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Evaluating Machine Learning-Based MRI Reconstruction Using Digital Image Quality Phantoms

Quantitative and objective evaluation tools are essential for assessing the performance of machine learning (ML)-based magnetic resonance imaging (MRI) reconstruction methods. However, the commonly used fidelity metrics, such as mean squared error (MSE), structural similarity (SSIM), and peak signal-to-noise ratio (PSNR), often fail to capture fundamental and clinically relevant MR image quality aspects. To address this, we propose evaluation of ML-based MRI reconstruction using digital image quality phantoms and automated evaluation methods. Our phantoms are based upon the American College of Radiology (ACR) large physical phantom but created in k-space to simulate their MR images, and they can vary in object size, signal-to-noise ratio, resolution, and image contrast. Our evaluation pipeline incorporates evaluation metrics of geometric accuracy, intensity uniformity, percentage ghosting, sharpness, signal-to-noise ratio, resolution, and low-contrast detectability. We demonstrate the utility of our proposed pipeline by assessing an example ML-based reconstruction model across various training and testing scenarios. The performance results indicate that training data acquired with a lower undersampling factor and coils of larger anatomical coverage yield a better performing model. The comprehensive and standardized pipeline introduced in this study can help to facilitate a better understanding of the performance and guide future development and advancement of ML-based reconstruction algorithms.

47 OTHER INSTRUMENTATION↗

WE-G-18C-08: Real Time Tumor Imaging Using a Novel Dynamic Keyhole MRI Reconstruction Technique

Purpose: To test the hypothesis that the novel Dynamic Keyhole MRI reconstruction technique can accelerate image acquisition whilst maintaining high image quality for lung cancer patients. Methods: 18 MRI datasets from 5 lung cancer patients were acquired using a 3T MRI scanner. These datasets were retrospectively reconstructed using (A) The novel Dynamic Keyhole technique, (B) The conventional keyhole technique and (C) the conventional zero filling technique. The dynamic keyhole technique in MRI refers to techniques in which previously acquired k-space data is used to supplement under sampled data obtained in real time. The novel Dynamic Keyhole technique utilizes a previously acquired a library of kspace datasets in conjunction with central k-space datasets acquired in realtime. A simultaneously acquired respiratory signal is utilized to sort, match and combine the two k-space streams with respect to respiratory displacement. Reconstruction performance was quantified by (1) comparing the keyhole size (which corresponds to imaging speed) required to achieve the same image quality, and (2) maintaining a constant keyhole size across the three reconstruction methods to compare the resulting image quality to the ground truth image. Results: (1) The dynamic keyhole method required a mean keyhole size which was 48% smaller than the conventional keyhole technique and 60% smaller than the zero filling technique to achieve the same image quality. This directly corresponds to faster imaging. (2) When a constant keyhole size was utilized, the Dynamic Keyhole technique resulted in the smallest difference of the tumor region compared to the ground truth. Conclusion: The dynamic keyhole is a simple and adaptable technique for clinical applications requiring real-time imaging and tumor monitoring such as MRI guided radiotherapy. Based on the results from this study, the dynamic keyhole method could increase the imaging frequency by a factor of five compared with full k-space methods.

60 APPLIED LIFE SCIENCES↗

MRI reconstruction of multi-image acquisitions using a rank regularizer with data reordering

Purpose: To improve rank constrained reconstructions for undersampled multi-image MRI acquisitions. Methods: Motivated by the recent developments in low-rank matrix completion theory and its applicability to rapid dynamic MRI, a new reordering-based rank constrained reconstruction of undersampled multi-image data that uses prior image information is proposed. Instead of directly minimizing the nuclear norm of a matrix of estimated images, the nuclear norm of reordered matrix values is minimized. The reordering is based on the prior image estimates. The method is tested on brain diffusion imaging data and dynamic contrast enhanced myocardial perfusion data. Results: Good quality images from data undersampled by a factor of three for diffusion imaging and by a factor of 3.5 for dynamic cardiac perfusion imaging with respiratory motion were obtained. Reordering gave visually improved image quality over standard nuclear norm minimization reconstructions. Root mean squared errors with respect to ground truth images were improved by ∼18% and ∼16% with reordering for diffusion and perfusion applications, respectively. Conclusions: The reordered low-rank constraint is a way to inject prior image information that offers improvements over a standard low-rank constraint for undersampled multi-image MRI reconstructions.

60 APPLIED LIFE SCIENCES↗

WE-EF-BRD-03: I Want It Now!: Advances in MRI Acquisition, Reconstruction and the Use of Priors to Enable Fast Anatomic and Physiologic Imaging to Inform Guidance and Adaptation Decisions

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗

SU-E-I-41: Non-Cartesian MR Image Reconstruction with Integrated Gradient Non-Linearity Correction

Purpose: Nonlinearities in the spatial encoding gradients of MRI systems cause geometric distortion in images. Typically, this is retrospectively corrected via image-domain interpolation (a.k.a., “gradwarp”) albeit with a loss of spatial resolution. For non-Cartesian MRI, the latter problem is exaggerated by noise and undersampling artifact. In this study, we describe a novel correction strategy that accounts for gradient nonlinearities during — rather than after — non-Cartesian MRI reconstruction, and demonstrate that this approach mitigates the resolution loss that can occur with standard methods. Methods: To test the proposed method, the American College of Radiology (ACR) quality control phantom was scanned on at 1.5 T (General Electric, v16.0, “zoom” gradient) using a 1.6x undersampled 3D non- Cartesian Shells trajectory (GRE, FOV=24 cm3, 120 shells, 16552 shots, 512 readout, matrix=2403). Image reconstruction was first performed via standard k-space density-compensated gridding and retrospectively corrected via cubic spline interpolation. Image reconstruction was then separately performed using a k-space and image-domain densitycompensated type-3 non-uniform fast Fourier transform (NUFFT), which provides a direct mapping between non-Cartesian k-space samples and warped image space voxel locations. Thus, no separate distortion correction procedure is needed for the proposed approach. The gradient distortion field was determined using vendor provided calibration data. Results: Phantom scan results show that both processing approaches successfully correct geometric distortion. However, visual inspection of the ACR phantom spatial resolution inserts shows that the proposed strategy preserves the resolution of the nominal (uncorrected) reconstruction while “gradwarp” imparts marked spatial blurring (especially for the 1.0 and 1.1 mm inserts) and thus resolution loss. Conclusion: We've presented a novel reconstruction strategy for non-Cartesian MRI that corrects for gradient nonlinearities during — rather than after — reconstruction, and thus better preserves image resolution than traditional interpolation-based methods. This approach is expected to be especially advantageous when imaging with non-standard magnet geometries. NIH RR018898; NIH EB10065.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Four-Dimensional Magnetic Resonance Imaging Using Axial Body Area as Respiratory Surrogate: Initial Patient Results

Purpose: To evaluate the feasibility of a retrospective binning technique for 4-dimensional magnetic resonance imaging (4D-MRI) using body area (BA) as a respiratory surrogate. Methods and Materials: Seven patients with hepatocellular carcinoma (4 of 7) or liver metastases (3 of 7) were enrolled in an institutional review board-approved prospective study. All patients were simulated with both computed tomography (CT) and MRI to acquire 3-dimensinal and 4D images for treatment planning. Multiple-slice multiple-phase cine-MR images were acquired in the axial plane for 4D-MRI reconstruction. Image acquisition time per slice was set to 10-15 seconds. Single-slice 2-dimensinal cine-MR images were also acquired across the center of the tumor in orthogonal planes. Tumor motion trajectories from 4D-MRI, cine-MRI, and 4D-CT were analyzed in the superior–inferior (SI), anterior–posterior (AP), and medial–lateral (ML) directions, respectively. Their correlation coefficients (CC) and differences in tumor motion amplitude were determined. Tumor-to-liver contrast-to-noise ratio (CNR) was measured and compared between 4D-CT, 4D-MRI, and conventional T2-weighted fast spin echo MRI. Results: The means (±standard deviations) of CC comparing 4D-MRI with cine-MRI were 0.97 ± 0.03, 0.97 ± 0.02, and 0.99 ± 0.04 in SI, AP, and ML directions, respectively. The mean differences were 0.61 ± 0.17 mm, 0.32 ± 0.17 mm, and 0.14 ± 0.06 mm in SI, AP, and ML directions, respectively. The means of CC comparing 4D-MRI and 4D-CT were 0.95 ± 0.02, 0.94 ± 0.02, and 0.96 ± 0.02 in SI, AP, and ML directions, respectively. The mean differences were 0.74 ± 0.02 mm, 0.33 ± 0.13 mm, and 0.18 ± 0.07 mm in SI, AP, and ML directions, respectively. The mean tumor-to-tissue CNRs were 2.94 ± 1.51, 19.44 ± 14.63, and 39.47 ± 20.81 in 4D-CT, 4D-MRI, and T2-weighted MRI, respectively. Conclusions: The preliminary evaluation of our 4D-MRI technique results in oncologic patients demonstrates its potential usefulness to accurately measure tumor respiratory motion with improved tumor CNR compared with 4D-CT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-G-JeP2-14: MRI-Based HDR Prostate Brachytherapy: A Phantom Study for Interstitial Catheter Reconstruction with 0.35T MRI Images

Purpose: To evaluate the accuracy of interstitial catheter reconstruction with 0.35T MRI images for MRI-based HDR prostate brachytherapy. Methods: Recently, a real-time MRI-guided radiotherapy system combining a 0.35T MRI system and three cobalt 60 heads (MRIdian System, ViewRay, Cleveland, OH, USA) was installed in our department. A TrueFISP sequence for MRI acquisition at lower field on Viewray was chosen due to its fast speed and high signal-to-noise efficiency. Interstitial FlexiGuide needles were implanted into a tissue equivalent ultrasound prostate phantom (CIRS, Norfolk, Virginia, USA). After an initial 15s pilot MRI to confirm the location of the phantom, planning MRI was acquired with a 172s TrueFISP sequence. The pulse sequence parameters included: flip angle = 60 degree, echo time (TE) =1.45 ms, repetition time (TR) = 3.37 ms, slice thickness = 1.5 mm, field of view (FOV) =500 × 450mm. For a reference image, a CT scan was followed. The CT and MR scans were then fused with the MIM Maestro (MIM software Inc., Cleveland, OH, USA) and sent to the Oncentra Brachy planning system (Elekta, Veenendaal, Netherlands). Automatic catheter reconstruction using CT and MR image intensities followed by manual reconstruction was used to digitize catheters. The accuracy of catheter reconstruction was evaluated from the catheter tip location. Results: The average difference between the catheter tip locations reconstructed from the CT and MR in the transverse, anteroposterior, and craniocaudal directions was −0.1 ± 0.1 mm (left), 0.2 ± 0.2 mm (anterior), and −2.3 ± 0.5 mm (cranio). The average distance in 3D was 2.3 mm ± 0.5 mm. Conclusion: This feasibility study proved that interstitial catheters can be reconstructed with 0.35T MRI images. For more accurate catheter reconstruction which can affect final dose distribution, a systematic shift should be applied to the MR based catheter reconstruction in HDR prostate brachytherapy.

60 APPLIED LIFE SCIENCES↗

High-resolution whole-brain DCE-MRI using constrained reconstruction: Prospective clinical evaluation in brain tumor patients

Purpose: To clinically evaluate a highly accelerated T1-weighted dynamic contrast-enhanced (DCE) MRI technique that provides high spatial resolution and whole-brain coverage via undersampling and constrained reconstruction with multiple sparsity constraints. Methods: Conventional (rate-2 SENSE) and experimental DCE-MRI (rate-30) scans were performed 20 minutes apart in 15 brain tumor patients. The conventional clinical DCE-MRI had voxel dimensions 0.9 × 1.3 × 7.0 mm{sup 3}, FOV 22 × 22 × 4.2 cm{sup 3}, and the experimental DCE-MRI had voxel dimensions 0.9 × 0.9 × 1.9 mm{sup 3}, and broader coverage 22 × 22 × 19 cm{sup 3}. Temporal resolution was 5 s for both protocols. Time-resolved images and blood–brain barrier permeability maps were qualitatively evaluated by two radiologists. Results: The experimental DCE-MRI scans showed no loss of qualitative information in any of the cases, while achieving substantially higher spatial resolution and whole-brain spatial coverage. Average qualitative scores (from 0 to 3) were 2.1 for the experimental scans and 1.1 for the conventional clinical scans. Conclusions: The proposed DCE-MRI approach provides clinically superior image quality with higher spatial resolution and coverage than currently available approaches. These advantages may allow comprehensive permeability mapping in the brain, which is especially valuable in the setting of large lesions or multiple lesions spread throughout the brain.

60 APPLIED LIFE SCIENCES↗

Magnetoacoustic tomography with magnetic induction for high-resolution bioimepedance imaging through vector source reconstruction under the static field of MRI magnet

Purpose: Magnetoacoustic tomography with magnetic induction (MAT-MI) is an imaging modality to reconstruct the electrical conductivity of biological tissue based on the acoustic measurements of Lorentz force induced tissue vibration. This study presents the feasibility of the authors' new MAT-MI system and vector source imaging algorithm to perform a complete reconstruction of the conductivity distribution of real biological tissues with ultrasound spatial resolution. Methods: In the present study, using ultrasound beamformation, imaging point spread functions are designed to reconstruct the induced vector source in the object which is used to estimate the object conductivity distribution. Both numerical studies and phantom experiments are performed to demonstrate the merits of the proposed method. Also, through the numerical simulations, the full width half maximum of the imaging point spread function is calculated to estimate of the spatial resolution. The tissue phantom experiments are performed with a MAT-MI imaging system in the static field of a 9.4 T magnetic resonance imaging magnet. Results: The image reconstruction through vector beamformation in the numerical and experimental studies gives a reliable estimate of the conductivity distribution in the object with a ∼1.5 mm spatial resolution corresponding to the imaging system frequency of 500 kHz ultrasound. In addition, the experiment results suggest that MAT-MI under high static magnetic field environment is able to reconstruct images of tissue-mimicking gel phantoms and real tissue samples with reliable conductivity contrast. Conclusions: The results demonstrate that MAT-MI is able to image the electrical conductivity properties of biological tissues with better than 2 mm spatial resolution at 500 kHz, and the imaging with MAT-MI under a high static magnetic field environment is able to provide improved imaging contrast for biological tissue conductivity reconstruction.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

T2-weighted four dimensional magnetic resonance imaging with result-driven phase sorting

Purpose: T2-weighted MRI provides excellent tumor-to-tissue contrast for target volume delineation in radiation therapy treatment planning. This study aims at developing a novel T2-weighted retrospective four dimensional magnetic resonance imaging (4D-MRI) phase sorting technique for imaging organ/tumor respiratory motion. Methods: A 2D fast T2-weighted half-Fourier acquisition single-shot turbo spin-echo MR sequence was used for image acquisition of 4D-MRI, with a frame rate of 2–3 frames/s. Respiratory motion was measured using an external breathing monitoring device. A phase sorting method was developed to sort the images by their corresponding respiratory phases. Besides, a result-driven strategy was applied to effectively utilize redundant images in the case when multiple images were allocated to a bin. This strategy, selecting the image with minimal amplitude error, will generate the most representative 4D-MRI. Since we are using a different image acquisition mode for 4D imaging (the sequential image acquisition scheme) with the conventionally used cine or helical image acquisition scheme, the 4D dataset sufficient condition was not obviously and directly predictable. An important challenge of the proposed technique was to determine the number of repeated scans (N{sub R}) required to obtain sufficient phase information at each slice position. To tackle this challenge, the authors first conducted computer simulations using real-time position management respiratory signals of the 29 cancer patients under an IRB-approved retrospective study to derive the relationships between N{sub R} and the following factors: number of slices (N{sub S}), number of 4D-MRI respiratory bins (N{sub B}), and starting phase at image acquisition (P{sub 0}). To validate the authors’ technique, 4D-MRI acquisition and reconstruction were simulated on a 4D digital extended cardiac-torso (XCAT) human phantom using simulation derived parameters. Twelve healthy volunteers were involved in an IRB-approved study to investigate the feasibility of this technique. Results: 4D data acquisition completeness (C{sub p}) increases as NR increases in an inverse-exponential fashion (C{sub p} = 100 − 99 × exp(−0.18 × N{sub R}), when N{sub B} = 6, fitted using 29 patients’ data). The N{sub R} required for 4D-MRI reconstruction (defined as achieving 95% completeness, C{sub p} = 95%, N{sub R} = N{sub R,95}) is proportional to N{sub B} (N{sub R,95} ∼ 2.86 × N{sub B}, r = 1.0), but independent of N{sub S} and P{sub 0}. Simulated XCAT 4D-MRI showed a clear pattern of respiratory motion. Tumor motion trajectories measured on 4D-MRI were comparable to the average input signal, with a mean relative amplitude error of 2.7% ± 2.9%. Reconstructed 4D-MRI for healthy volunteers illustrated clear respiratory motion on three orthogonal planes, with minimal image artifacts. The artifacts were presumably caused by breathing irregularity and incompleteness of data acquisition (95% acquired only). The mean relative amplitude error between critical structure trajectory and average breathing curve for 12 healthy volunteers is 2.5 ± 0.3 mm in superior–inferior direction. Conclusions: A novel T2-weighted retrospective phase sorting 4D-MRI technique has been developed and successfully applied on digital phantom and healthy volunteers.

60 APPLIED LIFE SCIENCES↗

Boosting the signal-to-noise of low-field MRI with deep learning image reconstruction

Recent years have seen a resurgence of interest in inexpensive low magnetic field (< 0.3 T) MRI systems mainly due to advances in magnet, coil and gradient set designs. Most of these advances have focused on improving hardware and signal acquisition strategies, and far less on the use of advanced image reconstruction methods to improve attainable image quality at low field. We describe here the use of our end-to-end deep neural network approach (AUTOMAP) to improve the image quality of highly noise-corrupted low-field MRI data. We compare the performance of this approach to two additional state-of-the-art denoising pipelines. We find that AUTOMAP improves image reconstruction of data acquired on two very different low-field MRI systems: human brain data acquired at 6.5 mT, and plant root data acquired at 47 mT, demonstrating SNR gains above Fourier reconstruction by factors of 1.5- to 4.5-fold, and 3-fold, respectively. In these applications, AUTOMAP outperformed two different contemporary image-based denoising algorithms, and suppressed noise-like spike artifacts in the reconstructed images. The impact of domain-specific training corpora on the reconstruction performance is discussed. The AUTOMAP approach to image reconstruction will enable significant image quality improvements at low-field, especially in highly noise-corrupted environments.

42 ENGINEERING↗

SU-D-207A-05: Investigating Sparse-Sampled MRI for Motion Management in Thoracic Radiotherapy

Purpose: Sparse sampling and reconstruction-based MRI techniques represent an attractive strategy to achieve sufficiently high image acquisition speed while maintaining image quality for the task of radiotherapy guidance. In this study, we examine rapid dynamic MRI using a sparse sampling sequence k-t BLAST in capturing motion-induced, cycle-to-cycle variations in tumor position. We investigate the utility of long-term MRI-based motion monitoring as a means of better characterizing respiration-induced tumor motion compared to a single-cycle 4DCT. Methods: An MRI-compatible, programmable, deformable lung motion phantom with eleven 1.5 ml water marker tubes was placed inside a 3.0 T whole-body MR scanner (Philips Ingenia). The phantom was programmed with 10 lung tumor motion traces previously recorded using the Synchrony system. 2D+t image sequences of a coronal slice were acquired using a balanced-SSFP sequence combined with k-t BLAST (accn=3, resolution=0.66×0.66×5 mm3; acquisition time = 110 ms/slice). kV fluoroscopic (ground truth) and 4DCT imaging was performed with the same phantom setup and motion trajectories. Marker positions in all three modalities were segmented and tracked using an opensource deformable image registration package, NiftyReg. Results: Marker trajectories obtained from rapid MRI exhibited <1 mm error compared to kv Fluoro trajectories in the presence of complex motion including baseline shifts and changes in respiratory amplitude, indicating the ability of MRI to monitor motion with adequate geometric fidelity for the purpose of radiotherapy guidance. In contrast, the trajectory derived from 4DCT exhibited significant errors up to 6 mm due to cycle-to-cycle variations and baseline shifts. Consequently, 4DCT was found to underestimate the range of marker motion by as much as 50%. Conclusion: Dynamic MRI is a promising tool for radiotherapy motion management as it permits for longterm, dose-free, soft-tissue-based monitoring of motion, yielding richer and more accurate information about tumor position and motion range compared to the current state-of-the-art, 4DCT. This work was partially supported through research funding from National Institutes of Health (R01CA169102).

60 APPLIED LIFE SCIENCES↗

Framework for 3D histologic reconstruction and fusion with in vivo MRI: Preliminary results of characterizing pulmonary inflammation in a mouse model

Purpose: Pulmonary inflammation is associated with a variety of diseases. Assessing pulmonary inflammation on in vivo imaging may facilitate the early detection and treatment of lung diseases. Although routinely used in thoracic imaging, computed tomography has thus far not been compellingly shown to characterize inflammation in vivo. Alternatively, magnetic resonance imaging (MRI) is a nonionizing radiation technique to better visualize and characterize pulmonary tissue. Prior to routine adoption of MRI for early characterization of inflammation in humans, a rigorous and quantitative characterization of the utility of MRI to identify inflammation is required. Such characterization may be achieved by considering ex vivo histology as the ground truth, since it enables the definitive spatial assessment of inflammation. In this study, the authors introduce a novel framework to integrate 2D histology, ex vivo and in vivo imaging to enable the mapping of the extent of disease from ex vivo histology onto in vivo imaging, with the goal of facilitating computerized feature analysis and interrogation of disease appearance on in vivo imaging. The authors’ framework was evaluated in a preclinical preliminary study aimed to identify computer extracted features on in vivo MRI associated with chronic pulmonary inflammation. Methods: The authors’ image analytics framework first involves reconstructing the histologic volume in 3D from individual histology slices. Second, the authors map the disease ground truth onto in vivo MRI via coregistration with 3D histology using the ex vivo lung MRI as a conduit. Finally, computerized feature analysis of the disease extent is performed to identify candidate in vivo imaging signatures of disease presence and extent. Results: The authors evaluated the framework by assessing the quality of the 3D histology reconstruction and the histology—MRI fusion, in the context of an initial use case involving characterization of chronic inflammation in a mouse model. The authors’ evaluation considered three mice, two with an inflammation phenotype and one control. The authors’ iterative 3D histology reconstruction yielded a 70.1% ± 2.7% overlap with the ex vivo MRI volume. Across a total of 17 anatomic landmarks manually delineated at the division of airways, the target registration error between the ex vivo MRI and 3D histology reconstruction was 0.85 ± 0.44 mm, suggesting that a good alignment of the ex vivo 3D histology and ex vivo MRI had been achieved. The 3D histology-in vivo MRI coregistered volumes resulted in an overlap of 73.7% ± 0.9%. Preliminary computerized feature analysis was performed on an additional four control mice, for a total of seven mice considered in this study. Gabor texture filters appeared to best capture differences between the inflamed and noninflamed regions on MRI. Conclusions: The authors’ 3D histology reconstruction and multimodal registration framework were successfully employed to reconstruct the histology volume of the lung and fuse it with in vivo MRI to create a ground truth map for inflammation on in vivo MRI. The analytic platform presented here lays the framework for a rigorous validation of the identified imaging features for chronic lung inflammation on MRI in a large prospective cohort.

60 APPLIED LIFE SCIENCES↗

WE-EF-BRD-00: New Developments in Hybrid MR-Treatment: Applications

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗

WE-EF-BRD-01: Past, Present and Future: MRI-Guided Radiotherapy From 2005 to 2025

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗

WE-EF-BRD-02: Battling Maxwell’s Equations: Physics Challenges and Solutions for Hybrid MRI Systems

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗

WE-EF-BRD-04: MR in the OR: The Growth and Applications of MRI for Interventional Radiology and Surgery

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗

Super-resolution reconstruction in frequency, image, and wavelet domains to reduce through-plane partial voluming in MRI

Purpose: To compare and evaluate the use of super-resolution reconstruction (SRR), in frequency, image, and wavelet domains, to reduce through-plane partial voluming effects in magnetic resonance imaging. Methods: The reconstruction of an isotropic high-resolution image from multiple thick-slice scans has been investigated through techniques in frequency, image, and wavelet domains. Experiments were carried out with thick-slice T2-weighted fast spin echo sequence on the Academic College of Radiology MRI phantom, where the reconstructed images were compared to a reference high-resolution scan using peak signal-to-noise ratio (PSNR), structural similarity image metric (SSIM), mutual information (MI), and the mean absolute error (MAE) of image intensity profiles. The application of super-resolution reconstruction was then examined in retrospective processing of clinical neuroimages of ten pediatric patients with tuberous sclerosis complex (TSC) to reduce through-plane partial voluming for improved 3D delineation and visualization of thin radial bands of white matter abnormalities. Results: Quantitative evaluation results show improvements in all evaluation metrics through super-resolution reconstruction in the frequency, image, and wavelet domains, with the highest values obtained from SRR in the image domain. The metric values for image-domain SRR versus the original axial, coronal, and sagittal images were PSNR = 32.26 vs 32.22, 32.16, 30.65; SSIM = 0.931 vs 0.922, 0.924, 0.918; MI = 0.871 vs 0.842, 0.844, 0.831; and MAE = 5.38 vs 7.34, 7.06, 6.19. All similarity metrics showed high correlations with expert ranking of image resolution with MI showing the highest correlation at 0.943. Qualitative assessment of the neuroimages of ten TSC patients through in-plane and out-of-plane visualization of structures showed the extent of partial voluming effect in a real clinical scenario and its reduction using SRR. Blinded expert evaluation of image resolution in resampled out-of-plane views consistently showed the superiority of SRR compared to original axial and coronal image acquisitions. Conclusions: Thick-slice 2D T2-weighted MRI scans are part of many routine clinical protocols due to their high signal-to-noise ratio, but are often severely affected by through-plane partial voluming effects. This study shows that while radiologic assessment is performed in 2D on thick-slice scans, super-resolution MRI reconstruction techniques can be used to fuse those scans to generate a high-resolution image with reduced partial voluming for improved postacquisition processing. Qualitative and quantitative evaluation showed the efficacy of all SRR techniques with the best results obtained from SRR in the image domain. The limitations of SRR techniques are uncertainties in modeling the slice profile, density compensation, quantization in resampling, and uncompensated motion between scans.

60 APPLIED LIFE SCIENCES↗