title: Technical feasibility of integrating 7 T anatomical MRI in image-guided radiotherapy of glioblastoma: a preparatory study.
abstract: OBJECTIVE
  The use of 7 Tesla (T) magnetic resonance imaging (MRI) has recently shown great potential for high-resolution soft-tissue neuroimaging and visualization of microvascularization in glioblastoma (GBM). We have designed a clinical trial to explore the value of 7 T MRI in radiation treatment of GBM. For this aim we performed a preparatory study to investigate the technical feasibility of incorporating 7 T MR images into the neurosurgical navigation and radiotherapy treatment planning (RTP) systems via qualitative and quantitative assessment of the image quality.
  
  
  METHODS
  The MR images were acquired with a Siemens Magnetom 7 T whole-body scanner and a Nova Medical 32-channel head coil. The 7 T MRI pulse sequences included magnetization-prepared two rapid acquisition gradient echoes (MP2RAGE), T2-SPACE, SPACE-FLAIR and gradient echo sequences (GRE). A pilot study with three healthy volunteers and an anthropomorphic 3D phantom was used to assess image quality and geometrical image accuracy.
  
  
  RESULTS
  The MRI scans were well tolerated by the volunteers. Susceptibility artefacts were observed in both the cortex and subcortical white matter at close proximity to air-tissue interfaces. Regional loss of signal and contrast could be minimized by the use of dielectric pads. Image transfer and processing did not degrade image quality. The system-related spatial uncertainty of geometrical distortion-corrected MP2RAGE pulse sequences was ≤2 mm.
  
  
  CONCLUSIONS
  Integration of high-quality and geometrically-reliable 7 T MR images into neurosurgical navigation and RTP software is technically feasible and safe.
authors.affiliation: Department of Radiation Oncology (MAASTRO CLINIC), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. inge.compter@maastro.nl.
authors.forename: Inge
authors.identifier: http://orcid.org/0000-0002-6155-1565
authors.initials: I
authors.lastname: Compter
authors.affiliation: Department of Radiation Oncology (MAASTRO CLINIC), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.|Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Peerlings
authors.affiliation: Department of Radiation Oncology (MAASTRO CLINIC), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Daniëlle B P
authors.initials: DB
authors.lastname: Eekers
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Alida A
authors.initials: AA
authors.lastname: Postma
authors.affiliation: Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Dimo
authors.initials: D
authors.lastname: Ivanov
authors.affiliation: Scannexus, Maastricht, The Netherlands.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Wiggins
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Kubben
authors.affiliation: Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Benno
authors.initials: B
authors.lastname: Küsters
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Wesseling
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Ackermans
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Olaf E M G
authors.initials: OE
authors.lastname: Schijns
authors.affiliation: Department of Radiation Oncology (MAASTRO CLINIC), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
authors.affiliation: Department of Radiation Oncology (MAASTRO CLINIC), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.|Institute of Radiooncology, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.|Department of Radiation Oncology, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany.
authors.forename: Aswin L
authors.initials: AL
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D000886:Anthropometry; D016477:Artifacts; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D005909:Glioblastoma / Q000532:radiotherapy*; D064368:Healthy Volunteers; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D060526:Magnetic Fields; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015233:Models, Statistical; D019047:Phantoms, Imaging; D010865:Pilot Projects; D011880:Radiotherapy Planning, Computer-Assisted; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D015203:Reproducibility of Results
keywords: Geometrical distortion; Glioblastoma; Radiotherapy; Treatment planning; Ultra-high field MRI