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Simultaneous multi-slice accelerated 4D-MRI for radiotherapy guidance.

K Keijnemans1, P T S Borman1, A L H M W van Lier1

  • 1Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

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Summary
This summary is machine-generated.

Simultaneous multi-slice (SMS) 4D-MRI accelerates radiotherapy guidance for thoracic and abdominal cancers. This technique provides clear tumor visibility and anatomically plausible images, making it suitable for treatment simulation and daily guidance.

Keywords:
4D-MRIMR-linaclung cancermid-positionrespiratory motionsimultaneous multi-slice

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Area of Science:

  • Radiology and Medical Imaging
  • Magnetic Resonance Imaging
  • Radiation Oncology

Background:

  • 4D-MRI is crucial for guiding thoracic and abdominal radiotherapy.
  • Accelerated MRI acquisition techniques are needed to improve workflow efficiency.
  • Simultaneous multi-slice (SMS) imaging offers potential for faster 4D-MRI.

Purpose of the Study:

  • To develop and evaluate simultaneous multi-slice (SMS) accelerated 4D-MRI sequences for radiotherapy guidance.
  • To assess the image quality, motion quantification, and anatomical accuracy of SMS-4D-MRI.
  • To investigate the feasibility of SMS-4D-MRI for thoracic tumor visibility and MR-Linac compatibility.

Main Methods:

  • Developed SMS-accelerated balanced turbo field echo (bTFE) and turbo spin echo (TSE) coronal 4D-MRI sequences on 1.5 T scanners.
  • Utilized navigator slices at the liver-lung interface for automatic motion sorting.
  • Validated motion analysis with in vivo peak-to-peak measurements and quantified image registration accuracy using the distance discordance metric (DDM).

Main Results:

  • SMS-4D-MRI sequences were successfully developed, enabling acquisition of 52 coronal images over 30 dynamics in approximately 7 minutes.
  • Reconstruction was possible for 26/27 datasets with minimal missing data (4-26%).
  • Motion analysis showed good agreement (1.8 mm SD for volunteers, 0.9 mm SD for patients), and DDM values indicated high registration accuracy (85-92% < 2 mm).
  • Lung tumors were clearly visible in SMS-4D-TSE and derived 3D MidP images.

Conclusions:

  • SMS-accelerated 4D-MRI sequences provide T2/T1 or T2 weighted contrast with anatomically plausible images.
  • The technique demonstrates good tumor visibility and is compatible with MR-Linac workflows, generating 3D mid-position images.
  • SMS-4D-MRI is a promising tool for treatment simulation and daily guidance in thoracic and abdominal MR-guided radiotherapy.