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Nosrati R, Paudel M, Ravi A, Pejovic-Milic A, Morton G, Stanisz GJ. Potential applications of the quantitative susceptibility mapping (QSM) in MR-guided radiation therapy. ACTA ACUST UNITED AC 2019; 64:145013. [DOI: 10.1088/1361-6560/ab2623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Beld E, Moerland MA, van der Voort van Zyp JRN, Viergever MA, Lagendijk JJW, Seevinck PR. MRI artifact simulation for clinically relevant MRI sequences for guidance of prostate HDR brachytherapy. Phys Med Biol 2019; 64:095006. [PMID: 30947159 DOI: 10.1088/1361-6560/ab15ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
For the purpose of magnetic resonance imaging (MRI) guidance of prostate high-dose-rate (HDR) brachytherapy, this paper presents a study on the potential of clinically relevant MRI sequences to facilitate tracking or localization of brachytherapy devices (HDR source/titanium needle), and which could simultaneously be used to visualize the anatomy. The tracking or localization involves simulation of the MRI artifact in combination with a template matching algorithm. Simulations of the MRI artifacts induced by an HDR brachytherapy source and a titanium needle were implemented for four types of sequences: spoiled gradient echo, spin echo, balanced steady-state free precession (bSSFP) and bSSFP with spectral attenuated inversion recovery (SPAIR) fat suppression. A phantom study was conducted in which mentioned sequences (in 2D) as well as the volumetric MRI sequences of the current clinical scan protocol were applied to obtain the induced MRI artifacts for an HDR source and a titanium needle. Localization of the objects was performed by a phase correlation based template matching algorithm. The simulated images demonstrated high correspondences with the acquired MR images, and allowed localization of the objects. A comparison between the object positions obtained for all applied MRI sequences showed deviations (from the average position) of 0.2-0.3 mm, proving that all MRI sequences were suitable for localization of the objects, irrespective of their 2D or volumetric nature. This study demonstrated that the MRI artifact induced by an HDR source or a titanium needle could be simulated for the four investigated types of MRI sequences (spoiled gradient echo, spin echo, bSSFP and bSSFP-SPAIR), valuable for real-time object localization in clinical practice. This leads to more flexibility in the choice of MRI sequences for guidance of HDR brachytherapy, as they are suitable for both object localization and anatomy visualization.
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Affiliation(s)
- Ellis Beld
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. Author to whom correspondence may be addressed
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McNabb E, Wong R, Noseworthy MD. Differentiating platinum coated brachytherapy seeds and gold fiducial markers with varying off-resonant frequency offsets. Magn Reson Imaging 2019; 60:68-75. [PMID: 30959177 DOI: 10.1016/j.mri.2019.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 03/14/2019] [Accepted: 04/04/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To develop an off-resonant frequency filtered method to selectively differentiate between implanted gold fiducial markers and platinum coated brachytherapy seeds. MATERIALS AND METHODS The magnetic susceptibilities for gold fiducial markers and brachytherapy seeds differ in magnitude and also in their signs, resulting in B0-field inhomogeneity patterns with opposite main lobes. A pulse sequence used to localize brachytherapy seeds with positive contrast, centre-out radial sampling with off-resonance reception (co-RASOR), was used to reconstruct images with a range of off-resonant frequency offsets. The proposed method utilizes two frequency filters to selectively reconstruct maximum intensity projections through band-pass regions where each seed has its maximal localized hyperintensity. Seeds were simulated and then placed in gel and tissue phantoms to validate the technique using orthogonal 2D slices with seeds both parallel and perpendicular to the B0-field. RESULTS Dual-plane 2D co-RASOR sequences were reconstructed off-resonance with applied frequency filters to create two projections displaying each seed, which were then colour-coded to negative and positive frequencies. Phantom validation showed that each seed contains its maximal CNR in opposing frequency regions as predicted. Local maxima can also appear in both negative and positive frequency regions. The relative difference between the signal of each seed and these local maxima ranged from 1.19 to 3.73, and an image threshold was determined in all cases. Tissue validation showed the technique differentiates seeds correctly and is limited by the hyperintensity patterns observed in the co-RASOR method. CONCLUSIONS Dual-plane co-RASOR offers sub-millimetre positive contrast from implanted seeds that contain unique off-resonant frequency maxima, which frequency filters can selectively differentiate.
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Affiliation(s)
- Evan McNabb
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Raimond Wong
- Juravinski Cancer Centre, Hamilton, Ontario, Canada; Department of Oncology, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael D Noseworthy
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada; Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada; Department of Radiology, McMaster University, Hamilton, Ontario, Canada; Imaging Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
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Nosrati R, Soliman A, Safigholi H, Hashemi M, Wronski M, Morton G, Pejović-Milić A, Stanisz G, Song WY. MRI-based automated detection of implanted low dose rate (LDR) brachytherapy seeds using quantitative susceptibility mapping (QSM) and unsupervised machine learning (ML). Radiother Oncol 2018; 129:540-547. [DOI: 10.1016/j.radonc.2018.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 12/19/2022]
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McNabb E, Wong R, Noseworthy MD. Resolution and registration in dual-plane co-RASOR MR. Phys Med Biol 2018; 63:215005. [PMID: 30260799 DOI: 10.1088/1361-6560/aae4d5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Magnetic resonance imaging (MRI) has superior soft tissue contrast and lower interobserver variability compared to computed tomography and advances in equipment and pseudo-CT estimation have allowed for MR-only radiation therapy planning. Dedicated MR sequences have been used to localize paramagnetic structures with positive contrast, and most implanted seeds are gold fiducial markers (GFMs). We used a fast, dual-plane co-RASOR sequence to localize implanted GFMs with positive contrast in phantom and tissue to assess their resolution and registration accuracy of registration to CT. Off-resonant reconstructions of co-RASOR images were able to resolve GFMs down to 5 mm apart at 12 cm FOV. No systematic biases were observed by comparing registration of co-RASOR and bSSFP to CT images in an MR-compatible Lego phantom with a set of highly visible known points. The standard deviations of the MR to CT distance errors were <0.5 mm in all directions. We separated the component due to registration by comparing the two MR sequences, which had a maximum standard deviation of 0.36 mm in the SI-direction. Registration using the positive contrast points in a porcine sample phantom showed increased errors, but co-RASOR still performs acceptably with a target registration error of <0.75 mm. The dual-plane co-RASOR sequence could then be used for both registration and image tracking when performing MR-only radiation therapy planning.
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Affiliation(s)
- Evan McNabb
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
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Beld E, Moerland MA, Zijlstra F, Viergever MA, Lagendijk JJW, Seevinck PR. MR-based source localization for MR-guided HDR brachytherapy. Phys Med Biol 2018. [PMID: 29516866 DOI: 10.1088/1361-6560/aab50b] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
For the purpose of MR-guided high-dose-rate (HDR) brachytherapy, a method for real-time localization of an HDR brachytherapy source was developed, which requires high spatial and temporal resolutions. MR-based localization of an HDR source serves two main aims. First, it enables real-time treatment verification by determination of the HDR source positions during treatment. Second, when using a dummy source, MR-based source localization provides an automatic detection of the source dwell positions after catheter insertion, allowing elimination of the catheter reconstruction procedure. Localization of the HDR source was conducted by simulation of the MR artifacts, followed by a phase correlation localization algorithm applied to the MR images and the simulated images, to determine the position of the HDR source in the MR images. To increase the temporal resolution of the MR acquisition, the spatial resolution was decreased, and a subpixel localization operation was introduced. Furthermore, parallel imaging (sensitivity encoding) was applied to further decrease the MR scan time. The localization method was validated by a comparison with CT, and the accuracy and precision were investigated. The results demonstrated that the described method could be used to determine the HDR source position with a high accuracy (0.4-0.6 mm) and a high precision (⩽0.1 mm), at high temporal resolutions (0.15-1.2 s per slice). This would enable real-time treatment verification as well as an automatic detection of the source dwell positions.
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Affiliation(s)
- E Beld
- Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, Netherlands
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Johansen JG, Rylander S, Buus S, Bentzen L, Hokland SB, Søndergaard CS, With AKM, Kertzscher G, Tanderup K. Time-resolved in vivo dosimetry for source tracking in brachytherapy. Brachytherapy 2018; 17:122-132. [DOI: 10.1016/j.brachy.2017.08.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/11/2017] [Accepted: 08/15/2017] [Indexed: 11/25/2022]
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McNabb E, Wong R, Noseworthy MD. Localizing implanted fiducial markers using undersampled co-RASOR MR imaging. Magn Reson Imaging 2017; 48:1-9. [PMID: 29229307 DOI: 10.1016/j.mri.2017.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 12/04/2017] [Indexed: 01/04/2023]
Abstract
The goal of this work was to use an undersampled, dual-plane centre-out radial sampling acquisition pulse sequence, with off-resonance reception, to localize fiducial markers with reduced acquisition time. Two iterative reconstruction techniques, conjugate gradient CG-SENSE and the variational penalty Total Generalized Variation (TGV), were investigated to minimize the undersampling artifacts in off-resonant radial imaging. Simulations of a field perturber were performed at sub-millimeter resolution and reconstructed to display signal pileups that can be radially compressed towards the geometric centre of the perturber for high contrast visualization, but contrast is non-recoverable as the echo time increases. A cylindrical platinum fiducial marker, placed in a phantom parallel and perpendicular to the B0-field was imaged with a short-TE half-echo readout. Contrast-to-Noise (CNR) between the signal of the fiducial its adjacent surrounding shell and half-maximum area were used to compare reconstruction methods and undersampling factors. For single slice acquisitions centred about the fiducial, each slice can be performed in as little as 2.8s. The total acquisition time to localize the fiducial marker in a phantom was reduced to 73s by undersampling (R=8) 37 axial and 15 coronal slices, effectively encoding 1.4s/slice. The noise present in undersampled images, for both scan planes and fiducial orientations, decreased significantly using TGV and CG-SENSE reconstructions, with TGV displaying better spatial resolution from reduced half-maximum area.
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Affiliation(s)
- Evan McNabb
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Canada
| | - Raimond Wong
- Juravinksi Cancer Centre, Hamilton, Ontario, Canada; Department of Oncology, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael D Noseworthy
- McMaster School of Biomedical Engineering, McMaster University, Hamilton, Canada; Imaging Research Centre, St. Joseph's Healthcare, Hamilton, Ontario, Canada; Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada; Department of Radiology, McMaster University, Hamilton, Ontario, Canada.
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Real-Time Verification of a High-Dose-Rate Iridium 192 Source Position Using a Modified C-Arm Fluoroscope. Int J Radiat Oncol Biol Phys 2016; 97:858-865. [PMID: 28244423 DOI: 10.1016/j.ijrobp.2016.12.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/25/2016] [Accepted: 12/02/2016] [Indexed: 11/21/2022]
Abstract
PURPOSE High-dose-rate (HDR) brachytherapy misdeliveries can occur at any institution, and they can cause disastrous results. Even a patient's death has been reported. Misdeliveries could be avoided with real-time verification methods. In 1996, we developed a modified C-arm fluoroscopic verification of an HDR Iridium 192 source position prevent these misdeliveries. This method provided excellent image quality sufficient to detect errors, and it has been in clinical use at our institutions for 20 years. The purpose of the current study is to introduce the mechanisms and validity of our straightforward C-arm fluoroscopic verification method. METHODS AND MATERIALS Conventional X-ray fluoroscopic images are degraded by spurious signals and quantum noise from Iridium 192 photons, which make source verification impractical. To improve image quality, we quadrupled the C-arm fluoroscopic X-ray dose per pulse. The pulse rate was reduced by a factor of 4 to keep the average exposure compliant with Japanese medical regulations. The images were then displayed with quarter-frame rates. RESULTS Sufficient quality was obtained to enable observation of the source position relative to both the applicators and the anatomy. With this method, 2 errors were detected among 2031 treatment sessions for 370 patients within a 6-year period. CONCLUSIONS With the use of a modified C-arm fluoroscopic verification method, treatment errors that were otherwise overlooked were detected in real time. This method should be given consideration for widespread use.
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Beld E, Seevinck PR, Lagendijk JJW, Viergever MA, Moerland MA. Monte Carlo study of the impact of a magnetic field on the dose distribution in MRI-guided HDR brachytherapy using Ir-192. Phys Med Biol 2016; 61:6791-6807. [PMID: 27580406 DOI: 10.1088/0031-9155/61/18/6791] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Soliman AS, Owrangi A, Ravi A, Song WY. Metal artefacts in MRI-guided brachytherapy of cervical cancer. J Contemp Brachytherapy 2016; 8:363-9. [PMID: 27648092 PMCID: PMC5018526 DOI: 10.5114/jcb.2016.61817] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/28/2016] [Indexed: 11/29/2022] Open
Abstract
The importance of assessing the metal-induced artefacts in magnetic resonance imaging (MRI)-guided brachytherapy is growing along with the increasing interest of integrating MRI into the treatment procedure of cervical cancer. Examples of metal objects in use include intracavitary cervical applicators and interstitial needles. The induced artefacts increase the uncertainties in the clinical workflow and can be a potential obstacle for the accurate delivery of the treatment. Overcoming this problem necessitates a good understanding of its originating sources. Several efforts are recorded in the literature to quantify the extent of such artefacts, in phantoms and in clinical practice. Here, we elaborate on the origin of metal-induced artefacts in the light of brachytherapy applications, while summarizing recent efforts that have been made to assess and overcome the induced distortions.
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Affiliation(s)
- Abraam S Soliman
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Physical Sciences Platform, Sunnybrook Research Institute, Toronto
| | - Amir Owrangi
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Ananth Ravi
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Physical Sciences Platform, Sunnybrook Research Institute, Toronto; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - William Y Song
- Department of Medical Physics, Sunnybrook Health Sciences Centre, Toronto; Physical Sciences Platform, Sunnybrook Research Institute, Toronto; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
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Henken KR, Seevinck PR, Dankelman J, van den Dobbelsteen JJ. Manually controlled steerable needle for MRI-guided percutaneous interventions. Med Biol Eng Comput 2016; 55:235-244. [PMID: 27108292 PMCID: PMC5272900 DOI: 10.1007/s11517-016-1490-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 03/18/2016] [Indexed: 12/03/2022]
Abstract
This study aims to develop and evaluate a manually controlled steerable needle that is compatible with and visible on MRI to facilitate full intra-procedural control and accurate navigation in percutaneous interventions. The steerable needle has a working channel that provides a lumen to a cutting stylet or a therapeutic instrument. A steering mechanism based on cable-operated compliant elements is integrated in the working channel. The needle can be steered by adjusting the orientation of the needle tip through manipulation of the handle. The steering mechanism is evaluated by recording needle deflection at constant steering angles. A steering angle of 20.3° results in a deflection of 9.1–13.3 mm in gelatin and 4.6–18.9 mm in porcine liver tissue at an insertion depth of 60 mm. Additionally, the possibility to control the needle path under MRI guidance is evaluated in a gelatin phantom. The needle can be steered to targets at different locations while starting from the same initial position and orientation under MRI guidance with generally available sequences. The steerable needle offers flexibility to the physician in control and choice of the needle path when navigating the needle toward the target position, which allows for optimization of individual treatment and may increase target accuracy.
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Affiliation(s)
- Kirsten R Henken
- TUDelft, Biomechanical Engineering, Mekelweg 2, 2628 CD, Delft, The Netherlands.
| | - Peter R Seevinck
- Imaging Division, Image Sciences Institute, University Medical Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Jenny Dankelman
- TUDelft, Biomechanical Engineering, Mekelweg 2, 2628 CD, Delft, The Netherlands
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Mazeron R, Champoudry J, Gilmore J, Dumas I, Goulart J, Oberlander AS, Rivin del Campo E, Diallo I, Lefkopoulos D, Haie-Meder C. Intrafractional organs movement in three-dimensional image-guided adaptive pulsed-dose-rate cervical cancer brachytherapy: Assessment and dosimetric impact. Brachytherapy 2015; 14:260-6. [DOI: 10.1016/j.brachy.2014.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/10/2014] [Accepted: 11/19/2014] [Indexed: 12/31/2022]
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Lagendijk JJW, Raaymakers BW, Van den Berg CAT, Moerland MA, Philippens ME, van Vulpen M. MR guidance in radiotherapy. Phys Med Biol 2014; 59:R349-69. [PMID: 25322150 DOI: 10.1088/0031-9155/59/21/r349] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Jan J W Lagendijk
- Department of Radiotherapy, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, The Netherlands
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