An image acquisition and registration strategy for the fusion of hyperpolarized helium-3 MRI and x-ray CT images of the lung

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The purpose of this ethics committee approved prospective study was to evaluate an image acquisition and registration protocol for hyperpolarized helium-3 magnetic resonance imaging (3He-MRI) and x-ray computed tomography. Nine patients with non-small cell lung cancer (NSCLC) gave written informed consent to undergo a free-breathing CT, an inspiration breath-hold CT and a 3D ventilation 3He-MRI in CT position using an elliptical birdcage radiofrequency (RF) body coil. 3He-MRI to CT image fusion was performed using a rigid registration algorithm which was assessed by two observers using anatomical landmarks and a percentage volume overlap coefficient. Registration of 3He-MRI to breath-hold CT was more accurate than to free-breathing CT; overlap 82.9 ± 4.2% versus 59.8 ± 9.0% (p < 0.001) and mean landmark error 0.75 ± 0.24 cm versus 1.25 ± 0.60 cm (p = 0.002). Image registration is significantly improved by using an imaging protocol that enables both 3He-MRI and CT to be acquired with similar breath holds and body position through the use of a birdcage 3He-MRI body RF coil and an inspiration breath-hold CT. Fusion of 3He-MRI to CT may be useful for the assessment of patients with lung diseases.