Machine QA for the Elekta Unity system: A Report from the Elekta MR-linac consortium.

Over the last few years, magnetic resonance image-guided radiotherapy systems have been introduced into the clinic, allowing for daily online plan adaption. While quality assurance (QA) is similar to conventional radiotherapy systems, there is a need to introduce or modify measurement techniques. As yet, there is no consensus guidance on the QA equipment and test requirements for such systems. Therefore, this report provides an overview of QA equipment and techniques for mechanical, dosimetric, and imaging performance of such systems and recommendation of the QA procedures, particularly for a 1.5T MR-linac device. An overview of the system design and considerations for QA measurements, particularly the effect of the machine geometry and magnetic field on the radiation beam measurements is given. The effect of the magnetic field on measurement equipment and methods is reviewed to provide a foundation for interpreting measurement results and devising appropriate methods. And lastly, a consensus overview of recommended QA, appropriate methods, and tolerances is provided based on conventional QA protocols. The aim of this consensus work was to provide a foundation for QA protocols, comparative studies of system performance, and for future development of QA protocols and measurement methods.

Current-density imaging using ultra-low-field MRI with zero-field encoding.

Electric current density can be measured noninvasively with magnetic resonance imaging (MRI). Determining all three components of the current density, however, requires physical rotation of the sample or current injection from several directions when done with conventional methods. However, the emerging technology of ultra-low-field (ULF) MRI, in which the signal encoding and acquisition is conducted at a microtesla-range magnetic field, offers new possibilities. The low applied magnetic fields can even be switched off completely within the pulse sequence, increasing the flexibility of the available sequences. In this article, we present a ULF-MRI sequence designed for obtaining all three components of a current-density pattern without the need of sample rotations. The sequence consists of three steps: prepolarization of the sample, signal encoding in the current-density-associated magnetic field without applying any MRI fields, and spatial encoding in a microtesla-range field using any standard ULF-MRI sequence. The performance of the method is evaluated by numerical simulations. The method may find applications, e.g., in noninvasive conductivity imaging of tissue.

Efficient concomitant and remanence field artifact reduction in ultra-low-field MRI using a frequency-space formulation.

PURPOSE: For ultra-low-field MRI, the spatial-encoding magnetic fields generated by gradient coils can have strong concomitant fields leading to prominent image distortion. Additionally, using superconducting magnet to pre-polarize magnetization can improve the signal-to-noise ratio of ultra-low-field MRI. Yet the spatially inhomogeneous remanence field due to the permanently trapped flux inside a superconducting pre-polarizing coil modulates magnetization and causes further image distortion. METHOD: We propose a two-stage frequency-space (f-x) formulation to accurately describe the dynamics of spatially-encoded magnetization under the influence of concomitant and remanence fields, which allows for correcting image distortion due to concomitant and remanence fields. RESULTS: Our method is computationally efficient as it uses a combination of the fast Fourier transform algorithm and a linear equation solver. With sufficiently dense discretization in solving the linear equation, the performance of this f-x method was found to be stable among different choices of the regularization parameter and the regularization matrix. CONCLUSION: We present this method together with numerical simulations and experimental data to demonstrate how concomitant and remanence field artifacts in ultra-low-field MRI can be corrected efficiently.

Current-density imaging using ultra-low-field MRI with adiabatic pulses.

Magnetic resonance imaging (MRI) allows measurement of electric current density in an object. The measurement is based on observing how the magnetic field of the current density affects the associated spins. However, as high-field MRI is sensitive to static magnetic field variations of only the field component along the main field direction, object rotations are typically needed to image three-dimensional current densities. Ultra-low-field (ULF) MRI, on the other hand, with B0 on the order of 10-100 µT, allows novel MRI sequences. We present a rotation-free method for imaging static magnetic fields and current densities using ULF MRI. The method utilizes prepolarization pulses with adiabatic switch-off ramps. The technique is designed to reveal complete field and current-density information without the need to rotate the object. The method may find applications, e.g., in conductivity imaging. We present simulation results showing the feasibility of the sequence.

Temperature dependence of relaxation times and temperature mapping in ultra-low-field MRI.

Ultra-low-field MRI is an emerging technology that allows MRI and NMR measurements in microtesla-range fields. In this work, the possibilities of relaxation-based temperature measurements with ultra-low-field MRI were investigated by measuring T1 and T2 relaxation times of agarose gel at 50 µT-52 mT and at temperatures 5-45°C. Measurements with a 3T scanner were made for comparison. The Bloembergen-Purcell-Pound relaxation theory was combined with a two-state model to explain the field-strength and temperature dependence of the data. The results show that the temperature dependencies of agarose gel T1 and T2 in the microtesla range differ drastically from those at 3T; the effect of temperature on T1 is reversed at approximately 5 mT. The obtained results were used to reconstruct temperature maps from ultra-low-field scans. These time-dependent temperature maps measured from an agarose gel phantom at 50 µT reproduced the temperature gradient with good contrast.

Suppressing multi-channel ultra-low-field MRI measurement noise using data consistency and image sparsity.

Ultra-low-field (ULF) MRI (B 0 = 10-100 µT) typically suffers from a low signal-to-noise ratio (SNR). While SNR can be improved by pre-polarization and signal detection using highly sensitive superconducting quantum interference device (SQUID) sensors, we propose to use the inter-dependency of the k-space data from highly parallel detection with up to tens of sensors readily available in the ULF MRI in order to suppress the noise. Furthermore, the prior information that an image can be sparsely represented can be integrated with this data consistency constraint to further improve the SNR. Simulations and experimental data using 47 SQUID sensors demonstrate the effectiveness of this data consistency constraint and sparsity prior in ULF-MRI reconstruction.

Hybrid ultra-low-field MRI and magnetoencephalography system based on a commercial whole-head neuromagnetometer.

Ultra-low-field MRI uses microtesla fields for signal encoding and sensitive superconducting quantum interference devices for signal detection. Similarly, modern magnetoencephalography (MEG) systems use arrays comprising hundreds of superconducting quantum interference device channels to measure the magnetic field generated by neuronal activity. In this article, hybrid MEG-MRI instrumentation based on a commercial whole-head MEG device is described. The combination of ultra-low-field MRI and MEG in a single device is expected to significantly reduce coregistration errors between the two modalities, to simplify MEG analysis, and to improve MEG localization accuracy. The sensor solutions, MRI coils (including a superconducting polarizing coil), an optimized pulse sequence, and a reconstruction method suitable for hybrid MEG-MRI measurements are described. The performance of the device is demonstrated by presenting ultra-low-field-MR images and MEG recordings that are compared with data obtained with a 3T scanner and a commercial MEG device.

Noise amplification in parallel whole-head ultra-low-field magnetic resonance imaging using 306 detectors.

In ultra-low-field magnetic resonance imaging, arrays of up to hundreds of highly sensitive superconducting quantum interference devices (SQUIDs) can be used to detect the weak magnetic fields emitted by the precessing magnetization. Here, we investigate the noise amplification in sensitivity-encoded ultra-low-field MRI at various acceleration rates using a SQUID array consisting of 102 magnetometers, 102 gradiometers, or 306 magnetometers and gradiometers, to cover the whole head. Our results suggest that SQUID arrays consisting of 102 magnetometers and 102 gradiometers are similar in g-factor distribution. A SQUID array of 306 sensors (102 magnetometers and 204 gradiometers) only marginally improves the g-factor. Corroborating with previous studies, the g-factor in 2D sensitivity-encoded ultra-low-field MRI with 9 to 16-fold 2D accelerations using the SQUID array studied here may be acceptable.

SQUID-sensor-based ultra-low-field MRI calibration with phantom images: towards quantitative imaging.

In ultra-low-field magnetic resonance imaging (ULF MRI), measured resonance signals oscillate at Larmor frequencies around 1 kHz compared to even above 100 MHz in high-field MRI. Thus, detection by induction coils in ULF MRI is not feasible, whereas superconducting quantum interference device (SQUID) sensors can measure these femtotesla-level signals. The signal-to-noise ratio is enhanced by prepolarization in a field that is typically 100-1000 times higher than the field during acquisition. Based on both measurements and simulations, a procedure for calibrating a SQUID-sensor-based MRI system with MR images is presented in this article. Magnetoencephalography (MEG) can be integrated with ULF MRI, and may also benefit from such a calibration procedure. Conventionally, electromagnet probe signals have been used for the SQUID-sensor calibration in MEG; the presented ULF-MRI-based approach using an imaging phantom could replace this procedure in hybrid MEG-MRI or ULF MRI alone. The necessary theory is provided here with experimental verification. The calibration procedure opens the possibility of performing quantitative ULF MRI without sample-specific reference scans.

Gradient-excitation encoding combined with frequency and phase encodings for three-dimensional ultra-low-field MRI.

Ultra-low-field magnetic resonance imaging (ULF MRI) in microtesla fields is a new technology with features unseen in tesla-range MRI. Instead of induction coils as sensors, superconducting quantum interference device (SQUID) sensors are used, providing a frequency-independent signal-to-noise ratio (SNR). Owing to its tolerance for large relative imaging-field inhomogeneities, electromagnet shimming is not necessary. ULF MRI can also be combined with magnetoencephalography (MEG) to image the brain with close to millimetre-millisecond resolution. In this paper, the hybrid MEG-MRI device developed at Aalto University will be presented, as well as a 3D imaging scheme combining gradient-excitation encoding with frequency and phase and encodings. It is noteworthy that, regarding the presented gradient-excitation encoding in ULF MRI, the kilohertz-range Larmor frequencies allow MR signals to propagate unattenuated through tissue, which is not the case in tesla-range MRI with Larmor frequencies even above 100 MHz. Thus, the presented encoding method is especially compatible with ULF MRI, where the use of three different encoding mechanisms for three-dimensional imaging is possible. The feasibility of image reconstruction with the gradient-excitation-encoding method is demonstrated by simulations.

Avoiding eddy-current problems in ultra-low-field MRI with self-shielded polarizing coils.

In ultra-low-field magnetic resonance imaging (ULF MRI), superconductive sensors are used to detect MRI signals typically in fields on the order of 10-100 µT. Despite the highly sensitive detectors, it is necessary to prepolarize the sample in a stronger magnetic field on the order of 10-100 mT, which has to be switched off rapidly in a few milliseconds before signal acquisition. In addition, external magnetic interference is commonly reduced by situating the ULF-MRI system inside a magnetically shielded room (MSR). With typical dipolar polarizing coil designs, the stray field induces strong eddy currents in the conductive layers of the MSR. These eddy currents cause significant secondary magnetic fields that may distort the spin dynamics of the sample, exceed the dynamic range of the sensors, and prevent simultaneous magnetoencephalography and MRI acquisitions. In this paper, we describe a method to design self-shielded polarizing coils for ULF MRI. The experimental results show that with a simple self-shielded polarizing coil, the magnetic fields caused by the eddy currents are largely reduced. With the presented shielding technique, ULF-MRI devices can utilize stronger and spatially broader polarizing fields than achievable with unshielded polarizing coils.

Improved determination of FID signal parameters in low-field NMR.

In this work, novel methods are suggested for assessing signal parameters of the free induction decay (FID) in nuclear magnetic resonance (NMR) experiments. The FID signal was recorded in a microtesla field and analysed to determine its relaxation time, amplitude, Larmor frequency and phase. The challenge was posed by the narrow line width, whose related effects were investigated through simulations, also. The developed methods give a new view on FID signal estimation in microtesla as well as lower and higher fields. It is shown that the transverse relaxation time of a sample can be accurately determined in the frequency domain by other means than the Lorentz peak half width. Also, with some realistic approximations, a simple functional form for the power spectrum Lorentz peak shape is proposed. As shown in this work, the inspection of the power spectrum instead of the absorption and dispersion Lorentzians is advantageous in the sense that the waveform is independent of the FID phase. The automatic and efficient methods presented in this work incorporate an integral exponential fit, the fit of the power spectrum Lorentz peak and two ways to determine the FID phase. When there are sufficiently many data points in the Lorentz peak, the power spectrum Lorentz peak shape fit provides a quick, simple and accurate way of determining the amplitude, relaxation time and Larmor frequency of the FID. In the measurements of this work, however, the narrow line width led to establishing a more applicable method which is based on the exponential decay of the Lorentz peak with a temporally moving power spectrum window.