Respiratory motion poses significant challenges in image-guided interventions. In emerging treatments such as MR-guided HIFU or MR-guided radiotherapy, it may cause significant misalignments between interventional road maps obtained pre-procedure and the anatomy during the treatment, and may affect intra-procedural imaging such as MR-thermometry. Patient specific respiratory motion models provide a solution to this problem. They establish a correspondence between the patient motion and simpler surrogate data which can be acquired easily during the treatment. Patient motion can then be estimated during the treatment by acquiring only the simpler surrogate data.#R##N##R##N#In the majority of classical motion modelling approaches once the correspondence between the surrogate data and the patient motion is established it cannot be changed unless the model is recalibrated. However, breathing patterns are known to significantly change in the time frame of MR-guided interventions. Thus, the classical motion modelling approach may yield inaccurate motion estimations when the relation between the motion and the surrogate data changes over the duration of the treatment and frequent recalibration may not be feasible.#R##N##R##N#We propose a novel methodology for motion modelling which has the ability to automatically adapt to new breathing patterns. This is achieved by choosing the surrogate data in such a way that it can be used to estimate the current motion in 3D as well as to update the motion model. In particular, in this work, we use 2D MR slices from different slice positions to build as well as to apply the motion model. We implemented such an autoadaptive motion model by extending our previous work on manifold alignment.#R##N##R##N#We demonstrate a proof-of-principle of the proposed technique on cardiac gated data of the thorax and evaluate its adaptive behaviour on realistic synthetic data containing two breathing types generated from 6 volunteers, and real data from 4 volunteers. On synthetic data the autoadaptive motion model yielded 21.45% more accurate motion estimations compared to a non-adaptive motion model 10 min after a change in breathing pattern. On real data we demonstrated the method’s ability to maintain motion estimation accuracy despite a drift in the respiratory baseline. Due to the cardiac gating of the imaging data, the method is currently limited to one update per heart beat and the calibration requires approximately 12 min of scanning. Furthermore, the method has a prediction latency of 800 ms. These limitations may be overcome in future work by altering the acquisition protocol.
['Christian F. Baumgartner', 'Christoph Kolbitsch', 'Jamie McClelland', 'Daniel Rueckert', 'Andrew P. King']
Autoadaptive motion modelling for MR-based respiratory motion estimation