Super-resolution reconstruction of time-resolved four-dimensional computed tomography (TR-4DCT) with multiple breathing cycles based on TR-4DMRI Journal Article
| Authors: | Liu, Y.; Nie, X.; Ahmad, A.; Rimner, A.; Li, G. |
| Article Title: | Super-resolution reconstruction of time-resolved four-dimensional computed tomography (TR-4DCT) with multiple breathing cycles based on TR-4DMRI |
| Abstract: | Background: Respiratory motion irregularities in lung cancer patients are common and can be severe during multi-fractional (∼20 mins/fraction) radiotherapy. However, the current clinical standard of motion management is to use a single-breath respiratory-correlated four-dimension computed tomography (RC-4DCT or 4DCT) to estimate tumor motion to delineate the internal tumor volume (ITV), covering the trajectory of tumor motion, as a treatment target. Purpose: To develop a novel multi-breath time-resolved (TR) 4DCT using the super-resolution reconstruction framework with TR 4D magnetic resonance imaging (TR-4DMRI) as guidance for patient-specific breathing irregularity assessment, overcoming the shortcomings of RC-4DCT, including binning artifacts and single-breath limitations. Methods: Six lung cancer patients participated in the IRB-approved protocol study to receive multiple T1w MRI scans, besides an RC-4DCT scan on the simulation day, including 80 low-resolution (lowR: 5 × 5 × 5 mm3) free-breathing (FB) 3D cine MRFB images in 40 s (2 Hz) and a high-resolution (highR: 2 × 2 × 2 mm3) 3D breath-hold (BH) MRBH image for each patient. A CT (1 × 1 × 3 mm3) image was selected from 10-bin RC-4DCT with minimal binning artifacts and a close diaphragm match (<1 cm) to the MRBH image. A mutual-information-based Freeform deformable image registration (DIR) was used to register the CT and MRBH via the opposite directions (namely F1: (Formula presented.) and F2: (Formula presented.)) to establish CT-MR voxel correspondences. An intensity-based enhanced Demons DIR was then applied for (Formula presented.), in which the original MRBH was used in D1: (Formula presented.), while the deformed MRBH was used in D2: (Formula presented.). The deformation vector fields (DVFs) obtained from each DIR were composed to apply to the deformed CT (D1) and original CT (D2) to reconstruct TR-4DCT images. A digital 4D-XCAT phantom at the end of inhalation (EOI) and end of exhalation (EOE) with 2.5 cm diaphragmatic motion and three spherical targets (φ = 2, 3, 4 cm) were first tested to reconstruct TR-4DCT. For each of the six patients, TR-4DCT images at the EOI, middle (MID), and EOE were reconstructed with both D1 and D2 approaches. TR-4DCT image quality was evaluated with mean distance-to-agreement (MDA) at the diaphragm compared with MRFB, tumor volume ratio (TVR) referenced to MRBH, and tumor shape difference (DICE index) compared with the selected input CT. Additionally, differences in the tumor center of mass (|∆COMD1–D2|), together with TVR and DICE comparison, was assessed in the D1 and D2 reconstructed TR-4DCT images. Results: In the phantom, TR-4DCT quality is assessed by MDA = 2.0 ± 0.8 mm at the diaphragm, TVR = 0.8 ± 0.0 for all tumors, and DICE = 0.83 ± 0.01, 0.85 ± 0.02, 0.88 ± 0.01 for φ = 2, 3, 4 cm tumors, respectively. In six patients, the MDA in diaphragm match is –1.6 ± 3.1 mm (D1) and 1.0 ± 3.9 mm (D2) between the reconstructed TR-4DCT and lowR MRFB among 18 images (3 phases/patient). The tumor similarity is TVR = 1.2 ± 0.2 and DICE = 0.70 ± 0.07 for D1 and TVR = 1.4 ± 0.3 (D2) and DICE = 0.73 ± 0.07 for D2. The tumor position difference is |∆COMD1–D2| = 1.2 ± 0.8 mm between D1 and D2 reconstructions. Conclusion: The feasibility of super-resolution reconstruction of multi-breathing-cycle TR-4DCT is demonstrated and image quality at the diaphragm and tumor is assessed in both the 4D-XCAT phantom and six lung cancer patients. The similarity of D1 and D2 reconstruction suggests consistent and reliable DIR results. Clinically, TR-4DCT has the potential for breathing irregularity assessment and dosimetry evaluation in radiotherapy. © 2024 American Association of Physicists in Medicine. |
| Keywords: | clinical article; nuclear magnetic resonance imaging; magnetic resonance imaging; electron microscopy; tumor volume; lung cancer; computerized tomography; image quality; diaphragm; arthroplasty; image reconstruction; image registration; motion estimation; breath-hold; diffusion tensor imaging; breathing; paramagnetic resonance; pulmonary diseases; deformable image registration; chemical shift; four dimensional computed tomography; four-dimensional computed tomography; human; article; optical flows; super-resolution image reconstruction; time-resolved 4dmri; multi-breath motion cycles; time-resolved 4dct; frequency bands; functional neural stimulation; video on demand; motion cycle; multi-breath motion cycle; time-resolved; time resolved four dimensional computed tomography; time resolved four dimensional nuclear magnetic resonance imaging |
| Journal Title: | Medical Physics |
| Volume: | 52 |
| Issue: | 1 |
| ISSN: | 0094-2405 |
| Publisher: | American Association of Physicists in Medicine |
| Date Published: | 2025-01-01 |
| Start Page: | 504 |
| End Page: | 517 |
| Language: | English |
| DOI: | 10.1002/mp.17487 |
| PUBMED: | 39460999 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Guang Li -- Source: Scopus |
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