@article{2985750,
    title = "Characterization of system-related geometric distortions in MR images employed in Gamma Knife radiosurgery applications",
    author = "Pappas, E.P. and Seimenis, I. and Moutsatsos, A. and Georgiou, E. and Nomikos, P. and Karaiskos, P.",
    journal = "Physics in Medicine and Biology",
    year = "2016",
    volume = "61",
    number = "19",
    pages = "6993-7011",
    publisher = "INSTITUTE OF PHYSICS PUBLISHING",
    issn = "0031-9155, 1361-6560",
    doi = "10.1088/0031-9155/61/19/6993",
    keywords = "Aluminum;  Computerized tomography;  Geometry;  Magnetic resonance imaging;  Radiotherapy, Control points (CPs);  Gamma knife radiosurgery;  Geometric distortion;  Gradient nonlinearity;  Induced eddy currents;  Registration process;  Stereotactic frames;  Stereotactic radiosurgery, Eddy currents, poly(methyl methacrylate), devices;  human;  image processing;  imaging phantom;  nuclear magnetic resonance imaging;  procedures;  radiosurgery;  radiotherapy planning system;  theoretical model;  three dimensional imaging, Humans;  Image Processing, Computer-Assisted;  Imaging, Three-Dimensional;  Magnetic Resonance Imaging;  Models, Theoretical;  Phantoms, Imaging;  Polymethyl Methacrylate;  Radiosurgery;  Radiotherapy Planning, Computer-Assisted",
    abstract = "This work provides characterization of system-related geometric distortions present in MRIs used in Gamma Knife (GK) stereotactic radiosurgery (SRS) treatment planning. A custom-made phantom, compatible with the Leksell stereotactic frame model G and encompassing 947 control points (CPs), was utilized. MR images were obtained with and without the frame, thus allowing discrimination of frame-induced distortions. In the absence of the frame and following compensation for field inhomogeneities, measured average CP disposition owing to gradient nonlinearities was 0.53 mm. In presence of the frame, contrarily, detected distortion was greatly increased (up to about 5 mm) in the vicinity of the frame base due to eddy currents induced in the closed loop of its aluminum material. Frame-related distortion was obliterated at approximately 90 mm from the frame base. Although the region with the maximum observed distortion may not lie within the GK treatable volume, the presence of the frame results in distortion of the order of 1.5 mm at a 7 cm distance from the center of the Leksell space. Additionally, severe distortions observed outside the treatable volume could possibly impinge on the delivery accuracy mainly by adversely affecting the registration process (e.g. the position of the lower part of the N-shaped fiducials used to define the stereotactic space may be miss-registered). Images acquired with a modified version of the frame developed by replacing its front side with an acrylic bar, thus interrupting the closed aluminum loop and reducing the induced eddy currents, were shown to benefit from relatively reduced distortion. System-related distortion was also identified in patient MR images. Using corresponding CT angiography images as a reference, an offset of 1.1 mm was detected for two vessels lying in close proximity to the frame base, while excellent spatial agreement was observed for a vessel far apart from the frame base. © 2016 Institute of Physics and Engineering in Medicine."
}