Magnetic resonance-guided high intensity focused ultrasound treatment of the liver is a promising noninvasive technique for ablation of liver lesions. For the technique to be used in clinical practice, however, the issue of liver motion needs to be addressed. A subject-specific four-dimensional liver motion model is presented that is created based on registration of dynamically acquired magnetic resonance data. This model can be used for predicting the tumor motion trajectory for treatment planning and to indicate the tumor position for treatment guidance. The performance of the model was evaluated on a dynamic scan series that was not used to build the model. The method achieved an average Dice coefficient of 0.93 between the predicted and actual liver profiles and an average vessel misalignment of 3.0 mm. The model performed robustly, with a small variation in the results per subject. The results demonstrate the potential of the model to be used for MRI-guided treatment of liver lesions. Furthermore, the model can possibly be applied in other image-guided therapies, for instance radiotherapy of the liver.
<strong>Introduction:</strong> Image-guided minimally invasive procedures are becoming increasingly popular. Currently, High-Intensity Focused Ultrasound (HIFU) treatment of lesions in mobile organs, such as the liver, is in development. A requirement for such treatment is automatic motion tracking, such that the position of the lesion can be
followed in real time. We propose a 4D liver motion model, which can be used during planning of this procedure. During treatment, the model can serve as a motion predictor. In a similar fashion, this model could be used for radiotherapy treatment of the liver. <strong>Method:</strong> The model is built by acquiring 2D dynamic sagittal MRI data at six locations in the liver. By registering these dynamics to a 3D MRI liver image, 2D deformation fields are obtained at every location. The 2D fields are ordered according to the position of the liver at that specific time point, such that liver motion during an average breathing period can be simulated. This way, a sparse deformation field is created over time. This deformation field is finally interpolated over the entire volume, yielding a 4D motion model. <strong>Results:</strong> The accuracy of the model is evaluated by comparing unseen slices to the slice predicted by the model at that specific location and phase in the breathing cycle. The mean Dice coefficient of the liver regions was
0.90. The mean misalignment of the vessels was 1.9 mm.<strong> Conclusion</strong>: The model is able to predict patient specific deformations of the liver and can predict regular motion accurately.