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Purpose: To develop and evaluate a free-breathing respiratory motion compensated 4D (3D+respiration) $T_2$-weighted turbo spin echo sequence with application to radiology and MR-guided radiotherapy. Methods: k-space data are continuously acquired using a rewound Cartesian acquisition with spiral profile ordering (rCASPR) to provide matching contrast to the conventional linear phase encode ordering and to sort data into multiple respiratory phases. Low-resolution respiratory-correlated 4D images were reconstructed with compressed sensing and used to estimate non-rigid deformation vector fields, which were subsequently used for a motion compensated image reconstruction. rCASPR sampling was compared to linear and CASPR sampling in terms of point-spread-function (PSF) and image contrast with in silico, phantom and in vivo experiments. Reconstruction parameters for low-resolution 4D-MRI (spatial resolution and temporal regularization) were determined using a grid search. The proposed motion compensated rCASPR was evaluated in eight healthy volunteers and compared to free-breathing scans with linear sampling. Image quality was compared based on visual inspection and quantitatively by means of the gradient entropy. Results: rCASPR provided a superior PSF (similar in ky and narrower in kz) and showed no considerable differences in images contrast compared to linear sampling. The optimal 4D-MRI reconstruction parameters were spatial resolution=$4.5 mm^3$ and $\lambda_t=10^{-4}$. The groupwise average gradient entropy was 22.31 for linear, 22.20 for rCASPR, 22.14 for soft-gated rCASPR and 22.02 for motion compensated rCASPR. Conclusion: The proposed motion compensated rCASPR enables high quality free-breathing T2-TSE with minimal changes in image contrast and scan time. The proposed method therefore enables direct transfer of clinically used 3D TSE sequences to free-breathing., Comment: 19 pages, 11 figures

Hybrid MRI-linac (MRL) systems enable daily multiparametric quantitative MRI to assess tumor response to radiotherapy. Magnetic Resonance Fingerprinting (MRF) may provide time efficient means of rapid multiparametric quantitative MRI. The accuracy of MRF, however, relies on adequate control over system imperfections, such as eddy currents and B1+, which are different and not as well established on MRL systems compared to diagnostic systems. In this study we investigate the technical feasibility of gradient spoiled 2D MRF on a 1.5T MRL. We show with phantom experiments that the MRL generates reliable MRF signals that are temporally stable during the day and have good agreement with spin-echo reference measurements. Subsequent in-vivo MRF scans in healthy volunteers and a patient with a colorectal liver metastasis showed good image quality, where the quantitative values of selected organs corresponded with the values reported in literature. Therefore we conclude that gradient spoiled 2D MRF is feasible on a 1.5T MRL with similar performance as on a diagnostic system. The precision and accuracy of the parametric maps are sufficient for further investigation of the clinical utility of MRF for online quantitatively MRI-guided radiotherapy., Comment: 17 pages, 9 figures, Submitted to Physics in Medicine & Biology as a technical note