Volumetric cine magnetic resonance imaging (VC-MRI) using motion modeling, free-form deformation and multi-slice undersampled 2D cine MRI reconstructed with spatio-temporal low-rank decomposition

Background: The purpose of this study is to improve on-board volumetric cine magnetic resonance imaging (VC-MRI) using multi-slice undersampled cine images reconstructed using spatio-temporal k-space data, patient prior 4D-MRI, motion modeling (MM) and free-form deformation (FD) for real-time 3D target verification of liver and lung radiotherapy. Methods: A previous method was developed to generate on-board VC-MRI by deforming prior MRI images based on a MM and a single-slice on-board 2D-cine image. The two major improvements over the previous method are: (I) FD was introduced to estimate VC-MRI to correct for inaccuracies in the MM; (II) multi-slice undersampled 2D-cine images reconstructed by a k-t SLR reconstruction method were used for FD-based estimation to maintain the temporal resolution while improving the accuracy of VC-MRI. The method was evaluated using XCAT lung simulation and four liver patients’ data. Results: For XCAT, VC-MRI estimated using ten undersampled sagittal 2D-cine MRIs resulted in volume percent difference/volume dice coefficient/center-of-mass shift of 9.77%±3.71%/0.95±0.02/0.75±0.26 mm among all scenarios based on estimation with MM and FD. Adding FD optimization improved VC-MRI accuracy substantially for scenarios with anatomical changes. For patient data, the mean tumor tracking errors were 0.64±0.51, 0.62±0.47 and 0.24±0.24 mm along the superior-inferior (SI), anterior-posterior (AP) and lateral directions, respectively, across all liver patients. Conclusions: It is feasible to improve VC-MRI accuracy while maintaining high temporal resolution using FD and multi-slice undersampled 2D cine images for real-time 3D target verification.