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Abstract #4848

Short and long-term breathing irregularities in MR navigator and bellow surrogates and enhancement of external-internal motion correlation

Andrew Milewski1,2, Can Wu1, Yilin Liu1, Victoria Yu1, Jouke Smink3, Ramin Jafari3, and Guang Li1
1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 2Department of Anesthesiology, Weill Cornell Medical School, New York, NY, United States, 3Philips Healthcare, Best, Netherlands

Synopsis

Keywords: MR-Guided Radiotherapy, Radiotherapy, Navigator, Bellows, Motion, Respiratory, Correlation

Motivation: Breathing irregularities affect respiratory-correlated 4D-imaging quality with assumed periodic respiration and external-to-internal motion prediction.

Goal(s): To assess the variety of breathing irregularities and predictability of internal motion.

Approach: External bellows and concurrent internal navigator waveforms were collected during two 50-minute MRI scans for three subjects. Data analysis included breathing periodicity index (BPI), external-internal correlation, and correlation enhancement by phase-shift correction.

Results: BPI decreases as subjects transition from awake to semi-asleep stages. The mean correlation between external and internal BPI is 0.55 across 12 scans in three subjects. The native external-internal correlation (c=0.75±0.01) is enhanced to c=0.88±0.01 with phase-shift correction.

Impact: Both short-term and long-term respiratory irregularities were characterized. Keeping subjects awake through communication reduced irregularities and increased gating efficiency. Additionally, phase-shift correction improved the external-internal motion correlation, suggesting a higher fidelity in 4D-imaging surrogates and better internal motion prediction.

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Keywords