Jonas F. Faust1,2, Axel J. Krafft2, Daniel Polak2, Ralf Vogel3, Peter Speier2, Nicolas G. R. Behl2, Mark E. Ladd4, and Florian Maier2
1Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany, 2Siemens Healthcare GmbH, Erlangen, Germany, 3Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, 4Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
Synopsis
Accurate 3D
localization of biopsy needles during MR-guided interventions is especially
challenging due to time restrictions in real-time workflows. While active
tracking methods rely on additional RF-sensitive hardware, rapid passive
tracking methods often make use of markers or prior knowledge regarding the
needle location. In an ex-vivo study, we investigated a novel passive tracking
method using heavily undersampled, radial acquisitions in combination with
contrast-optimized White Marker imaging and CNN image postprocessing regarding
its potential to speed up passive needle artifact localization without the use
of additional hardware or prior knowledge on the needle location.
Introduction
For
MR-guided in-bore needle interventions, typically 2D real-time imaging is used
for guidance. Due to 2D imaging, the needle will not be visible if the imaging
planes are not aligned appropriately. Accurate needle localization can support
the interventionalist by enabling automatic alignment of the imaging planes
with the needle. Techniques used for needle localization in real-time workflows
achieve acquisition times below one second but often require the use of
additional markers/hardware or prior knowledge on the needle location.1-3
Recently, the use of Convolutional Neural Networks (CNNs) has been introduced
for the automatic segmentation of needle artifacts in 3D MR images (acquisition
time: 1min), allowing for the accurate path localization of MR-compatible needles4,
and has also been shown to enable 2D needle tracking5,6. We investigated
contrast-optimized White Marker7, radial acquisitions combined with
CNN-based image postprocessing in an ex-vivo study using porcine phantoms to explore
the feasibility of rapid 3D passive needle localization without the use of
additional markers or prior knowledge on the needle location.Methods
A prototype
sequence was implemented on a 1.5T MAGNETOM Sola system (Siemens Healthcare
GmbH, Erlangen, Germany). A White Marker (WM) gradient moment7 was
added to the z-gradient in a FLASH sequence before readout (Fig. 1) to compensate
susceptibility-induced field inhomogeneities close to the needle, rendering a
sparse image contrast with a bright needle artifact on dark, dephased
anatomical background (Fig. 2c). Using a 3D golden means radial acquisition8
allows for retrospective undersampling. A 3D U-Net9 was implemented
and trained to perform a regression towards the presumed needle artifact location
based on the reconstructed images. A principal component analysis (PCA) allowed
determination of both the centroid and orientation of the (thresholded) U-Net
output.
The
proposed tracking technique was evaluated in an ex-vivo study. To train the
U-Net, an MR-compatible needle (KIM16/14, ITP GmbH, Bochum, Germany) was
inserted into six porcine phantoms (Fig. 2a,2b), obtaining 284 different needle
poses (90% training set, 10% validation set) with the phantoms rotated by a random
angle around the vertical axis for every new needle pose (Fig. 3). An
additional phantom was used to evaluate the performance of the localization
method (test set with 35 needle poses). Entry point and tip of the needle
artifact were manually annotated on images reconstructed from the fully sampled
data sets to generate ground truth labels (Fig. 2c,2d). Images were acquired
with k-space fully sampled (6434 projections10) and retrospectively
undersampled to 500, 200, 100, 50 and 20 projections, corresponding to acquisition
times of 76.1s, 6.6s, 3.1s, 2.0s, 1.4s and 1.0s (measurement times including
unused WM-encodings in x- and y-direction and 200 dummy pulses). The U-Net was
specifically trained for the different undersampling factors, using an L2 loss
function and a Stochastic-Gradient-Decent (SGD) optimizer. Performance of the
needle artifact localization method was compared using two measures (Fig. 5a),
the angle α between the annotated needle artifact and the U-Net prediction and
the distance Δx between the predicted needle path and the center point of the manual
annotation. The measures were used to assess the feasibility of automatic slice
positioning using the proposed technique, as they allow estimation of the
required slice thickness Δs to cover the entire needle artifact with length l:
$$\Delta s=\Delta x+\frac{l}{2}\cdot\sin{\alpha}$$
Measurements
were performed using a 20-channel head coil. Image matrix size = (64px)3;
FOV = (300mm)3; res = (4.7mm)3; flip angle = 5°; WM
gradient moment = 5.008mT∙m-1∙ms; TR = 3.9ms; TE = 1.65ms, bandwidth
= 900Hz.Results
Fig. 4
shows the method’s performance for a representative sample from the test set. Fig.
5b and 5c compare Δx and α evaluated over the test set for various
undersampling factors. For the fully sampled images, a median accuracy of (3.1±0.7)mm
for Δx and a median accuracy of (3.8±2.1)° for α were found (median given with
the respective median absolute deviation). For the images reconstructed from a
subset of 20 projections, a median accuracy of (4.0±1.2)mm and (7.8±4.5)° was
found. For a potential application of the localization method to automatically
position a 2D imaging slice, a maximum required slice thickness of 6.4mm and 10.8mm
is estimated for 6434 and 20 projections, assuming a needle path length of
10cm.Discussion
We successfully
developed a novel method for rapid passive needle localization and evaluated
the technique in ex-vivo phantoms. Automatic slice positioning appears feasible
with the slice thickness chosen appropriately. A significant speed-up of the
needle localization could be achieved using high undersampling factors.
Reduction of the acquisition time to less than 1/3 is probably feasible by
removing unused acquisitions. A further improvement of the achieved accuracy is
expected to be feasible with better label quality, e.g., by annotating the
needle location on additionally acquired Fast-Spin-Echo reference scans.Conclusion
The
developed technique allows 3D image-based needle artifact localization in
ex-vivo phantoms and provides sufficient accuracy for automatic slice
positioning. A potential speed-up of the technique can be achieved by heavy
undersampling as demonstrated in the retrospective data analysis. Therefore, the
concept appears promising for further optimization and integration into
real-time workflows. It will be evaluated in-vivo as a next step.Acknowledgements
The authors
thank Dr. Heinz-Werner Henke (Innovative Tomography Products GmbH, Bochum,
Germany) for providing the MR-compatible needle.References
- de Oliveira A, Rauschenberg J,
Beyersdorff D et al. Automatic passive
tracking of an endorectal prostate biopsy device using phase-only
cross-correlation. Magnetic Resonance in
Medicine 2008;59:1043-1050.
- Reichert
A, Reiss S, Krafft, AJ et al. Passive needle guide tracking with radial
acquisition and phase-only cross-correlation. Magnetic Resonance in Medicine
2021;85(2):1039-1046.
- Patil S, Bieri O, Jhooti P and
Scheffler, K. Automatic slice positioning (ASP) for passive real-time tracking
of interventional devices using projection-reconstruction imaging with
echo-dephasing (PRIDE). Magnetic Resonance in Medicine 2009;62: 935-942.
- Mehrtash
A, Ghafoorian M, Pernelle G et al. Automatic Needle Segmentation and
Localization in MRI With 3-D Convolutional Neural Networks: Application to
MRI-Targeted Prostate Biopsy. IEEE Transactions on Medical Imaging 2019;38(4):1026-1036.
- Weine
J, Schneider R, Kägebein U et al. Interleaved White Marker Contrast with bSSFP
Real-Time Imaging for Deep Learning based Needle Localization in MR-Guided
Percutaneous Interventions. ISMRM 27th Annual Meeting &
Exhibition 2019.
- Li X, Young AS, Raman SS et al.
Automatic needle tracking using Mask R-CNN for MRI-guided percutaneous
interventions. International Journal of Computer Assisted Radiology and Surgery
2020;15:1673-1684.
- Seppenwoolde
JH, Viergever MA, Bakker CJ. Passive
tracking exploiting local signal conservation: the white marker phenomenon.
Magnetic Resonance in Medicine 2003;50(4):784-790.
- Chan RW, Ramsay EA, Cunningham CH et
al. Temporal stability of adaptive 3D radial MRI using multidimensional golden
means. Magnetic Resonance in Imaging 2009;61(2):354-363.
- Çiçek Ö, Abdulkadir A, Lienkamp S et
al. 3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation. Medical
Image Computing and Computer-Assisted Intervention - MICCAI 2016;424-432.
- Park J, Lee J, Lee J et al. Strategies
for rapid reconstruction in 3D MRI with radial data acquisition: 3D fast
Fourier transform vs two-step 2D filtered back-projection. Scientific Reports 2020;10:13813.