Usability of magnetic resonance images acquired at a novel low-field 0.55 T scanner for brain radiotherapy treatment planning

Background and Purpose: Low-field magnetic resonance imaging (MRI) may offer specific advantages over high-field MRI, e.g. lower susceptibility-dependent distortions and simpler installation. The study aim was to evaluate if a novel 0.55 T MRI scanner provides sufficient image accuracy and quality for radiotherapy (RT) treatment planning. Material and methods: The geometric accuracy of images acquired at a low-field MRI scanner was evaluated in phantom measurements regarding gradient non-linearity-related distortions. Patient-induced B0-susceptibility changes were investigated via B0-field-mapping in ten volunteers. Patients were positioned in RT-setup using a 3D-printed insert for the head/neck-coil that was tested for sufficient signal-to-noise-ratio (SNR). The suitability of the MRI-system for detection of metastases was evaluated in eleven patients. In comparison to diagnostic images, acquired at ≥1.5 T, three physicians evaluated the detectability of metastases by counting them in low- and high-field-images, respectively. Results: The phantom measurements showed a high imaging fidelity after 3D-distortion-correction with (1.2 ± 0.9) mm geometric distortion in 10 cm radius from isocentre. At the edges remaining distortions were greater than at 1.5 T. The mean susceptibility-induced distortions in the head were (0.05 ± 0.05) mm and maximum 0.69 mm. SNR analysis showed that optimised positioning of RT-patients without signal loss in the head/neck-coil was possible with the RT-insert. No significant differences (p = 0.48) in detectability of metastases were found. Conclusion: The 0.55 T MRI system provided sufficiently geometrically accurate and high-resolution images that can be used for RT-planning for brain metastases. Hence, modern low-field MRI may contribute to simply access MRI for RT-planning after further investigations.