Fifty-sixth annual meeting of the American association of physicists in medicine
TH-A-BRF-12: Assessment of 4D-MRI for Robust Motion and Volume Characterization
Precise radiation therapy for abdominal lesions is complicated by respiratory motion and poor soft tissue contrast from 4DCT whereas 4DMRI provides superior tissue discrimination. We evaluated a novel 4D-MRI algorithm for MR-SIM motion management.
Respiratory-triggered, T2-weighted single-shot Turbo Spin Echo 4D-MRI was evaluated for open high-field 1.0T MR-SIM. A programmable platform pulled objects on a trolley ∼2 cm superior-inferior (S-I) for “regular” (sinusoidal, (1-cos2), 3-5 second periods) and “irregular” breathing patterns (exaggerated (1-cos2) and patient curves), while a respiratory waveform was generated via a pressure sensor device. Coronal 4D-MRIs (2–12;10 phases, TE/TR/α = 35−61/6100 ms/90°, voxel=1×1×4 mm3) were acquired for 54 unique phantom cases. Abdominal 4D−MRIs were evaluated for 5 healthy volunteers and 1 liver cancer patient (6–10 phases, TE/TR/α = 30−96/4500−6100 ms/90°, voxel=1×1×5–10 mm3) on an IRB-approved protocol. Duty cycle, scan time, and excursion were evaluated between phase acquisitions and compared to coronal cine-MRI (∼1 frame/sec). Maximum intensity projections (MIPs) were analyzed.
In phantom, average duty cycle was 42.6 ± 11.4% (range: 23.6–69.1%). Regular, periodic breathing (sinusoidal, (1-cos2)) yielded higher duty cycles than irregular (48.5% and 35.9%, respectively, p<0.001) and fast periods had higher duty cycles than slow (50.4% for 3s and 39.4% for 5s, p<0.001). ∼4-fold acquisition time increase was measured for 10-phase versus 2-phase. MIP renderings revealed that SI object extent was underestimated a maximum of 4% (3mm) and 8% (6mm) for cine and 2-phase 4D-MRI, respectively, with respect to 10-phases. However, this was waveform dependent. A highly irregular breathing volunteer yielded lowest duty cycle (23%) and longest 10-phase scan time (∼14 minutes), although 6-phase acquisition for a liver cancer patient was reasonable (50% and 7.4 minutes, respectively).
4D-MRI offers potential for excursion characterization, although results suggest the use of adequate phases is important. Further application and clinical validation are warranted.
Research supported in part by a grant from Philips HealthCare (Best, Netherlands) and an Internal Mentored Grant from Henry Ford Health System.