The purpose of this work is the development of a robust and reliable three-dimensional (3D) Cartesian imaging technique for fast and flexible retrospective 4D abdominal MRI during free breathing. To this end, a non-uniform quasi random (NU-QR) reordering of the phase encoding (k -k ) lines was incorporated into 3D Cartesian acquisition. The proposed sampling scheme allocates more phase encoding points near the k-space origin while reducing the sampling density in the outer part of the k-space. Respiratory self-gating in combination with SPIRiT-reconstruction is used for the reconstruction of abdominal data sets in different respiratory phases (4D-MRI). Six volunteers and three patients were examined at 1.5 T during free breathing. Additionally, data sets with conventional two-dimensional (2D) linear and 2D quasi random phase encoding order were acquired for the volunteers for comparison. A quantitative evaluation of image quality versus scan times (from 70 s to 626 s) for the given sampling schemes was obtained by calculating the normalized mutual information (NMI) for all volunteers. Motion estimation was accomplished by calculating the maximum derivative of a signal intensity profile of a transition (e.g. tumor or diaphragm). The 2D non-uniform quasi-random distribution of phase encoding lines in Cartesian 3D MRI yields more efficient undersampling patterns for parallel imaging compared to conventional uniform quasi-random and linear sampling. Median NMI values of NU-QR sampling are the highest for all scan times. Therefore, within the same scan time 4D imaging could be performed with improved image quality. The proposed method allows for the reconstruction of motion artifact reduced 4D data sets with isotropic spatial resolution of 2.1 × 2.1 × 2.1 mm in a short scan time, e.g. 10 respiratory phases in only 3 min. Cranio-caudal tumor displacements between 23 and 46 mm could be observed. NU-QR sampling enables for stable 4D-MRI with high temporal and spatial resolution within short scan time for visualization of organ or tumor motion during free breathing. Further studies, e.g. the application of the method for radiotherapy planning are needed to investigate the clinical applicability and diagnostic value of the approach.
Purpose To assess the impact of isocenter shifts due to linac gantry and table rotation during cranial stereotactic radiosurgery on D98, target volume coverage (TVC), conformity (CI), and gradient index (GI). Methods Winston‐Lutz (WL) checks were performed on two Elekta Synergy linacs. A stereotactic quality assurance (QA) plan was applied to the ArcCHECK phantom to assess the impact of isocenter shift corrections on Gamma pass rates. These corrections included gantry sag, distance of collimator and couch axes to the gantry axis, and distance between cone‐beam computed tomography (CBCT) isocenter and treatment beam (MV) isocenter. We applied the shifts via script to the treatment plan in Pinnacle 16.2. In a planning study, isocenter and mechanical rotation axis shifts of 0.25 to 2 mm were applied to stereotactic plans of spherical planning target volumes (PTVs) of various volumes. The shifts determined via WL measurements were applied to 16 patient plans with PTV sizes between 0.22 and 10.4 cm3. Results ArcCHECK measurements of a stereotactic treatment showed significant increases in Gamma pass rate for all three measurements (up to 3.8 percentage points) after correction of measured isocenter deviations. For spherical targets of 1 cm3, CI was most severely affected by increasing the distance of the CBCT isocenter (1.22 to 1.62). Gradient index increased with an isocenter‐collimator axis distance of 1.5 mm (3.84 vs 4.62). D98 (normalized to reference) dropped to 0.85 (CBCT), 0.92 (table axis), 0.95 (collimator axis), and 0.98 (gantry sag), with similar but smaller changes for larger targets. Applying measured shifts to patient plans lead to relevant drops in D98 and TVC (7%) for targets below 2 cm3 treated on linac 1. Conclusion Mechanical deviations during gantry, collimator, and table rotation may adversely affect the treatment of small stereotactic lesions. Adjustments of beam isocenters in the treatment planning system (TPS) can be used to both quantify their impact and for prospective correction of treatment plans.
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