Adaptive bulk motion exclusion for improved robustness of abdominal magnetic resonance imaging.
ABSTRACT: Non-Cartesian magnetic resonance imaging (MRI) sequences have shown great promise for abdominal examination during free breathing, but break down in the presence of bulk patient motion (i.e. voluntary or involuntary patient movement resulting in translation, rotation or elastic deformations of the body). This work describes a data-consistency-driven image stabilization technique that detects and excludes bulk movements during data acquisition. Bulk motion is identified from changes in the signal intensity distribution across different elements of a multi-channel receive coil array. A short free induction decay signal is acquired after excitation and used as a measure to determine alterations in the load distribution. The technique has been implemented on a clinical MR scanner and evaluated in the abdomen. Six volunteers were scanned and two radiologists scored the reconstructions. To show the applicability to other body areas, additional neck and knee images were acquired. Data corrupted by bulk motion were successfully detected and excluded from image reconstruction. An overall increase in image sharpness and reduction of streaking and shine-through artifacts were seen in the volunteer study, as well as in the neck and knee scans. The proposed technique enables automatic real-time detection and exclusion of bulk motion during MR examinations without user interaction. It may help to improve the reliability of pediatric MRI examinations without the use of sedation.
Project description:In brain/head-and-neck radiotherapy (RT), thermoplastic immobilization masks guarantee reproducible patient positioning in treatment position between MRI, CT, and irradiation. Since immobilization masks do not fit in the diagnostic MR head/head-and-neck coils, flexible surface coils are used for MRI imaging in clinical practice. These coils are placed around the head/neck, in contact with the immobilization masks. However, the positioning of these flexible coils is technician dependent, thus leading to poor image reproducibility. Additionally, flexible surface coils have an inferior signal-to-noise-ratio (SNR) compared to diagnostic coils. The aim of this work was to create a new immobilization setup which fits into the diagnostic MR coils in order to enhance MR image quality and reproducibility. For this purpose, a practical immobilization setup was constructed. The performances of the standard clinical and the proposed setups were compared with four tests: SNR, image quality, motion restriction, and reproducibility of inter-fraction subject positioning. The new immobilization setup resulted in 3.4 times higher SNR values on average than the standard setup, except directly below the flexible surface coils where similar SNR was observed. Overall, the image quality was superior for brain/head-and-neck images acquired with the proposed RT setup. Comparable motion restriction in feet-head/left-right directions (maximum motion ?1 mm) and comparable inter-fraction repositioning accuracy (mean inter-fraction movement 1 ± 0.5 mm) were observed for the standard and the new setup.
Project description:The purpose of this study was to investigate the potential of a head and neck magnetic resonance simulation and immobilization protocol on reducing motion-induced artifacts and improving positional variance for radiation therapy applications.Two groups (group 1, 17 patients; group 2, 14 patients) of patients with head and neck cancer were included under a prospective, institutional review board-approved protocol and signed informed consent. A 3.0-T magnetic resonance imaging (MRI) scanner was used for anatomic and dynamic contrast-enhanced acquisitions with standard diagnostic MRI setup for group 1 and radiation therapy immobilization devices for group 2 patients. The impact of magnetic resonance simulation/immobilization was evaluated qualitatively by 2 observers in terms of motion artifacts and positional reproducibility and quantitatively using 3-dimensional deformable registration to track intrascan maximum motion displacement of voxels inside 7 manually segmented regions of interest.The image quality of group 2 (29 examinations) was significantly better than that of group 1 (50 examinations) as rated by both observers in terms of motion minimization and imaging reproducibility (P < .0001). The greatest average maximum displacement was at the region of the larynx in the posterior direction for patients in group 1 (17 mm; standard deviation, 8.6 mm), whereas the smallest average maximum displacement was at the region of the posterior fossa in the superior direction for patients in group 2 (0.4 mm; standard deviation, 0.18 mm). Compared with group 1, maximum regional motion was reduced in group 2 patients in the oral cavity, floor of mouth, oropharynx, and larynx regions; however, the motion reduction reached statistical significance only in the regions of the oral cavity and floor of mouth (P < .0001).The image quality of head and neck MRI in terms of motion-related artifacts and positional reproducibility was greatly improved by use of radiation therapy immobilization devices. Consequently, immobilization with external and intraoral fixation in MRI examinations is required for radiation therapy application.
Project description:OBJECTIVES:Acceleration of MR sequences beyond current parallel imaging techniques is possible with the Compressed SENSE technique that has recently become available for 1.5 and 3 Tesla scanners, for nearly all image contrasts and for 2D and 3D sequences. The impact of this technique on examination timing parameters and MR protocols in a clinical setting was investigated in this retrospective study. MATERIAL AND METHODS:A numerical analysis of the examination timing parameters (scan time, exam time, procedure time, interscan delay time, changeover time, nonscan time) based on the MR protocols of 6 different body regions (brain, knee, lumbar spine, breast, shoulder) using MR log files was performed and the total number of examinations acquired from January to April both in 2017 and 2018 on a 1.5 T MR scanner was registered. Percentages, box plots and unpaired two-sided t tests were obtained for statistical evaluation. RESULTS:All examination timing parameters of the six anatomical regions analysed were significantly shortened after implementation of Compressed SENSE. On average, scan times were accelerated by 20.2% (p<0.0001) while procedure times were shortened by 16% (p<0.0001). Considering all anatomical regions and all MR protocols, 27% more examinations were performed over the same 4 month period in 2018 compared to 2017. CONCLUSION:Compressed SENSE allows for a significant acceleration of MR examinations and a considerable increase in the total number of MR examinations is possible.
Project description:We have previously developed a retrospective 4D-MRI technique using body area as the respiratory surrogate, but generally, the reconstructed 4D MR images suffer from severe or mild artifacts mainly caused by irregular motion during image acquisition. Those image artifacts may potentially affect the accuracy of tumor target delineation or the shape representation of surrounding nontarget tissues and organs. So the purpose of this study is to propose an approach employing principal component analysis (PCA), combined with a linear polynomial fitting model, to remodel the displacement vector fields (DVFs) obtained from deformable image registration (DIR), with the main goal of reducing the motion artifacts in 4D MR images. Seven patients with hepatocellular carcinoma (2/7) or liver metastases (5/7) in the liver, as well as a patient with non-small cell lung cancer (NSCLC), were enrolled in an IRB-approved prospective study. Both CT and MR simulations were performed for each patient for treatment planning. Multiple-slice, multiple-phase, cine-MRI images were acquired in the axial plane for 4D-MRI reconstruction. Single-slice 2D cine-MR images were acquired across the center of the tumor in axial, coronal, and sagittal planes. For a 4D MR image dataset, the DVFs in three orthogonal direction (inferior–superior (SI), anterior–posterior (AP), and medial–lateral (ML)) relative to a specific reference phase were calculated using an in-house DIR algorithm. The DVFs were preprocessed in three temporal and spatial dimensions using a polynomial fitting model, with the goal of correcting the potential registration errors introduced by three-dimensional DIR. Then PCA was used to decompose each fitted DVF into a linear combination of three principal motion bases whose spanned subspaces combined with their projections had been validated to be sufficient to represent the regular respiratory motion. By wrapping the reference MR image using the remodeled DVFs, 'synthetic' MR images with reduced motion artifacts were generated at selected phase. Tumor motion trajectories derived from cine-MRI, 4D CT, original 4D MRI, and 'synthetic' 4D MRI were analyzed in the SI, AP, and ML directions, respectively. Their correlation coefficient (CC) and difference (D) in motion amplitude were calculated for comparison. Of all the patients, the means and standard deviations (SDs) of CC comparing 'synthetic' 4D MRI and cine-MRI were 0.98 ± 0.01, 0.98 ± 0.01, and 0.99 ± 0.01 in SI, AP, and ML directions, respectively. The mean ± SD Ds were 0.59 ± 0.09 mm, 0.29± 0.10 mm, and 0.15 ± 0.05 mm in SI, AP and ML directions, respectively. The means and SDs of CC comparing 'synthetic' 4D MRI and 4D CT were 0.96 ± 0.01, 0.95± 0.01, and 0.95 ± 0.01 in SI, AP, and ML directions, respectively. The mean ± SD Ds were 0.76 ± 0.20 mm, 0.33 ± 0.14 mm, and 0.19± 0.07 mm in SI, AP, and ML directions, respectively. The means and SDs of CC comparing 'synthetic' 4D MRI and original 4D MRI were 0.98 ± 0.01, 0.98± 0.01, and 0.97± 0.01 in SI, AP, and ML directions, respectively. The mean ± SD Ds were 0.58 ± 0.10 mm, 0.30 ± 0.09mm, and 0.17 ± 0.04 mm in SI, AP, and ML directions, respectively. In this study we have proposed an approach employing PCA combined with a linear polynomial fitting model to capture the regular respiratory motion from a 4D MR image dataset. And its potential usefulness in reducing motion artifacts and improving image quality has been demonstrated by the preliminary results in oncological patients.
Project description:Cardiac PET is a versatile imaging technique providing important diagnostic information about ischemic heart diseases. Respiratory and cardiac motion of the heart can strongly impair image quality and therefore diagnostic accuracy of cardiac PET scans. The aim of this study was to investigate a new cardiac PET/MR approach providing respiratory and cardiac motion-compensated MR and PET images in less than 5 min. Methods: Free-breathing 3-dimensional MR data were acquired and retrospectively binned into multiple respiratory and cardiac motion states. Three-dimensional cardiac and respiratory motion fields were obtained with a nonrigid registration algorithm and used in motion-compensated MR and PET reconstructions to improve image quality. The improvement in image quality and diagnostic accuracy of the technique was assessed in simultaneous 18F-FDG PET/MR scans of a canine model of myocardial infarct and was demonstrated in a human subject. Results: MR motion fields were successfully used to compensate for in vivo cardiac motion, leading to improvements in full width at half maximum of the canine myocardium of 13% ± 5%, similar to cardiac gating but with a 90% ± 57% higher contrast-to-noise ratio between myocardium and blood. Motion correction led to an improvement in MR image quality in all subjects, with an increase in sharpness of the canine coronary arteries of 85% ± 72%. A functional assessment showed good agreement with standard MR cine scans with a difference in ejection fraction of -2% ± 3%. MR-based respiratory and cardiac motion information was used to improve the PET image quality of a human in vivo scan. Conclusion: The MR technique presented here provides both diagnostic and motion information that can be used to improve MR and PET image quality. Reliable respiratory and cardiac motion correction could make cardiac PET results more reproducible.
Project description:BACKGROUND:Carpal instability is defined as a condition where wrist motion and/or loading creates mechanical dysfunction, resulting in weakness, pain and decreased function. When conventional methods do not identify the instability patterns, yet clinical signs of instability exist, the diagnosis of dynamic instability is often suggested to describe carpal derangement manifested only during the wrist's active motion or stress. We addressed the question: can advanced MRI techniques provide quantitative means to evaluate dynamic carpal instability and supplement standard static MRI acquisition? Our objectives were to (i) develop a real-time, three-dimensional MRI method to image the carpal joints during their active, uninterrupted motion; and (ii) demonstrate feasibility of the method for assessing metrics relevant to dynamic carpal instability, thus overcoming limitations of standard MRI. METHODS:Twenty wrists (bilateral wrists of ten healthy participants) were scanned during radial-ulnar deviation and clenched-fist maneuvers. Images resulting from two real-time MRI pulse sequences, four sparse data-acquisition schemes, and three constrained image reconstruction techniques were compared. Image quality was assessed via blinded scoring by three radiologists and quantitative imaging metrics. RESULTS:Real-time MRI data-acquisition employing sparse radial sampling with a gradient-recalled-echo acquisition and constrained iterative reconstruction appeared to provide a practical tradeoff between imaging speed (temporal resolution up to 135 ms per slice) and image quality. The method effectively reduced streaking artifacts arising from data undersampling and enabled the derivation of quantitative measures pertinent to evaluating dynamic carpal instability. CONCLUSION:This study demonstrates that real-time, three-dimensional MRI of the moving wrist is feasible and may be useful for the evaluation of dynamic carpal instability.
Project description:Magnetic resonance imaging (MRI) of the chest has long suffered from its sensitivity to respiratory and cardiac motion with an intrinsically low signal to noise ratio and a limited spatial resolution. The purpose of this study was to perform chest MRI under an adapted non invasive pulsatile flow ventilation system (high frequency percussive ventilation, HFPV®) allowing breath hold durations 10 to 15 times longer than other existing systems.One volunteer and one patient known for a thymic lesion underwent a chest MRI under ventilation percussion technique (VP-MR). Routinely used sequences were performed with and without the device during three sets of apnoea on inspiration.VP-MR was well tolerated in both cases. The mean duration of the thoracic stabilization was 10.5 min (range 8.5-12) and 5.8 min (range 5-6.2) for Volunteer 1 and Patient 1, respectively. An overall increased image quality was seen under VP-MR with a better delineation of the mediastinal lesion for Patient 1. Nodules discovered in Volunteer 1 were confirmed with low dose CT.VP-MR was feasible and increased spatial resolution of chest MRI by allowing acquisition at full inspiration during thoracic stabilization approaching prolonged apnoea. This new technique could be of benefit to numerous thoracic disorders.
Project description:<h4>Background and purpose</h4>In this report, we describe our implementation and initial clinical experience using 4D-MRI driven MR-guided online adaptive radiotherapy (MRgOART) for abdominal stereotactic body radiotherapy (SBRT) on the Elekta Unity MR-Linac.<h4>Materials and methods</h4>Eleven patients with abdominal malignancies were treated with free-breathing SBRT in three to five fractions on a 1.5 T MR-Linac. Online adaptive plans were generated using Adapt-To-Position (ATP) or Adapt-To-Shape (ATS) workflows based on motion averaged or mid-position images derived from a pre-beam 4D-MRI. A high performance server positioned on the local MR-Linac machine network was utilized for 4D-MR image reconstruction. A parallel contour editing approach was employed in the ATS workflow. Intravoxel incoherent motion (IVIM) and T2 mapping sequences were acquired during adaptive planning in both ATP and ATS workflows for treatment response monitoring. Adaptive plans were delivered under real-time cine image motion monitoring.<h4>Results</h4>The shortest 4D-MRI time-to-image was the motion averaged image, followed by mid position and respiratory binned images. In this cohert of patients, 50% of treatments utilized the ATS workflow; the remaining treatments utilized the ATP workflow. Mid-position images were utilized as daily planning images for two of the eleven patients. The mean daily adaptive plan secondary dose calculation and ArcCheck 3D Gamma passing rates were 97.5% (92.1-100.0%) and 99.3% (96.2-100.0%), respectively. The median overall treatment times for abdominal SBRT was 46 and 62 min for ATP and ATS workflows, respectively.<h4>Conclusion</h4>We have successfully implemented and utilized a 4D-MRI driven MRgOART process with ATP and ATS workflows for free-breathing abdominal SBRT on a 1.5 T Elekta Unity MR-Linac.
Project description:Magnetic resonance imaging (MRI) is a widely used method for non-invasive study of the structure and function of the human brain. Increasing magnetic field strengths enable higher resolution imaging; however, long scan times and high motion sensitivity mean that image quality is often limited by the involuntary motion of the subject. Prospective motion correction is a technique that addresses this problem by tracking head motion and continuously updating the imaging pulse sequence, locking the imaging volume position and orientation relative to the moving brain. The accuracy and precision of current MR-compatible tracking systems and navigator methods allows the quantification and correction of large-scale motion, but not the correction of very small involuntary movements in six degrees of freedom. In this work, we present an MR-compatible tracking system comprising a single camera and a single 15 mm marker that provides tracking precision in the order of 10 m and 0.01 degrees. We show preliminary results, which indicate that when used for prospective motion correction, the system enables improvement in image quality at both 3 T and 7 T, even in experienced and cooperative subjects trained to remain motionless during imaging. We also report direct observation and quantification of the mechanical ballistocardiogram (BCG) during simultaneous MR imaging. This is particularly apparent in the head-feet direction, with a peak-to-peak displacement of 140 m.