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Background  Respiratory‐resolved four‐dimensional magnetic resonance imaging (4D‐MRI) provides essential motion information for accurate radiation treatments of mobile tumors. However, obtaining high‐quality 4D‐MRI suffers from long acquisition and reconstruction times.    Purpose  To develop a deep learning architecture to quickly acquire and reconstruct high‐quality 4D‐MRI, enabling accurate motion quantification for MRI‐guided radiotherapy (MRIgRT).    Methods  A small convolutional neural network called MODEST is proposed to reconstruct 4D‐MRI by performing a spatial and temporal decomposition, omitting the need for 4D convolutions to use all the spatio‐temporal information present in 4D‐MRI. This network is trained on undersampled 4D‐MRI after respiratory binning to reconstruct high‐quality 4D‐MRI obtained by compressed sensing reconstruction. The network is trained, validated, and tested on 4D‐MRI of 28 lung cancer patients acquired with a T1‐weighted golden‐angle radial stack‐of‐stars (GA‐SOS) sequence. The 4D‐MRI of 18, 5, and 5 patients were used for training, validation, and testing. Network performances are evaluated on image quality measured by the structural similarity index (SSIM) and motion consistency by comparing the position of the lung‐liver interface on undersampled 4D‐MRI before and after respiratory binning. The network is compared to conventional architectures such as a U‐Net, which has 30 times more trainable parameters.    Results  MODEST can reconstruct high‐quality 4D‐MRI with higher image quality than a U‐Net, despite a thirty‐fold reduction in trainable parameters. High‐quality 4D‐MRI can be obtained using MODEST in approximately 2.5 min, including acquisition, processing, and reconstruction.    Conclusion  High‐quality accelerated 4D‐MRI can be obtained using MODEST, which is particularly interesting for MRIgRT.

Accelerated respiratory‐resolved 4D‐MRI with separable spatio‐temporal neural networks