MR imaging of the liver and pancreas.     

Comparison of single-shot fast spin-echo and conventional spin-echo sequences for MR imaging of the heart: initial experience

A conventional T1-weighted spin-echo (SE) magnetic resonance (MR) imaging sequence was compared with breath-hold and non-breath-hold half- Fourier single-shot fast SE MR sequences with black-blood preparation and high spatial resolution for imaging of various cardiac diseases. The optimized single-shot fast SE sequence provided better or equal image quality in less time. Breath-hold and non-breath-hold single-shot fast SE sequences may replace the conventional T1-weighted SE sequence for first-line cardiac MR imaging.     

Improved tissue characterization of focal liver lesions with ferumoxide-enhanced T1 and T2-weighted MR imaging

The purpose of our study was to evaluate the potential value of ferumoxide-enhanced T1-weighted magnetic resonance (MR) imaging for tissue characterization of focal liver lesions when combined with T2-weighted sequences. Images were acquired within 30 minutes after the end of ferumoxide administration, when ferrite particles were not totally cleared from the intravascular compartment. Thirty-eight patients with 47 focal liver lesions underwent T1-weighted gradient-echo (TR/TE 150/4.1 msec) and T2-weighted fast spin-echo (3180-8638/90 msec) MR imaging at 1.5 T before and after intravenous administration of ferumoxides (10 micromol/kg body weight). A qualitative and quantitative analysis was performed. During the early phase after infusion of ferumoxide, blood vessels showed hypersignal intensity on T1-weighted fast low-angle shot (FLASH) images, while liver signal decreased. Hemangiomas showed both homogeneous and inhomogeneous enhancement patterns, and liver metastasis most typically showed ring enhancement. Hypervascular tumors (hepatocellular carcinomas and focal nodular hyperplasias) showed a slight degree of homogeneous enhancement. Quantitatively, the degree of enhancement and lesion-to-liver contrast on ferumoxide-enhanced images were significantly different among these tumors. Our results demonstrate that distinct enhancement patterns obtained on ferumoxide-enhanced T1-weighted MR imaging improve tissue characterization of focal liver lesions when combined with T2-weighted images.     

On-line monitoring of ultrasonic surgery with MR imaging

Ultrasonic surgery was performed in rabbits and dogs under the guidance of magnetic resonance (MR) imaging. Two different MR techniques were used to guide the ultrasound beam. T2-weighted images showed lesion formation within a few minutes after sonication. T1-weighted GRASS (gradient-recalled acquisition in the steady state) images were sensitive to temperature elevations, permitting monitoring of lesion creation with MR imaging. Short TR T1-weighted GRASS images were not as helpful in detecting temperature elevation because of a reduction in signal-to-noise ratio. T2-weighted fast spin-echo images were compared with conventional T2-weighted spin-echo images. The former produced high-quality images in a fraction of the imaging time. This study shows that it is possible to monitor and guide ultrasonic surgery with MR imaging.     

Fast spin-echo imaging of the knee: Factors influencing contrast

Conventional T2-weighted spin-echo magnetic resonance imaging of the knee requires a long TR. Fast spin-echo (FSE) imaging can improve acquisition efficiency severalfold by collecting multiple lines of k space for each TR. Compromises in resolution, section coverage, and contrast inevitably result. The authors examined the compromises encountered in FSE imaging of the knee and discuss the variations in image contrast and resolution due to choices of sequence parameters. For short TR/TE knee imaging, FSE does not appear to offer any advantages, since the increased collection efficiency for one section reduces the available number of sections, so that the total imaging time for a given number of sections remains constant relative to conventional spin-echo imaging. For T2-weighted images, considerable time can be saved and comparable quality images can be obtained. This saved time can be usefully spent on increasing both the resolution of the image and its signal-to-noise ratio, while still reducing total acquisition time by a factor of two. The preferred FSE T2-weighted images were acquired with a TR of 4,500 msec, TE of 120 msec, and eight echoes. The available number of sections is compromised, and the sequence remains sensitive to flow artifacts; however, the FSE sequence appears to be promising for knee imaging.     

Rectal carcinoma: high-spatial-resolution MR imaging and T2 quantification in rectal cancer specimens

PURPOSE: To prospectively compare high-spatial-resolution T1-weighted, T2-weighted, and intermediate-weighted spectral fat-saturated magnetic resonance (MR) imaging for the differentiation of tumor from fibrosis and for delineation of rectal wall layers in rectal cancer specimens. MATERIALS AND METHODS: The local ethics committee approved the protocol, and written informed consent was obtained from each patient. Thin-section high-spatial-resolution MR imaging was performed in specimens obtained from 23 patients (16 men, seven women; median age, 64 years; age range, 39-84 years) immediately after resection. Seven patients underwent neoadjuvant treatment. T1-weighted spin-echo, T2-weighted fast spin-echo, and intermediate-weighted spectral fat-saturated MR images were obtained in the transverse plane. Differences in signal intensity between tumor and fibrosis and between tumor and rectal wall layers were evaluated by using visual scoring and measurements of T2 relaxation time. Statistical differences were evaluated by using the Wilcoxon signed rank test and a mixed-model regression analysis. All images were compared with whole-mount histopathologic slices (n = 86). RESULTS: T2-weighted MR images provided the best differentiation between tumor and fibrosis (P < .001). Mean visual signal intensity scores were -1.8 for T2-weighted MR images, -1.4 for intermediate-weighted spectral fat-saturated MR images, and -0.2 for T1-weighted MR images. T2 relaxation times were 97 msec +/- 4.6 for tumor and 70 msec +/- 3.8 for fibrosis (P < .001). Substantial overlap was noted between the tumor and the circular layer of the muscularis propria (97 msec +/- 2.1), and less overlap was noted between the tumor and the longitudinal layer of the muscularis propria (88 msec +/- 1.6). CONCLUSION: T2-weighted MR imaging provides superior delineation of rectal wall layers and better differentiation of tumor from fibrosis in rectal cancer specimens compared with T1-weighted MR imaging and intermediate-weighted spectral fat-saturated MR imaging by using thin-section high-spatial-resolution sequences.     

Visualization of brain iron by mid-field MR

Brain iron was visualized on a mid-field (0.5 T) scanner using a spin-echo pulse sequence. Methemoglobin was hyperintense on T1- and T2-weighted images. Deoxyhemoglobin, hemosiderin, and ferritin were seen as decreased intensity on T2-weighted images. The spin-echo pulse sequences were improved for identification of deoxyhemoglobin, hemosiderin, and ferritin by prolonging the TR to 3000 msec and the TE to 80-120 msec. Phase-encoding artifacts at the level of the sylvian fissures caused increased noise, obscuring the brain iron in the lentiform nuclei with the TE of 120 msec. This artifact was substantially reduced or eliminated by lowering the TE to 80 msec, changing the phase-encoding gradient to the Y axis, or using additional pulsing in the slice and read gradients. Use of either the improved spin-echo or gradient-echo pulse sequences on a mid-field MR scanner provides improved evaluation of brain iron.     

MR imaging of the lungs: value of short TE spin-echo pulse sequences.

OBJECTIVE. An experimental short echo delay (TE = 7 msec) T1-weighted spin-echo sequence was compared with a conventional (TE = 20 msec) T1-weighted spin-echo sequence in the assessment of normal and abnormal lung parenchyma. Comparison was also made with high-resolution CT of abnormal lung parenchyma. SUBJECTS AND METHOD. At 1.5 T, an experimental short echo delay T1-weighted multislice spin-echo sequence (TR = RR interval, TE = 7 msec) was compared with an optimal conventional T1-weighted spin-echo sequence (TR = RR interval, TE = 20 msec, spatial presaturation). Ten healthy volunteers were examined with both sequences. The mean signal intensity and signal-to-noise ratios were calculated in lung parenchyma for both sequences. Two radiologists compared the visualization of normal lung parenchymal structures with the two techniques. In 24 patients with diffuse lung disease, results with both MR sequences and with high-resolution CT were compared. RESULTS. The signal intensity was significantly greater (p < .001) with the TE of 7 msec than with the TE of 20 msec, resulting in a 3.5-fold improvement in the signal-to-noise ratio. The 7-msec TE improved visualization of lung parenchymal structures, including peripheral vessels, interlobular septa or veins, and centrilobular arteries. In the patients with diffuse lung disease, pulmonary parenchymal abnormalities were better visualized on the images with TEs of 7 msec than on images with TEs of 20 msec. When compared with high-resolution CT, the sequence with a TE of 7 msec provided comparable assessment of air-space opacification and dense consolidation, but it was inferior to high-resolution CT in the anatomic assessment of lung parenchyma. CONCLUSION. This experimental spin-echo sequence with a TE of 7 msec significantly improves the signal-to-noise ratio, allowing improved visualization of normal and abnormal pulmonary parenchyma when compared with conventional spin-echo images with a TE of 20 msec. Although anatomic detail remains inferior to that seen with high-resolution CT, the improved image quality with a TE of 7 msec suggests that assessment and follow-up of parenchymal lung disease might be possible with MR, thereby avoiding ionizing radiation.     

Temperature measurement using echo-shifted FLASH at low field for interventional MRI

We investigated the feasibility of using echo-shifted fast low-angle shot (FLASH) for temperature-monitored thermo-therapeutic procedures in a 0.2 T interventional magnetic resonance (MR) scanner. Based on the proton resonance frequency shift technique, modified echo-shifted FLASH has sufficiently high signal-to-noise ratio to provide accurate temperature maps with short scan times, i.e., 5 seconds in phantoms (TR = 20.5 msec; effective TE = 30 msec; one echo shift; NSA = 2) and ex vivo experiments (TR = 19.4 msec; effective TE = 28.9 msec; one echo shift; NSA = 2) and 3 seconds (TR = 19.4 msec; effective TE = 28.9 msec, one echo shift; NSA 1) for an in vivo case. The proton resonance frequency shifts with temperature observed in a 0.2 T MR scanner using this sequence were -0.0072 ppm/degrees C (temperature uncertainty = +/-2.5 degrees C) for polyacrylamide phantoins and -0.0086 ppm/degrees C (temperature uncertainty = +/- 1 degrees C) for ex vivo bovine liver. These experiments demonstrated that echo-shifted FLASH is a viable method for low-field temperature monitoring despite the decreased signal and decreased phase sensitivity compared with its counterpart in a 1.5 T MR imaging system. The improved temporal resolution of temperature images, now possible in low-field interventional MR systems using echo-shifted FLASH, will allow clinicians more accurate monitoring of interstitial ablation in MR-guided interventional procedures.