Abstract
MATERIALS & METHODS
The first step of the midP workflow is the generation of a simulation midP-MRI from a 4D-MRI scan using deformable image registration. Next, a planning midP-CT is warped to the midP-MRI to enable planning in the midP-MRI anatomy. For daily MRI-guidance, three different registration methods to the simulation midP-MRI are proposed; (1) 4D rigid registration of all phases of the daily 4D-MRI, (2) 3D rigid registration of the daily midP-MRI, and (3) 3D deformable registration of the daily midP-MRI. The midP-MRI image quality was assessed with respect to 4D-MRI acquisition time, which is related to over-sampling of the data acquisition (i.e. number of dynamics). The deformable registration precision for the midP-MRI generation was validated using the distance discordance metric (DDM). The deformable CT-MRI and daily MRI-MRI registration accuracies were quantified using the 'full circle method'.
CONCLUSION
The feasibility of an MRI-guided mid-position workflow for liver SBRT is supported by the demonstrated high precision of all image processing and registration steps.
RESULTS
The DDM was 1.5 mm (median) within the liver, independent of the number of dynamics. The root-mean-squared difference between midP-MRIs based on 10 and 60 dynamics was only 5.2%. The full circle CT-MRI deformable registration error had a median 3D vector length of 1.8 mm in the liver. The daily MRI-MRI registration error was submillimeter for all three evaluated methods.
BACKGROUND & PURPOSE
To propose a novel mid-position (midP) workflow for MRI-guided liver SBRT and provide a validation of the required midP-MRI generation and registration steps.