Image‐based retrospective 4D MRI in external beam radiotherapy: A comparative study with a digital phantom

Purpose Several image‐based retrospective sorting methods of 4D magnetic resonance imaging (4D MRI) have been proposed for respiratory motion reconstruction in external beam radiotherapy. However, the optimal strategy for providing accurate and artifact‐free 4D MRI, ideally corresponding to an average breathing cycle, is not yet defined. This study presents a proactive comparison of three published image‐based sorting methods, to define a groundwork for benchmarking in 4D MRI. Methods Three published 4D MRI methods were selected for image retrospective sorting: body area, mutual information, and navigator slice. The three image‐based methods were compared against a conventional retrospective sorting method based on an external surrogate. Comparisons were performed by means of an MRI digital phantom, derived from the XCAT CT phantom generated with different patient‐derived signals, for a total of 12 cases. Specific multislice MRI acquisitions were simulated for slice sorting and sagittal, coronal, and axial orientations were tested. An average 4D cycle was generated as ground truth. Results Individual and grouped patient analyses showed better performance of the navigator slice and mutual information in amplitude binning with respect to the body area strategy. Binning artifacts were reduced on the diaphragm with the slice navigator method due to the acquired internal information. Tumor motion description accurately matched the ground truth in the mutual information strategy with amplitude binning. The body area method followed the performance of the external surrogate and presented larger errors, since was not correlated with the internal anatomy. Sagittal and coronal orientations reported lower errors than axial slicing. Individual analysis showed the need of a patient‐specific evaluation for the selection of the best method. Conclusions A comparison between three different image‐based retrospective sorting methods for 4D MRI is proposed, providing guidelines for benchmark definition in MRI‐guided radiotherapy.

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