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A new 4D-MRI strategy enables daily liver radiotherapy guidance on an MR-Linac. This fast imaging technique provides clear T2-weighted tumor visibility without contrast agents.

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4D-MRILiverMR-LinacMRI-guidanceRespiratory motionSelf-gating

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Area of Science:

  • Medical Imaging
  • Radiotherapy
  • Magnetic Resonance Imaging

Background:

  • Magnetic Resonance-Linear Accelerators (MR-Linacs) enable daily MRI-guidance for liver radiotherapy.
  • Developing efficient 4D-MRI (four-dimensional magnetic resonance imaging) strategies is crucial for real-time motion management during treatment.

Purpose of the Study:

  • To develop a 4D-MRI strategy for liver radiotherapy on an MR-Linac.
  • The strategy aims for an acquisition-reconstruction time under 5 minutes.
  • It should provide T2-weighted images for non-contrast enhanced tumor visibility.

Main Methods:

  • Utilized an axial multi-slice 2D Turbo Spin Echo (TSE) sequence with variable dynamics.
  • Developed a self-sorting signal (SsS) for respiratory motion tracking.
  • Validated the method in phantom and volunteer studies, assessing image quality (SSIM) and motion quantification.

Main Results:

  • The self-sorting signal (SsS) showed good agreement with reference navigator signals.
  • Image quality (SSIM) remained approximately 0.6 for interpolated slices.
  • Quantified liver motion had a Root Mean Square Deviation (RMSD) of <1 mm with >10 dynamics.

Conclusions:

  • The 4D-MRI strategy achieved an acquisition-reconstruction time under 5 minutes with 30 dynamics.
  • Validation experiments demonstrated good performance.
  • Tumor visibility was clearly achieved in patient images, supporting its clinical utility.