4D-MRI Technique Research Articles

Investigation of sagittal image acquisition for 4D-MRI with body area as respiratory surrogate.

The authors have recently developed a novel 4D-MRI technique for imaging organ respiratory motion employing cine acquisition in the axial plane and using body area (BA) as a respiratory surrogate. A potential disadvantage associated with axial image acquisition is the space-dependent phase shift in the superior-inferior (SI) direction, i.e., different axial slice positions reach the respiratory peak at different respiratory phases. Since respiratory motion occurs mostly in the SI and anterior-posterior (AP) directions, sagittal image acquisition, which embeds motion information in these two directions, is expected to be more robust and less affected by phase-shift than axial image acquisition. This study aims to develop and evaluate a 4D-MRI technique using sagittal image acquisition. The authors evaluated axial BA and sagittal BA using both 4D-CT images (11 cancer patients) and cine MR images (6 healthy volunteers and 1 cancer patient) by comparing their corresponding space-dependent phase-shift in the SI direction (δSPS (SI)) and in the lateral direction (δSPS (LAT)), respectively. To evaluate sagittal BA 4D-MRI method, a motion phantom study and a digital phantom study were performed. Additionally, six patients who had cancer(s) in the liver were prospectively enrolled in this study. For each patient, multislice sagittal MR images were acquired for 4D-MRI reconstruction. 4D retrospective sorting was performed based on respiratory phases. Single-slice cine MRI was also acquired in the axial, coronal, and sagittal planes across the tumor center from which tumor motion trajectories in the SI, AP, and medial-lateral (ML) directions were extracted and used as references from comparison. All MR images were acquired in a 1.5 T scanner using a steady-state precession sequence (frame rate ∼ 3 frames/s). 4D-CT scans showed that δSPS (SI) was significantly greater than δSPS (LAT) (p-value: 0.012); the median phase-shift was 16.9% and 7.7%, respectively. Body surface motion measurement from axial and sagittal MR cines also showed δSPS (SI) was significantly greater than δSPS (LAT). The median δSPS (SI) and δSPS (LAT) was 11.0% and 9.2% (p-value = 0.008), respectively. Tumor motion trajectories from 4D-MRI matched with those from single-slice cine MRI: the mean (±SD) absolute differences in tumor motion amplitude between the two were 1.5 ± 1.6 mm, 2.1 ± 1.9 mm, and 1.1 ± 1.0 mm in the SI, ML, and AP directions from this patient study. Space-dependent phase shift is less problematic for sagittal acquisition than for axial acquisition. 4D-MRI using sagittal acquisition was successfully carried out in patients with hepatic tumors.

WE‐G‐18C‐03: Effects of Breathing Irregularity On Tumor Motion Measurement of 4D‐MRI: A Comparison Between Cine and Sequential Image Acquisition Modes

Purpose:We have recently developed a cine‐mode T2*/T1‐weighted 4DMRI technique, and a sequential‐mode T2‐weighted 4D‐MRI for imaging respiratory motion . The latter has better tumor‐contrast due to its T2‐ weighting. This study aims at investigating which 4D‐MRI image acquisition mode, cine or sequential, provides more accurate measurement of respiratory motion.Methods:A 4D Digital Extended Cardiac‐Torso (XCAT) human phantom with a hypothesized tumor was used to simulate image acquisition and 4D‐MRI reconstruction. Tumor was set to move continuously with a given breathing signal. Its trajectories were measured from both sequential‐ and cine‐mode 4D‐MRI. Comparisons of measurements with the average tumor trajectories calculated from the input profile as references were conducted. Absolute tumor motion amplitude differences (D) were determined. A total of 500 simulated respiratory profiles with a wide range of irregularity were used to investigate the relationship between D and Ir. Statistical analysis of D for breathing profiles of 20 real cancer patients were conducted with a sign rank test regarding two modes. Lastly, we investigated the possibility of further improving motion measurement accuracy in sequential‐mode 4D‐MRI by removing data points of high irregularity. An irregularity filter was applied to the same 20 patients. Sign rank tests for D of sequential‐mode with filter and cine‐mode were performed.Results:D increased faster for cine‐mode (D=0.37*Ir) than sequential‐mode (D=0.16*Ir) as irregularity increased. For 20 cancer patients, D was 0.12cm and 0.10cm for cine‐ and sequentialmodes on average; p‐value was 0.0228. Removing highly irregular data points increased accuracy of tumor trajectory for sequential‐mode 4D‐MRI, D was decreased by 10%. P‐value was 0.0065.Conclusion:Tumor motion measurement is more accurate and less susceptible to breathing irregularity in sequential‐mode 4D‐MRI than that in cine‐mode 4D‐MRI; its accuracy could be further improved in sequential‐mode 4D‐MRI by selectively removing data points of high irregularity.NIH (1R21CA165384‐01A1)

Four-Dimensional Magnetic Resonance Imaging Using Axial Body Area as Respiratory Surrogate: Initial Patient Results

To evaluate the feasibility of a retrospective binning technique for 4-dimensional magnetic resonance imaging (4D-MRI) using body area (BA) as a respiratory surrogate. Seven patients with hepatocellular carcinoma (4 of 7) or liver metastases (3 of 7) were enrolled in an institutional review board-approved prospective study. All patients were simulated with both computed tomography (CT) and MRI to acquire 3-dimensional and 4D images for treatment planning. Multiple-slice multiple-phase cine-MR images were acquired in the axial plane for 4D-MRI reconstruction. Image acquisition time per slice was set to 10-15 seconds. Single-slice 2-dimensional cine-MR images were also acquired across the center of the tumor in orthogonal planes. Tumor motion trajectories from 4D-MRI, cine-MRI, and 4D-CT were analyzed in the superior-inferior (SI), anterior-posterior (AP), and medial-lateral (ML) directions, respectively. Their correlation coefficients (CC) and differences in tumor motion amplitude were determined. Tumor-to-liver contrast-to-noise ratio (CNR) was measured and compared between 4D-CT, 4D-MRI, and conventional T2-weighted fast spin echo MRI. The means (± standard deviations) of CC comparing 4D-MRI with cine-MRI were 0.97 ± 0.03, 0.97 ± 0.02, and 0.99 ± 0.04 in SI, AP, and ML directions, respectively. The mean differences were 0.61 ± 0.17 mm, 0.32 ± 0.17 mm, and 0.14 ± 0.06 mm in SI, AP, and ML directions, respectively. The means of CC comparing 4D-MRI and 4D-CT were 0.95 ± 0.02, 0.94 ± 0.02, and 0.96 ± 0.02 in SI, AP, and ML directions, respectively. The mean differences were 0.74 ± 0.02 mm, 0.33 ± 0.13 mm, and 0.18 ± 0.07 mm in SI, AP, and ML directions, respectively. The mean tumor-to-tissue CNRs were 2.94 ± 1.51, 19.44 ± 14.63, and 39.47 ± 20.81 in 4D-CT, 4D-MRI, and T2-weighted MRI, respectively. The preliminary evaluation of our 4D-MRI technique results in oncologic patients demonstrates its potential usefulness to accurately measure tumor respiratory motion with improved tumor CNR compared with 4D-CT.

4D-MRI Using Sagittal Acquisition and Body Area as Respiratory Surrogate

We have recently developed a novel 4D-MRI technique for imaging organ respiratory motion employing cine acquisition in the axial plane and using body area (BA) as internal respiratory surrogate. A potential pitfall associated with this is inaccurate respiratory phases due to space-dependent phase-shift in the superior-inferior (SI) direction (i.e., different axial slices reach the respiratory peak at different time points). Since respiratory motion occurs mostly in the SI and anterior-posterior (AP) directions, sagittal acquisition, which embeds motion information in both directions, is expected to be more robust and less affected by phase-shift.

WE-G-213CD-04: A Triggering System to Guide 4DMRI Image Acquisition.

To develop a practical triggering system based on pre-selected respiratory amplitudes to guide prospectively the image acquisition of 4DMRI to track abdominal tumor motion for radiotherapy treatment planning. The proposed triggering scheme consists of a preparation stage and an acquisition stage. Immediately prior to MRI acquisition, the preparation stage monitors the respiration via an external respiratory belt. Based on the respiratory amplitude and status (i.e., inhalation↑ or exhalation↓), the respiration cycle is equally divided into N respiratory states. For example, in the 4-state case, the 4 respiratory states are 5%↓″, 50%↑, 95%↑ and 50%↓. The 5%↓ and 95%↑ are used instead of 0% and 100% to improve the robustness of the triggering system. Each state is associated with a trigger which starts image acquisition for one and only one slice. A complete 4DMRI imageset requires N dynamic scans. In each dynamic scan, all slices are acquired once and each is in a specific respiratory state. In different dynamic scans, each slice is associated with different respiratory states to form a 4D dataset. For proof-of-principle, the triggering system was integrated into a T2-weighted turbo spin echo sequence (TE=100ms, TR=7122ms) on a clinical 1.5T MRI (Philips Achieva) scanner. The 4-state case was tested on a healthy subject. Plots of the physiology data recorded and exported from the scanner clearly verified that triggers occurred at the expected locations. Four T2-weighted images from a representative slice recorded the liver motion corresponding to the 4 respiratory states. Our results confirmed that the newly-developed system could trigger prospectively to guide 4DMRI image acquisition to achieve T2 weighting, which has a better tumor-tissue contrast than those offered by previous 4DMRI techniques with T1 or T2/T1 weighting. This is a first report of a pure T2-weighted 4DMRI to track respiration induced abdominal motion.

Four‐dimensional magnetic resonance imaging (4D‐MRI) using image‐based respiratory surrogate: A feasibility study

Four-dimensional computed tomography (4D-CT) has been widely used in radiation therapy to assess patient-specific breathing motion for determining individual safety margins. However, it has two major drawbacks: low soft-tissue contrast and an excessive imaging dose to the patient. This research aimed to develop a clinically feasible four-dimensional magnetic resonance imaging (4D-MRI) technique to overcome these limitations. The proposed 4D-MRI technique was achieved by continuously acquiring axial images throughout the breathing cycle using fast 2D cine-MR imaging, and then retrospectively sorting the images by respiratory phase. The key component of the technique was the use of body area (BA) of the axial MR images as an internal respiratory surrogate to extract the breathing signal. The validation of the BA surrogate was performed using 4D-CT images of 12 cancer patients by comparing the respiratory phases determined using the BA method to those determined clinically using the Real-time position management (RPM) system. The feasibility of the 4D-MRI technique was tested on a dynamic motion phantom, the 4D extended Cardiac Torso (XCAT) digital phantom, and two healthy human subjects. Respiratory phases determined from the BA matched closely to those determined from the RPM: mean (± SD) difference in phase: -3.9% (± 6.4%); mean (± SD) absolute difference in phase: 10.40% (± 3.3%); mean (± SD) correlation coefficient: 0.93 (± 0.04). In the motion phantom study, 4D-MRI clearly showed the sinusoidal motion of the phantom; image artifacts observed were minimal to none. Motion trajectories measured from 4D-MRI and 2D cine-MRI (used as a reference) matched excellently: the mean (± SD) absolute difference in motion amplitude: -0.3 (± 0.5) mm. In the 4D-XCAT phantom study, the simulated "4D-MRI" images showed good consistency with the original 4D-XCAT phantom images. The motion trajectory of the hypothesized "tumor" matched excellently between the two, with a mean (± SD) absolute difference in motion amplitude of 0.5 (± 0.4) mm. 4D-MRI was able to reveal the respiratory motion of internal organs in both human subjects; superior-inferior (SI) maximum motion of the left kidney of Subject #1 and the diaphragm of Subject #2 measured from 4D-MRI was 0.88 and 1.32 cm, respectively. Preliminary results of our study demonstrated the feasibility of a novel retrospective 4D-MRI technique that uses body area as a respiratory surrogate.