Background and purpose: Physiological motion impacts the dose delivered to tumours and vital organs in external beam radiotherapy and particularly in particle therapy. The excellent soft-tissue demarcation of 4D magnetic resonance imaging (4D-MRI) could inform on intra-fractional motion, but long image reconstruction times hinder its use in online treatment adaptation. Here we employ techniques from high-performance computing to reduce 4D-MRI reconstruction times below two minutes to facilitate their use in MR-guided radiotherapy. Material and methods: Four patients with pancreatic adenocarcinoma were scanned with a radial stack-of-stars gradient echo sequence on a 1.5T MR-Linac. Fast parallelised open-source implementations of the extra-dimensional golden-angle radial sparse parallel algorithm were developed for central processing unit (CPU) and graphics processing unit (GPU) architectures. We assessed the impact of architecture, oversampling and respiratory binning strategy on 4D-MRI reconstruction time and compared images using the structural similarity (SSIM) index against a MATLAB reference implementation. Scaling and bottlenecks for the different architectures were studied using multi-GPU systems. Results: All reconstructed 4D-MRI were identical to the reference implementation (SSIM > 0.99). Images reconstructed with overlapping respiratory bins were sharper at the cost of longer reconstruction times. The CPU + GPU implementation was over 17 times faster than the reference implementation, reconstructing images in 60 ± 1 s and hyper-scaled using multiple GPUs. Conclusion: Respiratory-resolved 4D-MRI reconstruction times can be reduced using high-performance computing methods for online workflows in MR-guided radiotherapy with potential applications in particle therapy.

Field Programmable Gate Arrays (FPGAs) are gaining popularity in the context of scientific computing due to the recent advances of High-Level Synthesis (HLS) toolchains for customised hardware implementations combined with the increase in computing capabilities of modern FPGAs. As a result, developers are able to implement more complex scientific workloads which often require the evaluation of univariate numerical functions. In this study, we propose a methodology for table-based polynomial interpolation aiming at producing area-efficient implementations of such functions on FPGAs achieving the same accuracy and at similar performance as direct implementations. We also provide a rigorous error analysis to guarantee the correctness of the results. Our methodology covers the forecast of resource utilisation of the polynomial interpolator and, based on the characteristics of the function, guides the developer to the most area-efficient FPGA implementation. Our experiments show that in the case of a radiation spectrum of a Black Body application based on evaluating Planck's Law, it is possible to reduce resource utilisation by up to 90% when compared to direct implementations not using table-based methods. Moreover, when only the kernels are considered, our method uses up to two orders of magnitude fewer resources with no performance penalties. Based on previous more theoretical works, our study investigates practical applications of table-based methods in the context of high performance and scientific computing where it is used to implement common but more complex functions than the elementary functions widely studied in the related literature.

Magnetic Resonance (MR)-guided online Adaptive RadioTherapy (MRgoART) utilises the excellent soft-tissue contrast of MR images taken just before the patient's treatment to quickly update and personalise radiotherapy treatment plans. Four-dimensional (4D) MR Imaging (MRI) can resolve variations in respiratory motion patterns. 4D MRI data can be used to adapt the radiation beams to maximally target the tumour while sparing as much healthy tissue as possible. 4D MRI reconstruction, however, is computationally challenging and current state-of-the-art implementations are unable to meet MRgoART time requirements. This study bridges the gap between high-performance computing and medical applications by developing and implementing a parallel, heterogeneous architecture for the XD-GRASP algorithm capable of meeting the MRgoART time requirements. Our architecture exploits long-vector instructions and utilises all available resources, while minimising and hiding the communication overhead when external GPUs are used. As a result, the reconstruction time was reduced from 994 seconds to just 90 seconds with a speedup of more than 11x. In addition, we evaluated the impact of the emerging Processing-in-Memory (PIM) technology. Our simulation results show that 16 low power, in-order PIM cores with no SIMD unit are 2.7x faster than an Intel Core™ i7-9700 8-core CPU equipped with AVX512 SIMD units. Additionally, 40 PIM cores match the performance of two AMD EPYC 7551 CPUs, with 32 cores each and just 87 PIM cores will match the performance of an NVIDIA Tesla V100 GPU equipped with 5,120 CUDA cores.

We propose a novel reconfigurable hardware architecture to implement Monte Carlo based simulation of physical dose accumulation for intensity-modulated adaptive radiotherapy. The long term goal of our effort is to provide accurate dose calculation in real-time during patient treatment. This will allow wider adoption of personalised patient therapies which has the potential to significantly reduce dose exposure to the patient as well as shorten treatment and greatly reduce costs. The proposed architecture exploits the inherent parallelism of Monte Carlo simulations to perform domain decomposition and provide high resolution simulation without being limited by on-chip memory capacity. We present our architecture in detail and provide a performance model to estimate execution time, hardware area and bandwidth utilisation. Finally, we evaluate our architecture on a Xilinx VU9P platform as well as the Xilinx Alveo U250 and show that three VU9P based cards or two Alevo U250s are sufficient to meet our real time target of 100 million randomly generated particle histories per second.

We propose a novel reconfigurable hardware architecture to implement Monte Carlo based simulation of physical dose accumulation for intensity-modulated adaptive radiotherapy. The long term goal of our effort is to provide accurate online dose calculation in real-time during patient treatment. This will allow wider adoption of personalised patient therapies which has the potential to significantly reduce dose exposure to the patient as well as shorten treatment and greatly reduce costs. The proposed architecture exploits the inherent parallelism of Monte Carlo simulations to perform domain decomposition and provide high resolution simulation without being limited by on-chip memory capacity. We present our architecture in detail and provide a performance model to estimate execution time, hardware area and bandwidth utilisation. Finally, we evaluate our architecture on a Xilinx VU9P platform and show that three cards are sufficient to meet our real time target of 100 million randomly generated particle histories per second.