Auto-contouring of cardiac substructures for Stereotactic arrhythmia radioablation (STAR): A STOPSTORM.eu consortium study.

Background/purpose: High doses to healthy cardiac substructures (CS) in stereotactic arrhythmia radioablation (STAR) raise concerns regarding potential treatment-induced cardio-toxicity. However, CS contours are not routinely created, hindering the understanding of the CS dose-effect relationships. To address this issue, the alignment of CS contouring was initiated within the STOPSTORM consortium.

Color-map recommendation for MR relaxometry maps.

Purpose: To harmonize the use of color for MR relaxometry maps and therefore recommend the use of specific color-maps for representing , , and maps and their inverses.

Methods: Perceptually linearized color-maps were chosen to have similar color settings as those proposed by Griswold et al. in 2018.

Evaluation of the impact of cardiac implantable electronic devices on cine MRI for real-time adaptive cardiac radioablation on a 1.5 T MR-linac.

Background: Stereotactic arrhythmia radioablation (STAR) is a novel treatment approach for refractory ventricular tachycardia (VT). The risk of treatment-induced toxicity and geographic miss can be reduced with online MRI-guidance on an MR-linac. However, most VT patients carry cardiac implantable electronic devices (CIED), which compromise MR images.

Improving the lesion appearance on FLAIR images synthetized from quantitative MRI: a fast, hybrid approach.

Objective: The image quality of synthetized FLAIR (fluid attenuated inversion recovery) images is generally inferior to its conventional counterpart, especially regarding the lesion contrast mismatch. This work aimed to improve the lesion appearance through a hybrid methodology.

Materials And Methods: We combined a full brain 5-min MR-STAT acquisition followed by FLAIR synthetization step with an ultra-under sampled conventional FLAIR sequence and performed the retrospective and prospective analysis of the proposed method on the patient datasets and a healthy volunteer.

Color Maps: Facilitating the Clinical Impact of Quantitative MRI.

Presenting quantitative data using non-standardized color maps potentially results in unrecognized misinterpretation of data. Clinically meaningful color maps should intuitively and inclusively represent data without misleading interpretation. Uniformity of the color gradient for color maps is critically important.

Unrolled Optimization via Physics-Assisted Convolutional Neural Network for MR-Based Electrical Properties Tomography: A Numerical Investigation.

Magnetic Resonance imaging based Electrical Properties Tomography (MR-EPT) is a non-invasive technique that measures the electrical properties (EPs) of biological tissues. In this work, we present and numerically investigate the performance of an unrolled, physics-assisted method for 2D MR-EPT reconstructions, where a cascade of Convolutional Neural Networks is used to compute the contrast update. Each network takes in input the EPs and the gradient descent direction (encoding the physics underlying the adopted scattering model) and returns as output the updated contrast function.

Preparation-based B mapping in the heart using Bloch-Siegert shifts.

Purpose: To develop and evaluate a robust cardiac mapping sequence at 3 T, using Bloch-Siegert shift (BSS)-based preparations.

Methods: A longitudinal magnetization preparation module was designed to encode . After magnetization tip-down, off-resonant Fermi pulses, placed symmetrically around two refocusing pulses, induced BSS, followed by tipping back of the magnetization.

Experimental demonstration of real-time cardiac physiology-based radiotherapy gating for improved cardiac radioablation on an MR-linac.

Background: Cardiac radioablation is a noninvasive stereotactic body radiation therapy (SBRT) technique to treat patients with refractory ventricular tachycardia (VT) by delivering a single high-dose fraction to the VT isthmus. Cardiorespiratory motion induces position uncertainties resulting in decreased dose conformality. Electocardiograms (ECG) are typically used during cardiac MRI (CMR) to acquire images in a predefined cardiac phase, thus mitigating cardiac motion during image acquisition.

Generalizable synthetic MRI with physics-informed convolutional networks.

Background: Magnetic resonance imaging (MRI) provides state-of-the-art image quality for neuroimaging, consisting of multiple separately acquired contrasts. Synthetic MRI aims to accelerate examinations by synthesizing any desirable contrast from a single acquisition.

Purpose: We developed a physics-informed deep learning-based method to synthesize multiple brain MRI contrasts from a single 5-min acquisition and investigate its ability to generalize to arbitrary contrasts.

A Framework for Assessing the Effect of Cardiac and Respiratory Motion for Stereotactic Arrhythmia Radioablation Using a Digital Phantom With a 17-Segment Model: A STOPSTORM.eu Consortium Study.

Purpose: The optimal motion management strategy for patients receiving stereotactic arrhythmia radioablation (STAR) for the treatment of ventricular tachycardia (VT) is not fully known. We developed a framework using a digital phantom to simulate cardiorespiratory motion in combination with different motion management strategies to gain insight into the effect of cardiorespiratory motion on STAR.

Methods And Materials: The 4-dimensional (4D) extended cardiac-torso (XCAT) phantom was expanded with the 17-segment left ventricular (LV) model, which allowed placement of STAR targets in standardized ventricular regions.

Stereotactic Arrhythmia Radioablation (STAR): Assessment of cardiac and respiratory heart motion in ventricular tachycardia patients - A STOPSTORM.eu consortium review.

Aim: To identify the optimal STereotactic Arrhythmia Radioablation (STAR) strategy for individual patients, cardiorespiratory motion of the target volume in combination with different treatment methodologies needs to be evaluated. However, an authoritative overview of the amount of cardiorespiratory motion in ventricular tachycardia (VT) patients is missing.

Methods: In this STOPSTORM consortium study, we performed a literature review to gain insight into cardiorespiratory motion of target volumes for STAR.

Data-driven electrical conductivity brain imaging using 3 T MRI.

Magnetic resonance electrical properties tomography (MR-EPT) is a non-invasive measurement technique that derives the electrical properties (EPs, e.g., conductivity or permittivity) of tissues in the radiofrequency range (64 MHz for 1.

Real-time myocardial landmark tracking for MRI-guided cardiac radio-ablation using Gaussian Processes.

The high speed of cardiorespiratory motion introduces a unique challenge for cardiac stereotactic radio-ablation (STAR) treatments with the MR-linac. Such treatments require tracking myocardial landmarks with a maximum latency of 100 ms, which includes the acquisition of the required data. The aim of this study is to present a new method that allows to track myocardial landmarks from few readouts of MRI data, thereby achieving a latency sufficient for STAR treatments.

STereotactic Arrhythmia Radioablation (STAR): the Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary consortium (STOPSTORM.eu) and review of current patterns of STAR practice in Europe.

The EU Horizon 2020 Framework-funded Standardized Treatment and Outcome Platform for Stereotactic Therapy Of Re-entrant tachycardia by a Multidisciplinary (STOPSTORM) consortium has been established as a large research network for investigating STereotactic Arrhythmia Radioablation (STAR) for ventricular tachycardia (VT). The aim is to provide a pooled treatment database to evaluate patterns of practice and outcomes of STAR and finally to harmonize STAR within Europe. The consortium comprises 31 clinical and research institutions.

Synthetic MRI with Magnetic Resonance Spin TomogrAphy in Time-Domain (MR-STAT): Results from a Prospective Cross-Sectional Clinical Trial.

Background: Magnetic Resonance Spin TomogrAphy in Time-domain (MR-STAT) can reconstruct whole-brain multi-parametric quantitative maps (eg, T , T ) from a 5-minute MR acquisition. These quantitative maps can be leveraged for synthetization of clinical image contrasts.

Purpose: The objective was to assess image quality and overall diagnostic accuracy of synthetic MR-STAT contrasts compared to conventional contrast-weighted images.

Intrafraction motion during radiotherapy of breast tumor, breast tumor bed, and individual axillary lymph nodes on cine magnetic resonance imaging.

Background And Purpose: In (ultra-)hypofractionation, the contribution of intrafraction motion to treatment accuracy becomes increasingly important. Our purpose was to evaluate intrafraction motion and resulting geometric uncertainties for breast tumor (bed) and individual axillary lymph nodes, and to compare prone and supine position for the breast tumor (bed).

Materials And Methods: During 1-3 min of free breathing, we acquired transverse/sagittal interleaved 1.

Acceleration Strategies for MR-STAT: Achieving High-Resolution Reconstructions on a Desktop PC Within 3 Minutes.

MR-STAT is an emerging quantitative magnetic resonance imaging technique which aims at obtaining multi-parametric tissue parameter maps from single short scans. It describes the relationship between the spatial-domain tissue parameters and the time-domain measured signal by using a comprehensive, volumetric forward model. The MR-STAT reconstruction solves a large-scale nonlinear problem, thus is very computationally challenging.

Dynamic Contrast-enhanced and Diffusion-weighted Magnetic Resonance Imaging for Response Evaluation After Single-Dose Ablative Neoadjuvant Partial Breast Irradiation.

Purpose: We aimed to evaluate changes in dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) magnetic resonance imaging (MRI) scans acquired before and after single-dose ablative neoadjuvant partial breast irradiation (NA-PBI), and explore the relation between semiquantitative MRI parameters and radiologic and pathologic responses.

Methods And Materials: We analyzed 3.0T DCE and DW-MRI of 36 patients with low-risk breast cancer who were treated with single-dose NA-PBI, followed by breast-conserving surgery 6 or 8 months later.

Feasibility of cardiac-synchronized quantitative T and T mapping on a hybrid 1.5 Tesla magnetic resonance imaging and linear accelerator system.

Background And Purpose: The heart is important in radiotherapy either as target or organ at risk. Quantitative T and T cardiac magnetic resonance imaging (qMRI) may aid in target definition for cardiac radioablation, and imaging biomarker for cardiotoxicity assessment. Hybrid MR-linac devices could facilitate daily cardiac qMRI of the heart in radiotherapy.

Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis.

Epidural electrical stimulation (EES) targeting the dorsal roots of lumbosacral segments restores walking in people with spinal cord injury (SCI). However, EES is delivered with multielectrode paddle leads that were originally designed to target the dorsal column of the spinal cord. Here, we hypothesized that an arrangement of electrodes targeting the ensemble of dorsal roots involved in leg and trunk movements would result in superior efficacy, restoring more diverse motor activities after the most severe SCI.

MRI of the intraspinal nerve roots in patients with chronic inflammatory neuropathies: abnormalities correlate with clinical phenotypes.

Objective: Chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN) are caused by inflammatory changes of peripheral nerves. It is unknown if the intra-spinal roots are also affected. This MRI study systematically visualized intra-spinal nerve roots, i.

Prone vs. supine accelerated partial breast irradiation on an MR-Linac: A planning study.

Background And Purpose: Accelerated partial breast irradiation (APBI) may benefit from the MR-Linac for target definition, patient setup, and motion monitoring. In this planning study, we investigated whether prone or supine position is dosimetrically beneficial for APBI on an MR-Linac and we evaluated patient comfort.

Materials And Methods: Twenty-patients (9 postoperative, 11 preoperative) with a DCIS or breast tumor <3 cm underwent 1.

Improving phase-based conductivity reconstruction by means of deep learning-based denoising of phase data for 3T MRI.

Purpose: To denoise phase using a deep learning method for phase-based in vivo electrical conductivity reconstruction in a 3T MR system.

Methods: For phase deep-learning denoising, a convolutional neural network (U-net) was chosen. Training was performed on data sets from 10 healthy volunteers.