Florian Friedrich1,2, Philipp Mann3,4, C. Katharina Spindeldreier5, Peter Bachert1,2, Mark E. Ladd1, Sebastian Klüter5, and Benjamin R. Knowles1
1Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany, 2Department of Physics and Astronomy, Heidelberg University, Heidelberg, Germany, 3Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany, 4National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany, 5Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg, Germany
Synopsis
Hybrid MRI linear accelerators (MR-linacs) enable real-time image
guidance during radiotherapy. Under real-time MRI, a compromise must be found
between spatio-temporal resolution and SNR, whereas to precisely track tumour
position, both should be maximised. The presented method implements a
motion-adaptive image reconstruction based on a golden-angle radial acquisition
scheme. This allows producing SNR-optimised images under periods of small
motion and images optimised for temporal resolution when motion is larger. The
technique was implemented at a low-field MR-linac (0.35T) to image a
free-breathing volunteer and a motion phantom.
Introduction
A
hybrid MRI linear accelerator (MR-linac) enables real-time image guidance for
tumour position tracking during irradiation. The aim is to either gate or
update the x-ray beam position based on tumour location to reduce the radiation
dose of healthy tissue and to enable tumour dose escalation. Real-time imaging
is particularly relevant for treatments in the abdomen and thorax, where organ
motion is particularly problematic. An additional challenge is the small signal
due to a low B0 field on the MR-linac system used in this
study. The aim of this work was to apply a motion-adaptive temporal resolution
technique on a MR-linac, using a self-navigated golden-angle radial acquisition
approach, to increase SNR for periods of small motions and temporal resolution
for large motion.Methods
All
experiments were performed on a 0.35T MRIdian system (ViewRay Inc., Cleveland,
Ohio,
USA), using a 12-channel receive coil. A motion tracking sequence was
implemented based on balanced steady-state free precession (bSSFP) [1]
with a radial k-space sampling scheme using radial lines (spokes) acquired in a
golden angle (Ψ1=111.24...°) [2] or tiny golden angle (Ψ10=16.95...°)
[3] fashion.
The sequence was used in conjunction with an offline motion-adapted
reconstruction [4] implemented in Python 3.6.1. Individual images were reconstructed
using the ‘sliding window’ technique in which the previous n radial
spokes were used for reconstruction, using a non-uniform fast Fourier transform
[5] implemented in pynufft 0.3.2.9 [6]. The sliding window width (i.e., the size of n) was automatically derived from the
magnitude of the detected motion as derived from observation of the magnitude
of the k-space centre signal value, smoothed by a Savitzky-Golay filter before
motion analysis. The minimum window width was set to 28 spokes per
image, which represents a temporal resolution of 2 frames/s.
Experiments were performed on a motion phantom (Fig.1) and one healthy
subject. Imaging parameters of the tracking sequence were: 2D acquisition; 1
slice; TR/TE=9.0/4.5ms; (Δx)³=2.2x2.2x8mm³; FOV=280x280mm²; FA=60°; bandwidths
of 200 and 800Hz/px were tested. The in-house-built motion phantom [7] was
driven by a CIRS motor (CIRS Inc., Norfolk, Virginia, USA). The motor was
driven with a sin4 trajectory to simulate breathing motion
(3cm peak-to-peak amplitude, 6s breathing circle). Rigid image registration was
performed using phase correlation [8] implemented in skimage 0.13.1, and in the
case of the phantom, the mean deviation to the motion was compared between
adaptive and fixed temporal resolution. The healthy subject was given no
breathing instructions.Results
The
comparison between the acquisition schemes with the standard golden and the
tiny golden angle at 200Hz/px bandwidth shows a significant reduction of eddy
current related artefacts for the smaller angle increment (Fig.2). One large
banding artefact is visible in both images independent of the angle increment.
This banding artefact disappeared by increasing the bandwidth to 800Hz/px
(Fig.2), which comes at a cost of decreased SNR.
The
motion-adaptive temporal resolution created a large reconstruction window
towards the end of the exhaled and inhaled states, in which motion is slow
(Fig.3). This enabled an increase in image quality due to the increased number
of spokes in the image reconstruction. During fast motion, a short
reconstruction window ensured blurring was avoided (Fig.4). The image
registration showed improved position detection when the adaptive
reconstruction was used (Fig.5).Discussion
The
tiny golden angle increment produces superior image quality compared to the
standard golden angle, most likely due to the reduction of eddy current
effects. The choice for an optimal bandwidth is a compromise between reducing B0-related
banding artefacts and increasing SNR, especially because of the inherently low
SNR of the imaging system (B0=0.35T). Moreover, a high
bandwidth enables shorter gradients and a smaller repetition time and thus a
higher temporal resolution, which is an advantage for reducing image motion.
While the filtering of the amplitude in k-space centre and the image
reconstruction were performed retrospectively, both were implemented in a way
to allow real-time online imaging.Conclusion
A
tracking sequence with a motion-adaptive reconstruction window has been applied
to a low-field MR-linac. This technique has the advantage over fixed temporal
resolution approaches in that image quality is improved in areas of slow motion
whilst a high temporal resolution is maintained when necessary. An advantage of
radial readout over Cartesian is the continuous motion monitoring, updated by
every spoke, which is much faster than motion monitoring and radiation gating
based on the reconstructed Cartesian image. Future work will be focused on
optimising the adaptive reconstruction window with regards to image quality for
tracking algorithms as well as more advanced real-time data reconstructions to
improve image quality.Acknowledgements
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