Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Philips Healthcare, MR Therapy, Cleveland, OH, USA.
Med Phys. 2020 Jul;47(7):3091-3102. doi: 10.1002/mp.14136. Epub 2020 Apr 18.
The purpose of this study was to develop T2-weighted (T2w) time-resolved (TR) four-dimensional magnetic resonance imaging (4DMRI) reconstruction technique with higher soft-tissue contrast for multiple breathing cycle motion assessment by building a super-resolution (SR) framework using the T1w TR-4DMRI reconstruction as guidance.
The multi-breath T1w TR-4DMRI was reconstructed by deforming a high-resolution (HR: 2 × 2 × 2 mm ) volumetric breath-hold (BH, 20s) three-dimensional magnetic resonance imaging (3DMRI) image to a series of low-resolution (LR: 5 × 5 × 5 mm ) 3D cine images at a 2Hz frame rate in free-breathing (FB, 40 s) using an enhanced Demons algorithm, namely [T1 →FB] reconstruction. Within the same imaging session, respiratory-correlated (RC) T2w 4DMRI (2 × 2 × 2 mm ) was acquired based on an internal navigator to gain HR T2w (T2 ) in three states (full exhalation and mid and full inhalation) in ~5 min. Minor binning artifacts in the RC-4DMRI were automatically identified based on voxel intensity correlation (VIC) between consecutive slices as outliers (VIC < VIC -σ) and corrected by deforming the artifact slices to interpolated slices from the adjacent slices iteratively until no outliers were identified. A T2 image with minimal deformation (<1 cm at the diaphragm) from the T1 image was selected for multi-modal B-Spline deformable image registration (DIR) to establish the T2 -T1 voxel correspondence. Two approaches to reconstruct T2w TR-4DMRI were investigated: (A) T2 →[T1 →FB]: to deform T2w HR to T1w BH only as T1w TR-4DMRI was reconstructed, and combine the two displacement vector fields (DVFs) to reconstruct T2w TR-4DMRI, and (B) [T2 ←T1 ]→FB: to deform T1w BH to T2w HR first and apply the deformed T1w BH to reconstruct T2w TR-4DMRI. The reconstruction times were similar, 8-12 min per volume. To validate the two methods, T2w- and T1w-mapped 4D XCAT digital phantoms were utilized with three synthetic spherical tumors (ϕ = 2.0, 3.0, and 4.0 cm) in the lower or mid lobes as the ground truth to evaluate the tumor location (the center of mass, COM), size (volume ratio, %V), and shape (Dice index). Six lung cancer patients were scanned under an IRB-approved protocol and the T2w TR-4DMRI images reconstructed from the two methods were compared based on the preservation of the three tumor characteristics. The local tumor-contained image quality was also characterized using the VIC and structure similarity (SSIM) indexes.
In the 4D digital phantom, excellent tumor alignment after T2 -T1 DIR is achieved: ∆COM = 0.8 ± 0.5 mm, %V = 1.06 ± 0.02, and Dice = 0.91 ± 0.03, in both deformation directions using the DIR-target image as the reference. In patients, binning artifacts are corrected with improved image quality: average VIC increases from 0.92 ± 0.03 to 0.95 ± 0.01. Both T2w TR-4DMRI reconstruction methods produce similar tumor alignment errors ∆COM = 2.9 ± 0.6 mm. However, method B ([T2 ←T1 ]→FB) produces superior results in preserving more T2w tumor features with a higher %V = 0.99 ± 0.03, Dice = 0.81 ± 0.06, VIC = 0.85 ± 0.06, and SSIM = 0.65 ± 0.10 in the T2w TR-4DMRI images.
This study has demonstrated the feasibility of T2w TR-4DMRI reconstruction with high soft-tissue contrast and adequately-preserved tumor position, size, and shape in multiple breathing cycles. The T2w-centric DIR (method B) produces a superior solution for the SR-based framework of T2w TR-4DMRI reconstruction with highly preserved tumor characteristics and local image features, which are useful for tumor delineation and motion management in radiation therapy.
本研究旨在开发一种具有更高软组织对比度的 T2 加权(T2w)时分辨(TR)四维磁共振成像(4DMRI)重建技术,通过使用 T1w TR-4DMRI 重建作为指导构建超分辨率(SR)框架,对多个呼吸周期的运动进行评估。
通过使用增强的 Demons 算法,将高分辨率(HR:2×2×2mm)容积屏气(BH,20s)三维磁共振成像(3DMRI)图像变形为低分辨率(LR:5×5×5mm)3D 电影图像系列,在自由呼吸(FB,40s)中以 2Hz 的帧率进行重建,即[T1→FB]重建。在同一成像过程中,基于内部导航仪获取呼吸相关(RC)T2w 4DMRI(2×2×2mm),以在约 5 分钟内获得三个状态(完全呼气和中、完全吸气)的 HR T2w(T2)。通过对连续切片之间的体素强度相关性(VIC)进行自动识别,将 RC-4DMRI 中的小-bin 伪影作为异常值(VIC<VIC-σ),并通过将异常值的切片变形为相邻切片的插值切片来进行校正。从 T1 图像中选择一个变形最小(膈肌处<1cm)的 T2 图像,用于多模态 B 样条变形图像配准(DIR),以建立 T2-T1 体素对应关系。研究了两种重建 T2w TR-4DMRI 的方法:(A)T2→[T1→FB]:仅对 T2w HR 进行变形以重建 T1w BH,然后组合两个位移向量场(DVFs)以重建 T2w TR-4DMRI,和(B)[T2←T1]→FB:先对 T1w BH 进行变形以重建 T2w HR,然后应用变形后的 T1w BH 来重建 T2w TR-4DMRI。两种方法的重建时间相似,每个容积的重建时间为 8-12 分钟。为了验证这两种方法,使用 T2w 和 T1w 映射的 4D XCAT 数字体模,以及在下叶或中叶的三个合成球形肿瘤(ϕ=2.0、3.0 和 4.0cm)作为地面真实来评估肿瘤位置(质心,COM)、大小(体积比,%V)和形状(Dice 指数)。对 6 名肺癌患者进行了扫描,并根据三种肿瘤特征的保留情况对两种方法重建的 T2w TR-4DMRI 图像进行了比较。还使用体素强度相关性(VIC)和结构相似性(SSIM)指数来评估局部肿瘤包含的图像质量。
在 4D 数字体模中,通过 T2-T1 DIR 实现了肿瘤的精确配准:在两个变形方向上,以 DIR-目标图像为参考,COM 的偏差为 0.8±0.5mm,%V 为 1.06±0.02,Dice 为 0.91±0.03。在患者中,校正了 binning 伪影,提高了图像质量:平均 VIC 从 0.92±0.03 增加到 0.95±0.01。两种 T2w TR-4DMRI 重建方法产生的肿瘤配准误差相似,COM 偏差为 2.9±0.6mm。然而,方法 B([T2←T1]→FB)在保留更多 T2w 肿瘤特征方面产生了更好的结果,具有更高的%V=0.99±0.03、Dice=0.81±0.06、VIC=0.85±0.06 和 SSIM=0.65±0.10 的 T2w TR-4DMRI 图像。
本研究证明了具有高软组织对比度和充分保留肿瘤位置、大小和形状的 T2w TR-4DMRI 重建的可行性。基于 T2w 的 DIR(方法 B)产生了一种更优的解决方案,用于基于 SR 的 T2w TR-4DMRI 重建框架,具有高度保留的肿瘤特征和局部图像特征,这对于放射治疗中的肿瘤勾画和运动管理非常有用。