Real-time 3D synthetic MRI based on kV imaging for motion monitoring of abdominal radiotherapy in a conventional LINAC Journal Article


Authors: Quintero, P.; Wu, C.; Zhang, H.; Otazo, R.; Cerviño, L.; Harrys, W.
Article Title: Real-time 3D synthetic MRI based on kV imaging for motion monitoring of abdominal radiotherapy in a conventional LINAC
Abstract: Introduction. Real-time 2D-kV-triggered images used to evaluate intra-fraction motion during abdominal radiotherapy only provides 2D information with poor soft-tissue contrast. The main goal of this research is to evaluate a novel method that generates synthetic 3D-MRI from single 2D-kV images for online motion monitoring in abdominal radiotherapy. Methods. Deformable image registration (DIR) is performed between one 4D-MRI reference phase and all other phases, and principal-component-analysis (PCA) is implemented on their respective deformation vectors. By sampling 1000 times the PCA eigenvalues and applying the new deformations over a reference CT, 1000 digital reconstructed radiographs (DRRs) were generated to train a convolutional neural network to predict their respective eigenvalues. The method was implemented and tested using a digital phantom (XCAT) and an MRI-compatible phantom (ZEUS) with five DRR angles (0°, 45°, 90°, 135°, 180°). Seven motion scenarios were tested. For model performance, mean absolute error (MAE) and root mean square error (RMSE) were reported. Image quality was evaluated with structure similarity index (SSIM) and normalized RMSE (nRMSE), and target-volume variations were evaluated with volumetric dice coefficient (VDC) and Hausdorff-distance (HD). Results. The model performance across the evaluated angles were MAE(XCAT, ZEUS) = (0.053 ± 0.003, 0.094 ± 0.003), and RMSE(XCAT, ZEUS) = (0.054 ± 0.007, 0.103 ± 0.002). Similarly, SSIM(XCAT, ZEUS) = (0.994 ± 0.001, 0.96 ± 0.02), and nRMSE(XCAT, ZEUS) = (0.13 ± 0.01, 0.17 ± 0.03). For all motion scenarios for XCAT and ZEUS, SSIM were 0.98 ± 0.01 and 0.84 ± 0.02, nRMSE were 0.14 ± 0.01 and 0.27 ± 0.02, VDC were 0.98 ± 0.01 and 0.90 ± 0.01, and HD were 0.24 ± 0.02 mm and 2.3 ± 0.8 mm, respectively, averaged across all angles. Finally, SSIM, nRMSE, VDC and HU values for ZEUS using the deformed images as ground truth, presented an improvement of 13%, 28%, 4%, and 76%, respectively. Conclusions. Results from a digital and physical phantom demonstrate a novel approach to generate real-time 3D synthetic MRI from onboard kV images on a conventional LINAC for intra-fraction monitoring in abdominal radiotherapy. © 2025 Institute of Physics and Engineering in Medicine. All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Keywords: radiotherapy; computerized tomography; image quality; arthroplasty; image registration; motion estimation; phantoms; millimeter waves; eigenvalues and eigenfunctions; dice coefficient; volumetrics; motion tracking; structure similarity; root mean square errors; real- time; similarity indices; synthetic-mri; abdominal-radiotherapy; ai-methods; motion-monitoring; image sampling; ai-method
Journal Title: Physics in Medicine and Biology
Volume: 70
Issue: 7
ISSN: 0031-9155
Publisher: IOP Publishing Ltd  
Date Published: 2025-04-06
Start Page: 075004
Language: English
DOI: 10.1088/1361-6560/adbeb5
PROVIDER: scopus
PUBMED: 40064117
PMCID: PMC12036502
DOI/URL:
Notes: PDF misspells MSK author Wendy Harris last name -- The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Paulo Quintero -- Source: Scopus
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MSK Authors
  1. Hao Zhang
    62 Zhang
  2. Wendy Harris
    10 Harris
  3. Can Wu
    19 Wu