Minimizing 3T MRI Geometric Distortions for Stereotactic Radiosurgery via Anterior–Posterior Phase Encoding–A Phantom Study

To directly address the important issue of MRI geometric distortions in stereotactic radiosurgery (SRS) planning, we performed a phantom study of sequence acquisition optimization. This study analyzed, in particular, the effects of clinically relevant gadolinium (Gd) concentration as filling solution for the phantom, as well as phase encoding reversal direction and flip angle on distortion. We created a rigid geometric grid phantom with 840 fiducial markers for distortion quantification on a 3T MRI scanner. To choose the optimal filling solution, an anthropomorphic RANDO phantom was employed, and 1 mmol/L gadolinium was chosen due to clinical relevance. An automated Python-based software (version 3.7.1) was developed for efficient detection and matching of phantom inserts between MRI and CT scans. A series of MRI acquisition parameter optimizations were systematically evaluated. The standard SRS protocol exhibited the highest average distortion of 1.301 mm. Notably, reversing the phase-encoding direction to anterior–posterior (AP) reduced the mean distortion to 0.725 mm, a 44.27% decrease, while the maximum distortion was reduced by 15.65%. The AP phase sequence maintained acquisition time, SAR, SNR, and CNR within acceptable limits. Additional distortion reduction was achieved by increasing the flip angle from 12° to 18°. In this work, we succeeded in significantly reducing the mean distortion observed in phantom images. As the gadolinium concentration used in the phantom is clinically similar to the gadolinium concentration observed in patients undergoing MRI scans with contrast agents, the achieved distortion reduction is prospectively reproducible in patients.