Science.gov

Sample records for angiography computed tomography

  1. Computed tomography imaging and angiography - principles.

    PubMed

    Kamalian, Shervin; Lev, Michael H; Gupta, Rajiv

    2016-01-01

    The evaluation of patients with diverse neurologic disorders was forever changed in the summer of 1973, when the first commercial computed tomography (CT) scanners were introduced. Until then, the detection and characterization of intracranial or spinal lesions could only be inferred by limited spatial resolution radioisotope scans, or by the patterns of tissue and vascular displacement on invasive pneumoencaphalography and direct carotid puncture catheter arteriography. Even the earliest-generation CT scanners - which required tens of minutes for the acquisition and reconstruction of low-resolution images (128×128 matrix) - could, based on density, noninvasively distinguish infarct, hemorrhage, and other mass lesions with unprecedented accuracy. Iodinated, intravenous contrast added further sensitivity and specificity in regions of blood-brain barrier breakdown. The advent of rapid multidetector row CT scanning in the early 1990s created renewed enthusiasm for CT, with CT angiography largely replacing direct catheter angiography. More recently, iterative reconstruction postprocessing techniques have made possible high spatial resolution, reduced noise, very low radiation dose CT scanning. The speed, spatial resolution, contrast resolution, and low radiation dose capability of present-day scanners have also facilitated dual-energy imaging which, like magnetic resonance imaging, for the first time, has allowed tissue-specific CT imaging characterization of intracranial pathology. PMID:27432657

  2. Can 64-row computed tomography replace angiography after coronary bypass?

    PubMed

    Doi, Hirosato; Koshima, Ryuji; Suzuki, Masato; Takahashi, Ken; Yokoyama, Hiroichi; Yoshida, Naoya

    2008-12-01

    Multi-detector (64-row) computed tomography has become an alternative to coronary angiography to diagnose graft occlusion and stenosis after coronary artery bypass. We compared the power of evaluation of multi-detector computed tomography with that of conventional coronary angiography in 60 patients who underwent coronary artery bypass with 135 grafts and 210 graft anastomoses. The diagnostic power of multi-detector computed tomography for graft occlusion was: 100% (2/2) sensitivity, 98.5% (131/133) specificity, 50% (2/4) positive predictive value, and 100% (133/133) negative predictive value; there were no significant differences in rates of occlusion among the different types of graft. The diagnostic power of multi-detector computed tomography for stenosis of the graft anastomosis was: 100% (2/2) sensitivity, 95.1% (194/204) specificity, 16.6% (2/12) positive predictive value, and 100% (194/194) negative predictive value, with no significant differences among grafts. Multi-detector computed tomography permits evaluation of bypass grafts and is much less invasive for the patients. PMID:18984751

  3. Giant coronary aneurysm caused by Kawasaki disease: consistency between catheter angiography and electrocardiogram gated dual-source computed tomography angiography.

    PubMed

    Hwang, Eun-Ha; Ju, Jung-Ki; Cho, Min-Jung; Lee, Ji-Won; Lee, Hyoung-Doo

    2015-12-01

    We present the case of a 5-year-old child with coronary complications due to Kawasaki disease; this patient unintentionally underwent both dual-source computed tomography (DSCT) coronary angiography and invasive coronary angiographic examination in 2 months. This case highlights the strong consistency of the results between DSCT coronary angiography and invasive coronary angiography. Compared to conventional invasive coronary angiography, DSCT coronary angiography offered additional advantages such as minimal invasiveness and less radiation exposure. PMID:26770226

  4. Computed tomography angiography in patients with active gastrointestinal bleeding.

    PubMed

    Reis, Fatima Regina Silva; Cardia, Patricia Prando; D'Ippolito, Giuseppe

    2015-01-01

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding.

  5. Multi-Detector Computed Tomography Angiography for Coronary Artery Disease

    PubMed Central

    2005-01-01

    Executive Summary Purpose Computed tomography (CT) scanning continues to be an important modality for the diagnosis of injury and disease, most notably for indications of the head and abdomen. (1) According to a recent report published by the Canadian Institutes of Health Information, (1) there were about 10.3 scanners per million people in Canada as of January 2004. Ontario had the fewest number of CT scanners per million compared to the other provinces (8 CT scanners per million). The wait time for CT in Ontario of 5 weeks approaches the Canadian median of 6 weeks. This health technology and policy appraisal systematically reviews the published literature on multidetector CT (MDCT) angiography as a diagnostic tool for the newest indication for CT, coronary artery disease (CAD), and will apply the results of the review to current health care practices in Ontario. This review does not evaluate MDCT to detect coronary calcification without contrast medium for CAD screening purposes. The Technology Compared with conventional CT scanning, MDCT can provide smaller pieces of information and can cover a larger area faster. (2) Advancing MDCT technology (8, 16, 32, 64 slice systems) is capable of producing more images in less time. For general CT scanning, this faster capability can reduce the time that patients must stay still during the procedure, thereby reducing potential movement artefact. However, the additional clinical utility of images obtained from faster scanners compared to the images obtained from conventional CT scanners for current CT indications (i.e., non-moving body parts) is not known. There are suggestions that the new fast scanners can reduce wait times for general CT. MDCT angiography that utilizes a contrast medium, has been proposed as a minimally invasive replacement to coronary angiography to detect coronary artery disease. MDCT may take between 15 to 45 minutes; coronary angiography may take up to 1 hour. Although 16-slice and 32-slice CT

  6. Didactics and training in cardiovascular computed tomography angiography.

    PubMed

    Bhojraj, Sanjay D; Al-Mallah, Mouaz H

    2009-01-01

    As the role of cardiovascular computed tomography angiography (CCTA) is further expanded through research, the use of this technology will expand as a result of demand both from medical professionals and the public. To ensure a standardized quality of interpretation of these scans in the face of an increased demand for physicians qualified to interpret these studies, the Society of Cardiovascular Computed Tomography, along with several other professional societies, has proposed a didactic curriculum for the study of CCTA. This review highlights the currently proposed didactic curriculum for the study of CCTA, examines current trends in training for both medical trainees and physicians in practice, and proposes future directions for the study of CCTA. PMID:19203747

  7. Didactics and training in cardiovascular computed tomography angiography.

    PubMed

    Bhojraj, Sanjay D; Al-Mallah, Mouaz H

    2009-01-01

    As the role of cardiovascular computed tomography angiography (CCTA) is further expanded through research, the use of this technology will expand as a result of demand both from medical professionals and the public. To ensure a standardized quality of interpretation of these scans in the face of an increased demand for physicians qualified to interpret these studies, the Society of Cardiovascular Computed Tomography, along with several other professional societies, has proposed a didactic curriculum for the study of CCTA. This review highlights the currently proposed didactic curriculum for the study of CCTA, examines current trends in training for both medical trainees and physicians in practice, and proposes future directions for the study of CCTA.

  8. Noninvasive coronary artery angiography using electron beam computed tomography

    NASA Astrophysics Data System (ADS)

    Rumberger, John A.; Rensing, Benno J.; Reed, Judd E.; Ritman, Erik L.; Sheedy, Patrick F., II

    1996-04-01

    Electron beam computed tomography (EBCT), also known as ultrafast-CT or cine-CT, uses a unique scanning architecture which allows for multiple high spatial resolution electrocardiographic triggered images of the beating heart. A recent study has demonstrated the feasibility of qualitative comparisons between EBCT derived 3D coronary angiograms and invasive angiography. Stenoses of the proximal portions of the left anterior descending and right coronary arteries were readily identified, but description of atherosclerotic narrowing in the left circumflex artery (and distal epicardial disease) was not possible with any degree of confidence. Although these preliminary studies support the notion that this approach has potential, the images overall were suboptimal for clinical application as an adjunct to invasive angiography. Furthermore, these studies did not examine different methods of EBCT scan acquisition, tomographic slice thicknesses, extent of scan overlap, or other segmentation, thresholding, and interpolation algorithms. Our laboratory has initiated investigation of these aspects and limitations of EBCT coronary angiography. Specific areas of research include defining effects of cardiac orientation; defining the effects of tomographic slice thickness and intensity (gradient) versus positional (shaped based) interpolation; and defining applicability of imaging each of the major epicardial coronary arteries for quantitative definition of vessel size, cross-sectional area, taper, and discrete vessel narrowing.

  9. Patient radiation dose from computed tomography angiography and digital subtraction angiography of the brain

    NASA Astrophysics Data System (ADS)

    Netwong, Y.; Krisanachinda, A.

    2016-03-01

    The 64-row multidetector computed tomography angiography (64-MDCTA) provides vascular image quality of the brain similar to digital subtraction angiography (DSA), but the effective dose of CTA is lower than DSA studied in phantom. The purpose of this study is to evaluate the effective dose from 64-MDCTA and DSA. Effective dose (according to ICRP 103) from 64-MDCTA and DSA flat panel detector for cerebral vessels examination of the brain using standard protocols as recommended by the manufacturer was calculated for 30 cases of MDCTA (15 male and 15 female).The mean patient age was 49.5 (23-89) yrs. 30 cases of DSA (14 male and 16 female), the mean patient age was 46.8 (21-81) yrs. For CTA, the mean effective dose was 3.7 (2.82- 5.19) mSv. For DSA, the mean effective dose was 5.78 (3.3-10.06) mSv. The effective dose of CTA depends on the scanning protocol and scan length. Low tube current can reduce patient dose whereas the number of exposures and number of series in 3D rotational angiography (3D RA) resulted in increasing effective dose in DSA patients.

  10. Time-Resolved 4-Dimensional Computed-Tomography Angiography Can Correctly Identify Carotid Pseudo-Occlusion.

    PubMed

    Ng, Felix C; Datta, Mineesh; Choi, Philip M C

    2016-04-01

    Correct identification of symptomatic high-grade internal carotid artery stenosis from low-grade or total chronic occlusion is critical for patient selection for urgent carotid endarterectomy. Carotid pseudo-occlusion is a flow-related artifact on noninvasive imaging that can lead to an incorrect diagnosis of total internal carotid artery occlusion, thereby denying an eligible patient for appropriate surgical treatment. We present an 82-year-old man with a symptomatic critical internal carotid artery, which was detected on time-resolved 4-dimensional computed-tomography angiography, whereas single-phase computed-tomography angiography, magnetic resonance angiography, and Doppler ultrasonography suggested apparent occlusion. To our understanding, the use of 4-dimensional computed-tomography angiography to identify carotid pseudo-occlusion has not been previously reported.

  11. Coronary Computed Tomography Angiography in the Assessment of Acute Chest Pain in the Emergency Room

    PubMed Central

    dos Prazeres, Carlos Eduardo Elias; Cury, Roberto Caldeira; Carneiro, Adriano Camargo de Castro; Rochitte, Carlos Eduardo

    2013-01-01

    The coronary computed tomography angiography has recently emerged as an accurate diagnostic tool in the evaluation of coronary artery disease, providing diagnostic and prognostic data that correlate directly with the data provided by invasive coronary angiography. The association of recent technological developments has allowed improved temporal resolution and better spatial coverage of the cardiac volume with significant reduction in radiation dose, and with the crucial need for more effective protocols of risk stratification of patients with chest pain in the emergency room, recent evaluation of the computed tomography coronary angiography has been performed in the setting of acute chest pain, as about two thirds of invasive coronary angiographies show no significantly obstructive coronary artery disease. In daily practice, without the use of more efficient technologies, such as coronary angiography by computed tomography, safe and efficient stratification of patients with acute chest pain remains a challenge to the medical team in the emergency room. Recently, several studies, including three randomized trials, showed favorable results with the use of this technology in the emergency department for patients with low to intermediate likelihood of coronary artery disease. In this review, we show data resulting from coronary angiography by computed tomography in risk stratification of patients with chest pain in the emergency room, its diagnostic value, prognosis and cost-effectiveness and a critical analysis of recently published multicenter studies. PMID:24145392

  12. Renal trauma: radiological studies - comparison of urography, computed tomography, angiography, and radionuclide studies

    SciTech Connect

    Lang, E.K.; Sullivan, J.; Frentz, G.

    1985-01-01

    Excretory urography, computed radionuclide urography, angiography, and both conventional and dynamic computed tomography (CT) were compared with regard to accuracy, sensitivity, and specificity in 388 patients with renal trauma. Used as the triage examination, urography established the absence of significant renal injury with an accuracy of 87%, obviating further evaluation. Dynamic CT proved to be the best methods of assessing parenchymal injuries, establishing the correct diagnosis in 129 out of 130 cases compared to 116/130 for conventional CT. Angiography was the procedure of choice for diagnosis and categorization of renal artery injuries, which were diagnosed correctly in all 43 cases. The choice between dynamic CT and angiography as the second examination rests upon careful evaluation of clinical and urographic findings for signs of renal artery injury which would mandate angiographic assessment.

  13. Coronary computed tomography angiography and its increasing application in day to day cardiology practice.

    PubMed

    Markham, R; Murdoch, D; Walters, D L; Hamilton-Craig, C

    2016-01-01

    Coronary artery disease (CAD) is the leading single cause of death in Australia affecting around 1.4 million people. Coronary computed tomography angiography has an established role in the assessment of patients with low to intermediate pretest probability for CAD who have chest pain and is typically used with the aim to rule out significant coronary artery stenosis. Use was initially limited because of concerns over radiation exposure, a Medicare rebate restricted to specialist referrals and an absence of data supporting its use as an alternative to functional testing in patients with chest pain. Recent advances in scanner technology and image sequencing, along with data from randomised control trials, have addressed these issues and indicate that coronary computed tomography angiography will play a greater role in the assessment of CAD in the coming years. PMID:26813899

  14. Computed tomography angiography in acute stroke (revisiting the 4Ps of imaging).

    PubMed

    Varadharajan, Shriram; Saini, Jitender; Acharya, Ullas V; Gupta, Arun Kumar

    2016-02-01

    Imaging in acute stroke has traditionally focussed on the 4Ps-parenchyma, pipes, perfusion, and penumbra-and has increasingly relied upon advanced techniques including magnetic resonance imaging to evaluate such patients. However, as per European Magnetic Resonance Forum estimates, the availability of magnetic resonance imaging scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and United States (35 per million), with most of them only present in urban cities. On the other hand, computed tomography (CT) is more widely available and has reduced scanning duration. Computed tomography angiography of cervical and intracranial vessels is relatively simpler to perform with extended coverage and can provide all pertinent information required in such patients. This imaging review will discuss relevant imaging findings on CT angiography in patients with acute ischemic stroke through illustrated cases.

  15. Comparison of effective doses between computed tomography cardiac angiography and conventional angiography at Pantai Hospital, Kuala Lumpur

    NASA Astrophysics Data System (ADS)

    Mohamed, Faizal; Moin, F. H. A.

    2013-05-01

    This research studies two types of cardiac angiography procedures, namely Computed Tomography Cardiac Angiography (CTCA) and Conventional Angiography (CA). The following research was executed to estimate the difference of mean effective doses that the patients received through both procedures. The mean dose-length-product (DLP) from CTCA and mean dose-area-product (DAP) from CA were utilized in calculating the effective doses. The result shows that the mean effective dose for CTCA and CA are 1.71±0.59 mSv and 53.25±14.22 mSv respectively. This proves that the mean effective dose received by patients undergoing CA is higher than patients undergoing CTCA. According to t-test, both procedures differ significantly, with a difference amounting to p<0.0001. The increases of the effective dose that the patients received through CA procedure were influenced by exposure time, the coronary anatomical condition, the operator's experience, and the operation methods.

  16. Should computed tomography angiography supersede invasive coronary angiography for the evaluation of graft patency following coronary artery bypass graft surgery?

    PubMed

    Gabriel, Joseph; Klimach, Stefan; Lang, Peter; Hildick-Smith, David

    2015-08-01

    Invasive coronary angiography (ICA) has long been the established gold standard in assessing graft patency following coronary artery bypass graft (CABG). Over the past decade or so however, improvements in computed tomography angiography (CTA) technology have allowed its emergence as a useful clinical tool in graft assessment. The recent introduction of 64-slice and now 128-slice scanners into widespread distribution, and the development of 320-detector row technology allowing volumetric imaging of the entire heart at single points in time within one cardiac cycle, has increased the potential of CTA to supersede ICA in this capacity. This study sought to examine the evidence surrounding this potential. A best evidence topic was constructed according to a structured protocol. The enquiry: In [patients who have undergone coronary artery bypass graft surgery] is [computed tomography angiography or invasive coronary angiography] superior in terms of [graft patency assessment, stenosis detection, radiation exposure and complication rate]? Four hundred and twenty-four articles were identified from the search strategy. Four additional articles were identified from references of key articles. Seventeen articles selected as best evidence were tabulated. The reliability of CTA as a tool in the detection of graft patency and stenosis has continued to improve with each successive generation of multislice technology. The latest 64- and 128-slice CTA techniques are able to detect graft patency and stenosis with very high sensitivities and specificities comparable with ICA, while remaining non-invasive procedures associated with fewer complications (ICA carries a 0.08% risk of myocardial infarction and 0.7% risk of minor complications in clinically stable patients). Present limitations of the technology include the accurate visualization of distal anastomoses and clip artefacts. In addition, the capacity of diagnostic ICA to be combined simultaneously with percutaneous coronary

  17. Diagnostic accuracy and implementation of computed tomography angiography for gastrointestinal hemorrhage according to clinical severity

    PubMed Central

    Choi, Yoo Jin; Kim, Kyung Su; Suh, Gil Joon; Kwon, Woon Yong

    2016-01-01

    Objective This study compared the diagnostic accuracy of computed tomography (CT) angiography in patients with various severities of gastrointestinal hemorrhage (GIH). Methods We retrospectively enrolled adult patients (n=262) with GIH who had undergone CT angiography from January 2012 to December 2013. Age, sex, comorbidities, presenting symptoms, initial vital signs, laboratory results, transfusion volume, emergency department disposition, and hospital mortality were abstracted from patient records. CT angiography findings were reviewed and compared to reference standards consisting of endoscopy, conventional angiography, bleeding scan, capsule endoscopy, and surgery, either alone or in combination. Clinical severity was stratified according to the number of packed red blood cell units transfused during the first two days: the first quartile was categorized as mild severity, while the second and third quartiles were categorized as moderate severity. The fourth quartile was categorized as severe. Results Patients were categorized into the mild (n=75, 28.6%), moderate (n=139, 53.1%), and severe (n=48, 18.3%) groups. The mean number of transfused packed red blood cell units was 0, 3, and 9.6 in the mild, moderate, and severe groups, respectively. The overall sensitivity, specificity, positive predictive value, and negative predictive value of CT angiography were 73.8%, 94.0%, 97.3%, and 55.3%, respectively. The area under the receiver operating characteristics curve for the diagnostic performance of CT angiography was 0.780, 0.841, and 0.930 in the mild, moderate, and severe groups, respectively, which significantly differed among groups (P=0.006). Conclusion The diagnostic accuracy of CT angiography is better in patients with more severe GIH. PMID:27752620

  18. Pulsatile Tinnitus with a Dural Arterio-Venous Fistula Diagnosed by Computed Tomography-Angiography

    PubMed Central

    Kim, Sujin; Byun, Jaeyong; Park, Moonsuh

    2013-01-01

    A 43 year-old female patient suffered the sudden onset of pulsatile tinnitus in the left ear 2 months ago. The tinnitus did not subside spontaneously and remained unchanged. The patient had no history of head trauma or surgery of the head and neck. The character of the tinnitus was pulsatile, and it was synchronous with the heart beat. Audiologic examinations were performed and all of the results were normal. Computed tomography with angiography was performed and evidence of an arterio-venous fistula (AVF) was found. 4-vessel angiography was performed to confirm the dural AVF between the external carotid artery and sigmoid sinus. Embolization of the feeder-vessels was done under a fluoroscope and 70% of the fistula flow was controlled after embolization and the tinnitus totally subsided during the embolization. PMID:24653921

  19. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations.

    PubMed

    de Mello Júnior, Carlos Fernando; Araujo Neto, Severino Aires; de Carvalho Junior, Arlindo Monteiro; Rebouças, Rafael Batista; Negromonte, Gustavo Ramalho Pessoa; de Oliveira, Carollyne Dantas

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations.

  20. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations*

    PubMed Central

    de Mello Júnior, Carlos Fernando; Araujo Neto, Severino Aires; de Carvalho Junior, Arlindo Monteiro; Rebouças, Rafael Batista; Negromonte, Gustavo Ramalho Pessoa; de Oliveira, Carollyne Dantas

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations. PMID:27403020

  1. Multidetector computed tomography angiography of the renal arteries: normal anatomy and its variations.

    PubMed

    de Mello Júnior, Carlos Fernando; Araujo Neto, Severino Aires; de Carvalho Junior, Arlindo Monteiro; Rebouças, Rafael Batista; Negromonte, Gustavo Ramalho Pessoa; de Oliveira, Carollyne Dantas

    2016-01-01

    Conventional angiography is still considered the gold standard for the study of the anatomy and of vascular diseases of the abdomen. However, the advent of multidetector computed tomography and techniques of digital image reconstruction has provided an alternative means of performing angiography, without the risks inherent to invasive angiographic examinations. Therefore, within the field of radiology, there is an ever-increasing demand for deeper knowledge of the anatomy of the regional vasculature and its variations. Variations in the renal vascular system are relatively prevalent in the venous and arterial vessels. For various conditions in which surgical planning is crucial to the success of the procedure, knowledge of this topic is important. The aim of this study was to familiarize the general radiologist with variations in the renal vascular system. To that end, we prepared a pictorial essay comprising multidetector computed tomography images obtained in a series of cases. We show patterns representative of the most common anatomical variations in the arterial blood supply to the kidneys, calling attention to the nomenclature, as well as to the clinical and surgical implications of such variations. PMID:27403020

  2. Automated Axial Right Ventricle to Left Ventricle Diameter Ratio Computation in Computed Tomography Pulmonary Angiography

    PubMed Central

    Rodríguez-López, Sara; Kumamaru, Kanako K.; George, Elizabeth; San José Estépar, Raúl; Rybicki, Frank J.; Ledesma-Carbayo, Maria J.

    2015-01-01

    Background and Purpose Right Ventricular to Left Ventricular (RV/LV) diameter ratio has been shown to be a prognostic biomarker for patients suffering from acute Pulmonary Embolism (PE). While Computed Tomography Pulmonary Angiography (CTPA) images used to confirm a clinical suspicion of PE do include information of the heart, a numerical RV/LV diameter ratio is not universally reported, likely because of lack in training, inter-reader variability in the measurements, and additional effort by the radiologist. This study designs and validates a completely automated Computer Aided Detection (CAD) system to compute the axial RV/LV diameter ratio from CTPA images so that the RV/LV diameter ratio can be a more objective metric that is consistently reported in patients for whom CTPA diagnoses PE. Materials and Methods The CAD system was designed specifically for RV/LV measurements. The system was tested in 198 consecutive CTPA patients with acute PE. Its accuracy was evaluated using reference standard RV/LV radiologist measurements and its prognostic value was established for 30-day PE-specific mortality and a composite outcome of 30-day PE-specific mortality or the need for intensive therapies. The study was Institutional Review Board (IRB) approved and HIPAA compliant. Results The CAD system analyzed correctly 92.4% (183/198) of CTPA studies. The mean difference between automated and manually computed axial RV/LV ratios was 0.03±0.22. The correlation between the RV/LV diameter ratio obtained by the CAD system and that obtained by the radiologist was high (r=0.81). Compared to the radiologist, the CAD system equally achieved high accuracy for the composite outcome, with areas under the receiver operating characteristic curves of 0.75 vs. 0.78. Similar results were found for 30-days PE-specific mortality, with areas under the curve of 0.72 vs. 0.75. Conclusions An automated CAD system for determining the CT derived RV/LV diameter ratio in patients with acute PE has high

  3. Evaluation of pulmonary sequestration with multidetector computed tomography angiography in a select cohort of patients: A retrospective study

    PubMed Central

    Long, Qihua; Zha, Yunfei; Yang, Zhigang

    2016-01-01

    OBJECTIVES: This study aimed to evaluate the role of multidetector computed tomography angiography in diagnosing patients with pulmonary sequestration. METHODS: We retrospectively analyzed the computed tomography studies and clinical materials of 43 patients who had undergone preoperative multidetector computed tomography angiography in our hospital and had pathologically proven pulmonary sequestration. Each examination of pulmonary sequestration was reviewed for type, location, parenchymal changes, arterial supply and venous drainage on two-dimensional and three-dimensional computed tomography images. RESULTS: Multidetector computed tomography successfully detected all pulmonary sequestrations in the 43 patients (100%). This included 40 patients (93.0%) with intralobar sequestration and 3 patients (7.0%) with extralobar sequestration. The locations of pulmonary sequestration were left lower lobe (28 cases, 70% of intralobar sequestrations), right lower lobe (12 cases, 30% of intralobar sequestrations) and costodiaphragmatic sulcus (3 cases). Cases of sequestered lung presented as mass lesions (37.2%), cystic lesions (32.6%), pneumonic lesions (16.3%), cavitary lesions (9.3%) and bronchiectasis (4.6%). The angioarchitecture of pulmonary sequestration, including feeding arteries from the thoracic aorta (86.1%), celiac truck (9.3%), abdominal aorta (2.3%) and left gastric artery (2.3%) and venous drainage into inferior pulmonary veins (86.0%) and the azygos vein system (14.0%), was visualized on multidetector computed tomography. Finally, the multidetector computed tomography angiography results of the sequestered lungs and angioarchitectures were surgically confirmed in all the patients. CONCLUSIONS: As a noninvasive modality, multidetector computed tomography angiography is helpful for making diagnostic decisions regarding pulmonary sequestration with high confidence and for visualizing the related parenchymal characteristics, arterial supply, and venous drainage

  4. Image Quality of Coronary Computed Tomography Angiography with 320-Row Area Detector Computed Tomography in Children with Congenital Heart Disease.

    PubMed

    Tada, Akihiro; Sato, Shuhei; Kanie, Yuichiro; Tanaka, Takashi; Inai, Ryota; Akagi, Noriaki; Morimitsu, Yusuke; Kanazawa, Susumu

    2016-03-01

    The objective of this study was to assess factors affecting image quality of 320-row computed tomography angiography (CTA) of coronary arteries in children with congenital heart disease (CHD). We retrospectively reviewed 28 children up to 3 years of age with CHD who underwent prospective electrocardiography (ECG)-gated 320-row CTA with iterative reconstruction. We assessed image quality of proximal coronary artery segments using a five-point scale. Age, body weight, average heart rate, and heart rate variability were recorded and compared between two groups: patients with good diagnostic image quality in all four coronary artery segments and patients with at least one coronary artery segment with nondiagnostic image quality. Altogether, 96 of 112 segments (85.7 %) had diagnostic-quality images. Patients with nondiagnostic segments were significantly younger (10.0 ± 11.6 months) and had lower body weight (5.9 ± 2.9 kg) (each p < 0.05) than patients with diagnostic image quality of all four segments (20.6 ± 13.8 months and 8.4 ± 2.5 kg, respectively; each p < 0.05). Differences in heart rate and heart rate variability between the two imaging groups were not significant. Receiver operating characteristic analyses for predicting patients with nondiagnostic image quality revealed an optimal body weight cutoff of ≤5.6 kg and an optimal age cutoff of ≤12.5 months. Prospective ECG-gated 320-row CTA with iterative reconstruction provided feasible image quality of coronary arteries in children with CHD. Younger age and lower body weight were factors that led to poorer image quality of coronary arteries.

  5. Detection, grading and classification of coronary stenoses in computed tomography angiography.

    PubMed

    Kelm, B Michael; Mittal, Sushil; Zheng, Yefeng; Tsymbal, Alexey; Bernhardt, Dominik; Vega-Higuera, Fernando; Zhou, S Kevin; Meer, Peter; Comaniciu, Dorin

    2011-01-01

    Recently conducted clinical studies prove the utility of Coronary Computed Tomography Angiography (CCTA) as a viable alternative to invasive angiography for the detection of Coronary Artery Disease (CAD). This has lead to the development of several algorithms for automatic detection and grading of coronary stenoses. However, most of these methods focus on detecting calcified plaques only. A few methods that can also detect and grade non-calcified plaques require substantial user involvement. In this paper, we propose a fast and fully automatic system that is capable of detecting, grading and classifying coronary stenoses in CCTA caused by all types of plaques. We propose a four-step approach including a learning-based centerline verification step and a lumen cross-section estimation step using random regression forests. We show state-of-the-art performance of our method in experiments conducted on a set of 229 CCTA volumes. With an average processing time of 1.8 seconds per case after centerline extraction, our method is significantly faster than competing approaches. PMID:22003680

  6. PULMONARY ANGIOGRAPHY WITH 64-MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY IN NORMAL DOGS

    PubMed Central

    Drees, Randi; Frydrychowicz, Alex; Keuler, Nicholas S.; Reeder, Scott B.; Johnson, Rebecca

    2012-01-01

    Pulmonary angiography using 64-multidetector-row computed tomography (MDCT) was used to evaluate pulmonary artery anatomy, and determine the sensitivity of pulmonary artery segment visualization in four Beagle dogs using images reconstructed to 0.625 mm and retro-reconstructed to 1.25 and 2.5 mm slice thickness. Morphologically, characteristic features included a focal narrowing in the right cranial pulmonary artery in all dogs, which should not be mistaken as stenosis. While the right cranial pulmonary artery divided into two equally sized branches that were tracked into the periphery of the lung lobe in all dogs, only a single left cranial (cranial portion) lobar artery was present. Compared with 1.25 and 2.5 mm retro-reconstructions, 0.625 mm reconstructions allowed for detection of significantly (P ≤ 0.05) more pulmonary artery segments and sharper depiction of vessel margins. Clinical applications such as prevalence and significance of diameter changes, and detection of pulmonary arterial thrombembolism on lobar and sublobar level, using pulmonary angiography with 64-MDCT applying 0.625 mm reconstruction slice thickness remain to be established. PMID:21545367

  7. Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization

    PubMed Central

    Fujimoto, Shinichiro; Kondo, Takeshi; Kumamaru, Kanako K; Shinozaki, Tomohiro; Takamura, Kazuhisa; Kawaguchi, Yuko; Matsumori, Rie; Hiki, Makoto; Miyauchi, Katsumi; Daida, Hiroyuki; Rybicki, Frank J

    2015-01-01

    Background Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment. Methods and Results Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell’s C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). Conclusions High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization. PMID:26296858

  8. Effect of obesity on coronary artery plaque using 64 slice multidetector cardiac computed tomography angiography.

    PubMed

    Isma'eel, Hussain; Tellalian, David; Hamirani, Yasmin S; Kadakia, Jigar; Nasir, Khurram; Budoff, Matthew J

    2010-04-30

    Patients with a coronary artery calcification score (CACS) of zero and an intermediate risk of coronary artery disease have been shown to have a low prevalence of non-calcified coronary artery plaque (NCP). 181 consecutive patients with CAC 'zero', undergoing cardiac computed tomography angiography (CCTA) angiography at our center were evaluated. Presence of detectable NCP on CCTA in these patients was 13.8%. Mild non-obstructive disease (<30% and limited to one segment) was present in 76% of patients while only one patient (0.6%) had significant stenosis (>50%). Traditional risk factors were not found to be associated with the presence of NCP. However higher body mass index (BMI) was strongly found to be associated with NCP (31.6 in patients with NCP vs. 27.6 kg/m(2) in patients without NCP, p<.05). Obesity was 2.76 times more likely to be associated with NCP as compared to normal BMI (p<0.05).

  9. Novel Non-invasive Estimation of Coronary Blood Flow using Contrast Advection in Computed Tomography Angiography

    NASA Astrophysics Data System (ADS)

    Eslami, Parastou; Seo, Jung-Hee; Rahsepar, Amirali; George, Richard; Lardo, Albert; Mittal, Rajat

    2014-11-01

    Coronary computed tomography angiography (CTA) is a promising tool for assessment of coronary stenosis and plaque burden. Recent studies have shown the presence of axial contrast concentration gradients in obstructed arteries, but the mechanism responsible for this phenomenon is not well understood. We use computational fluid dynamics to study intracoronary contrast dispersion and the correlation of concentration gradients with intracoronary blood flow and stenotic severity. Data from our CFD patient-specific simulations reveals that contrast dispersions are generated by intracoronary advection effects, and therefore, encode the coronary flow velocity. This novel method- Transluminal Attenuation Flow Encoding (TAFE) - is used to estimate the flowrate in phantom studies as well as preclinical experiments. Our results indicate a strong correlation between the values estimated from TAFE and the values measured in these experiments. The flow physics of contrast dispersion associated with TAFE will be discussed. This work is funded by grants from Coulter Foundation and Maryland Innovation Initiative. The authors have pending patents in this technology and RM and ACL have other financial interests associated with TAFE.

  10. Structured learning algorithm for detection of nonobstructive and obstructive coronary plaque lesions from computed tomography angiography

    PubMed Central

    Kang, Dongwoo; Dey, Damini; Slomka, Piotr J.; Arsanjani, Reza; Nakazato, Ryo; Ko, Hyunsuk; Berman, Daniel S.; Li, Debiao; Kuo, C.-C. Jay

    2015-01-01

    Abstract. Visual identification of coronary arterial lesion from three-dimensional coronary computed tomography angiography (CTA) remains challenging. We aimed to develop a robust automated algorithm for computer detection of coronary artery lesions by machine learning techniques. A structured learning technique is proposed to detect all coronary arterial lesions with stenosis ≥25%. Our algorithm consists of two stages: (1) two independent base decisions indicating the existence of lesions in each arterial segment and (b) the final decision made by combining the base decisions. One of the base decisions is the support vector machine (SVM) based learning algorithm, which divides each artery into small volume patches and integrates several quantitative geometric and shape features for arterial lesions in each small volume patch by SVM algorithm. The other base decision is the formula-based analytic method. The final decision in the first stage applies SVM-based decision fusion to combine the two base decisions in the second stage. The proposed algorithm was applied to 42 CTA patient datasets, acquired with dual-source CT, where 21 datasets had 45 lesions with stenosis ≥25%. Visual identification of lesions with stenosis ≥25% by three expert readers, using consensus reading, was considered as a reference standard. Our method performed with high sensitivity (93%), specificity (95%), and accuracy (94%), with receiver operator characteristic area under the curve of 0.94. The proposed algorithm shows promising results in the automated detection of obstructive and nonobstructive lesions from CTA. PMID:26158081

  11. A radioanatomic study of the internal mammary artery and its perforators using multidetector computed tomography angiography.

    PubMed

    Tan, Onder; Yuce, Ihsan; Aydin, Osman Enver; Kantarci, Mecit

    2014-05-01

    The Internal Mammary Artery (IMA) and its perforators play an important role in coronary bypass grafting and reconstructive breast, head, and neck surgery. This study aimed to obtain anatomic data pertaining to these vessels using Multi Detector Computed Tomography Angiography (MDCTA) and to demonstrate that the MDCTA could be a considerable assessment tool prior to surgery. In 50 outpatients (27 males and 23 females), the above-mentioned arteries were bilaterally evaluated with a 16-detector spiral computed tomography scanner. Based on the obtained images, diameters of the bilateral IMAs were separately measured in each intercostal spaces from 1 to 5 through their traces. IMAPs greater than 0.5 mm in diameter were bilaterally evaluated in terms of distance from the sternal border to the ramification point under the muscular layer, maximal external diameter at ramification from the IMA, and the length between the ramification point from the IMA and enter point to the subcutaneous fat tissue. Mean diameters of the left and right IMAs were 2.05 ± 0.50 mm and 2.20 ± 0.57 mm, respectively. Mean diameters, distances, and lengths of the perforators were 1.30 ± 0.30 mm, 6.80 ± 3.40 mm, 17.05 ± 6.07 mm on the left side and 1.32 ± 0.25 mm, 6.71 ± 3.43 mm, 17.35 ± 3.48 mm on the right side, respectively. No statistically difference was found between the sides (P > 0.05). About 20 of 36 perforators appeared in the second intercostal space, whereas there were eight in the first and eight in the third intercostal space. MDCTA, as a non-invasive vascular imaging method, can be a valuable tool for investigating the anatomic characteristics of the IMA and its perforators before planning an operation. PMID:24105707

  12. Multidetector computed tomography angiography of the celiac trunk and hepatic arterial system: normal anatomy and main variants *

    PubMed Central

    Araujo Neto, Severino Aires; de Mello Júnior, Carlos Fernando; Franca, Henrique Almeida; Duarte, Cláudia Martina Araújo; Borges, Rafael Farias; de Magalhães, Ana Guardiana Ximenes

    2016-01-01

    Although digital angiography remains as the gold standard for imaging the celiac arterial trunk and hepatic arteries, multidetector computed tomography in association with digital images processing by software resources represents a useful tool particularly attractive for its non invasiveness. Knowledge of normal anatomy as well as of its variations is helpful in images interpretation and to address surgical planning on a case-by-case basis. The present essay illustrates several types of anatomical variations of celiac trunk, hepatic artery and its main branches, by means of digitally reconstructed computed tomography images, correlating their prevalence in the population with surgical implications. PMID:26929461

  13. Multidetector computed tomography angiography of the celiac trunk and hepatic arterial system: normal anatomy and main variants.

    PubMed

    Araujo Neto, Severino Aires; de Mello Júnior, Carlos Fernando; Franca, Henrique Almeida; Duarte, Cláudia Martina Araújo; Borges, Rafael Farias; de Magalhães, Ana Guardiana Ximenes

    2016-01-01

    Although digital angiography remains as the gold standard for imaging the celiac arterial trunk and hepatic arteries, multidetector computed tomography in association with digital images processing by software resources represents a useful tool particularly attractive for its non invasiveness. Knowledge of normal anatomy as well as of its variations is helpful in images interpretation and to address surgical planning on a case-by-case basis. The present essay illustrates several types of anatomical variations of celiac trunk, hepatic artery and its main branches, by means of digitally reconstructed computed tomography images, correlating their prevalence in the population with surgical implications.

  14. Automatic pericardium segmentation and quantification of epicardial fat from computed tomography angiography.

    PubMed

    Norlén, Alexander; Alvén, Jennifer; Molnar, David; Enqvist, Olof; Norrlund, Rauni Rossi; Brandberg, John; Bergström, Göran; Kahl, Fredrik

    2016-07-01

    Recent findings indicate a strong correlation between the risk of future heart disease and the volume of adipose tissue inside of the pericardium. So far, large-scale studies have been hindered by the fact that manual delineation of the pericardium is extremely time-consuming and that existing methods for automatic delineation lack accuracy. An efficient and fully automatic approach to pericardium segmentation and epicardial fat volume (EFV) estimation is presented, based on a variant of multi-atlas segmentation for spatial initialization and a random forest classifier for accurate pericardium detection. Experimental validation on a set of 30 manually delineated computer tomography angiography volumes shows a significant improvement on state-of-the-art in terms of EFV estimation [mean absolute EFV difference: 3.8 ml (4.7%), Pearson correlation: 0.99] with run times suitable for large-scale studies (52 s). Further, the results compare favorably with interobserver variability measured on 10 volumes. PMID:27660804

  15. The hemodynamics in intracranial aneurysm ruptured region with active contrast leakage during computed tomography angiography

    NASA Astrophysics Data System (ADS)

    Li, Ming-Lung; Wang, Yi-Chou; Liou, Tong-Miin; Lin, Chao-An

    2014-10-01

    Precise locations of rupture region under contrast agent leakage of five ruptured cerebral artery aneurysms during computed tomography angiography, which is to our knowledge for the first time, were successfully identified among 101 patients. These, together with numerical simulations based on the reconstructed aneurysmal models, were used to analyze hemodynamic parameters of aneurysms under different cardiac cyclic flow rates. For side wall type aneurysms, different inlet flow rates have mild influences on the shear stresses distributions. On the other hand, for branch type aneurysms, the predicted wall shear stress (WSS) correlates strongly with the increase of inlet vessel velocity. The mean and time averaged WSSes at rupture regions are found to be lower than those over the surface of the aneurysms. Also, the levels of the oscillatory shear index (OSI) are higher than the reported threshold value, supporting the assertion that high OSI correlates with rupture of the aneurysm. However, the present results also indicate that OSI level at the rupture region is relatively lower.

  16. Registration of coronary arteries in computed tomography angiography images using Hidden Markov Model.

    PubMed

    Luo, Yuxuan; Feng, Jianjiang; Xu, Miao; Zhou, Jie; Min, James K; Xiong, Guanglei

    2015-08-01

    Computed tomography angiography (CTA) allows for not only diagnosis of coronary artery disease (CAD) with high spatial resolution but also monitoring the remodeling of vessel walls in the progression of CAD. Alignment of coronary arteries in CTA images acquired at different times (with a 3-7 years interval) is required to visualize and analyze the geometric and structural changes quantitatively. Previous work in image registration primarily focused on large anatomical structures and leads to suboptimal results when applying to registration of coronary arteries. In this paper, we develop a novel method to directly align the straightened coronary arteries in the cylindrical coordinate system guided by the extracted centerlines. By using a Hidden Markov Model (HMM), image intensity information from CTA and geometric information of extracted coronary arteries are combined to align coronary arteries. After registration, the pathological features in two straightened coronary arteries can be directly visualized side by side by synchronizing the corresponding cross-sectional slices and circumferential rotation angles. By evaluating with manually labeled landmarks, the average distance error is 1.6 mm. PMID:26736676

  17. Automatic detection and quantification of the Agatston coronary artery calcium score on contrast computed tomography angiography.

    PubMed

    Ahmed, Wehab; de Graaf, Michiel A; Broersen, Alexander; Kitslaar, Pieter H; Oost, Elco; Dijkstra, Jouke; Bax, Jeroen J; Reiber, Johan H C; Scholte, Arthur J

    2015-01-01

    Potentially, Agatston coronary artery calcium (CAC) score could be calculated on contrast computed tomography coronary angiography (CTA). This will make a separate non-contrast CT scan superfluous. This study aims to assess the performance of a novel fully automatic algorithm to detect and quantify the Agatston CAC score in contrast CTA images. From a clinical registry, 20 patients were randomly selected for each CAC category (i.e. 0, 1-99, 100-399, 400-999, ≥1,000). The Agatston CAC score on non-contrast CT was calculated manually, while the novel algorithm was used to automatically detect and quantify Agatston CAC score in contrast CTA images. The resulting Agatston CAC scores were validated against the non-contrast images. A total of 100 patients (60 ± 11 years, 63 men) were included. The median CAC score on non-contrast CT was 145 (IQR 5-760), whereas the contrast CTA CAC score was 170 (IQR 23-594) (P = 0.004). The automatically computed CAC score showed a high correlation (R = 0.949; P < 0.001) and intra-class correlation (R = 0.863; P < 0.001) with non-contrast CT CAC score. Moreover, agreement within CAC categories was good (κ 0.588). Fully automatic detection of Agatston CAC score on contrast CTA is feasible and showed high correlation with non-contrast CT CAC score. This could imply a radiation dose reduction and time saving by omitting the non-contrast scan. PMID:25159031

  18. Changes of size and shape of small, unruptured intracranial aneurysms in repeated computed tomography angiography studies

    PubMed Central

    Kunert, Przemysław; Jaworski, Maciej; Rosiak, Grzegorz; Marchel, Andrzej; Rowiński, Olgierd

    2015-01-01

    Introduction Unruptured intracranial aneurysms (UIAs) are frequently detected in noninvasive imaging studies such as computed tomography angiography (CTA) or magnetic resonance angiography (MRA). If small, UIAs are observed in these modalities in order to detect growth or shape change, but there are many questions about proper protocol of the follow-up. Aim To assess changes of small (< 7 mm) UIAs dome size and shape in repeated CTA studies as predictors of growth and rupture. Material and methods One hundred and ten UIAs (10 posterior circulation) in 70 patients (55 women) were observed, with a cumulative observation time of 333.32 years. Aneurysms’ dome and neck perpendicular dimensions were measured in the first and the last CTA study at least twice with the developed application. Confidence intervals (CI) for measurements and dome shape parameters were calculated. For aneurysms ruptured during follow-up intermediate studies were analyzed. Patients’ clinical information was recorded. The aneurysm growth detection algorithm integrated CI and spatial resolution of the CT scanner. Results Twenty-three aneurysms increased in volume, 10 in height and 14 in dome width. Volume increased in 90% of cases of height and 93% of width increase. Posterior circulation aneurysms grew faster than anterior ones (p < 0.003), but calculated time to significant size increase (eT) did not differ between the groups due to higher CI in the posterior circulation. Analysis of eT with Kaplan-Meier curves showed that 75% of growing aneurysms could be detected in the first 3 years of observation. During the follow-up 3 aneurysms bled, and they grew faster than other growing aneurysms. Two of the bleeding aneurysms formed daughter sacs. Conclusions Dome volume assessment is superior to single dimension assessment in aneurysm growth detection. Confidence intervals assessment helps to avoid overestimation of growth. Seventy-five percent of growing aneurysms could be detected in the first 3

  19. Preoperative evaluation value of aortic arch lesions by multidetector computed tomography angiography in type A aortic dissection.

    PubMed

    Huang, Fang; Chen, Qiang; Lai, Qing-Quan; Huang, Wen-Han; Wu, Hong; Li, Wei-Cheng

    2016-09-01

    The purpose of this study was to preoperatively evaluate the value of aortic arch lesions by multidetector computed tomography (MDCT) angiography in type A aortic dissection (AD).From January 2013 to December 2015, we enrolled 42 patients with type A AD who underwent MDCT angiography in our hospital. The institutional database of patients was retrospectively reviewed to identify MDCT angiography examinations for type A AD. Surgical corrections were conducted in all patients to confirm diagnostic accuracy.In this study, the diagnostic accuracy of MDCT angiography was 100% in all 42 patients. The intimal tear site locations that were identified in patients included the ascending aorta (n = 25), aortic arch (n = 12), and all other sites (n = 5). Compared with the control group, there were significant differences in the aortic arch anatomy among the cases. Regarding the distance between the left common carotid and left subclavian arteries, compared with the control group, most cases with type A AD had a significant variation.MDCT angiography plays an important role in detecting aortic arch lesions of type A AD, especially in determining the location of the intimal entry site and change of branch blood vessels. Surgeons can formulate an appropriate operating plan, according to the preoperative MDCT diagnosis information. PMID:27684852

  20. Duplex ultrasound and computed tomography angiography in the follow-up of endovascular abdominal aortic aneurysm repair: a comparative study*

    PubMed Central

    Cantador, Alex Aparecido; Siqueira, Daniel Emílio Dalledone; Jacobsen, Octavio Barcellos; Baracat, Jamal; Pereira, Ines Minniti Rodrigues; Menezes, Fábio Hüsemann; Guillaumon, Ana Terezinha

    2016-01-01

    Objective To compare duplex ultrasound and computed tomography (CT) angiography in terms of their performance in detecting endoleaks, as well as in determining the diameter of the aneurysm sac, in the postoperative follow-up of endovascular abdominal aortic aneurysm repair. Materials and Methods This was a prospective study involving 30 patients who had undergone endovascular repair of infrarenal aortoiliac aneurysms. Duplex ultrasound and CT angiography were performed simultaneously by independent radiologists. Measurements of the aneurysm sac diameter were assessed, and the presence or absence of endoleaks was determined. Results The average diameter of the aneurysm sac, as determined by duplex ultrasound and CT angiography was 6.09 ± 1.95 and 6.27 ± 2.16 cm, respectively. Pearson's correlation coefficient showing a statistically significant correlation (R = 0.88; p < 0.01). Comparing the duplex ultrasound and CT angiography results regarding the detection of endoleaks, we found that the former had a negative predictive value of 92.59% and a specificity of 96.15%. Conclusion Our results show that there is little variation between the two methods evaluated, and that the choice between the two would have no significant effect on clinical management. Duplex ultrasound could replace CT angiography in the postoperative follow-up of endovascular aneurysm repair of the infrarenal aorta, because it is a low-cost procedure without the potential clinical complications related to the use of iodinated contrast and exposure to radiation. PMID:27777476

  1. Diagnostic implications of computed tomography pulmonary angiography in patients with pulmonary embolism

    PubMed Central

    El-Menyar, Ayman; Nabir, Syed; Ahmed, Nadeem; Asim, Mohammad; Jabbour, Gaby; Al-Thani, Hassan

    2016-01-01

    INTRODUCTION: Pulmonary embolism (PE) is a serious cardiovascular and pulmonary complication worldwide. We aimed to assess the implications of different computed tomography pulmonary angiography (CTPA) parameters in patients with acute PE. METHODS: A retrospective observational study to include patients presented with clinical suspicious of PE who underwent CTPA was conducted. Patients' demographics, clinical presentation, risk factors, laboratory investigations, management, and outcome were analyzed. Computed tomography findings included clot burden (Qanadli score [QS]) and right ventricular dysfunction (RVD) parameters. RESULTS: A total of 45 patients with radiologically confirmed diagnosis of PE were included in the study; of these patients, 8 (17.8%) died during the hospital course. Patients who died were 13 years older than those who survived, and the mortality rate was significantly higher in patients with cancer. The two groups were comparable for cardiovascular parameters. The mean clot burden (QS) was 19.5 ± 11.3 points and 53% of patients had QS >18 points. Obesity (52.4% vs. 12.5%; P = 0.01), hypertension (54.4% vs. 23.8%; P = 0.03), and median D-dimer levels (7.8 vs. 3.4; P = 0.03) were significantly higher in patients with QS >18. Among right ventricular (RV) dysfunction parameters, only higher RV/left ventricular (LV) ratio (P = 0.001) and bowing of interventricular septum (P = 0.001) were associated with higher QS. A significant positive correlation was found between RV short axis (r = 0.499, P = 0.001), RV/LV ratio (r = 0.592, P = 0.001), and pulmonary artery (PA) diameter (r = 0.301, P = 0.04) with the PA clot burden. Receiver operating characteristic curve for clot burden showed a cutoff value of 17.5 points to accurately predict RV dysfunction. CONCLUSIONS: Clot burden >18 is associated with RV dysfunction in patients with acute PE. Echocardiography and RVD parameters showed no correlation with in-hospital deaths. CTPA has clinicoradiological

  2. Run-Off Computed Tomography Angiography (CTA) for Discriminating the Underlying Causes of Intermittent Claudication

    PubMed Central

    Werncke, Thomas; Steffen, Ingo G.; Hamm, Bernd; Elgeti, Thomas

    2016-01-01

    Aim To evaluate run-off computed tomography angiography (CTA) of abdominal aorta and lower extremities for detecting musculoskeletal pathologies and clinically relevant extravascular incidental findings in patients with intermittent claudication (IC) and suspected peripheral arterial disease (PAD). Does run-off CTA allow image-based therapeutic decision making by discriminating the causes of intermittent claudication in patients with suspected peripheral arterial disease PAD? Material and Methods Retrospective re-evaluation of CTAs performed in patients with acute or chronic intermittent claudication (i.e., Fontaine stages I to IIB) between January 2005 and October 2013. Allocation to one of three categories of underlying causes of IC symptoms: vascular, musculoskeletal (MSK) or both. Clinically relevant extravascular incidental findings were evaluated. Medical records were reviewed to verify specific therapies as well as main and incidental findings. Results While focused on vascular imaging, CTA image quality was sufficient for evaluation of the MSK system in all cases. The underlying cause of IC was diagnosed in run-off CTA as vascular, MSK and a combination in n = 138 (65%), n = 10 (4%), and n = 66 (31%) cases, respectively. Specific vascular or MSK therapy was recorded in n = 123 and n = 9 cases. In n = 82, no follow-up was possible. Clinically relevant extravascular incidental findings were detected in n = 65 patients (30%) with neoplasia, ascites and pleural effusion being the most common findings. Discussion Run-off CTA allows identification of vascular, MSK, and combined causes of IC in patients with suspected PAD and can guide specific therapy. CTA also allowed confident detection of crEVIF although detection did not necessarily trigger workup or treatment. PMID:27054846

  3. Comparison of accuracy of 64-slice cardiovascular computed tomography with coronary angiography in patients with suspected coronary artery disease.

    PubMed

    Fine, Jeffrey J; Hopkins, Christie B; Ruff, Nicol; Newton, F Carter

    2006-01-15

    Cardiovascular computed tomography (CVCT) with the recently released 64-slice technology increases spatial resolution and decreases acquisition times and slice thickness. We investigated the accuracy of 64-slice CVCT in relation to catheter angiography. We studied 66 sequential subjects who underwent 64-slice CVCT and catheter angiography within 30 days. Accuracy results were 94% for interpretable images, 95% for sensitivity, 96% for specificity, 97% for positive predictive value, and 92% for negative predictive value for lesions with >50% stenosis. We found 100% agreement between 64-slice CVCT and catheterization among vein graft evaluations (9 of 9). These metrics are vastly improved from the 16-slice generation and support 64-slice CVCT as a reliable diagnostic tool.

  4. High spatial resolution time-resolved magnetic resonance angiography of lower extremity tumors at 3T: Comparison with computed tomography angiography.

    PubMed

    Wu, Gang; Jin, Teng; Li, Ting; Morelli, John; Li, Xiaoming

    2016-09-01

    The aim of this study was to compare diagnostic value of high spatial resolution time-resolved magnetic resonance angiography with interleaved stochastic trajectory (TWIST) using Gadobutrol to Computed tomography angiography (CTA) for preoperative evaluation of lower extremity tumors.This prospective study was approved by the institutional review board. Fifty consecutive patients (31 men, 19 women, age range 18-80 years, average age 42.7 years) with lower extremity tumors underwent TWIST magnetic resonance angiography (MRA) and CTA. Digital subtraction angiography was available for 8 patients. Image quality of MRA was compared with CTA by 2 radiologists according to a 4-point Likert scale. Arterial involvement by tumor was compared using kappa test between MRA and CTA. The ability to identify feeding arteries and arterio-venous fistulae (AVF) was compared using Wilcoxon signed rank test and McNemar test, respectively.Image quality of MRA and CTA was rated without a statistically significant difference (3.88 ± 0.37 vs. 3.97 ± 0.16, P = 0.135). Intramodality agreement was high for the identification of arterial invasion (kappa = 0.806 ± 0.073 for Reader 1, kappa = 0.805 ± 0.073 for Reader 2). Readers found AVF in 27 of 50 MRA cases and 14 of 50 CTA cases (P < 0.001). Mean feeding arteries identified with MRA were significantly more than that with CTA (2.08 ± 1.72 vs. 1.62 ± 1.52, P = .02).TWIST MRA is a reliable imaging modality for the assessment of lower extremity tumors. TWIST MRA is comparable to CTA for the identification of AVF and feeding arteries. PMID:27631262

  5. A novel method for non-invasive plaque morphology analysis by coronary computed tomography angiography.

    PubMed

    Fujimoto, Shinichiro; Kondo, Takeshi; Kodama, Takahide; Fujisawa, Yasuko; Groarke, John; Kumamaru, Kanako K; Takamura, Kazuhisa; Matsunaga, Eriko; Miyauchi, Katsumi; Daida, Hiroyuki; Rybicki, Frank J

    2014-10-01

    Coronary computed tomography angiography (CCTA) plaque morphology based on conventional Hounsfield units relies on absolute CT numbers is influenced by imaging and anatomical variables. The project describes and tests a novel alternative method, termed the "labeling method", which uses relative CT numbers and 3-dimensional plaque structure. Using virtual histology intravascular ultrasound (VH-IVUS) as the reference standard, this study compares the labeling method to a conventional CT-number based method to determine coronary plaque morphology. Thirty-seven high-risk, non-calcified atherosclerotic coronary lesions were prospectively evaluated in 33 consecutive patients who underwent CCTA followed by VH-IVUS (mean interval 8.6 ± 13.3 days). CCTA-derived vessel and minimum lumen areas were compared to VH-IVUS measures. Fibrotic and necrotic core areas were calculated by both the labeling method to the CT-number based method; both were tested for agreement with reference standard VH-IVUS. Inter- and intra-observer correlations were assessed. CCTA significantly underestimated minimum lumen area when compared to VH-IVUS (mean difference -1.4 ± 0.9 mm(2), p < 0.0001). Necrotic core and fibrous areas quantified using the labeling method demonstrated superior correlation with VH-IVUS compared to those quantified using the CT-number based method, Pearson's r = 0.75 versus 0.42 and r = 0.80 and 0.59, respectively. Compared to VH-IVUS, limits of agreement for the labeling method-derived necrotic core (-2.0 to 2.5 mm(2)) and fibrous areas (0.6-8.0 mm(2)) were more narrow than those determined using the CT-number based method (-3.7 to 7.3 and -4.0 to 8.9 mm(2), respectively). Inter- and intraobserver correlations were excellent for all CCTA derived measures (r = 0.85-0.98). A novel CCTA-based labeling method offers an alternative to conventional CT-number based analyses for plaque morphology. The labeling method demonstrates superior correlation to VH-IVUS for measures of

  6. Detection of Type II Endoleak After Endovascular Aortic Repair: Comparison Between Magnetic Resonance Angiography and Blood-Pool Contrast Agent and Dual-Phase Computed Tomography Angiography

    SciTech Connect

    Wieners, Gero; Meyer, Frank; Halloul, Zuhir; Peters, Nils; Ruehl, Ricarda; Dudeck, Oliver; Tautenhahn, Joerg; Ricke, Jens; Pech, Maciej

    2010-12-15

    PurposeThis prospective study was designed to assess the diagnostic value of magnetic resonance angiography (MRA) with blood-pool contrast agent (gadofosveset) in the detection of type-II endoleak after endovascular aortic repair (EVAR).MethodsThirty-two patients with aortic aneurysms who had undergone EVAR were included in this study. All patients were examined by dual-phase computed tomography angiography (CTA) as well as MRA with gadofosveset in the first-pass and steady-state phases. Two independent readers evaluated the images of CTA and MRA in terms of endoleak type II, feeding vessel, and image quality.ResultsMedian follow-up-time after EVAR was 22 months (range 4 to 59). Endoleak type II was detected by CTA in 12 of 32 patients (37.5%); MRA detected endoleak in all of these patients as well as in another 9 patients (n = 21, 65.6%), of whom the endoleaks in 6 patients showed an increasing diameter. Most endoleaks were detected in the steady-state phase (n = 14). The decrease in diameter of the aneurysmal sac was significantly greater in the patients without a visible endoleak that was visible on MRA (P = 0.004). In the overall estimation of diagnostic accuracy, MRA was judged superior to CTA in 66% of all examinations.ConclusionMRA with gadofosveset appeared superior to CTA, and has higher diagnostic accuracy, in the detection of endoleak after EVAR.

  7. Diagnostic imaging methods applied in long-term surveillance after EVAR. Will computed tomography angiography be replaced by other methods?

    PubMed Central

    Stefaniak, Karolina; Gabriel, Marcin; Oszkinis, Grzegorz

    2016-01-01

    Endovascular implantation of a stent graft in the abdominal aorta (endovascular aneurysm repair – EVAR) is a widely accepted alternative to open surgery in treatment of abdominal aortic aneurysms. Although EVAR is connected with a significant reduction in the risk of peri- and post-operative complications, it does not eliminate them totally. Long-term surveillance of post-EVAR patients is aimed at early detection of and fast reaction to a group of complications called endovascular leaks. Currently, the gold standard in leak diagnostics is computed tomography angiography (CTA). The other methods are ultrasonography, magnetic resonance (MR) angiography, intra-aneurysm sac pressure measurement, X-ray, and digital subtraction angiography (DSA). Despite many analyses based on long-term research, emphasising the high value and competitiveness of less invasive tests such as US or X-ray compared to CTA, it is still difficult for them to win the trust and acceptance of clinicians. The persisting view is that computed tomography is the test that finally resolves any inaccuracies. Consequently, a patient with a number of concurrent diseases is subject to absurdly high radiation exposure and effects of a radiocontrast agent within a short time. It is therefore logical to acknowledge that the EVAR-related risk is catching up with the open surgery risk, while the endovascular procedure is much more costly. Nevertheless, the status of CTA as the gold standard ultimately seems to be unthreatened. This paper presents a description of the diagnostic imaging tests that make it possible to detect any vascular leaks and to develop strategies for therapeutic processes. PMID:26966443

  8. The role of multidetector computed tomography versus digital subtraction angiography in triaging care and management in abdominopelvic trauma

    PubMed Central

    Hallinan, James Thomas Patrick Decourcy; Tan, Cher Heng; Pua, Uei

    2016-01-01

    INTRODUCTION This study aimed to assess the ability of contrast-enhanced computed tomography (CECT) to detect active abdominopelvic haemorrhage in patients with blunt trauma, as compared to digital subtraction angiography (DSA). METHODS In this retrospective study, patients who underwent DSA within 24 hours following CECT for blunt abdominal and/or pelvic trauma were identified. The computed tomography (CT) trauma protocol consisted of a portal venous phase scan without CT angiography; delayed phase study was performed if appropriate. All selected CECT studies were independently reviewed for the presence of active extravasation of contrast by two radiologists, who were blinded to the DSA results. Fisher’s exact test was used to correlate the presence of extravasation on CT with subsequent confirmed haemorrhage on DSA. RESULTS During the eight-year study period, 51 patients underwent CECT prior to emergent DSA for abdominal or pelvic trauma. Evidence of active extravasation of contrast on CECT was observed in 35 patients and active haemorrhage was confirmed on DSA in 31 of these patients; embolisation was performed in all 31 patients. Two patients who were negative for active extravasation of contrast on CECT but positive for active haemorrhage on DSA had extensive bilateral pelvic fractures and haematomas. The sensitivity, specificity, and positive and negative predictive values of CECT in detecting active abdominopelvic haemorrhage, as compared to DSA, were 93.9%, 77.8%, 88.6% and 87.5%, respectively. CONCLUSION When compared with DSA, dual-phase CECT without CT angiography shows high sensitivity and positive predictive value for the detection of active haemorrhage in patients with blunt abdominopelvic trauma. PMID:26778466

  9. The place of indirect venography tests after pulmonary computed tomography angiography in the diagnosis of pulmonary thromboemboli

    PubMed Central

    Karaoglu, Oguzhan; Tertemiz, Kemal Can; Yilmaz, Erkan; Akkoclu, Atila; Elibol, Cenk; Elibol, Funda Dinc

    2014-01-01

    Aim To investigate the effectiveness of indirect computed tomography (CT) venography applied after pulmonary CT angiography to patients with suspected pulmonary embolism. Material and methods The study comprised 80 patients at high/moderate risk of pulmonary embolism (PE) according to the clinical findings. Computed tomography venography (CTV) was performed 3-3.5 minutes after taking pulmonary CTA images. Color Doppler ultrasonography (CDUS) of the lower extremities was applied to all patients before pulmonary CTA or within 24 hours after CTA. Results Pulmonary embolism was determined in a total of 19 patients (23%). Six patients had deep venous thrombosis on CTV examination even though the CDUS findings were normal. Accepting color Doppler ultrasonography findings as the gold standard, the sensitivity of CTV in determining deep vein thrombosis (DVT) was found to be 100%, specificity 91%, positive predictive value 60%, negative predictive value 100%, likelihood of giving a positive result 11.1, and likelihood of giving a negative result 0. There was a statistically significant good degree of correlation between the two methods (r = 0.741, p < 0.001). Conclusions Computed tomography venography examination applied after pulmonary CTA is a fast imaging technique that has high diagnostic value and can be an alternative to CDUS, especially when CDUS is insufficient in application and evaluation. PMID:26336468

  10. Computed Tomography (CT) -- Head

    MedlinePlus

    ... further information please consult the ACR Manual on Contrast Media and its references. The risk of serious allergic ... Angiography (CTA) Stroke Brain Tumors Computer Tomography (CT) Safety During Pregnancy Head and Neck Cancer X-ray, ...

  11. Diagnostic performance of computed tomography coronary angiography (from the Prospective National Multicenter Multivendor EVASCAN Study).

    PubMed

    Gueret, Pascal; Deux, Jean-François; Bonello, Laurent; Sarran, Anthony; Tron, Christophe; Christiaens, Luc; Dacher, Jean-Nicolas; Bertrand, David; Leborgne, Laurent; Renard, Cedric; Caussin, Christophe; Cluzel, Philippe; Helft, Gerard; Crochet, Dominique; Vernhet-Kovacsik, Hélène; Chabbert, Valérie; Ferrari, Emile; Gilard, Martine; Willoteaux, Serge; Furber, Alain; Barone-Rochette, Gilles; Jankowski, Adrien; Douek, Philippe; Mousseaux, Elie; Sirol, Marc; Niarra, Ralph; Chatellier, Gilles; Laissy, Jean-Pierre

    2013-02-15

    Computed tomographic coronary angiography (CTCA) has been proposed as a noninvasive test for significant coronary artery disease (CAD), but only limited data are available from prospective multicenter trials. The goal of this study was to establish the diagnostic accuracy of CTCA compared to coronary angiography (CA) in a large population of symptomatic patients with clinical indications for coronary imaging. This national, multicenter study was designed to prospectively evaluate stable patients able to undergo CTCA followed by conventional CA. Data from CTCA and CA were analyzed in a blinded fashion at central core laboratories. The main outcome was the evaluation of patient-, vessel-, and segment-based diagnostic performance of CTCA to detect or rule out significant CAD (≥50% luminal diameter reduction). Of 757 patients enrolled, 746 (mean age 61 ± 12 years, 71% men) were analyzed. They underwent CTCA followed by CA 1.7 ± 0.8 days later using a 64-detector scanner. The prevalence of significant CAD in native coronary vessels by CA was 54%. The rate of nonassessable segments by CTCA was 6%. In a patient-based analysis, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of CTCA were 91%, 50%, 68%, 83%, 1.82, and 0.18, respectively. The strongest predictors of false-negative results on CTCA were high estimated pretest probability of CAD (odds ratio [OR] 1.97, p <0.001), male gender (OR 1.5, p <0.002), diabetes (OR 1.5, p <0.0001), and age (OR 1.2, p <0.0001). In conclusion, in this large multicenter study, CTCA identified significant CAD with high sensitivity. However, in routine clinical practice, each patient should be individually evaluated, and the pretest probability of obstructive CAD should be taken into account when deciding which method, CTCA or CA, to use to diagnose its presence and severity.

  12. Determination of the recipient vessels in the head and neck using multislice spiral computed tomography angiography before free flap surgery: a preliminary study.

    PubMed

    Tan, Onder; Kantarci, Mecit; Parmaksizoglu, Duygu; Uyanik, Ummugulsum; Durur, Irmak

    2007-11-01

    Preoperative assessment of the recipient vessels in free flap surgery directly affects the success rate of the operation by determining the flap type, pedicle length, orientation to the recipient site, and need for a vein graft. For this purpose, conventional angiographic methods are still being used with some disadvantages. The aims of this study were to evaluate the potential success of multislice computed tomography angiography in assessment of the recipient vessels before free flap surgery and to reveal if this may be an alternative to conventional angiography. The study was bilaterally carried out in 33 outpatients using a 16-detector spiral computed tomography scanner. In images of multiplanar reconstructions, maximum intensity projections, and three-dimensional volume renderings, the external carotid artery and its main branches were evaluated in terms of availability; patency, stenosis, or occlusion; maximal and minimal external diameters through their traces; variations involving ramification from another main vessel; and abnormal course. The superior thyroid artery was absent bilaterally in two patients (6.06%). The external carotid artery was stenotic on one side in two patients (6.06%) and on each side in one (3.03%). All the remaining vessels appeared without stenosis, occlusion, or variation. We think that multislice computed tomography angiography can provide detailed information about vascular structures and the remaining anatomic structures and their relationships with the recipient vessels. Therefore, multislice computed tomography angiography, as a less invasive vascular imaging method, can be a useful tool before planning free flap surgery. PMID:17993870

  13. The Prognosis of Patients With Nonobstructive Coronary Artery Disease Versus Normal Arteries Determined by Invasive Coronary Angiography or Computed Tomography Coronary Angiography: A Systematic Review.

    PubMed

    Huang, Fang-Yang; Huang, Bao-Tao; Lv, Wen-Yu; Liu, Wei; Peng, Yong; Xia, Tian-Li; Wang, Peng-Ju; Zuo, Zhi-Liang; Liu, Rui-Shuang; Zhang, Chen; Gui, Yi-Yue; Liao, Yan-Biao; Chen, Mao; Zhu, Ye

    2016-03-01

    Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77-3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79-2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries.

  14. The Prognosis of Patients With Nonobstructive Coronary Artery Disease Versus Normal Arteries Determined by Invasive Coronary Angiography or Computed Tomography Coronary Angiography

    PubMed Central

    Huang, Fang-Yang; Huang, Bao-Tao; Lv, Wen-Yu; Liu, Wei; Peng, Yong; Xia, Tian-Li; Wang, Peng-Ju; Zuo, Zhi-Liang; Liu, Rui-Shuang; Zhang, Chen; Gui, Yi-Yue; Liao, Yan-Biao; Chen, Mao; Zhu, Ye

    2016-01-01

    Abstract Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77–3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79–2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries. PMID:26986161

  15. The Prognosis of Patients With Nonobstructive Coronary Artery Disease Versus Normal Arteries Determined by Invasive Coronary Angiography or Computed Tomography Coronary Angiography: A Systematic Review.

    PubMed

    Huang, Fang-Yang; Huang, Bao-Tao; Lv, Wen-Yu; Liu, Wei; Peng, Yong; Xia, Tian-Li; Wang, Peng-Ju; Zuo, Zhi-Liang; Liu, Rui-Shuang; Zhang, Chen; Gui, Yi-Yue; Liao, Yan-Biao; Chen, Mao; Zhu, Ye

    2016-03-01

    Limited data exist regarding the outcomes of patients with nonobstructive coronary artery disease (CAD) detected by computed tomography coronary angiography (CTCA) or invasive coronary angiography (ICA). Our aim was to compare the prognosis of patients with nonobstructive coronary artery plaques with that of patients with entirely normal arteries. The MEDLINE, Cochrane Library, and Embase databases were searched. Studies comparing the prognosis of individuals with nonobstructive CAD versus normal coronary arteries detected by CTCA or ICA were included. The primary outcome was major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, hospitalization due to unstable angina or revascularization. A fixed effects model was chosen to pool the estimates of odds ratios (ORs). Forty-eight studies with 64,905 individuals met the inclusion criteria. Patients in the nonobstructive CAD arm had a significantly higher risk of MACE compared to their counterparts in the normal artery arm (pooled OR, 3.17, 95% confidence interval, 2.77-3.63). When excluding revascularization as an endpoint, hard cardiac composite outcomes were also more frequent among patients with nonobstructive CAD (pooled OR, 2.10; 95%CI, 1.79-2.45). All subgroups (age, sex, follow-up duration, different outcomes, diagnostic modality, and CAD risk factor) consistently showed a poorer prognosis with nonobstructive CAD than with normal arteries. When dividing the studies into a CTCA and ICA group for further analysis based on the indications for diagnostic tests, we also found nonobstructive CAD to be associated with a higher risk of MACE in both stable and acute chest pain. Patients with nonobstructive CAD had a poorer prognosis compared with their counterparts with normal arteries. PMID:26986161

  16. Cardiac magnetic resonance and computed tomography angiography for clinical imaging of stable coronary artery disease. Diagnostic classification and risk stratification

    PubMed Central

    Korosoglou, Grigorios; Giusca, Sorin; Gitsioudis, Gitsios; Erbel, Christian; Katus, Hugo A.

    2014-01-01

    Despite advances in the pharmacologic and interventional treatment of coronary artery disease (CAD), atherosclerosis remains the leading cause of death in Western societies. X-ray coronary angiography has been the modality of choice for diagnosing the presence and extent of CAD. However, this technique is invasive and provides limited information on the composition of atherosclerotic plaque. Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) have emerged as promising non-invasive techniques for the clinical imaging of CAD. Hereby, CCTA allows for visualization of coronary calcification, lumen narrowing and atherosclerotic plaque composition. In this regard, data from the CONFIRM Registry recently demonstrated that both atherosclerotic plaque burden and lumen narrowing exhibit incremental value for the prediction of future cardiac events. However, due to technical limitations with CCTA, resulting in false positive or negative results in the presence of severe calcification or motion artifacts, this technique cannot entirely replace invasive angiography at the present time. CMR on the other hand, provides accurate assessment of the myocardial function due to its high spatial and temporal resolution and intrinsic blood-to-tissue contrast. Hereby, regional wall motion and perfusion abnormalities, during dobutamine or vasodilator stress, precede the development of ST-segment depression and anginal symptoms enabling the detection of functionally significant CAD. While CT generally offers better spatial resolution, the versatility of CMR can provide information on myocardial function, perfusion, and viability, all without ionizing radiation for the patients. Technical developments with these 2 non-invasive imaging tools and their current implementation in the clinical imaging of CAD will be presented and discussed herein. PMID:25147526

  17. Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses.

    PubMed

    Ghekiere, Olivier; Dewilde, Willem; Bellekens, Michel; Hoa, Denis; Couvreur, Thierry; Djekic, Julien; Coolen, Tim; Mancini, Isabelle; Vanhoenacker, Piet K; Dendale, Paul; Nchimi, Alain

    2015-12-01

    Fractional flow reserve (FFR) during invasive coronary angiography has become an established tool for guiding treatment. However, only one-third of intermediate-grade coronary artery stenosis (ICAS) are hemodynamically significant and require coronary revascularization. Additionally, the severity of stenosis visually established by coronary computed tomography angiography (CCTA) does not reliably correlate with the functional severity. Therefore, additional angiographic morphologic descriptors affecting hemodynamic significance are required. To evaluate quantitative stenosis analysis and plaque descriptors by CCTA in predicting the hemodynamic significance of ICAS and to compare it with quantitative catheter coronary angiography (QCA). QCA was performed in 65 patients (mean age 63 ± 9 years; 47 men) with 76 ICAS (40-70%) on CCTA. Plaque descriptors were determined including circumferential extent of calcification, plaque composition, minimal lumen diameter (MLD) and area, diameter stenosis percentage (Ds %), area stenosis percentage and stenosis length on CCTA. MLD and Ds % were also analyzed on QCA. FFR was measured on 52 ICAS lesions on CCTA and QCA. The diagnostic values of the best CCTA and QCA descriptors were calculated for ICAS with FFR ≤ 0.80. Of the 76 ICAS on CCTA, 52 (68%) had a Ds % between 40 and 70% on QCA. Significant intertechnique correlations were found between CCTA and QCA for MLD and Ds % (p < 0.001). In 17 (33%) of the 52 ICAS lesions on QCA, FFR values were ≤ 0.80. Calcification circumference extent (p = 0.50) and plaque composition assessment (p = 0.59) did not correlate with the hemodynamic significance. Best predictors for FFR ≤ 0.80 stenosis were ≤ 1.35 mm MLD (82% sensitivity, 66% specificity), and ≤ 2.3 mm(²) minimal lumen area (88% sensitivity, 60% specificity) on CCTA, and ≤ 1.1 mm MLD (59% sensitivity, 77% specificity) on QCA. Quantitative CCTA and QCA poorly predict hemodynamic significance of ICAS, though CCTA seems to

  18. Dynamic Computed Tomography Angiography: Role in the Evaluation of Popliteal Artery Entrapment Syndrome

    SciTech Connect

    Anil, Gopinathan Tay, Kiang-Hiong; Howe, Tse-Chiang; Tan, Bien-Soo

    2011-04-15

    This study reviews our experience with dynamic computed tomographic angiography (CTA) as an imaging modality in the evaluation of popliteal artery entrapment syndrome (PAES). Eight patients with surgically proven PAES were included in this study. Dynamic CTA studies performed with the feet in neutral and plantar flexed positions were reviewed for the detailed anatomy of the region and to define the location and extent of the stenosis, occlusions and collateral circulation. These findings were compared with intraoperative observations. CTA provided adequate angiographic and anatomic information required to arrive at the diagnosis and make a surgical decision. Thirteen limbs were affected in eight patients. There was popliteal artery occlusion in four limbs, stenosis at rest that was accentuated on stress imaging in two limbs, and patent popliteal artery with marked stenosis on stress imaging in seven limbs. Long-segment stenosis was seen in functional entrapment compared to short-segment stenosis in anatomic PAES. Anteroposterior compression of the popliteal artery in anatomic PAES unlike the side-to-side compression in functional PAES was a unique observation in this study. The CTA and surgical characterisation and classification of PAES matched in all the patients, except for misinterpretation of compressing fibrous bands as accessory slips of muscles in three limbs. In conclusion, dynamic CTA is a robust diagnostic tool that provides clinically relevant information and serves as a rapidly performed and easily available 'one-stop-shop' imaging modality in the management of PAES.

  19. A New Method for Computed Tomography Angiography (CTA) Imaging via Wavelet Decomposition-Dependented Edge Matching Interpolation.

    PubMed

    Li, Zeyu; Chen, Yimin; Zhao, Yan; Zhu, Lifeng; Lv, Shengqing; Lu, Jiahui

    2016-08-01

    The interpolation technique of computed tomography angiography (CTA) image provides the ability for 3D reconstruction, as well as reduces the detect cost and the amount of radiation. However, most of the image interpolation algorithms cannot take the automation and accuracy into account. This study provides a new edge matching interpolation algorithm based on wavelet decomposition of CTA. It includes mark, scale and calculation (MSC). Combining the real clinical image data, this study mainly introduces how to search for proportional factor and use the root mean square operator to find a mean value. Furthermore, we re- synthesize the high frequency and low frequency parts of the processed image by wavelet inverse operation, and get the final interpolation image. MSC can make up for the shortage of the conventional Computed Tomography (CT) and Magnetic Resonance Imaging(MRI) examination. The radiation absorption and the time to check through the proposed synthesized image were significantly reduced. In clinical application, it can help doctor to find hidden lesions in time. Simultaneously, the patients get less economic burden as well as less radiation exposure absorbed. PMID:27307267

  20. Coronary optical coherence tomography: minimally invasive virtual histology as part of targeted post-mortem computed tomography angiography.

    PubMed

    Adlam, David; Joseph, Shiju; Robinson, Claire; Rousseau, Clement; Barber, Jade; Biggs, Mike; Morgan, Bruno; Rutty, Guy

    2013-09-01

    Social, cultural and practical barriers to conventional invasive autopsy have led to considerable interest in the development of minimally invasive radiological techniques as an alternative to the invasive autopsy for determining the cause of death. Critical to accurate diagnosis in this context is detailed examination of coronary anatomy and pathology. Current computed tomography and magnetic resonance imaging approaches have significantly advanced minimally invasive autopsy practice but have limited spatial resolution. This prohibits assessment at a microscopic level, meaning that histological assessment is still required for detailed analysis of, for example, coronary plaque rupture or dissection. Coronary optical coherence tomography (OCT) is used in the living during percutaneous coronary interventions to provide high-resolution coronary imaging, but this technique for obtaining virtual histology has not, to date, been translated into minimally invasive autopsy practice. We present a first description of minimally invasive post-mortem coronary OCT and discuss the potential for this technique to advance current practice. PMID:23455719

  1. Italian Chapter of the International Society of Cardiovascular Ultrasound expert consensus document on coronary computed tomography angiography: overview and new insights.

    PubMed

    Sozzi, Fabiola B; Maiello, Maria; Pelliccia, Francesco; Parato, Vito Maurizio; Canetta, Ciro; Savino, Ketty; Lombardi, Federico; Palmiero, Pasquale

    2016-09-01

    Coronary computed tomography angiography is a noninvasive heart imaging test currently undergoing rapid development and advancement. The high resolution of the three-dimensional pictures of the moving heart and great vessels is performed during a coronary computed tomography to identify coronary artery disease and classify patient risk for atherosclerotic cardiovascular disease. The technique provides useful information about the coronary tree and atherosclerotic plaques beyond simple luminal narrowing and plaque type defined by calcium content. This application will improve image-guided prevention, medical therapy, and coronary interventions. The ability to interpret coronary computed tomography images is of utmost importance as we develop personalized medical care to enable therapeutic interventions stratified on the bases of plaque characteristics. This overview provides available data and expert's recommendations in the utilization of coronary computed tomography findings. We focus on the use of coronary computed tomography to detect coronary artery disease and stratify patients at risk, illustrating the implications of this test on patient management. We describe its diagnostic power in identifying patients at higher risk to develop acute coronary syndrome and its prognostic significance. Finally, we highlight the features of the vulnerable plaques imaged by coronary computed tomography angiography.

  2. A Computed Tomography Based Coronary Lesion Score to Predict Acute Coronary Syndrome Among Patients With Acute Chest Pain and a Significant Coronary Stenosis on Coronary Computed Tomography Angiography

    PubMed Central

    Ferencik, Maros; Schlett, Christopher L.; Ghoshhajra, Brian B.; Kriegel, Mathias F.; Joshi, Subodh B.; Maurovich-Horvat, Pal; Rogers, Ian S.; Banerji, Dahlia; Bamberg, Fabian; Truong, Quynh A.; Brady, Thomas J.; Nagurney, John T.; Hoffmann, Udo

    2012-01-01

    We tested the hypothesis that the assessment of lesion morphology helped to detect acute coronary syndrome (ACS) during index hospitalization among patients with acute chest pain who had a significant stenosis on coronary computed tomography angiography (CTA). Patients who presented to the emergency department with chest pain but no objective signs of myocardial ischemia (non-diagnostic ECG and negative initial biomarkers) underwent CTA. CTA was analyzed for the degree and length of stenosis, plaque area and volume, remodeling index, CT attenuation of plaque, and spotty calcium in all patients with a significant stenosis (>50% in diameter) in CTA. ACS during the index hospitalization was determined by the panel of 2 physicians blinded to results of CTA. For lesion characteristics associated with ACS, we determined cutpoints optimized for diagnostic accuracy and created lesion scores. For each score, we determined odds ratio and discriminatory capacity for the prediction of ACS. Of the overall population of 368 patients, 34 had significant stenosis and among those 21 had ACS. Score A (remodeling index+spotty calcium: OR 3.5, 95%CI 1.2–10.1, AUC 0.734), B (remodeling index+spotty calcium+stenosis length: OR 4.6, 95%CI 1.6–13.7, AUC 0.824) and C (remodeling index+spotty calcium+stenosis length+volume of <90HU plaque: OR 3.4, 95%CI 1.5–7.9, AUC 0.833) were significantly associated with ACS. In conclusion, among patients presenting with acute chest pain and with a stenosis on coronary CTA, a CT-based score incorporating morphologic characteristics of coronary lesions had a good discriminatory value for the detection ACS during index hospitalization. PMID:22481015

  3. Meta-Analysis of Diagnostic Performance of Coronary Computed Tomography Angiography, Computed Tomography Perfusion, and Computed Tomography-Fractional Flow Reserve in Functional Myocardial Ischemia Assessment Versus Invasive Fractional Flow Reserve.

    PubMed

    Gonzalez, Jorge A; Lipinski, Michael J; Flors, Lucia; Shaw, Peter W; Kramer, Christopher M; Salerno, Michael

    2015-11-01

    We sought to compare the diagnostic performance of coronary computed tomography angiography (CCTA), computed tomography perfusion (CTP), and computed tomography (CT)-fractional flow reserve (FFR) for assessing the functional significance of coronary stenosis as defined by invasive FFR in patients with known or suspected coronary artery disease (CAD). CCTA has proved clinically useful for excluding obstructive CAD because of its high sensitivity and negative predictive value (NPV); however, the ability of CTA to identify functionally significant CAD has remained challenging. We searched PubMed/Medline for studies evaluating CCTA, CTP, or CT-FFR for the noninvasive detection of obstructive CAD compared with catheter-derived FFR as the reference standard. Pooled sensitivity, specificity, PPV, NPV, likelihood ratios, and odds ratio of all diagnostic tests were assessed. Eighteen studies involving a total of 1,535 patients were included. CTA demonstrated a pooled sensitivity of 0.92, specificity 0.43, PPV of 0.56, and NPV of 0.87 on a per-patient level. CT-FFR and CTP increased the specificity to 0.72 and 0.77, respectively (p = 0.004 and p = 0.0009) resulting in higher point estimates for PPV 0.70 and 0.83, respectively. There was no improvement in the sensitivity. The CTP protocol involved more radiation (3.5 mSv CCTA vs 9.6 mSv CTP) and a higher volume of iodinated contrast (145 ml). In conclusion, CTP and CT-FFR improve the specificity of CCTA for detecting functionally significant stenosis as defined by invasive FFR on a per-patient level; both techniques could advance the ability to noninvasively detect the functional significance of coronary lesions.

  4. Multidetector computed tomography angiography for assessment of in-stent restenosis: meta-analysis of diagnostic performance

    PubMed Central

    Vanhoenacker, Piet K; Decramer, Isabel; Bladt, Olivier; Sarno, Giovanna; Van Hul, Erik; Wijns, William; Dwamena, Ben A

    2008-01-01

    Background Multi-detector computed tomography angiography (MDCTA)of the coronary arteries after stenting has been evaluated in multiple studies. The purpose of this study was to perform a structured review and meta-analysis of the diagnostic performance of MDCTA for the detection of in-stent restenosis in the coronary arteries. Methods A Pubmed and manual search of the literature on in-stent restenosis (ISR) detected on MDCTA compared with conventional coronary angiography (CA) was performed. Bivariate summary receiver operating curve (SROC) analysis, with calculation of summary estimates was done on a stent and patient basis. In addition, the influence of study characteristics on diagnostic performance and number of non-assessable segments (NAP) was investigated with logistic meta-regression. Results Fourteen studies were included. On a stent basis, Pooled sensitivity and specificity were 0.82(0.72–0.89) and 0.91 (0.83–0.96). Pooled negative likelihood ratio and positive likelihood ratio were 0.20 (0.13–0.32) and 9.34 (4.68–18.62) respectively. The exclusion of non-assessable stents and the strut thickness of the stents had an influence on the diagnostic performance. The proportion of non-assessable stents was influenced by the number of detectors, stent diameter, strut thickness and the use of an edge-enhancing kernel. Conclusion The sensitivity of MDTCA for the detection of in-stent stenosis is insufficient to use this test to select patients for further invasive testing as with this strategy around 20% of the patients with in-stent stenosis would be missed. Further improvement of scanner technology is needed before it can be recommended as a triage instrument in practice. In addition, the number of non-assessable stents is also high. PMID:18671850

  5. Semi-automatic 3D segmentation of carotid lumen in contrast-enhanced computed tomography angiography images.

    PubMed

    Hemmati, Hamidreza; Kamli-Asl, Alireza; Talebpour, Alireza; Shirani, Shapour

    2015-12-01

    The atherosclerosis disease is one of the major causes of the death in the world. Atherosclerosis refers to the hardening and narrowing of the arteries by plaques. Carotid stenosis is a narrowing or constriction of carotid artery lumen usually caused by atherosclerosis. Carotid artery stenosis can increase risk of brain stroke. Contrast-enhanced Computed Tomography Angiography (CTA) is a minimally invasive method for imaging and quantification of the carotid plaques. Manual segmentation of carotid lumen in CTA images is a tedious and time consuming procedure which is subjected to observer variability. As a result, there is a strong and growing demand for developing computer-aided carotid segmentation procedures. In this study, a novel method is presented for carotid artery lumen segmentation in CTA data. First, the mean shift smoothing is used for uniformity enhancement of gray levels. Then with the help of three seed points, the centerlines of the arteries are extracted by a 3D Hessian based fast marching shortest path algorithm. Finally, a 3D Level set function is performed for segmentation. Results on 14 CTA volumes data show 85% of Dice similarity and 0.42 mm of mean absolute surface distance measures. Evaluation shows that the proposed method requires minimal user intervention, low dependence to gray levels changes in artery path, resistance to extreme changes in carotid diameter and carotid branch locations. The proposed method has high accuracy and can be used in qualitative and quantitative evaluation. PMID:26429385

  6. Evaluation of lower-limb arteries with multidetector computed tomography angiography prior to free flap surgery: a radioanatomic study.

    PubMed

    Tan, Onder; Yuce, Ihsan; Kantarci, Mecit; Algan, Said

    2011-03-01

    In this study, we aimed to evaluate the vascular structures of the lower limb with multidetector computed tomography (CT) angiography and to reveal the importance of this method in preoperative planning of microsurgical transplantation. In 24 patients, lower-limb arteries were bilaterally evaluated with 16-detector spiral CT scanner in terms of patency, stenosis, or occlusion; maximal and minimal external diameters through their traces; and variations as well as length of the peroneal artery. The peroneal artery was absent unilaterally in two patients (4.3%). The mean maximal and minimal diameters were as 2.77 and 1.63, 2.92 and 1.75, and 2.72 and 1.50 mm for anterior and posterior tibial and peroneal arteries, respectively. The ranges of lengths of peroneal arteries were 50 to 117 mm. This valuable tool can provide detailed information about vascular and the remaining anatomic structures by means of its high-resolution characteristics before planning free flap surgery. PMID:21181625

  7. Prevalence of coronary artery ectasia in older adults and the relationship with epicardial fat volume by cardiac computed tomography angiography

    PubMed Central

    Yang, Jun-Jie; Yang, Xia; Chen, Zhi-Ye; Wang, Qi; He, Bai; Du, Luo-Shan; Chen, Yun-Dai

    2013-01-01

    Objective Coronary artery ectasia (CAE) refers to abnormal dilation of coronary artery segments to 1.5 times of adjacent normal ones. Epicardial fat is associated with cardiovascular risk factors. The relationship between CAE and epicardial fat has not yet been investigated. This study aimed to assess the relationship between CAE and epicardial fat volume (EFV) in older people by dual-source computed tomography coronary angiography (CTCA). Methods We prospectively enrolled 1400 older adults who were scheduled for dual-source CTCA. Under reconstruction protocols, patients with abnormal segments 1.5 times larger than the adjacent segments were accepted as CAE. EFV was measured by semi-automated software. Traditional risk factors in CAE patients, as well as the extent of EFV, were analyzed and compared to non-CAE group. Results A total of 885 male and 515 female older patients were enrolled. CAE was identified by univariable analysis in 131 patients and significantly correlated to hypertension, smoking, hyperlipidemia, prior percutaneous coronary intervention and ascending aorta aneurysm. EFV was shown to be significantly higher in CAE patients than patients without ectasia. In multivariable analyses, EFV (P = 0.018), hypertension (P < 0.001) and hyperlipidemia (P < 0.001) were significantly correlated to CAE. There was a significant negative correlation between EFV and Markis classification. Conclusions CAE can be reliably recognized by dual-source CTCA. Epicardial fat might play a role in etiopathogenesis and progression of CAE, providing a new target for treating ectasia. PMID:23610568

  8. Suboptimal implementation of diagnostic algorithms and overuse of computed tomography-pulmonary angiography in patients with suspected pulmonary embolism

    PubMed Central

    Alhassan, Sulaiman; Sayf, Alaa Abu; Arsene, Camelia; Krayem, Hicham

    2016-01-01

    BACKGROUND: Majority of our computed tomography-pulmonary angiography (CTPA) scans report negative findings. We hypothesized that suboptimal reliance on diagnostic algorithms contributes to apparent overuse of this test. METHODS: A retrospective review was performed on 2031 CTPA cases in a large hospital system. Investigators retrospectively calculated pretest probability (PTP). Use of CTPA was considered as inappropriate when it was ordered for patients with low PTP without checking D-dimer (DD) or following negative DD. RESULTS: Among the 2031 cases, pulmonary embolism (PE) was found in 7.4% (151 cases). About 1784 patients (88%) were considered “PE unlikely” based on Wells score. Out of those patients, 1084 cases (61%) did not have DD test prior to CTPA. In addition, 78 patients with negative DD underwent unnecessary CTPA; none of them had PE. CONCLUSIONS: The suboptimal implementation of PTP assessment tools can result in the overuse of CTPA, contributing to ineffective utilization of hospital resources, increased cost, and potential harm to patients. PMID:27803751

  9. Diagnosis of pulmonary embolism: ventilation perfusion scintigraphy versus helical computed tomography pulmonary angiography.

    PubMed

    Macdonald, W B G; Patrikeos, A P; Thompson, R I; Adler, B D; van der Schaaf, A A

    2005-02-01

    The present study compared the accuracy of ventilation perfusion scintigraphy (VQS) and CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism. This was a prospective observational study of 112 patients with suspected pulmonary embolism (PE) who could be studied with both investigations within 24 h. Results were compared to final diagnosis at completion of 6-month follow up, using receiver operating characteristic (ROC) analysis. Pulmonary embolism was diagnosed in 27 referred patients (24%). The sensitivity and specificity of VQS and CTPA were similar to that reported from the literature. A normal VQ scan had the highest negative predictive value (100%), while a high-probability VQ scan had the highest positive predictive value (92%). There was no overall difference (area under the ROC curve (AUC)) between VQS (AUC (95% CI) = 0.82 (0.75,0.89)) and CTPA (AUC = 0.88 (0.81,0.94)) for the diagnosis of PE. Among patients with abnormal chest X-rays, CTPA (AUC 0.90 (0.83,0.97)) appeared somewhat better than VQS (AUC 0.78 (0.68,0.88)) but this difference did not reach statistical significance. In this instance, CTPA is at least as accurate as VQS and may provide an opportunity to make alternative diagnoses.

  10. Coronary computed tomography angiography using ultra-low-dose contrast media: radiation dose and image quality.

    PubMed

    Komatsu, Sei; Kamata, Teruaki; Imai, Atsuko; Ohara, Tomoki; Takewa, Mitsuhiko; Ohe, Ryoko; Miyaji, Kazuaki; Yoshida, Junichi; Kodama, Kazuhisa

    2013-08-01

    To analyze the invasiveness and image quality of coronary CT angiography (CCTA) with 80 kV. We enrolled 181 patients with low body weight and low calcium level. Of these, 154 patients were randomly assigned to 1 of 3 groups: 280 HU/80 kV (n = 51); 350 HU/80 kV (n = 51); or 350 HU/120 kV (n = 52). The amount of contrast media (CM) was decided with a CT number-controlling system. Twenty-seven patients were excluded because of an invalid time density curve by timing bolus. The predicted amount of CM, volume CT dose index, dose-length product, effective dose, image noise, and 5-point image quality were measured. The amounts of CM for the 80 kV/280 HU, 80 kV/350 HU, and 120 kV/350 HU groups were 10 ± 4 mL, 15 ± 7 mL, and 30 ± 6 mL, respectively. Although image noise was greater at 80 than 120 kV, there was no significant difference in image quality between 80 kV/350 HU and 120 kV/350 HU (p = 0.390). There was no significant difference in image quality between 80 kV/280 HU and 80 kV/350 HU (4.4 ± 0.7 vs. 4.7 ± 0.4, p = 0.056). The amount of CM and effective dose was lower for 80 kV CCTA than for 120 kV CCTA. CCTA at 80 kV/280 HU may decrease the amount of CM and radiation dose necessary while maintaining image quality.

  11. Subjective assessment of right ventricle enlargement from computed tomography pulmonary angiography images.

    PubMed

    Kumamaru, Kanako K; Hunsaker, Andetta R; Bedayat, Arash; Soga, Shigeyoshi; Signorelli, Jason; Adams, Kimberly; Wake, Nicole; Lu, Michael T; Rybicki, Frank J

    2012-04-01

    To retrospectively evaluate prognostic accuracy of subjective assessment of right ventricle (RV) enlargement on CT pulmonary angiography (CTPA) images in comparison with objective measures of RV enlargement in patients with acute pulmonary embolism (PE). For 200 consecutive patients with acute PE, two readers blinded to patient outcomes subjectively determined whether the maximum RV diameter was greater than that of the left ventricle (LV) using axial CTPA images. For the objective measurements, RV/LV diameter ratios were calculated using axial images and 4-chamber reformatted images. For all assessments, sensitivities and specificities for predicting PE-related death within 30-days and a composite outcome including PE-related death or the need for intensive therapies were compared. The agreement between two readers was 91.5% (kappa = 0.83) and all other assessments had pair-wise agreement over 75% (kappa = 0.53-0.72). There was no significant difference in sensitivity between the subjective and objective methods for predicting both outcomes. The specificity for subjective RV enlargement (55.4-67.7%) was significantly higher than objective measures (45.8-53.1%), except for the 4-chamber views where, for one reader, the specificity of the subjective evaluation was higher but did not reach statistical significance. Complex measurements of RV/LV diameter ratios may not be needed to maximize the prognostic value from CTPA. The radiologist who interprets the CTPA images should report RV enlargement when the RV diameter subjectively appears larger than the LV.

  12. Imaging of the Coronary Venous System: Validation of Three-Dimensional Rotational Venous Angiography Against Dual-Source Computed Tomography

    SciTech Connect

    Knackstedt, Christian; Muehlenbruch, Georg; Mischke, Karl; Bruners, Philipp; Schimpf, Thomas; Frechen, Dirk; Schummers, Georg; Mahnken, Andreas H.; Guenther, Rolf W.; Kelm, Malte; Schauerte, Patrick

    2008-11-15

    Information on the anatomy of the cardiac venous system (CVS) is increasingly important for cardiac resynchronization therapy or percutaneous transvenous mitral valve annuloplasty. Three-dimensional (3D) imaging can further improve the understanding of the relationship of cardiac structures. This study was performed to validate the accuracy of rotational coronary sinus angiography (CSA) displaying the 3D anatomy of the CVS compared to ECG-gated, contrast-enhanced, cardiac dual-source computed tomography (DSCT). Five domestic pigs (60 kg) underwent DSCT using a standardized examination protocol. Using a standard C-arm for fluoroscopy, a rotational CSA was obtained and 3D-image reconstructions performed. Side branches were identified using both methods and enumerated. Vessel visibility was estimated for each side branch and great cardiac vein/anterior interventricular vein. Also, vessel diameters were measured at distinct landmarks, i.e., side branching. The amount of contrast medium was determined and the effective radiation exposure of both methods was calculated. There was no significant difference regarding the vessel diameter of the great cardiac vein/anterior interventricular vein or its side branches. Also, estimation of vessel visibility was not different between the two imaging modalities. Estimated radiation exposure and amount of contrast medium were lower for rotational CSA. In conclusion, a 3D reconstruction of rotational CSA images is possible. All parts of the CVS are well depicted, allowing a 3D overview of the CVS anatomy. On-site 3D visualization might improve decision making during cardiac interventions. In contrast to DSCT, rotational CSA does not demonstrate the anatomy of the mitral annulus or the course of the left circumflex artery.

  13. Risk factors for traumatic blunt cerebrovascular injury diagnosed by computed tomography angiography in the pediatric population: a retrospective cohort study.

    PubMed

    Ravindra, Vijay M; Riva-Cambrin, Jay; Sivakumar, Walavan; Metzger, Ryan R; Bollo, Robert J

    2015-06-01

    OBJECT Computed tomography angiography (CTA) is frequently used to examine patients for blunt cerebrovascular injury (BCVI) after cranial trauma, but the pediatric population at risk for BCVI is poorly defined. Although CTA is effective for BCVI screening in adults, the increased lifetime risk for malignant tumors associated with this screening modality warrants efforts to reduce its use in children. The authors' objective was to evaluate the incidence of BCVI diagnosed by CTA in a pediatric patient cohort and to create a prediction model to identify children at high risk for BCVI. METHODS Demographic, clinical, and radiographic data were collected retrospectively for pediatric patients who underwent CTA during examination for traumatic cranial injury from 2003 through 2013. The primary outcome was injury to the carotid or vertebral artery diagnosed by CTA. RESULTS The authors identified 234 patients (mean age 8.3 years, range 0.04-17 years, 150 [64%] boys) who underwent CTA screening for BCVI. Of these, 24 (10.3%) had a focal neurological deficit, and 153 (65.4%) had intracranial hemorrhage on a head CTA. Thirty-seven BCVIs were observed in 36 patients (15.4%), and 16 patients (6.8%) died. Multivariate regression analysis identified fracture through the carotid canal, petrous temporal bone fracture, Glasgow Coma Scale (GCS) score of < 8, focal neurological deficit, and stroke on initial CT scan as independent risk factors for BCVI. A prediction model for identifying children at high risk for BCVI was created. A score of ≤ 2 yielded a 7.9% probability of BCVI and a score of ≥ 3 a risk of 39.3% for BCVI. CONCLUSIONS For cranial trauma in children, fracture of the petrous temporal bone or through the carotid canal, focal neurological deficit, stroke, and a GCS score of < 8 are independent risk factors for BCVI.

  14. Stereoscopic Vascular Models of the Head and Neck: A Computed Tomography Angiography Visualization

    ERIC Educational Resources Information Center

    Cui, Dongmei; Lynch, James C.; Smith, Andrew D.; Wilson, Timothy D.; Lehman, Michael N.

    2016-01-01

    Computer-assisted 3D models are used in some medical and allied health science schools; however, they are often limited to online use and 2D flat screen-based imaging. Few schools take advantage of 3D stereoscopic learning tools in anatomy education and clinically relevant anatomical variations when teaching anatomy. A new approach to teaching…

  15. Computed Tomography

    NASA Astrophysics Data System (ADS)

    Castellano, Isabel; Geleijns, Jacob

    After its clinical introduction in 1973, computed tomography developed from an x-ray modality for axial imaging in neuroradiology into a versatile three dimensional imaging modality for a wide range of applications in for example oncology, vascular radiology, cardiology, traumatology and even in interventional radiology. Computed tomography is applied for diagnosis, follow-up studies and screening of healthy subpopulations with specific risk factors. This chapter provides a general introduction in computed tomography, covering a short history of computed tomography, technology, image quality, dosimetry, room shielding, quality control and quality criteria.

  16. Recent Update on Radiation Dose Assessment for the State-of-the-Art Coronary Computed Tomography Angiography Protocols

    PubMed Central

    Tan, Sock Keow; Yeong, Chai Hong; Ng, Kwan Hoong; Abdul Aziz, Yang Faridah; Sun, Zhonghua

    2016-01-01

    Objectives This study aimed to measure the absorbed doses in selected organs for prospectively ECG-triggered coronary computed tomography angiography (CCTA) using five different generations CT scanners in a female adult anthropomorphic phantom and to estimate the effective dose (HE). Materials and Methods Prospectively ECG-triggered CCTA was performed using five commercially available CT scanners: 64-detector-row single source CT (SSCT), 2 × 32-detector-row-dual source CT (DSCT), 2 × 64-detector-row DSCT and 320-detector-row SSCT scanners. Absorbed doses were measured in 34 organs using pre-calibrated optically stimulated luminescence dosimeters (OSLDs) placed inside a standard female adult anthropomorphic phantom. HE was calculated from the measured organ doses and compared to the HE derived from the air kerma-length product (PKL) using the conversion coefficient of 0.014 mSv∙mGy-1∙cm-1 for the chest region. Results Both breasts and lungs received the highest radiation dose during CCTA examination. The highest HE was received from 2 × 32-detector-row DSCT scanner (6.06 ± 0.72 mSv), followed by 64-detector-row SSCT (5.60 ± 0.68 and 5.02 ± 0.73 mSv), 2 × 64-detector-row DSCT (1.88 ± 0.25 mSv) and 320-detector-row SSCT (1.34 ± 0.48 mSv) scanners. HE calculated from the measured organ doses were about 38 to 53% higher than the HE derived from the PKL-to-HE conversion factor. Conclusion The radiation doses received from a prospectively ECG-triggered CCTA are relatively small and are depending on the scanner technology and imaging protocols. HE as low as 1.34 and 1.88 mSv can be achieved in prospectively ECG-triggered CCTA using 320-detector-row SSCT and 2 × 64-detector-row DSCT scanners. PMID:27552224

  17. Improving the Evaluation of Collateral Circulation by Multiphase Computed Tomography Angiography in Acute Stroke Patients Treated with Endovascular Reperfusion Therapies

    PubMed Central

    García-Tornel, Alvaro; Carvalho, Vanessa; Boned, Sandra; Flores, Alan; Rodríguez-Luna, David; Pagola, Jorge; Muchada, Marian; Sanjuan, Estela; Coscojuela, Pilar; Juega, Jesus; Rodriguez-Villatoro, Noelia; Menon, Bijoy; Goyal, Mayank; Ribó, Marc; Tomasello, Alejandro; Molina, Carlos A.; Rubiera, Marta

    2016-01-01

    Good collateral circulation (CC) is associated with favorable outcomes in acute stroke, but the best technique to evaluate collaterals is controversial. Single-phase computed tomography angiography (sCTA) is widely used but lacks temporal resolution. We aim to compare CC evaluation by sCTA and multiphase CTA (mCTA) as predictors of outcome in endovascular treated patients. Methods Consecutive endovascular treated patients with M1 middle cerebral artery (MCA) or terminal intracranial carotid artery (TICA) occlusion confirmed by sCTA were included. Two more CTA acquisitions with 8- and 16-second delays were performed for mCTA. Endovascular thrombectomy was performed independently of the CC status according to a local protocol [Alberta Stroke Program Early CT score (ASPECTS) >6, modified Rankin scale (mRS) score <3]. CC on sCTA and mCTA were compared. Results 108 patients were included. Their mean age was 69.6 ± 13 years and their median National Institutes of Health Stroke Scale (NIHSS) score was 17 (interquartile range 8). 79 (73.1%) had M1 MCA and 29 (26.9%) TICA occlusions. The mean time from symptom onset to CTA was 146.8 ± 96.5 min. On sCTA, 50.9% patients presented good CC vs. 57.5% on mCTA. Good CC status in both sCTA and mCTA had a lower 24-hour infarct volume (27.4 vs. 74.8 cm3 on sCTA, p = 0.04; 17.2 vs. 97.8 cm3 on mCTA, p < 0.01). However, only good CC on mCTA was associated with lower 24-hour (5 vs. 8.5, p = 0.04) and median discharge NIHSS (2 vs. 4.5, p = 0.04) scores and functional independency (mRS score <3) at 3 months (76.9 vs. 23.1%, p < 0.01). In a logistic regression model including age, NIHSS, ASPECTS and recanalization, only age (OR 0.96, 95% CI 0.93–0.99, p = 0.02) and good CC on mCTA (OR 5, 95% CI 1.99-12.6, p < 0.01) were independent predictors of functional outcome at 3 months. Conclusion CC evaluation by mCTA is a better prognostic marker than CC evaluation by sCTA for clinical and functional endpoints in acute stroke patients treated

  18. The Association of Brachial-Ankle Pulse Wave Velocity with Coronary Artery Disease Evaluated by Coronary Computed Tomography Angiography

    PubMed Central

    Seo, Jae-Bin; Choi, Young Ho; Chung, Woo-Young; Kim, Sang-Hyun; Kim, Myung-A; Zo, Joo-Hee

    2015-01-01

    The aim of this study was to investigate whether brachial-ankle pulse wave velocity (baPWV) is associated with the severity of coronary artery disease (CAD) assessed by coronary computed tomography angiography (CCTA), and to evaluate baPWV as a predictor of obstructive CAD on CCTA. A total of 470 patients who underwent both baPWV and CCTA were included. We evaluated stenosis degree and plaque characteristics on CCTA. To estimate the severity of CAD, we calculated the number of segment with plaque (segment involvement score; SIS), stenosis degree-weighted plaque score (segment stenosis score; SSS), and coronary artery calcium score (CACS). The mean baPWV was 1,485 ± 315 cm/s (range, 935-3,175 cm/s). Non-obstructive (stenosis < 50%) and obstructive (stenosis ≥ 50%) CAD was found in 129 patients (27.4%) and 144 (30.6%), respectively. baPWV in patients with obstructive CAD was higher than that of patients with non-obstructive (1,680 ± 396 cm/s versus 1,477 ± 244 cm/s, P < 0.001) or no CAD (1,680 ± 396 cm/s versus ± 196 1,389 cm/s, P < 0.001). baPWV showed significant correlation with SSS (r = 0.429, P < 0.001), SIS (r = 0.395, P < 0.001), CACS (r 0.346, P < 0.001), and the number of segment with non-calcified plaque (r 0.092, P = 0.047), mixed plaque (r = 0.267, P < 0.001), and calcified plaque (r = 0.348, P < 0.001), respectively. The optimal baPWV cut-off value for the detection of obstructive CAD was 1,547 cm/s. baPWV ≥ 1,547 cm/s was independent predictor for the obstructive CAD. In conclusion, baPWV is well correlated with the severity of CAD evaluated by CCTA. baPWV has the potential to predict severity of coronary artery atherosclerosis. PMID:25875036

  19. Automatic quantification and characterization of coronary atherosclerosis with computed tomography coronary angiography: cross-correlation with intravascular ultrasound virtual histology.

    PubMed

    de Graaf, Michiel A; Broersen, Alexander; Kitslaar, Pieter H; Roos, Cornelis J; Dijkstra, Jouke; Lelieveldt, Boudewijn P F; Jukema, J Wouter; Schalij, Martin J; Delgado, Victoria; Bax, Jeroen J; Reiber, Johan H C; Scholte, Arthur J

    2013-06-01

    Plaque constitution on computed tomography coronary angiography (CTA) is associated with prognosis. At present only visual assessment of plaque constitution is possible. An accurate automatic, quantitative approach for CTA plaque constitution assessment would improve reproducibility and allows higher accuracy. The present study assessed the feasibility of a fully automatic and quantitative analysis of atherosclerosis on CTA. Clinically derived CTA and intravascular ultrasound virtual histology (IVUS VH) datasets were used to investigate the correlation between quantitatively automatically derived CTA parameters and IVUS VH. A total of 57 patients underwent CTA prior to IVUS VH. First, quantitative CTA quantitative computed tomography (QCT) was performed. Per lesion stenosis parameters and plaque volumes were assessed. Using predefined HU thresholds, CTA plaque volume was differentiated in 4 different plaque types necrotic core (NC), dense calcium (DC), fibrotic (FI) and fibro-fatty tissue (FF). At the identical level of the coronary, the same parameters were derived from IVUS VH. Bland-Altman analyses were performed to assess the agreement between QCT and IVUS VH. Assessment of plaque volume using QCT in 108 lesions showed excellent correlation with IVUS VH (r = 0.928, p < 0.001) (Fig. 1). The correlation of both FF and FI volume on IVUS VH and QCT was good (r = 0.714, p < 0.001 and r = 0.695, p < 0.001 respectively) with corresponding bias and 95 % limits of agreement of 24 mm(3) (-42; 90) and 7.7 mm(3) (-54; 70). Furthermore, NC and DC were well-correlated in both modalities (r = 0.523, p < 0.001) and (r = 0.736, p < 0.001). Automatic, quantitative CTA tissue characterization is feasible using a dedicated software tool. Fig. 1 Schematic illustration of the characterization of coronary plaque on CTA: cross-correlation with IVUS VH. First, the 3-dimensional centerline was generated from the CTA data set using an automatic tree extraction algorithm (Panel I). Using

  20. Automatic quantification and characterization of coronary atherosclerosis with computed tomography coronary angiography: cross-correlation with intravascular ultrasound virtual histology.

    PubMed

    de Graaf, Michiel A; Broersen, Alexander; Kitslaar, Pieter H; Roos, Cornelis J; Dijkstra, Jouke; Lelieveldt, Boudewijn P F; Jukema, J Wouter; Schalij, Martin J; Delgado, Victoria; Bax, Jeroen J; Reiber, Johan H C; Scholte, Arthur J

    2013-06-01

    Plaque constitution on computed tomography coronary angiography (CTA) is associated with prognosis. At present only visual assessment of plaque constitution is possible. An accurate automatic, quantitative approach for CTA plaque constitution assessment would improve reproducibility and allows higher accuracy. The present study assessed the feasibility of a fully automatic and quantitative analysis of atherosclerosis on CTA. Clinically derived CTA and intravascular ultrasound virtual histology (IVUS VH) datasets were used to investigate the correlation between quantitatively automatically derived CTA parameters and IVUS VH. A total of 57 patients underwent CTA prior to IVUS VH. First, quantitative CTA quantitative computed tomography (QCT) was performed. Per lesion stenosis parameters and plaque volumes were assessed. Using predefined HU thresholds, CTA plaque volume was differentiated in 4 different plaque types necrotic core (NC), dense calcium (DC), fibrotic (FI) and fibro-fatty tissue (FF). At the identical level of the coronary, the same parameters were derived from IVUS VH. Bland-Altman analyses were performed to assess the agreement between QCT and IVUS VH. Assessment of plaque volume using QCT in 108 lesions showed excellent correlation with IVUS VH (r = 0.928, p < 0.001) (Fig. 1). The correlation of both FF and FI volume on IVUS VH and QCT was good (r = 0.714, p < 0.001 and r = 0.695, p < 0.001 respectively) with corresponding bias and 95 % limits of agreement of 24 mm(3) (-42; 90) and 7.7 mm(3) (-54; 70). Furthermore, NC and DC were well-correlated in both modalities (r = 0.523, p < 0.001) and (r = 0.736, p < 0.001). Automatic, quantitative CTA tissue characterization is feasible using a dedicated software tool. Fig. 1 Schematic illustration of the characterization of coronary plaque on CTA: cross-correlation with IVUS VH. First, the 3-dimensional centerline was generated from the CTA data set using an automatic tree extraction algorithm (Panel I). Using

  1. Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial

    PubMed Central

    Rief, Matthias; Martus, Peter; Kendziora, Benjamin; Feger, Sarah; Dreger, Henryk; Priem, Sascha; Knebel, Fabian; Böhm, Marko; Schlattmann, Peter; Hamm, Bernd; Schönenberger, Eva; Laule, Michael; Zimmermann, Elke

    2016-01-01

    Objective To evaluate whether invasive coronary angiography or computed tomography (CT) should be performed in patients clinically referred for coronary angiography with an intermediate probability of coronary artery disease. Design Prospective randomised single centre trial. Setting University hospital in Germany. Participants 340 patients with suspected coronary artery disease and a clinical indication for coronary angiography on the basis of atypical angina or chest pain. Interventions 168 patients were randomised to CT and 172 to coronary angiography. After randomisation one patient declined CT and 10 patients declined coronary angiography, leaving 167 patients (88 women) and 162 patients (78 women) for analysis. Allocation could not be blinded, but blinded independent investigators assessed outcomes. Main outcome measure The primary outcome measure was major procedural complications within 48 hours of the last procedure related to CT or angiography. Results Cardiac CT reduced the need for coronary angiography from 100% to 14% (95% confidence interval 9% to 20%, P<0.001) and was associated with a significantly greater diagnostic yield from coronary angiography: 75% (53% to 90%) v 15% (10% to 22%), P<0.001. Major procedural complications were uncommon (0.3%) and similar across groups. Minor procedural complications were less common in the CT group than in the coronary angiography group: 3.6% (1% to 8%) v 10.5% (6% to 16%), P=0.014. CT shortened the median length of stay in the angiography group from 52.9 hours (interquartile range 49.5-76.4 hours) to 30.0 hours (3.5-77.3 hours, P<0.001). Overall median exposure to radiation was similar between the CT and angiography groups: 5.0 mSv (interquartile range 4.2-8.7 mSv) v 6.4 mSv (3.4-10.7 mSv), P=0.45. After a median follow-up of 3.3 years, major adverse cardiovascular events had occurred in seven of 167 patients in the CT group (4.2%) and six of 162 (3.7%) in the coronary angiography group (adjusted hazard

  2. Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography: protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT)

    PubMed Central

    2013-01-01

    Background Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography. To do this, a test should have, at clinically appropriate pretest likelihoods, minimal false-negative outcomes resulting in a high negative predictive value. However, little is known about the influence of patient characteristics on the clinical predictive values of coronary computed tomography angiography. Previous regular systematic reviews and meta-analyses had to rely on limited summary patient cohort data offered by primary studies. Performing an individual patient data meta-analysis will enable a much more detailed and powerful analysis and thus increase representativeness and generalizability of the results. The individual patient data meta-analysis is registered with the PROSPERO database (CoMe-CCT, CRD42012002780). Methods/Design The analysis will include individual patient data from published and unpublished prospective diagnostic accuracy studies comparing coronary computed tomography angiography with conventional coronary angiography. These studies will be identified performing a systematic search in several electronic databases. Corresponding authors will be contacted and asked to provide obligatory and additional data. Risk factors, previous test results and symptoms of individual patients will be used to estimate the pretest

  3. Automatic detection of aorto-femoral vessel trajectory from whole-body computed tomography angiography data sets.

    PubMed

    Gao, Xinpei; Kitslaar, Pieter H; Budde, Ricardo P J; Tu, Shengxian; de Graaf, Michiel A; Xu, Liang; Xu, Bo; Scholte, Arthur J H A; Dijkstra, Jouke; Reiber, Johan H C

    2016-08-01

    Extraction of the aorto-femoral vessel trajectory is important to utilize computed tomography angiography (CTA) in an integrated workflow of the image-guided work-up prior to trans-catheter aortic valve replacement (TAVR). The aim of this study was to develop a new, fully-automated technique for the extraction of the entire arterial access route from the femoral artery to the aortic root. An automatic vessel tracking algorithm was first used to find the centerline that connected the femoral accessing points and the aortic root. Subsequently, a deformable 3D-model fitting method was used to delineate the lumen boundary of the vascular trajectory in the whole-body CTA dataset. A validation was carried out by comparing the automatically obtained results with semi-automatically obtained results from two experienced observers. The whole framework was validated on whole body CTA datasets of 36 patients. The average Dice similarity indexes between the segmentations of the automatic method and observer 1 for the left ilio-femoral artery, the right ilio-femoral artery and the aorta were 0.977 ± 0.030, 0.980 ± 0.019, 0.982 ± 0.016; the average Dice similarity indexes between the segmentations of the automatic method and observer 2 were 0.950 ± 0.040, 0.954 ± 0.031 and 0.965 ± 0.019, respectively. The inter-observer variability resulted in a Dice similarity index of 0.954 ± 0.038, 0.952 ± 0.031 and 0.969 ± 0.018 for the left ilio-femoral artery, the right ilio-femoral artery and the aorta. The average minimal luminal diameters (MLDs) of the ilio-femoral artery were 6.03 ± 1.48, 5.70 ± 1.43 and 5.52 ± 1.32 mm for the automatic method, observer 1 and observer 2 respectively. The MLDs of the aorta were 13.43 ± 2.54, 12.40 ± 2.93 and 12.08 ± 2.40 mm for the automatic method, observer 1 and observer 2 respectively. The automatic measurement overestimated the MLD slightly in the ilio-femoral artery at the

  4. Automatic detection of aorto-femoral vessel trajectory from whole-body computed tomography angiography data sets.

    PubMed

    Gao, Xinpei; Kitslaar, Pieter H; Budde, Ricardo P J; Tu, Shengxian; de Graaf, Michiel A; Xu, Liang; Xu, Bo; Scholte, Arthur J H A; Dijkstra, Jouke; Reiber, Johan H C

    2016-08-01

    Extraction of the aorto-femoral vessel trajectory is important to utilize computed tomography angiography (CTA) in an integrated workflow of the image-guided work-up prior to trans-catheter aortic valve replacement (TAVR). The aim of this study was to develop a new, fully-automated technique for the extraction of the entire arterial access route from the femoral artery to the aortic root. An automatic vessel tracking algorithm was first used to find the centerline that connected the femoral accessing points and the aortic root. Subsequently, a deformable 3D-model fitting method was used to delineate the lumen boundary of the vascular trajectory in the whole-body CTA dataset. A validation was carried out by comparing the automatically obtained results with semi-automatically obtained results from two experienced observers. The whole framework was validated on whole body CTA datasets of 36 patients. The average Dice similarity indexes between the segmentations of the automatic method and observer 1 for the left ilio-femoral artery, the right ilio-femoral artery and the aorta were 0.977 ± 0.030, 0.980 ± 0.019, 0.982 ± 0.016; the average Dice similarity indexes between the segmentations of the automatic method and observer 2 were 0.950 ± 0.040, 0.954 ± 0.031 and 0.965 ± 0.019, respectively. The inter-observer variability resulted in a Dice similarity index of 0.954 ± 0.038, 0.952 ± 0.031 and 0.969 ± 0.018 for the left ilio-femoral artery, the right ilio-femoral artery and the aorta. The average minimal luminal diameters (MLDs) of the ilio-femoral artery were 6.03 ± 1.48, 5.70 ± 1.43 and 5.52 ± 1.32 mm for the automatic method, observer 1 and observer 2 respectively. The MLDs of the aorta were 13.43 ± 2.54, 12.40 ± 2.93 and 12.08 ± 2.40 mm for the automatic method, observer 1 and observer 2 respectively. The automatic measurement overestimated the MLD slightly in the ilio-femoral artery at the

  5. Optical Coherence Tomography Angiography in Fovea Plana.

    PubMed

    Dolz-Marco, Rosa; Phasukkijwatana, Nopasak; Sarraf, David; Freund, K Bailey

    2016-07-01

    Fovea plana is characterized by the anatomical absence of the foveal pit in eyes with normal visual function. The authors have analyzed three cases of idiopathic fovea plana with optical coherence tomography angiography (OCTA). As previously reported, the authors found the absence of a foveal avascular zone in all cases with OCTA; however, a preserved fusion of both the superficial and the deep capillary plexuses was found around the foveal center. This novel observation cannot be detected with conventional dye-based angiography, in which the deep capillary plexus is not visualized. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:670-673.].

  6. Computed Analysis of Three-Dimensional Cone-Beam Computed Tomography Angiography for Determination of Tumor-Feeding Vessels During Chemoembolization of Liver Tumor: A Pilot Study

    SciTech Connect

    Deschamps, Frederic; Solomon, Stephen B.; Thornton, Raymond H.; Rao, Pramod; Hakime, Antoine; Kuoch, Viseth; Baere, Thierry de

    2010-12-15

    The purpose of this study was to evaluate computed analysis of three-dimensional (3D) cone-beam computed tomography angiography (CTA) of the liver for determination of subsegmental tumor-feeding vessels (FVs). Eighteen consecutive patients underwent transarterial chemoembolization (TACE) from January to October 2008 for 25 liver tumors (15 hepatocellular carcinomas [HCCs] and 10 neuroendocrine metastases). Anteroposterior projection angiogram (two-dimensional [2D]) and 3D cone-beam CTA images were acquired by injection of the common hepatic artery. Retrospectively, FVs were independently identified by three radiology technologists using a software package (S) that automatically determines FVs by analysis of 3D images. Subsequently, three interventional radiologists (IRs) independently identified FVs by reviewing the 2D images followed by examination of the 3D images. Finally, the 'ground truth' for the number and location of FVs was obtained by consensus among the IRs, who were allowed to use any imaging-including 2D, 3D, and all oblique or selective angiograms-for such determination. Sensitivities, durations, and degrees of agreement for review of 2D, 3D, and S results were evaluated. Sensitivity of 3D (73%) was higher than 2D (64%) images for identification of FVs (P = 0.036). The sensitivity of S (93%) was higher than 2D (P = 0.02) and 3D (P = 0.005) imaging. The duration for review of 3D imaging was longer than that for 2D imaging (187 vs. 94 s, P = 0.0001) or for S (135 s, P = 0.0001). The degree of agreement between the IRs using 2D and 3D imaging were 54% and 62%, respectively, whereas it was 82% between the three radiology technologists using S. These preliminary data show that computed determination of FVs is both accurate and sensitive.

  7. Relation of diagonal ear lobe crease to the presence, extent, and severity of coronary artery disease determined by coronary computed tomography angiography.

    PubMed

    Shmilovich, Haim; Cheng, Victor Y; Rajani, Ronak; Dey, Damini; Tamarappoo, Balaji K; Nakazato, Ryo; Smith, Thomas W; Otaki, Yuka; Nakanishi, Rine; Gransar, Heidi; Paz, William; Pimentel, Raymond T; Hayes, Sean W; Friedman, John D; Thomson, Louise E J; Berman, Daniel S

    2012-05-01

    Controversy exists concerning the relation between diagonal ear lobe crease (DELC) and coronary artery disease (CAD). We examined whether DELC is associated with CAD using coronary computed tomography (CT) angiography. We studied 430 consecutive patients without a history of coronary artery intervention who underwent CT angiography on a dual-source scanner. Presence of DELC was agreed by 2 blinded observers. Two blinded readers evaluated CT angiography images for presence of CAD and for significant CAD (≥50% stenosis). Chi-square and t tests were used to assess demographic differences between subgroups with and without DELC and the relation of DELC to 4 measurements of CAD: any CAD, significant CAD, multivessel disease (cutoff ≥2), and number of segments with plaque (cutoff ≥3). Multivariable logistic regression was performed to adjust for CAD confounders: age, gender, symptoms, and CAD risk factors. Mean age was 61 ± 13 and 61% were men. DELC was found in 71%, any CAD in 71%, and significant CAD in 17% of patients. After adjusting for confounders, DELC remained a significant predictor of all 4 measurements of CAD (odds ratio 1.8 to 3.3, p = 0.002 to 0.017). Sensitivity, specificity, and positive and negative predictive values for DELC in detecting any CAD were 78%, 43%, 77%, and 45%. Test accuracy was calculated at 67%. Area under the receiver operator characteristic curve was 61% (p = 0.001). In conclusion, in this study of patients imaged with CT angiography, finding DELC was independently and significantly associated with increased prevalence, extent, and severity of CAD.

  8. Nonvisualization of the Internal Carotid Artery on Computed Tomography Angiography: Discussion of Two Cases with Review of Literature

    PubMed Central

    Saran, Sonal; Rajagopal, Rengarajan; Khera, Pushpinder S.; Mehta, Neeraj

    2016-01-01

    Nonvisualization of the internal carotid artery (ICA) on cross-sectional imaging studies can be due to congenital (dysgenesis of the ICA) or acquired (complete occlusion of ICA) causes. We report two cases, one with absent carotid canal on bone window setting of computed tomography (CT) suggestive of congenital cause and the other with normal carotid canal, suggesting acquired cause. Development of aortic arches with six pathways of collateral circulation in brain is also discussed. PMID:27298744

  9. Evaluation of surgical outcome, complications, and mortality in dogs undergoing preoperative computed tomography angiography for diagnosis of an extrahepatic portosystemic shunt: 124 cases (2005–2014)

    PubMed Central

    Brunson, Benjamin W.; Case, J. Brad; Ellison, Gary W.; Fox-Alvarez, W. Alexander; Kim, Stanley E.; Winter, Matthew; Garcia-Pereira, Fernando L.; Farina, Lisa L.

    2016-01-01

    This study evaluated the safety of preoperative computed tomography angiography (CTA) and its effect on surgical time and clinical outcomes in dogs that underwent surgical correction of a single congenital extrahepatic portosystemic shunt (CEPSS). Patient data were retrospectively collected from medical records and owner communications for 124 dogs with single CEPSS, undergoing preoperative CTA (n = 43) or not (n = 81) which were surgically treated from 2005 to 2014. The frequency of major postoperative complications was 4.7% and 9.9% for the CTA and no CTA groups, respectively (P = 0.49). Mean ± standard deviation (SD) surgical time for the preoperative CTA group was 84 ± 40 min and 81 ± 31 min for the no CTA group (P = 0.28). We conclude that anesthetized preoperative CTA appears to be a safe method for diagnosis and surgical planning in dogs with single CEPSS, and does not appear to affect surgical procedure time, complication rate, or clinical outcome. PMID:26740699

  10. The effect on cadaver blood DNA identification by the use of targeted and whole body post-mortem computed tomography angiography.

    PubMed

    Rutty, Guy N; Barber, Jade; Amoroso, Jasmin; Morgan, Bruno; Graham, Eleanor A M

    2013-12-01

    Post-mortem computed tomography angiography (PMCTA) involves the injection of contrast agents. This could have both a dilution effect on biological fluid samples and could affect subsequent post-contrast analytical laboratory processes. We undertook a small sample study of 10 targeted and 10 whole body PMCTA cases to consider whether or not these two methods of PMCTA could affect post-PMCTA cadaver blood based DNA identification. We used standard methodology to examine DNA from blood samples obtained before and after the PMCTA procedure. We illustrate that neither of these PMCTA methods had an effect on the alleles called following short tandem repeat based DNA profiling, and therefore the ability to undertake post-PMCTA blood based DNA identification.

  11. Coronary computed tomography angiography for the assessment of acute chest pain in the emergency department: evidence, guidelines, and tips for implementation.

    PubMed

    Ropp, Alan; Lin, Cheng T; White, Charles S

    2015-05-01

    Acute chest pain is an important clinical challenge and a major reason for presentation to the emergency department. Although multiple imaging techniques are available to assess such patients, considerable interest has focused on the use of coronary computed tomography (CT) angiography. Three recent multicenter trials have demonstrated the value of coronary CT angiography (CCTA) to diagnose patients with acute coronary syndrome (ACS) rapidly and accurately. Guidelines developed on the basis of these and other studies suggest that CCTA is optimally used in patients with low to intermediate risk for ACS. A related protocol, the triple rule-out scan, may be valuable if overlapping symptoms occur, particularly between those of ACS and pulmonary embolism. In developing a program to perform CCTA in the emergency room, it is important to work closely with emergency physicians and cardiologists to maximize appropriate use of this technique and to develop appropriate protocols that minimize radiation dose. Ongoing efforts to improve existing capabilities of CCTA include better characterization of coronary plaque and the use of CT fractional flow reserve and perfusion techniques.

  12. Application of intelligent optimal kV scanning technology (CARE kV) in dual-source computed tomography (DSCT) coronary angiography.

    PubMed

    Zhang, Jun; Kang, Shaolei; Han, Dan; Xie, Xiaojie; Deng, Yaming

    2015-01-01

    This study aims to evaluate the applications and values of dual-source computed tomography (DSCT) intelligent optimal kV scanning technology (CARE kV) in coronary CT angiography (CCTA). 150 patients with normal body mass index were performed DSCT coronary angiography, then randomly divided into the "Semi", 120,100 and 80 kV Group, and the 2 "on" groups, with 30 patients in each group. The first 5 groups used the reference voltage as 120 kV, and the reference current as 400 mAs, while the other group used the reference voltage as 100 kV, and the reference current as 400 mAs. The image quality, average CT value, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and radiation dose were comparatively analyzed among the 5 groups. The image quality scores of the five groups showed no significant difference (P > 0.05); the average CT values and image noises had significance (P < 0.05), while SNR and CNR showed no significant difference (P > 0.05). The 80 kV group showed the biggest noise, with the CT value as 700 HU, while the radiation dose was the lowest, followed by the on group. As for the patients with normal body mass index (BMI), CARE kV-"on" could obtain high-quality images and lower radiation dose for CCTA, while the operation was simple and convenient.

  13. The Incremental Diagnostic Performance of Coronary Computed Tomography Angiography Added to Myocardial Perfusion Imaging in Patients with Intermediate-to-High Cardiovascular Risk

    PubMed Central

    Hsu, Pei-Ying; Lee, Wen-Jeng; Cheng, Mei-Fang; Yen, Ruoh-Fang; Tzen, Kai-Yuan; Wu, Yen-Wen

    2016-01-01

    Purpose Several studies have suggested that a combined approach of stress myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) can provide diagnostic results with excellent accuracy. We aimed to explore whether the addition of CCTA to stress MPI provides incremental diagnostic value in intermediate-to-high cardiovascular risk patients. Methods A total of 106 consecutive patients (93 male, 65 ± 10.4 years) underwent coronary artery calcium scoring (CACS), CCTA and 201Thallium stress MPI before coronary angiography was reviewed. Thirty-seven patients (34.9%) had a history of proven coronary artery disease (CAD) or revascularization procedures, and four had documented non-significant CAD (3.8%). The remaining patients consisted of 17 (16.0%) classified as intermediate, and 48 (45.3%) as the high-risk groups. Results Obstructive CAD was diagnosed by invasive coronary angiography in 88 patients with 161 vessels. The sensitivity and specificity in a patient-based analysis for obstructive CAD were 99% and 17% for CCTA, 80% and 50% for MPI and 91% and 67% for the combined method, respectively. The per-vessel diagnostic sensitivity and specificity were 95% and 54% for CCTA, 59% and 75% for MPI and 84% and 76% for the combined method. There were significant differences (p < 0.05) when comparing the combined method with MPI or CCTA by areas under the curve in a patient- or vessel-based analysis. However, CACS of 400 or more could not further stratify the patients with obstructive CAD. Conclusions CCTA, not CACS, provided additional diagnostic values to stress MPI in patients with intermediate-to-high cardiovascular risk. PMID:27122945

  14. Overuse of Computed Tomography Pulmonary Angiography in the Evaluation of Patients with Suspected Pulmonary Embolism in the Emergency Department

    PubMed Central

    Crichlow, Amanda; Cuker, Adam; Mills, Angela M.

    2012-01-01

    Background Clinical decision rules have been developed and validated for the evaluation of patients presenting with suspected pulmonary embolism (PE) to the emergency department (ED). Objectives To assess the percentage of computed tomographic pulmonary angiography (CT-PA) which could have been avoided by use of the Wells score coupled with D-dimer testing (Wells/D-dimer) or Pulmonary Embolism Rule-Out Criteria (PERC) in ED patients with suspected PE. Methods The authors conducted a prospective cohort study of adult ED patients undergoing CT-PA for suspected PE. Wells score and PERC were calculated. A research blood sample was obtained for D-dimer testing for subjects who did not undergo testing as part of their ED evaluation. The primary outcome was PE by CT-PA or 90-day follow-up. Secondary outcomes were ED length of stay (LOS) and CT-PA time as defined by time from order to initial radiologist interpretation. Results Of 152 suspected PE subjects available for analysis (mean age 46.3±15.6 years, 74% female, 59% black or African American, 11.8% diagnosed with PE), 14 (9.2%) met PERC, none of whom were diagnosed with PE. A low-risk Wells score (≤4) was assigned to 110 (72%) subjects, of whom only 38 (35%) underwent clinical D-dimer testing (elevated in 33/38). Of the 72 subjects with low-risk Wells scores who did not have D-dimers performed in the ED, archived research samples were negative in 16 (22%). All 21 subjects with low-risk Wells scores and negative D-dimers were PE-negative. CT-PA time (median 160 minutes) accounted for more than half of total ED LOS (median 295 minutes). Conclusions In total, 9.2% and 13.8% of CT-PA could have been avoided by use of PERC and Wells/D-dimer, respectively. PMID:23167851

  15. Usefulness of Cone-Beam Computed Tomography During Ultraselective Transcatheter Arterial Chemoembolization for Small Hepatocellular Carcinomas that Cannot be Demonstrated on Angiography

    SciTech Connect

    Miyayama, Shiro Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Sugimori, Natsuki; Igarashi, Saya; Nakashima, Yoshiko; Matsui, Osamu

    2009-03-15

    This study evaluated the usefulness of cone-beam computed tomography (CBCT) during ultraselective transcatheter arterial chemoembolization (TACE) for hepatocellular carcinomas (HCC) that could not be demonstrated on angiography. Twenty-eight patients with 33 angiographically occult tumors (mean diameter 1.3 {+-} 0.3 cm) were enrolled in the study. The ability of CBCT during arterial portography (CBCTAP), during hepatic arteriography (CBCTHA), and after iodized oil injection (LipCBCT) to detect HCC lesions was retrospectively analyzed. The technical success of TACE was divided into three grades: complete (the embolized area included the entire tumor with at least a 5-mm wide margin), adequate (the embolized area included the entire tumor but without a 5-mm wide margin in parts), and incomplete (the embolized area did not include the entire tumor) according to computed axial tomographic (CAT) images obtained 1 week after TACE. Local tumor progression was also evaluated. CBCTAP, CBCTHA, and LipCBCT detected HCC lesions in 93.9% (31 of 33), 96.7% (29 of 30), and 100% (29 of 29) of patients, respectively. A single branch was embolized in 28 tumors, and 2 branches were embolized in five tumors. Twenty-seven tumors (81.8%) were classed as complete, and 6 (18.2%) were classed as adequate. None of the tumors were classed as incomplete. Twenty-five tumors (75.8%) had not recurred during 12.0 {+-} 6.2 months. Eight tumors (24.2%), 5 (18.5%) of 27 complete success and 3 (50%) of 6 adequate success, recurred during 10.1 {+-} 6.2 months. CBCT during TACE is useful in detecting and treating small HCC lesions that cannot not be demonstrated on angiography.

  16. Optical Coherence Tomography Angiography in Retinal Diseases

    PubMed Central

    Chalam, K. V.; Sambhav, Kumar

    2016-01-01

    Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging system that generates volumetric data of retinal and choroidal layers. It has the ability to show both structural and blood flow information. Split-spectrum amplitude-decorrelation angiography (SSADA) algorithm (a vital component of OCTA software) helps to decrease the signal to noise ratio of flow detection thus enhancing visualization of retinal vasculature using motion contrast. Published studies describe potential efficacy for OCTA in the evaluation of common ophthalmologic diseases such as diabetic retinopathy, age related macular degeneration (AMD), retinal vascular occlusions and sickle cell disease. OCTA provides a detailed view of the retinal vasculature, which allows accurate delineation of microvascular abnormalities in diabetic eyes and vascular occlusions. It helps quantify vascular compromise depending upon the severity of diabetic retinopathy. OCTA can also elucidate the presence of choroidal neovascularization (CNV) in wet AMD. In this paper, we review the knowledge, available in English language publications regarding OCTA, and compare it with the conventional angiographic standard, fluorescein angiography (FA). Finally, we summarize its potential applications to retinal vascular diseases. Its current limitations include a relatively small field of view, inability to show leakage, and tendency for image artifacts. Further larger studies will define OCTA's utility in clinical settings and establish if the technology may offer a non-invasive option of visualizing the retinal vasculature, enabling us to decrease morbidity through early detection and intervention in retinal diseases. PMID:27195091

  17. Optical Coherence Tomography Angiography in Retinal Diseases.

    PubMed

    Chalam, K V; Sambhav, Kumar

    2016-01-01

    Optical coherence tomography angiography (OCTA) is a new, non-invasive imaging system that generates volumetric data of retinal and choroidal layers. It has the ability to show both structural and blood flow information. Split-spectrum amplitude-decorrelation angiography (SSADA) algorithm (a vital component of OCTA software) helps to decrease the signal to noise ratio of flow detection thus enhancing visualization of retinal vasculature using motion contrast. Published studies describe potential efficacy for OCTA in the evaluation of common ophthalmologic diseases such as diabetic retinopathy, age related macular degeneration (AMD), retinal vascular occlusions and sickle cell disease. OCTA provides a detailed view of the retinal vasculature, which allows accurate delineation of microvascular abnormalities in diabetic eyes and vascular occlusions. It helps quantify vascular compromise depending upon the severity of diabetic retinopathy. OCTA can also elucidate the presence of choroidal neovascularization (CNV) in wet AMD. In this paper, we review the knowledge, available in English language publications regarding OCTA, and compare it with the conventional angiographic standard, fluorescein angiography (FA). Finally, we summarize its potential applications to retinal vascular diseases. Its current limitations include a relatively small field of view, inability to show leakage, and tendency for image artifacts. Further larger studies will define OCTA's utility in clinical settings and establish if the technology may offer a non-invasive option of visualizing the retinal vasculature, enabling us to decrease morbidity through early detection and intervention in retinal diseases.

  18. Comparison of computed tomography pulmonary angiography and point-of-care tests for pulmonary thromboembolism diagnosis in dogs

    PubMed Central

    Goggs, R; Chan, D L; Benigni, L; Hirst, C; Kellett-Gregory, L; Fuentes, V L

    2014-01-01

    Objectives To evaluate the feasibility of CT pulmonary angiography for identification of naturally occurring pulmonary thromboembolism in dogs using predefined diagnostic criteria and to assess the ability of echocardiography, cardiac troponins, D-dimers and kaolin-activated thromboelastography to predict the presence of pulmonary thromboembolism in dogs. Methods Twelve dogs with immune-mediated haemolytic anaemia and evidence of respiratory distress were prospectively evaluated. Dogs were sedated immediately before CT pulmonary angiography using intravenous butorphanol. Spiral CT pulmonary angiography was performed with a 16 detector-row CT scanner using a pressure injector to infuse contrast media through peripheral intravenous catheters. Pulmonary thromboembolism was diagnosed using predefined criteria. Contemporaneous tests included echocardiography, arterial blood gas analysis, kaolin-activated thromboelastography, D-dimers and cardiac troponins. Results Based on predefined criteria, four dogs were classified as pulmonary thromboembolism positive, three dogs were suspected to have pulmonary thromboembolism and the remaining five dogs had negative scans. The four dogs identified with pulmonary thromboembolism all had discrete filling defects in main or lobar pulmonary arteries. None of the contemporaneous tests was discriminant for pulmonary thromboembolism diagnosis, although the small sample size was limiting. Clinical Significance CT pulmonary angiography can be successfully performed in dogs under sedation, even in at-risk patients with respiratory distress and can both confirm and rule out pulmonary thromboembolism in dogs. PMID:24521253

  19. Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

    PubMed Central

    Jia, Yali; Wei, Eric; Wang, Xiaogang; Zhang, Xinbo; Morrison, John C.; Parikh, Mansi; Lombardi, Lori H.; Gattey, Devin M.; Armour, Rebecca L.; Edmunds, Beth; Kraus, Martin F.; Fujimoto, James G.; Huang, David

    2014-01-01

    Purpose To compare optic disc perfusion between normal and glaucoma subjects using optical coherence tomography (OCT) angiography and detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 glaucoma patients were included. Methods One eye of each subject was scanned by a high-speed 1050 nm wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography algorithm (SSADA) was used to compute three-dimensional optic disc angiography. A disc flow index was computed from four registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc ratios. Wide field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measurements Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations between disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in glaucoma subjects. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV respectively. The disc flow index was reduced by 25% in the glaucoma group (p = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, p = 0.001). These correlations were significant even after accounting for age, cup/disc area ratio, NFL, and rim area. Conclusions OCT angiography, generated by the new SSADA algorithm, repeatably measures optic disc perfusion. OCT

  20. Optical Coherence Tomography Angiography of Chorioretinal Diseases.

    PubMed

    Novais, Eduardo A; Roisman, Luiz; de Oliveira, Paulo Ricardo Chaves; Louzada, Ricardo N; Cole, Emily D; Lane, Mark; Filho, Marco Bonini; Romano, André; de Oliveira Dias, João Rafael; Regatieri, Caio V; Chow, David; Belfort, Rubens; Rosenfeld, Philip; Waheed, Nadia K; Ferrara, Daniela; Duker, Jay S

    2016-09-01

    Fluorescein angiography (FA) and indocyanine green angiography (ICGA) have been the gold standard for the evaluation of retinal and choroidal vasculature in the last three decades and have revolutionized the diagnosis of retinal and choroidal vascular diseases. The advantage of these imaging modalities lies in their ability to document retinal and choroidal vasculature through the dynamic assessment of contrast transit over time in the intravascular and extravascular spaces. However, disadvantages include the absence of depth resolution, blurring of details by contrast leakage, and the inability to selectively evaluate different levels of the retinal and choroidal microvasculature. In addition, these angiographic methods require intravenous dye, which may cause adverse reactions such as nausea, vomiting, and rarely, anaphylaxis. Optical coherence tomography angiography (OCTA) is a noninvasive imaging technique that, in contrast to dye-based angiography, is faster and depth-resolved, allowing in some cases for more precise evaluation of the vascular plexuses of the retina and choroid. The method has been demonstrated in the assessment of various vascular diseases such as venous occlusions, diabetic retinopathy, macular neovascularization, and others. Limitations of this imaging modality include a small registered field of view and the inability to visualize leakage and dye transit over time. It is also subject to a variety of artifacts, including those generated by blinking and eye movement during image acquisition. However, more than an alternative for FA and ICGA, OCTA is bringing new insights to our understanding of retinal and choroidal vascular structure and is changing fundamental paradigms in the clinical management of pathologic conditions. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:848-861.]. PMID:27631482

  1. Diagnostic Value of Prospective Electrocardiogram-triggered Dual-source Computed Tomography Angiography for Infants and Children with Interrupted Aortic Arch

    PubMed Central

    Li, Hai-Ou; Wang, Xi-Ming; Nie, Pei; Ji, Xiao-Peng; Cheng, Zhao-Ping; Chen, Jiu-Hong; Xu, Zhuo-Dong

    2015-01-01

    Background: Accurate assessment of intra- as well as extra-cardiac malformations and radiation dosage concerns are especially crucial to infants and children with interrupted aortic arch (IAA). The purpose of this study is to investigate the value of prospective electrocardiogram (ECG)-triggered dual-source computed tomography (DSCT) angiography with low-dosage techniques in the diagnosis of IAA. Methods: Thirteen patients with suspected IAA underwent prospective ECG-triggered DSCT scan and transthoracic echocardiography (TTE). Surgery was performed on all the patients. A five-point scale was used to assess image quality. The diagnostic accuracy of DSCT angiography and TTE was compared with the surgical findings as the reference standard. A nonparametric Chi-square test was used for comparative analysis. P <0.05 was considered as a significant difference. The mean effective radiation dose (ED) was calculated. Results: Diagnostic DSCT images were obtained for all the patients. Thirteen IAA cases with 60 separate cardiovascular anomalies were confirmed by surgical findings. The diagnostic accuracy of TTE and DSCT for total cardiovascular malformations was 93.7% and 97.9% (P > 0.05), and that for extra-cardiac vascular malformations was 92.3% and 99.0% (P < 0.05), respectively. The mean score of image quality was 3.77 ± 0.83. The mean ED was 0.30 ± 0.04 mSv (range from 0.23 mSv to 0.39 mSv). Conclusions: In infants and children with IAA, prospective ECG-triggered DSCT with low radiation exposure and high diagnostic efficiency has higher accuracy compared to TTE in detection of extra-cardiac vascular anomalies. PMID:25947401

  2. Structural and functional changes relevant to maxillary arterial flow observed during computed tomography and nonselective digital subtraction angiography in cats with the mouth closed and opened.

    PubMed

    Scrivani, Peter V; Martin-Flores, Manuel; van Hatten, Ruth; Bezuidenhout, Abraham J

    2014-01-01

    Some cats develop blindness during procedures with mouth gags, which possibly relates to maxillary arterial occlusion by opening the mouth. Our first aim was to use computed tomography (CT) to describe how vascular compression is possible based on morphologic differences between mouth positions. Our second aim was to use nonselective digital subtraction angiography to assess whether opening the mouth induces collateral circulation. Six healthy cats were examined. During CT, the maxillary artery coursed between the angular process of the mandible and the rostrolateral wall of the tympanic bulla. The median distance between these structures was shorter when the mouth was opened (left, 4.3 mm; right, 3.6 mm) vs. closed (left, 6.9 mm; right, 7.1 mm). Additionally, the distance was shorter on the side ipsilateral to the gag (P = 0.03). During nonselective angiography, with the mouth closed, there was strong sequential opacification of the external carotid arteries, maxillary arteries, maxillary retia mirabilia, cerebral arterial circle, and basilar artery. Additionally, there was uniform opacification of the cerebrum and cerebellum. With the mouth opened, opacification of the maxillary arteries (rostral to the angular processes) was reduced in all cats, the cerebral arterial circle and basilar artery had simultaneous opacification in four of six (67%) cats, and the cerebrum had reduced opacification compared to the cerebellum in four of six (67%). In conclusion, the maxillary arteries are situated such that they can be compressed when opening the mouth. Opening the mouth did not consistently induce collateral circulation sufficient to produce comparable cerebral opacification as when the mouth was closed.

  3. Visceral adipose tissue influences on coronary artery calcification at young and middle-age groups using computed tomography angiography

    PubMed Central

    Abazid, Rami M.; Kattea, M. Obadah; Sayed, Sawsan; Saqqah, Hanaa; Qintar, Mohammed; Smettei, Osama A.

    2015-01-01

    Purpose: The purpose of the study was to evaluate the impact of excessive visceral adipose tissue (VAT) on subclinical coronary atherosclerosis and coronary artery calcifications (CAC) in young and middle-age groups using multislice computed tomography. Methods: This study is a single center, cross-sectional study. Eligible patients (n = 159), who under the age of 61 years, with chest pain and mild to moderate probability to have coronary artery disease (CAD) were enrolled. Coronary calcium score and epicardial adipose tissue (EAT) were measured at the level of the left main coronary artery while VAT was measured at the level of the iliac crest. Results: The average age was (48 ± 8 years). The mean VAT was (38 ± 21 cm2) with no significant difference between men and women (38 ± 22 vs. 37 ± 19 P = 0.8) respectively. Student's t-test analysis showed significantly higher VAT in patients with detectable CAC than patients with no CAC (48 ± 24 vs. 33 ± 18 P = 0.00002), respectively. Univariate regression analysis showed that VAT and EAT, are strong predictor for CAC (hazard ratio [HR] 1.034, 95% confidence interval [CI: 1.016–1.052]. P <0.001 and [HR] 1.344, 95% CI: [1.129–1.601] P = 0.001), respectively. Conclusion: Excessive VAT is significantly associated with positive CAC. VAT can strongly predict subclinical CAD in individuals at young and middle-age groups. PMID:26229760

  4. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography*

    PubMed Central

    Araujo Neto, Severino Aires; Franca, Henrique Almeida; de Mello Júnior, Carlos Fernando; Silva Neto, Eulâmpio José; Negromonte, Gustavo Ramalho Pessoa; Duarte, Cláudia Martina Araújo; Cavalcanti Neto, Bartolomeu Fragoso; Farias, Rebeca Danielly da Fonseca

    2015-01-01

    Objective To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials and Methods Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS. PMID:26811552

  5. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    SciTech Connect

    Girinsky, Theodore; M’Kacher, Radhia; Koscielny, Serge; Elfassy, Eric; Raoux, François; Carde, Patrice; Santos, Marcos Dos; Margainaud, Jean-Pierre; Sabatier, Laure; Paul, Jean-François

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  6. Effect of diltiazem on myocardial infarct size estimated by enzyme release, serial thallium-201 single-photon emission computed tomography and radionuclide angiography

    SciTech Connect

    Zannad, F.; Amor, M.; Karcher, G.; Maurin, P.; Ethevenot, G.; Sebag, C.; Bertrand, A.; Pernot, C.; Gilgenkrantz, J.M.

    1988-06-01

    Diltiazem is a calcium antagonist with demonstrated experimental cardioprotective effects. Its effects on myocardial infarct size were studied in 34 patients admitted within 6 hours after the first symptoms of acute myocardial infarction. These patients were randomized, double-blind to placebo or diltiazem (10-mg intravenous bolus followed by 15 mg/hr intravenous infusion during 72 hours, followed by 4 X 60 mg during 21 days). Myocardial infarct size was assessed by plasma creatine kinase and creatine kinase-MB indexes, perfusion defect scores using single-photon emission computed tomography with thallium-201 and left ventricular ejection fraction measured by radionuclide angiography. Tomographic and angiographic scanning was performed serially before randomization, after 48 hours and 21 days later. Groups were comparable in terms of age, sex, inclusion time and baseline infarct location and size. Results showed no difference in creatine kinase and creatine kinase-MB data between controls and treated patients, a significant decrease in the perfusion defect scores in the diltiazem group (+0.1 +/- 3.0 placebo vs -2.2 +/- 1.9 diltiazem, p less than 0.02) and a better ejection fraction recovery in the diltiazem group (-4.2 +/- 7.4 placebo vs +7.7 +/- 11.2 diltiazem, p less than 0.05). Myocardial infarct size estimates from perfusion defect scores and enzyme data were closely correlated. These preliminary results suggest that diltiazem may reduce ischemic injury in acute myocardial infarction.

  7. Enhanced characterization of calcified areas in intravascular ultrasound virtual histology images by quantification of the acoustic shadow: validation against computed tomography coronary angiography.

    PubMed

    Broersen, Alexander; de Graaf, Michiel A; Eggermont, Jeroen; Wolterbeek, Ron; Kitslaar, Pieter H; Dijkstra, Jouke; Bax, Jeroen J; Reiber, Johan H C; Scholte, Arthur J

    2016-04-01

    We enhance intravascular ultrasound virtual histology (VH) tissue characterization by fully automatic quantification of the acoustic shadow behind calcified plaque. VH is unable to characterize atherosclerosis located behind calcifications. In this study, the quantified acoustic shadows are considered calcified to approximate the real dense calcium (DC) plaque volume. In total, 57 patients with 108 coronary lesions were included. A novel post-processing step is applied on the VH images to quantify the acoustic shadow and enhance the VH results. The VH and enhanced VH results are compared to quantitative computed tomography angiography (QTA) plaque characterization as reference standard. The correlation of the plaque types between enhanced VH and QTA differs significantly from the correlation with unenhanced VH. For DC, the correlation improved from 0.733 to 0.818. Instead of an underestimation of DC in VH with a bias of 8.5 mm(3), there was a smaller overestimation of 1.1 mm(3) in the enhanced VH. Although tissue characterization within the acoustic shadow in VH is difficult, the novel algorithm improved the DC tissue characterization. This algorithm contributes to accurate assessment of calcium on VH and could be applied in clinical studies.

  8. Enhanced characterization of calcified areas in intravascular ultrasound virtual histology images by quantification of the acoustic shadow: validation against computed tomography coronary angiography.

    PubMed

    Broersen, Alexander; de Graaf, Michiel A; Eggermont, Jeroen; Wolterbeek, Ron; Kitslaar, Pieter H; Dijkstra, Jouke; Bax, Jeroen J; Reiber, Johan H C; Scholte, Arthur J

    2016-04-01

    We enhance intravascular ultrasound virtual histology (VH) tissue characterization by fully automatic quantification of the acoustic shadow behind calcified plaque. VH is unable to characterize atherosclerosis located behind calcifications. In this study, the quantified acoustic shadows are considered calcified to approximate the real dense calcium (DC) plaque volume. In total, 57 patients with 108 coronary lesions were included. A novel post-processing step is applied on the VH images to quantify the acoustic shadow and enhance the VH results. The VH and enhanced VH results are compared to quantitative computed tomography angiography (QTA) plaque characterization as reference standard. The correlation of the plaque types between enhanced VH and QTA differs significantly from the correlation with unenhanced VH. For DC, the correlation improved from 0.733 to 0.818. Instead of an underestimation of DC in VH with a bias of 8.5 mm(3), there was a smaller overestimation of 1.1 mm(3) in the enhanced VH. Although tissue characterization within the acoustic shadow in VH is difficult, the novel algorithm improved the DC tissue characterization. This algorithm contributes to accurate assessment of calcium on VH and could be applied in clinical studies. PMID:26667446

  9. [A pilot study of contrast medium dose reduction using low tube voltage and iterative reconstruction: computed tomography angiography of the head].

    PubMed

    Ihara, Riku; Itou, Kouhei; Terashita, Takayoshi; Fuse, Yoshihiro

    2015-03-01

    This study aimed to reduce contrast medium dose without reducing the diagnostic capability of computed tomography (CT) angiography of the head. We evaluated the advanced statistical iterative reconstruction (ASiR) settings to adjust to low tube voltage CT. A syringe phantom was constructed using dilute contrast medium and was imaged at tube voltages of 80-120 kV. The iodine volumes, CT values, and image noise were measured in these images. The noise-power spectrum and modulation transfer function were measured from quality assurance phantom images that had been obtained using the tube voltage selected after considering the image noise results as described above and reconstructed using different ASiR rate settings and convolution kernels. Our results suggested that imaging at 100 kV could reduce the contrast medium dose by 14%, compared with imaging at 120 kV, and that the resulting image quality could equal that of conventional imaging by performing reconstruction at a 40% ASiR rate and detail kernel.

  10. Tissue microscopic changes and artifacts in multi-phase post-mortem computed tomography angiography in a hospital setting: a fatal case of systemic vasculitis.

    PubMed

    Capuani, Caroline; Guilbeau-Frugier, Céline; Mokrane, Fatima-Zohra; Delisle, Marie-Bernadette; Marcheix, Bertrand; Rousseau, Hervé; Telmon, Norbert; Rougé, Daniel; Dedouit, Fabrice

    2014-09-01

    A 27-year-old man suddenly died in hospital of acute respiratory distress syndrome secondary to severe systemic vasculitis. Multi-phase post-mortem computed tomography angiography followed by scientific autopsy of the thoracic and abdominal cavity and histology was performed, illustrating the advantages and drawbacks of such techniques. Imaging enabled us to examine the cranium, as the family refused cerebral dissection. MPMCTA revealed absence of opacification of the left middle cerebral artery. But parenchymal findings of thoracic and abdominal organs were still difficult to interpret after both imaging and macroscopic examination during the autopsy. Microscopic examination provided the definitive diagnosis of cause of death. Analysis revealed systemic vasculitis of the lung complicated by diffuse alveolar, mediastinal, splenic and retroperitoneal lesions. We were unable to determine the type of vasculitis, whether polyarteritis nodosa or microscopic polyangiitis, because of artifactual glomerular collapse. We observed some structural changes in tissue secondary to contrast agent injection, affecting the vascular system and renal parenchyma in particular. Such artifacts must be known in order to avoid misinterpreting them as pathological findings. MPMCTA and conventional autopsy are two complementary techniques showing both their specific advantages and limits which have to be known in order to choose the appropriate technique. One limit of both techniques is the detection of microscopic findings which can only be obtained by additional histological examination. This case report underlines this fact and demonstrates that caution is required in some cases if microscopic analyses are carried out after contrast agent injection.

  11. An unusual homicidal stab wound of the cervical spinal cord: A single case examined by post-mortem computed tomography angiography (PMCTA).

    PubMed

    Savall, Frederic; Dedouit, Fabrice; Mokrane, Fatima-Zohra; Rougé, Daniel; Saint-Martin, Pauline; Telmon, Norbert

    2015-09-01

    We report an unusual case of homicidal stab wound of the cervical spinal cord, which illustrates the value of post-mortem computed tomography angiography (PMCTA) in cases of vascular injury. First, we noted a posterior and horizontal trajectory to the neck with complete section of the cervical spinal cord between the first and second cervical vertebrae. This lesion was accompanied by section of the right vertebral and right deep cervical arteries. We also noted an anterior cervical trajectory with an injury to the right internal jugular vein and an anterior right chest wound with a lung trajectory and section of the internal mammary vessels. Cases of spinal cord injuries secondary to stab wounds are rare in the literature. Only one large series has been published from Cape Town. Complete section of the cervical spinal cord accounts for only 4.5% of all cases. Furthermore, lethal cases are rare and classically victims survive and present neurological sequelae. We found only one similar case but despite the transection of the cervical spinal cord the patient survived. Some studies suggest that PMCTA may be very helpful in visualizing vascular system injuries. Our observations are consistent with this proposal. The use of different-time acquisitions was essential for detection of the injured vessels.

  12. Lumican as a novel potential clinical indicator for acute aortic dissection: A comparative study, based on multi-slice computed tomography angiography

    PubMed Central

    GU, GUORONG; WAN, FANG; XUE, YUAN; CHENG, WEIZHONG; ZHENG, HAIYIN; ZHAO, YUN; FAN, FAN; HAN, YI; TONG, CHAOYANG; YAO, CHENLING

    2016-01-01

    The aim of the present study was to investigate the association between serum lumican levels and acute aortic dissection (AAD) severity. A total of 82 patients with chest or back pain and 30 healthy volunteers were recruited. Among the patients, there were 70 cases of AAD and 12 cases of intramural hematoma (IMH). AAD severity was determined using multi-slice computed tomography angiography (MSCTA). Serum was collected from the patients upon admission, and lumican levels were detected using an enzyme-linked immunosorbent assay. In addition, correlation analyses were conducted between lumican levels and AAD severity by designing a ‘SCORE X, RANGE Y’ system to measure the number of affected vital arteries and vertical range of false lumen, based on the MSCTA. Lumican levels differed significantly among the AAD patients (2.32±4.29 ng/ml), IMH patients (0.72±0.32 ng/ml) and healthy volunteers (0.85±0.53 ng/ml; P=0.003). In the AAD patients presenting within 12–72 h of symptom onset, the Spearman's rho correlation coefficient between lumican and SCORE or RANGE was 0.373 (P=0.046) and 0.468 (P=0.010), respectively. The present results suggest that lumican may be a potential marker for aiding the diagnosis and screening for AAD, and may be used to predict the severity of AAD. PMID:26998013

  13. Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis

    PubMed Central

    Wu, Wen; Pan, Dao-Rong; Foin, Nicolas; Pang, Si; Ye, Peng; Holm, Niels; Ren, Xiao-Min; Luo, Jie; Nanjundappa, Aravinda; Chen, Shao-Liang

    2016-01-01

    Detection of coronary ischemic lesions by fractional flow reserve (FFR) has been established as the gold standard. In recent years, novel computer based methods have emerged and they can provide simulation of FFR using coronary artery images acquired from coronary computed tomography angiography (FFRCT). This meta-analysis aimed to evaluate diagnostic performance of FFRCT using FFR as the reference standard. Databases of PubMed, Cochrane Library, EMBASE, Medion and Web of Science were searched. Seven studies met the inclusion criteria, including 833 stable patients (1377 vessels or lesions) with suspected or known coronary artery disease (CAD). The patient-based analysis showed pooled estimates of sensitivity, specificity and diagnostic odds ratio (DOR) for detection of ischemic lesions were 0.89 [95%confidence interval (CI), 0.85–0.93], 0.76 (95%CI, 0.64–0.84) and 26.21 (95%CI, 13.14–52.28). At a per-vessel or per-lesion level, the pooled estimates were as follows: sensitivity 0.84 (95%CI, 0.80–0.87), specificity 0.76 (95%CI, 0.67–0.83) and DOR 16.87 (95%CI, 9.41–30.25). Area under summary receiver operating curves was 0.90 (95%CI, 0.87–0.92) and 0.86 (95%CI, 0.83–0.89) at the two analysis levels, respectively. In conclusion, FFRCT technology achieves a moderate diagnostic performance for noninvasive identification of ischemic lesions in stable patients with suspected or known CAD in comparison to invasive FFR measurement. PMID:27377422

  14. Noninvasive fractional flow reserve derived from coronary computed tomography angiography for identification of ischemic lesions: a systematic review and meta-analysis.

    PubMed

    Wu, Wen; Pan, Dao-Rong; Foin, Nicolas; Pang, Si; Ye, Peng; Holm, Niels; Ren, Xiao-Min; Luo, Jie; Nanjundappa, Aravinda; Chen, Shao-Liang

    2016-01-01

    Detection of coronary ischemic lesions by fractional flow reserve (FFR) has been established as the gold standard. In recent years, novel computer based methods have emerged and they can provide simulation of FFR using coronary artery images acquired from coronary computed tomography angiography (FFRCT). This meta-analysis aimed to evaluate diagnostic performance of FFRCT using FFR as the reference standard. Databases of PubMed, Cochrane Library, EMBASE, Medion and Web of Science were searched. Seven studies met the inclusion criteria, including 833 stable patients (1377 vessels or lesions) with suspected or known coronary artery disease (CAD). The patient-based analysis showed pooled estimates of sensitivity, specificity and diagnostic odds ratio (DOR) for detection of ischemic lesions were 0.89 [95%confidence interval (CI), 0.85-0.93], 0.76 (95%CI, 0.64-0.84) and 26.21 (95%CI, 13.14-52.28). At a per-vessel or per-lesion level, the pooled estimates were as follows: sensitivity 0.84 (95%CI, 0.80-0.87), specificity 0.76 (95%CI, 0.67-0.83) and DOR 16.87 (95%CI, 9.41-30.25). Area under summary receiver operating curves was 0.90 (95%CI, 0.87-0.92) and 0.86 (95%CI, 0.83-0.89) at the two analysis levels, respectively. In conclusion, FFRCT technology achieves a moderate diagnostic performance for noninvasive identification of ischemic lesions in stable patients with suspected or known CAD in comparison to invasive FFR measurement. PMID:27377422

  15. Important advances in technology and unique applications to cardiovascular computed tomography.

    PubMed

    Chaikriangkrai, Kongkiat; Choi, Su Yeon; Nabi, Faisal; Chang, Su Min

    2014-01-01

    For the past decade, multidetector cardiac computed tomography and its main application, coronary computed tomography angiography, have been established as a noninvasive technique for anatomical assessment of coronary arteries. This new era of coronary artery evaluation by coronary computed tomography angiography has arisen from the rapid advancement in computed tomography technology, which has led to massive diagnostic and prognostic clinical studies in various patient populations. This article gives a brief overview of current multidetector cardiac computed tomography systems, developing cardiac computed tomography technologies in both hardware and software fields, innovative radiation exposure reduction measures, multidetector cardiac computed tomography functional studies, and their newer clinical applications beyond coronary computed tomography angiography. PMID:25574342

  16. Optical Coherence Tomography Angiography in Choroideremia

    PubMed Central

    Jain, Nieraj; Jia, Yali; Gao, Simon S.; Zhang, Xinbo; Weleber, Richard G.; Huang, David; Pennesi, Mark E.

    2016-01-01

    Importance Novel therapies for choroideremia, an X-linked recessive chorioretinal degeneration, demand a better understanding of the primary site(s) of cellular degeneration. Optical coherence tomography angiography allows for choriocapillaris (CC) imaging. We compared the extent of structural alterations of the CC, retinal pigment epithelium, and photoreceptors with multimodal imaging. Observations In a clinical case series conducted from September 15,2014, through February 5,2015,14 eyes of 7 male patients with choroideremia (median age, 34 years [interquartile range, 15-46 years]; age range, 13-48 years), 4 eyes of 2 women with choroideremia carrier state (both in mid-50s), and 6 eyes of 6 controls (median age, 42.5 years [interquartile range, 33-55 years]; age range, 24-55 years) underwent multimodal imaging with optical coherence tomography angiography and electroretinography. The mean (SD) macular CC density was 82.9% (13.4%) in patients with choroideremia, 93.0% (3.8%) in female carriers, and 98.2% (1.3%) in controls. The mean (SD) CC density in affected eyes was higher in regions with preserved (92.6% [5.8%]) vs absent (75.9% [12.6%]) ellipsoid zone (mean difference. 16.7%; 95% CI, 12.1% to 21.3%; P < .001). Seventeen of 18 eyes of the patients and carriers had outer retinal tubulations forming pseudopod-like extensions from islands of preserved ellipsoid zone. Outer retinal tubulations were associated with absence of underlying retinal pigment epithelium and were longer (r = −0.62; 95% CI, −0.84 to −0.19; P < .001) and more numerous (r = −0.71; 95% CI, −0.91 to −0.27; P < .001) in more severely affected eyes. Conclusions and Relevance These findings suggest that regional changes in CC density correlate with photoreceptor structural alterations in choroideremia. Although closely coupled, the results suggest that retinal pigment epithelium loss is more extensive than photoreceptor loss. PMID:27149258

  17. Significance of noncalcified coronary plaque in asymptomatic subjects with low coronary artery calcium score: assessment with coronary computed tomography angiography.

    PubMed

    Yoo, Dong Hyun; Chun, Eun Ju; Choi, Sang Il; Kim, Jeong A; Jin, Kwang Nam; Yeon, Tae-Jin; Choi, Dong-Ju

    2011-12-01

    We aimed to investigate the prevalence and severity of noncalcified coronary plaques (NCP) using coronary CT angiography (CCTA) and analyze predictors of significant coronary stenosis by NCP in asymptomatic subjects with low coronary artery calcium score (CACS). The institutional review board approved this retrospective study and all patients gave written, informed consent. The presence of plaque, severity of stenosis, plaque characteristics, and CACS were assessed in 7,515 asymptomatic subjects. We evaluated the prevalence and severity of NCP in subjects having low CACS (707 subjects; men with CACS from 1 to 50 and women from 1 to 10) in comparison to those having 0 CACS (6,040 subjects) as the reference standard. Conventional risk factors were assessed for predictors of NCP and significant stenosis by NCP. We also investigated the cardiac events of the patients through medical records. Compared to subjects with 0 CACS, those with low CACS showed higher prevalence of NCP (6.9% vs. 31.5%, P < 0.001) and significant stenosis caused by NCP (0.8% vs. 7.5%, P < 0.001). In the low CACS group, independent predictors for significant NCP included diabetes mellitus (DM), hypertension, and elevated low-density lipoprotein (LDL)-cholesterol (all P < 0.05). However, 47.2% of subjects with significant NCP were classified into the low to intermediate risk according to Framingham Risk Score. At the median follow up of 42 months (range: 3-60 months), cardiac events were significantly higher in the low CACS group compared to the 0 CACS group (2.6% vs. 0.27%, P < 0.001). In asymptomatic subjects having low CACS, the prevalence and severity of NCP were higher as compared to subjects having zero CACS and predictors of significant stenosis by NCP were DM, hypertension and LDL-Cholesterol. Therefore, CCTA may be useful for risk stratification of coronary artery disease as added value over CACS in selected populations with low CACS who have predictors of significant NCP.

  18. Effect of heart rate on the diagnostic accuracy of 256-slice computed tomography angiography in the detection of coronary artery stenosis: ROC curve analysis

    PubMed Central

    WANG, GANG; WU, YIFEN; ZHANG, ZHENTAO; ZHENG, XIAOLIN; ZHANG, YULAN; LIANG, MANQIU; YUAN, HUANCHU; SHEN, HAIPING; LI, DEWEI

    2016-01-01

    The aim of the present study was to investigate the effect of heart rate (HR) on the diagnostic accuracy of 256-slice computed tomography angiography (CTA) in the detection of coronary artery stenosis. Coronary imaging was performed using a Philips 256-slice spiral CT, and receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic value of 256-slice CTA in coronary artery stenosis. The HR of the research subjects in the study was within a certain range (39–107 bpm). One hundred patients suspected of coronary heart disease underwent 256-slice CTA examination. The cases were divided into three groups: Low HR (HR <75 bpm), moderate HR (75≤ HR <90 bpm) and high HR (HR ≥90 bpm). For the three groups, two observers independently assessed the image quality for all coronary segments on a four-point ordinal scale. An image quality of grades 1–3 was considered diagnostic, while grade 4 was non-diagnostic. A total of 97.76% of the images were diagnostic in the low-HR group, 96.86% in the moderate-HR group and 95.80% in the high-HR group. According to the ROC curve analysis, the specificity of CTA in diagnosing coronary artery stenosis was 98.40, 96.00 and 97.60% in the low-, moderate- and high-HR groups, respectively. In conclusion, 256-slice coronary CTA can be used to clearly show the main segments of the coronary artery and to effectively diagnose coronary artery stenosis. Within the range of HRs investigated, HR was found to have no significant effect on the diagnostic accuracy of 256-slice coronary CTA for coronary artery stenosis. PMID:27168831

  19. Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study

    PubMed Central

    Gitsioudis, Gitsios; Schmahl, Christina; Missiou, Anna; Voss, Andreas; Schüssler, Alena; Abdel-Aty, Hassan; Buss, Sebastian J.; Mueller, Dirk; Vembar, Mani; Bryant, Mark; Kauczor, Hans-Ulrich; Giannitsis, Evangelos; Katus, Hugo A.; Korosoglou, Grigorios

    2016-01-01

    Objectives We sought to investigate the association of epicardial adipose tissue (eCAT) volume with plaque burden, circulating biomarkers and cardiac outcomes in patients with intermediate risk for coronary artery disease (CAD). Methods and Results 177 consecutive outpatients at intermediate risk for CAD and completed biomarker analysis including high-sensitive Troponin T (hs-TnT) and hs-CRP underwent 256-slice cardiac computed tomography angiography (CCTA) between June 2008 and October 2011. Patients with lumen narrowing ≥50% exhibited significantly higher eCAT volume than patients without any CAD or lumen narrowing <50% (median (interquartile range, IQR): 108 (73–167) cm3 vs. 119 (82–196) cm3, p = 0.04). Multivariate regression analysis demonstrated an independent association eCAT volume with plaque burden by number of lesions (R2 = 0.22, rpartial = 0.29, p = 0.026) and CAD severity by lumen narrowing (R2 = 0.22, rpartial = 0.23, p = 0.038) after adjustment for age, diabetes mellitus, hyperlidipemia, body-mass-index (BMI), hs-CRP and hs-TnT. Univariate Cox proportional hazards regression analysis identified a significant association for both increased eCAT volume and maximal lumen narrowing with all cardiac events. Multivariate Cox proportional hazards regression analysis revealed an independent association of increased eCAT volume with all cardiac events after adjustment for age, >3 risk factors, presence of CAD, hs-CRP and hs-TnT. Conclusion Epicardial adipose tissue volume is independently associated with plaque burden and maximum luminal narrowing by CCTA and may serve as an independent predictor for cardiac outcomes in patients at intermediate risk for CAD. PMID:27187590

  20. Study on the anatomy of the lumbosacral anterior great vessels pertinent to L5/S1 anterior interbody surgery with computer tomography angiography.

    PubMed

    Liu, Liehua; Liang, Yong; Zhou, Qiang; Zhang, Hong; Wang, Haoming; Li, Songtao; Zhao, Chen; Hou, Tianyong; Liu, Ling

    2014-12-01

    We investigate the anatomy of the lumbosacral anterior great vessels using computer tomography (CT) angiography before L5/S1 anterior interbody surgery. Sixty-two adult patients were selected. The location of the abdominal aortic bifurcation and common iliac venous confluence in the lumbar vertebrae and the anatomic parameters of the iliac vascular space (e.g., distances from the included angle vertex of the iliac vascular space to the median sagittal plane and to the inferior boundary of L5 and distances between the left and right iliac vessels on the inferior boundary of L5 and on the superior boundary of S1) were analysed. Overall, 67.73% of the 62 cases had an abdominal aortic bifurcation located at L4 and L4/5 intervertebral disc; 61.29%, the common iliac venous confluence located at L5. The four distances mentioned above were 0.98 cm ± 0.38 cm, 2.01 cm ± 1.26 cm, 3.11 cm ± 1.35 cm and 4.34 cm ± 1.10 cm, respectively. A classification system of types A, B and C was developed. The calculated L5/S1 intervertebral space exposure percentages of types A, B and C were 32.21%, 82.58% and 54.68%, respectively. During L5/S1 anterior interbody surgery, type B intervertebral discs can be exposed conveniently, preventing injury of the iliac vessels, which was also observed in 54.68% and 32.21% of the type C and type A discs, respectively. Because the type A intervertebral disc has minimal exposure, the risk of iliac vascular injury is relatively high in these patients.

  1. Effectiveness of Integrating Delayed Computed Tomography Angiography Imaging for Left Atrial Appendage Thrombus Exclusion into the Care of Patients Undergoing Ablation of Atrial Fibrillation

    PubMed Central

    Bilchick, Kenneth C.; Mealor, Augustus; Gonzalez, Jorge; Norton, Patrick; Zhuo, David; Mason, Pamela; Ferguson, John D.; Malhotra, Rohit; Mangrum, J. Michael; Darby, Andrew E.; DiMarco, John; Hagspiel, Klaus; Dent, John; Kramer, Christopher M.; Stukenborg, George J.; Salerno, Michael

    2015-01-01

    Background Computed tomography angiography (CTA) can identify and rule out left atrial appendage (LAA) thrombus when delayed imaging is also performed. Objective In patients referred for CTA for pulmonary vein anatomy prior to ablation of atrial fibrillation or atypical left atrial flutter (AF), we sought to determine the effectiveness of a novel clinical protocol for integrating results of CTA delayed imaging of the LAA into pre-procedure care. Methods After making delayed imaging of the LAA part of our routine pre-ablation CTA protocol, we integrated early reporting of pre-ablation CTA LAA imaging results into clinical practice as part of a formal protocol in June 2013. We then analyzed the effectiveness of this protocol by evaluating 320 AF ablation patients with CTA imaging during 2012–2014. Results Among CTA patients with delayed LAA imaging, the sensitivity and negative predictive values for LAA thrombus with intracardiac echocardiography (ICE) or transesophageal echocardiograms (TEEs) as the reference standard were both 100%. ICE during ablation confirmed absence of thrombus in patients with a negative CTA or negative TEE. No patients with either a negative CTA or an equivocal CTA combined with a negative TEE had strokes or transient ischemic attacks. Overall, the need for TEEs decreased from 57.5% to 24.0% during the 3-year period as a result of the CTA protocol. Conclusions Clinical integration of CTA with delayed LAA imaging into the care of patients having catheter ablation of AF is feasible, safe, and effective. Such a protocol could be applied broadly to improve patient care. PMID:26341605

  2. Diagnostic performance of coronary computed tomography angiography versus exercise electrocardiography for coronary artery disease: a systematic review and meta-analysis

    PubMed Central

    Yin, Xinxin; Zheng, Wen; Ma, Jingjing; Hao, Panpan

    2016-01-01

    Background Both coronary computed tomography angiography (CCTA) and exercise electrocardiography (ExECG) are non-invasive testing methods for the evaluation of coronary artery disease (CAD). However, there was controversy on the diagnostic performance of these methods due to the limited data in each single study. Therefore, we performed a meta-analysis to address these issues. Methods We searched PubMed and Embase databases up to May 22, 2015. Two authors identified eligible studies, extracted data and accessed quality. Pooled estimation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver-operating characteristic curve (SROC) and the area under curve (AUC) of CCTA and ExECG for the diagnosis of CAD were calculated using Stata, Meta-Disc and Review Manager statistical software. Results Seven articles were included. Pooled sensitivity of CCTA and ExECG were 0.98 [95% confidence intervals (CIs): 0.95–0.99] and 0.66 (95% CIs: 0.59–0.72); pooled specificity of CCTA and ExECG were 0.84 (95% CIs: 0.81–0.87) and 0.75 (95% CIs: 0.71–0.79); pooled DOR of CCTA and ExECG were 110.24 (95% CIs: 35.07–346.55) and 6.28 (95% CIs: 2.06–19.13); and AUC of CCTA and ExECG were 0.9950±0.0046 and 0.7727±0.0638, respectively. There is no heterogeneity caused by threshold effect in CCTA or ExECG analysis. The Deeks’ test showed no potential publication bias (P=0.17). Conclusions CCTA has better diagnostic performance than ExECG in the evaluation of CAD, which can provide a better solution for the clinical problem of the diagnosis for CAD. PMID:27499958

  3. Sensitivity of 3D Gradient Recalled Echo Susceptibility-Weighted Imaging Technique Compared to Computed Tomography Angiography for Detection of Middle Cerebral Artery Thrombus in Acute Stroke.

    PubMed

    Agarwal, Amit; Vijay, Kanupriya; Thamburaj, Krishnamoorthy; Kanekar, Sangam; Kalapos, Paul

    2014-10-23

    We aimed at comparing the sensitivity of magnetic resonance (MR) susceptibility-weighted imaging (SWI) with computed tomography angiography (CTA) in the detection of middle cerebral artery (MCA) thrombus in acute stroke. Seventy-nine patients with acute MCA stroke was selected using our search engine software; only the ones showing restricted diffusion in the MCA territory on diffusion-weighted images were included. We finally selected 35 patients who had done both MRI (including SWI) and CTA. Twenty random subjects with completely normal MRI (including SWI) exam were selected as control. Two neuroradiologists (blinded to the presence or absence of stroke) reviewed the SW images and then compared the findings with CT angiogram (in patients with stroke). The number of MCA segments showing thrombus in each patient was tabulated to estimate the thrombus burden. Thrombus was detected on SWI in one or more MCA segments in 30 out of 35 patients, on the first review. Of the 30, SWI showed thrombus in more than one MCA segments in 7 patients. CTA depicted branch occlusion in 31 cases. Thrombus was seen on both SWI and CTA in 28 patients. Thrombus was noted in two patients on SWI only, with no corresponding abnormality seen on CTA. Two patients with acute MCA showed no vascular occlusion or thrombus on either CTA or SWI. Only two case of false-positive thrombus was reported in normal control subjects. Susceptibility-weighted images had sensitivity and specificity of 86% and 90% respectively, with positive predictive value 94%. Sensitivity was 86% for SWI, compared with 89% for CTA, and this difference was statistically insignificant (P>0.05). Of all the positive cases on CTA (31) corresponding thrombus was seen on SWI in 90% of subjects (28 of 31). Susceptibility-weighted imaging has high sensitivity for detection of thrombus in acute MCA stroke. Moreover, SWI is a powerful technique for estimation of thrombus burden, which can be challenging on CTA.

  4. Evaluation of clinical bradycardiac effect and respiratory adverse effect of β-blocking agents in coronary computed tomography angiography based on theoretical analysis.

    PubMed

    Fujito, Kaori; Takayanagi, Risa; Kimura, Koji; Yokoyama, Haruko; Yamada, Yasuhiko

    2016-04-01

    β-blocking agents are used for patients with tachycardia to improve the image quality of coronary computed tomography angiography (CCTA). In this study, we analyzed the clinical bradycardiac effects and the adverse respiratory effects of five β-blocking agents (landiolol, esmolol, propranolol, metoprolol and atenolol) used for CCTA. The changes of the occupancy binding to β1 or β2 receptor of these drugs were calculated based on the receptor occupancy theory. Thereafter, we predicted both the rate of heart rate decline (▲HR) as a clinical effect and the rate of decrease in forced expiratory volume in 1 s (▲FEV1) as an adverse effect, by using the ternary complex model. The results showed that the drugs with ▲HR greater than 10 %, necessary for CCTA, were as follows: landiolol at 13.5 %, propranolol at 11.0 %, and atenolol at 22.6 %. The ▲HR values at the end of CCTA for those three drugs were 0.3, 6.7, and 22.9 %, respectively. It is desirable for the bradycardiac effect to disappear at the end of CCTA. Therefore, landiolol is thought to be a preferable drug. On the other hand, ▲FEV1 at start and end of CCTA for those three drugs was 0.04-2.5, 34.9-40.3, and 6.0-6.1 %, respectively. Our results suggested that landiolol has the most appropriate effect and safety for patients with tachycardia who are undergoing a CCTA procedure. PMID:25510848

  5. Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) imaging in the assessment of patients presenting with chest pain suspected for acute coronary syndrome

    PubMed Central

    De Filippo, Massimo; Capasso, Raffaella

    2016-01-01

    Acute chest pain is an important clinical challenge and a major reason for presentation to the emergency department. Although multiple imaging techniques are available to assess patients with suspected acute coronary syndrome (ACS), considerable interest has been focused on the use of non-invasive imaging options as coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR). According to several recent evidences, CCTA has been shown to represent a useful tool to rapidly and accurately diagnose coronary artery disease (CAD) in patients with low to intermediate cardiovascular risk. CCTA examination has the unique ability to non-invasively depict the coronary anatomy, not only allowing visualization of the lumen of the arteries in order to detect severe stenosis or occlusion responsible of myocardial ischemia, but also allows the assessment of coronary artery wall by demonstrating the presence or absence of CAD. However, routine CCTA is not able to differentiate ischemic from non-ischemic chest pain in patients with known CAD and it does not provide any functional assessment of the heart. Conversely, CMR is considered the gold standard in the evaluation of morphology, function, viability and tissue characterization of the heart. CMR offers a wide range of tools for diagnosing myocardial infarction (MI) at least at the same time of the elevation of cardiac troponin values, differentiating infarct tissue and ischemic myocardium from normal myocardium or mimicking conditions, and distinguishing between new and old ischemic events. In high-risk patients, with acute and chronic manifestations of CAD, CMR may be preferable to CCTA, since it would allow detection, differential diagnosis, prognostic evaluation and management of MI. PMID:27500156

  6. When Do We Really Need Coronary Calcium Scoring Prior to Contrast-Enhanced Coronary Computed Tomography Angiography? Analysis by Age, Gender and Coronary Risk Factors

    PubMed Central

    Iwan, Johannes; Voss, Andreas; Atsiatorme, Edem; Hofmann, Nina P.; Buss, Sebastian J.; Siebert, Stefan; Kauczor, Hans-Ulrich; Giannitsis, Evangelos; Katus, Hugo A.; Korosoglou, Grigorios

    2014-01-01

    Aims To investigate the value of coronary calcium scoring (CCS) as a filter scan prior to coronary computed tomography angiography (CCTA). Methods and Results Between February 2008 and April 2011, 732 consecutive patients underwent clinically indicated CCTA. During this ‘control phase’, CCS was performed in all patients. In patients with CCS≥800, CCTA was not performed. During a subsequent ‘CCTA phase’ (May 2011–May 2012) another 200 consecutive patients underwent CCTA, and CCS was performed only in patients with increased probability for severe calcification according to age, gender and atherogenic risk factors. In patients where CCS was not performed, calcium scoring was performed in contrast-enhanced CCTA images. Significant associations were noted between CCS and age (r = 0.30, p<0.001) and coronary risk factors (χ2 = 37.9; HR = 2.2; 95%CI = 1.7–2.9, p<0.001). Based on these associations, a ≤3% pre-test probability for CCS≥800 was observed for males <61 yrs. and females <79 yrs. According to these criteria, CCS was not performed in 106 of 200 (53%) patients during the ‘CCTA phase’, including 47 (42%) males and 59 (67%) females. This resulted in absolute radiation saving of ∼1 mSv in 75% of patients younger than 60 yrs. Of 106 patients where CCS was not performed, estimated calcium scoring was indeed <800 in 101 (95%) cases. Non-diagnostic image quality due to calcification was similar between the ‘control phase’ and the ‘CCTA’ group (0.25% versus 0.40%, p = NS). Conclusion The value of CCS as a filter for identification of a high calcium score is limited in younger patients with intermediate risk profile. Omitting CCS in such patients can contribute to further dose reduction with cardiac CT studies. PMID:24714677

  7. [Computer tomography in acute pyelonephritis].

    PubMed

    Triller, J; Scheidegger, J; Terrier, F

    1983-07-01

    Computer tomography of the kidneys was performed on 30 patients with acute renal infections (acute suppurative pyelonephritis, acute renal abscess, infected cyst, pyelonephrosis, calculus perforation, retroperitoneal abscess). Computer tomography provided more accurate information concerning the extent of the renal and extra-renal inflammatory process than did the urogram or sonogram. This may significantly affect the choice of treatment, particularly concerning the use of drugs or of surgery. Angiography and retrograde pyelography may be used in selected cases, especially where there is a suspicion of acute bacterial nephritis, renal vein thrombosis or ureteric obstruction.

  8. A method for semi-automatic segmentation and evaluation of intracranial aneurysms in bone-subtraction computed tomography angiography (BSCTA) images

    NASA Astrophysics Data System (ADS)

    Krämer, Susanne; Ditt, Hendrik; Biermann, Christina; Lell, Michael; Keller, Jörg

    2009-02-01

    The rupture of an intracranial aneurysm has dramatic consequences for the patient. Hence early detection of unruptured aneurysms is of paramount importance. Bone-subtraction computed tomography angiography (BSCTA) has proven to be a powerful tool for detection of aneurysms in particular those located close to the skull base. Most aneurysms though are chance findings in BSCTA scans performed for other reasons. Therefore it is highly desirable to have techniques operating on standard BSCTA scans available which assist radiologists and surgeons in evaluation of intracranial aneurysms. In this paper we present a semi-automatic method for segmentation and assessment of intracranial aneurysms. The only user-interaction required is placement of a marker into the vascular malformation. Termination ensues automatically as soon as the segmentation reaches the vessels which feed the aneurysm. The algorithm is derived from an adaptive region-growing which employs a growth gradient as criterion for termination. Based on this segmentation values of high clinical and prognostic significance, such as volume, minimum and maximum diameter as well as surface of the aneurysm, are calculated automatically. the segmentation itself as well as the calculated diameters are visualised. Further segmentation of the adjoining vessels provides the means for visualisation of the topographical situation of vascular structures associated to the aneurysm. A stereolithographic mesh (STL) can be derived from the surface of the segmented volume. STL together with parameters like the resiliency of vascular wall tissue provide for an accurate wall model of the aneurysm and its associated vascular structures. Consequently the haemodynamic situation in the aneurysm itself and close to it can be assessed by flow modelling. Significant values of haemodynamics such as pressure onto the vascular wall, wall shear stress or pathlines of the blood flow can be computed. Additionally a dynamic flow model can be

  9. Coronary Events and Anatomy After Arterial Switch Operation for Transposition of the Great Arteries: Detection by 16-Row Multislice Computed Tomography Angiography in Pediatric Patients

    SciTech Connect

    Oztunc, Funda Baris, Safa; Adaletli, Ibrahim Onol, Nurper Onder Olgun, Deniz Cebi; Guezeltas, Alper Ozyilmaz, Isa Ozdil, Mine; Kurugoglu, Sebuh; Eroglu, Ayse Gueler

    2009-03-15

    The purpose of this study was to evaluate the feasibility of multislice computed tomographic (MSCT) angiography as a noninvasive method for detecting ostial, proximal, and middle segment coronary stenosis or occlusion and anatomy in patients with transposition of the great arteries who had undergone arterial switch operation (ASO). Sixteen-detector-row MSCT angiography was performed in 16 patients treated with ASO for transposition of the great arteries. The median age was 10.3 years (range, 6.2-16.3 years). Sixteen-detector-row MSCT angiography was performed in 16 patients who had undergone ASO. CT imaging was performed in the craniocaudal direction from 2 cm above the carina up to the heart basis. Noninvasive assessment of coronary artery stenosis and anatomy were investigated by MSCT angiography. Two patients were excluded from the study because of artifacts. Of 14 evaluated patients, 1 patient had ostial stenosis (7.1%). A coronary artery anatomy variant was present in six patients: left main artery (LMA) and right coronary artery (RCA) originating from the right sinus as a single orifice (n = 2); left circumflex artery (LCX) originating from the RCA (n = 1); LMA and RCA, after branching to the LCX, originating separately from the right sinus (n = 1); and LMA (n = 1) and left anterior descending artery (LADA; n = 1) originating directly from the right sinus. Intramural bridging in the LAD (n = 2) was detected. Five patients were normal. In conclusion, MSCT angiography, as a noninvasive, feasible technique for assessing coronary stenosis or occlusion and anatomy, can be used in the follow-up of patients who have undergone ASO.

  10. CT angiography - head and neck

    MedlinePlus

    Computed tomography angiography - brain; CTA - skull; CTA - cranial; TIA-CTA head; Stroke-CTA head; Computed tomography angiography - neck; CTA - neck; Vertebral artery - CTA; Carotid artery stenosis - CTA; ...

  11. Reappraisal of velocity criteria for carotid bulb/internal carotid artery stenosis utilizing high-resolution B-mode ultrasound validated with computed tomography angiography

    PubMed Central

    Shaalan, Wael E.; Wahlgren, Carl M.; Desai, Tina; Piano, Giancarlo; Skelly, Christopher; Bassiouny, Hisham S.

    2012-01-01

    Objective Reliability of the most commonly used duplex ultrasound (DUS) velocity thresholds for internal carotid artery (ICA) stenosis has been questioned since these thresholds were developed using less precise methods to grade stenosis severity based on angiography. In this study, maximum percent diameter carotid bulb ICA stenosis (European Carotid Surgery Trial [ECST] method) was objectively measured using high resolution B-mode DUS validated with computed tomography angiography (CTA) and used to determine optimum velocity thresholds for ≥50% and ≥80% bulb internal carotid artery stenosis (ICA). Methods B-mode DUS and CTA images of 74 bulb ICA stenoses were compared to validate accuracy of the DUS measurements. In 337 mild, moderate, and severe bulb ICA stenoses (n = 232 patients), the minimal residual lumen and the maximum outer bulb/proximal ICA diameter were determined on longitudinal and transverse images. This in contrast to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method using normal distal ICA lumen diameter as the denominator. Severe calcified carotid segments and patients with contralateral occlusion were excluded. In each study, the highest peak systolic (PSV) and end-diastolic (EDV) velocities as well as ICA/common carotid artery (CCA) ratio were recorded. Using receiver operating characteristic (ROC) analysis, the optimum threshold for each hemodynamic parameter was determined to predict ≥50% (n = 281) and ≥80% (n = 62) bulb ICA stenosis. Results Patients mean age was 74 ± 8 years; 49% females. Clinical risk factors for atherosclerosis included coronary artery disease (40%), diabetes mellitus (32%), hypertension (70%), smoking (34%), and hypercholesterolemia (49%). Thirty-three percent of carotid lesions (n = 110) presented with ischemic cerebrovascular symptoms and 67% (n = 227) were asymptomatic. There was an excellent agreement between B-mode DUS and CTA (r = 0.9, P = .002). The inter/intraobserver agreement

  12. The 2013 ACC/AHA cardiovascular prevention guidelines improve alignment of statin therapy with coronary atherosclerosis as detected by coronary computed tomography angiography.

    PubMed

    Pursnani, Amit; Mayrhofer, Thomas; Ferencik, Maros; Hoffmann, Udo

    2014-11-01

    The recently released 2013 ACC/AHA guidelines for management of blood cholesterol have substantially increased the number of adults who are eligible for preventive statin therapy. We sought to determine whether eligibility for statin therapy as determined by the 2013 ACC/AHA guideline recommendation is better aligned with the actual presence of coronary artery disease (CAD) as detected by coronary CT angiography (CCTA) when compared to prior guidelines including the 2004 NCEP ATP III and 2011 ESC/EAS guidelines. In this secondary analysis of the prospective observational ROMICAT I (Rule Out Myocardial Infarction with Computer Assisted Tomography) cohort study, we included all men and women aged 40-79 years presenting with acute chest pain but not diagnosed with acute coronary syndrome nor on admission statin. Based on risk factor assessment and lipid data, we determined guideline-based eligibility for statin therapy by the 2013 ACC/AHA, the 2004 NCEP ATP III, and the 2011 ESC/EAS guidelines. We determined the presence and severity of CAD as detected by CCTA. The 2013 ACC/AHA algorithm identified nearly twice as many individuals as eligible for statins (n = 77/189; 41%) as compared to the 2004 ATP III criteria: (n = 41/189; 22%), (p < .0001) In addition, the 2013 ACC/AHA guidelines were more sensitive for treatment of CCTA-detected CAD than the 2004 ATP III guidelines [53.4% (42.5-64.1) vs 27.3% (18.3-37.8), p < .001] and the 2011 ESC/EAE guidelines [53.4% (42.5-64.1) vs 34.1% (24.3-45.0), p < .001]. However, the specificity of these guidelines was modestly reduced compared to the 2004 ATP III guidelines [70.3 (60.4-79.0) vs 83.2 (74.4-89.9), p < .001] and the 2011 ESC/EAE guidelines [70.3 (60.4-79.0) vs 86.1 (77.8-92.2), p < .001], suggesting increased treatment of subjects without CCTA-detected CAD. Overall, the 2013 ACC/AHA guidelines are more sensitive to identify patients who have CAD detected by CCTA eligible for statin therapy as compared with prior

  13. Association between serum N-terminal pro-B-type natriuretic peptide levels and characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography

    PubMed Central

    Gan, Lu; Feng, Cong; Liu, Chunlei; Tian, Shuping; Song, Xiang; Yang, Li

    2016-01-01

    The aim of the present study was to explore the association between the levels of serum N-terminal pro-B-type natriuretic peptide (NT-pro BNP) and the characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography (CCTA), in patients with unstable angina (UA). A total of 202 patients (age range, 47–82 years) were divided into the following three groups: Non-cardiac disease group (57 patients); stable angina pectoris (SAP) group (62 patients); and UA group (83 patients). There were significant differences between the serum NT-pro BNP levels among the three groups (P=0.007). However, in multivariant diagnoses, NT-pro BNP level was not an independent risk factor for UA. The levels of serum NT-pro BNP were observed to be positively correlated with the number of vessels involved (r=0.462; P<0.001), SIS (r=0.475; P<0.001), segment-stenosis score (r=0.453; P<0.001), coronary calcification score (r=0.412; P=0.001), number of obstructive diseases (r=0.346; P<0.001), and the number of segments with non-calcified plaque (r=0.235; P=0.017), mixed plaque (r=0.234; P=0.017) and calcified plaque (r=0.431; P<0.001). The levels of serum NT-pro BNP were significantly higher in patients with UA and left main-left anterior descending (LM-LAD) disease, compared with UA patients without LM-LAD disease (P<0.001). In addition, serum NT-pro BNP was significantly higher in patients with obstructive disease and UA than in those without obstructive disease (P<0.001). The area under the curve of log(NT-pro BNP) was 0.656 (P=0.006; optimal cut-off value, 1.74; sensitivity, 77.6%; specificity, 51.9%). In conclusion, the levels of serum NT-pro BNP are associated with the burden and severity of coronary artery atherosclerotic disease in patients with UA, and may be helpful in risk stratification of patients with UA. PMID:27446259

  14. Diabetes as an independent predictor of high atherosclerotic burden assessed by coronary computed tomography angiography: the coronary artery disease equivalent revisited.

    PubMed

    de Araújo Gonçalves, Pedro; Garcia-Garcia, Hector M; Carvalho, Maria Salomé; Dores, Helder; Sousa, Pedro Jeronimo; Marques, Hugo; Ferreira, Antonio; Cardim, Nuno; Teles, Rui Campante; Raposo, Luís; Gabriel, Henrique Mesquita; Almeida, Manuel; Aleixo, Ana; Carmo, Miguel Mota; Machado, Francisco Pereira; Mendes, Miguel

    2013-06-01

    (1) To study the prevalence and severity of coronary artery disease (CAD) in diabetic patients. (2) To provide a detailed characterization of the coronary atherosclerotic burden, including the localization, degree of stenosis and plaque composition by coronary computed tomography angiography (CCTA). Single center prospective registry including a total of 581 consecutive stable patients (April 2011-March 2012) undergoing CCTA (Dual-source CT) for the evaluation of suspected CAD without previous myocardial infarction or revascularization procedures. Different coronary plaque burden indexes and plaque type and distribution patterns were compared between patients with (n = 85) and without diabetes (n = 496). The prevalence of CAD (any plaque; 74.1 vs. 56%; p = 0.002) and obstructive CAD (≥50% stenosis; 31.8 vs. 10.3%; p < 0.001) were significantly higher in diabetic patients. The remaining coronary atherosclerotic burden indexes evaluated (plaque in LM-3v-2v with prox. LAD; SIS; SSS; CT-LeSc) were also significantly higher in diabetic patients. In the per segment analysis, diabetics had a higher percentage of segments with plaque in every vessel (2.6/13.1/7.5/10.5% for diabetics vs. 1.4/7.1/3.3/4.4% for nondiabetics for LM, LAD, LCx, RCA respectively; p < 0.001 for all) and of both calcified (19.3 vs. 9.2%, p < 0.001) and noncalcified or mixed types (14.4 vs. 7.0%; p < 0.001); the ratio of proximal-to-distal relative plaque distribution (calculated as LM/proximal vs. mid/distal/branches) was lower for diabetics (0.75 vs. 1.04; p = 0.009). Diabetes was an independent predictor of CAD and was also associated with more advanced CAD, evaluated by indexes of coronary atherosclerotic burden. Diabetics had a significantly higher prevalence of plaques in every anatomical subset and for the different plaque composition. In this report, the relative geographic distribution of the plaques within each subgroup, favored a more mid-to-distal localization in the diabetic patients

  15. Coronary Computed Tomography Angiography (CTA)

    MedlinePlus

    ... A radiologist with expertise in supervising and interpreting radiology examinations will analyze the images and send an ... is given. However, both the American College of Radiology (ACR) and the European Society of Urogenital Radiology ...

  16. Computed Tomography (CT) - Spine

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Spine Computed tomography (CT) of the spine is a diagnostic imaging ... Spine? What is CT Scanning of the Spine? Computed tomography, more commonly known as a CT or CAT ...

  17. Exercise transcutaneous oxygen pressure measurement has good sensitivity and specificity to detect lower extremity arterial stenosis assessed by computed tomography angiography.

    PubMed

    Koch, Caroline; Chauve, Emmanuel; Chaudru, Ségolène; Le Faucheur, Alexis; Jaquinandi, Vincent; Mahé, Guillaume

    2016-09-01

    Peripheral artery disease (PAD) is a highly prevalent disease diagnosed by the use of ankle-brachial index (ABI) at rest. In some clinical conditions (diabetes, renal insufficiency, advanced age), ABI can be falsely normal and other tests are required for the PAD diagnosis (American Heart Association statement). This study was conducted to determine the accuracy of exercise transcutaneous oxygen pressure measurement (exercise-TcPo2) in detection of arterial stenosis ≥50% using computed tomography angiography (CTA) as the gold standard.We retrospectively analyzed consecutive patients referred to our vascular unit (University Hospital, Rennes, France) for exercise-TcPo2 testing from 2014 to 2015. All included patients had a CTA performed within 3 months of the exercise-TcPo2 test. Exercise-TcPo2 was performed on treadmill (10% slope; 2 mph speed). We calculated the Delta from Resting Oxygen Pressure (DROP) index (expressed in mm Hg) at the proximal and distal levels. Two blinded physicians performed stenosis quantification on CTA. The receiver operating characteristic (ROC) curve was used to define a cutoff point to detect arterial stenosis ≥50%, stenosis ≥60%, and stenosis ≥70%.A total of 34 patients (mean age 64 ± 2 years old; 74% men) were analyzed. The highest areas under the curve (AUC) were found for 60% stenosis at both proximal and distal levels. For stenosis ≥50%, sensitivity and specificity of proximal minimal DROP were 80.9% [67.1-89.7], 81.0% [59.3-92.7] respectively. For stenosis ≥50%, sensitivity and specificity of distal minimal DROP were 73.2% [60.3-83.1], 83.3% [53.8-96.2], respectively. For stenosis ≥60%, sensitivity and specificity of proximal minimal DROP were 82.5% [67.6-91.5] and 85.7% [67.7-94.8] respectively. For stenosis ≥60%, sensitivity and specificity of distal minimal DROP were 80.4% [67.3-89.1] and 88.2% [64.2-97.7], respectively. For stenosis ≥70%, sensitivity and specificity of proximal minimal DROP were 85

  18. Exercise transcutaneous oxygen pressure measurement has good sensitivity and specificity to detect lower extremity arterial stenosis assessed by computed tomography angiography.

    PubMed

    Koch, Caroline; Chauve, Emmanuel; Chaudru, Ségolène; Le Faucheur, Alexis; Jaquinandi, Vincent; Mahé, Guillaume

    2016-09-01

    Peripheral artery disease (PAD) is a highly prevalent disease diagnosed by the use of ankle-brachial index (ABI) at rest. In some clinical conditions (diabetes, renal insufficiency, advanced age), ABI can be falsely normal and other tests are required for the PAD diagnosis (American Heart Association statement). This study was conducted to determine the accuracy of exercise transcutaneous oxygen pressure measurement (exercise-TcPo2) in detection of arterial stenosis ≥50% using computed tomography angiography (CTA) as the gold standard.We retrospectively analyzed consecutive patients referred to our vascular unit (University Hospital, Rennes, France) for exercise-TcPo2 testing from 2014 to 2015. All included patients had a CTA performed within 3 months of the exercise-TcPo2 test. Exercise-TcPo2 was performed on treadmill (10% slope; 2 mph speed). We calculated the Delta from Resting Oxygen Pressure (DROP) index (expressed in mm Hg) at the proximal and distal levels. Two blinded physicians performed stenosis quantification on CTA. The receiver operating characteristic (ROC) curve was used to define a cutoff point to detect arterial stenosis ≥50%, stenosis ≥60%, and stenosis ≥70%.A total of 34 patients (mean age 64 ± 2 years old; 74% men) were analyzed. The highest areas under the curve (AUC) were found for 60% stenosis at both proximal and distal levels. For stenosis ≥50%, sensitivity and specificity of proximal minimal DROP were 80.9% [67.1-89.7], 81.0% [59.3-92.7] respectively. For stenosis ≥50%, sensitivity and specificity of distal minimal DROP were 73.2% [60.3-83.1], 83.3% [53.8-96.2], respectively. For stenosis ≥60%, sensitivity and specificity of proximal minimal DROP were 82.5% [67.6-91.5] and 85.7% [67.7-94.8] respectively. For stenosis ≥60%, sensitivity and specificity of distal minimal DROP were 80.4% [67.3-89.1] and 88.2% [64.2-97.7], respectively. For stenosis ≥70%, sensitivity and specificity of proximal minimal DROP were 85

  19. Exercise transcutaneous oxygen pressure measurement has good sensitivity and specificity to detect lower extremity arterial stenosis assessed by computed tomography angiography

    PubMed Central

    Koch, Caroline; Chauve, Emmanuel; Chaudru, Ségolène; Le Faucheur, Alexis; Jaquinandi, Vincent; Mahé, Guillaume

    2016-01-01

    Abstract Peripheral artery disease (PAD) is a highly prevalent disease diagnosed by the use of ankle-brachial index (ABI) at rest. In some clinical conditions (diabetes, renal insufficiency, advanced age), ABI can be falsely normal and other tests are required for the PAD diagnosis (American Heart Association statement). This study was conducted to determine the accuracy of exercise transcutaneous oxygen pressure measurement (exercise-TcPo2) in detection of arterial stenosis ≥50% using computed tomography angiography (CTA) as the gold standard. We retrospectively analyzed consecutive patients referred to our vascular unit (University Hospital, Rennes, France) for exercise-TcPo2 testing from 2014 to 2015. All included patients had a CTA performed within 3 months of the exercise-TcPo2 test. Exercise-TcPo2 was performed on treadmill (10% slope; 2 mph speed). We calculated the Delta from Resting Oxygen Pressure (DROP) index (expressed in mm Hg) at the proximal and distal levels. Two blinded physicians performed stenosis quantification on CTA. The receiver operating characteristic (ROC) curve was used to define a cutoff point to detect arterial stenosis ≥50%, stenosis ≥60%, and stenosis ≥70%. A total of 34 patients (mean age 64 ± 2 years old; 74% men) were analyzed. The highest areas under the curve (AUC) were found for 60% stenosis at both proximal and distal levels. For stenosis ≥50%, sensitivity and specificity of proximal minimal DROP were 80.9% [67.1–89.7], 81.0% [59.3–92.7] respectively. For stenosis ≥50%, sensitivity and specificity of distal minimal DROP were 73.2% [60.3–83.1], 83.3% [53.8–96.2], respectively. For stenosis ≥60%, sensitivity and specificity of proximal minimal DROP were 82.5% [67.6–91.5] and 85.7% [67.7–94.8] respectively. For stenosis ≥60%, sensitivity and specificity of distal minimal DROP were 80.4% [67.3–89.1] and 88.2% [64.2–97.7], respectively. For stenosis ≥70%, sensitivity and specificity of proximal

  20. Computed tomographic angiography in tetralogy of Fallot.

    PubMed

    Kasar, Pankajkumar Ashok; Ravikumar, Radhakrishnan; Varghese, Roy; Kotecha, Monika; Vimala, Jesudian; Kumar, Raghavan Nair Suresh

    2011-10-01

    Echocardiography is often inadequate for imaging tetralogy of Fallot, prompting cineangiography. This study prospectively evaluated multidetector computed tomographic angiography for preoperative evaluation of tetralogy of Fallot in 112 consecutive patients. Forty-eight had nonconfluent or hypoplastic pulmonary arteries (mean z-score, -2; range, -11.1-0.13) permitting only palliative or no surgery; 64 had adequate pulmonary artery anatomy (mean z-score, 0.59; range, -2.53-3.4) allowing total repair. The surgical data of 50 patients who underwent total correction were compared with transthoracic echocardiography and multidetector computed tomographic angiography findings. Multidetector computed tomographic angiography tended to reveal unsuspected collaterals and coronary abnormalities besides outlining the right ventricular outflow tract and pulmonary artery branches. The branch pulmonary artery diameter z-score was the most important determinant of surgical strategy, with the worst figures being associated with no surgical options or palliative surgery, and the best figures leading to corrective surgery. The mean radiation dose was 3.45 mSv. Multidetector computed tomographic angiography is a powerful supplement to echocardiography in the preoperative evaluation of tetralogy of Fallot.

  1. [Computer tomography of retroperitoneal trauma (author's transl)].

    PubMed

    Fischedick, A R; Müller, R P; Kramps, H; Cramer, B

    1982-01-01

    Computer tomography changes after retroperitoneal trauma are described on the basis of 19 patients seen by the authors. It appears that this method is superior to conventional techniques, both as a screening method and for carrying out follow-ups. The indications for angiography are thereby reduced.

  2. Split-spectrum phase-gradient optical coherence tomography angiography.

    PubMed

    Liu, Gangjun; Jia, Yali; Pechauer, Alex D; Chandwani, Rahul; Huang, David

    2016-08-01

    A phase gradient angiography (PGA) method is proposed for optical coherence tomography (OCT). This method allows the use of phase information to map the microvasculature in tissue without the correction of bulk motion and laser trigger jitter induced phase artifacts. PGA can also be combined with the amplitude/intensity to improve the performance. Split-spectrum technique can further increase the signal to noise ratio by more than two times. In-vivo imaging of human retinal circulation is shown with a 70 kHz, 840 nm spectral domain OCT system and a 200 kHz, 1050 nm swept source OCT system. Four different OCT angiography methods are compared. The best performance was achieved with split-spectrum amplitude and phase-gradient angiography. PMID:27570689

  3. Split-spectrum phase-gradient optical coherence tomography angiography

    PubMed Central

    Liu, Gangjun; Jia, Yali; Pechauer, Alex D.; Chandwani, Rahul; Huang, David

    2016-01-01

    A phase gradient angiography (PGA) method is proposed for optical coherence tomography (OCT). This method allows the use of phase information to map the microvasculature in tissue without the correction of bulk motion and laser trigger jitter induced phase artifacts. PGA can also be combined with the amplitude/intensity to improve the performance. Split-spectrum technique can further increase the signal to noise ratio by more than two times. In-vivo imaging of human retinal circulation is shown with a 70 kHz, 840 nm spectral domain OCT system and a 200 kHz, 1050 nm swept source OCT system. Four different OCT angiography methods are compared. The best performance was achieved with split-spectrum amplitude and phase-gradient angiography. PMID:27570689

  4. Assessment of the Circle of Willis with Cranial Tomography Angiography

    PubMed Central

    Karatas, Ayse; Coban, Gokmen; Cinar, Celal; Oran, Ismail; Uz, Aysun

    2015-01-01

    Background The circle of Willis is a major collateral pathway important in ischemic conditions. The aim of our study was to assess the structural characteristics of the circle of Willis within the Turkish adult population, along with variations and arteries involved in the measurement of diameters and lengths on cranial computed tomography angiography (CTA). Material/Methods One hundred adult patients who underwent CTA images were evaluated retrospectively. Results Results of the study revealed 82% adult, 17% fetal, and 1% transitional configurations. A complete polygonal structure was observed in 28% of cases. Variations of the circle of Willis were more common in the posterior portion. Hypoplasia was found to be the most common variation and was observed as a maximum in the posterior communicating artery (AComP). Conclusions The patency and size of arteries in the circle of Willis are important in occlusive cerebrovascular diseases and cerebrovascular surgery. Although CTA is an easily accessible non-invasive clinical method for demonstrating the vascular structure, CTA should be evaluated taking into account image resolution quality and difficulties in the identification of small vessels. PMID:26343887

  5. CT angiography - chest

    MedlinePlus

    Computed tomography angiography - thorax; CTA - lungs; Pulmonary embolism - CTA chest; Thoracic aortic aneurysm - CTA chest; Venous thromboembolism - CTA lung; Blood clot - CTA lung; Embolus - CTA lung; CT ...

  6. Dual left anterior descending artery with anomalous origin of long LAD from pulmonary artery - rare coronary anomaly detected on computed tomography coronary angiography

    PubMed Central

    Vohra, Aditi; Narula, Harneet

    2016-01-01

    Dual left anterior descending artery is a rare coronary artery anomaly showing two left anterior descending arteries. Short anterior descending artery usually arises from the left coronary artery, while long anterior descending artery has anomalous origin and course. Dual left anterior descending artery with origin of long anterior descending artery from the pulmonary artery (ALCAPA) is a very rare coronary artery anomaly which has not been reported previously in the literature. We present the computed tomography coronary angiographic findings of this rare case in a young female patient who presented with atypical chest pain. PMID:27413266

  7. Non-invasive detection of aortic and coronary atherosclerosis in homozygous familial hypercholesterolemia by 64 slice multi-detector row computed tomography angiography.

    PubMed

    Santos, Raul D; Miname, Marcio H; Martinez, Lilton R C; Rochitte, Carlos E; Chacra, Ana P M; Nakandakare, Edna R; Chen, David; Schaefer, Ernst J

    2008-04-01

    Homozygous familial hypercholesterolemia (HoFH) is a rare disorder characterized by the early onset of atherosclerosis, often at the ostia of coronary arteries. In this study we document for the first time that aortic and coronary atherosclerosis can be detected using 64 slice multiple detector row computed tomographic coronary angiography (CTCA). We studied five HoFH patients (three females, two males, mean age 19.8+/-2.9 years, age range 15-23 years, with a mean low density lipoprotein (LDL) cholesterol 618+/-211 mg/dL) using 64 slice CTCA. None of the patients showed evidence of ischemia with standard exercise testing. Calcified and mixed atherosclerotic plaques adjacent to or compromising the coronary artery ostia were found in all study subjects. Coronary plaques causing significant obstruction were found in one patient, who had previously undergone coronary artery bypass surgery and aortic valve replacement. Two other patients were noted to have non-obstructive calcified, mixed and non-calcified coronary artery plaques. Our data suggest that CTCA could be a useful non-invasive method for detection of early aortic and coronary atherosclerosis specifically affecting the coronary ostia in HoFH subjects. PMID:17884061

  8. Computed body tomography.

    PubMed

    Alfidi, R J; Haaga, J R

    1976-12-01

    Only the surface of the diagnostic possibilities inherent in CT imaging has been scratched. Solic organ pathology is readily visible in most instances by computed tomography. With further extension of present knowledge and development of newer contrast agents, the ability of computed body tomography to image a wide range of diseases appears almost limitless.

  9. Is Coronary Computed Tomography Angiography a Resource Sparing Strategy in the Risk Stratification and Evaluation of Acute Chest Pain? Results of a Randomized Controlled Trial

    PubMed Central

    Miller, Adam H.; Pepe, Paul E.; Peshock, Ron; Bhore, Rafia; Yancy, Clyde C.; Xuan, Lei; Miller, Margarita M.; Huet, Gisselle R.; Trimmer, Clayton; Davis, Rene; Chason, Rebecca; Kashner, Micheal T.

    2011-01-01

    Objectives Annually, almost 6 million U.S. citizens are evaluated for acute chest pain syndromes (ACPSs), and billions of dollars in resources are utilized. A large part of the resource utilization results from precautionary hospitalizations that occur because care providers are unable to exclude the presence of coronary artery disease (CAD) as the underlying cause of ACPSs. The purpose of this study was to examine whether the addition of coronary computerized tomography angiography (CCTA) to the concurrent standard care (SC) during an index emergency department (ED) visit could lower resource utilization when evaluating for the presence of CAD. Methods Sixty participants were assigned randomly to SC or SC + CCTA groups. Participants were interviewed at the index ED visit and at 90 days. Data collected included demographics, perceptions of the value of accessing health care, and clinical outcomes. Resource utilization included services received from both the primary in-network and the primary out-of-network providers. The prospectively defined primary endpoint was the total amount of resources utilized over a 90-day follow-up period when adding CCTA to the SC risk stratification in ACPSs. Results The mean (± standard deviation [SD]) for total resources utilized at 90 days for in-network plus out-of-network services was less for the participants in the SC + CCTA group ($10,134; SD ± $14,239) versus the SC-only group ($16,579; SD ± $19,148; p = 0.144), as was the median for the SC + CCTA ($4,288) versus SC only ($12,148; p = 0.652; median difference = −$1,291; 95% confidence interval [CI] = −$12,219 to $1,100; p = 0.652). Among the 60 total study patients, only 19 had an established diagnosis of CAD at 90 days. However, 18 (95%) of these diagnosed participants were in the SC + CCTA group. In addition, there were fewer hospital readmissions in the SC + CCTA group (6 of 30 [20%] vs. 16 of 30 [53%]; difference in proportions = −33%; 95% CI = −56% to −10%; p

  10. Prognostic utility of coronary computed tomographic angiography

    PubMed Central

    Otaki, Yuka; Berman, Daniel S.; Min, James K.

    2013-01-01

    Coronary computed tomographic angiography (CCTA) employing CT scanners of 64-detector rows or greater represents a noninvasive method that enables accurate detection and exclusion of anatomically obstructive coronary artery disease (CAD), providing excellent diagnostic information when compared to invasive angiography. There are numerous potential advantages of CCTA beyond simply luminal stenosis assessment including quantification of atherosclerotic plaque volume as well as assessment of plaque composition, extent, location and distribution. In recent years, an array of studies has evaluated the prognostic utility of CCTA findings of CAD for the prediction of major adverse cardiac events, all-cause death and plaque instability. This prognostic information enhances risk stratification and, if properly acted upon, may improve medical therapy and/or behavioral changes that may enhance event-free survival. The goal of the present article is to summarize the current status of the prognostic utility of CCTA findings of CAD. PMID:23809386

  11. Feature space optical coherence tomography based micro-angiography

    PubMed Central

    Zhang, Anqi; Wang, Ruikang K.

    2015-01-01

    Current optical coherence tomography (OCT) based micro-angiography is prone to noise that arises from static background. This work presents a novel feature space based optical micro-angiography (OMAG) method (fsOMAG) that can effectively differentiate flow signal from static background in the feature space. fsOMAG consists of two steps. In the first step a classification map is generated that provides criterion for classification in the second step to extract functional blood flow from experimental data set. The performance of fsOMAG is examined through phantom experiments and in-vivo human retinal imaging, and compared with the existing OMAG. The results indicate its potential for clinical applications. PMID:26137391

  12. Recent Scientific Evidence and Technical Developments in Cardiovascular Computed Tomography.

    PubMed

    Marcus, Roy; Ruff, Christer; Burgstahler, Christof; Notohamiprodjo, Mike; Nikolaou, Konstantin; Geisler, Tobias; Schroeder, Stephen; Bamberg, Fabian

    2016-05-01

    In recent years, coronary computed tomography angiography has become an increasingly safe and noninvasive modality for the evaluation of the anatomical structure of the coronary artery tree with diagnostic benefits especially in patients with a low-to-intermediate pretest probability of disease. Currently, increasing evidence from large randomized diagnostic trials is accumulating on the diagnostic impact of computed tomography angiography for the management of patients with acute and stable chest pain syndrome. At the same time, technical advances have substantially reduced adverse effects and limiting factors, such as radiation exposure, the amount of iodinated contrast agent, and scanning time, rendering the technique appropriate for broader clinical applications. In this work, we review the latest developments in computed tomography technology and describe the scientific evidence on the use of cardiac computed tomography angiography to evaluate patients with acute and stable chest pain syndrome.

  13. Recent Scientific Evidence and Technical Developments in Cardiovascular Computed Tomography.

    PubMed

    Marcus, Roy; Ruff, Christer; Burgstahler, Christof; Notohamiprodjo, Mike; Nikolaou, Konstantin; Geisler, Tobias; Schroeder, Stephen; Bamberg, Fabian

    2016-05-01

    In recent years, coronary computed tomography angiography has become an increasingly safe and noninvasive modality for the evaluation of the anatomical structure of the coronary artery tree with diagnostic benefits especially in patients with a low-to-intermediate pretest probability of disease. Currently, increasing evidence from large randomized diagnostic trials is accumulating on the diagnostic impact of computed tomography angiography for the management of patients with acute and stable chest pain syndrome. At the same time, technical advances have substantially reduced adverse effects and limiting factors, such as radiation exposure, the amount of iodinated contrast agent, and scanning time, rendering the technique appropriate for broader clinical applications. In this work, we review the latest developments in computed tomography technology and describe the scientific evidence on the use of cardiac computed tomography angiography to evaluate patients with acute and stable chest pain syndrome. PMID:27025303

  14. Computed Tomographic Angiography of the Abdominal Aorta.

    PubMed

    Hansen, Neil J

    2016-01-01

    Computed tomographic (CT) angiography (CTA) has become the preferred imaging test of choice for various aortic conditions because of its excellent spatial resolution, rapid image acquisition, and its wide availability. CTA provides a robust tool for planning aortic interventions and diagnosing acute and chronic vascular diseases in the abdomen. CTA is the standard for imaging aneurysms before intervention and evaluating the aorta in the acute setting to assess traumatic injury, dissection, and aneurysm rupture. Knowledge of the imaging features of these disease processes, inflammatory vasculitides, and occlusive atherosclerotic disease is essential for guiding surgical and medical management of patients. PMID:26654390

  15. Automated choroidal neovascularization detection algorithm for optical coherence tomography angiography

    PubMed Central

    Liu, Li; Gao, Simon S.; Bailey, Steven T.; Huang, David; Li, Dengwang; Jia, Yali

    2015-01-01

    Optical coherence tomography angiography has recently been used to visualize choroidal neovascularization (CNV) in participants with age-related macular degeneration. Identification and quantification of CNV area is important clinically for disease assessment. An automated algorithm for CNV area detection is presented in this article. It relies on denoising and a saliency detection model to overcome issues such as projection artifacts and the heterogeneity of CNV. Qualitative and quantitative evaluations were performed on scans of 7 participants. Results from the algorithm agreed well with manual delineation of CNV area. PMID:26417524

  16. Computed Tomography (CT) -- Sinuses

    MedlinePlus

    ... further information please consult the ACR Manual on Contrast Media and its references. The risk of serious allergic ... X-ray, Interventional Radiology and Nuclear Medicine Radiation Safety Images related to Computed Tomography (CT) - Sinuses About ...

  17. Diagnostic Performance of First-Pass Myocardial Perfusion Imaging without Stress with Computed Tomography (CT) Compared with Coronary CT Angiography Alone, with Fractional Flow Reserve as the Reference Standard

    PubMed Central

    Osawa, Kazuhiro; Miyoshi, Toru; Miki, Takashi; Koyama, Yasushi; Sato, Shuhei; Kanazawa, Susumu; Ito, Hiroshi

    2016-01-01

    Coronary computed tomography angiography (CCTA) in combination with first-pass CT myocardial perfusion imaging (MPI) has a better diagnostic performance than CCTA alone, compared with invasive coronary angiography as the reference standard. The aim of this study was to investigate the additional diagnostic value of first-pass CT-MPI without stress for detecting hemodynamic significance of coronary stenosis, compared with invasive fractional flow reserve (FFR). We recruited 53 patients with suspected coronary artery disease undergoing both CCTA and first-pass CT-MPI without stress and invasive FFR, and 75 vessels were analyzed. We used the same raw data for CCTA and CT-MPI. First-pass CT-MPI was reconstructed by examining the diastolic signal densities as a bull’s eye map. Invasive FFR <0.8 was considered as positive. On per-vessel analysis, the area under the receiver operating characteristic curve for CCTA plus first-pass CT-MPI and CCTA alone was 0.81 (0.73–0.90) and 0.70 (0.61–0.81), respectively (P = 0.036). CCTA plus first-pass CT-MPI without stress showed 0.73 sensitivity, 0.74 specificity, 0.53 positive predictive value, and 0.87 negative predictive value for detecting hemodynamically significant coronary stenosis. First-pass CT-MPI without stress correctly reclassified 38% of CCTA false-positive vessels as true negative. First-pass CT-MPI without stress combined with CCTA demonstrated excellent diagnostic accuracy, compared with invasive FFR as the reference standard. This technique could complement CCTA for diagnosis of coronary artery disease. PMID:26894686

  18. Stent sizing strategies in renal artery stenting: the comparison of conventional invasive renal angiography with renal computed tomographic angiography

    PubMed Central

    Michalowska, Ilona; Pregowski, Jerzy; Janaszek-Sitkowska, Hanna; Lech, Katarzyna; Kabat, Marek; Staruch, Adam; Januszewicz, Andrzej; Witkowski, Adam

    2016-01-01

    Introduction Randomized trials comparing invasive treatment of renal artery stenosis with standard pharmacotherapy did not show substantial benefit from revascularization. One of the potential reasons for that may be suboptimal procedure technique. Aim To compare renal stent sizing using two modalities: three-dimensional renal computed tomography angiography (CTA) versus conventional angiography. Material and methods Forty patients (41 renal arteries), aged 65.1 ±8.5 years, who underwent renal artery stenting with preprocedural CTA performed within 6 months, were retrospectively analyzed. In CTA analysis, reference diameter (CTA-D) and lesion length (CTA_LL) were measured and proposed stent diameter and length were recorded. Similarly, angiographic reference diameter (ANGIO_D) and lesion length (ANGIO_LL) as well as proposed stent dimensions were obtained by visual estimation. Results The median CTA_D was 0.5 mm larger than the median ANGIO_D (p < 0.001). Also, the proposed stent diameter in CTA evaluation was 0.5 mm larger than that in angiography (p < 0.0001). The median CTA_LL was 1 mm longer than the ANGIO_LL (p = NS), with significant correlation of these variables (r = 0.66, p < 0.0001). The median proposed stent length with CTA was equal to that proposed with angiography. The median diameter of the implanted stent was 0.5 mm smaller than that proposed in CTA (p < 0.0005) and identical to that proposed in angiography. The median length of the actual stent was longer than that proposed in angiography (p = 0.0001). Conclusions Renal CTA has potential advantages as a tool adjunctive to angiography in appropriate stent sizing. Careful evaluation of the available CTA scans may be beneficial and should be considered prior to the planned procedure. PMID:27279870

  19. Rationale and Design of the Dual Energy Computed Tomography for Ischemia Determination Compared to “Gold Standard” Non-invasive and Invasive Techniques (DECIDE-Gold): A Multicenter International Efficacy Diagnostic Study of Rest-Stress Dual-Energy Computed Tomography Angiography with Perfusion

    PubMed Central

    Truong, Quynh A.; Knaapen, Paul; Pontone, Gianluca; Andreini, Daniele; Leipsic, Jonathon; Carrascosa, Patricia; Lu, Bin; Branch, Kelley; Raman, Subha; Bloom, Stephen; Min, James K.

    2014-01-01

    BACKGROUND Dual-energy CT (DECT) has potential to improve myocardial perfusion for physiologic assessment of coronary artery disease (CAD). Diagnostic performance of rest-stress DECT perfusion (DECTP) is unknown. OBJECTIVE DECIDE-Gold is a prospective multicenter study to evaluate the accuracy of DECT to detect hemodynamic (HD) significant CAD, as compared to fractional flow reserve (FFR) as a reference standard. METHODS Eligible participants are subjects with symptoms of CAD referred for invasive coronary angiography (ICA). Participants will undergo DECTP, which will be performed by pharmacological stress, and participants will subsequently proceed to ICA and FFR. HD-significant CAD will be defined as FFR ≥ 0.80. In those undergoing myocardial stress imaging (MPI) by positron emission tomography (PET), single photon emission computed tomography (SPECT) or cardiac magnetic resonance (CMR) imaging, ischemia will be graded by % ischemic myocardium. Blinded core laboratory interpretation will be performed for CCTA, DECTP, MPI, ICA and FFR. RESULTS Primary endpoint is accuracy of DECTP to detect ≥ 1 HD-significant stenosis at the subject-level when compared to FFR. Secondary and tertiary endpoints are accuracies of combinations of DECTP at the subject and vessel levels compared to FFR and MPI. CONCLUSION DECIDE-Gold will determine the performance of DECTP for diagnosing ischemia. PMID:25549826

  20. Use of postmortem coronary computed tomography angiography with water-insoluble contrast medium to detect stenosis of the left anterior descending artery in a case of sudden death.

    PubMed

    Takahashi, Yoichiro; Sano, Rie; Takahashi, Keiko; Kominato, Yoshihiko; Takei, Hiroyuki; Kobayashi, Susumu; Shimada, Takehiro; Tokue, Hiroyuki; Awata, Sachiko; Hirasawa, Satoshi

    2016-03-01

    A 40-year-old man was found dead on a sidewalk in an expressway parking area one hour after he had entered the area on a motorcycle. A medicolegal autopsy was performed to reveal the cause of this sudden and unexpected death. Postmortem coronary CT angiography after introduction of 5% gelatin-barium emulsion as a radiopaque contrast medium into the heart demonstrated a significant arterial luminal filling defect in the left anterior descending (LAD) coronary artery. Macroscopic and microscopic examinations revealed that a thrombus had become deposited on ruptured plaque within the LAD artery, and that a small amount of the contrast medium was present between the thrombus and the vessel endothelium. These histological findings were consistent with incomplete occlusion of the LAD artery in the 3D reconstructed image. The cause of death in this case was definitively determined to be ischemic heart disease. Postmortem angiography played a role in screening of a vascular lesion that was subsequently verified by histology to have been responsible for sudden and unexpected death. PMID:26980254

  1. Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma

    PubMed Central

    Liu, Liang; Jia, Yali; Takusagawa, Hana L.; Pechauer, Alex D.; Edmunds, Beth; Lombardi, Lorinna; Davis, Ellen; Morrison, John C.; Huang, David

    2016-01-01

    IMPORTANCE Vascular factors may have important roles in the pathophysiology of glaucoma. A practical method for the clinical evaluation of ocular perfusion is needed to improve glaucoma management. OBJECTIVE To detect peripapillary retinal perfusion in glaucomatous eyes compared with normal eyes using optical coherence tomography (OCT) angiography. DESIGN, SETTING, AND PARTICIPANTS Prospective observational study performed from July 24, 2013, to April 17, 2014. Participants were recruited and tested at Casey Eye Institute, Oregon Health & Science University. In total, 12 glaucomatous eyes and 12 age-matched normal eyes were analyzed. The optic disc region was imaged twice using a 3 × 3-mm scan by a 70-kHz, 840-nm-wavelength spectral OCT system. The split-spectrum amplitude-decorrelation angiography algorithm was used. Peripapillary flow index was calculated as the mean decorrelation value in the peripapillary region, defined as a 700-μm-wide elliptical annulus around the disc. Peripapillary vessel density was the percentage area occupied by vessels. The data statistical analysis was performed from October 30, 2013, to May 30, 2014. MAIN OUTCOMES AND MEASURES Variability was assessed by the coefficient of variation. The Mann-Whitney test was used to compare the 2 groups of eyes. Correlations between vascular and visual field variables were assessed by linear regression analysis. RESULTS In 12 normal eyes, a dense microvascular network around the disc was visible on OCT angiography. In 12 glaucomatous eyes, this network was visibly attenuated globally and focally. In normal eyes, between-visit reproducibilities of peripapillary flow index and peripapillary vessel density were 4.3% and 2.7% of the coefficient of variation, respectively, while the population variabilities of peripapillary flow index and peripapillary vessel density were 8.2% and 3.0% of the coefficient of variation, respectively. Peripapillary flow index and peripapillary vessel density in

  2. Relationship between glycemic control and coronary artery disease severity, prevalence and plaque characteristics by computed tomography coronary angiography in asymptomatic type 2 diabetic patients.

    PubMed

    Tavares, C A F; Rassi, C H R E; Fahel, M G; Wajchenberg, B L; Rochitte, C E; Lerario, A C

    2016-10-01

    Evaluate whether glycemic control in type 2 diabetes (DM2) asymptomatic for coronary artery disease (CAD) affects not only the presence and magnitude of CAD but also the characteristics of plaque vulnerability using multidetector row computed coronary tomography (MDCT). Acute coronary syndrome (ACS) is frequently observed in asymptomatic DM2 patients. Positive vessel remodeling (PR) and low-attenuation plaques (LAP) identified by MDCT have been demonstrated to be characteristics of subsequent culprit lesions of ACS. However, little is known regarding plaque characteristics in asymptomatic diabetic patients and their relationship with glycemic control. Ninety asymptomatic DM2 patients, aged 40-65 years old, underwent MDCT. The presence of atherosclerotic obstruction, defined as coronary stenosis ≥50 %, and plaque characteristics were compared between two groups of patients with A1c < 7 and A1c ≥ 7 %. Of the 90 patients, 38 (42.2 %) presented with coronary atherosclerotic plaques, 11 had A1c < 7 % and 27 had A1c ≥ 7 % (p = 0.0006). Fourteen patients had significant lumen obstruction higher than 50 %: 3 in the A1c < 7 % group and 11 in the A1c ≥ 7 % group (p = 0.02). Non-calcified plaque was more prevalent in the A1c ≥ 7 % group (p = 0.005). In eleven patients, the simultaneous presence of two vulnerability plaque characteristics (PR and LAP) were observed more frequently in the A1c ≥ 7 group (n = 8) than in the A1c < 7 group (n = 3) (p = 0.04). Asymptomatic DM2 patients with A1c ≥ 7 % have a higher frequency of CAD and a higher proportion of vulnerable atherosclerotic coronary plaque by MDCT compared to patients with DM2 with A1c < 7 in our study.

  3. Optical Coherence Tomography Angiography of Iris Nevus: A Case Report

    PubMed Central

    Allegrini, Davide; Montesano, Giovanni; Pece, Alfredo

    2016-01-01

    Iris nevus is common: 6% of patients with suspected iris melanoma have lesions other than melanoma, and 36% of them are nevi. Iris nevus turns into melanoma in approximately 8% of cases at a mean of 15 years. This case report provides the first description of an iris tumor examined with iris optical coherence tomography angiography (OCTA) compared to iris fluorescein angiography (IFA). A 60-year-old man with a diagnosis of iris nevus in the left eye was referred to our department for IFA and iris OCTA. The iris vasculature in IFA was visible only in the early phases, but not clearly. OCTA, however, gave visualization of the vascular network and very precisely defined the vessels of the whole lesion, except for the pupillary portion, which was masked by superficial pigment accumulations. IFA and iris OCTA can add information about the vascular architecture compared to slit-lamp biomicroscopy, ultrasound biomicroscopy, and anterior-segment OCT. However, IFA is time-consuming and invasive and can – very occasionally – cause serious adverse reactions. In contrast, OCTA defines the texture of the iris vasculature better. In conclusion, OCTA is a new method, easy to execute, needing no dye injection, and provides useful information on the vascular network of iris lesions. It could therefore be helpful in the diagnosis and follow-up of these lesions. PMID:27790134

  4. Statistical analysis of motion contrast in optical coherence tomography angiography

    NASA Astrophysics Data System (ADS)

    Cheng, Yuxuan; Guo, Li; Pan, Cong; Lu, Tongtong; Hong, Tianyu; Ding, Zhihua; Li, Peng

    2015-11-01

    Optical coherence tomography angiography (Angio-OCT), mainly based on the temporal dynamics of OCT scattering signals, has found a range of potential applications in clinical and scientific research. Based on the model of random phasor sums, temporal statistics of the complex-valued OCT signals are mathematically described. Statistical distributions of the amplitude differential and complex differential Angio-OCT signals are derived. The theories are validated through the flow phantom and live animal experiments. Using the model developed, the origin of the motion contrast in Angio-OCT is mathematically explained, and the implications in the improvement of motion contrast are further discussed, including threshold determination and its residual classification error, averaging method, and scanning protocol. The proposed mathematical model of Angio-OCT signals can aid in the optimal design of the system and associated algorithms.

  5. Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration

    PubMed Central

    Jia, Yali; Bailey, Steven T.; Wilson, David J.; Tan, Ou; Klein, Michael L.; Flaxel, Christina J.; Potsaid, Benjamin; Liu, Jonathan J.; Lu, Chen D.; Kraus, Martin F.; Fujimoto, James G.; Huang, David

    2014-01-01

    Purpose To detect and quantify choroidal neovascularization (CNV) in age-related macular degeneration (AMD) patients using optical coherence tomography (OCT) angiography. Design Observational, cross-sectional study. Participants Five normal subjects and five neovascular AMD patients were included. Methods Five eyes with neovascular AMD and five normal age-matched controls were scanned by a high-speed (100,000 A-scans/sec) 1050 nm wavelength swept-source OCT. The macular angiography scan covered a 3×3 mm area and comprised 200×200×8 A-scans acquired in 3.5 sec. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were removed by three dimensional (3D) orthogonal registration and merging of 4 scans. The 3D angiography was segmented into 3 layers: inner retina (to show retinal vasculature), outer retina (to identify CNV), and choroid. En face maximum projection was used to obtain 2D angiograms from the 3 layers. CNV area and flow index were computed from the en face OCT angiogram of the outer retinal layer. Flow (decorrelation) and structural data were combined in composite color angiograms for both en face and cross-sectional views. Main Outcome Measurements CNV angiogram, CNV area, and CNV flow index. Results En face OCT angiograms of CNVs showed sizes and locations that were confirmed by fluorescein angiography. OCT angiography provided more distinct vascular network patterns that were less obscured by subretinal hemorrhage. The en face angiograms also showed areas of reduced choroidal flow adjacent to the CNV in all cases and significantly reduced retinal flow in one case. Cross-sectional angiograms were used to visualize CNV location relative to the retinal pigment epithelium and Bruch’s layer and classify type I and type II CNV. A feeder vessel could be identified in one case. Higher flow indexes were associated with larger CNV and type II CNV. Conclusions OCT angiography provides depth

  6. Optical Coherence Tomography Angiography in Mice: Comparison with Confocal Scanning Laser Microscopy and Fluorescein Angiography

    PubMed Central

    Giannakaki-Zimmermann, Helena; Kokona, Despina; Wolf, Sebastian; Ebneter, Andreas; Zinkernagel, Martin S.

    2016-01-01

    Purpose Optical coherence tomography angiography (OCT-A) allows noninvasive visualization of retinal vessels in vivo. OCT-A was used to characterize the vascular network of the mouse retina and was compared with fluorescein angiography (FA) and histology. Methods In the present study, OCT-A based on a Heidelberg Engineering Spectralis system was used to investigate the vascular network in mice. Data was compared with FA and confocal microscopy of flat-mount histology stained with isolectin IB4. For quantitative analysis the National Cancer Institute's AngioTool software was used. Vessel density, the number of vessel junctions, and endpoints were measured and compared between the imaging modalities. Results The configuration of the superficial capillary network was comparable with OCT-A and flat-mount histology in BALBc mice. However, vessel density and the number of vessel junctions per region of interest (P = 0.0161 and P = 0.0015, respectively) in the deep vascular network of BALBc mice measured by OCT-A was significantly higher than with flat-mount histology. In C3A.Cg-Pde6b+Prph2Rd2/J mice, where the deep capillary plexus is absent, analysis of the superficial network provided similar results for all three imaging modalities. Conclusion OCT-A is a helpful imaging tool for noninvasive, in vivo imaging of the vascular plexus in mice. It may offer advantages over FA and confocal microscopy especially for imaging the deep vascular plexus. Translational Relevance The present study shows that OCT-A can be employed for small animal imaging to assess the vascular network and offers advantages over flat-mount histology and FA. PMID:27570710

  7. Can Early Computed Tomography Angiography after Endovascular Aortic Aneurysm Repair Predict the Need for Reintervention in Patients with Type II Endoleak?

    SciTech Connect

    Dudeck, O.; Schnapauff, D.; Herzog, L.; Löwenthal, D.; Bulla, K.; Bulla, B.; Halloul, Z.; Meyer, F.; Pech, M.; Gebauer, B.; Ricke, J.

    2015-02-15

    PurposeThis study was designed to identify parameters on CT angiography (CTA) of type II endoleaks following endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), which can be used to predict the subsequent need for reinterventions.MethodsWe retrospectively identified 62 patients with type II endoleak who underwent early CTA in mean 3.7 ± 1.9 days after EVAR. On the basis of follow-up examinations (mean follow-up period 911 days; range, 373–1,987 days), patients were stratified into two groups: those who did (n = 18) and those who did not (n = 44) require reintervention. CTA characteristics, such as AAA, endoleak, as well as nidus dimensions, patency of the inferior mesenteric artery, number of aortic branch vessels, and the pattern of endoleak appearance, were recorded and correlated with the clinical outcome.ResultsUnivariate and receiver operating characteristic curve regression analyses revealed significant differences between the two groups for the endoleak volume (surveillance group: 1391.6 ± 1427.9 mm{sup 3}; reintervention group: 3227.7 ± 2693.8 mm{sup 3}; cutoff value of 2,386 mm{sup 3}; p = 0.002), the endoleak diameter (13.6 ± 4.3 mm compared with 25.9 ± 9.6 mm; cutoff value of 19 mm; p < 0.0001), the number of aortic branch vessels (2.9 ± 1.2 compared with 4.2 ± 1.4 vessels; p = 0.001), as well as a “complex type” endoleak pattern (13.6 %, n = 6 compared with 44.4 %, n = 8; p = 0.02).ConclusionsEarly CTA can predict the future need for reintervention in patients with type II endoleak. Therefore, treatment decision should be based not only on aneurysm enlargement alone but also on other imaging characteristics.

  8. Computed tomography in neurocysticercosis.

    PubMed Central

    Minguetti, G; Ferreira, M V

    1983-01-01

    Neurocysticercosis is a major public health problem in developing countries. Before computed tomography became available its diagnosis was very restricted and the conventional diagnostic methods were unreliable. It also was frequently necessary to submit patients to costly and dangerous surgical procedures to confirm the precise nature of the disease. One hundred and seventy-one patients with neurocysticercosis were evaluated by computed tomography. The diagnostic findings of the different types of lesions produced by the larva of the parasite (Taenia solium) in the central nervous system, and the advantages of CT in the diagnosis of this clinical entity are described, as well as the main signs and symptoms of the patients referred for examination. The effect of corticosteroids in the acute stages of the disease and the changes they provoke in the CT images are described. Images PMID:6644318

  9. Computed tomography status

    SciTech Connect

    Hansche, B.D.

    1983-01-01

    Computed tomography (CT) is a relatively new radiographic technique which has become widely used in the medical field, where it is better known as computerized axial tomographic (CAT) scanning. This technique is also being adopted by the industrial radiographic community, although the greater range of densities, variation in samples sizes, plus possible requirement for finer resolution make it difficult to duplicate the excellent results that the medical scanners have achieved.

  10. Computed Tomography Status

    DOE R&D Accomplishments Database

    Hansche, B. D.

    1983-01-01

    Computed tomography (CT) is a relatively new radiographic technique which has become widely used in the medical field, where it is better known as computerized axial tomographic (CAT) scanning. This technique is also being adopted by the industrial radiographic community, although the greater range of densities, variation in samples sizes, plus possible requirement for finer resolution make it difficult to duplicate the excellent results that the medical scanners have achieved.

  11. Arterioportal shunts on dynamic computed tomography

    SciTech Connect

    Nakayama, T.; Hiyama, Y.; Ohnishi, K.; Tsuchiya, S.; Kohno, K.; Nakajima, Y.; Okuda, K.

    1983-05-01

    Thirty-two patients, 20 with hepatocelluar carcinoma and 12 with liver cirrhosis, were examined by dynamic computed tomography (CT) using intravenous bolus injection of contrast medium and by celiac angiography. Dynamic CT disclosed arterioportal shunting in four cases of hepatocellular carcinoma and in one of cirrhosis. In three of the former, the arterioportal shunt was adjacent to a mass lesion on CT, suggesting tumor invasion into the portal branch. In one with hepatocellular carcinoma, the shunt was remote from the mass. In the case with cirrhosis, there was no mass. In these last two cases, the shunt might have been caused by prior percutaneous needle puncture. In another case of hepatocellular carcinoma, celiac angiography but not CT demonstrated an arterioportal shunt. Thus, dynamic CT was diagnostic in five of six cases of arteriographically demonstrated arterioportal shunts.

  12. Heidelberg Spectralis Optical Coherence Tomography Angiography: Technical Aspects.

    PubMed

    Coscas, Gabriel; Lupidi, Marco; Coscas, Florence

    2016-01-01

    Optical coherence tomography angiography (OCT-A) is a promising new method for visualizing the retinal vasculature and choroidal vascular layers in the macular area and provides depth-resolved functional information on blood flow in these vessels. OCT-A is based on the concept that in a static eye the only moving structure in the fundus of the eye is blood flowing through the vessels. Contrast is generated based on the difference between moving cells in the vasculature and the static surrounding tissue. Artifacts can arise due to scan positioning errors caused by normal ocular microsaccades. In order to avoid artifacts, a sequence of OCT B-scans in the exact same retinal location must be taken to detect flow. Active eye-tracking (TruTrack™) using the simultaneous acquisition of fundus and optical coherence tomography (OCT) images presents a very reliable method of acquiring OCT volume scans without motion artifacts and helps significantly improve signal-to-noise ratio. This system also allows the use of a full spectrum amplitude decorrelation algorithm that produces clear differentiation between blood flow and static tissue without sacrificing the axial resolution of OCT images. Accuracy in layer segmentation, which requires high-resolution OCT B-scans, is crucial for producing reliable OCT-A images. This can be achieved through automated or manual layer segmentation. During OCT scan acquisition, the effect of axial motion (e.g. a patient moving towards the camera) is compensated for by geometric alignment of successive B-scans before analyzing temporal changes.

  13. Compensation for Reflectance Variation in Vessel Density Quantification by Optical Coherence Tomography Angiography

    PubMed Central

    Gao, Simon S.; Jia, Yali; Liu, Liang; Zhang, Miao; Takusagawa, Hana L.; Morrison, John C.; Huang, David

    2016-01-01

    Purpose To compensate for reflectance variation when quantifying vessel density by optical coherence tomography angiography (OCTA). Methods Healthy participants received 6×6-mm macular and 4.5×4.5-mm optic nerve head (ONH) angiography scans on a 70-kHz spectral-domain optical coherence tomography system. The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to compute the OCTA signal. Mean reflectance projection and maximum decorrelation projection were used to create en face OCT and OCTA images. Background OCTA noise in static tissue was evaluated in the foveal avascular zone (FAZ). Vessel density was calculated from en face retinal OCTA that was binarized according to a decorrelation threshold. Results The average retinal decorrelation noise in the FAZ was linearly related to the average logarithmic-scale OCT reflectance signal. Based on this relationship, a reflectance-adjusted decorrelation threshold equation was developed to filter out 97.5% of background OCTA noise. A fixed threshold was also used for comparison. The superficial vascular complex vessel density in the macula and ONH were significantly correlated with reflectance signal strength index (SSI) using the fixed threshold. This correlation was removed by using the reflectance-adjusted threshold. Reflectance compensation reduced population variation in 25 healthy eyes from 8.5% to 4.8% (coefficient of variation) in the macula and from 6.7% to 5.4% in the peripapillary region. Within-visit repeatability also improved from 4.4% to 1.8% in the macula and from 3% to 1.7% in the peripapillary region. Conclusions Compensating for reflectance variation resulted in more reliable vessel density quantification in OCTA. PMID:27571015

  14. Freehand photoacoustic tomography for 3D angiography using local gradient information

    NASA Astrophysics Data System (ADS)

    Kirchner, Thomas; Wild, Esther; Maier-Hein, Klaus H.; Maier-Hein, Lena

    2016-03-01

    Photo-acoustic tomography (PAT) is capable of imaging optical absorption in depths beyond the diffusion limit. As blood is one of the main absorbers in tissue, one important application is the visualization of vasculature, which can provide important clues for diagnosing diseases like cancer. While the state-of-the-art work in photo-acoustic 3D angiography has focused on computed tomography systems involving complex setups, we propose an approach based on optically tracking a freehand linear ultrasound probe that can be smoothly integrated into the clinical workflow. To this end, we present a method for calibration of a PAT system using an N-wire phantom specifically designed for PAT and show how to use local gradient information in the 3D reconstructed volume to significantly enhance the signal. According to experiments performed with a tissue mimicking intra-lipid phantom, the signal-to-noise ratio, contrast and contrast-to-noise ratio measured in the full field of view of the linear probe can be improved by factors of 1.7+/-0.7, 14.6+/-5.8 and 2.8+/-1.2 respectively, when comparing the post envelope detection reconstructed 3D volume with the processed one. Qualitative validation performed in tissue mimicking gelatin phantoms further showed good agreement of the reconstructed vasculature with corresponding structures extracted from X-ray computed tomographies. As our method provides high contrast 3D images of the vasculature despite a low hardware complexity its potential for clinical application is high.

  15. Computed Tomography Measuring Inside Machines

    NASA Technical Reports Server (NTRS)

    Wozniak, James F.; Scudder, Henry J.; Anders, Jeffrey E.

    1995-01-01

    Computed tomography applied to obtain approximate measurements of radial distances from centerline of turbopump to leading edges of diffuser vanes in turbopump. Use of computed tomography has significance beyond turbopump application: example of general concept of measuring internal dimensions of assembly of parts without having to perform time-consuming task of taking assembly apart and measuring internal parts on coordinate-measuring machine.

  16. Technical innovation: Multidimensional computerized software enabled subtraction computed tomographic angiography.

    PubMed

    Bhatia, Mona; Rosset, Antoine; Platon, Alexandra; Didier, Dominique; Becker, Christoph D; Poletti, Pierre-Alexandre

    2010-01-01

    Computed tomographic angiography (CTA) is a frequent noninvasive alternative to digital subtraction angiography. We previously reported the development of a new subtraction software to overcome limitations of adjacent bone and calcification in CT angiographic subtraction. Our aim was to further develop and improve this fast and automated computerized software, universally available for free use and compatible with most CT scanners, thus enabling better delineation of vascular structures, artifact reduction, and shorter reading times with potential clinical benefits. This computer-based free software will be available as an open source in the next release of OsiriX at the Web site http://www.osirix-viewer.com.

  17. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye

    PubMed Central

    Jia, Yali; Bailey, Steven T.; Hwang, Thomas S.; McClintic, Scott M.; Pennesi, Mark E.; Flaxel, Christina J.; Lauer, Andreas K.; Wilson, David J.; Hornegger, Joachim; Fujimoto, James G.; Huang, David

    2015-01-01

    Retinal vascular diseases are important causes of vision loss. A detailed evaluation of the vascular abnormalities facilitates diagnosis and treatment in these diseases. Optical coherence tomography (OCT) angiography using the highly efficient split-spectrum amplitude decorrelation angiography algorithm offers an alternative to conventional dye-based retinal angiography. OCT angiography has several advantages, including 3D visualization of retinal and choroidal circulations (including the choriocapillaris) and avoidance of dye injection-related complications. Results from six illustrative cases are reported. In diabetic retinopathy, OCT angiography can detect neovascularization and quantify ischemia. In age-related macular degeneration, choroidal neovascularization can be observed without the obscuration of details caused by dye leakage in conventional angiography. Choriocapillaris dysfunction can be detected in the nonneovascular form of the disease, furthering our understanding of pathogenesis. In choroideremia, OCT's ability to show choroidal and retinal vascular dysfunction separately may be valuable in predicting progression and assessing treatment response. OCT angiography shows promise as a noninvasive alternative to dye-based angiography for highly detailed, in vivo, 3D, quantitative evaluation of retinal vascular abnormalities. PMID:25897021

  18. Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease

    PubMed Central

    Williams, Michelle C.; Hunter, Amanda; Shah, Anoop S.V.; Assi, Valentina; Lewis, Stephanie; Smith, Joel; Berry, Colin; Boon, Nicholas A.; Clark, Elizabeth; Flather, Marcus; Forbes, John; McLean, Scott; Roditi, Giles; van Beek, Edwin J.R.; Timmis, Adam D.; Newby, David E.

    2016-01-01

    Background In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes. Methods In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records. Results Despite similar overall rates (409 vs. 401; p = 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios [HRs]: 0.39 [95% confidence interval (CI): 0.23 to 0.68]; p < 0.001) but more likely to show obstructive coronary artery disease (283 vs. 230; HR: 1.29 [95% CI: 1.08 to 1.55]; p = 0.005) in those allocated to CCTA. More preventive therapies (283 vs. 74; HR: 4.03 [95% CI: 3.12 to 5.20]; p < 0.001) were initiated after CCTA, with each drug commencing at a median of 48 to 52 days after clinic attendance. From the median time for preventive therapy initiation (50 days), fatal and nonfatal myocardial infarction was halved in patients allocated to CCTA compared with those assigned to standard care (17 vs. 34; HR: 0.50 [95% CI: 0.28 to 0.88]; p = 0.020). Cumulative 6-month costs were slightly higher with CCTA: difference $462 (95% CI: $303 to $621). Conclusions In patients with suspected angina due to coronary heart disease, CCTA leads to more appropriate use of invasive angiography and alterations in preventive therapies that were associated with a halving of fatal and non-fatal myocardial infarction. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590) PMID:27081014

  19. Multidetector computed tomographic angiography of aberrant subclavian arteries.

    PubMed

    Türkvatan, Aysel; Büyükbayraktar, Fatma Gül; Olçer, Tülay; Cumhur, Turhan

    2009-02-01

    The purpose of this study was to evaluate the utility of 16-slice multidetector computed tomographic (MDCT) angiography for identifying anatomic features of aberrant subclavian arteries. Seventeen patients with aberrant subclavian arteries were assessed by MDCT angiography. The aortic arch position, the presence of a Kommerell's diverticulum, aneurysm, vascular compression of trachea and oesophagus and associated cardiovascular abnormalities were evaluated. MDCT findings were confirmed by surgery in eight patients but in the other nine patients no further evaluation or management was warranted as the aberrant subclavian artery had no significant clinical consequence. Eleven patients had an aberrant right subclavian artery arising from the left aortic arch and six patients had an aberrant left subclavian artery arising from the right aortic arch. Kommerell's diverticulum was identified in three patients with an aberrant right subclavian artery and in five patients with an aberrant left subclavian artery. In two patients it was aneurysmal. Oesophageal compression was detected in eight patients, and tracheal compression was identified in only one paediatric patient. An aberrant subclavian artery was associated with complex congenital heart disease in one patient, intracardiac defects in two patients, aortic coarctation in two patients, patent ductus arteriosus in two patients and an aberrant vertebral artery in one patient. In conclusion, MDCT angiography is superior to digital subtraction angiography for the assessment of aberrant subclavian arteries since digital subtraction angiography has only a poor ability to visualize adjacent structures completely and is invasive in nature. MDCT angiography or magnetic resonance angiography are the current standard in the initial evaluation of thoracic vascular anomalies.

  20. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-11-23

    The American College of Cardiology Foundation, along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:20975004

  1. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D; Kramer, Christopher M; Berman, Daniel; Brown, Alan; Chaudhry, Farooq A; Cury, Ricardo C; Desai, Milind Y; Einstein, Andrew J; Gomes, Antoinette S; Harrington, Robert; Hoffmann, Udo; Khare, Rahul; Lesser, John; McGann, Christopher; Rosenberg, Alan; Schwartz, Robert; Shelton, Marc; Smetana, Gerald W; Smith, Sidney C

    2010-11-23

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21087721

  2. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-01-01

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21232696

  3. Computed tomography of the body

    SciTech Connect

    Lee, J.K.T.; Stanley, R.J.

    1982-01-01

    By the end of the fourth year of clinical use, the number of articles dealing with computed body tomography (CT) had increased exponentially. Over 100 articles were published during this review period. This chapter examines new application of CT in the neck, musculoskeletal system and the breast. The chapter begins with an examination of the technical aspects of the operation and performance of CT scanners during this review period. The anatomy of various regions of the body, such as neck, chest, liver and biliary system, genitourinary tract, and pelvis are examined. Brief discussions of pediatric computed tomography, computed tomography-guided biopsy, and radiation therapy are presented. (KRM)

  4. Early Swept-Source Optical Coherence Tomography Angiography Findings in Unilateral Acute Idiopathic Maculopathy.

    PubMed

    Nicolo, Massimo; Rosa, Raffaella; Musetti, Donatella; Musolino, Maria; Traverso, Carlo Enrico

    2016-02-01

    Unilateral acute idiopathic maculopathy (UAIM) is a rare disorder presenting in young people with an acute onset of unilateral central visual loss often associated with a prodromal flu-like illness. The authors present the early anatomical findings of a 35-year-old man clinically diagnosed with UAIM using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography.

  5. Computed tomography of the prostate.

    PubMed

    Van Engelshoven, J M; Kreel, L

    1979-02-01

    The conventional anatomy of the prostate is reviewed and the computed tomography (CT) anatomy described and illustrated. The results of 55 "normal" cases were analyzed for size and relationship to the symphysis pubis, retropubic space, and bladder, as shown on CT sections correlating the features with age and possible urinary symptoms. Attention is also drawn to the differences between phleboliths and prostatic calcification. Computed tomography is an effective method of demonstrating the prostate and surrounding structures and of assessing prostatic enlargement.

  6. Pictorial review: electron beam computed tomography and multislice spiral computed tomography for cardiac imaging.

    PubMed

    Lembcke, Alexander; Hein, Patrick A; Dohmen, Pascal M; Klessen, Christian; Wiese, Till H; Hoffmann, Udo; Hamm, Bernd; Enzweiler, Christian N H

    2006-03-01

    Electron beam computed tomography (EBCT) revolutionized cardiac imaging by combining a constant high temporal resolution with prospective ECG triggering. For years, EBCT was the primary technique for some non-invasive diagnostic cardiac procedures such as calcium scoring and non-invasive angiography of the coronary arteries. Multislice spiral computed tomography (MSCT) on the other hand significantly advanced cardiac imaging through high volume coverage, improved spatial resolution and retrospective ECG gating. This pictorial review will illustrate the basic differences between both modalities with special emphasis to their image quality. Several experimental and clinical examples demonstrate the strengths and limitations of both imaging modalities in an intraindividual comparison for a broad range of diagnostic applications such as coronary artery calcium scoring, coronary angiography including stent visualization as well as functional assessment of the cardiac ventricles and valves. In general, our examples indicate that EBCT suffers from a number of shortcomings such as limited spatial resolution and a low contrast-to-noise ratio. Thus, EBCT should now only be used in selected cases where a constant high temporal resolution is a crucial issue, such as dynamic (cine) imaging. Due to isotropic submillimeter spatial resolution and retrospective data selection MSCT seems to be the non-invasive method of choice for cardiac imaging in general, and for assessment of the coronary arteries in particular. However, technical developments are still needed to further improve the temporal resolution in MSCT and to reduce the substantial radiation exposure. PMID:16427236

  7. Methods and algorithms for optical coherence tomography-based angiography: a review and comparison

    NASA Astrophysics Data System (ADS)

    Zhang, Anqi; Zhang, Qinqin; Chen, Chieh-Li; Wang, Ruikang K.

    2015-10-01

    Optical coherence tomography (OCT)-based angiography is increasingly becoming a clinically useful and important imaging technique due to its ability to provide volumetric microvascular networks innervating tissue beds in vivo without a need for exogenous contrast agent. Numerous OCT angiography algorithms have recently been proposed for the purpose of contrasting microvascular networks. A general literature review is provided on the recent progress of OCT angiography methods and algorithms. The basic physics and mathematics behind each method together with its contrast mechanism are described. Potential directions for future technical development of OCT based angiography is then briefly discussed. Finally, by the use of clinical data captured from normal and pathological subjects, the imaging performance of vascular networks delivered by the most recently reported algorithms is evaluated and compared, including optical microangiography, speckle variance, phase variance, split-spectrum amplitude decorrelation angiography, and correlation mapping. It is found that the method that utilizes complex OCT signal to contrast retinal blood flow delivers the best performance among all the algorithms in terms of image contrast and vessel connectivity. The purpose of this review is to help readers understand and select appropriate OCT angiography algorithm for use in specific applications.

  8. Methods and algorithms for optical coherence tomography-based angiography: a review and comparison

    PubMed Central

    Zhang, Anqi; Zhang, Qinqin; Chen, Chieh-Li; Wang, Ruikang K.

    2015-01-01

    Abstract. Optical coherence tomography (OCT)-based angiography is increasingly becoming a clinically useful and important imaging technique due to its ability to provide volumetric microvascular networks innervating tissue beds in vivo without a need for exogenous contrast agent. Numerous OCT angiography algorithms have recently been proposed for the purpose of contrasting microvascular networks. A general literature review is provided on the recent progress of OCT angiography methods and algorithms. The basic physics and mathematics behind each method together with its contrast mechanism are described. Potential directions for future technical development of OCT based angiography is then briefly discussed. Finally, by the use of clinical data captured from normal and pathological subjects, the imaging performance of vascular networks delivered by the most recently reported algorithms is evaluated and compared, including optical microangiography, speckle variance, phase variance, split-spectrum amplitude decorrelation angiography, and correlation mapping. It is found that the method that utilizes complex OCT signal to contrast retinal blood flow delivers the best performance among all the algorithms in terms of image contrast and vessel connectivity. The purpose of this review is to help readers understand and select appropriate OCT angiography algorithm for use in specific applications. PMID:26473588

  9. Methods and algorithms for optical coherence tomography-based angiography: a review and comparison.

    PubMed

    Zhang, Anqi; Zhang, Qinqin; Chen, Chieh-Li; Wang, Ruikang K

    2015-10-01

    Optical coherence tomography (OCT)-based angiography is increasingly becoming a clinically useful and important imaging technique due to its ability to provide volumetric microvascular networks innervating tissue beds in vivo without a need for exogenous contrast agent. Numerous OCT angiography algorithms have recently been proposed for the purpose of contrasting microvascular networks. A general literature review is provided on the recent progress of OCT angiography methods and algorithms. The basic physics and mathematics behind each method together with its contrast mechanism are described. Potential directions for future technical development of OCT based angiography is then briefly discussed. Finally, by the use of clinical data captured from normal and pathological subjects, the imaging performance of vascular networks delivered by the most recently reported algorithms is evaluated and compared, including optical microangiography, speckle variance,phase variance, split-spectrum amplitude decorrelation angiography, and correlation mapping. It is found that the method that utilizes complex OCT signal to contrast retinal blood flow delivers the best performance among all the algorithms in terms of image contrast and vessel connectivity. The purpose of this review is to help readers understand and select appropriate OCT angiography algorithm for use in specific applications.

  10. [Comparative evaluation of ultrasonography, computerized tomography, angiography and lipiodol CT in defining extent of hepatocarcinoma. A multicenter study].

    PubMed

    Dalla Palma, L; Pozzi Mucelli, R; Sponza, M; Bartolozzi, C; De Santis, M; Gandini, G; Mannella, P; Matricardi, L; Rossi, C; Simonetti, G

    1995-03-01

    The authors report the results of a multicentric trial on hepatocellular carcinoma (HCC) patients, whose lesions were confirmed with biopsy or by high (> 400 ng/ml) alpha-fetoprotein levels. The series consisted of 149 patients examined in 8 different centers and submitted to ultrasonography (US), Computed Tomography (CT) before and after contrast agent administration, angiography and Lipiodol CT. According to lesion size and number, the patients were divided with each imaging modality into three groups: a) group 1: unifocal HCC < 5 cm diameter; b) group 2: multifocal HCC with 2-3 nodules and/or tumor mass < 80 ml; c) multifocal HCC with more than 3 nodules (with total tumor mass not exceeding 40% of liver volume) or with total tumor mass > 80 ml. In 77 patients all the examinations were available for comparison. US and CT diagnosed more patients as belonging to group 1 than angiography and Lipiodol CT, while more patients were classified as groups 2 and 3 with angiography and Lipiodol CT, meaning that US and CT may understage some HCC cases (about 15%) because they show a lower number of nodules. This observation was confirmed by the direct comparison between US and Lipiodol CT (in 114 patients), CT and Lipiodol CT (in 103 patients) and angiography and Lipiodol CT (in 116 patients). US and Lipiodol CT were in disagreement in 18 cases, CT and Lipiodol CT in 16 cases and angiography and Lipiodol CT in 13 cases. In most of these cases, Lipiodol CT showed more lesions than the other techniques. The size of the undetected lesions was small, ranging few mm to 2 cm in nearly all cases. To conclude, the results of this multicentric trial show that Lipiodol CT is a fundamental tool to evaluate HCC extent. In contrast, conventional CT appeared not to add any significant piece of information and can therefore be excluded from the diagnostic protocol of HCC.

  11. CT angiography - abdomen and pelvis

    MedlinePlus

    Computed tomography angiography - abdomen and pelvis; CTA - abdomen and pelvis; Renal artery - CTA; Aortic - CTA; Mesenteric CTA ... belly or pelvis Masses and tumors in the abdomen or pelvis, including cancer, when needed to help ...

  12. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter.

    PubMed

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G

    2016-08-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm(2) area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated. PMID:27570688

  13. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter

    PubMed Central

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E.; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G.

    2016-01-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm2 area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated. PMID:27570688

  14. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter.

    PubMed

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G

    2016-08-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm(2) area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated.

  15. Computed tomography of intramuscular myxoma

    SciTech Connect

    Ekelund, L.; Herrlin, K.; Rydholm, A.

    1982-11-01

    Computed tomography (CT) was performed in seven patients with intramuscular myxoma. All lesions were well demarcated, of homogeneous appearance and attenuation values ranging from 10 to 60 (HU). The tumor size, as estimated at CT, correlated well with the size of the surgical specimen, which is in contrast to the findings in some high grade malignant sarcomas.

  16. X-ray Computed Tomography.

    ERIC Educational Resources Information Center

    Michael, Greg

    2001-01-01

    Describes computed tomography (CT), a medical imaging technique that produces images of transaxial planes through the human body. A CT image is reconstructed mathematically from a large number of one-dimensional projections of a plane. The technique is used in radiological examinations and radiotherapy treatment planning. (Author/MM)

  17. Computed tomography:the details.

    SciTech Connect

    Doerry, Armin Walter

    2007-07-01

    Computed Tomography (CT) is a well established technique, particularly in medical imaging, but also applied in Synthetic Aperture Radar (SAR) imaging. Basic CT imaging via back-projection is treated in many texts, but often with insufficient detail to appreciate subtleties such as the role of non-uniform sampling densities. Herein are given some details often neglected in many texts.

  18. Computer-aided CT coronary artery stenosis detection: comparison with human reading and quantitative coronary angiography.

    PubMed

    Rief, Matthias; Kranz, Anisha; Hartmann, Lisa; Roehle, Robert; Laule, Michael; Dewey, Marc

    2014-12-01

    To evaluate computer-aided stenosis detection for computed tomography coronary angiography (CTA) in comparison with human reading and conventional coronary angiography (CCA) as the reference standard. 50 patients underwent CTA and CCA and out of these 44 were evaluable for computer-aided stenosis detection. The diagnostic performance of the software and of human reading were compared and quantitative coronary angiography (QCA) served as the reference standard for the detection of significant stenosis (>50 %). Overall, three readers with high (reader 1), intermediate (reader 2) and low (reader 3) experience in cardiac CT imaging performed the manual CTA evaluation on a commercially available workstation, whereas the automated software processed the datasets without any human interaction. The prevalence of coronary artery disease was 41 % (18/44) and QCA indicated significant stenosis (>50 %) in 33 coronary vessels. The automated software accurately diagnosed 18 individuals with significant coronary artery disease (CAD), and correctly ruled out CAD in 10 patients. In summary the sensitivity of computer-aided detection was 100 %/94 % (per-patient/per-vessel) and the specificity was 38 %/70 %, the positive predictive value (PPV) was 53 %/42 % and the negative predictive value (NPV) was 100 %/98 %. In comparison, reader 1-3 showed per-patient sensitivities of 100/94/89 %, specificities of 73/69/50 %, PPVs of 72/68/55 % and NPVs of 100/95/87 %. Computer-aided detection yields a high NPV that is comparable to more experienced human readers. However, PPV is rather low and in the range of an unexperienced reader.

  19. Cardiac Computed Tomography (Multidetector CT, or MDCT)

    MedlinePlus

    ... High Blood Pressure Tools & Resources Stroke More Cardiac Computed Tomography (Multidetector CT, or MDCT) Updated:Sep 3,2015 ... facts MDCT is a very fast type of computed tomography (CT) scan. MDCT creates pictures of the healthy ...

  20. Congenital Anomalies of the Aortic Arch: Evaluation with the Use of Multidetector Computed Tomography

    PubMed Central

    Büyükbayraktar, Fatma Gül; Ölçer, Tülay; Cumhur, Turhan

    2009-01-01

    Congenital anomalies of the aortic arch have clinical importance, as the anomalies may be associated with vascular rings or other congenital cardiovascular diseases. Multidetector computed tomography (MDCT) angiography enables one to display the detailed anatomy of vascular structures and the spatial relationships with adjacent organs; this ability is the greatest advantage of the use of MDCT angiography in comparison to other imaging modalities in the evaluation of the congenital anomalies of the aortic arch. In this review article, we illustrate 16-slice MDCT angiography appearances of congenital anomalies of the aortic arch. PMID:19270864

  1. Optical Coherence Tomography Angiography in Retinal Vascular Diseases and Choroidal Neovascularization

    PubMed Central

    Mastropasqua, Rodolfo; Di Antonio, Luca; Di Staso, Silvio; Agnifili, Luca; Di Gregorio, Angela; Ciancaglini, Marco; Mastropasqua, Leonardo

    2015-01-01

    Purpose. To assess the ability of optical coherence tomography-angiography (OCT-A) to show and analyze retinal vascular patterns and the choroidal neovascularization (CNV) in retinal vascular diseases. Methods. Seven eyes of seven consecutive patients with retinal vascular diseases were examined. Two healthy subjects served as controls. All eyes were scanned with the SD-OCT XR Avanti (Optovue Inc, Fremont CA, USA). Split spectrum amplitude decorrelation angiography algorithm was used to identify the blood flow within the tissue. Fluorescein angiography (FA) and indocyanine green angiography (ICGA) with Spectralis HRA + OCT (Heidelberg Engineering GmbH) were performed. Results. In healthy subjects OCT-A visualized major macular vessels and detailed capillary networks around the foveal avascular zone. Patients were affected with myopic CNV (2 eyes), age-related macular degeneration related (2), branch retinal vein occlusion (BRVO) (2), and branch retinal artery occlusion (BRAO) (1). OCT-A images provided distinct vascular patterns, distinguishing perfused and nonperfused areas in BRVO and BRAO and recognizing the presence, location, and size of CNV. Conclusions. OCT-A provides detailed images of retinal vascular plexuses and quantitative data of pathologic structures. Further studies are warranted to define the role of OCT-A in the assessment of retinovascular diseases, with respect to conventional FA and ICG-A. PMID:26491548

  2. Pediatric cranial computed tomography

    SciTech Connect

    Yamada, H.

    1984-01-01

    The introduction of CT in the investigation of intercranial pathology has revolutionized the approach to clinical neurological and neurosurgical practice. This book applies the advances of cranial CT to the pediatric patient. The test is divided into two sections. The first portion describes the practical methodology, anatomy and normal and abnormal CT scan appearance, including high or low density lesions, cystic lesions and ventricular or subarachnoid space dilation. The characteristic scans for various neurological diseases are presented and discussed. The author has given special attention to the CT diagnosis of congenital malformations and cerebral neoplasms. Partial Contents: Normal Computed Tomographic Anatomy/ High Density Lesions/Low Density Lesions/Cystic Lesions; Supratentorial/Cystic Lesions; Infratentorial/Increased Head Circumference/Increased Ventricular Size/Small Ventricular Size/Cranial Lesions/Spinal Lesions/CT Cisternography/Part II CT in Neonates/Congenital Craniocerebral Malformations/Hydrocephalus/Craniosynostosis/Head Trauma/Cerebrovascular Lesions/Intracranial Lesions/Seizure Disorders/Intracranial and Other Chronic Neurological Disorders.

  3. Computed tomography of the abdomen.

    PubMed

    Leslie, E V; Panaro, V A; Alker, G J; Oh, Y S

    1980-01-01

    In a few short years, computed tomography has become an important diagnostic procedure in the examination of the abdomen and pelvis. Its forte lies in its ability to provide cross-sectional views of excellent anatomical detail. Imaging of deep-seated structures such as the pancreas, adrenal glands, and enlarged retroperitoneal lymph nodes is now possible. The ability to distinguish small variations in tissue density enables the radiologist to evaluate the texture of solid structures, and to differentiate them from cysts or abscesses. The addition of contrast enhancement makes it possible to determine the vascularity of a lesson. The major limitation of CT is poorer delineation of structures in thin patients, and in patients in whom voluntary and involuntary motion cannot be interrupted. Computed tomography is compared with other complementary imaging procedures to include sonography, radionuclide imaging, and conventional radiograph procedures. It has replaced invasive diagnostic procedures in many instances. In a given situation, one or more imaging modalities may be appropriate.

  4. Computed tomography of gynecologic diseases

    SciTech Connect

    Gross, B.H.; Moss, A.A.; Mihara, K.; Goldberg, H.I.; Glazer, G.M.

    1983-10-01

    Although computed tomography (CT) provides superb images of all areas of the body, sonography, because of its lack of ionizing radiation and its real-time and multiplanar capacities, has become the preferred initial method of evaluating the female pelvis. This has resulted in a relative paucity of information in the literature concerning CT features of benign pelvic disorders in particular and prompted the authors to review our experience with third-generation CT scanning of the uterus and ovaries.

  5. Cranial computed tomography and MRI

    SciTech Connect

    Lee, S.H.; Rao, K.C.V.G.

    1987-01-01

    This book appears to be a hybrid between an atlas and a text. The second edition attempts to depict the current status of both computed tomography (CT) and magnetic resonance (MR) imaging in neuroradiology. Although only the final chapter of the book is completely devoted to cranial MR imaging, MR images are scattered throughout various other chapters. There is coverage of the major anatomic and pathophysiologic entities. There are 17 chapters with images, tables, and diagrams.

  6. Hermaphroditism demonstrated by computed tomography

    SciTech Connect

    Gale, M.E.

    1983-07-01

    The categorization of disorders of gender differentiation is based on chromosome analysis, physical examination, gonadal histology, and endocrine evaluation. In most cases of hermaphroditism, radiologic studies have been limited to assessment of associated urinary tract anomalies before surgical revconstruction. Noninvasive evaluation with computed tomography (CT) or sonography is potentially useful for investigation of internal pelvic anatomy in these cases. A case report of a 65-year-old man is reported. (KRM)

  7. Cardiac computed tomographic angiography and the primary care physician.

    PubMed

    Mikolich, J Ronald

    2012-05-01

    Through advancements in computer processing speed and storage capacity, new cardiac imaging modalities have become clinically feasible and useful. Cardiac computed tomographic angiography, a new diagnostic imaging modality, is capable of assessing coronary artery disease and left ventricular function on a par with invasive coronary arteriography in selected patients who meet appropriate use criteria. This imaging modality is of clinical value in the assessment of patients with chest pain who have an intermediate risk of coronary atherosclerosis. The purpose of the present report is to educate primary care physicians about the basic principles of advanced cardiac imaging techniques and to convey a useful strategy for their appropriate use in the current environment of medical economics.

  8. Optical Coherence Tomography Angiography for Detecting Choroidal Neovascularization Secondary to Choroidal Osteoma.

    PubMed

    Szelog, Jason T; Bonini Filho, Marco A; Lally, David R; de Carlo, Talisa E; Duker, Jay S

    2016-01-01

    Choroidal osteoma is an ossifying tumor that is found predominantly in the peripapillary and macular areas. It typically affects otherwise healthy females. Vision loss may occur secondary to the development of choroidal neovascularization (CNV). Fluorescein angiography (FA) remains the gold standard for diagnosing CNV; however, the use of optical coherence tomography angiography (OCTA) as an adjunct to FA is growing. In this report, a 16-year-old female with a large, unilateral peripapillary choroidal osteoma presented with blurred vision. Exam revealed scattered intraretinal hemorrhage, but FA was unable to detect CNV overlying the tumor. OCTA detected abnormal flow in the outer retina corresponding to a type 2 CNV. Following intravitreal anti-vascular endothelial growth factor therapy, the CNV regressed, the hemorrhage resolved, and there was less fluid. OCTA may be helpful in detecting CNV noninvasively in eyes in which FA is equivocal, such as those with choroidal osteoma.

  9. [Digital angiography and lipiodol computerized tomography in the anatomopathological framework of hepatocarcinoma].

    PubMed

    Pozzi-Mucelli, R; Pozzi-Mucelli, R; Pagnan, L; Dalla Palma, L

    1994-12-01

    The introduction of therapies other than conventional surgery of hepatocellular carcinoma (HCC) requires an accurate pathologic classification, which is important because it is well known that HCC may have multicentric growth. The Liver Cancer Study Group of Japan has proposed a classification dividing HCCs into three macroscopic forms from the pathologic point of view: nodular, massive and infiltrating HCCs. The nodular type is subdivided into four types: single nodular type, single nodular type with surrounding proliferation, multinodular fused type and multinodular type. Forty-six HCC patients were examined with Lipiodol Computed Tomography (LCT) to investigate the agreement between pathologic and imaging findings. LCT proved to be in close agreement with pathologic findings. Sixteen cases were classified as type I (single nodular type), 8 as type II (single nodular type with limited foci), 1 as type III (multinodular fused type), 18 as type IV (multiple nodular type with diffuse foci) and 3 cases as type V (massive form). No cases of infiltrative forms were observed in our series. Based on LCT findings, the capabilities of digital subtraction angiography (DSA) were studied in the pathologic classification of HCCs. DSA exhibited some limitations in the pathologic classification of HCCs in 5 of 16 patients with type I lesions. In these cases DSA suggested false-positive diagnoses because of regenerative nodules in cirrhotic liver in 3 cases and of daughter nodules (not confirmed at LCT) in 2 cases. In 7 of 8 patients with type II HCCs, DSA failed to show the daughter nodules surrounding the main nodule. In the 18 patients with multiple distant nodules (type IV), DSA was less sensitive in defining nodule number and site. In the massive form, the information obtained with LCT and DSA was comparable. In conclusion, LCT should be considered a basic examination in the study of HCC extent. Based on LCT findings, the most appropriate treatment can be selected, be it

  10. Multidetector Computed Tomography for Congenital Anomalies of the Aortic Arch: Vascular Rings.

    PubMed

    García-Guereta, Luis; García-Cerro, Estefanía; Bret-Zurita, Montserrat

    2016-07-01

    The development of multidetector computed tomography has triggered a revolution in the study of the aorta and other large vessels and has replaced angiography in the diagnosis of congenital anomalies of the aortic arch, particularly vascular rings. The major advantage of multidetector computed tomography is that it permits clear 3-dimensional assessment of not only vascular structures, but also airway and esophageal compression. The current update aims to summarize the embryonic development of the aortic arch and the developmental anomalies leading to vascular ring formation and to discuss the current diagnostic and therapeutic role of multidetector computed tomography in this field.

  11. Three energy computed tomography with synchrotron radiation

    SciTech Connect

    Menk, R.H.; Thomlinson, W.; Zhong, Z.; Charvet, A.M.; Arfelli, F. |; Chapman, L.

    1997-09-01

    Preliminary experiments for digital subtraction computed tomography (CT) at the K-edge of iodine (33.1 keV) were carried out at SMERF (Synchrotron Medical Research Facility X17B2) at the National Synchrotron Light Source, Brookhaven National Laboratory. The major goal was to evaluate the availability of this kind of imaging for in vivo neurological studies. Using the transvenous coronary angiography system, CT images of various samples and phantoms were taken simultaneously at two slightly different energies bracketing the K-absorption edge of iodine. The logarithmic subtraction of the two images resulted in the contrast enhancement of iodine filled structures. An additional CT image was taken at 99.57 keV (second harmonic of the fundamental wave). The third energy allowed the calculation of absolute iodine, tissue and bone images by means of a matrix inversion. A spatial resolution of 0.8 LP/mm was measured in single energy images and iodine concentrations down to 0.082 mg/ml in a 1/4 diameter detail were visible in the reconstructed subtraction image.

  12. A Focal Chorioretinal Bartonella Lesion Analyzed by Optical Coherence Tomography Angiography.

    PubMed

    Pichi, Francesco; Srivastava, Sunil K; Levinson, Ashleigh; Baynes, Kimberly M; Traut, Caitlyn; Lowder, Careen Y

    2016-06-01

    Neovascularization may be associated with cat-scratch neuroretinitis in the absence of retinal vascular occlusion. Bartonella organisms establish an intimate relationship with the vascular endothelium, causing angioproliferative lesions, which might represent a dedicated pathogenic strategy for expanding the bacterial host cell habitat. In the eye, pathological angiogenesis caused by Bartonella has been described as peripapillary or macular choroidal neovascularization, but the presence of neovascularization within foci of chorioretinitis has never before been reported. The authors present a case of Bartonella chorioretinitis in which optical coherence tomography angiography, by detecting erythrocyte motion, was able to identify neovessels inside the infectious focus. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:585-588.].

  13. Quantification of choroidal neovascularization vessel length using optical coherence tomography angiography

    NASA Astrophysics Data System (ADS)

    Gao, Simon S.; Liu, Li; Bailey, Steven T.; Flaxel, Christina J.; Huang, David; Li, Dengwang; Jia, Yali

    2016-07-01

    Quantification of choroidal neovascularization (CNV) as visualized by optical coherence tomography angiography (OCTA) may have importance clinically when diagnosing or tracking disease. Here, we present an automated algorithm to quantify the vessel skeleton of CNV as vessel length. Initial segmentation of the CNV on en face angiograms was achieved using saliency-based detection and thresholding. A level set method was then used to refine vessel edges. Finally, a skeleton algorithm was applied to identify vessel centerlines. The algorithm was tested on nine OCTA scans from participants with CNV and comparisons of the algorithm's output to manual delineation showed good agreement.

  14. Multimodality Imaging in Coronary Artery Disease: Focus on Computed Tomography

    PubMed Central

    Lee, Ji Hyun; Han, Donghee; Danad, Ibrahim; Hartaigh, Bríain ó; Lin, Fay Y.

    2016-01-01

    Coronary artery disease (CAD) is the leading cause of mortality worldwide, and various cardiovascular imaging modalities have been introduced for the purpose of diagnosing and determining the severity of CAD. More recently, advances in computed tomography (CT) technology have contributed to the widespread clinical application of cardiac CT for accurate and noninvasive evaluation of CAD. In this review, we focus on imaging assessment of CAD based upon CT, which includes coronary artery calcium screening, coronary CT angiography, myocardial CT perfusion, and fractional flow reserve CT. Further, we provide a discussion regarding the potential implications, benefits and limitations, as well as the possible future directions according to each modality. PMID:27081438

  15. Differential diagnosis of intrasellar tumors by computed tomography

    SciTech Connect

    Daniels, D.L.; Williams, A.L.; Thornton, R.S.; Meyer, G.A.; Cusick, J.F.; Haughton, V.M.

    1981-12-01

    The specificity of the computed tomography (CT) diagnosis of intrasellar adenoma has not been studied. We compared the CT findings in intrasellar meningiomas, craniopharyngiomas, aneurysms, and metastases with those of pituitary adenomas. Calcification was a feature of intrasellar meningiomas, aneurysms, and craniopharyngiomas, but not a typical feature of adenomas. Low-density regions representing necrosis or cyst were found in most types of intrasellar tumors. Eccentricity, hyperostosis, and bone destruction were useful signs of aneurysm, meningioma, and metastasis, respectively. Since adenoma cannot always be distinghished from another intrasellar mass, angiography to demonstrate tumor angioarchitecture may be needed to characterize some neoplasms or to confirm an intrasellar aneurysm.

  16. Computed tomography of fibrous dysplasia

    SciTech Connect

    Daffner, R.H.; Kirks, D.R.; Gehweiler, J.A. Jr.; Heaston, D.K.

    1982-11-01

    Skeletal fibrous dysplasia produces changes that are usually readily recognized on plain radiographs. Occasionally, routine radiography may not demonstrate the characteristic appearance of the disease. The density of abormal bone in craniofacial fibrous dysplasia may preclude adequate assessment of areas where soft-tissue impingement may occur. Computed tomography (CT) is useful in demonstrating the amorphous ''ground-glass'' texture of the lesion and in defining the extent of craniofacial disease including impingement upon orbital structures. CT was useful in five patients with fibrous dysplasia in whom the nature or extent of involvement was not entirely clear.

  17. Dual-energy computed tomography.

    PubMed

    Furlow, Bryant

    2015-01-01

    Dual-energy computed tomography (DECT) yields precise anatomic and functional images by exploiting differences in the interactions of high- and low-energy photon spectra with different tissues' and materials' atomic components to more precisely differentiate the chemistry of tissues and disease processes than is possible with traditional single-energy CT scan acquisitions. This article introduces the history of DECT, its physical basis, scanner designs, radiation dose considerations, and postprocessing techniques. DECT's clinical applications also are described, and this relatively new imaging modality's clinical limitations and future prospects are discussed.

  18. Computed tomography of parosteal osteosarcoma

    SciTech Connect

    Hudson, T.M.; Springfield, D.S.; Benjamin, M.; Bertoni, F.; Present, D.A.

    1985-05-01

    Twelve patients with parosteal osteosarcomas were evaluated by computed tomography (CT). CT accurately defined the extent of the tumors for purposes of surgical planning, although tumor bone often could not be distinguished from thickened host bone. Nine tumors invaded the medullary cavity, a feature that implies a poorer prognosis when the tumor also contains high-grade areas. Six CT studies accurately detected the medullary invasion, but three did not. Lucent areas within dense tumors contained either benign tissue or high- or low-grade tumor; CT did not differentiate among these different tissues. CT also did not reveal small satellite nodules of tumor beyond the main tumor mass.

  19. Scalable wide-field optical coherence tomography-based angiography for in vivo imaging applications

    PubMed Central

    Xu, Jingjiang; Wei, Wei; Song, Shaozhen; Qi, Xiaoli; Wang, Ruikang K.

    2016-01-01

    Recent advances in optical coherence tomography (OCT)-based angiography have demonstrated a variety of biomedical applications in the diagnosis and therapeutic monitoring of diseases with vascular involvement. While promising, its imaging field of view (FOV) is however still limited (typically less than 9 mm2), which somehow slows down its clinical acceptance. In this paper, we report a high-speed spectral-domain OCT operating at 1310 nm to enable wide FOV up to 750 mm2. Using optical microangiography (OMAG) algorithm, we are able to map vascular networks within living biological tissues. Thanks to 2,048 pixel-array line scan InGaAs camera operating at 147 kHz scan rate, the system delivers a ranging depth of ~7.5 mm and provides wide-field OCT-based angiography at a single data acquisition. We implement two imaging modes (i.e., wide-field mode and high-resolution mode) in the OCT system, which gives highly scalable FOV with flexible lateral resolution. We demonstrate scalable wide-field vascular imaging for multiple finger nail beds in human and whole brain in mice with skull left intact at a single 3D scan, promising new opportunities for wide-field OCT-based angiography for many clinical applications. PMID:27231630

  20. Computed tomography of the genitourinary tract.

    PubMed

    Stanley, R J; Sagel, S S; Fair, W R

    1978-06-01

    Eighteen months of experience with computed body tomography have revealed that this radiologic modality is useful in the diagnostic evaluation and management of urologic patients. Renal masses, perirenal lesions, poorly functioning kidneys, pelvic tumors and associated retroperitoneal nodal spread and other diagnostic problems related to the urinary tract have been imaged successfully with computed body tomography. Accuracy is high in the differentiation of benign renal cysts from renal neoplasms. Tumor staging and computed body tomography is being explored currently.

  1. MD CT Angiography and MR Angiography of Nonatherosclerotic Renal Artery Disease

    SciTech Connect

    Flors, Lucia; Leiva-Salinas, Carlos; Ahmad, Ehab Ali; Norton, Patrick T.; Turba, Ulku C.; Bozlar, Ugur; Hagspiel, Klaus D.

    2011-12-15

    We reviewed the computed tomographic and magnetic resonance angiographic appearances of the various nonatherosclerotic renal artery pathologies. Rapid progress in cross-sectional techniques has allowed computed tomography and magnetic resonance angiography to replace digital subtraction angiography in most circumstances. When state-of-the-art equipment and optimized protocols are used, diagnosing a wide range of nonatherosclerotic pathologies is possible.

  2. Computed tomography for planning transcatheter aortic valve replacement.

    PubMed

    Apfaltrer, Paul; Henzler, Thomas; Blanke, Phillip; Krazinski, Aleksander W; Silverman, Justin R; Schoepf, U Joseph

    2013-07-01

    Transcatheter aortic valve replacement (TAVR) is rapidly becoming a widely used alternative to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis at high surgical risk. In these patients, TAVR has been associated with markedly improved survival and relief from symptoms. Despite a very-high risk patient profile, recent multicenter registries have confirmed the safety and efficacy of this procedure. Moreover, the randomized, controlled PARTNER (Placement of AoRTic TraNscathetER Valves) trial has confirmed both the superiority of TAVR over medical treatment in patients not considered to be candidates for standard SAVR and the noninferiority of TAVR compared with SAVR in high-risk patients. The TAVR procedure requires a comprehensive preinterventional diagnostic workup. Above all, detailed information on the anatomy of the aortic annulus (AA) and the relation of the AA to the coronary arteries is essential to avoid complications. So far, no imaging reference standard for AA sizing has been established. Echocardiography, catheter angiography, and computed tomography angiography are widely and often complementarily used imaging techniques for this purpose. Compared with 2-dimensional imaging techniques, computed tomography (CT) has been proven to provide comprehensive information on AA anatomy and geometry, supporting appropriate patient selection and prosthesis sizing. In addition, CT is gaining an increasing role in evaluating the vascular access route before the procedure. This article describes the rapidly emerging role of CT in the context of pre-TAVR assessment.

  3. Cardiac computed tomography in patients with acute chest pain.

    PubMed

    Nieman, Koen; Hoffmann, Udo

    2015-04-14

    The efficient and reliable evaluation of patients with acute chest pain is one of the most challenging tasks in the emergency department. Coronary computed tomography (CT) angiography may play a major role, since it permits ruling out coronary artery disease with high accuracy if performed with expertise in properly selected and prepared patients. Several randomized trials have established early cardiac CT as a viable safe and potentially more efficient alternative to functional testing in the evaluation of acute chest pain. Ongoing investigations explore whether advanced anatomic and functional assessments such as high-risk coronary plaque, resting myocardial perfusion, and left ventricular function, or the simulation of the fractional coronary flow reserve will add information to the anatomic assessment for stenosis, which would allow expanding the benefits of cardiac CT from triage to treatment decisions. Especially, the combination of high-sensitive troponins and coronary computed tomography angiography may play a valuable role in future strategies for the management of patients presenting with acute chest pain.

  4. Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy

    PubMed Central

    Hwang, Thomas S; Gao, Simon S; Liu, Liang; Lauer, Andreas K.; Bailey, Steven T; Flaxel, Christina J; Wilson, David J; Huang, David; Jia, Yali

    2016-01-01

    Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. Objective To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. Design, Setting, and Participants An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 × 6-mm OCT angiography obtained with commercially available 70-kHz OCT and fluorescein angiography (FA). The study was conducted from January 22 to September 18, 2014. Data analysis was performed from October 1, 2014, to April 7, 2015. Participants included 12 individuals with normal vision serving as controls and 12 patients with various levels of DR. Main Outcomes and Measures Preplanned primary measures were parafoveal and perifoveal vessel density, total avascular area, and foveal avascular zone as detected with 6 × 6-mm OCT angiography and analyzed using an automated algorithm. Secondary measures included the agreement of the avascular area between the OCT angiogram and FA. Results Compared with the 12 healthy controls (11 women; mean [SD] age, 54.2 [14.2] years), the 12 participants with DR (4 women; mean [SD] age, 55.1 [12.1] years) had reduced parafoveal and perifoveal vessel density by 12.6% (95% CI, 7.7%-17.5%; P < .001) and 10.4% (95% CI, 6.8%-14.1%; P < .001), respectively. Total avascular area and foveal avascular zone area were greater in eyes with DR by 0.82 mm2 (95% CI. 0.65-0.99 mm2; P = .02) and 0.16 mm2 (95% CI, 0.05-0.28 mm2; P < .001). The agreement between the vascular areas in the OCT angiogram and FA had a κ value of 0.45 (95% CI, 0.21-0.70; P < .001). Total avascular area in the central 5.5-mm-diameter area distinguished eyes with DR from control eyes with 100% sensitivity and specificity. Conclusions and Relevance Avascular area analysis with an automated

  5. [Computer tomography of sports injuries].

    PubMed

    Reiser, M; Rupp, N

    1984-01-01

    Computed tomography (CT) provides axial slices plane and shows excellent details of bones and different soft tissues, favoring its use in traumatic lesions caused by sporting activities. Complex anatomical structures such as the shoulder, the vertebral column, the pelvis, the knee, the tarsal and carpal bones are often better recognized in detail than by conventional radiography. Fracture lines, localization of bone fragments and involvement of soft tissues are clearly demonstrated. Luxations and bone changes leading to luxations can be shown. CT arthrography provides for the first time a direct visualization of joint cartilage and of cruciate ligaments in the knee joint, so traumatic lesions such as chondropathia patellae or rupture of the cruciate ligaments are shown with a high degree of reliability.

  6. Single photon emission computed tomography

    SciTech Connect

    Piez, C.W. Jr.; Holman, B.L.

    1985-07-01

    Single photon emission computed tomography (SPECT) is becoming an increasingly important part of routine clinical nuclear medicine. By providing tomographic reconstructions in multiple planes through the patient, SPECT expands the clinical applications in nuclear medicine as well as providing better contrast, edge definition and separation of target from background activities. Imaging techniques have been developed for the evaluation of regional cerebral blood flow using radiolabeled amines. Thus, cerebral functional imaging can be used in the diagnosis of acute cerebral infarction, cerebral vascular disease, dementia and epilepsy. SPECT plays a complementary role in the evaluation of coronary artery disease, particularly when it is coupled with thallium-201 and exercise testing. SPECT extends our diagnostic capabilities in additional areas, such as liver and bone scintigraphy as well as tumor imaging with gallium-67.

  7. Computed tomography of cryogenic cells

    SciTech Connect

    Schneider, Gerd; Anderson, E.; Vogt, S.; Knochel, C.; Weiss, D.; LeGros, M.; Larabell, C.

    2001-08-30

    Due to the short wavelengths of X-rays and low numerical aperture of the Fresnel zone plates used as X-ray objectives, the depth of field is several microns. Within the focal depth, imaging a thick specimen is to a good approximation equivalent to projecting the specimen absorption. Therefore, computed tomography based on a tilt series of X-ray microscopic images can be used to reconstruct the local linear absorption coefficient and image the three-dimensional specimen structure. To preserve the structural integrity of biological objects during image acquisition, microscopy is performed at cryogenic temperatures. Tomography based on X-ray microscopic images was applied to study the distribution of male specific lethal 1 (MSL-1), a nuclear protein involved in dosage compensation in Drosophila melanogaster, which ensures that males with single X chromosome have the same amount of most X-linked gene products as females with two X chromosomes. Tomographic reconstructions of X-ray microscopic images were used to compute the local three-dimensional linear absorption coefficient revealing the arrangement of internal structures of Drosophila melanogaster cells. Combined with labelling techniques, nanotomography is a new technique to study the 3D distribution of selected proteins inside whole cells. We want to improve this technique with respect to resolution and specimen preparation. The resolution in the reconstruction can be significantly improved by reducing the angular step size to collect more viewing angles, which requires an automated data acquisition. In addition, fast-freezing with liquid ethane instead of cryogenic He gas will be applied to improve the vitrification of the hydrated samples. We also plan to apply cryo X-ray nanotomography in order to study different types of cells and their nuclear protein distributions.

  8. Radiation dose measurements in coronary CT angiography

    PubMed Central

    Sabarudin, Akmal; Sun, Zhonghua

    2013-01-01

    Coronary computed tomography (CT) angiography is associated with high radiation dose and this has raised serious concerns in the literature. Awareness of various parameters for dose estimates and measurements of coronary CT angiography plays an important role in increasing our understanding of the radiation exposure to patients, thus, contributing to the implementation of dose-saving strategies. This article provides an overview of the radiation dose quantity and its measurement during coronary CT angiography procedures. PMID:24392190

  9. Relationship between Functional and Structural Changes in Diabetic Vessels in Optical Coherence Tomography Angiography

    PubMed Central

    Miwa, Yuko; Murakami, Tomoaki; Suzuma, Kiyoshi; Uji, Akihito; Yoshitake, Shin; Fujimoto, Masahiro; Yoshitake, Tatsuya; Tamura, Yukino; Yoshimura, Nagahisa

    2016-01-01

    The decorrelation signals in optical coherence tomography angiography (OCTA) are derived from the flow of erythrocytes and concomitantly delineate the retinal vasculature. We compared the structural and functional characteristics of vascular lesions visualized in fluorescein angiography (FA), OCTA, and en-face OCT images in 53 eyes (28 patients) with diabetic retinopathy (DR). The foveal avascular zone (FAZ) areas in OCTA images in the superficial layer almost corresponded to those in FA images. The FAZ areas in the en-face OCT images in the superficial layer were smaller than those in the FA images and correlated with each other, which agreed with the finding that en-face OCT images often delineated the vascular structure in the nonperfused areas in FA images. Microaneurysms appeared as fusiform, saccular, or coiled capillaries in OCTA images and ringed, round, or oval hyperreflective lesions in en-face OCT images. OCTA and en-face OCT images detected 41.0 ± 16.1% and 40.1 ± 18.6%, respectively, of microaneurysms in FA images, although both depicted only 13.9 ± 16.4%. The number of microaneurysms in FA images was correlated with that in OCTA and en-face OCT images. Comparisons of these modalities showed the associations and dissociations between blood flow and vascular structures, which improves the understanding of the pathogenesis of DR. PMID:27350562

  10. Optical coherence tomography angiography of stimulus evoked hemodynamic responses in individual retinal layers.

    PubMed

    Son, Taeyoon; Wang, Benquan; Thapa, Damber; Lu, Yiming; Chen, Yanjun; Cao, Dingcai; Yao, Xincheng

    2016-08-01

    Blood flow changes are highly related to neural activities in the retina. It has been reported that neural activity increases when flickering light stimulation of the retina is used. It is known that blood flow changes with flickering light stimulation can be altered in patients with vascular disease and that measurement of flicker-induced vasodilatation is an easily applied tool for monitoring functional microvascular alterations. However, details of distortions in retinal neurovascular coupling associated with major eye diseases are not well understood due to the limitation of existing techniques. In this study, flickering light stimulation was applied to mouse retinas to investigate stimulus evoked hemodynamic responses in individual retinal layers. A spectral domain optical coherence tomography (OCT) angiography imaging system was developed to provide dynamic mapping of hemodynamic responses in the ganglion cell layer, inner plexiform layer, outer plexiform layer and choroid layer before, during and after flickering light stimulation. Experimental results showed hemodynamic responses with different magnitudes and time courses in individual retinal layers. We anticipate that the dynamic OCT angiography of stimulus evoked hemodynamic responses can greatly foster the study of neurovascular coupling mechanisms in the retina, promising new biomarkers for retinal disease detection and diagnosis. PMID:27570706

  11. Optical coherence tomography angiography of stimulus evoked hemodynamic responses in individual retinal layers

    PubMed Central

    Son, Taeyoon; Wang, Benquan; Thapa, Damber; Lu, Yiming; Chen, Yanjun; Cao, Dingcai; Yao, Xincheng

    2016-01-01

    Blood flow changes are highly related to neural activities in the retina. It has been reported that neural activity increases when flickering light stimulation of the retina is used. It is known that blood flow changes with flickering light stimulation can be altered in patients with vascular disease and that measurement of flicker-induced vasodilatation is an easily applied tool for monitoring functional microvascular alterations. However, details of distortions in retinal neurovascular coupling associated with major eye diseases are not well understood due to the limitation of existing techniques. In this study, flickering light stimulation was applied to mouse retinas to investigate stimulus evoked hemodynamic responses in individual retinal layers. A spectral domain optical coherence tomography (OCT) angiography imaging system was developed to provide dynamic mapping of hemodynamic responses in the ganglion cell layer, inner plexiform layer, outer plexiform layer and choroid layer before, during and after flickering light stimulation. Experimental results showed hemodynamic responses with different magnitudes and time courses in individual retinal layers. We anticipate that the dynamic OCT angiography of stimulus evoked hemodynamic responses can greatly foster the study of neurovascular coupling mechanisms in the retina, promising new biomarkers for retinal disease detection and diagnosis. PMID:27570706

  12. Characterization of rat model of acute anterior uveitis using optical coherence tomography angiography

    NASA Astrophysics Data System (ADS)

    Choi, Woo June; Pepple, Kathryn L.; Zhi, Zhongwei; Wang, Ruikang K.

    2015-03-01

    Uveitis, or ocular inflammation, is a cause of severe visual impairment. Rodent models of uveitis are powerful tools used to investigate the pathological mechanisms of ocular inflammation and to study the efficacy of new therapies prior to human testing. In this paper, we report the utility of spectral-domain optical coherence tomography (SD-OCT) angiography in characterizing the inflammatory changes induced in the anterior segment of a rat model of uveitis. Acute anterior uveitis (AAU) was induced in two rats by intravitreal injection of a killed mycobacterial extract. One of them received a concurrent periocular injection of steroids to model a treatment effect. OCT imaging was performed prior to inflammation induction on day 0 (baseline), and 2 days post-injection (peak inflammation). Baseline and inflamed images were compared. OCT angiography identified swelling of the cornea, inflammatory cells in the anterior and posterior chambers, a fibrinous papillary membrane, and dilation of iris vessels in the inflamed eyes when compared to baseline images. Steroid treatment was shown to prevent the changes associated with inflammation. This is a novel application of anterior OCT imaging in animal models of uveitis, and provides a high resolution, in vivo assay for detecting and quantifying ocular inflammation and the response to new therapies.

  13. Optical Coherence Tomography Angiography of Type 2 Neovascularization in Age-Related Macular Degeneration.

    PubMed

    Souied, Eric H; El Ameen, Ala; Semoun, Oudy; Miere, Alexandra; Querques, Giuseppe; Cohen, Salomon Yves

    2016-01-01

    Well-defined choroidal neovascularization, known as type 2 neovascularization (NV) or classic NV, is the least representative phenotype of exudative age-related macular degeneration. Clinical aspects of type 2 NV have been widely described in the literature, and to date fluorescein angiography remains the gold standard for imaging age-related macular degeneration at initial presentation. Optical coherence tomography angiography (OCT-A) can be used to image vessels based on flow characteristics without any dye injection. Type 2 NV can be visualized using OCT-A with very typical patterns. A neovascular membrane appears as either a medusa-shaped complex or a glomerulus-shaped lesion in the outer retina and the choriocapillaris layer. Furthermore, in the choriocapillaris layer, the external borders of the lesion appear as a dark ring in most cases, and one or more central feeder vessels that extend deeply into the more profound choroidal layers are visible. Identification of type 2 NV is easily feasible for any clinician using OCT-A, especially in areas where there are normally no vessels, like in subretinal space, if the interpretation rules are respected. PMID:27023798

  14. In vivo monitoring of external pressure induced hemodynamics in skin tissue using optical coherence tomography angiography

    NASA Astrophysics Data System (ADS)

    Choi, Woo June; Wang, Hequn; Wang, Ruikang K.

    2015-03-01

    Characterization of the relationship between external pressure and blood flow is important in the examination of pressure-induced disturbance in tissue microcirculation. Optical coherence tomography (OCT) angiography is a promising imaging technique, capable of providing the noninvasive extraction of functional vessels within the skin tissue with capillary-scale resolution. Here, we present a feasibility study of OCT angiography to monitor effect of external pressures on blood perfusion in human skin tissue in vivo. Graded external pressure is loaded normal to the surface of the nailfold tissue of a healthy human. The incremental loading is applied step by step and then followed by an immediate release. Concurrent OCT imaging of the nailfold is performed during the pre/post loading. Blood perfusion images including baseline (at pre-loading) and corresponding tissue strain maps are calculated from 3D OCT dataset obtained at the different applied pressures, allowing visualization of capillary perfusion events at stressed nailfold tissue. The results indicate that the perfusion progressively decreases with the constant increase of tissue strain. Reactive hyperemia is occurred right after the removal of the pressure corresponding to quick drop of the increased strain. The perfusion is returned to the baseline level after a few minutes. These findings suggest that OCT microangiography may have great potential for quantitatively assessing tissue microcirculation in the locally pressed tissue in vivo.

  15. [Computed tomography and cranial paleoanthropology].

    PubMed

    Cabanis, Emmanuel Alain; Badawi-Fayad, Jackie; Iba-Zizen, Marie-Thérèse; Istoc, Adrian; de Lumley, Henry; de Lumley, Marie-Antoinette; Coppens, Yves

    2007-06-01

    Since its invention in 1972, computed tomography (C.T.) has significantly evolved. With the advent of multi-slice detectors (500 times more sensitive than conventional radiography) and high-powered computer programs, medical applications have also improved. CT is now contributing to paleoanthropological research. Its non-destructive nature is the biggest advantage for studying fossil skulls. The second advantage is the possibility of image analysis, storage, and transmission. Potential disadvantages include the possible loss of files and the need to keep up with rapid technological advances. Our experience since the late 1970s, and a recent PhD thesis, led us to describe routine applications of this method. The main contributions of CT to cranial paleoanthropology are five-fold: --Numerical anatomy with rapid acquisition and high spatial resolution (helicoidal and multidetector CT) offering digital storage and stereolithography (3D printing). --Numerical biometry (2D and 3D) can be used to create "normograms" such as the 3D craniofacial reference model used in maxillofacial surgery. --Numerical analysis offers thorough characterization of the specimen and its state of conservation and/or restoration. --From "surrealism" to virtual imaging, anatomical structures can be reconstructed, providing access to hidden or dangerous zones. --The time dimension (4D imaging) confers movement and the possibility for endoscopic simulation and internal navigation (see Iconography). New technical developments will focus on data processing and networking. It remains our duty to deal respectfully with human fossils. PMID:18402165

  16. 3D reconstruction of coronary arteries using frequency domain optical coherence tomography images and biplane angiography.

    PubMed

    Athanasiou, L S; Bourantas, C V; Siogkas, P K; Sakellarios, A I; Exarchos, T P; Naka, K K; Papafaklis, M I; Michalis, L K; Prati, F; Fotiadis, D I

    2012-01-01

    The aim of this study is to describe a new method for three-dimensional (3D) reconstruction of coronary arteries using Frequency Domain Optical Coherence Tomography (FD-OCT) images. The rationale is to fuse the information about the curvature of the artery, derived from biplane angiographies, with the information regarding the lumen wall, which is produced from the FD-OCT examination. The method is based on a three step approach. In the first step the lumen borders in FD-OCT images are detected. In the second step a 3D curve is produced using the center line of the vessel from the two biplane projections. Finally in the third step the detected lumen borders are placed perpendicularly onto the path based on the centroid of each lumen border. The result is a 3D reconstructed artery produced by all the lumen borders of the FD-OCT pullback representing the 3D arterial geometry of the vessel.

  17. Quantitative assessment of the retinal microvasculature using optical coherence tomography angiography

    NASA Astrophysics Data System (ADS)

    Chu, Zhongdi; Lin, Jason; Gao, Chen; Xin, Chen; Zhang, Qinqin; Chen, Chieh-Li; Roisman, Luis; Gregori, Giovanni; Rosenfeld, Philip J.; Wang, Ruikang K.

    2016-06-01

    Optical coherence tomography angiography (OCTA) is clinically useful for the qualitative assessment of the macular microvasculature. However, there is a need for comprehensive quantitative tools to help objectively analyze the OCT angiograms. Few studies have reported the use of a single quantitative index to describe vessel density in OCT angiograms. In this study, we introduce a five-index quantitative analysis of OCT angiograms in an attempt to detect and assess vascular abnormalities from multiple perspectives. The indices include vessel area density, vessel skeleton density, vessel diameter index, vessel perimeter index, and vessel complexity index. We show the usefulness of the proposed indices with five illustrative cases. Repeatability is tested on both a healthy case and a stable diseased case, giving interclass coefficients smaller than 0.031. The results demonstrate that our proposed quantitative analysis may be useful as a complement to conventional OCTA for the diagnosis of disease and monitoring of treatment.

  18. Radiological protection in computed tomography and cone beam computed tomography.

    PubMed

    Rehani, M M

    2015-06-01

    The International Commission on Radiological Protection (ICRP) has sustained interest in radiological protection in computed tomography (CT), and ICRP Publications 87 and 102 focused on the management of patient doses in CT and multi-detector CT (MDCT) respectively. ICRP forecasted and 'sounded the alarm' on increasing patient doses in CT, and recommended actions for manufacturers and users. One of the approaches was that safety is best achieved when it is built into the machine, rather than left as a matter of choice for users. In view of upcoming challenges posed by newer systems that use cone beam geometry for CT (CBCT), and their widened usage, often by untrained users, a new ICRP task group has been working on radiological protection issues in CBCT. Some of the issues identified by the task group are: lack of standardisation of dosimetry in CBCT; the false belief within the medical and dental community that CBCT is a 'light', low-dose CT whereas mobile CBCT units and newer applications, particularly C-arm CT in interventional procedures, involve higher doses; lack of training in radiological protection among clinical users; and lack of dose information and tracking in many applications. This paper provides a summary of approaches used in CT and MDCT, and preliminary information regarding work just published for radiological protection in CBCT.

  19. Computed tomography using synchrotron radiation

    SciTech Connect

    Thompson, A.C.; Llacer, J.; Finman, L.C.; Hughes, E.B.; Otis, J.N.; Wilson, S.; Zeman, H.D.

    1983-09-01

    X-ray computed tomography (CT) is a widely used method of obtaining cross-sectional views of objects. The high intensity, natural collimation, monochromaticity and energy tunability of synchrotron x-ray sources could potentially be used to provide CT images of improved quality. The advantages of these systems would be that images could be produced more rapidly with better spatial resolution and reduced beam artifacts. In addition, images, in some cases, could be acquired with elemental sensitivity. As a demonstration of the capability of such a system, CT images were obtained of four slices of an excised pig heart in which the arteries and the cardiac chambers were filled with an iodinated medium. Images were taken with incident x-rays tuned successively to energies just above and below the iodine K edge. Iodine specific images were obtained by logarithmically subtracting the low energy image data from the high energy data and then reconstructing the image. CT imaging using synchrotron radiation may become a convenient and non-destructive method of imaging samples difficult to study by other methods.

  20. Direct coronal body computed tomography.

    PubMed

    van Waes, P F; Zonneveld, F W

    1982-02-01

    Three patient positioning technique have been developed for direct coronal computed tomography (CT) of the body, covering the complete torso: position A, to study pelvis, including retroperitoneal space and lower abdomen; position B, to study upper abdomen and lower chest; and position C, to study upper chest, including neck and posterior fossa. In comparison with multiplanar reformatting (MPR), direct coronal CT has three basic advantages: (a) image quality is improved as a result of a lack of partial volume averaging and patient motion disturbance; (b) the direct coronal planes can be truly parallel to the spinal axis, due to stretching of the lordotic segments of the spine; and (c) examination time is reduced, since a large number of overlapping slices and time consuming MPR effort are not required. Direct coronal CT of the body has been carried out in more than 600 cases and was often uniquely informative. In our institution, use of MPR CT is now restricted to small volumes and/or disabled patients.

  1. Coronary computed tomographic angiography: current role in the diagnosis and management of coronary artery disease

    PubMed Central

    Bowman, Andrew W.; Kantor, Birgit; Gerber, Thomas C.

    2009-01-01

    Advances in computed tomography (CT) technology allow images to be obtained with high spatial and temporal resolution. These features now permit noninvasive coronary CT angiography (CCTA). Many studies addressing proof of concept, feasibility, and clinical robustness have been published since CCTA was first described. More recently, the scientific evaluation of CCTA has rightly focused less on technical aspects and more on multicenter trials of the diagnostic value of CCTA and on head-to-head comparisons with other noninvasive modalities for the detection of coronary artery disease (CAD), such as stress myocardial perfusion imaging (MPI) with radionuclides. Recent peer-reviewed publications that compare CCTA to invasive, selective coronary angiography (SCA) or MPI, or that address radiation protection issues related to CCTA, were reviewed and summarized. Overall, there is high agreement between CCTA and both SCA and MPI for the presence of CAD. However, CCTA can over- or underestimate the severity of CAD compared to SCA as a reference standard. Initial studies that compared CCTA to MPI found their accuracies for determining the presence of high-grade luminal obstructions comparable. Limitations of CCTA include inability to reliably assess the coronary artery lumen dimensions in patients with large amounts of coronary artery calcium, artifacts caused by coronary and respiratory motion, and the need for ionizing radiation and intravenous administration of iodinated contrast material. Various dose reduction methods for CCTA now exist that may substantially lower patient dose to levels less than those of SCA or MPI. Although current expert consensus does not call for CCTA to be a first-line test for CAD, particularly for screening in asymptomatic individuals, current data suggest a promising role in the evaluation of symptomatic patients for possible CAD. PMID:19694220

  2. Interlaced X-ray diffraction computed tomography

    PubMed Central

    Vamvakeros, Antonios; Jacques, Simon D. M.; Di Michiel, Marco; Senecal, Pierre; Middelkoop, Vesna; Cernik, Robert J.; Beale, Andrew M.

    2016-01-01

    An X-ray diffraction computed tomography data-collection strategy that allows, post experiment, a choice between temporal and spatial resolution is reported. This strategy enables time-resolved studies on comparatively short timescales, or alternatively allows for improved spatial resolution if the system under study, or components within it, appear to be unchanging. The application of the method for studying an Mn–Na–W/SiO2 fixed-bed reactor in situ is demonstrated. Additionally, the opportunities to improve the data-collection strategy further, enabling post-collection tuning between statistical, temporal and spatial resolutions, are discussed. In principle, the interlaced scanning approach can also be applied to other pencil-beam tomographic techniques, like X-ray fluorescence computed tomography, X-ray absorption fine structure computed tomography, pair distribution function computed tomography and tomographic scanning transmission X-ray microscopy. PMID:27047305

  3. Nondestructive computed tomography for pit inspections

    SciTech Connect

    Martz, H.; Logan, C.; Haskins, J.; Johansson, E.; Perkins, D.; Hernandez, J.M.; Schneberk, D.; Dolan, K.

    1997-02-07

    Objective is to develop new approaches to electronically capture digital radiography and computed tomography images at high x-ray energies to satisfy spatial and contrast requirements for inspection of high-density weapons components.

  4. Computed tomography of the rectosigmoid region.

    PubMed

    Dixon, A K

    1996-05-01

    Knowledge of the anatomy and embryology of the rectosigmoid region is useful for the correct interpretation of computed tomography in this region. The appearances and differential diagnoses of some of the common conditions affecting this region are presented and discussed.

  5. Single Photon Emission Computed Tomography (SPECT)

    MedlinePlus

    ... High Blood Pressure Tools & Resources Stroke More Single Photon Emission Computed Tomography (SPECT) Updated:Sep 11,2015 ... Persantine) or dobutamine. The tests may take between 2 and 2 1/2 hours. What happens after ...

  6. Computed Tomography For Internal Inspection Of Castings

    NASA Technical Reports Server (NTRS)

    Hanna, Timothy L.

    1995-01-01

    Computed tomography used to detect internal flaws in metal castings before machining and otherwise processing them into finished parts. Saves time and money otherwise wasted on machining and other processing of castings eventually rejected because of internal defects. Knowledge of internal defects gained by use of computed tomography also provides guidance for changes in foundry techniques, procedures, and equipment to minimize defects and reduce costs.

  7. Computed Tomography of Pancreatitis and Pancreatic Cancer.

    PubMed

    Furlow, Bryant

    2015-01-01

    Pancreatic disease often is asymptomatic until tissue damage and complications occur or until malignancies have reached advanced stages and have metastasized. Contrast-enhanced multidetector computed tomography plays a central role in diagnosing, staging, and treatment planning for pancreatitis and pancreatic cancer. This article introduces the functional anatomy of the pancreas and common bile duct and the epidemiology, pathobiology, and computed tomography imaging of pancreatitis, calculi, and pancreatic cancer.

  8. Computed tomography features of supracardiac total anomalous pulmonary venous connection in an infant.

    PubMed

    Alam, Tariq; Hamidi, Hidayatullah; Hoshang, Mer Mahmood Shah

    2016-09-01

    Total anomalous pulmonary venous connection (TAPVC) is a rare congenital anomaly of the pulmonary veins drainage. In this entity, the pulmonary veins, instead of draining to left atrium, connect abnormally to the systemic venous circulation. A right-to-left shunt is obligatory for survival. Based on its type and degree of pulmonary venous obstruction, TAPVC may result in pulmonary hypertension and congestive heart failure. In severe cases, urgent diagnosis and surgical correction is essential to reduce morbidity and mortality. Echocardiography as the first and safest imaging modality for cardiovascular abnormalities may fail in complete depiction of some complex feature of TAPVC. Computed tomography angiography is then a noninvasive and sensitive choice for mapping the pulmonary veins without the need for invasive cardiac catheterization. Contrast-enhanced MR angiography can be a radiation-free alternative. Authors present a computed tomography-detected supracardiac TAPVC with small patent ductus arteriosus in a 2 months cyanotic infant. PMID:27594934

  9. Combined multi-modal photoacoustic tomography, optical coherence tomography (OCT) and OCT angiography system with an articulated probe for in vivo human skin structure and vasculature imaging

    PubMed Central

    Liu, Mengyang; Chen, Zhe; Zabihian, Behrooz; Sinz, Christoph; Zhang, Edward; Beard, Paul C.; Ginner, Laurin; Hoover, Erich; Minneman, Micheal P.; Leitgeb, Rainer A.; Kittler, Harald; Drexler, Wolfgang

    2016-01-01

    Cutaneous blood flow accounts for approximately 5% of cardiac output in human and plays a key role in a number of a physiological and pathological processes. We show for the first time a multi-modal photoacoustic tomography (PAT), optical coherence tomography (OCT) and OCT angiography system with an articulated probe to extract human cutaneous vasculature in vivo in various skin regions. OCT angiography supplements the microvasculature which PAT alone is unable to provide. Co-registered volumes for vessel network is further embedded in the morphologic image provided by OCT. This multi-modal system is therefore demonstrated as a valuable tool for comprehensive non-invasive human skin vasculature and morphology imaging in vivo.

  10. Combined multi-modal photoacoustic tomography, optical coherence tomography (OCT) and OCT angiography system with an articulated probe for in vivo human skin structure and vasculature imaging

    PubMed Central

    Liu, Mengyang; Chen, Zhe; Zabihian, Behrooz; Sinz, Christoph; Zhang, Edward; Beard, Paul C.; Ginner, Laurin; Hoover, Erich; Minneman, Micheal P.; Leitgeb, Rainer A.; Kittler, Harald; Drexler, Wolfgang

    2016-01-01

    Cutaneous blood flow accounts for approximately 5% of cardiac output in human and plays a key role in a number of a physiological and pathological processes. We show for the first time a multi-modal photoacoustic tomography (PAT), optical coherence tomography (OCT) and OCT angiography system with an articulated probe to extract human cutaneous vasculature in vivo in various skin regions. OCT angiography supplements the microvasculature which PAT alone is unable to provide. Co-registered volumes for vessel network is further embedded in the morphologic image provided by OCT. This multi-modal system is therefore demonstrated as a valuable tool for comprehensive non-invasive human skin vasculature and morphology imaging in vivo. PMID:27699106

  11. Role of computed tomography and magnetic resonance imaging for deep venous thrombosis and pulmonary embolism.

    PubMed

    Kanne, Jeffrey P; Lalani, Tasneem A

    2004-03-30

    During the 1990s, computed tomography (CT) and magnetic resonance (MR) imaging underwent extensive technological advancement and expanded clinical use in patients with venous thromboembolic disease, particularly with regard to evaluation of the pulmonary vasculature. In many institutions, helical (spiral) CT pulmonary angiography has become the initial imaging study of choice to evaluate patients with suspected pulmonary embolism, supplanting ventilation/perfusion scintigraphy. In addition, CT venography of the pelvis and lower extremities is often incorporated into the CT angiography protocol to identify or exclude concurrent deep venous thrombosis. MR pulmonary angiography and MR venography are second-line diagnostic tools because of their higher cost, limited availability, and other logistical constraints. As the technology improves and becomes more widely available, MR imaging may play a greater role in the evaluation of patients with venous thromboembolic disease.

  12. Automated registration and enhanced processing of clinical optical coherence tomography angiography

    PubMed Central

    Camino, Acner; Zhang, Miao; Dongye, Changlei; Pechauer, Alex D.; Hwang, Thomas S.; Bailey, Steven T.; Lujan, Brandon; Wilson, David J.; Huang, David

    2016-01-01

    Background Motion artifacts degrade the quality of optical coherence tomography angiography (OCTA). Orthogonal registration can eliminate the majority of these artifacts, but some artifacts persist in most clinical images. We evaluate an automated registration algorithm with selective merging and filtering to remove remaining artifacts and improve the quality of images. Methods A 70 kHz commercial spectral domain OCT was used to obtain 3 mm × 3 mm OCTA in 10 healthy, 5 age-related macular degeneration (AMD), and 31 diabetic retinopathy (DR) participants. Projection artifacts were removed and images were segmented into 3 inner retinal plexuses. Amplitude thresholding identified lines containing a residual artifact and correlation between neighboring lines identified distorted stripes. Then the angiograms were registered and the lines selectively merged. A vesselness filter was applied to the resulting images. The images were evaluated for signal-to-noise ratio (SNR), image entropy, vessel connectivity and vessel density. Results Registration and selective merging (RSM) algorithm improved the SNR (P<0.02) compared to orthogonal registration alone. RSM with vesselness filter increased the image entropy (P<10−8) and reduced inter-subject variability (standard error ≤3%, n=10) in healthy eyes. The method improved vessel details and connectivity in OCTA of healthy, DR and neovascular AMD eyes. Conclusions This automated registration method eliminates residual motion artifacts and enhances the visualization of vessels in OCTA. PMID:27709075

  13. Repeatability and reproducibility of optic nerve head perfusion measurements using optical coherence tomography angiography

    NASA Astrophysics Data System (ADS)

    Chen, Chieh-Li; Bojikian, Karine D.; Xin, Chen; Wen, Joanne C.; Gupta, Divakar; Zhang, Qinqin; Mudumbai, Raghu C.; Johnstone, Murray A.; Chen, Philip P.; Wang, Ruikang K.

    2016-06-01

    Optical coherence tomography angiography (OCTA) has increasingly become a clinically useful technique in ophthalmic imaging. We evaluate the repeatability and reproducibility of blood perfusion in the optic nerve head (ONH) measured using optical microangiography (OMAG)-based OCTA. Ten eyes from 10 healthy volunteers are recruited and scanned three times with a 68-kHz Cirrus HD-OCT 5000-based OMAG prototype system (Carl Zeiss Meditec Inc., Dublin, California) centered at the ONH involving two separate visits within six weeks. Vascular images are generated with OMAG processing by detecting the differences in OCT signals between consecutive B-scans acquired at the same retina location. ONH perfusion is quantified as flux, vessel area density, and normalized flux within the ONH for the prelaminar, lamina cribrosa, and the full ONH. Coefficient of variation (CV) and intraclass correlation coefficient (ICC) are used to evaluate intravisit and intervisit repeatability, and interobserver reproducibility. ONH perfusion measurements show high repeatability [CV≤3.7% (intravisit) and ≤5.2% (intervisit)] and interobserver reproducibility (ICC≤0.966) in all three layers by three metrics. OCTA provides a noninvasive method to visualize and quantify ONH perfusion in human eyes with excellent repeatability and reproducibility, which may add additional insight into ONH perfusion in clinical practice.

  14. Split-spectrum amplitude-decorrelation angiography with optical coherence tomography

    PubMed Central

    Jia, Yali; Tan, Ou; Tokayer, Jason; Potsaid, Benjamin; Wang, Yimin; Liu, Jonathan J.; Kraus, Martin F.; Subhash, Hrebesh; Fujimoto, James G.; Hornegger, Joachim; Huang, David

    2012-01-01

    Amplitude decorrelation measurement is sensitive to transverse flow and immune to phase noise in comparison to Doppler and other phase-based approaches. However, the high axial resolution of OCT makes it very sensitive to the pulsatile bulk motion noise in the axial direction. To overcome this limitation, we developed split-spectrum amplitude-decorrelation angiography (SSADA) to improve the signal-to-noise ratio (SNR) of flow detection. The full OCT spectrum was split into several narrower bands. Inter-B-scan decorrelation was computed using the spectral bands separately and then averaged. The SSADA algorithm was tested on in vivo images of the human macula and optic nerve head. It significantly improved both SNR for flow detection and connectivity of microvascular network when compared to other amplitude-decorrelation algorithms. PMID:22418228

  15. Panoramic cone beam computed tomography

    SciTech Connect

    Chang Jenghwa; Zhou Lili; Wang Song; Clifford Chao, K. S.

    2012-05-15

    Purpose: Cone-beam computed tomography (CBCT) is the main imaging tool for image-guided radiotherapy but its functionality is limited by a small imaging volume and restricted image position (imaged at the central instead of the treatment position for peripheral lesions to avoid collisions). In this paper, the authors present the concept of ''panoramic CBCT,'' which can image patients at the treatment position with an imaging volume as large as practically needed. Methods: In this novel panoramic CBCT technique, the target is scanned sequentially from multiple view angles. For each view angle, a half scan (180 deg. + {theta}{sub cone} where {theta}{sub cone} is the cone angle) is performed with the imaging panel positioned in any location along the beam path. The panoramic projection images of all views for the same gantry angle are then stitched together with the direct image stitching method (i.e., according to the reported imaging position) and full-fan, half-scan CBCT reconstruction is performed using the stitched projection images. To validate this imaging technique, the authors simulated cone-beam projection images of the Mathematical Cardiac Torso (MCAT) thorax phantom for three panoramic views. Gaps, repeated/missing columns, and different exposure levels were introduced between adjacent views to simulate imperfect image stitching due to uncertainties in imaging position or output fluctuation. A modified simultaneous algebraic reconstruction technique (modified SART) was developed to reconstruct CBCT images directly from the stitched projection images. As a gold standard, full-fan, full-scan (360 deg. gantry rotation) CBCT reconstructions were also performed using projection images of one imaging panel large enough to encompass the target. Contrast-to-noise ratio (CNR) and geometric distortion were evaluated to quantify the quality of reconstructed images. Monte Carlo simulations were performed to evaluate the effect of scattering on the image quality and

  16. Aggressive fibromatosis: evaluation by computed tomography and angiography

    SciTech Connect

    Hudson, T.M.; Vandergriend, R.A.; Springfield, D.S.; Hawkins, I.F. Jr.; Spanier, S.S.; Enneking, W.F.; Hamlin, D.J.

    1984-02-01

    Fifteen CT scans of 13 patients who had aggressive fibromatosis were generally accurate in showing the extent of disease, although the CT definition of half or more of the margins of nine lesions was poor. Fibromatosis tumors were typically isodense or slightly hypodense with muscle when no contrast medium was used, and they enhanced to hyperdense with better delineation during infusion of contrast medium. Obliterated intermuscular planes did not always signify disease extension; the relationship to bone was often obscured by beam-hardening artifact; and small blood vessels were often invisible. Arteriograms of seven of eight patients showed some hypervascularity and helped to delineate lesions and vessels that were poorly seen on CT scans. In four instances CT findings were clearer, in two instances arteriographic findings were clearer, and twice the findings were equally clear. Three of six bone scintigrams added accurate information about involvement of adjacent bones.

  17. The Characteristics of Peripapillary Retinal Perfusion by Optical Coherence Tomography Angiography in Tessellated Fundus Eyes

    PubMed Central

    Kong, Xiangmei; Zhu, Li; Sun, Xinghuai

    2016-01-01

    Purpose To evaluate the peripapillary and perifoveal retinal perfusions of young healthy eyes with a tessellated fundus using optical coherence tomography (OCT) angiography. Methods Thirty-five Chinese subjects with a tessellated fundus and 35 subjects without a tessellated fundus from a population-based cross-sectional study in Shanghai were included. All participants underwent OCT angiography. The flow index and vessel density were examined in the peripapillary and perifoveal retinal areas, and their relationships with other ocular parameters were analyzed. Results In the peripapillary area, the eyes with a tessellated fundus had a lower retinal nerve fiber layer (RNFL) flow index (0.055 ± 0.009 vs. 0.061 ± 0.007, P = 0.006), RNFL vessel density (61.8 ± 7.3 vs. 65.9 ± 5.2, P = 0.010), retinal flow index (0.086 ± 0.010 vs. 0.092 ± 0.008, P = 0.012), and retinal vessel density (83.7 ± 5.0 vs. 86.4 ± 3.7, P = 0.018) than the control eyes, and the difference remained significant even after adjustments were made for gender and RNFL thickness. No difference was found in the perifoveal area. Multivariable linear regression analysis showed that the retinal flow index and vessel density in the peripapillary area were significantly correlated with the tessellated fundus diagnosis (flow index: β = -0.006, P = 0.005; vessel density: β = -2.597, P = 0.006), gender (flow index: β = 0.005, P = 0.019; vessel density: β = 3.129, P = 0.002) and RNFL thickness (flow index: β = 0.000, P = 0.002; vessel density: β = 0.190, P = 0.002). The RNFL flow index and vessel density were significantly associated with the tessellated fundus diagnosis (flow index: β = -0.005, P = 0.005; vessel density: β = -3.572, P = 0.008) and the thickness of RNFL (flow index: β = 0.001, P < 0.001; vessel density: β = 0.421, P < 0.001). Conclusions Eyes with tessellated fundus with a relative decreased peripapillary retinal perfusion compared with eyes without a tessellated fundus were

  18. Stress Computed Tomography Myocardial Perfusion Imaging: A New Topic in Cardiology.

    PubMed

    Seitun, Sara; Castiglione Morelli, Margherita; Budaj, Irilda; Boccalini, Sara; Galletto Pregliasco, Athena; Valbusa, Alberto; Cademartiri, Filippo; Ferro, Carlo

    2016-02-01

    Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination. In this article, the emerging role and state-of-the-art of myocardial computed tomography perfusion imaging are reviewed and are illustrated by clinical cases from our experience with a second-generation dual-source 128-slice scanner (Somatom Definition Flash, Siemens; Erlangen, Germany). Technical aspects, data analysis, diagnostic accuracy, radiation dose and future prospects are reviewed.

  19. Stress Computed Tomography Myocardial Perfusion Imaging: A New Topic in Cardiology.

    PubMed

    Seitun, Sara; Castiglione Morelli, Margherita; Budaj, Irilda; Boccalini, Sara; Galletto Pregliasco, Athena; Valbusa, Alberto; Cademartiri, Filippo; Ferro, Carlo

    2016-02-01

    Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination. In this article, the emerging role and state-of-the-art of myocardial computed tomography perfusion imaging are reviewed and are illustrated by clinical cases from our experience with a second-generation dual-source 128-slice scanner (Somatom Definition Flash, Siemens; Erlangen, Germany). Technical aspects, data analysis, diagnostic accuracy, radiation dose and future prospects are reviewed. PMID:26774540

  20. Computed Tomography: Image and Dose Assessment

    NASA Astrophysics Data System (ADS)

    Valencia-Ortega, F.; Ruiz-Trejo, C.; Rodríguez-Villafuerte, M.; Buenfil, A. E.; Mora-Hernández, L. A.

    2006-09-01

    In this work an experimental evaluation of image quality and dose imparted during a computed tomography study in a Public Hospital in Mexico City is presented; The measurements required the design and construction of two phantoms at the Institute of Physics, UNAM, according to the recommendations of American Association of Physicists in Medicine (AAPM). Image assessment was performed in terms the spatial resolution and image contrast. Dose measurements were carried out using LiF: Mg,Ti (TLD-100) dosemeters and pencil-shaped ionisation chamber; The results for a computed tomography head study in single and multiple detector modes are presented.

  1. Swept Source Optical Coherence Tomography Angiography for Contact Lens-Related Corneal Vascularization

    PubMed Central

    Cai, Yijun; Tan, Anna C. S.

    2016-01-01

    Purpose. To describe a novel technique of adapting a swept-source optical coherence tomography angiography (OCTA) to image corneal vascularization. Methods. In this pilot cross-sectional study, we obtained 3 × 3 mm scans, where 100,000 A-scans are acquired per second with optical axial resolution of 8 μm and lateral resolution of 20 μm. This was performed with manual “XYZ” focus without the anterior segment lens, until the focus of the corneoscleral surface was clearly seen and the vessels of interest were in focus on the corresponding red-free image. En face scans were evaluated based on image quality score and repeatability. Results. We analyzed scans from 10 eyes (10 patients) with corneal vascularization secondary to contact lens use in 4 quadrants, with substantial repeatability of scans in all quadrants (mean image quality score 2.7 ± 0.7; κ = 0.75). There was no significant difference in image quality scores comparing quadrants (superior temporal: 2.9 ± 0.6, superior nasal: 2.8 ± 0.4, inferior temporal: 2.5 ± 0.9, and inferior nasal: 2.4 ± 1.0; P = 0.276) and able to differentiate deep and superficial corneal vascularization. Conclusion. This early clinical study suggests that the swept-source OCTA used may be useful for examining corneal vascularization, which may have potential for clinical applications such as detecting early limbal stem cell damage. PMID:27752366

  2. Computed Tomography Analysis of NASA BSTRA Balls

    SciTech Connect

    Perry, R L; Schneberk, D J; Thompson, R R

    2004-10-12

    Fifteen 1.25 inch BSTRA balls were scanned with the high energy computed tomography system at LLNL. This system has a resolution limit of approximately 210 microns. A threshold of 238 microns (two voxels) was used, and no anomalies at or greater than this were observed.

  3. Radiologist, computed tomography, and radiation therapy

    SciTech Connect

    Goitein, M.; Meyer, J.

    1982-06-01

    The use of computed tomography (CT) in planning radiation therapy is discussed. The three major issues that involve collaboration between the diagnostic radiologist and the radiation therapist are identified as selection of equipment, logistics, and conduct of individual CT studies. The importance of cooperation between the diagnostic and therapeutic radiologist is stressed.

  4. Cerebral computed tomography, 3rd Edition

    SciTech Connect

    Weisberg, L.; Nice, C.

    1988-01-01

    This book is an introduction to the utilization of computed tomography in evaluating patients with intracranial and orbital disorders. It features clinical correlations and provides an overview of general principles, performance, and normal anatomy of CT. It covers evaluation of specific neurologic signs and symptoms, including stroke, metastatic disease, increased intracranial pressure, head injury, pediatric conditions, and more.

  5. Computed tomography demonstration of cholecystogastric fistula.

    PubMed

    Chou, Chung Kuao

    2016-06-01

    Cholecystogastric fistula is a rare complication of chronic cholecystitis or long-standing cholelithiasis. It results from the gradual erosion of the approximated, chronically inflamed wall of the gall bladder and stomach with fistulous tract formation. The present case describes the direct visualization of a cholecystogastric fistula by computed tomography in a patient without prior biliary system complaints. PMID:27257453

  6. Computed tomography in the evaluation of trauma

    SciTech Connect

    Federle, M.P.; Brant-Zawadzki, M.

    1982-01-01

    This book is intended to be the current standard for computed tomography in the evaluation of trauma. It summarizes two years of experience at San Francisco General Hospital. The book is organized into seven chapters, covering head, maxillofacial, laryngeal, spinal, chest, abdominal, acetabular, and pelvic trauma. Extremity trauma is not discussed.

  7. Computed tomography in trauma: An atlas approach

    SciTech Connect

    Toombs, B.D.; Sandler, C.

    1986-01-01

    This book discussed computed tomography in trauma. The text is organized according to mechanism of injury and site of injury. In addition to CT, some correlation with other imaging modalities is included. Blunt trauma, penetrating trauma, complications and sequelae of trauma, and use of other modalities are covered.

  8. Diagnosis of juvenile angiofibroma by computed tomography.

    PubMed

    Weinstein, M A; Levine, H; Duchesneau, P M; Tucker, H M

    1978-03-01

    Computed tomography (CT) accurately localized juvenile angiofibromata in 3 patients. The expanded pterygopalatine fossa and canal were visualized by CT in all three cases. Because of the hemorrhagic tendency of these tumors, a noninvasive modality such as CT is especially valuable in planning therapy.

  9. Spiral Computed Tomographic Angiography of the Renal Arteries: A Prospective Comparison with Intravenous and Intraarterial Digital Subtraction Angiography

    SciTech Connect

    Farres, Maria Teresa; Lammer, Johannes; Schima, Wolfgang; Wagner, Brunhilde; Wildling, Reinhard; Winkelbauer, Friedrich; Thurnher, Siegfried

    1996-03-15

    Purpose: To assess the accuracy of computed tomographic angiography (CTA) in the evaluation of the renal arteries in comparison with intravenous (IVDSA) and intraarterial digital subtraction angiography (IADSA). Methods: In 18 patients, 35 CTAs and DSAs (27 IADSA, 8 IVDSA) of the renal arteries were performed. CTA was done with 2-3 mm collimation, 2-4 mm/sec table speed, after intravenous injection of 80 ml of contrast medium at 4 ml/sec with a scanning delay time of 14-21 sec. No previous circulation time curve was performed. CTA data were reconstructed with maximum intensity projection (MIP) and shaded surface display (SSD). The presence of stenosis was assessed on a three-point rating scale (grade 1-3). The quality of the examinations; visualization of the ostium, the main artery, and its branches; vessel sharpness, linearity, and intraluminal contrast filling were evaluated. We compared CTA with DSA. Results: CTA had 96% sensitivity, 77% specificity, and 89% accuracy in the detection of stenoses > 50%. Due to technical errors two stenoses were erroneously diagnosed as positive but there were no false negative diagnoses. The quality of CTA was good in 56% and moderate in 34% of cases. Visualization of the ostium and main artery was graded as 1.74 (out of 2) points and of the renal branches as 1.02 (out of 2) points. The quality of CTA images was worse than that of IADSA in 52%, equal in 41%, and better in 7% of cases. CTA was equal to IVDSA in 25% and better in 75% of the cases. Conclusion: CTA is an accurate noninvasive method for the evaluation of renal arteries. Examination quality is essential for the diagnosis. CTA is limited in its ability to visualize the branches of the renal artery and accessory arteries. CTA seems to be superior to IVDSA.

  10. Parallel Computing for the Computed-Tomography Imaging Spectrometer

    NASA Technical Reports Server (NTRS)

    Lee, Seungwon

    2008-01-01

    This software computes the tomographic reconstruction of spatial-spectral data from raw detector images of the Computed-Tomography Imaging Spectrometer (CTIS), which enables transient-level, multi-spectral imaging by capturing spatial and spectral information in a single snapshot.

  11. Diagnosis and Follow-Up of Nonexudative Choroidal Neovascularization With Multiple Optical Coherence Tomography Angiography Devices: A Case Report.

    PubMed

    Lane, Mark; Ferrara, Daniela; Louzada, Ricardo Noguera; Fujimoto, James G; Seddon, Johanna M

    2016-08-01

    Nonexudative choroidal neovascularization (CNV) is a new phenomenon that has only recently been described in the literature with the advent of optical coherence tomography angiography (OCTA) imaging. The authors present a 1-year longitudinal follow-up of a nonexudative CNV lesion secondary to age-related macular degeneration. This report describes the appearance of the lesion on two commercially available spectral-domain OCTA devices and one prototype swept-source OCTA device. Management of these cases is still debatable. Watchful waiting with regular follow-up using serial OCTA to monitor disease progression has been valuable in this case. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:778-781.]. PMID:27548457

  12. Clinical application of a light-pen computer system for quantitative angiography

    NASA Technical Reports Server (NTRS)

    Alderman, E. L.

    1975-01-01

    The important features in a clinical system for quantitative angiography were examined. The human interface for data input, whether an electrostatic pen, sonic pen, or light-pen must be engineered to optimize the quality of margin definition. The computer programs which the technician uses for data entry and computation of ventriculographic measurements must be convenient to use on a routine basis in a laboratory performing multiple studies per day. The method used for magnification correction must be continuously monitored.

  13. Computed tomography of the spine

    SciTech Connect

    Haughton, V.M.; Williams, A.L.

    1982-01-01

    The book describes the computed tomographic (CT) techniques for imaging the different elements comprising the spinal column and canal. The use of intravenous and intrathecal contrast enhancement and of xenon enhancement is briefly mentioned. Reconstruction techniques and special problems regarding CT of the spine are presented. CT of the spinal cord, meninges and subarachnoid space, epidural space, intervertebral discs, facet joints, and vertebrae present normal anatomy, and several common pathologic conditions. (KRM)

  14. Prognostic capabilities of coronary computed tomographic angiography before non-cardiac surgery: prospective cohort study

    PubMed Central

    Chan, Matthew; Butler, Craig; Chow, Benjamin; Tandon, Vikas; Nagele, Peter; Mitha, Ayesha; Mrkobrada, Marko; Szczeklik, Wojciech; Faridah, Yang; Biccard, Bruce; Stewart, Lori K; Heels-Ansdell, Diane; Devereaux, P J

    2015-01-01

    Objectives To determine if coronary computed tomographic angiography enhances prediction of perioperative risk in patients before non-cardiac surgery and to assess the preoperative coronary anatomy in patients who experience a myocardial infarction after non-cardiac surgery. Design Prospective cohort study. Setting 12 centers in eight countries. Participants 955 patients with, or at risk of, atherosclerotic disease who underwent non-cardiac surgery. Interventions Coronary computed tomographic angiography was performed preoperatively; clinicians were blinded to the results unless left main disease was suspected. Results were classified as normal, non-obstructive (<50% stenosis), obstructive (one or two vessels with ≥50% stenosis), or extensive obstructive (≥50% stenosis in two vessels including the proximal left anterior descending artery, three vessels, or left main). Main outcome measure Composite of cardiovascular death and non-fatal myocardial infarction within 30 days after surgery (primary outcome). This was the dependent variable in Cox regression. The independent variables were scores on the revised cardiac risk index and findings on coronary computed tomographic angiography. Results The primary outcome occurred in 74 patients (8%). The model that included both scores on the revised cardiac risk index and findings on coronary computed tomographic angiography showed that coronary computed tomographic angiography provided independent prognostic information (P=0.014; C index=0.66). The adjusted hazard ratios were 1.51 (95% confidence interval 0.45 to 5.10) for non-obstructive disease; 2.05 (0.62 to 6.74) for obstructive disease; and 3.76 (1.12 to 12.62) for extensive obstructive disease. For the model with coronary computed tomographic angiography compared with the model based on the revised cardiac risk index alone, with 30 day risk categories of <5%, 5-15%, and >15% for the primary outcome, the results of risk reclassification indicate that in a sample of

  15. Computed tomography of the medulla

    SciTech Connect

    Daniels, D.L.; Williams, A.L.; Haughton, V.M.

    1982-10-01

    The medulla was studied in cadavers and in 100 patients both with and without the intrathecal administration of contrast material. The computed tomographic (CT) anatomy was correlated with the appearance on anatomic dissections. The pyramids, olives, and inferior cerebellar peduncles produced characteristic contours on cross sections of the medulla. The hypoglossal nerve by its location and course in the medullary cistern could be distinguished from the glossopharyngeal, vagal, and spinal accessory nerves. For optimal evaluation of the medulla, intrathecal administration of metrizamide and 5- and/or 1.5-mm-thick axial and coronal sections are recommended.

  16. Introducing Seismic Tomography with Computational Modeling

    NASA Astrophysics Data System (ADS)

    Neves, R.; Neves, M. L.; Teodoro, V.

    2011-12-01

    Learning seismic tomography principles and techniques involves advanced physical and computational knowledge. In depth learning of such computational skills is a difficult cognitive process that requires a strong background in physics, mathematics and computer programming. The corresponding learning environments and pedagogic methodologies should then involve sets of computational modelling activities with computer software systems which allow students the possibility to improve their mathematical or programming knowledge and simultaneously focus on the learning of seismic wave propagation and inverse theory. To reduce the level of cognitive opacity associated with mathematical or programming knowledge, several computer modelling systems have already been developed (Neves & Teodoro, 2010). Among such systems, Modellus is particularly well suited to achieve this goal because it is a domain general environment for explorative and expressive modelling with the following main advantages: 1) an easy and intuitive creation of mathematical models using just standard mathematical notation; 2) the simultaneous exploration of images, tables, graphs and object animations; 3) the attribution of mathematical properties expressed in the models to animated objects; and finally 4) the computation and display of mathematical quantities obtained from the analysis of images and graphs. Here we describe virtual simulations and educational exercises which enable students an easy grasp of the fundamental of seismic tomography. The simulations make the lecture more interactive and allow students the possibility to overcome their lack of advanced mathematical or programming knowledge and focus on the learning of seismological concepts and processes taking advantage of basic scientific computation methods and tools.

  17. Phase-Contrast Optical Coherence Tomography: A New Technique for Non-Invasive Angiography

    PubMed Central

    Schwartz, Daniel M.; Fingler, Jeff; Kim, Dae Yu; Zawadzki, Robert J.; Morse, Lawrence S.; Park, Susanna S.; Fraser, Scott E.; Werner, John S.

    2014-01-01

    Purpose Phase-contrast optical coherence tomography (PC-OCT) provides volumetric imaging of the retinal vasculature without the need for intravenous injection of a fluorophore. Here, we compare images from PC-OCT and fluorescein angiography (FA) for normal individuals and patients with age-related macular degeneration and diabetic retinopathy. Design This is an evaluation of a diagnostic technology. Participants 4 patients underwent comparative retinovascular imaging using FA and PC-OCT. Imaging was performed on 1 normal individual, 1 patient with dry age-related macular degeneration, 1 patient with exudative age-related macular degeneration and 1 patient with non-proliferative diabetic retinopathy. Methods FA imaging was performed using a Topcon (TRC-50IX) camera having resolution of 1280 (H) x 1024 (V) pixels. PC-OCT images were generated by software data processing of the entire cross-sectional image from consecutively acquired B-scans. Bulk axial motion was calculated and corrected for each transverse location, reducing the phase noise introduced from eye motion. Phase contrast was calculated through the variance of the motion-corrected phase changes acquired within multiple B-scans at the same position. Repeating these calculations over the entire volumetric scan produced a three-dimensional PC-OCT representation of the vasculature. Main Outcome Measures Feasibility of rendering retinal and choroidal microvasculature using PC-OCT was compared qualitatively to FA, the current gold standard for retinovascular imaging. Results PC-OCT rendered a two-dimensional depth color-coded vasculature map of the retinal and choroidal vasculature non-invasively. The choriocapillaris was imaged with better resolution of microvascular detail using PC-OCT. Areas of geographic atrophy and choroidal neovascularization imaged by FA were depicted by PC-OCT. Regions of capillary non-perfusion from diabetic retinopathy were shown by both imaging techniques; there was not complete

  18. Diagnostic Accuracy of Dual-Source Computerized Tomography Coronary Angiography in Symptomatic Patients Presenting to a Referral Cardiovascular Center During Daily Clinical Practice

    PubMed Central

    Mahdavi, Arash; Mohammadzadeh, Ali; Joodi, Golsa; Tabatabaei, Mohammad Reza; Sheikholeslami, Farhad; Motevalli, Marzieh

    2016-01-01

    Background There are numerous studies that address the diagnostic value of dual-source computed tomography (DSCT) as an alternative to conventional coronary angiography (CCA). However, the benefit of application of DSCT in a real world clinical setting should be evaluated. Objectives To determine the diagnostic accuracy of DSCT technique compared with CCA as the gold standard method in detection of coronary artery stenosis among symptomatic patients who are presented to a referral cardiovascular center during daily clinical practice. Patients and Methods Evaluating the medical records of a tertiary care referral cardiovascular center, 47 patients who had undergone DSCT and CCA, and also met the inclusion and exclusion criteria of the study were selected. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LRs) of the DSCT imaging technique were calculated. Results In total, 97.8% of the segments (628/642) could be visualized with diagnostic image quality via DSCT coronary angiography. The mean heart rate during DSCT was 69.2 ± 12.2 bpm (range: 39 - 83 bpm), and the mean Agatston score was 507.7 ± 590.5 (range: 0 - 2328). Per segment analysis of the findings revealed that the sensitivity, specificity, PPV, NPV, positive LR (PLR) and negative LR (NLR) of DSCT technique for evaluation of patients with coronary artery disease were 93.7%, 96.8%, 92.7%, 97.2%, 29.4, and 0.066, respectively. Also per vessel, analysis of the findings showed a sensitivity of 97.1%, a specificity of 94.0%, PPV of 95.3%, NPV of 96.3%, PLR of 16.1, and NLR of 0.030. Conclusion Our results indicate that DSCT coronary angiography provides high diagnostic accuracy for the evaluation of CAD patients during daily routine practice of a referral cardiovascular setting.

  19. Evaluation of Vascular Supply with Angio-Computed Tomography During Intra-Arterial Chemotherapy for Brain Tumors

    SciTech Connect

    Hirai, Toshinori Korogi, Yukunori; Ono, Ken; Yamashita, Yasuyuki

    2005-04-15

    We report the utility of a combined angiography and computed tomography (angio-CT) system in assessing drug distribution to the tumor during intra-arterial chemotherapy for metastatic brain tumors in a 65-year-old man. Although digital subtraction angiography did not clearly show tumor perfusion in two cerebellar tumors, angio-CT provided definite tumor perfusion in the complicated vascular territory, and anticancer agents were infused based on its findings. To our knowledge, however, this application for intra-arterial chemotherapy of brain tumors has not been previously described.

  20. Dipyridamole stress myocardial perfusion by computed tomography in patients with left bundle branch block

    PubMed Central

    Cabeda, Estêvan Vieira; Falcão, Andréa Maria Gomes; Soares Jr., José; Rochitte, Carlos Eduardo; Nomura, César Higa; Ávila, Luiz Francisco Rodrigues; Parga, José Rodrigues

    2015-01-01

    Background Functional tests have limited accuracy for identifying myocardial ischemia in patients with left bundle branch block (LBBB). Objective To assess the diagnostic accuracy of dipyridamole-stress myocardial computed tomography perfusion (CTP) by 320-detector CT in patients with LBBB using invasive quantitative coronary angiography (QCA) (stenosis ≥ 70%) as reference; to investigate the advantage of adding CTP to coronary computed tomography angiography (CTA) and compare the results with those of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy. Methods Thirty patients with LBBB who had undergone SPECT for the investigation of coronary artery disease were referred for stress tomography. Independent examiners performed per-patient and per-coronary territory assessments. All patients gave written informed consent to participate in the study that was approved by the institution’s ethics committee. Results The patients’ mean age was 62 ± 10 years. The mean dose of radiation for the tomography protocol was 9.3 ± 4.6 mSv. With regard to CTP, the per-patient values for sensitivity, specificity, positive and negative predictive values, and accuracy were 86%, 81%, 80%, 87%, and 83%, respectively (p = 0.001). The per-territory values were 63%, 86%, 65%, 84%, and 79%, respectively (p < 0.001). In both analyses, the addition of CTP to CTA achieved higher diagnostic accuracy for detecting myocardial ischemia than SPECT (p < 0.001). Conclusion The use of the stress tomography protocol is feasible and has good diagnostic accuracy for assessing myocardial ischemia in patients with LBBB. PMID:26421532

  1. [Pneumothorax revealed by postoperative computed tomography].

    PubMed

    Ikeda, Shizuka; Katori, Kiyoshi; Fujimoto, Minoru; Nitahara, Keiichi; Higa, Kazuo

    2005-11-01

    We report a case of pneumothorax revealed by postoperative computed tomography. A 39-year-old obese woman (height 153 cm, weight 70 kg) with fractures of the radius, ulna, clavicle, and femur in a traffic accident, was scheduled for osteosynthesis. Anesthesia was induced with thiopental and maintained with 50% nitrous oxide in oxygen and sevoflurane. The Spo2 decreased from 99% to 94% during the surgery. Bilateral chest sounds were symmetrical. The Spo2 increased to 100% after discontinuation of nitrous oxide. Pneumothorax was not evident on a postoperative chest X-ray, but computed tomography of the chest demonstrated right-sided pneumothorax. An ECG electrode had overlapped the fractured rib on the preoperative chest X-ray.

  2. Clinical use and research applications of Heidelberg retinal angiography and spectral-domain optical coherence tomography - a review.

    PubMed

    Hassenstein, Andrea; Meyer, Carsten H

    2009-01-01

    Fluorescein angiography (FA) was discovered by Nowotny and Alvis in the 1960s of the 20th century and has evolved to become the 'Gold standard' for macular diagnostics. Scanning laser imaging technology achieved enhancement of contrast and resolution. The combined Heidelberg retina angiograph (HRA2) adds novel innovative features to established fundus cameras. The principle of confocal scanning laser imaging provides a high resolution of retinal and choroidal vasculature with low light exposure providing comfort and safety for the patient. Enhanced contrast, details and image sharpness image are generated using confocality. For the visualization of the choroid an indocyanine green angiography (ICGA) is the most suitable application. The main indications for ICGA are age-related macular degeneration, choroidal polypoidal vasculopathy and choroidal haemangiomas. Simultaneous digital FA and ICGA images with three-dimensional resolution offer improved diagnosis of retinal and choroidal pathologies. High-speed ICGA dynamic imaging can identify feeder vessels and retinal choroidal anastomoses, ensuring safer treatment of choroidal neovascularization. Autofluorescence imaging and fundus reflectance imaging with blue and infrared light offer new follow-up parameters for retinal diseases. Finally, the real-time optical coherence tomography provides a new level of accuracy for assessment of the angiographic and morphological correlation. The combination of various macular diagnostic tools, such as infrared, blue reflectance, fundus autofluorescence, FA, ICGA and also spectral domain optical coherence tomography, lead to a better understanding and improved knowledge of macular diseases. PMID:19338610

  3. Computed tomography of the postoperative abdominal aorta

    SciTech Connect

    Hilton, S.; Megibow, A.J.; Naidich, D.P.; Bosniak, M.A.

    1982-11-01

    Computed tomography (CT) of the abdomen was performed on 46 patients who had undergone graft replacement of abdominal aortic aneurysms. Twelve post-operative complications were found in nine patients. They included hemorrhage, infection, anastomotic pseudoaneurysms, major vessel occlusion, postoperative pancreatitis, and others. The varied apperance of the normal postoperative graft is also presented. It is concluded that CT is a rapid, sensitive, and noninvasive method for detecting or excluding postoperative complications of abdominal aortic surgery.

  4. Computed tomography of hamstring muscle strains.

    PubMed

    Garrett, W E; Rich, F R; Nikolaou, P K; Vogler, J B

    1989-10-01

    Acute hamstring muscle strains occurring in ten college athletes were evaluated using computed tomography to identify the location and characteristics of these common injuries. Acute muscle strains appeared as areas of hypodensity within the muscle 1-2 d following injury. This suggests that inflammation and edema are the major component of injury, not bleeding as commonly assumed. Injuries were seen most commonly in the proximal and lateral portions of the hamstring muscle group, particularly in the biceps femoris.

  5. Computed tomography of ancient Egyptian mummies.

    PubMed

    Harwood-Nash, D C

    1979-12-01

    This first report of the application of computed tomography (CT) to the study of ancient mummies, the desiccated brain of a boy and the body of a young woman within her cartonnage, shows that CT is uniquely suitable for the study of such antiquities, a study that does not necessitate destruction of the mummy or its cartonnage. Exquisite images result that are of great paleoanatomical, paleopathological, and archeological significance.

  6. Computed tomography of the eye and orbit

    SciTech Connect

    Hammerschlag, S.B.; Hesselink, J.R.; Weber, A.L.

    1982-01-01

    This book is the product of the evolution of computed tomography (CT) into subspecialization and the need for one source of information for the busy radiologist. The authors have succeeded in providing a readable overview of orbital CT as well as a reference book. The book is divided into seven major catagories of pathology (Neurofibromatosis, Primary Orbital Neoplasms, Secondary and Metastic Tumors of the Orbit, Vascular Disorders, Inflammatory Disease, Occular Lesions, and Trauma) after separate discussions of anatomy and technique.

  7. Pharyngitis of infectious mononucleosis: computed tomography findings.

    PubMed

    Kutuya, Naoki; Kurosaki, Yoshihisa; Suzuki, Kazuhiro; Takata, Koremochi; Shiraihshi, Akihiko

    2008-05-01

    Two women presented with sore throat and fever. Their symptoms were not alleviated by antibiotics. Cervical computed tomography (CT) with contrast enhancement demonstrated enlargement of predominant posterior cervical lymph nodes and streaky heterogeneous tonsils with interspersed low attenuation. They were diagnosed as having infectious mononucleosis by their laboratory data. Thus, when radiologists encounter these CT findings of pharyngitis that is not alleviated by antibiotic therapy, infectious mononucleosis should be considered in the differential diagnosis.

  8. Therapy response evaluation with positron emission tomography-computed tomography.

    PubMed

    Segall, George M

    2010-12-01

    Positron emission tomography-computed tomography with F-18-fluorodeoxyglucose is widely used for evaluation of therapy response in patients with solid tumors but has not been as readily adopted in clinical trials because of the variability of acquisition and processing protocols and the absence of universal response criteria. Criteria proposed for clinical trials are difficult to apply in clinical practice, and gestalt impression is probably accurate in individual patients, especially with respect to the presence of progressive disease and complete response. Semiquantitative methods of determining tissue glucose metabolism, such as standard uptake value, can be a useful descriptor for levels of tissue glucose metabolism and changes in response to therapy if technical quality control measures are carefully maintained. The terms partial response, complete response, and progressive disease are best used in clinical trials in which the terms have specific meanings and precise definitions. In clinical practice, it may be better to use descriptive terminology agreed upon by imaging physicians and clinicians in their own practice. PMID:21147376

  9. [Review of pre- and post-treatment multidetector computed tomography findings in abdominal aortic aneurysms].

    PubMed

    Casula, E; Lonjedo, E; Cerverón, M J; Ruiz, A; Gómez, J

    2014-01-01

    The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period. PMID:23489768

  10. [Review of pre- and post-treatment multidetector computed tomography findings in abdominal aortic aneurysms].

    PubMed

    Casula, E; Lonjedo, E; Cerverón, M J; Ruiz, A; Gómez, J

    2014-01-01

    The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period.

  11. Computed tomography to quantify tooth abrasion

    NASA Astrophysics Data System (ADS)

    Kofmehl, Lukas; Schulz, Georg; Deyhle, Hans; Filippi, Andreas; Hotz, Gerhard; Berndt-Dagassan, Dorothea; Kramis, Simon; Beckmann, Felix; Müller, Bert

    2010-09-01

    Cone-beam computed tomography, also termed digital volume tomography, has become a standard technique in dentistry, allowing for fast 3D jaw imaging including denture at moderate spatial resolution. More detailed X-ray images of restricted volumes for post-mortem studies in dental anthropology are obtained by means of micro computed tomography. The present study evaluates the impact of the pipe smoking wear on teeth morphology comparing the abraded tooth with its contra-lateral counterpart. A set of 60 teeth, loose or anchored in the jaw, from 12 dentitions have been analyzed. After the two contra-lateral teeth were scanned, one dataset has been mirrored before the two datasets were registered using affine and rigid registration algorithms. Rigid registration provides three translational and three rotational parameters to maximize the overlap of two rigid bodies. For the affine registration, three scaling factors are incorporated. Within the present investigation, affine and rigid registrations yield comparable values. The restriction to the six parameters of the rigid registration is not a limitation. The differences in size and shape between the tooth and its contra-lateral counterpart generally exhibit only a few percent in the non-abraded volume, validating that the contralateral tooth is a reasonable approximation to quantify, for example, the volume loss as the result of long-term clay pipe smoking. Therefore, this approach allows quantifying the impact of the pipe abrasion on the internal tooth morphology including root canal, dentin, and enamel volumes.

  12. Computer tomography imaging of fast plasmachemical processes

    SciTech Connect

    Denisova, N. V.; Katsnelson, S. S.; Pozdnyakov, G. A.

    2007-11-15

    Results are presented from experimental studies of the interaction of a high-enthalpy methane plasma bunch with gaseous methane in a plasmachemical reactor. The interaction of the plasma flow with the rest gas was visualized by using streak imaging and computer tomography. Tomography was applied for the first time to reconstruct the spatial structure and dynamics of the reagent zones in the microsecond range by the maximum entropy method. The reagent zones were identified from the emission of atomic hydrogen (the H{sub {alpha}} line) and molecular carbon (the Swan bands). The spatiotemporal behavior of the reagent zones was determined, and their relation to the shock-wave structure of the plasma flow was examined.

  13. Positron Computed Tomography: Current State, Clinical Results and Future Trends

    DOE R&D Accomplishments Database

    Schelbert, H. R.; Phelps, M. E.; Kuhl, D. E.

    1980-09-01

    An overview is presented of positron computed tomography: its advantages over single photon emission tomography, its use in metabolic studies of the heart and chemical investigation of the brain, and future trends. (ACR)

  14. Evolution in Computed Tomography: The Battle for Speed and Dose.

    PubMed

    Lell, Michael M; Wildberger, Joachim E; Alkadhi, Hatem; Damilakis, John; Kachelriess, Marc

    2015-09-01

    The advent of computed tomography (CT) has revolutionized radiology. Starting as head-only scanners, modern CT systems are now capable of performing whole-body examinations within a couple of seconds in isotropic resolution. Technical advancements of scanner hardware and image reconstruction techniques are reviewed and discussed in their clinical context. These improvements have led to a steady increase of CT examinations in all age groups for a number of reasons. On the one hand, it is very easy today to obtain whole-body data for oncologic staging and follow-up or for trauma imaging. On the other hand, new examinations such as cardiac imaging, virtual colonoscopy, gout imaging, and whole-organ perfusion imaging have widened the application profile of CT. The increasing awareness of risks associated with radiation exposure triggered the development of a variety of dose reduction techniques. Effective dose values below 1 mSv, less than the annual natural background radiation (3.1 mSv/year on average in the United States), are now routinely possible for a number of dedicated examinations, even for coronary CT angiography. PMID:26135019

  15. Computed tomographic angiography in evaluation of superficial temporal to middle cerebral artery bypass.

    PubMed

    Besachio, David A; Ziegler, Jordan I; Duncan, Timothy D; Wanebo, John S

    2010-01-01

    Catheter-directed digital subtraction angiography (DSA) is considered the standard for evaluation of superficial temporal to middle cerebral artery (STA-MCA) bypass patency. Few clinical investigations have been performed that evaluate the efficacy of computed tomographic angiography (CTA) in the assessment of extracranial-intracranial bypass. Using multi-detector row CTA, STA-MCA bypass patency was assessed in the initial postoperative period and several months afterward and compared with DSA. No significant difference was identified in the evaluation of graft patency between DSA and CTA. Although multiple modalities exist to evaluate STA-MCA bypass graft patency, the multidetector CTA is widely available and allows for rapid, accurate patency assessment. PMID:20498550

  16. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

    PubMed Central

    Jin, Wen-Ying; Zhao, Xiu-Juan; Chen, Hong

    2016-01-01

    Background: Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD). Women, more frequently than men, are known to develop atypical angina symptoms. The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men. Methods: We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or proven CAD who successively underwent both MSCT and invasive CAG. CAD was defined as any coronary stenosis of ≥50% on conventional invasive CAG, which was used as the reference standard. The patients were divided into typical and atypical groups based on their symptoms of angina pectoris. The diagnostic accuracy of MSCT, including its sensitivity, specificity, negative predictive value, and positive predictive value (PPV), was calculated to determine the usefulness of MSCT in assessing stenoses. The diagnostic performance of MSCT was also assessed by constructing receiver operating characteristic (ROC) curves. Results: The PPV (91% vs. 97%, χ2 = 5.705, P < 0.05) and diagnostic accuracy (87% vs. 93%, χ2 = 5.093, P < 0.05) of MSCT in detecting CAD were lower in women than in men. Atypical presentation was an independent influencing factor on the diagnostic accuracy of MSCT in women (odds ratio = 4.94, 95% confidence intervals: 1.16–20.92, Walds = 4.69, P < 0.05). Compared with those in the atypical group, women with typical angina pectoris had higher PPV (98% vs. 74%, χ2 = 17.283. P < 0.001), diagnostic accuracy (93% vs. 72%, χ2 = 9.571, P < 0.001), and area under the ROC curve (0.91 vs. 0.64, Z = 2.690, P < 0.01) in MSCT diagnosis. Conclusions: Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients, gender and atypical symptoms might have some influence on its diagnostic accuracy. PMID:27625091

  17. Cone Beam Computed Tomography - Know its Secrets

    PubMed Central

    Kumar, Mohan; Shanavas, Muhammad; Sidappa, Ashwin; Kiran, Madhu

    2015-01-01

    Cone-beam computed tomography (CBCT) is an advanced imaging modality that has high clinical applications in the field of dentistry. CBCT proved to be a successful investigative modality that has been used for dental and maxillofacial imaging. Radiation exposure dose from CBCT is 10 times less than from conventional CT scans during maxillofacial exposure. Furthermore, CBCT is highly accurate and can provide a three-dimensional volumetric data in axial, sagittal and coronal planes. This article describes the basic technique, difference in CBCT from CT and main clinical applications of CBCT. PMID:25859112

  18. Emerging clinical applications of computed tomography

    PubMed Central

    Liguori, Carlo; Frauenfelder, Giulia; Massaroni, Carlo; Saccomandi, Paola; Giurazza, Francesco; Pitocco, Francesca; Marano, Riccardo; Schena, Emiliano

    2015-01-01

    X-ray computed tomography (CT) has recently been experiencing remarkable growth as a result of technological advances and new clinical applications. This paper reviews the essential physics of X-ray CT and its major components. Also reviewed are recent promising applications of CT, ie, CT-guided procedures, CT-based thermometry, photon-counting technology, hybrid PET-CT, use of ultrafast-high pitch scanners, and potential use of dual-energy CT for material differentiations. These promising solutions and a better knowledge of their potentialities should allow CT to be used in a safe and effective manner in several clinical applications. PMID:26089707

  19. Perforated Appendicitis: Assessment With Multidetector Computed Tomography.

    PubMed

    Iacobellis, Francesca; Iadevito, Isabella; Romano, Federica; Altiero, Michele; Bhattacharjee, Bikram; Scaglione, Mariano

    2016-02-01

    Appendicitis is one of the most common abdominal surgical emergencies. In some cases, the correct diagnosis may be challenging, owing to different conditions that can mimic this pathology. In this context, abdominal computed tomography (CT) is the imaging modality of choice, leading to an accurate diagnosis and to a reduction in unnecessary laparotomies. The diagnosis of perforated appendix is crucial, but the detection of the perforation signs by CT may not be so simple in the early process. The aim of this article is to review the multiple detector CT signs of perforated appendicitis.

  20. Computed tomography of infantile hepatic hemangioendothelioma

    SciTech Connect

    Lucaya, J.; Enriquez, G.; Amat, L.; Gonzalez-Rivero, M.A.

    1985-04-01

    Computed tomography (CT) was performed on five infants with hepatic hemangioendothelioma. Precontrast scans showed solitary or multiple, homogeneous, circumscribed areas with reduced attenuation values. Tiny tumoral calcifications were identified in two patients. Serial scans, after injection of a bolus of contrast material, showed early massive enhancement, which was either diffuse or peripheral. On delayed scans, multinocular tumors became isodense with surrounding liver, while all solitary ones showed varied degrees of centripetal enhancement and persistent central cleftlike unenhanced areas. The authors believe that these CT features are characteristic and obviate arteriographic confirmation.

  1. Advances in computed tomography imaging technology.

    PubMed

    Ginat, Daniel Thomas; Gupta, Rajiv

    2014-07-11

    Computed tomography (CT) is an essential tool in diagnostic imaging for evaluating many clinical conditions. In recent years, there have been several notable advances in CT technology that already have had or are expected to have a significant clinical impact, including extreme multidetector CT, iterative reconstruction algorithms, dual-energy CT, cone-beam CT, portable CT, and phase-contrast CT. These techniques and their clinical applications are reviewed and illustrated in this article. In addition, emerging technologies that address deficiencies in these modalities are discussed.

  2. Computed tomography and sialography: 2. Pathology.

    PubMed

    Carter, B L; Karmody, C S; Blickman, J R; Panders, A K

    1981-02-01

    Computed tomography (CT) has added a significant amount of diagnostic information to the imaging of the salivary glands. Two groups of patients were evaluated at two institutions to determine the impact of CT on the diagnosis of various diseases and to evaluate the contribution of CT versus conventional sialography, respectively. Patients were studied by each modality alone and in combination. Emphasis has been placed on the group that had CT combined with sialography, since benign and malignant tumors were found to be better evaluated by the two techniques together.

  3. Integrating photoacoustic ophthalmoscopy with scanning laser ophthalmoscopy, optical coherence tomography, and fluorescein angiography for a multimodal retinal imaging platform

    NASA Astrophysics Data System (ADS)

    Song, Wei; Wei, Qing; Liu, Tan; Kuai, David; Burke, Janice M.; Jiao, Shuliang; Zhang, Hao F.

    2012-06-01

    Photoacoustic ophthalmoscopy (PAOM) is a newly developed retinal imaging technology that holds promise for both fundamental investigation and clinical diagnosis of several blinding diseases. Hence, integrating PAOM with other existing ophthalmic imaging modalities is important to identify and verify the strengths of PAOM compared with the established technologies and to provide the foundation for more comprehensive multimodal imaging. To this end, we developed a retinal imaging platform integrating PAOM with scanning laser ophthalmoscopy (SLO), spectral-domain optical coherence tomography (SD-OCT), and fluorescein angiography (FA). In the system, all the imaging modalities shared the same optical scanning and delivery mechanisms, which enabled registered retinal imaging from all the modalities. High-resolution PAOM, SD-OCT, SLO, and FA images were acquired in both albino and pigmented rat eyes. The reported in vivo results demonstrate the capability of the integrated system to provide comprehensive anatomic imaging based on multiple optical contrasts.

  4. CT Angiography after 20 Years

    PubMed Central

    Rubin, Geoffrey D.; Leipsic, Jonathon; Schoepf, U. Joseph; Fleischmann, Dominik; Napel, Sandy

    2015-01-01

    Through a marriage of spiral computed tomography (CT) and graphical volumetric image processing, CT angiography was born 20 years ago. Fueled by a series of technical innovations in CT and image processing, over the next 5–15 years, CT angiography toppled conventional angiography, the undisputed diagnostic reference standard for vascular disease for the prior 70 years, as the preferred modality for the diagnosis and characterization of most cardiovascular abnormalities. This review recounts the evolution of CT angiography from its development and early challenges to a maturing modality that has provided unique insights into cardiovascular disease characterization and management. Selected clinical challenges, which include acute aortic syndromes, peripheral vascular disease, aortic stent-graft and transcatheter aortic valve assessment, and coronary artery disease, are presented as contrasting examples of how CT angiography is changing our approach to cardiovascular disease diagnosis and management. Finally, the recently introduced capabilities for multispectral imaging, tissue perfusion imaging, and radiation dose reduction through iterative reconstruction are explored with consideration toward the continued refinement and advancement of CT angiography. PMID:24848958

  5. COMPUTED TOMOGRAPHY OF TOOTH RESORPTION IN CATS.

    PubMed

    Lang, Linda G; Wilkinson, Thomas E; White, Tammy L; Farnsworth, Raelynn K; Potter, Kathleen A

    2016-09-01

    Tooth resorption is the most common dental disease in cats and can be a source of oral pain. The current clinical gold standard for diagnosis includes a combination of oral exam and dental radiography, however early lesions are not always detected. Computed tomography (CT) of the skull, including the dental arches, is a commonly performed diagnostic procedure, however the appearance of tooth resorption on CT and the diagnostic ability of CT to detect tooth resorption have not been evaluated. The purpose of this prospective, descriptive, diagnostic accuracy study was to characterize the CT appearance of tooth resorption in a sample of affected cats and to evaluate the sensitivity and specificity of CT for tooth resorption compared to the clinical gold standard of oral exam and intraoral dental radiography. Twenty-eight cat cadaver specimens were recruited for inclusion. Each specimen was evaluated using oral exam, intraoral dental radiography, and computed tomography (four different slice thicknesses). Each tooth was evaluated for the presence or absence of tooth resorption. Teeth with lesions and a subset of normal teeth were evaluated with histopathology. On CT, tooth resorption appeared as irregularly marginated hypoattenuating defects in the mineral attenuating tooth components, most commonly involving the root or cementoenamel junction. Sensitivity for CT detection of tooth resorption was fair to poor (42.2-57.7%) and specificity was good to excellent (92.8-96.3%). Findings from this study indicated that CT has high specificity but low sensitivity for detection of tooth resorption in cats.

  6. Comparison of computed tomography dose reporting software.

    PubMed

    Abdullah, A; Sun, Z; Pongnapang, N; Ng, K-H

    2012-08-01

    Computed tomography (CT) dose reporting software facilitates the estimation of doses to patients undergoing CT examinations. In this study, comparison of three software packages, i.e. CT-Expo (version 1.5, Medizinische Hochschule, Hannover, Germany), ImPACT CT Patients Dosimetry Calculator (version 0.99×, Imaging Performance Assessment on Computed Tomography, www.impactscan.org) and WinDose (version 2.1a, Wellhofer Dosimetry, Schwarzenbruck, Germany), has been made in terms of their calculation algorithm and the results of calculated doses. Estimations were performed for head, chest, abdominal and pelvic examinations based on the protocols recommended by European guidelines using single-slice CT (SSCT) (Siemens Somatom Plus 4, Erlangen, Germany) and multi-slice CT (MSCT) (Siemens Sensation 16, Erlangen, Germany) for software-based female and male phantoms. The results showed that there are some differences in final dose reporting provided by these software packages. There are deviations of effective doses produced by these software packages. Percentages of coefficient of variance range from 3.3 to 23.4 % in SSCT and from 10.6 to 43.8 % in MSCT. It is important that researchers state the name of the software that is used to estimate the various CT dose quantities. Users must also understand the equivalent terminologies between the information obtained from the CT console and the software packages in order to use the software correctly.

  7. Unexpected Angiography Findings and Effects on Management

    PubMed Central

    Neill, Matthew; Charles, Hearns W; Gross, Jonathan S; Farquharson, Sean; Deipolyi, Amy R

    2016-01-01

    Despite progress in noninvasive imaging with computed tomography and magnetic resonance imaging, conventional angiography still contributes to the diagnostic workup of oncologic and other diseases. Arteriography can reveal tumors not evident on cross-sectional imaging, in addition to defining aberrant or unexpected arterial supply to targeted lesions. This additional and potentially unanticipated information can alter management decisions during interventional procedures. PMID:27688932

  8. Unexpected Angiography Findings and Effects on Management.

    PubMed

    Neill, Matthew; Charles, Hearns W; Gross, Jonathan S; Farquharson, Sean; Deipolyi, Amy R

    2016-01-01

    Despite progress in noninvasive imaging with computed tomography and magnetic resonance imaging, conventional angiography still contributes to the diagnostic workup of oncologic and other diseases. Arteriography can reveal tumors not evident on cross-sectional imaging, in addition to defining aberrant or unexpected arterial supply to targeted lesions. This additional and potentially unanticipated information can alter management decisions during interventional procedures. PMID:27688932

  9. Unexpected Angiography Findings and Effects on Management

    PubMed Central

    Neill, Matthew; Charles, Hearns W; Gross, Jonathan S; Farquharson, Sean; Deipolyi, Amy R

    2016-01-01

    Despite progress in noninvasive imaging with computed tomography and magnetic resonance imaging, conventional angiography still contributes to the diagnostic workup of oncologic and other diseases. Arteriography can reveal tumors not evident on cross-sectional imaging, in addition to defining aberrant or unexpected arterial supply to targeted lesions. This additional and potentially unanticipated information can alter management decisions during interventional procedures.

  10. Computed Tomography Technology: Development and Applications for Defence

    SciTech Connect

    Baheti, G. L.; Saxena, Nisheet; Tripathi, D. K.; Songara, K. C.; Meghwal, L. R.; Meena, V. L.

    2008-09-26

    Computed Tomography(CT) has revolutionized the field of Non-Destructive Testing and Evaluation (NDT and E). Tomography for industrial applications warrants design and development of customized solutions catering to specific visualization requirements. Present paper highlights Tomography Technology Solutions implemented at Defence Laboratory, Jodhpur (DLJ). Details on the technological developments carried out and their utilization for various Defence applications has been covered.

  11. Computed Tomography Technology: Development and Applications for Defence

    NASA Astrophysics Data System (ADS)

    Baheti, G. L.; Saxena, Nisheet; Tripathi, D. K.; Songara, K. C.; Meghwal, L. R.; Meena, V. L.

    2008-09-01

    Computed Tomography(CT) has revolutionized the field of Non-Destructive Testing and Evaluation (NDT&E). Tomography for industrial applications warrants design and development of customized solutions catering to specific visualization requirements. Present paper highlights Tomography Technology Solutions implemented at Defence Laboratory, Jodhpur (DLJ). Details on the technological developments carried out and their utilization for various Defence applications has been covered.

  12. Use of Coronary Computed Tomographic Angiography Findings to Modify Statin and Aspirin Prescription in Patients With Acute Chest Pain.

    PubMed

    Pursnani, Amit; Celeng, Csilla; Schlett, Christopher L; Mayrhofer, Thomas; Zakroysky, Pearl; Lee, Hang; Ferencik, Maros; Fleg, Jerome L; Bamberg, Fabian; Wiviott, Stephen D; Truong, Quynh A; Udelson, James E; Nagurney, John T; Hoffmann, Udo

    2016-02-01

    Coronary CT angiography (CCTA) is used in patients with low-intermediate chest pain presenting to the emergency department for its reliability in excluding acute coronary syndrome (ACS). However, its influence on medication modification in this setting is unclear. We sought to determine whether knowledge of CCTA-based coronary artery disease (CAD) was associated with change in statin and aspirin prescription. We used the CCTA arm of the Rule Out Myocardial Infarction using Computed Angiographic Tomography II multicenter, randomized control trial (R-II) and comparison cohort from the observational Rule Out Myocardial Infarction using Computed Angiographic Tomography I cohort (R-I). In R-II, subjects were randomly assigned to CCTA to guide decision making, whereas in R-I patients underwent CCTA with results blinded to caregivers and managed according to standard care. Our final cohort consisted of 277 subjects from R-I and 370 from R-II. ACS rate was similar (6.9% vs 6.2% respectively, p = 0.75). For subjects with CCTA-detected obstructive CAD without ACS, initiation of statin was significantly greater after disclosure of CCTA results (0% in R-I vs 20% in R-II, p = 0.009). Conversely, for subjects without CCTA-detected CAD, aspirin prescription was lower with disclosure of CCTA results (16% in R-I vs 4.8% in R-II, p = 0.001). However, only 68% of subjects in R-II with obstructive CAD were discharged on statin and 65% on aspirin. In conclusion, physician knowledge of CCTA results leads to improved alignment of aspirin and statin with the presence and severity of CAD although still many patients with CCTA-detected CAD are not discharged on aspirin or statin. Our findings suggest opportunity for practice improvement when CCTA is performed in the emergency department.

  13. Newer cardiac imaging techniques: multidetector CT angiography.

    PubMed

    Davidoff, Ravin; Ruberg, Frederick L

    2006-01-01

    An update of new developments with multidetector computed tomography (MDCT) coronary angiography is presented. Similar to what has occurred with the introduction of other new technologies such as electron beam computed tomography (EBCT), life insurance medical directors are expected to evaluate a technology before there are sufficient data from large clinical trials. Well-performed studies of the performance of MDCT coronary angiography have only recently appeared. MDCT appears to perform well for excluding significant coronary disease, and will perhaps be useful in emergency room "rule-out" situations. Other applications may be for the diagnosis of significant coronary obstruction (> 75% stenosis), as well as for the evaluation of bypass grafts. Limitations include the requirement for radiologic contrast administration and significant radiation exposure. MDCT does not provide information on atheroma morphology. Given these limitations, MDCT coronary angiography utilization will grow, and it will prove to be a useful tool in specific situations. PMID:16845845

  14. [Radiation to the orbits during computer tomography with the emi scanner ct 1010 (author's transl)].

    PubMed

    Schneider, G; Sager, W D; Spreizer, H

    1978-06-01

    Radiation dose to the lens during examinations with the EMI scanner CT 1010 depends on the region examined, on the angle of swing, duration of scan and the plane of the examination. In the most common position (horizontal, 180 degrees and 60 seconds) lens dose during examination of the orbit is about 900 mR., and for examination of the skull about 300 mR. Longer durations of scan and greater swings may increase the dose to the lens to 9 R. Even in the most unfavourable cases, the dose to the lens is less than would be obtained from skull tomography and skull angiography in two planes. Nevertheless, axial computer tomography used under certain conditions, and particularly when repeated, will have to be considered as a possible cause of damage to the lens.

  15. Spatiotemporal computed tomography of dynamic processes

    NASA Astrophysics Data System (ADS)

    Kaestner, Anders; Münch, Beat; Trtik, Pavel; Butler, Les

    2011-12-01

    Modern computed tomography (CT) equipment allowing fast 3-D imaging also makes it possible to monitor dynamic processes by 4-D imaging. Because the acquisition time of various 3-D-CT systems is still in the range of at least milliseconds or even hours, depending on the detector system and the source, the balance of the desired temporal and spatial resolution must be adjusted. Furthermore, motion artifacts will occur, especially at high spatial resolution and longer measuring times. We propose two approaches based on nonsequential projection angle sequences allowing a convenient postacquisition balance of temporal and spatial resolution. Both strategies are compatible with existing instruments, needing only a simple reprograming of the angle list used for projection acquisition and care with the projection order list. Both approaches will reduce the impact of artifacts due to motion. The strategies are applied and validated with cold neutron imaging of water desorption from originally saturated particles during natural air-drying experiments and with x-ray tomography of a polymer blend heated during imaging.

  16. Single-photon emission computed tomography (SPECT): Applications and potential

    SciTech Connect

    Holman, B.L.; Tumeh, S.S. )

    1990-01-26

    Single-photon emission computed tomography has received increasing attention as radiopharmaceuticals that reflect perfusion, metabolism, and receptor and cellular function have become widely available. Perfusion single-photon emission computed tomography of the brain provides functional information useful for the diagnosis and management of stroke, dementia, and epilepsy. Single-photon emission computed tomography has been applied to myocardial, skeletal, hepatic, and tumor scintigraphy, resulting in increased diagnostic accuracy over planar imaging because background activity and overlapping tissues interfere far less with activity from the target structure when tomographic techniques are used. Single-photon emission computed tomography is substantially less expensive and far more accessible than positron emission tomography and will become an increasingly attractive alternative for transferring the positron emission tomography technology to routine clinical use.

  17. Ultra-high resolution computed tomography imaging

    DOEpatents

    Paulus, Michael J.; Sari-Sarraf, Hamed; Tobin, Jr., Kenneth William; Gleason, Shaun S.; Thomas, Jr., Clarence E.

    2002-01-01

    A method for ultra-high resolution computed tomography imaging, comprising the steps of: focusing a high energy particle beam, for example x-rays or gamma-rays, onto a target object; acquiring a 2-dimensional projection data set representative of the target object; generating a corrected projection data set by applying a deconvolution algorithm, having an experimentally determined a transfer function, to the 2-dimensional data set; storing the corrected projection data set; incrementally rotating the target object through an angle of approximately 180.degree., and after each the incremental rotation, repeating the radiating, acquiring, generating and storing steps; and, after the rotating step, applying a cone-beam algorithm, for example a modified tomographic reconstruction algorithm, to the corrected projection data sets to generate a 3-dimensional image. The size of the spot focus of the beam is reduced to not greater than approximately 1 micron, and even to not greater than approximately 0.5 microns.

  18. Quality assessment of clinical computed tomography

    NASA Astrophysics Data System (ADS)

    Berndt, Dorothea; Luckow, Marlen; Lambrecht, J. Thomas; Beckmann, Felix; Müller, Bert

    2008-08-01

    Three-dimensional images are vital for the diagnosis in dentistry and cranio-maxillofacial surgery. Artifacts caused by highly absorbing components such as metallic implants, however, limit the value of the tomograms. The dominant artifacts observed are blowout and streaks. Investigating the artifacts generated by metallic implants in a pig jaw, the data acquisition for the patients in dentistry should be optimized in a quantitative manner. A freshly explanted pig jaw including related soft-tissues served as a model system. Images were recorded varying the accelerating voltage and the beam current. The comparison with multi-slice and micro computed tomography (CT) helps to validate the approach with the dental CT system (3D-Accuitomo, Morita, Japan). The data are rigidly registered to comparatively quantify their quality. The micro CT data provide a reasonable standard for quantitative data assessment of clinical CT.

  19. System Matrix Analysis for Computed Tomography Imaging

    PubMed Central

    Flores, Liubov; Vidal, Vicent; Verdú, Gumersindo

    2015-01-01

    In practical applications of computed tomography imaging (CT), it is often the case that the set of projection data is incomplete owing to the physical conditions of the data acquisition process. On the other hand, the high radiation dose imposed on patients is also undesired. These issues demand that high quality CT images can be reconstructed from limited projection data. For this reason, iterative methods of image reconstruction have become a topic of increased research interest. Several algorithms have been proposed for few-view CT. We consider that the accurate solution of the reconstruction problem also depends on the system matrix that simulates the scanning process. In this work, we analyze the application of the Siddon method to generate elements of the matrix and we present results based on real projection data. PMID:26575482

  20. Clinically applicable gated cardiac computed tomography

    SciTech Connect

    Cipriano, P.R.; Nassi, M.; Brody, W.R.

    1983-03-01

    Several attempts have been made to improve cardiac images obtained with x-ray transmission computed tomography (CT) by stopping cardiac motion through electrocardiographic gating. These methods reconstruct images that correspond to time intervals of the cardiac cycle identified by electrocardiography using either a pulsed x-ray beam at a selected time in the cardiac cycle or selected measurements in retrospect from regularly pulsed measurements made over several cardiac cycles. Missing CT angles of view (line integrals) have been a major problem contributing to degradation of such gated cardiac CT images. A new method for CT reconstruction from an incomplete set of projection data is presented that can be used clinically with a standard fan-beam reconstruction algorithm to improve gated cardiac CT images.

  1. Analysis of Ventricular Function by Computed Tomography

    PubMed Central

    Rizvi, Asim; Deaño, Roderick C.; Bachman, Daniel P.; Xiong, Guanglei; Min, James K.; Truong, Quynh A.

    2014-01-01

    The assessment of ventricular function, cardiac chamber dimensions and ventricular mass is fundamental for clinical diagnosis, risk assessment, therapeutic decisions, and prognosis in patients with cardiac disease. Although cardiac computed tomography (CT) is a noninvasive imaging technique often used for the assessment of coronary artery disease, it can also be utilized to obtain important data about left and right ventricular function and morphology. In this review, we will discuss the clinical indications for the use of cardiac CT for ventricular analysis, review the evidence on the assessment of ventricular function compared to existing imaging modalities such cardiac MRI and echocardiography, provide a typical cardiac CT protocol for image acquisition and post-processing for ventricular analysis, and provide step-by-step instructions to acquire multiplanar cardiac views for ventricular assessment from the standard axial, coronal, and sagittal planes. Furthermore, both qualitative and quantitative assessments of ventricular function as well as sample reporting are detailed. PMID:25576407

  2. Imaging of the heart with computed tomography.

    PubMed

    Flohr, Thomas G; Ohnesorge, Bernd M

    2008-03-01

    Imaging of the heart with computed tomography (CT) was already introduced in the 1980Is and has meanwhile entered clinical routine as a consequence of the rapid evolution of CT technology during the last decade. In this review article, we give an overview on the technology and clinical performance of different CT-scanner generations used for cardiac imaging, such as Electron Beam CT (EBCT), single-slice CT und multi-detector row CT (MDCT) with 4, 16 and 64 simultaneously acquired slices. We identify the limitations of current CT-scanners, indicate potential of improvement and discuss alternative system concepts such as CT with area detectors and dual source CT (DSCT). PMID:18324372

  3. Computed tomography of radioactive objects and materials

    NASA Astrophysics Data System (ADS)

    Sawicka, B. D.; Murphy, R. V.; Tosello, G.; Reynolds, P. W.; Romaniszyn, T.

    1990-12-01

    Computed tomography (CT) has been performed on a number of radioactive objects and materials. Several unique technical problems are associated with CT of radioactive specimens. These include general safety considerations, techniques to reduce background-radiation effects on CT images and selection criteria for the CT source to permit object penetration and to reveal accurate values of material density. In the present paper, three groups of experiments will be described, for objects with low, medium and high levels of radioactivity. CT studies on radioactive specimens will be presented. They include the following: (1) examination of individual ceramic reactor-fuel (uranium dioxide) pellets, (2) examination of fuel samples from the Three Mile Island reactor, (3) examination of a CANDU (CANada Deuterium Uraniun: registered trademark) nuclear-fuel bundle which underwent a simulated loss-of-coolant accident resulting in high-temperature damage and (4) examination of a PWR nuclear-reactor fuel assembly.

  4. Computed tomography of the abnormal thymus

    SciTech Connect

    Baron, R.L.; Lee, J.K.T.; Sagel, S.S.; Levitt, R.G.

    1982-01-01

    Computed tomography (CT) should be the imaging method of choice following plain chest radiographs when a suspected thymic abnormality requires further evaluation. Based upon a six-year experience, including the evaluation of 25 patients with thymic pathology, CT was found useful in suggesting or excluding a diagnosis of thymoma and in distinguishing thymic hyperplasis from thymoma in patients with myasthenia gravis. The thickness of the thymic lobes determined by CT was found to be a more accurate indicator of infiltrative disease (thymic hyperplasia and lymphoma) than the width. CT was helpful in differentiating benign thymic cysts from solid tumors, and in defining the extent of a thymic neoplasms. On occasion, CT may suggest the specific histologic nature of a thymic lesion.

  5. System Matrix Analysis for Computed Tomography Imaging.

    PubMed

    Flores, Liubov; Vidal, Vicent; Verdú, Gumersindo

    2015-01-01

    In practical applications of computed tomography imaging (CT), it is often the case that the set of projection data is incomplete owing to the physical conditions of the data acquisition process. On the other hand, the high radiation dose imposed on patients is also undesired. These issues demand that high quality CT images can be reconstructed from limited projection data. For this reason, iterative methods of image reconstruction have become a topic of increased research interest. Several algorithms have been proposed for few-view CT. We consider that the accurate solution of the reconstruction problem also depends on the system matrix that simulates the scanning process. In this work, we analyze the application of the Siddon method to generate elements of the matrix and we present results based on real projection data. PMID:26575482

  6. Human echinococcosis: diagnostic value of computed tomography.

    PubMed

    Grabbe, E; Kern, P; Heller, M

    1981-03-01

    The diagnostic value of computed tomography was assessed in 44 patients with alveolar or cystic echinococcosis. The CT-examination was concentrated mainly on the liver, which was involved in all patients. It was extended to other organs, i.e. to lung, intra- or retroperitoneal space, bone and brain if necessary. The CT image of the liver in cystic echinococcosis was often characteristic. It showed sharply outlined masses with attenuation values similar to water. Internal structures were caused by daughter cysts. Furthermore, typical marginal calcium deposits indicated regressive changes in the host membrane. In all cases with alveolar echinococcosis in indistinct solid mass was found, often with central necrotic colliquation and plaque-like calcifications within the tumor.

  7. Computed tomography of osteosarcoma after intraarterial chemotherapy

    SciTech Connect

    Shirkhoda, A.; Jaffe, N.; Wallace, S.; Ayala, A.; Lindell, M.M.; Zornoza, J.

    1985-01-01

    The response to intraarterial cis-diamminedichloroplatinum II (CDP) chemotherapy was evaluated by computed tomography (CT) in 33 patients with pathologically proved osteosarcoma of the long or flat bones. Twenty-one of the 33 patients had a CT scan before chemotherapy was started. In the other 12 patients, a CT scan was obtained after at least two courses of treatment, and additional studies were performed during the course of therapy. In those patients responding to treatment, the posttherapy scan revealed a remarkable decrease or complete disappearance of the associated soft-tissue mass and clear reestablishment of the fat planes between the muscle bundles that had been obscured. There was sharp definition of the peripheral margins of the calcified healing neoplasm, and the calcification in the healing tumor could be differentiated easily from that of the original bone neoplasm. CT was more accurate than conventional studies in detecting healing process and diagnosis of remission.

  8. Computed tomography on small explosive parts

    SciTech Connect

    Ryon, R.W.

    1994-05-01

    We have investigated three small explosive parts for the Pantex Plant in Amarillo, Texas using computed tomography (CT). A medium resolution, fan beam system was used to test imaging capabilities for small holes drilled into one of the parts, and to identify any inhomogeneities, cracks, voids, and inclusions if present in the other two parts. This system provides volumetric imaging. Its information is qualitative in that is allows us to see interior features but it cannot provide quantitative attenuation data. A second part of the investigation was to perform effective atomic number computed tomography on the parts using energy dispersive spectroscopy methods. We wanted to experimentally identify the {open_quotes}average{close_quotes} chemical composition of the materials in the explosive and its shell and to detect any possible inhomogeneities in composition. A single beam, nuclear spectroscopy based system was used for this work. The radiation source was a silver anode x-ray tube. By measuring x-ray attenuation at specific energies (characteristic lines and narrow bands of continuum) we are able to quantitatively determine linear attenuation coefficients. By using ratios of such measurements, density cancels out and we effectively have ratios of mass attenuation coefficients. Through a look-up scheme of mass attenuation coefficients for different elements, we can determine the weighted average chemical composition, as averaged by x-ray attenuation. We call this averaged composition the effective atomic number ({open_quotes}Z{sub eff}{close_quotes}). We thereby obtain cross sectional images of a parameter related to the averaged chemistry of the object. Such images and the underlying data can reveal, for instance, segregation of explosive and binder.

  9. Depiction of ventriculoperitoneal shunt obstruction with single-photon emission computed tomography/computed tomography

    PubMed Central

    Aksoy, Sabire Yılmaz; Vatankulu, Betül; Uslu, Lebriz; Halac, Metin

    2016-01-01

    An 83-year-old male patient with ventriculoperitoneal shunt underwent radionuclide shunt study using single-photon emission computed tomography/computed tomography (SPECT/CT) to evaluate the shunt patency. The planar images showed activity at the cranial region and spinal canal but no significant activity at the peritoneal cavity. However, SPECT/CT images clearly demonstrated accumulation of activity at the superior part of bifurcation level with no activity at the distal end of shunt as well as no spilling of radiotracer into the peritoneal cavity indicating shunt obstruction. SPECT/CT makes the interpretation of radionuclide shunt study more accurate and easier as compared with traditional planar images. PMID:27385906

  10. Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies.

    PubMed

    Westphal, Saskia E; Apitzsch, Jonas C; Penzkofer, Tobias; Kuhl, Christiane K; Mahnken, Andreas H; Knüchel, Ruth

    2014-09-01

    Postmortem computed tomography (PMCT) is a modern tool that complements autopsy diagnostics. In clinical autopsies, a major cause of death is cardiovascular disease. To improve the performance of PMCT in cardiovascular disease, full body angiography was developed (PMCT angiography [PMCTA]). Twenty PMCTA scans generated before autopsy were compared with native PMCT and clinical autopsy. The objective of the study was to quantify the additional diagnostic value of adding angiography to native imaging and to compare PMCT and PMCTA findings to autopsy findings. The diagnosis of the cause of death was identical or overlapped in 80% of the cases that used PMCTA and 70% that used PMCT. The additional diagnostic yield given by PMCT and PMCTA in combination with autopsy was 55%. PMCT yielded additional diagnoses in the musculoskeletal system. The greatest additional diagnostic value of PMCTA was in association with cardiovascular diagnoses. The accuracy of PMCTA for cardiac causes of death was 80%, and the positive predictive value was 90%. The findings indicate that native PMCT cannot display the cardiovascular system sufficiently clearly for high-quality diagnostic assessment. However, PMCTA is a powerful tool in autopsy cases with a history of cardiovascular disease and/or a suspected cardiovascular cause of death. The combination of PMCTA and clinical autopsy enhances diagnostic quality and completeness of the autopsy report. Furthermore, in cases without consent or with a restricted consent for clinical autopsy, PMCTA has the potential to provide information on cardiovascular causes of death.

  11. 21 CFR 892.1200 - Emission computed tomography system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Emission computed tomography system. 892.1200 Section 892.1200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... system. (a) Identification. An emission computed tomography system is a device intended to detect...

  12. 21 CFR 892.1200 - Emission computed tomography system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Emission computed tomography system. 892.1200 Section 892.1200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... system. (a) Identification. An emission computed tomography system is a device intended to detect...

  13. 21 CFR 892.1200 - Emission computed tomography system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Emission computed tomography system. 892.1200 Section 892.1200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... system. (a) Identification. An emission computed tomography system is a device intended to detect...

  14. Persistent Primitive Trigeminal Artery That Mimics Persistent Primitive Otic Artery on Cerebral Angiography

    PubMed Central

    Lee, Kwangho; Park, Insung; Han, Jongwoo

    2016-01-01

    Persistent primitive trigeminal artery (PPTA) is the most common carotid-basilar anastomosis; on the other hand, persistent primitive otic artery (PPOA) is extremely rare. PPTA is often misdiagnosed as PPOA on cerebral angiography. We present a case of PPTA that mimicked PPOA on cerebral angiography. We further describe the utility of brain computed tomography angiography for differential diagnosis of PPTA from PPOA, together with a review of previous literature. PMID:27790403

  15. Computational hemodynamics of an implanted coronary stent based on three-dimensional cine angiography reconstruction.

    PubMed

    Chen, Mounter C Y; Lu, Po-Chien; Chen, James S Y; Hwang, Ned H C

    2005-01-01

    Coronary stents are supportive wire meshes that keep narrow coronary arteries patent, reducing the risk of restenosis. Despite the common use of coronary stents, approximately 20-35% of them fail due to restenosis. Flow phenomena adjacent to the stent may contribute to restenosis. Three-dimensional computational fluid dynamics (CFD) and reconstruction based on biplane cine angiography were used to assess coronary geometry and volumetric blood flows. A patient-specific left anterior descending (LAD) artery was reconstructed from single-plane x-ray imaging. With corresponding electrocardiographic signals, images from the same time phase were selected from the angiograms for dynamic three-dimensional reconstruction. The resultant three-dimensional LAD artery at end-diastole was adopted for detailed analysis. Both the geometries and flow fields, based on a computational model from CAE software (ANSYS and CATIA) and full three-dimensional Navier-Stroke equations in the CFD-ACE+ software, respectively, changed dramatically after stent placement. Flow fields showed a complex three-dimensional spiral motion due to arterial tortuosity. The corresponding wall shear stresses, pressure gradient, and flow field all varied significantly after stent placement. Combined angiography and CFD techniques allow more detailed investigation of flow patterns in various segments. The implanted stent(s) may be quantitatively studied from the proposed hemodynamic modeling approach.

  16. Radiation dose at cardiac computed tomography: facts and fiction.

    PubMed

    Huda, Walter; Rowlett, W Taylor; Schoepf, U Joseph

    2010-08-01

    Cardiac computed tomography (CT) dosimetry makes use of two radiation parameters: a volume CT dose index (CTDI) and a dose length product (DLP). The volume CTDI quantifies the intensity of the radiation used to perform CT examinations, whereas DLP quantifies the amount of radiation used. CTDI metrics can be converted into patient dose metrics by using dose/CTDI conversion factors. In cardiac CT imaging, these need to take into account the x-ray tube voltage, scan length, and scan region, as well as patient size. Organ doses to patients in cardiac CT can be converted into cancer risks when patient demographic factors are taken into account. A risk analysis of patients undergoing cardiac CT angiography at our institution showed that a majority (62%) were males, with a median age of approximately 60 years and a median weight of approximately 90 kg. The median DLP was approximately 1100 mGy cm, corresponding to an effective dose of approximately 29 mSv in normal-sized patients. The average patient lifetime risk for a radiation-induced cancer was estimated to be 0.12%, with 85% of it attributed to lung cancer. Patients with an age and weight at the 10th percentile, who also received a DLP at the 90th percentile, would have cancer risk estimates approximately double the average value. Radiation risks are required to determine whether examinations are indicated, defined as examinations in which individual patient benefit exceeds corresponding patient risk. Understanding radiation risks in cardiac CT encourages operators to use the least amount of radiation to achieve satisfactory diagnostic performance. PMID:20711036

  17. Terahertz Computed Tomography of NASA Thermal Protection System Materials

    NASA Technical Reports Server (NTRS)

    Roth, D. J.; Reyes-Rodriguez, S.; Zimdars, D. A.; Rauser, R. W.; Ussery, W. W.

    2011-01-01

    A terahertz axial computed tomography system has been developed that uses time domain measurements in order to form cross-sectional image slices and three-dimensional volume renderings of terahertz-transparent materials. The system can inspect samples as large as 0.0283 cubic meters (1 cubic foot) with no safety concerns as for x-ray computed tomography. In this study, the system is evaluated for its ability to detect and characterize flat bottom holes, drilled holes, and embedded voids in foam materials utilized as thermal protection on the external fuel tanks for the Space Shuttle. X-ray micro-computed tomography was also performed on the samples to compare against the terahertz computed tomography results and better define embedded voids. Limits of detectability based on depth and size for the samples used in this study are loosely defined. Image sharpness and morphology characterization ability for terahertz computed tomography are qualitatively described.

  18. Swept-Source Optical Coherence Tomography Angiography and Vascular Perfusion Map Findings in Obstructive Sleep Apnea.

    PubMed

    Li, Daniel Q; Golding, John; Choudhry, Netan

    2016-09-01

    Obstructive sleep apnea (OSA) is a highly prevalent chronic sleep disorder associated with considerable systemic and ophthalmic consequences. The authors present the retinal vascular findings of a visually asymptomatic 56-year-old man clinically diagnosed with OSA using swept-source optical coherence tomography and vascular perfusion mapping. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:880-884.]. PMID:27631487

  19. Texture classification of lung computed tomography images

    NASA Astrophysics Data System (ADS)

    Pheng, Hang See; Shamsuddin, Siti M.

    2013-03-01

    Current development of algorithms in computer-aided diagnosis (CAD) scheme is growing rapidly to assist the radiologist in medical image interpretation. Texture analysis of computed tomography (CT) scans is one of important preliminary stage in the computerized detection system and classification for lung cancer. Among different types of images features analysis, Haralick texture with variety of statistical measures has been used widely in image texture description. The extraction of texture feature values is essential to be used by a CAD especially in classification of the normal and abnormal tissue on the cross sectional CT images. This paper aims to compare experimental results using texture extraction and different machine leaning methods in the classification normal and abnormal tissues through lung CT images. The machine learning methods involve in this assessment are Artificial Immune Recognition System (AIRS), Naive Bayes, Decision Tree (J48) and Backpropagation Neural Network. AIRS is found to provide high accuracy (99.2%) and sensitivity (98.0%) in the assessment. For experiments and testing purpose, publicly available datasets in the Reference Image Database to Evaluate Therapy Response (RIDER) are used as study cases.

  20. Computed Tomography in Diagnosis of Admantinoma

    PubMed Central

    Misra, Akansha; Misra, Deepankar; Rai, Shalu; Panjwani, Sapna; Ranjan, Vikash; Prabhat, Mukul; Bhalla, Kanika; Bhatnagar, Puneet

    2015-01-01

    Context: Admantinoma is second most common benign odontogenic tumor which clinically appears as an aggressive odontogenic tumor, often asymptomatic and slow growing, associated with symptoms such as swelling, dental malocclusion, pain, and paresthesia of the affected area. The radiographic appearance may vary from unilocular to multilocular radiolucencies, imparting a characteristic honey comb, soap bubble appearance or may resemble a caricature of spider. Case Report: This report highlights the importance of conventional and advanced imaging in the diagnosis of large and invasive lesions. Patient reported with complaint of swelling in jaw, which progressively increased; and was found to be bony hard, both intra- and extraorally. Radiographs revealed large multilocular radiolucency on left body and ramus of mandible with soap bubble pattern and knife edged root resorption. Computed tomographic examination evaluated the extent of the lesion, internal structure, and relation to adjacent structures; further a reconstructed image was obtained to evaluate extent of destruction in three dimensions. Conclusion: Computed tomography has an important role in the diagnosis and treatment planning is imperative as it is superior in revealing the cortical destruction and extension into the neighboring soft tissues than conventional radiography. PMID:26110136

  1. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram

  2. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG

  3. Novel Fluorescein Angiography-Based Computer-Aided Algorithm for Assessment of Retinal Vessel Permeability

    PubMed Central

    Chassidim, Yoash; Parmet, Yisrael; Tomkins, Oren; Knyazer, Boris; Friedman, Alon; Levy, Jaime

    2013-01-01

    Purpose To present a novel method for quantitative assessment of retinal vessel permeability using a fluorescein angiography-based computer algorithm. Methods Twenty-one subjects (13 with diabetic retinopathy, 8 healthy volunteers) underwent fluorescein angiography (FA). Image pre-processing included removal of non-retinal and noisy images and registration to achieve spatial and temporal pixel-based analysis. Permeability was assessed for each pixel by computing intensity kinetics normalized to arterial values. A linear curve was fitted and the slope value was assigned, color-coded and displayed. The initial FA studies and the computed permeability maps were interpreted in a masked and randomized manner by three experienced ophthalmologists for statistical validation of diagnosis accuracy and efficacy. Results Permeability maps were successfully generated for all subjects. For healthy volunteers permeability values showed a normal distribution with a comparable range between subjects. Based on the mean cumulative histogram for the healthy population a threshold (99.5%) for pathological permeability was determined. Clear differences were found between patients and healthy subjects in the number and spatial distribution of pixels with pathological vascular leakage. The computed maps improved the discrimination between patients and healthy subjects, achieved sensitivity and specificity of 0.974 and 0.833 respectively, and significantly improved the consensus among raters for the localization of pathological regions. Conclusion The new algorithm allows quantification of retinal vessel permeability and provides objective, more sensitive and accurate evaluation than the present subjective clinical diagnosis. Future studies with a larger patients’ cohort and different retinal pathologies are awaited to further validate this new approach and its role in diagnosis and treatment follow-up. Successful evaluation of vasculature permeability may be used for the early

  4. Digital subtraction angiography in pediatric cerebrovascular occlusive disease

    SciTech Connect

    Faerber, E.N.; Griska, L.A.B.; Swartz, J.D.; Capitanio, M.A.; Popky, G.L.

    1984-08-01

    While conventional angiography has been used to demonstrate cerebrovascular occlusive disease in the past, digital subtraction angiography (DSA) is capable of showing progressive vascular involvement with ease, simplicity, and extremely low morbidity, making it particularly well suited for children and outpatients either alone or coordinated with computed tomography. The authors discuss the usefulness and advantages of DSA as demonstrated in 7 infants and children with hemiplegia, 4 of whom had sickle-cell disease.

  5. [The importance of angiography in primary retroperitoneal tumors (author's transl)].

    PubMed

    Bardach, G; Grabenwöger, F

    1982-08-01

    During the past ten years, 18 patients with primary retroperitoneal tumours were operated on in the Second Surgical Department of Vienna University. Angiography was performed preoperatively in seven patients. In five out of seven patients, the origin of the tumour and its histological grade could be determined angiographically. Hence, angiography is indicated if surgery is contemplated in addition to the more recent tomographic imaging techniques (ultrasound, computed tomography).

  6. Grading of Age-Related Macular Degeneration: Comparison between Color Fundus Photography, Fluorescein Angiography, and Spectral Domain Optical Coherence Tomography

    PubMed Central

    Mokwa, Nils F.; Keane, Pearse A.; Kirchhof, Bernd; Sadda, Srinivas R.

    2013-01-01

    Purpose. To compare color fundus photography (FP), fluorescein angiography (FA), and spectral domain optical coherence tomography (SDOCT) for the detection of age-related macular degeneration (AMD), choroidal neovascularisation (CNV), and CNV activity. Methods. FPs, FAs, and SDOCT volume scans from 120 eyes of 66 AMD and control patients were randomly collected. Control eyes were required to show no AMD, but other retinal pathology was allowed. The presence of drusen, pigmentary changes, CNV, and signs for CNV activity was independently analyzed for all imaging modalities. Results. AMD was diagnosed based on FP in 75 eyes. SDOCT and FA showed sensitivity (specificity) of 89% (76%) and 92% (82%), respectively. CNV was present on FA in 68 eyes. Sensitivity (specificity) was 78% (100%) for FP and 94% (98%) for SDOCT. CNV activity was detected by SDOCT or FA in 60 eyes with an agreement in 46 eyes. Sensitivity was 88% for SDOCT and 88% for FA. FP showed sensitivity of 38% and specificity of 98%. Conclusions. CNV lesions and activity may be missed by FP alone, but FP may help identifying drusen and pigmentary changes. SDOCT is highly sensitive for the detection of AMD, CNV, and CNV activity; however, it cannot fully replace FA. PMID:23762528

  7. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver.

    PubMed

    Bapst, Blanche; Lagadec, Matthieu; Breguet, Romain; Vilgrain, Valérie; Ronot, Maxime

    2016-01-01

    Cone beam computed tomography (CBCT) is an imaging modality that provides computed tomographic images using a rotational C-arm equipped with a flat panel detector as part of the Angiography suite. The aim of this technique is to provide additional information to conventional 2D imaging to improve the performance of interventional liver oncology procedures (intraarterial treatments such as chemoembolization or selective internal radiation therapy, and percutaneous tumor ablation). CBCT provides accurate tumor detection and targeting, periprocedural guidance, and post-procedural evaluation of treatment success. This technique can be performed during intraarterial or intravenous contrast agent administration with various acquisition protocols to highlight liver tumors, liver vessels, or the liver parenchyma. The purpose of this review is to present an extensive overview of published data on CBCT in interventional oncology of the liver, for both percutaneous ablation and intraarterial procedures.

  8. Cone Beam Computed Tomography (CBCT) in the Field of Interventional Oncology of the Liver.

    PubMed

    Bapst, Blanche; Lagadec, Matthieu; Breguet, Romain; Vilgrain, Valérie; Ronot, Maxime

    2016-01-01

    Cone beam computed tomography (CBCT) is an imaging modality that provides computed tomographic images using a rotational C-arm equipped with a flat panel detector as part of the Angiography suite. The aim of this technique is to provide additional information to conventional 2D imaging to improve the performance of interventional liver oncology procedures (intraarterial treatments such as chemoembolization or selective internal radiation therapy, and percutaneous tumor ablation). CBCT provides accurate tumor detection and targeting, periprocedural guidance, and post-procedural evaluation of treatment success. This technique can be performed during intraarterial or intravenous contrast agent administration with various acquisition protocols to highlight liver tumors, liver vessels, or the liver parenchyma. The purpose of this review is to present an extensive overview of published data on CBCT in interventional oncology of the liver, for both percutaneous ablation and intraarterial procedures. PMID:26178776

  9. Dedicated breast computed tomography: Basic aspects.

    PubMed

    Sarno, Antonio; Mettivier, Giovanni; Russo, Paolo

    2015-06-01

    X-ray mammography of the compressed breast is well recognized as the "gold standard" for early detection of breast cancer, but its performance is not ideal. One limitation of screening mammography is tissue superposition, particularly for dense breasts. Since 2001, several research groups in the USA and in the European Union have developed computed tomography (CT) systems with digital detector technology dedicated to x-ray imaging of the uncompressed breast (breast CT or BCT) for breast cancer screening and diagnosis. This CT technology--tracing back to initial studies in the 1970s--allows some of the limitations of mammography to be overcome, keeping the levels of radiation dose to the radiosensitive breast glandular tissue similar to that of two-view mammography for the same breast size and composition. This paper presents an evaluation of the research efforts carried out in the invention, development, and improvement of BCT with dedicated scanners with state-of-the-art technology, including initial steps toward commercialization, after more than a decade of R&D in the laboratory and/or in the clinic. The intended focus here is on the technological/engineering aspects of BCT and on outlining advantages and limitations as reported in the related literature. Prospects for future research in this field are discussed. PMID:26127031

  10. Modelling the penumbra in Computed Tomography1

    PubMed Central

    Kueh, Audrey; Warnett, Jason M.; Gibbons, Gregory J.; Brettschneider, Julia; Nichols, Thomas E.; Williams, Mark A.; Kendall, Wilfrid S.

    2016-01-01

    BACKGROUND: In computed tomography (CT), the spot geometry is one of the main sources of error in CT images. Since X-rays do not arise from a point source, artefacts are produced. In particular there is a penumbra effect, leading to poorly defined edges within a reconstructed volume. Penumbra models can be simulated given a fixed spot geometry and the known experimental setup. OBJECTIVE: This paper proposes to use a penumbra model, derived from Beer’s law, both to confirm spot geometry from penumbra data, and to quantify blurring in the image. METHODS: Two models for the spot geometry are considered; one consists of a single Gaussian spot, the other is a mixture model consisting of a Gaussian spot together with a larger uniform spot. RESULTS: The model consisting of a single Gaussian spot has a poor fit at the boundary. The mixture model (which adds a larger uniform spot) exhibits a much improved fit. The parameters corresponding to the uniform spot are similar across all powers, and further experiments suggest that the uniform spot produces only soft X-rays of relatively low-energy. CONCLUSIONS: Thus, the precision of radiographs can be estimated from the penumbra effect in the image. The use of a thin copper filter reduces the size of the effective penumbra. PMID:27232198

  11. A Detector for Proton Computed Tomography

    SciTech Connect

    Blazey, G.; et al.,

    2013-12-06

    Radiation therapy is a widely recognized treatment for cancer. Energetic protons have distinct features that set them apart from photons and make them desirable for cancer therapy as well as medical imaging. The clinical interest in heavy ion therapy is due to the fact that ions deposit almost all of their energy in a sharp peak – the Bragg peak- at the very end of their path. Proton beams can be used to precisely localize a tumor and deliver an exact dose to the tumor with small doses to the surrounding tissue. Proton computed tomography (pCT) provides direct information on the location on the target tumor, and avoids position uncertainty caused by treatment planning based on imaging with X-ray CT. The pCT project goal is to measure and reconstruct the proton relative stopping power distribution directly in situ. To ensure the full advantage of cancer treatment with 200 MeV proton beams, pCT must be realized.

  12. Cosine fitting radiography and computed tomography

    NASA Astrophysics Data System (ADS)

    Li, Pan-Yun; Zhang, Kai; Huang, Wan-Xia; Yuan, Qing-Xi; Wang, Yan; Ju, Zai-Qiang; Wu, Zi-Yu; Zhu, Pei-Ping

    2015-06-01

    A new method in diffraction-enhanced imaging computed tomography (DEI-CT) that follows the idea developed by Chapman et al. [Chapman D, Thomlinson W, Johnston R E, Washburn D, Pisano E, Gmur N, Zhong Z, Menk R, Arfelli F and Sayers D 1997 Phys. Med. Biol. 42 2015] in 1997 is proposed in this paper. Merged with a “reverse projections” algorithm, only two sets of projection datasets at two defined orientations of the analyzer crystal are needed to reconstruct the linear absorption coefficient, the decrement of the real part of the refractive index and the linear scattering coefficient of the sample. Not only does this method reduce the delivered dose to the sample without degrading the image quality, but, compared with the existing DEI-CT approaches, it simplifies data-acquisition procedures. Experimental results confirm the reliability of this new method for DEI-CT applications. Project supported by the National Basic Research Program of China (Grant No. 2012CB825800), the National Natural Science Foundation of China (Grant Nos. 11205189, 11375225, and U1332109), the Knowledge Innovation Program of the Chinese Academy of Sciences (Grant Nos. KJCX2-YW-N42, Y4545320Y2, and 542014IHEPZZBS50659).

  13. Computed tomography characterisation of additive manufacturing materials.

    PubMed

    Bibb, Richard; Thompson, Darren; Winder, John

    2011-06-01

    Additive manufacturing, covering processes frequently referred to as rapid prototyping and rapid manufacturing, provides new opportunities in the manufacture of highly complex and custom-fitting medical devices and products. Whilst many medical applications of AM have been explored and physical properties of the resulting parts have been studied, the characterisation of AM materials in computed tomography has not been explored. The aim of this study was to determine the CT number of commonly used AM materials. There are many potential applications of the information resulting from this study in the design and manufacture of wearable medical devices, implants, prostheses and medical imaging test phantoms. A selection of 19 AM material samples were CT scanned and the resultant images analysed to ascertain the materials' CT number and appearance in the images. It was found that some AM materials have CT numbers very similar to human tissues, FDM, SLA and SLS produce samples that appear uniform on CT images and that 3D printed materials show a variation in internal structure.

  14. REVIEW: X-ray computed tomography

    NASA Astrophysics Data System (ADS)

    Kalender, Willi A.

    2006-07-01

    X-ray computed tomography (CT), introduced into clinical practice in 1972, was the first of the modern slice-imaging modalities. To reconstruct images mathematically from measured data and to display and to archive them in digital form was a novelty then and is commonplace today. CT has shown a steady upward trend with respect to technology, performance and clinical use independent of predictions and expert assessments which forecast in the 1980s that it would be completely replaced by magnetic resonance imaging. CT not only survived but exhibited a true renaissance due to the introduction of spiral scanning which meant the transition from slice-by-slice imaging to true volume imaging. Complemented by the introduction of array detector technology in the 1990s, CT today allows imaging of whole organs or the whole body in 5 to 20 s with sub-millimetre isotropic resolution. This review of CT will proceed in chronological order focussing on technology, image quality and clinical applications. In its final part it will also briefly allude to novel uses of CT such as dual-source CT, C-arm flat-panel-detector CT and micro-CT. At present CT possibly exhibits a higher innovation rate than ever before. In consequence the topical and most recent developments will receive the greatest attention.

  15. Intraperitoneal tuberculous abscess: Computed tomography features

    PubMed Central

    Dong, Peng; Chen, Jing-Jing; Wang, Xi-Zhen; Wang, Ya-Qin

    2015-01-01

    AIM: To evaluate the computed tomography (CT) features of intraperitoneal tuberculous abscess (IPTA). METHODS: Eight patients with IPTA confirmed by pathology were analyzed retrospectively. The clinical symptoms, medical images, and surgical findings were evaluated. Involvement of the intestine, peritoneum, viscera, and lymph nodes was also assessed. RESULTS: All 8 patients had a history of abdominal discomfort for 1 to 6 mo. Physical examination revealed a palpable abdominal mass in 6 patients. Three patients had no evidence of pulmonary tuberculosis (TB). All IPTAs (11 abscesses) were seen as a multiseptated, peripherally enhanced, hypodense mass with enlarged, rim-enhanced lymph nodes. The largest abscess diameter ranged from 4.5 cm to 12.2 cm. CT showed 2 types of IPTA: Lymph node fusion and encapsulation. Of the 8 patients, one had liver tuberculosis and one had splenic and ovarian tuberculosis. Two cases showed involvement of the terminal ileum and ileocecal junction. Ascites were found in 4 cases. Three patients had peritonitis and mesenteritis. Three patients showed involvement of the omentum. Three patients had histological evidence of caseating granuloma, and 5 had histological evidence of acid-fast bacilli. CONCLUSION: CT is crucial in the detection and characterization of IPTA. Certain CT findings are necessary for correct diagnosis. PMID:26435779

  16. Shape threat detection via adaptive computed tomography

    NASA Astrophysics Data System (ADS)

    Masoudi, Ahmad; Thamvichai, Ratchaneekorn; Neifeld, Mark A.

    2016-05-01

    X-ray Computed Tomography (CT) is used widely for screening purposes. Conventional x-ray threat detection systems employ image reconstruction and segmentation algorithms prior to making threat/no-threat decisions. We find that in many cases these pre-processing steps can degrade detection performance. Therefore in this work we will investigate methods that operate directly on the CT measurements. We analyze a fixed-gantry system containing 25 x-ray sources and 2200 photon counting detectors. We present a new method for improving threat detection performance. This new method is a so-called greedy adaptive algorithm which at each time step uses information from previous measurements to design the next measurement. We utilize sequential hypothesis testing (SHT) in order to derive both the optimal "next measurement" and the stopping criterion to insure a target probability of error Pe. We find that selecting the next x-ray source according to such a greedy adaptive algorithm, we can reduce Pe by a factor of 42.4× relative to the conventional measurement sequence employing all 25 sources in sequence.

  17. Portable Digital Radiography and Computed Tomography Manual

    SciTech Connect

    Not Available

    2007-11-01

    This user manual describes the function and use of the portable digital radiography and computed tomography (DRCT) scanner. The manual gives a general overview of x-ray imaging systems along with a description of the DRCT system. An inventory of the all the system components, organized by shipping container, is also included. In addition, detailed, step-by-step procedures are provided for all of the exercises necessary for a novice user to successfully collect digital radiographs and tomographic images of an object, including instructions on system assembly and detector calibration and system alignment. There is also a short section covering the limited system care and maintenance needs. Descriptions of the included software packages, the DRCT Digital Imager used for system operation, and the DRCT Image Processing Interface used for image viewing and tomographic data reconstruction are given in the appendixes. The appendixes also include a cheat sheet for more experienced users, a listing of known system problems and how to mitigate them, and an inventory check-off sheet suitable for copying and including with the machine for shipment purposes.

  18. Perfusion computed tomography in renal cell carcinoma

    PubMed Central

    Das, Chandan J; Thingujam, Usha; Panda, Ananya; Sharma, Sanjay; Gupta, Arun Kumar

    2015-01-01

    Various imaging modalities are available for the diagnosis, staging and response evaluation of patients with renal cell carcinoma (RCC). While contrast enhanced computed tomography (CT) is used as the standard of imaging for size, morphological evaluation and response assessment in RCC, a new functional imaging technique like perfusion CT (pCT), goes down to the molecular level and provides new perspectives in imaging of RCC. pCT depicts regional tumor perfusion and vascular permeability which are indirect parameters of tumor angiogenesis and thereby provides vital information regarding tumor microenvironment. Also response evaluation using pCT may predate the size criteria used in Response Evaluation Criteria in Solid Tumors, as changes in the perfusion occurs earlier following tissue kinase inhibitors before any actual change in size. This may potentially help in predicting prognosis, better selection of therapy and more accurate and better response evaluation in patients with RCC. This article describes the techniques and role of pCT in staging and response assessment in patients with RCCs. PMID:26217456

  19. Dedicated breast computed tomography: Basic aspects

    SciTech Connect

    Sarno, Antonio; Mettivier, Giovanni Russo, Paolo

    2015-06-15

    X-ray mammography of the compressed breast is well recognized as the “gold standard” for early detection of breast cancer, but its performance is not ideal. One limitation of screening mammography is tissue superposition, particularly for dense breasts. Since 2001, several research groups in the USA and in the European Union have developed computed tomography (CT) systems with digital detector technology dedicated to x-ray imaging of the uncompressed breast (breast CT or BCT) for breast cancer screening and diagnosis. This CT technology—tracing back to initial studies in the 1970s—allows some of the limitations of mammography to be overcome, keeping the levels of radiation dose to the radiosensitive breast glandular tissue similar to that of two-view mammography for the same breast size and composition. This paper presents an evaluation of the research efforts carried out in the invention, development, and improvement of BCT with dedicated scanners with state-of-the-art technology, including initial steps toward commercialization, after more than a decade of R and D in the laboratory and/or in the clinic. The intended focus here is on the technological/engineering aspects of BCT and on outlining advantages and limitations as reported in the related literature. Prospects for future research in this field are discussed.

  20. Acute Calculous Cholecystitis Missed on Computed Tomography and Ultrasound but Diagnosed with Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    PubMed Central

    Aparici, Carina Mari; Win, Aung Zaw

    2016-01-01

    We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results. PMID:27625897

  1. Acute Calculous Cholecystitis Missed on Computed Tomography and Ultrasound but Diagnosed with Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography.

    PubMed

    Aparici, Carina Mari; Win, Aung Zaw

    2016-01-01

    We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results. PMID:27625897

  2. Acute Calculous Cholecystitis Missed on Computed Tomography and Ultrasound but Diagnosed with Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    PubMed Central

    Aparici, Carina Mari; Win, Aung Zaw

    2016-01-01

    We present a case of a 69-year-old patient who underwent ascending aortic aneurysm repair with aortic valve replacement. On postsurgical day 12, he developed leukocytosis and low-grade fevers. The chest computed tomography (CT) showed a periaortic hematoma which represents a postsurgical change from aortic aneurysm repair, and a small pericardial effusion. The abdominal ultrasound showed cholelithiasis without any sign of cholecystitis. Finally, a fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT examination was ordered to find the cause of fever of unknown origin, and it showed increased FDG uptake in the gallbladder wall, with no uptake in the lumen. FDG-PET/CT can diagnose acute cholecystitis in patients with nonspecific clinical symptoms and laboratory results.

  3. Non-uniform projection angle processing in computed tomography

    NASA Astrophysics Data System (ADS)

    Simo, Yanic; Tayag, Tristan J.

    In this paper, we present a novel approach for the collection of computed tomography data. Non-uniform increments in projection angle may be used to reduce data acquisition time with minimal reduction in the accuracy of the reconstructed profile. The key is to exploit those projection angles which correspond to regions where the object contains few high spatial frequency components. This technique is applicable to optical phase computed tomography, as well as X-ray computed tomography. We present simulation results on intraocular lenses used in cataract surgery.

  4. Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings*

    PubMed Central

    Vermelho, Marli Batista Fernandes; Correia, Ademir Silva; Michailowsky, Tânia Cibele de Almeida; Suzart, Elizete Kazumi Kuniyoshi; Ibanês, Aline Santos; Almeida, Lanamar Aparecida; Khoury, Zarifa; Barba, Mário Flores

    2015-01-01

    Objective To evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and Methods Retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results Abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion Computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. PMID:25987748

  5. Predictors of internal mammary vessel diameter: A computed tomographic angiography-assisted anatomic analysis.

    PubMed

    Cook, Julia A; Tholpady, Sunil S; Momeni, Arash; Chu, Michael W

    2016-10-01

    The internal mammary vessels are the most common recipient vessels in free flap breast reconstruction. The literature on internal mammary vascular anatomy is limited by small sample sizes, cadaveric studies, or intraoperative changes. The purpose of this study is to analyze internal mammary anatomy using computed tomographic angiography. A retrospective review of 110 consecutive computed tomographic angiography studies of female patients was performed. Measurements of vessel caliber, distance of internal mammary vessels to sternum, location of internal mammary vein bifurcation, intercostal space height, and chest width were analyzed. Patient demographics and comorbidities were reviewed. The right internal mammary artery and vein were larger than the left in all intercostal spaces (p = 0.02 and p < 0.001, respectively). A significant correlation was found between both skeletal chest width and body mass index with internal mammary vessel caliber at the third intercostal space (p ≤ 0.02). The internal mammary vein bifurcated at the third intercostal space bilaterally, 4.3 and 1.2 mm caudal to the third rib on the right and left sides, respectively. The third intercostal space was <1.5 cm in 25% of patients. Understanding the anatomy, bifurcation, and caliber of internal mammary vessels can aid preoperative planning of autologous, free flap breast reconstruction. On average, the internal mammary vein bifurcates at the third intercostal space; patients with larger chest widths and body mass index had larger caliber internal mammary vessels, and 25% of patients had third intercostal space <1.5 cm and, thus, may not be suitable candidates for rib-sparing techniques. PMID:27475336

  6. Computed tomography of the liver in von Gierke's disease.

    PubMed

    Biondetti, P R; Fiore, D; Muzzio, P C

    1980-10-01

    The computed tomography findings in the liver of a patient with von Gierke's disease are presented. Precontrast scans demonstrated diffuse decreased density throughout the liver. In the postcontrast scans, a focal right sided hyperdense area was visualized. PMID:6931833

  7. Use of computed tomography in nondestructive testing of polymeric materials

    SciTech Connect

    Persson, S.; Oestman, E.

    1985-12-01

    Computed tomography has been used to detect imperfections and to measure cross-link density gradients in polymeric products, such as airplane tires, rubber shock absorbers, and filament-wound high-pressure tanks.

  8. Atlas of computed body tomography: normal and abnormal anatomy

    SciTech Connect

    Chiu, L.C.; Schapiro, R.L.

    1980-01-01

    This atlas contains comparative sections on normal and abnormal computed tomography of the neck, chest, abdomen, pelvis, upper and lower limbs, fascia, and peritoneum. Also included is a subject index to aid in the identification of abnormal scans. (DLS)

  9. Perfusion computed tomography to assist decision making for stroke thrombolysis.

    PubMed

    Bivard, Andrew; Levi, Christopher; Krishnamurthy, Venkatesh; McElduff, Patrick; Miteff, Ferdi; Spratt, Neil J; Bateman, Grant; Donnan, Geoffrey; Davis, Stephen; Parsons, Mark

    2015-07-01

    The use of perfusion imaging to guide selection of patients for stroke thrombolysis remains controversial because of lack of supportive phase three clinical trial evidence. We aimed to measure the outcomes for patients treated with intravenous recombinant tissue plasminogen activator (rtPA) at a comprehensive stroke care facility where perfusion computed tomography was routinely used for thrombolysis eligibility decision assistance. Our overall hypothesis was that patients with 'target' mismatch on perfusion computed tomography would have improved outcomes with rtPA. This was a prospective cohort study of consecutive ischaemic stroke patients who fulfilled standard clinical/non-contrast computed tomography eligibility criteria for treatment with intravenous rtPA, but for whom perfusion computed tomography was used to guide the final treatment decision. The 'real-time' perfusion computed tomography assessments were qualitative; a large perfusion computed tomography ischaemic core, or lack of significant perfusion lesion-core mismatch were considered relative exclusion criteria for thrombolysis. Specific volumetric perfusion computed tomography criteria were not used for the treatment decision. The primary analysis compared 3-month modified Rankin Scale in treated versus untreated patients after 'off-line' (post-treatment) quantitative volumetric perfusion computed tomography eligibility assessment based on presence or absence of 'target' perfusion lesion-core mismatch (mismatch ratio >1.8 and volume >15 ml, core <70 ml). In a second analysis, we compared outcomes of the perfusion computed tomography-selected rtPA-treated patients to an Australian historical cohort of non-contrast computed tomography-selected rtPA-treated patients. Of 635 patients with acute ischaemic stroke eligible for rtPA by standard criteria, thrombolysis was given to 366 patients, with 269 excluded based on visual real-time perfusion computed tomography assessment. After off-line quantitative

  10. Computed Tomography Staging of Middle Ear Cholesteatoma

    PubMed Central

    Razek, Ahmed Abdel Khalek Abdel; Ghonim, Mohamed Rashad; Ashraf, Bassem

    2015-01-01

    Summary Background To establish computed tomography (CT) staging of middle ear cholesteatoma and assess its impact on the selection of the surgical procedure. Material/Methods Prospective study was conducted on 61 consecutive patients (mean age 26.8 years) with middle ear cholesteatoma. CT scan of the temporal bone and surgery were performed in all patients. CT staging classified cholesteatoma according to its location in the tympanic cavity (T); extension into the mastoid (M); and associated complications (C). Cholesteatoma was staged as stage I (T1, T2), stage II (T3, M1, M2, C1), and stage III (C2). Results The overall sensitivity of CT staging of cholesteatoma compared to surgery was 88% with excellent agreement and correlation between CT findings and intra-operative findings (K=0.863, r=0.86, P=0.001). There was excellent agreement and correlation of CT staging with surgical findings for T location (K=0.811, r=0.89, P=0.001), good for M extension (K=0.734, r=0.88, P=0.001), and excellent for associated C complications (K=1.00, r=1.0, P=0.001). Atticotympanotomy was carried out in stage I (n=14), intact canal wall surgery was performed in stage II (n=38), and canal wall down surgery was done in stage III (n=5) and stage II (n=4). Conclusions We established CT staging of middle ear cholesteatoma that helps surgeons to select an appropriate surgery. PMID:26171086

  11. Dose in x-ray computed tomography

    NASA Astrophysics Data System (ADS)

    Kalender, Willi A.

    2014-02-01

    Radiation dose in x-ray computed tomography (CT) has become a topic of high interest due to the increasing numbers of CT examinations performed worldwide. This review aims to present an overview of current concepts for both scanner output metrics and for patient dosimetry and will comment on their strengths and weaknesses. Controversial issues such as the appropriateness of the CT dose index (CTDI) are discussed in detail. A review of approaches to patient dose assessment presently in practice, of the dose levels encountered and options for further dose optimization are also given and discussed. Patient dose assessment remains a topic for further improvement and for international consensus. All approaches presently in use are based on Monte Carlo (MC) simulations. Estimates for effective dose are established, but they are crude and not patient-specific; organ dose estimates are rarely available. Patient- and organ-specific dose estimates can be provided with adequate accuracy and independent of CTDI phantom measurements by fast MC simulations. Such information, in particular on 3D dose distributions, is important and helpful in optimization efforts. Dose optimization has been performed very successfully in recent years and even resulted in applications with effective dose values of below 1 mSv. In general, a trend towards lower dose values based on technical innovations has to be acknowledged. Effective dose values are down to clearly below 10 mSv on average, and there are a number of applications such as cardiac and pediatric CT which are performed routinely below 1 mSv on modern equipment.

  12. Detection of Foreign Bodies by Spiral Computed Tomography and Cone Beam Computed Tomography in Maxillofacial Regions

    PubMed Central

    Kaviani, Farzaneh; Javad Rashid, Reza; Shahmoradi, Zahra; Gholamian, Masoud

    2014-01-01

    Background and aims. The imaging techniques commonly used for foreign body detection include plain radiography, xeroradiography, computed tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasonography. The aim of the present study was to compare cone-beam computed tomography (CBCT) with conventional CT scan in determination of the exact location of a foreign body in the maxillofacial area in vitro. Materials and methods. In this descriptive study, seven different materials were selected as foreign bodies with dimensions of approximately 2 mm, 1 mm, and 0.5 mm. These materials consisted of metal, glass, wood, stone, plastic, graphite and tooth. These foreign bodies were placed in a sheep head between the corpus of the mandible and muscle, in the tongue and in an air space. One conventional CT scan and two CBCT scans were made on the models. Results. Tooth, metal, stone and glass foreign bodies were seen clearly on CT and CBCT scans made by NewTom at the smallest size in air. However, CBCT scan by NewTom was a more effective technique for visualization of foreign bodies in air compared to conventional CT. Foreign bodies measuring 0.5 mm made of metal, stone, glass, graphite and teeth were detected by all devices in muscle tissue and adjacent bone. Conclusion. According to the results, CBCT scans of NewTom and Planmeca are appropriate tools for detecting foreign bodies with relative high density in the maxillofacial area. PMID:25346836

  13. Image analysis of particle field by means of computed tomography

    NASA Technical Reports Server (NTRS)

    Nakayama, Mitsushige

    1987-01-01

    In order to visualize and investigate spray structures, computed tomography technique is applied to analyze droplet information. From the transmitted light intensity through the spray and/or the data of particle size distribution obtained from a Fraunhofer diffraction principle, the quantitative volume of spray droplet or local particle size was calculated and the reconstruction of spray structures was made. The background of computed tomography is described along with some experimental results of the structure of intermittent spray such as diesel spray.

  14. Simulation of an interferometric computed tomography system for intraocular lenses

    NASA Astrophysics Data System (ADS)

    Tayag, Tristan J.; Bachim, Brent L.

    2010-08-01

    In this paper, we present a metrology system to characterize the refractive index profile of intraocular lenses (IOLs). Our system is based on interferometric optical phase computed tomography. We believe this metrology system to be a key enabling technology in the development of the next generation of IOLs. We propose a Fizeau-based optical configuration and present a simulation study on the application of computed tomography to IOL characterization.

  15. Multiple Energy Computer Tomography (MECT) at the NSLS: Status report

    SciTech Connect

    Dilmanian, F.A.; Wu, X.Y.; Chen, Z.; Ren, B.; Slatkin, D.N.; Chapman, D.; Schleifer, M.; Staicu, F.A.; Thomlinson, W.

    1994-09-01

    Status of the synchrotron-based computed tomography (CT) system Multiple Energy Computed Tomography (MECT) system is described. MECT, that uses monochromatic beams from the X17 superconducting wiggler beam line at the National Synchrotron Light Source (NSLS), will be used for imaging the human head and neck. An earlier prototype MECT produced images of phantoms and living rodents. This report summarizes the studies with the prototype, and describes the design, construction, and test results of the Clinical MECT system components.

  16. Computed tomography in evolution of testicular cancer during intensive chemotherapy.

    PubMed

    Javadpour, N; Anderson, T; Doppman, J L

    1979-10-01

    The evolution of malignant testicular tumor to mature teratoma has been studied in 4 patients. Computed tomography has been helpful in early diagnosis of this biologic phenomenon in these patients receiving intensive chemotherapy for disseminated non-seminomatous testicular cancer. Although the potential significance of this conversion in terms of survival is not known its early recognition by computed tomography has been useful in selecting and monitoring the therapy of these patients.

  17. CT features and common causes of arc of Riolan expansion: an analysis with 64-detector-row computed tomographic angiography

    PubMed Central

    Xie, Yuanliang; Jin, Chaolin; Zhang, Shutong; Wang, Xiang; Jiang, Yanping

    2015-01-01

    Objective: To study the manifestations of arc of Riolan expansion (ARE) using multi-detector computed tomography angiography (MDCTA). Materials and methods: The manifestations and clinical data of 626 consecutive mesentery CTA images were retrospectively analyzed. The 47 cases with ARE and 47 patients without expansion were involved. The average diameter of arc of Riolan was measured. Two radiologists after reaching consensus analyzed the shapes of mesenteric artery, CT findings and the occurrence and causes of ARE. Results: The mean diameter of arc of Riolan was 1.2 mm, 4.6 mm, 2.5 mm, 2.3 mm, 1.9 mm, 2.5 mm, and 2.0 mm at baseline and following obstruction of superior mesenteric artery (SMA), stenosis of SMA, obstruction of inferior mesenteric artery (IMA), stenosis of IMA, colon cancer, and active ulcerative colitis, respectively. The expansion of arc of Riolan was the most significant following obstruction of SMA. The diameters of arc of Riolan were significantly different between the upward flow group and the downward or the two-way flow groups, and between the colon tumor group and the active ulcerative colitis group. CT findings such as bowel wall thickening, contrast enhancement, intestinal obstruction, marginal artery expansion, lymph node enlargement varied and were help to identify the cause of ARE. Conclusions: ARE often suggests the occurrence of obstructed intestinal feeding artery or intestinal lesions. MDCTA can clearly display the situation of arc of Riolan and collateral circulation, and together with CT symptoms, can guide the selection of diagnosis and treatment schemes in clinic. PMID:26064208

  18. Determining the haemodynamic significance of arterial stenosis: the relationship between CT angiography, computational fluid dynamics, and non-invasive fractional flow reserve.

    PubMed

    Pang, C L; Alcock, R; Pilkington, N; Reis, T; Roobottom, C

    2016-08-01

    Coronary artery disease causes significant morbidity and mortality worldwide. Invasive coronary angiography (ICA) is currently the reference standard investigation. Fractional flow reserve (FFR) complements traditional ICA by providing extra information on blood flow, which has convincingly led to better patient management and improved cost-effectiveness. Computed tomography coronary angiography (CTCA) is suitable for the investigation of chest pain, especially in the low- and intermediate-risk groups. FFR generated using CT data (producing FFRCT) may improve the positive predictive value of CTCA. The basic science of FFRCT is like a "black box" to most imaging professionals. A fundamental principle is that good quality CTCA is likely to make any post-processing easier and more reliable. Both diagnostic and observational studies have suggested that the accuracy and the short-term outcome of using FFRCT are both comparable with FFR in ICA. More multidisciplinary research with further refined diagnostic and longer-term observational studies will hopefully pinpoint the role of FFRCT in existing clinical pathways. PMID:27061041

  19. Fetal radiation dose in computed tomography.

    PubMed

    Kelaranta, Anna; Kaasalainen, Touko; Seuri, Raija; Toroi, Paula; Kortesniemi, Mika

    2015-07-01

    The connection between recorded volumetric CT dose index (CTDI vol) and determined mean fetal dose (Df) was examined from metal-oxide-semiconductor field-effect transistor dose measurements on an anthropomorphic female phantom in four stages of pregnancy in a 64-slice CT scanner. Automated tube current modulation kept the mean Df fairly constant through all pregnancy stages in trauma (4.4-4.9 mGy) and abdomino-pelvic (2.1-2.4 mGy) protocols. In pulmonary angiography protocol, the mean Df increased exponentially as the distance from the end of the scan range decreased (0.01-0.09 mGy). For trauma protocol, the relative mean Df as a function of gestational age were in the range 0.80-0.97 compared with the mean CTDI vol. For abdomino-pelvic protocol, the relative mean Df was 0.57-0.79 and for pulmonary angiography protocol, 0.01-0.05 compared with the mean CTDI vol, respectively. In conclusion, if the fetus is in the primary beam, the CTDI vol can be used as an upper estimate of the fetal dose. If the fetus is not in the primary beam, the fetal dose can be estimated by considering also the distance of the fetus from the scan range. PMID:25836690

  20. Safety and efficacy of oral fluorescein angiography in detecting macular edema in comparison with spectral domain optical coherence tomography

    PubMed Central

    Barteselli, Giulio; Chhablani, Jay; Lee, Su Na; Wang, Haiyan; Emam, Sharif El; Kozak, Igor; Cheng, Lingyun; Bartsch, Dirk-Uwe; Azen, Stanley; Freeman, William R.

    2013-01-01

    Purpose To evaluate the safety of oral fluorescein angiography (FA) and to compare its efficacy in detection of macular edema (ME) with spectral-domain optical coherence tomography (SD-OCT). Methods Results of imaging studies for 1,928 eyes of 1,019 patients who had simultaneously undergone both oral FA and SD-OCT by a confocal laser ophthalmoscope (cSLO) were reviewed. Sensitivity in detecting ME, discrepancy rate, and “kappa” agreement were determined for both the techniques, and with eyes stratified by disease diagnosis. Results No allergic reactions occurred after oral FA. Mild gastric discomfort was noted in <1% of the patients. 1,840 eyes (95.4%) showed concordance between the two techniques and “kappa” agreement was 90.3%. For ME, oral FA showed an overall sensitivity of 0.97 and SD-OCT of 0.91. Equivalent sensitivity was found in cases of wet age-related macular degeneration (0.99). Oral FA was more sensitive than SD-OCT in cases of retinovascular diseases. SD-OCT showed higher sensitivity in cases of macular holes. Detection of ME by SD-OCT was significantly higher in cases of intense leakage on oral FA (p<0.001). Conclusions Oral FA proved to be a safe and adequate technique to evaluate ME. It is more sensitive than SD-OCT in detection of ME in cases of retinovascular diseases, but can fail to detect ME in cases of macular holes. A non-invasive examination with simultaneous oral FA and SD-OCT may be considered to obtain a comprehensive evaluation of the presence of ME from different pathologies. PMID:23584697

  1. Comparison of frequency domain optical coherence tomography and quantitative coronary angiography for the assessment of coronary lesions

    NASA Astrophysics Data System (ADS)

    Zafar, Haroon; Sharif, Faisal; Leahy, Martin J.

    2014-03-01

    Quantitative coronary angiography (QCA) has been used as a standard technique for the evaluation of coronary artery disease for many years. Intracoronary optical coherence tomography (OCT) offers higher resolution, faster image acquisition speeds and greater sensitivity than the intravascular ultrasound (IVUS). Recently developed frequency domain OCT (FD-OCT) systems overcome many technical limitations of conventional time domain OCT systems (TDOCT). The main objective of this study was to compare the FD-OCT and QCA measurements for the assessment of coronary lesions. A total of 21 stenoses in 18 patients were analysed using QCA and FD-OCT. The average minimum lumen diameter (MLD) and percent lumen area stenosis (%AS) by QCA were 1.52+/-0.44 mm and 68+/-9% respectively. The average MLD and %AS by FD-OCT were 1.32+/-0.38 mm and 63+/-14% respectively. There was a moderate but significant correlation between QCA and FD-OCT measured MLD (r = 0.5, p < 0.01) and %AS (r = 0.56, p < 0.01). Bland-Altman analysis showed that the mean differences between the QCA and FD-OCT measurements were 0.18+/-0.81 (limits of agreement: -0.63 to 0.99) for MLD and 4.4+/-22.8 (limits of agreement: -18.4 to 27.2) for %AS. The root mean square error (RMSE) between the QCA and FD-OCT measured MLD and %AS was +/-0.44 mm and +/-12.1% respectively.

  2. Radiation epidemiology and recent paediatric computed tomography studies.

    PubMed

    Boice, J D

    2015-06-01

    Recent record-linkage studies of cancer risk following computed tomography (CT) procedures among children and adolescents under 21 years of age must be interpreted with caution. The reasons why the examinations were performed were not known, and the dosimetric approaches did not include individual dose reconstructions or account for the possibility for missed examinations. The recent report (2013) on children by the United Nations Scientific Committee on the Effects of Atomic Radiation concluded that the associations may have resulted from confounding by indication (also called 'reverse causation'), and not radiation exposure. The reported cancer associations may very well have been related to the patients' underlying health conditions that prompted the examinations. Reverse causation has been observed in other epidemiological investigations, such as a Swedish study of thyroid cancer risk following I-131 scintillation imaging scans, and in studies of brain cancer risk following Thorotrast for cerebral angiography. Epidemiological patterns reported in the CT studies were also inconsistent with the world's literature. For example, in a UK study, teenagers had a higher risk of brain tumour than young children; in an Australian study, cancers not previously linked to radiation were significantly elevated; and in a Taiwanese study, the risk of benign tumours decreased with age at the time of CT examination. In all studies, solid tumours appeared much earlier than previously reported. Remarkably, in the Australian study, brain cancer excesses were seen regardless of whether or not the CT was to the head, i.e. a significant excess was reported for CT examinations of the abdomen and extremities, which involved no radiation exposure to the brain. In the UK study, the significance of the 'leukaemia' finding was only because myelodysplastic syndrome was added to the category, and there was no significance for leukaemia alone. Without knowledge of why CT examinations were

  3. Self-inflicted nail-gun injury with cranial penetration and use of intraoperative computed tomography

    PubMed Central

    Carnevale, Joseph A.; Morrison, John F.; Choi, David B.; Klinge, Petra M.; Cosgrove, G. Rees; Oyelese, Adetokunbo A.

    2016-01-01

    Background: Management of penetrating cranial trauma remains a high acuity and imaging intense neurosurgical disorder. Imaging of vital structures, including angiography, is typically conducted to understand the proximity of vital structures in comparison to a foreign body and prepare for intraoperative complications such as hemorrhage. Preservation of function following initial injury in cases where minimal neurological deficit exists is essential. Case Description: Here, we present a case using intraoperative computed tomography to assist in early detection and resolution of hemorrhage in the surgical management of an intact patient with self-inflicted penetrating cranial trauma. Conclusions: This method may aid in early detection of hemorrhage and prevention of consequential neurological deterioration or emergent need for secondary surgery. PMID:27213112

  4. Multislice Spiral Computed Tomography of the Heart: Technique, Current Applications, and Perspective

    SciTech Connect

    Mahnken, Andreas H. Wildberger, Joachim E.; Koos, Ralf; Guenther, Rolf W.

    2005-05-15

    Multislice spiral computed tomography (MSCT) is a rapidly evolving, noninvasive technique for cardiac imaging. Knowledge of the principle of electrocardiogram-gated MSCT and its limitations in clinical routine are needed to optimize image quality. Therefore, the basic technical principle including essentials of image postprocessing is described. Cardiac MSCT imaging was initially focused on coronary calcium scoring, MSCT coronary angiography, and analysis of left ventricular function. Recent studies also evaluated the ability of cardiac MSCT to visualize myocardial infarction and assess valvular morphology. In combination with experimental approaches toward the assessment of aortic valve function and myocardial viability, cardiac MSCT holds the potential for a comprehensive examination of the heart using one single examination technique.

  5. Emergency computed tomography for acute pelvic trauma: where is the bleeder?

    PubMed

    Hallinan, J T P D; Tan, C H; Pua, U

    2014-05-01

    Contrast medium extravasation at computed tomography (CT) is an accurate indicator of active haemorrhage in pelvic trauma. When this is present, potentially lifesaving surgical or endovascular treatment should be considered. Identification of the site or territory of haemorrhage is helpful for the interventional radiologist as it allows for focused angiographic evaluation and expedites haemostatic angio-embolisation. Even with thin-section arterial phase CT, tracing the bleeding vessel is not always possible and is often time consuming. We introduce a technique for predicting the bleeding vessel based on knowledge of the cross-sectional anatomical territory of the vessel as an alternative to tracing the vessel's course. Several case examples with digital subtraction angiography (DSA) correlation will be provided.

  6. Application of Computer Tomography for Life Detection

    NASA Technical Reports Server (NTRS)

    Tsapin, A.; Nealson, K.

    2001-01-01

    Perhaps one of the most fundamentally difficult challenges facing those who would search for life is that of scale determination. Spatial scales of life on Earth range over more than 15 orders of magnitude in mass and volume, and more than 8 orders of magnitude in 2 dimensional space. If the distribution of life is sparse in comparison to the background on which it is found, then the choice of the right scale is critical to finding that life. But how does one identify the proper scale? To put this in other words, how does one recognize the "haystacks" in which the needles (biosignatures and evidence of life) might be most profitably searched for? The problem is further exacerbated when conditions get extreme because much of the life moves from the clement surface environment into the pores and more clement environments inside of rocks, minerals and soils. Once encased in their lithic homes, these microbes become nearly impossible to study by standard techniques because of the opacity of the rocks. It is this problem that we propose to address in the work proposed here. Computer Tomography (CT) has been a very valuable tool in medicine, where the best resolution available has typically been of the order of about 0.5 mm. However, to adapt the approach for life detection of microbial endoliths, the resolution needs to be moved to the micrometer and even submicrometer levels. Thus for the studies proposed here, we begin with a commercially available instrument that can yield resolution of approximately 10 micrometers. The rational for this is twofold: first, this is the "state of the art" in laboratory instruments; and second, that while the usual size of a microbial cell is about 1 micron, microorganisms tend to live in communities that usually exceed the 10 micrometer size range. The resolution also depends on the sample size itself, so having a small lab instrument into which small samples can be placed will be beneficial to the resolution. We have now used several

  7. Skeletal dosimetry in cone beam computed tomography

    SciTech Connect

    Walters, B. R. B.; Ding, G. X.; Kramer, R.; Kawrakow, I.

    2009-07-15

    Cone beam computed tomography (CBCT) is a relatively new patient imaging technique that has proved invaluable for treatment target verification and patient positioning during image-guided radiotherapy (IGRT). It has been shown that CBCT results in additional dose to bone that may amount to 10% of the prescribed dose. In this study, voxelized human phantoms, FAX06 (adult female) and MAX06 (adult male), are used together with phase-space data collected from a realistic model of a CBCT imager to calculate dose in the red bone marrow (RBM) and bone surface cells (BSCs), the two organs at risk within the bone spongiosa, during simulated head and neck, chest and pelvis CBCT scans. The FAX06/MAX06 phantoms model spongiosa based on micro-CT images, filling the relevant phantom voxels, which are 0.12x0.12x0.12 cm{sup 3}, with 17x17x17 {mu}m{sup 3} microvoxels to form a micromatrix of trabecular bone and bone marrow. FAX06/MAX06 have already been implemented in an EGSnrc-based Monte Carlo code to simulate radiation transport in the phantoms; however, this study required significant modifications of the code to allow use of phase-space data from a simulated CBCT imager as a source and to allow scoring of total dose, RBM dose and BSC dose on a voxel-by-voxel basis. In simulated CBCT scans, the BSC dose is significantly greater than the dose to other organs at risk. For example, in a simulated head and neck scan, the average BSC dose is 25% higher than the average dose to eye lens ({approx}8.3 cGy), and 80% greater than the average dose to brain (5.7 cGy). Average dose to RBM, on the other hand, is typically only {approx}50% of the average BSC dose and less than the dose to other organs at risk (54% of the dose to eye lens and 76% of dose to brain in a head and neck scan). Thus, elevated dose in bone due to CBCT results in elevated BSC dose. This is potentially of concern when using CBCT in conjunction with radiotherapy treatment.

  8. Evaluation of renal vascular anatomy in live renal donors: Role of multi detector computed tomography

    PubMed Central

    Pandya, Vaidehi Kumudchandra; Patel, Alpeshkumar Shakerlal; Sutariya, Harsh Chandrakant; Gandhi, Shruti Pradipkumar

    2016-01-01

    Background: Evaluation of renal vascular variations is important in renal donors to avoid vascular complications during surgery. Venous variations, mainly resulting from the errors of the embryological development, are frequently observed. Aim: This retrospective cross-sectional study aimed to investigate the renal vascular variants with multidetector computed tomography (MDCT) angiography to provide valuable information for surgery and its correlations with surgical findings. Materials and Methods: A total of 200 patients underwent MDCT angiography as a routine work up for live renal donors. The number, course, and drainage patterns of the renal veins were retrospectively observed from the scans. Anomalies of renal veins and inferior vena cava (IVC) were recorded and classified. Multiplanar reformations (MPRs), maximum intensity projections, and volume rendering were used for analysis. The results obtained were correlated surgically. Results: In the present study, out of 200 healthy donors, the standard pattern of drainage of renal veins was observed in only 67% of donors on the right side and 92% of donors on the left side. Supernumerary renal veins in the form of dual and triple renal veins were seen on the right side in about 32.5% of donors (dual right renal veins in 30.5% cases and triple right renal veins in 2.5% cases). Variations on the left side were classified into four groups: supernumerary, retro-aortic, circumaortic, and plexiform left renal veins in 1%, 2.5%, 4%, 0.5%, cases respectively. Conclusions: Developmental variations in renal veins can be easily detected on computed tomography scan, which can go unnoticed and can pose a fatal threat during major surgeries such as donor nephrectomies in otherwise healthy donors if undiagnosed. PMID:27453646

  9. Endocrine radionuclide scintigraphy with fusion single photon emission computed tomography/computed tomography

    PubMed Central

    Wong, Ka-Kit; Gandhi, Arpit; Viglianti, Benjamin L; Fig, Lorraine M; Rubello, Domenico; Gross, Milton D

    2016-01-01

    AIM: To review the benefits of single photon emission computed tomography (SPECT)/computed tomography (CT) hybrid imaging for diagnosis of various endocrine disorders. METHODS: We performed MEDLINE and PubMed searches using the terms: “SPECT/CT”; “functional anatomic mapping”; “transmission emission tomography”; “parathyroid adenoma”; “thyroid cancer”; “neuroendocrine tumor”; “adrenal”; “pheochromocytoma”; “paraganglioma”; in order to identify relevant articles published in English during the years 2003 to 2015. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts (case reports, reviews, meta-analyses and abstracts) concerning the application of SPECT/CT to endocrine imaging were analyzed to provide a descriptive synthesis of the utility of this technology. RESULTS: The emergence of hybrid SPECT/CT camera technology now allows simultaneous acquisition of combined multi-modality imaging, with seamless fusion of three-dimensional volume datasets. The usefulness of combining functional information to depict the bio-distribution of radiotracers that map cellular processes of the endocrine system and tumors of endocrine origin, with anatomy derived from CT, has improved the diagnostic capability of scintigraphy for a range of disorders of endocrine gland function. The literature describes benefits of SPECT/CT for 99mTc-sestamibi parathyroid scintigraphy and 99mTc-pertechnetate thyroid scintigraphy, 123I- or 131I-radioiodine for staging of differentiated thyroid carcinoma, 111In- and 99mTc- labeled somatostatin receptor analogues for detection of neuroendocrine tumors, 131I-norcholesterol (NP-59) scans for assessment of adrenal cortical hyperfunction, and 123I- or 131I-metaiodobenzylguanidine imaging for evaluation of pheochromocytoma and paraganglioma. CONCLUSION: SPECT/CT exploits the synergism between the functional information from radiopharmaceutical imaging and anatomy

  10. Assessment of the Radiation Effects of Cardiac Computed Tomographic Angiography Using Protein and Genetic Biomarkers

    PubMed Central

    Nguyen, Patricia K.; Lee, Won Hee; Li, Yong Fuga; Hong, Wan Xing; Hu, Shijun; Chan, Charles; Liang, Grace; Nguyen, Ivy; Ong, Sang-Ging; Churko, Jared; Wang, Jia; Altman, Russ B.; Fleischmann, Dominik; Wu, Joseph C.

    2016-01-01

    Objectives To evaluate whether radiation exposure from cardiac computed tomographic angiography is associated with DNA damage and whether damage leads to programmed cell death and activation of genes involved in apoptosis and DNA repair. Background Exposure to radiation from medical imaging has become a public health concern, but whether it causes significant cell damage remains unclear. Methods We conducted a prospective cohort study in 67 patients undergoing cardiac computed tomographic angiography (CTA) between January 2012 and December 2013 in two US medical centers. Median blood radiation exposure was estimated using phantom dosimetry. Biomarkers of DNA damage and apoptosis were measured by flow cytometry, whole genome sequencing, and single cell polymerase chain reaction. Results The median DLP was 1535.3 mGy·cm (969.7 – 2674.0 mGy·cm). The median radiation dose to the blood was 29.8 milliSieverts (18.8 – 48.8 mSv). Median DNA damage increased 3.39% (1.29 – 8.04%, P<0.0001) post-radiation. Median apoptosis increased 3.1-fold (1.4 – 5.1-fold, P<0.0001) post-radiation. Whole genome sequencing revealed changes in the expression of 39 transcription factors involved in the regulation of apoptosis, cell cycle, and DNA repair. Genes involved in mediating apoptosis and DNA repair were significantly changed post-radiation, including DDB2 [1.9-fold (1.5 – 3.0-fold), P<0.001], XRCC4 [3.0-fold (1.1 – 5.4-fold), P=0.005], and BAX [1.6-fold (0.9 – 2.6-fold), P<0.001]. Exposure to radiation was associated with DNA damage [OR: 1.8 (1.2 – 2.6), P=0.003]. DNA damage was associated with apoptosis [OR: 1.9 (1.2 – 5.1), P<0.0001] and gene activation [OR: 2.8 (1.2 – 6.2), P=0.002]. Conclusions Patients exposed to radiation from cardiac CTA had evidence of DNA damage, which was associated with programmed cell death and activation of genes involved in apoptosis and DNA repair. PMID:26210695

  11. Multi-slice computed tomography in the evaluation of patients with acute chest pain.

    PubMed

    Schuijf, J D; Jukema, J W; van der Wall, E E; Bax, J J

    2007-01-01

    Every year, a considerable number of patients present at the Emergency Department (ED) with acute chest pain complaints. In these patients, determining accurate diagnosis of acute coronary syndrome (ACS) remains clinically challenging. In general, triage is based on the initial clinical assessment including (stress) ECG and serial serum markers measurements. While management is relatively straightforward in case of ECG changes and elevated serum markers, a considerable number of patients presents with both serum markers and ECG that are either within normal limits or inconclusive. In these patients, non-invasive cardiac imaging has become an important tool in decision-making. Recently, non-invasive visualization of the coronary arteries has become possible with computed tomography (CT) techniques. Both electron beam CT (EBCT) and multi-slice CT (MSCT) allow assessment of coronary calcium burden as a marker of coronary artery disease (CAD). More recently, non-invasive coronary angiography can also be performed, for which MSCT in particular is increasingly used. Potentially these techniques could become useful in the clinical work-up of patients presenting with suspected ACS. The purpose of the present review is to discuss the potential roles of calcium scoring and non-invasive coronary angiography in patients presenting with suspected ACS. PMID:18030626

  12. Computed tomography in the evaluation of Crohn disease

    SciTech Connect

    Goldberg, H.I.; Gore, R.M.; Margulis, A.R.; Moss, A.A.; Baker, E.L.

    1983-02-01

    The abdominal and pelvic computed tomographic examinations in 28 patients with Crohn disease were analyzed and correlated with conventional barium studies, sinograms, and surgical findings. Mucosal abnormalities such as aphthous lesions, pseudopolyps, and ulcerations were only imaged by conventional techniques. Computed tomography proved superior in demonstrating the mural, serosal, and mesenteric abnormalities such as bowel wall thickening (82%), fibrofatty proliferation of mesenteric fat (39%), mesenteric abscess (25%), inflammatory reaction of the mesentery (14%), and mesenteric lymphadenopathy (18%). Computed tomography was most useful clinically in defining the nature of mass effects, separation, or displacement of small bowel segments seen on small bowel series. Although conventional barium studies remain the initial diagnostic procedure in evaluating Crohn disease, computed tomography can be a useful adjunct in resolving difficult clinical and radiologic diagnostic problems.

  13. A new method for real-time co-registration of 3D coronary angiography and intravascular ultrasound or optical coherence tomography.

    PubMed

    Carlier, Stéphane; Didday, Rich; Slots, Tristan; Kayaert, Peter; Sonck, Jeroen; El-Mourad, Mike; Preumont, Nicolas; Schoors, Dany; Van Camp, Guy

    2014-06-01

    We present a new clinically practical method for online co-registration of 3D quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) or optical coherence tomography (OCT). The workflow is based on two modified commercially available software packages. Reconstruction steps are explained and compared to previously available methods. The feasibility for different clinical scenarios is illustrated. The co-registration appears accurate, robust and induced a minimal delay on the normal cath lab activities. This new method is based on the 3D angiographic reconstruction of the catheter path and does not require operator's identification of landmarks to establish the image synchronization.

  14. Development of a proton Computed Tomography detector system

    NASA Astrophysics Data System (ADS)

    Naimuddin, Md.; Coutrakon, G.; Blazey, G.; Boi, S.; Dyshkant, A.; Erdelyi, B.; Hedin, D.; Johnson, E.; Krider, J.; Rukalin, V.; Uzunyan, S. A.; Zutshi, V.; Fordt, R.; Sellberg, G.; Rauch, J. E.; Roman, M.; Rubinov, P.; Wilson, P.

    2016-02-01

    Computer tomography is one of the most promising new methods to image abnormal tissues inside the human body. Tomography is also used to position the patient accurately before radiation therapy. Hadron therapy for treating cancer has become one of the most advantegeous and safe options. In order to fully utilize the advantages of hadron therapy, there is a necessity of performing radiography with hadrons as well. In this paper we present the development of a proton computed tomography system. Our second-generation proton tomography system consists of two upstream and two downstream trackers made up of fibers as active material and a range detector consisting of plastic scintillators. We present details of the detector system, readout electronics, and data acquisition system as well as the commissioning of the entire system. We also present preliminary results from the test beam of the range detector.

  15. Domain identification in impedance computed tomography by spline collocation method

    NASA Technical Reports Server (NTRS)

    Kojima, Fumio

    1990-01-01

    A method for estimating an unknown domain in elliptic boundary value problems is considered. The problem is formulated as an inverse problem of integral equations of the second kind. A computational method is developed using a splice collocation scheme. The results can be applied to the inverse problem of impedance computed tomography (ICT) for image reconstruction.

  16. Evaluating iterative reconstruction performance in computed tomography

    SciTech Connect

    Chen, Baiyu Solomon, Justin; Ramirez Giraldo, Juan Carlos; Samei, Ehsan

    2014-12-15

    Purpose: Iterative reconstruction (IR) offers notable advantages in computed tomography (CT). However, its performance characterization is complicated by its potentially nonlinear behavior, impacting performance in terms of specific tasks. This study aimed to evaluate the performance of IR with both task-specific and task-generic strategies. Methods: The performance of IR in CT was mathematically assessed with an observer model that predicted the detection accuracy in terms of the detectability index (d′). d′ was calculated based on the properties of the image noise and resolution, the observer, and the detection task. The characterizations of image noise and resolution were extended to accommodate the nonlinearity of IR. A library of tasks was mathematically modeled at a range of sizes (radius 1–4 mm), contrast levels (10–100 HU), and edge profiles (sharp and soft). Unique d′ values were calculated for each task with respect to five radiation exposure levels (volume CT dose index, CTDI{sub vol}: 3.4–64.8 mGy) and four reconstruction algorithms (filtered backprojection reconstruction, FBP; iterative reconstruction in imaging space, IRIS; and sinogram affirmed iterative reconstruction with strengths of 3 and 5, SAFIRE3 and SAFIRE5; all provided by Siemens Healthcare, Forchheim, Germany). The d′ values were translated into the areas under the receiver operating characteristic curve (AUC) to represent human observer performance. For each task and reconstruction algorithm, a threshold dose was derived as the minimum dose required to achieve a threshold AUC of 0.9. A task-specific dose reduction potential of IR was calculated as the difference between the threshold doses for IR and FBP. A task-generic comparison was further made between IR and FBP in terms of the percent of all tasks yielding an AUC higher than the threshold. Results: IR required less dose than FBP to achieve the threshold AUC. In general, SAFIRE5 showed the most significant dose reduction

  17. Gliomatosis cerebri mimicking encephalitis evaluated using fluorine-18 fluorodeoxyglucose: Positron emission tomography/computed tomography

    PubMed Central

    Kamaleshwaran, Koramadai Karuppusamy; Krishnan, Vijayan; Mohanan, Vyshakh; Shibu, Deepu; Shinto, Ajit Sugunan

    2015-01-01

    Gliomatosis cerebri (GC) is a rare condition in which an infiltrative glial neoplasm spreads through the brain with preservation of the underlying structure. F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has an important role in demonstrating the appropriate metabolism and differentiating pathologies mimicking GC on CT and magnetic resonance imaging. We describe imaging findings of FDG PET/CT in GC in a 9-year-old male child mimicking encephalitis. PMID:25589818

  18. Gliomatosis cerebri mimicking encephalitis evaluated using fluorine-18 fluorodeoxyglucose: Positron emission tomography/computed tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusamy; Krishnan, Vijayan; Mohanan, Vyshakh; Shibu, Deepu; Shinto, Ajit Sugunan

    2015-01-01

    Gliomatosis cerebri (GC) is a rare condition in which an infiltrative glial neoplasm spreads through the brain with preservation of the underlying structure. F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has an important role in demonstrating the appropriate metabolism and differentiating pathologies mimicking GC on CT and magnetic resonance imaging. We describe imaging findings of FDG PET/CT in GC in a 9-year-old male child mimicking encephalitis.

  19. Pigmented villonodular synovitis mimics metastases on fluorine 18 fluorodeoxyglucose position emission tomography-computed tomography

    PubMed Central

    Elumogo, Comfort O.; Kochenderfer, James N.; Civelek, A. Cahid

    2016-01-01

    Pigmented villonodular synovitis (PVNS) is a benign joint disease best characterized on magnetic resonance imaging (MRI). The role of fluorine 18 fluorodeoxyglucose (18F-FDG) position emission tomography-computed tomography (PET-CT) in the diagnosis or characterization remains unclear. PVNS displays as a focal FDG avid lesion, which can masquerade as a metastatic lesion, on PET-CET. We present a case of PVNS found on surveillance imaging of a lymphoma patient. PMID:27190776

  20. Cerebral angiography

    MedlinePlus

    ... Carotid angiogram; Cervicocerebral catheter-based angiography; Intra-arterial digital subtraction angiography; IADSA ... with the dye are seen. This is called digital subtraction angiography (DSA). After the x-rays are ...

  1. Micro-heterogeneity of flow in a mouse model of chronic cerebral hypoperfusion revealed by longitudinal Doppler optical coherence tomography and angiography

    PubMed Central

    Srinivasan, Vivek J; Yu, Esther; Radhakrishnan, Harsha; Can, Anil; Climov, Mihail; Leahy, Conor; Ayata, Cenk; Eikermann-Haerter, Katharina

    2015-01-01

    Although microvascular dysfunction accompanies cognitive decline in aging, vascular dementia, and Alzheimer's disease, tools to study microvasculature longitudinally in vivo are lacking. Here, we use Doppler optical coherence tomography (OCT) and angiography for noninvasive, longitudinal imaging of mice with chronic cerebral hypoperfusion for up to 1 month. In particular, we optimized the OCT angiography method to selectively image red blood cell (RBC)-perfused capillaries, leading to a novel way of assessing capillary supply heterogeneity in vivo. After bilateral common carotid artery stenosis (BCAS), cortical blood flow measured by Doppler OCT dropped to half of baseline throughout the imaged tissue acutely. Microscopic imaging of the capillary bed with OCT angiography further revealed local heterogeneities in cortical flow supply during hypoperfusion. The number of RBC-perfused capillaries decreased, leading to increased oxygen diffusion distances in the days immediately after BCAS. Linear regression showed that RBC-perfused capillary density declined by 0.3% for a drop in flow of 1 mL/100 g per minute, and decreases in RBC-perfused capillary density as high as 25% were observed. Taken together, these results demonstrate the existence of local supply heterogeneity at the capillary level even at nonischemic global flow levels, and demonstrate a novel imaging method to assess this heterogeneity. PMID:26243708

  2. Diagnosis of dementia with single photon emission computed tomography

    SciTech Connect

    Jagust, W.J.; Budinger, T.F.; Reed, B.R.

    1987-03-01

    Single photon emission computed tomography is a practical modality for the study of physiologic cerebral activity in vivo. We utilized single photon emission computed tomography and N-isopropyl-p-iodoamphetamine iodine 123 to evaluate regional cerebral blood flow in nine patients with Alzheimer's disease (AD), five healthy elderly control subjects, and two patients with multi-infarct dementia. We found that all subjects with AD demonstrated flow deficits in temporoparietal cortex bilaterally, and that the ratio of activity in bilateral temporoparietal cortex to activity in the whole slice allowed the differentiation of all patients with AD from both the controls and from the patients with multi-infarct dementia. Furthermore, this ratio showed a strong correlation with disease severity in the AD group. Single photon emission computed tomography appears to be useful in the differential diagnosis of dementia and reflects clinical features of the disease.

  3. Automatic centerline extraction of coronary arteries in coronary computed tomographic angiography.

    PubMed

    Yang, Guanyu; Kitslaar, Pieter; Frenay, Michel; Broersen, Alexander; Boogers, Mark J; Bax, Jeroen J; Reiber, Johan H C; Dijkstra, Jouke

    2012-04-01

    Coronary computed tomographic angiography (CCTA) is a non-invasive imaging modality for the visualization of the heart and coronary arteries. To fully exploit the potential of the CCTA datasets and apply it in clinical practice, an automated coronary artery extraction approach is needed. The purpose of this paper is to present and validate a fully automatic centerline extraction algorithm for coronary arteries in CCTA images. The algorithm is based on an improved version of Frangi's vesselness filter which removes unwanted step-edge responses at the boundaries of the cardiac chambers. Building upon this new vesselness filter, the coronary artery extraction pipeline extracts the centerlines of main branches as well as side-branches automatically. This algorithm was first evaluated with a standardized evaluation framework named Rotterdam Coronary Artery Algorithm Evaluation Framework used in the MICCAI Coronary Artery Tracking challenge 2008 (CAT08). It includes 128 reference centerlines which were manually delineated. The average overlap and accuracy measures of our method were 93.7% and 0.30 mm, respectively, which ranked at the 1st and 3rd place compared to five other automatic methods presented in the CAT08. Secondly, in 50 clinical datasets, a total of 100 reference centerlines were generated from lumen contours in the transversal planes which were manually corrected by an expert from the cardiology department. In this evaluation, the average overlap and accuracy were 96.1% and 0.33 mm, respectively. The entire processing time for one dataset is less than 2 min on a standard desktop computer. In conclusion, our newly developed automatic approach can extract coronary arteries in CCTA images with excellent performances in extraction ability and accuracy. PMID:21637981

  4. Virtual angiography for visualization and validation of computational fluid dynamics models of aneurysm hemodynamics

    NASA Astrophysics Data System (ADS)

    Ford, Matthew D.; Stuhne, Gordan R.; Nikolov, Hristo N.; Lownie, Stephen P.; Holdsworth, David W.; Steinman, David A.

    2005-04-01

    It has recently become possible to simulate aneurysmal blood flow dynamics in a patient-specific manner via the coupling of 3D X-ray angiography and computational fluid dynamics (CFD). Before such image-based CFD models can be used in a predictive capacity, however, it must be shown that they indeed reproduce the in vivo hemodynamic environment. Motivated by the fact that there is currently no technique for measuring complex blood velocity fields in vivo, in this paper we describe how cine X-ray angiograms may be simulated for the purpose of indirectly validating patient-specific CFD models. Mirroring the radiological procedure, a virtual angiogram is constructed by first simulating the time-varying injection of contrast agent into a previously computed patient-specific CFD model. A time-series of images is then constructed by simulating attenuation of X-rays through the simulated 3D contrast-agent flow dynamics. Virtual angiographic images and residence time maps, here derived from an image-based CFD model of a giant aneurysm, are shown to be in excellent agreement with the corresponding clinical images and maps, but only when the interaction between the quasi-steady contrast-agent injection and the pulsatile wash-out are properly accounted for. These virtual angiographic techniques therefore pave the way for validating image-based CFD models against routinely available clinical data, and also provide a means of visualizing complex, 3D blood flow dynamics in a clinically relevant manner. However, they also clearly show how the contrast-agent injection perturbs the normal blood flow dynamics, further highlighting the utility of CFD as a window into the true aneurysmal hemodynamics.

  5. Biplane angiography for experimental validation of computational fluid dynamic models of blood flow in artificial lungs.

    PubMed

    Jones, Cameron C; Capasso, Patrizio; McDonough, James M; Wang, Dongfang; Rosenstein, Kyle S; Zwischenberger, Joseph B

    2013-01-01

    This article presents an investigation into the validation of velocity fields obtained from computational fluid dynamic (CFD) models of flow through the membrane oxygenators using x-ray digital subtraction angiography (DSA). Computational fluid dynamic is a useful tool in characterizing artificial lung devices, but numerical results must be experimentally validated. We used DSA to visualize flow through a membrane oxygenator at 2 L/min using 37% glycerin at 22°C. A Siemens Artis Zee system acquired biplane x-ray images at 7.5 frames per second, after infusion of an iodinated contrast agent at a rate of 33 ml/s. A maximum cross-correlation (MCC) method was used to track the contrast perfusion through the fiber bundle. For the CFD simulations, the fiber bundle was treated as a single momentum sink according to the Ergun equation. Blood was modeled as a Newtonian fluid, with constant viscosity (3.3 cP) and density (1050 kg/m3). Although CFD results and experimental pressure measurements were in general agreement, the simulated 2 L/min perfusion did not reproduce the flow behavior seen in vitro. Simulated velocities in the fiber bundle were on average 42% lower than experimental values. These results indicate that it is insufficient to use only pressure measurements for validation of the flow field because pressure-validated CFD results can still significantly miscalculate the physical velocity field. We have shown that a clinical x-ray modality, together with a MCC tracking algorithm, can provide a nondestructive technique for acquiring experimental data useful for validation of the velocity field inside membrane oxygenators.

  6. Missing wedge computed tomography by iterative algorithm DIRECTT.

    PubMed

    Kupsch, Andreas; Lange, Axel; Hentschel, Manfred P; Lück, Sebastian; Schmidt, Volker; Grothausmann, Roman; Hilger, André; Manke, Ingo

    2015-01-01

    A strategy to mitigate typical reconstruction artefacts in missing wedge computed tomography is presented. These artefacts appear as elongations of reconstructed details along the mean direction (i.e. the symmetry centre of the projections). Although absent in standard computed tomography applications, they are most prominent in advanced electron tomography and also in special topics of X-ray and neutron tomography under restricted geometric boundary conditions. We investigate the performance of the DIRECTT (Direct Iterative Reconstruction of Computed Tomography Trajectories) algorithm to reduce the directional artefacts in standard procedures. In order to be sensitive to the anisotropic nature of missing wedge artefacts, we investigate isotropic substructures of metal foam as well as circular disc models. Comparison is drawn to filtered backprojection and algebraic techniques. Reference is made to reconstructions of complete data sets. For the purpose of assessing the reconstruction quality, Fourier transforms are employed to visualize the missing wedge directly. Deficient reconstructions of disc models are evaluated by a length-weighted kernel density estimation, which yields the probabilities of boundary orientations. The DIRECTT results are assessed at different signal-to-noise ratios by means of local and integral evaluation parameters. PMID:26367127

  7. Multiscale photoacoustic microscopy and computed tomography

    PubMed Central

    Wang, Lihong V.

    2009-01-01

    Photoacoustic tomography (PAT) is probably the fastest growing biomedical imaging technology owing to its capability of high-resolution sensing of rich optical contrast in vivo at depths beyond the optical transport mean free path (~1 mm in the skin). Existing high-resolution optical imaging technologies, such as confocal microscopy and two-photon microscopy, have fundamentally impacted biomedicine but cannot reach such depths. Taking advantage of low ultrasonic scattering, PAT indirectly improves tissue transparency by 100 to 1000 fold and consequently enables deeply penetrating functional and molecular imaging at high spatial resolution. Further, PAT holds the promise of in vivo imaging at multiple length scales ranging from subcellular organelles to organs with the same contrast origin, an important application in multiscale systems biology research. PMID:20161535

  8. Usefulness of Intraprocedural Coronary Computed Tomographic Angiography During Intervention for Chronic Total Coronary Occlusion.

    PubMed

    Kim, Byeong-Keuk; Cho, Iksung; Hong, Myeong-Ki; Chang, Hyuk-Jae; Shin, Dong-Ho; Kim, Jung-Sun; Shin, Sanghoon; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo

    2016-06-15

    Although intraprocedural coronary computed tomographic angiography (CCTA) allows for scanning during intervention without relocation of the patient, studies have yet to report on its use during chronic total occlusion (CTO) intervention. Therefore, we investigated the role of CCTA during CTO intervention, particularly whether CCTA could be used to evaluate the location of guidewires. A total of 61 patients scheduled for elective CTO intervention were consecutively enrolled and underwent CCTA and on-site analyses during intervention. Transverse axial and the curved multiplanar images in a 360-degree view were interactively used together to identify the location of guidewires, along with the adjustment of window condition. Intracoronary contrast injection was used for specific cases requiring enhancement of the distal part of the CTO. Most CCTAs were performed to confirm the location of a single guidewire; CCTA was also performed to evaluate parallel (3 patients) or retrograde wires (5 patients). The initial identification rate for guidewire location was 56% with immediate transaxial images, but it significantly increased to 87% after interactive on-site uses of the curved multiplanar images (p <0.001). Cases in which guidewire location could be predicted with CCTA evaluation show a numerically higher success rate than those that could not (83% vs 63%) but not statistical significance (p = 0.174). The mean time for CCTA evaluation and mean radiation dose were 8.6 minutes and 2.9 mSv, respectively. No specific complications occurred after CCTA and CTO procedures. Intraprocedural CCTA for identifying the location of the guidewires is feasible and safe when used for various CTO procedural steps. PMID:27134060

  9. Prevalence of coronary atherosclerosis in an Asian population: findings from coronary computed tomographic angiography.

    PubMed

    Park, Gyung-Min; Yun, Sung-Cheol; Cho, Young-Rak; Gil, Eun Ha; Her, Sung Ho; Kim, Seon Ha; Jo, Min-Woo; Lee, Moo Song; Lee, Seung-Whan; Kim, Young-Hak; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan; Kim, Beom-Jun; Koh, Jung-Min; Kim, Hong-Kyu; Choe, Jaewon; Park, Seong-Wook; Park, Seung-Jung

    2015-03-01

    We sought to estimate the prevalence of coronary atherosclerosis by coronary computed tomographic angiography (CCTA) and to identify risk factors attributable to the development of coronary atherosclerosis in an asymptomatic Asian population. We analyzed 6,311 consecutive asymptomatic individuals aged 40 and older with no prior history of coronary artery disease (CAD) who voluntarily underwent CCTA evaluation as part of a general health examination. The mean age of study participants was 54.7 ± 7.4 years, and 4,594 (72.8%) were male. After age and gender adjustment using the population census of the National Statistical Office, the prevalence of plaque was 40.5% [95% confidence interval (CI) 38.1-42.9], and significant CAD (diameter stenosis ≥50%) was observed in 9.0% (95% CI 7.7-10.2). Individuals with significant CAD were significantly older than those without (59.2 ± 8.8 vs. 54.0 ± 7.1 years, p < 0.001). Compared with individuals with no cardiovascular risk factors, there was a higher prevalence of significant CAD in individuals with diabetes mellitus [standardized rate ratio (SRR) 2.66; 95% CI 1.93-3.68; p < 0.001], hypertension (SRR 2.24; 95% CI 1.69-2.97; p < 0.001), or hyperlipidemia (SRR 1.65; 95% CI 1.25-2.17; p < 0.001). There was also a greater prevalence of significant CAD in individuals with an intermediate or high Framingham risk score (SRR 5.91; 95% CI 2.34-14.95; p < 0.001) or a high atherosclerotic cardiovascular disease risk score (SRR 8.04; 95% CI 3.04-21.23; p < 0.001). The prevalence of coronary atherosclerosis in this Asian population was not negligible and was associated with known cardiovascular risk factors and high-risk individuals.

  10. Coronary magnetic resonance angiography.

    PubMed

    Stuber, Matthias; Weiss, Robert G

    2007-08-01

    Coronary magnetic resonance angiography (MRA) is a powerful noninvasive technique with high soft-tissue contrast for the visualization of the coronary anatomy without X-ray exposure. Due to the small dimensions and tortuous nature of the coronary arteries, a high spatial resolution and sufficient volumetric coverage have to be obtained. However, this necessitates scanning times that are typically much longer than one cardiac cycle. By collecting image data during multiple RR intervals, one can successfully acquire coronary MR angiograms. However, constant cardiac contraction and relaxation, as well as respiratory motion, adversely affect image quality. Therefore, sophisticated motion-compensation strategies are needed. Furthermore, a high contrast between the coronary arteries and the surrounding tissue is mandatory. In the present article, challenges and solutions of coronary imaging are discussed, and results obtained in both healthy and diseased states are reviewed. This includes preliminary data obtained with state-of-the-art techniques such as steady-state free precession (SSFP), whole-heart imaging, intravascular contrast agents, coronary vessel wall imaging, and high-field imaging. Simultaneously, the utility of electron beam computed tomography (EBCT) and multidetector computed tomography (MDCT) for the visualization of the coronary arteries is discussed. PMID:17610288

  11. Computed tomography: Will the slices reveal the truth

    PubMed Central

    Haridas, Harish; Mohan, Abarajithan; Papisetti, Sravanthi; Ealla, Kranti K. R.

    2016-01-01

    With the advances in the field of imaging sciences, new methods have been developed in dental radiology. These include digital radiography, density analyzing methods, cone beam computed tomography (CBCT), magnetic resonance imaging, ultrasound, and nuclear imaging techniques, which provide high-resolution detailed images of oral structures. The current review aims to critically elaborate the use of CBCT in endodontics.

  12. Computed tomography of the temporo-mandibular joint.

    PubMed

    Avrahami, E; Horowitz, I; Cohn, D F

    1984-01-01

    Computed tomography (CT) of the temporo-mandibular joint (TMJ) has only been occasionally reported. As CT techniques improve, more detailed information is available. Though conventional radiography of the TMJ can supply sufficient diagnostic detail, it may well be replaced by CT as a preliminary examination, as it is able to offer more information with less radiation and minimal patient discomfort.

  13. An Easily Assembled Laboratory Exercise in Computed Tomography

    ERIC Educational Resources Information Center

    Mylott, Elliot; Klepetka, Ryan; Dunlap, Justin C.; Widenhorn, Ralf

    2011-01-01

    In this paper, we present a laboratory activity in computed tomography (CT) primarily composed of a photogate and a rotary motion sensor that can be assembled quickly and partially automates data collection and analysis. We use an enclosure made with a light filter that is largely opaque in the visible spectrum but mostly transparent to the near…

  14. Evolution of the Cranial Computed Tomography Scan in Child Abuse.

    ERIC Educational Resources Information Center

    Feldman, Kenneth W.; And Others

    1995-01-01

    A retrospective review of medical charts for 34 children with a diagnosis of child abuse, who had cranial computed tomography scans performed, revealed that some scans initially interpreted as normal were subsequently reinterpreted as abnormal, and some children's repeat scannings were interpreted as abnormal, modifying the medical and legal…

  15. Computed tomography: Will the slices reveal the truth.

    PubMed

    Haridas, Harish; Mohan, Abarajithan; Papisetti, Sravanthi; Ealla, Kranti K R

    2016-08-01

    With the advances in the field of imaging sciences, new methods have been developed in dental radiology. These include digital radiography, density analyzing methods, cone beam computed tomography (CBCT), magnetic resonance imaging, ultrasound, and nuclear imaging techniques, which provide high-resolution detailed images of oral structures. The current review aims to critically elaborate the use of CBCT in endodontics. PMID:27652253

  16. Computed Tomography-Enhanced Anatomy Course Using Enterprise Visualization

    ERIC Educational Resources Information Center

    May, Hila; Cohen, Haim; Medlej, Bahaa; Kornreich, Liora; Peled, Nathan; Hershkovitz, Israel

    2013-01-01

    Rapid changes in medical knowledge are forcing continuous adaptation of the basic science courses in medical schools. This article discusses a three-year experience developing a new Computed Tomography (CT)-based anatomy curriculum at the Sackler School of Medicine, Tel Aviv University, including describing the motivations and reasoning for the…

  17. Computed tomography: Will the slices reveal the truth

    PubMed Central

    Haridas, Harish; Mohan, Abarajithan; Papisetti, Sravanthi; Ealla, Kranti K. R.

    2016-01-01

    With the advances in the field of imaging sciences, new methods have been developed in dental radiology. These include digital radiography, density analyzing methods, cone beam computed tomography (CBCT), magnetic resonance imaging, ultrasound, and nuclear imaging techniques, which provide high-resolution detailed images of oral structures. The current review aims to critically elaborate the use of CBCT in endodontics. PMID:27652253

  18. RADIAL COMPUTED TOMOGRAPHY OF AIR CONTAMINANTS USING OPTICAL REMOTE SENSING

    EPA Science Inventory

    The paper describes the application of an optical remote-sensing (ORS) system to map air contaminants and locate fugitive emissions. Many ORD systems may utilize radial non-overlapping beam geometry and a computed tomography (CT) algorithm to map the concentrations in a plane. In...

  19. [X-ray computed tomography in the diagnosis of mediastinitis].

    PubMed

    Abakumov, M M; Barmina, T G; Ishmukhametov, A I

    2001-01-01

    Results of X-ray computed tomography (RCT) use in 21 patients treated for acute mediastinitis in N.V. Sklifosovsky Emergency Care Research Institute have been analyzed retrospectively. RCT proved able to defect accurate location, spreading and sizes of inflammatory disorders in the mediastinum are demonstrated. Semiotics of mediastinitis depending on location, spreading and phase of inflammatory process is presented.

  20. Cone beam computed tomography scanning and diagnosis for dental implants.

    PubMed

    Greenberg, Alex M

    2015-05-01

    Cone beam computed tomography (CBCT) has become an important new technology for oral and maxillofacial surgery practitioners. CBCT provides improved office-based diagnostic capability and applications for surgical procedures, such as CT guidance through the use of computer-generated drill guides. A thorough knowledge of the basic science of CBCT as well as the ability to interpret the images correctly and thoroughly is essential to current practice.

  1. Comparison of Computed Tomography Scout Based Reference Point Localization to Conventional Film and Axial Computed Tomography

    SciTech Connect

    Jiang Lan; Templeton, Alistair; Turian, Julius; Kirk, Michael; Zusag, Thomas; Chu, James C.H.

    2011-01-01

    Identification of source positions after implantation is an important step in brachytherapy planning. Reconstruction is traditionally performed from films taken by conventional simulators, but these are gradually being replaced in the clinic by computed tomography (CT) simulators. The present study explored the use of a scout image-based reconstruction algorithm that replaces the use of traditional film, while exhibiting low sensitivity to metal-induced artifacts that can appear in 3D CT methods. In addition, the accuracy of an in-house graphical software implementation of scout-based reconstruction was compared with seed location reconstructions for 2 phantoms by conventional simulator and CT measurements. One phantom was constructed using a planar fixed grid of 1.5-mm diameter ball bearings (BBs) with 40-mm spacing. The second was a Fletcher-Suit applicator embedded in Styrofoam (Dow Chemical Co., Midland, MI) with one 3.2-mm-diameter BB inserted into each of 6 surrounding holes. Conventional simulator, kilovoltage CT (kVCT), megavoltage CT, and scout-based methods were evaluated by their ability to calculate the distance between seeds (40 mm for the fixed grid, 30-120 mm in Fletcher-Suit). All methods were able to reconstruct the fixed grid distances with an average deviation of <1%. The worst single deviations (approximately 6%) were exhibited in the 2 volumetric CT methods. In the Fletcher-Suit phantom, the intermodality agreement was within approximately 3%, with the conventional sim measuring marginally larger distances, with kVCT the smallest. All of the established reconstruction methods exhibited similar abilities to detect the distances between BBs. The 3D CT-based methods, with lower axial resolution, showed more variation, particularly with the smaller BBs. With a software implementation, scout-based reconstruction is an appealing approach because it simplifies data acquisition over film-based reconstruction without requiring any specialized equipment

  2. Comparison of computed tomography scout based reference point localization to conventional film and axial computed tomography.

    PubMed

    Jiang, Lan; Templeton, Alistair; Turian, Julius; Kirk, Michael; Zusag, Thomas; Chu, James C H

    2011-01-01

    Identification of source positions after implantation is an important step in brachytherapy planning. Reconstruction is traditionally performed from films taken by conventional simulators, but these are gradually being replaced in the clinic by computed tomography (CT) simulators. The present study explored the use of a scout image-based reconstruction algorithm that replaces the use of traditional film, while exhibiting low sensitivity to metal-induced artifacts that can appear in 3D CT methods. In addition, the accuracy of an in-house graphical software implementation of scout-based reconstruction was compared with seed location reconstructions for 2 phantoms by conventional simulator and CT measurements. One phantom was constructed using a planar fixed grid of 1.5-mm diameter ball bearings (BBs) with 40-mm spacing. The second was a Fletcher-Suit applicator embedded in Styrofoam (Dow Chemical Co., Midland, MI) with one 3.2-mm-diameter BB inserted into each of 6 surrounding holes. Conventional simulator, kilovoltage CT (kVCT), megavoltage CT, and scout-based methods were evaluated by their ability to calculate the distance between seeds (40 mm for the fixed grid, 30-120 mm in Fletcher-Suit). All methods were able to reconstruct the fixed grid distances with an average deviation of <1%. The worst single deviations (approximately 6%) were exhibited in the 2 volumetric CT methods. In the Fletcher-Suit phantom, the intermodality agreement was within approximately 3%, with the conventional sim measuring marginally larger distances, with kVCT the smallest. All of the established reconstruction methods exhibited similar abilities to detect the distances between BBs. The 3D CT-based methods, with lower axial resolution, showed more variation, particularly with the smaller BBs. With a software implementation, scout-based reconstruction is an appealing approach because it simplifies data acquisition over film-based reconstruction without requiring any specialized equipment

  3. Cranial computed tomography in infancy and childhood

    SciTech Connect

    Hammock, M.K.; Mihorat, T.H.

    1981-01-01

    A large number of pediatric cases have been accumulated and categorized according to congenital abnormalities, trauma, hydrocephalus, tumors, and infection. Each category contains background material accompanied by computed-tomographic (CT) illustrations and a related discussion. The material is derived from 6,000 CT scans performed at Children's Hospital National Medical Center in Washington, DC since 1973. (JMT)

  4. Coronary Computed Tomographic Angiography Does Not Accurately Predict the Need of Coronary Revascularization in Patients with Stable Angina

    PubMed Central

    Hong, Sung-Jin; Her, Ae-Young; Suh, Yongsung; Won, Hoyoun; Cho, Deok-Kyu; Cho, Yun-Hyeong; Yoon, Young-Won; Lee, Kyounghoon; Kang, Woong Chol; Kim, Yong Hoon; Kim, Sang-Wook; Shin, Dong-Ho; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Byoung-Wook; Choi, Donghoon; Jang, Yangsoo

    2016-01-01

    Purpose To evaluate the ability of coronary computed tomographic angiography (CCTA) to predict the need of coronary revascularization in symptomatic patients with stable angina who were referred to a cardiac catheterization laboratory for coronary revascularization. Materials and Methods Pre-angiography CCTA findings were analyzed in 1846 consecutive symptomatic patients with stable angina, who were referred to a cardiac catheterization laboratory at six hospitals and were potential candidates for coronary revascularization between July 2011 and December 2013. The number of patients requiring revascularization was determined based on the severity of coronary stenosis as assessed by CCTA. This was compared to the actual number of revascularization procedures performed in the cardiac catheterization laboratory. Results Based on CCTA findings, coronary revascularization was indicated in 877 (48%) and not indicated in 969 (52%) patients. Of the 877 patients indicated for revascularization by CCTA, only 600 (68%) underwent the procedure, whereas 285 (29%) of the 969 patients not indicated for revascularization, as assessed by CCTA, underwent the procedure. When the coronary arteries were divided into 15 segments using the American Heart Association coronary tree model, the sensitivity, specificity, positive predictive value, and negative predictive value of CCTA for therapeutic decision making on a per-segment analysis were 42%, 96%, 40%, and 96%, respectively. Conclusion CCTA-based assessment of coronary stenosis severity does not sufficiently differentiate between coronary segments requiring revascularization versus those not requiring revascularization. Conventional coronary angiography should be considered to determine the need of revascularization in symptomatic patients with stable angina. PMID:27401637

  5. Computer tomography of large dust clouds in complex plasmas.

    PubMed

    Killer, Carsten; Himpel, Michael; Melzer, André

    2014-10-01

    The dust density is a central parameter of a dusty plasma. Here, a tomography setup for the determination of the three-dimensionally resolved density distribution of spatially extended dust clouds is presented. The dust clouds consist of micron-sized particles confined in a radio frequency argon plasma, where they fill almost the entire discharge volume. First, a line-of-sight integrated dust density is obtained from extinction measurements, where the incident light from an LED panel is scattered and absorbed by the dust. Performing these extinction measurements from many different angles allows the reconstruction of the 3D dust density distribution, analogous to a computer tomography in medical applications.

  6. Computer tomography of large dust clouds in complex plasmas

    SciTech Connect

    Killer, Carsten; Himpel, Michael; Melzer, André

    2014-10-15

    The dust density is a central parameter of a dusty plasma. Here, a tomography setup for the determination of the three-dimensionally resolved density distribution of spatially extended dust clouds is presented. The dust clouds consist of micron-sized particles confined in a radio frequency argon plasma, where they fill almost the entire discharge volume. First, a line-of-sight integrated dust density is obtained from extinction measurements, where the incident light from an LED panel is scattered and absorbed by the dust. Performing these extinction measurements from many different angles allows the reconstruction of the 3D dust density distribution, analogous to a computer tomography in medical applications.

  7. Assessment of asthmatic inflammation using hybrid fluorescence molecular tomography-x-ray computed tomography

    NASA Astrophysics Data System (ADS)

    Ma, Xiaopeng; Prakash, Jaya; Ruscitti, Francesca; Glasl, Sarah; Stellari, Fabio Franco; Villetti, Gino; Ntziachristos, Vasilis

    2016-01-01

    Nuclear imaging plays a critical role in asthma research but is limited in its readings of biology due to the short-lived signals of radio-isotopes. We employed hybrid fluorescence molecular tomography (FMT) and x-ray computed tomography (XCT) for the assessment of asthmatic inflammation based on resolving cathepsin activity and matrix metalloproteinase activity in dust mite, ragweed, and Aspergillus species-challenged mice. The reconstructed multimodal fluorescence distribution showed good correspondence with ex vivo cryosection images and histological images, confirming FMT-XCT as an interesting alternative for asthma research.

  8. [Positron emission tomography/computed tomography in follow-up programmes for patients with colorectal cancer].

    PubMed

    Hansen, Anne Fogh; Jensen, Mads Radmer; Nordholm-Carstensen, Andreas

    2016-09-12

    The current follow-up programmes for patients with colorectal cancer (CRC) after curative surgery do not include 18F-fluorodeoxyglucose-positron emission tomography (PET). Several small studies on selected patient populations indicate a high sensitivity of PET/computed tomography (CT) on visualizing relapse in patients with CRC after curative surgery. Therefore, PET/CT could probably be valuable in patients with unexplained increase in carcinoembryonic antigen level or a clinical suspicion of relapse, but PET/CT is not recommended as a standard in follow-up after CRC. PMID:27649583

  9. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Dehmer, Gregory J; Patel, Manesh R; Smith, Peter K; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian C; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Russo, Andrea M; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M

    2012-04-01

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  10. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2012-02-28

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  11. Computed tomography in acute cholecystitis: new observations

    SciTech Connect

    Kane, R.A.; Costello, P.; Duszlak, E.

    1983-10-01

    The computed tomographic CT findings in five patients with acute cholecystitis were analyzed. Common findings included thickening and nodularity of the gallbladder wall, cholelithiasis, and dilatation of the gallbladder lumen. Other more specific findings included poor definition of the gallbladder wall, pericholecystic fluid collections, and gas collections within the gallbladder wall. Most of the CT findings are suggestive but not pathognomonic, and correlation with the clinical, scintigraphic, and sonographic findings is necessary.

  12. Diagnostic yield and accuracy of CT angiography, MR angiography, and digital subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage: prospective, multicentre cohort study

    PubMed Central

    Velthuis, Birgitta K; Rinkel, Gabriël J E; Algra, Ale; de Kort, Gérard A P; Witkamp, Theo D; de Ridder, Johanna C M; van Nieuwenhuizen, Koen M; de Leeuw, Frank-Erik; Schonewille, Wouter J; de Kort, Paul L M; Dippel, Diederik W; Raaymakers, Theodora W M; Hofmeijer, Jeannette; Wermer, Marieke J H; Kerkhoff, Henk; Jellema, Korné; Bronner, Irene M; Remmers, Michel J M; Bienfait, Henri Paul; Witjes, Ron J G M; Greving, Jacoba P; Klijn, Catharina J M

    2015-01-01

    Study question What are the diagnostic yield and accuracy of early computed tomography (CT) angiography followed by magnetic resonance imaging/angiography (MRI/MRA) and digital subtraction angiography (DSA) in patients with non-traumatic intracerebral haemorrhage? Methods This prospective diagnostic study enrolled 298 adults (18-70 years) treated in 22 hospitals in the Netherlands over six years. CT angiography was performed within seven days of haemorrhage. If the result was negative, MRI/MRA was performed four to eight weeks later. DSA was performed when the CT angiography or MRI/MRA results were inconclusive or negative. The main outcome was a macrovascular cause, including arteriovenous malformation, aneurysm, dural arteriovenous fistula, and cavernoma. Three blinded neuroradiologists independently evaluated the images for macrovascular causes of haemorrhage. The reference standard was the best available evidence from all findings during one year’s follow-up. Study answer and limitations A macrovascular cause was identified in 69 patients (23%). 291 patients (98%) underwent CT angiography; 214 with a negative result underwent additional MRI/MRA and 97 with a negative result for both CT angiography and MRI/MRA underwent DSA. Early CT angiography detected 51 macrovascular causes (yield 17%, 95% confidence interval 13% to 22%). CT angiography with MRI/MRA identified two additional macrovascular causes (18%, 14% to 23%) and these modalities combined with DSA another 15 (23%, 18% to 28%). This last extensive strategy failed to detect a cavernoma, which was identified on MRI during follow-up (reference strategy). The positive predictive value of CT angiography was 72% (60% to 82%), of additional MRI/MRA was 35% (14% to 62%), and of additional DSA was 100% (75% to 100%). None of the patients experienced complications with CT angiography or MRI/MRA; 0.6% of patients who underwent DSA experienced permanent sequelae. Not all patients with negative CT angiography and

  13. 21 CFR 892.1750 - Computed tomography x-ray system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Computed tomography x-ray system. 892.1750 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1750 Computed tomography x-ray system. (a) Identification. A computed tomography x-ray system is a diagnostic x-ray system intended...

  14. 21 CFR 892.1750 - Computed tomography x-ray system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Computed tomography x-ray system. 892.1750 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1750 Computed tomography x-ray system. (a) Identification. A computed tomography x-ray system is a diagnostic x-ray system intended...

  15. 21 CFR 892.1750 - Computed tomography x-ray system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Computed tomography x-ray system. 892.1750 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1750 Computed tomography x-ray system. (a) Identification. A computed tomography x-ray system is a diagnostic x-ray system intended...

  16. 21 CFR 892.1750 - Computed tomography x-ray system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Computed tomography x-ray system. 892.1750 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1750 Computed tomography x-ray system. (a) Identification. A computed tomography x-ray system is a diagnostic x-ray system intended...

  17. 21 CFR 892.1750 - Computed tomography x-ray system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Computed tomography x-ray system. 892.1750 Section... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1750 Computed tomography x-ray system. (a) Identification. A computed tomography x-ray system is a diagnostic x-ray system intended...

  18. Clinical utility of dental cone-beam computed tomography: current perspectives

    PubMed Central

    Jaju, Prashant P; Jaju, Sushma P

    2014-01-01

    Panoramic radiography and computed tomography were the pillars of maxillofacial diagnosis. With the advent of cone-beam computed tomography, dental practice has seen a paradigm shift. This review article highlights the potential applications of cone-beam computed tomography in the fields of dental implantology and forensic dentistry, and its limitations in maxillofacial diagnosis. PMID:24729729

  19. The safe practice of CT coronary angiography in adult patients in UK imaging departments.

    PubMed

    Harden, S P; Bull, R K; Bury, R W; Castellano, E A; Clayton, B; Hamilton, M C K; Morgan-Hughes, G J; O'Regan, D; Padley, S P G; Roditi, G H; Roobottom, C A; Stirrup, J; Nicol, E D

    2016-08-01

    Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014.

  20. Giant intracranial aneurysms: rapid sequential computed tomography

    SciTech Connect

    Pinto, R.S.; Cohen, W.A.; Kricheff, I.I.; Redington, R.W.; Berninger, W.H.

    1982-11-01

    Giant intracranial aneurysms often present as mass lesions rather than with subarachnoid hemorrhage. Routine computed tomographic (CT) scans with contrast material will generally detect them, but erroneous diagnosis of basal meningioma is possible. Rapid sequential scanning (dynamic CT) after bolus injection of 40 ml of Renografin-76 can conclusively demonstrate an intracranial aneurysm, differentiating it from other lesions by transit-time analysis of the passage of contrast medium. In five patients, the dynamics of contrast bolus transit in aneurysms were consistently different from the dynamics in pituitary tumors, craniopharyngiomas, and meningiomas, thereby allowing a specific diagnosis. Dynamic CT was also useful after treatment of the aneurysms by carotid artery ligation and may be used as an alternative to angiographic evaluation in determining luminal patency or thrombosis.

  1. Computed tomography of human joints and radioactive waste drums

    SciTech Connect

    Ashby, E; Bernardi, R; Hollerbach, K; Logan, C; Martz, H; Roberson, G P

    1999-06-01

    X- and gamma-ray imaging techniques in nondestructive evaluation (NDE) and assay (NDA) have been increasing use in an array of industrial, environmental, military, and medical applications. Much of this growth in recent years is attributed to the rapid development of computed tomography (CT) and the use of NDE throughout the life-cycle of a product. Two diverse examples of CT are discussed. (1) The computational approach to normal joint kinematics and prosthetic joint analysis offers an opportunity to evaluate and improve prosthetic human joint replacements before they are manufactured or surgically implanted. Computed tomography data from scanned joints are segmented, resulting in the identification of bone and other tissues of interest, with emphasis on the articular surfaces. (2) They are developing NDE and NDE techniques to analyze closed waste drums accurately and quantitatively. Active and passive computed tomography (A and PCT) is a comprehensive and accurate gamma-ray NDA method that can identify all detectable radioisotopes present in a container and measure their radioactivity.

  2. Screening for lung cancer using low dose computed tomography.

    PubMed

    Tammemagi, Martin C; Lam, Stephen

    2014-01-01

    Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease. Algorithms are available for assessing people who screen positive to determine who needs additional imaging or invasive investigations. Concerns about low dose computed tomography screening include false positive results, overdiagnosis, radiation exposure, and costs. Further work is needed to define the frequency and duration of screening and to refine risk prediction models so that they can be used to assess the risk of lung cancer in special populations. Another important area is the use of computer vision software tools to facilitate high throughput interpretation of low dose computed tomography images so that costs can be reduced and the consistency of scan interpretation can be improved. Sufficient data are available to support the implementation of screening programs at the population level in stages that can be expanded when found to perform well to improve the outcome of patients with lung cancer. PMID:24865600

  3. Initial water quantification results using neutron computed tomography

    NASA Astrophysics Data System (ADS)

    Heller, A. K.; Shi, L.; Brenizer, J. S.; Mench, M. M.

    2009-06-01

    Neutron computed tomography is an important imaging tool in the field of non-destructive testing and in fundamental research for many engineering applications. Contrary to X-rays, neutrons can be attenuated by some light materials, such as hydrogen, but can penetrate many heavy materials. Thus, neutron computed tomography is useful in obtaining important three-dimensional information about a sample's interior structure and material properties that other traditional methods cannot provide. The neutron computed tomography system at the Pennsylvania State University's Radiation Science and Engineering Center is being utilized to develop a water quantification technique for investigation of water distribution in fuel cells under normal conditions. A hollow aluminum cylinder test sample filled with a known volume of water was constructed for purposes of testing the quantification technique. Transmission images of the test sample at different angles were easily acquired through the synthesis of a dedicated image acquisition computer driving a rotary table controller and an in-house developed synchronization software package. After data acquisition, Octopus (version 8.2) and VGStudio Max (version 1.2) were used to perform cross-sectional and three-dimensional reconstructions of the sample, respectively. The initial reconstructions and water quantification results are presented.

  4. Computed tomography of human joints and radioactive waste drums

    SciTech Connect

    Martz, Harry E.; Roberson, G. Patrick; Hollerbach, Karin; Logan, Clinton M.; Ashby, Elaine; Bernardi, Richard

    1999-12-02

    X- and gamma-ray imaging techniques in nondestructive evaluation (NDE) and assay (NDA) have seen increasing use in an array of industrial, environmental, military, and medical applications. Much of this growth in recent years is attributed to the rapid development of computed tomography (CT) and the use of NDE throughout the life-cycle of a product. Two diverse examples of CT are discussed, 1.) Our computational approach to normal joint kinematics and prosthetic joint analysis offers an opportunity to evaluate and improve prosthetic human joint replacements before they are manufactured or surgically implanted. Computed tomography data from scanned joints are segmented, resulting in the identification of bone and other tissues of interest, with emphasis on the articular surfaces. 2.) We are developing NDE and NDA techniques to analyze closed waste drums accurately and quantitatively. Active and passive computed tomography (A and PCT) is a comprehensive and accurate gamma-ray NDA method that can identify all detectable radioisotopes present in a container and measure their radioactivity.

  5. Hybrid averaging offers high-flow contrast by cost apportionment among imaging time, axial, and lateral resolution in optical coherence tomography angiography.

    PubMed

    Li, Peng; Cheng, Yuxuan; Li, Pei; Zhou, Liping; Ding, Zhihua; Ni, Yang; Pan, Cong

    2016-09-01

    The current temporal, wavelength, angular, and spatial averaging approaches trade imaging time and resolution for multiple independent measurements that improve the flow contrast in optical coherence tomography angiography (OCTA). We find that these averaging approaches are equivalent in principle, offering almost the same flow contrast enhancement as the number of averages increases. Based on this finding, we propose a hybrid averaging strategy for contrast enhancement by cost apportionment. We demonstrate that, compared with any individual approach, the hybrid averaging is able to offer a desired flow contrast without severe degradation of imaging time and resolution. Making use of the extended range of a VCSEL-based swept-source OCT, an angular averaging approach by path length encoding is also demonstrated for flow contrast enhancement. PMID:27607943

  6. Spent nuclear fuel assembly inspection using neutron computed tomography

    NASA Astrophysics Data System (ADS)

    Pope, Chad Lee

    The research presented here focuses on spent nuclear fuel assembly inspection using neutron computed tomography. Experimental measurements involving neutron beam transmission through a spent nuclear fuel assembly serve as benchmark measurements for an MCNP simulation model. Comparison of measured results to simulation results shows good agreement. Generation of tomography images from MCNP tally results was accomplished using adapted versions of built in MATLAB algorithms. Multiple fuel assembly models were examined to provide a broad set of conclusions. Tomography images revealing assembly geometric information including the fuel element lattice structure and missing elements can be obtained using high energy neutrons. A projection difference technique was developed which reveals the substitution of unirradiated fuel elements for irradiated fuel elements, using high energy neutrons. More subtle material differences such as altering the burnup of individual elements can be identified with lower energy neutrons provided the scattered neutron contribution to the image is limited. The research results show that neutron computed tomography can be used to inspect spent nuclear fuel assemblies for the purpose of identifying anomalies such as missing elements or substituted elements. The ability to identify anomalies in spent fuel assemblies can be used to deter diversion of material by increasing the risk of early detection as well as improve reprocessing facility operations by confirming the spent fuel configuration is as expected or allowing segregation if anomalies are detected.

  7. Classification of breast computed tomography data

    SciTech Connect

    Nelson, Thomas R.; Cervino, Laura I.; Boone, John M.; Lindfors, Karen K.

    2008-03-15

    Differences in breast tissue composition are important determinants in assessing risk, identifying disease in images and following changes over time. This paper presents an algorithm for tissue classification that separates breast tissue into its three primary constituents of skin, fat and glandular tissue. We have designed and built a dedicated breast CT scanner. Fifty-five normal volunteers and patients with mammographically identified breast lesions were scanned. Breast CT voxel data were filtered using a 5 pt median filter and the image histogram was computed. A two compartment Gaussian fit of histogram data was used to provide an initial estimate of tissue compartments. After histogram analysis, data were input to region-growing algorithms and classified as to belonging to skin, fat or gland based on their value and architectural features. Once tissues were classified, a more detailed analysis of glandular tissue patterns and a more quantitative analysis of breast composition was made. Algorithm performance assessment demonstrated very good or excellent agreement between algorithm and radiologist observers in 97.7% of the segmented data. We observed that even in dense breasts the fraction of glandular tissue seldom exceeded 50%. For most individuals the composition is better characterized as being a 70% (fat)-30% (gland) composition than a 50% (fat)-50% (gland) composition.

  8. Decoding Hemodynamics of Large Vessels via Dispersion of Contrast Agent in Cardiac Computed Tomography

    NASA Astrophysics Data System (ADS)

    Eslami, Parastou; Seo, Jung-Hee; Abd, Thura T.; George, Richard; Lardo, Albert C.; Chen, Marcus Y.; Mittal, Rajat

    2015-11-01

    Computed tomography angiography (CTA) has emerged as a powerful tool for the assessment of coronary artery disease and other cardiac conditions. Continuous improvements in the spatial and temporal resolution of CT scanners are revealing details regarding the spatially and temporally varying contrast concentration in the vasculature, that were not evident before. These contrast dispersion patterns offer the possibility of extracting useful information about the hemodynamics from the scans. In the current presentation, we will describe experimental studies carried out with CT compatible phantoms of coronary vessels that provide insights into the effect of imaging artifacts on the observed intracoronary contrast gradients. In addition, we will describe a series of computational fluid dynamics studies that explore the dispersion of contrast through the ascending-descending aorta with particular focus on the effect of the aortic curvature on the dispersion patterns. PE is supported by the NIH Graduate Partnership Program. RM and ACL pending patents in CTA based flow diagnostics and have other significant financial interests in these technologies.

  9. Computer-aided detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA): performance evaluation with independent data sets.

    PubMed

    Zhou, Chuan; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M; Chughtai, Aamer; Patel, Smita; Wei, Jun; Cascade, Philip N; Kazerooni, Ella A

    2009-08-01

    The authors are developing a computer-aided detection system for pulmonary emboli (PE) in computed tomographic pulmonary angiography (CTPA) scans. The pulmonary vessel tree is extracted using a 3D expectation-maximization segmentation method based on the analysis of eigen-values of Hessian matrices at multiple scales. A parallel multiprescreening method is applied to the segmented vessels to identify volume of interests (VOIs) that contained suspicious PE. A linear discriminant analysis (LDA) classifier with feature selection is designed to reduce false positives (FPs). Features that characterize the contrast, gray level, and size of PE are extracted as input predictor variables to the LDA classifier. With the IRB approval, 59 CTPA PE cases were collected retrospectively from the patient files (UM cases). With access permission, 69 CTPA PE cases were randomly selected from the data set of the prospective investigation of pulmonary embolism diagnosis (PIOPED) II clinical trial. Extensive lung parenchymal or pleural diseases were present in 22/59 UM and 26/69 PIOPED cases. Experienced thoracic radiologists manually marked 595 and 800 PE as the reference standards in the UM and PIOPED data sets, respectively. PE occlusion of arteries ranged from 5% to 100%, with PE located from the main pulmonary artery to the subsegmental artery levels. Of the 595 PE identified in the UM cases, 245 and 350 PE were located in the subsegmental arteries and the more proximal arteries, respectively. The detection performance was assessed by free response ROC (FROC) analysis. The FROC analysis indicated that the PE detection system could achieve an overall sensitivity of 80% at 18.9 FPs/case for the PIOPED cases when the LDA classifier was trained with the UM cases. The test sensitivity with the UM cases was 80% at 22.6 FPs/cases when the LDA classifier was trained with the PIOPED cases. The detection performance depended on the arterial level where the PE was located and on the

  10. Bone single photon emission computed tomography with computed tomography disclosing chronic uterine perforation with intrauterine device migration into the anterior wall of the bladder: a case report

    PubMed Central

    2013-01-01

    Introduction Extraosseous uptake of 99mTc-hydroxymethylene diphosphonate is a common situation of variable clinical relevance. Case presentation A 52-year-old Caucasian woman presented to our department for breast cancer staging. A 99mTc-hydroxymethylene diphosphonate bone scan was performed and showed focal pelvic hyperfixation that disclosed intrauterine device migration into the anterior wall of the bladder on single photon emission computed tomography with computed tomography. Conclusion This observation confirms the major role of single photon emission computed tomography with computed tomography in achieving an exact diagnosis. PMID:23759143

  11. [Computed tomography in space-occupying intraspinal processes].

    PubMed

    Prömper, C; Friedmann, G

    1983-02-01

    Spinal computed tomography has considerably enhanced differential diagnostic safety in the course of the past two years. It has disclosed new possibilities of indication in the diagnosis of the vertebral column. With the expected improvement in apparatus technology, computed tomography will increasingly replace invasive examination methods. Detailed knowledge of clinical data, classification of the neurological findings, and localisation of the height--as far as possible--are the necessary prerequisites of successful diagnosis. If they are absent, it is recommended to perform myelography followed by secondary CT-myelography. If these preliminary conditions are observed, spinal CT can make outstanding contributions to the diagnosis of slipped disk, of the constricted vertebral canal, as well as tumours, malformations and posttraumatic conditions, postoperative changes and inflammatory processes. PMID:6338578

  12. Analytic reconstruction approach for parallel translational computed tomography.

    PubMed

    Kong, Huihua; Yu, Hengyong

    2015-01-01

    To develop low-cost and low-dose computed tomography (CT) scanners for developing countries, recently a parallel translational computed tomography (PTCT) is proposed, and the source and detector are translated oppositely with respect to the imaging object without a slip-ring. In this paper, we develop an analytic filtered-backprojection (FBP)-type reconstruction algorithm for two dimensional (2D) fan-beam PTCT and extend it to three dimensional (3D) cone-beam geometry in a Feldkamp-type framework. Particularly, a weighting function is constructed to deal with data redundancy for multiple translations PTCT to eliminate image artifacts. Extensive numerical simulations are performed to validate and evaluate the proposed analytic reconstruction algorithms, and the results confirm their correctness and merits. PMID:25882732

  13. Single photon emission computed tomography in seizure disorders.

    PubMed Central

    Denays, R; Rubinstein, M; Ham, H; Piepsz, A; Noël, P

    1988-01-01

    Fourteen children with various seizure disorders were studied using a cerebral blood flow tracer, 123I iodoamphetamine (0.05 mCi/kg), and single photon emission computed tomography (SPECT). In the five patients with radiological lesions, SPECT showed congruent or more extensive abnormalities. Five of the nine children with a normal scan on computed tomography had abnormal SPECT studies consisting of focal hypoperfusion, diffuse hemispheric hypoperfusion, multifocal and bilateral hypoperfusion, or focal hyperperfusion. A focal lesion seen on SPECT has been found in children with tonic-clonic seizures suggesting secondarily generalised seizures. Moreover the pattern seen on SPECT seemed to be related to the clinical status. An extensive impairment found on SPECT was associated with a poor evolution in terms of intellectual performance and seizure frequency. Conversely all children with a normal result on SPECT had less than two seizures per year and normal neurological and intellectual development. Images Figure PMID:3264135

  14. [Potentialities of computed tomography in the diagnosis of hiatal hernia].

    PubMed

    Gorshkov, A N

    2003-01-01

    An analysis of the results of 98 studies has demonstrated the potentialities of X-ray computed tomography in the diagnosis of hiatal hernia (HH), provided the X-ray computed tomography (XCT) semiotics of HH. It has found that XCT may directly visualize and objectively evaluate anatomic structures, such as diagraphmatic crus and esophageal foremen. It has emphasized that when XCT of abdominal and thoracic organs is performed, it is necessary to include the areas of diagragmatic curs and esophageal foramen into the list of anatomic structures binding for visual assessment and characterization, which in combination with other studies will assist in the early diagnosis of hiatal hernia and eventually expand the potentialities of XCT to a greater extent.

  15. Computed Tomography Inspection and Analysis for Additive Manufacturing Components

    NASA Technical Reports Server (NTRS)

    Beshears, Ronald D.

    2016-01-01

    Computed tomography (CT) inspection was performed on test articles additively manufactured from metallic materials. Metallic AM and machined wrought alloy test articles with programmed flaws were inspected using a 2MeV linear accelerator based CT system. Performance of CT inspection on identically configured wrought and AM components and programmed flaws was assessed using standard image analysis techniques to determine the impact of additive manufacturing on inspectability of objects with complex geometries.

  16. Micro Computer Tomography for medical device and pharmaceutical packaging analysis.

    PubMed

    Hindelang, Florine; Zurbach, Raphael; Roggo, Yves

    2015-04-10

    Biomedical device and medicine product manufacturing are long processes facing global competition. As technology evolves with time, the level of quality, safety and reliability increases simultaneously. Micro Computer Tomography (Micro CT) is a tool allowing a deep investigation of products: it can contribute to quality improvement. This article presents the numerous applications of Micro CT for medical device and pharmaceutical packaging analysis. The samples investigated confirmed CT suitability for verification of integrity, measurements and defect detections in a non-destructive manner.

  17. [Efficiency of computed tomography in diagnosis of silicotuberculosis].

    PubMed

    Naumenko, E S; Gol'del'man, A G; Tikhotskaia, L I; Zhovtiak, E P; Iarina, A L; Ershov, V I; Larina, E N

    1998-01-01

    The routine methods X-ray study and computed tomography (CT) were compared in a group of patients engaged in fireproof industry. CT yields valuable additional data in early silicotuberculosis, which makes it possible to follow the extent of a silicotuberculous process more completely, to make a better diagnosis of nodal and focal shadows, to identify small decay cavities in the foci and infiltrates. CT is the method of choice in following up patients with silicotuberculosis.

  18. Use of Cone Beam Computed Tomography in Endodontics

    PubMed Central

    Scarfe, William C.; Levin, Martin D.; Gane, David; Farman, Allan G.

    2009-01-01

    Cone Beam Computed Tomography (CBCT) is a diagnostic imaging modality that provides high-quality, accurate three-dimensional (3D) representations of the osseous elements of the maxillofacial skeleton. CBCT systems are available that provide small field of view images at low dose with sufficient spatial resolution for applications in endodontic diagnosis, treatment guidance, and posttreatment evaluation. This article provides a literature review and pictorial demonstration of CBCT as an imaging adjunct for endodontics. PMID:20379362

  19. Computed tomography identification of an exophytic colonic liposarcoma.

    PubMed

    Chou, Chung Kuao; Chen, Sung-Ting

    2016-09-01

    It may be difficult to ascertain the relationship between a large intra-abdominal tumor and the adjacent organs if they are close together. In the current case, a definitive preoperative diagnosis of an exophytic colonic tumor was obtained by the demonstration of obtuse angles between the tumor and colon and by distinct recognition of the mucosa-submucosa of the colonic wall on computed tomography; the accuracy of this preoperative diagnosis was subsequently confirmed by pathologic findings. PMID:27594941

  20. A comparison between abdominal ultrasonography and computed tomography.

    PubMed

    Becker, H; Pienaar, G J

    1980-06-28

    Computed tomography (CT) and ultrasonography are based on entirely different physical principles. In the abdomen the two techniques have similar diagnostic applications. Whereas CT is in many instances more informative, it is also a more time-consuming and much more costly procedure. For clinicians who practise in areas where these techniques are available, this article may be useful as a quick guide to the choice of procedure.

  1. Ureterolithiasis: classical and atypical findings on unenhanced helical computed tomography.

    PubMed

    Vaswani, Kuldeep K; El-Dieb, Adam; Vitellas, Kenneth M; Bennett, William F; Bova, James G

    2002-03-01

    Evaluation of patients with acute flank pain using helical computed tomography (CT) is a well-accepted, rapid, and safe procedure in the emergency setting. Various primary and secondary signs are described in the literature for evaluation of these patients. Our purpose is to demonstrate both the classical findings associated with ureteral calculi on unenhanced helical CT and atypical findings and potential pitfalls. We also provide readers with a systematic approach to interpreting unenhanced helical CT scans performed for acute flank pain.

  2. [Multislice spiral computed tomography in the diagnosis of osteomyelitis].

    PubMed

    Egorova, E A; Zorina, I S; Sangaeva, L M

    2010-01-01

    This paper deals with the results of a radiation study in 34 patients with the clinical manifestations of maxillofacial osteomyelitides. It describes the radiation semiotics of changes occurring in the bone and its surrounding soft tissues of the maxillofacial region in different phases of osteomyelitis. Comparative analysis of orthopantograms and images obtained by multislice spiral computed tomography revealed the benefits of the latter in detecting soft tissue changes and subtle bone alterations.

  3. Comparison of computed tomography and pluridirectional tomography of the temporal bone

    SciTech Connect

    Lufkin, R.; Barni, J.J.; Glen, W.; Mancuso, A.; Canalis, R.; Hanafee, W.

    1982-06-01

    During pluridirectional tomography dense bone creates ghost shadows that simulate chronic disease and soft-tissue masses within the middle ear cavity. This effect was demonstrated in three dried skulls. Cholesteatomas were simulated in three more temporal bones with a mixture of 2% iodine in paraffin. Three different high-resolution computed tomographic scanners clearly demonstrated middle ear anatomy and the simulated soft-tissue masses in the skulls.

  4. SADMFR guidelines for the use of Cone-Beam Computed Tomography/ Digital Volume Tomography.

    PubMed

    Dula, Karl; Bornstein, Michael M; Buser, Daniel; Dagassan-Berndt, Dorothea; Ettlin, Dominik A; Filippi, Andreas; Gabioud, François; Katsaros, Christos; Krastl, Gabriel; Lambrecht, J Thomas; Lauber, Roland; Luebbers, Heinz-Theo; Pazera, Pawel; Türp, Jens C

    2014-01-01

    Cone-Beam Computed Tomography (CBCT) has been introduced in 1998. This radiological imaging procedure has been provided for dentistry and is comparable to computed tomography (CT) in medicine. It is expected that CBCT will have the same success in dental diagnostic imaging as computed tomography had in medicine. Just as CT is responsible for a significant rise in radiation dose to the population from medical X-ray diagnostics, CBCT studies will be accompanied by a significant increase of the dose to our patients by dentistry. Because of the growing concern for an uncritical and consequently rapidly increasing use of CBCT the Swiss Society of Dentomaxillofacial Radiology convened a first consensus conference in 2011 to formulate indications for CBCT, which can be used as guidelines. In this meeting, oral and maxillofacial surgery, orthodontics and temporomandibular joint disorders and diseases were treated and the most important and most experienced users of DVT in these areas were asked to participate. In general, a highly restrictive use of CBCT is required. Justifying main criterion for CBCT application is that additional, therapy-relevant information is expected that should lead to a significant benefit in patient care. All users of CBCT should have completed a structured, high-level training, just like that offered by the Swiss Society of Dentomaxillofacial Radiology.

  5. Validation of visual surface measurement using computed tomography

    NASA Astrophysics Data System (ADS)

    VanBerlo, Amy M.; Campbell, Aaron R.; Ellis, Randy E.

    2011-03-01

    Although dysesthesia is a common and persistent surgical complication, there is no accepted method for quantitatively tracking affected skin. To address this, two types of computer vision technologies were tested in a total of four configurations. Surface regions on plastic models of limbs were delineated with colored tape, imaged, and compared with computed tomography scans. The most accurate system used visually projected texture captured by a binocular stereo camera, capable of measuring areas to within 0.05% of the ground-truth areas with 1.4% variance. This simple, inexpensive technology shows promise for postoperative monitoring of dysesthesia surrounding surgical scars.

  6. [Role of cone-beam computed tomography in diagnostic otorhinolaryngological imaging].

    PubMed

    Perényi, Ádám; Bella, Zsolt; Baráth, Zoltán; Magyar, Péter; Nagy, Katalin; Rovó, László

    2016-01-10

    Accurate diagnosis and preoperative planning in modern otorhinolaryngology is strongly supported by imaging with enhanced visualization. Computed tomography is often used to examine structures within bone frameworks. Given the hazards of ionizing radiation, repetitive imaging studies exponentially increase the risk of damages to radiosensitive tissues. The authors compare multislice and cone-beam computed tomography and determine the role, advantages and disadvantages of cone-beam computed tomography in otorhinolaryngological imaging. They summarize the knowledge from the international literature and their individual imaging studies. They conclude that cone-beam computed tomography enables high-resolution imaging and reconstruction in any optional plane and in space with considerably lower effective radiation dose. Cone-beam computed tomography with appropriate indications proved to be an excellent diagnostic tool in otorhinolaryngological imaging. It makes an alternative to multislice computed tomography and it is an effective tool in perioperative and postoperative follow-up, especially in those cases which necessitate repetitive imaging with computed tomography.

  7. Parallel multithread computing for spectroscopic analysis in optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Trojanowski, Michal; Kraszewski, Maciej; Strakowski, Marcin; Pluciński, Jerzy

    2014-05-01

    Spectroscopic Optical Coherence Tomography (SOCT) is an extension of Optical Coherence Tomography (OCT). It allows gathering spectroscopic information from individual scattering points inside the sample. It is based on time-frequency analysis of interferometric signals. Such analysis requires calculating hundreds of Fourier transforms while performing a single A-scan. Additionally, further processing of acquired spectroscopic information is needed. This significantly increases the time of required computations. During last years, application of graphical processing units (GPU's) was proposed to reduce computation time in OCT by using parallel computing algorithms. GPU technology can be also used to speed-up signal processing in SOCT. However, parallel algorithms used in classical OCT need to be revised because of different character of analyzed data. The classical OCT requires processing of long, independent interferometric signals for obtaining subsequent A-scans. The difference with SOCT is that it requires processing of multiple, shorter signals, which differ only in a small part of samples. We have developed new algorithms for parallel signal processing for usage in SOCT, implemented with NVIDIA CUDA (Compute Unified Device Architecture). We present details of the algorithms and performance tests for analyzing data from in-house SD-OCT system. We also give a brief discussion about usefulness of developed algorithm. Presented algorithms might be useful for researchers working on OCT, as they allow to reduce computation time and are step toward real-time signal processing of SOCT data.

  8. Computed tomography and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography findings in adrenal candidiasis and histoplasmosis: two cases.

    PubMed

    Altinmakas, Emre; Guo, Ming; Kundu, Uma R; Habra, Mouhammed Amir; Ng, Chaan

    2015-01-01

    We report the contrast-enhanced computed tomography (CT) and (18)F-fluorodeoxyglucose positron emission tomography findings in adrenal histoplasmosis and candidiasis. Both demonstrated bilateral hypermetabolic heterogeneous adrenal masses with limited wash-out on delayed CT. Adrenal candidiasis has not been previously reported, nor have the CT wash-out findings in either infection. The adrenal imaging findings are indistinguishable from malignancy, which is more common; but in this setting, physicians should be alert to the differential diagnosis of fungal infections, since it can be equally deadly.

  9. Coronary computed tomographic angiography in clinical practice: state of the art.

    PubMed

    Meinel, Felix G; Bayer, Richard R; Zwerner, Peter L; De Cecco, Carlo Nicola; Schoepf, U Joseph; Bamberg, Fabian

    2015-03-01

    In patients with stable chest pain, coronary CT angiography (CCTA) has demonstrated high accuracy in excluding coronary artery disease and CCTA findings carry prognostic significance for the occurrence of future cardiovascular events. Increasingly, CCTA has been adopted as a triage tool in patients with acute chest pain. In specific clinical scenarios, CCTA further represents a useful tool to exclude an ischemic etiology in patients with cardiac arrhythmias or newly diagnosed heart failure. Several novel techniques are currently being investigated which may extend the ability of CCTA to characterize and quantify coronary artery plaque and assess the hemodynamic significance of stenosis. PMID:25726994

  10. Cardiac computed tomography--evidence, limitations and clinical application.

    PubMed

    Hamilton-Craig, Christian R; Friedman, Daniel; Achenbach, Stephan

    2012-02-01

    Coronary CT angiography and coronary calcium scoring offer a new approach to the diagnosis of coronary artery disease (CAD). They hold significant promise in improving patient outcomes, through identification of atherosclerosis and improved risk assessment. Coronary calcium scoring has proven predictive value concerning the occurrence of future cardiovascular events and outperforms current risk evaluation methods such as the Framingham Risk Score. Coronary CT angiography allows visualisation of the coronary artery lumen, detection of stenoses as well as visualisation of both calcified and non-calcified plaque. The accuracy of coronary CT angiography to detect obstructive coronary artery disease has been established by numerous trials. In particular the negative predictive value of the test approaches 100% in low and intermediate risk groups. Outcomes data demonstrate significant prognostic ability of coronary CT angiography. Modern techniques allow substantial reduction of dose values and radiation exposure of coronary CT angiography has significantly fallen. Coronary CT angiography can be reliably performed with doses similar to the level of annual background radiation, and less than one-third of a Tc Sestamibi scan. Coronary CT angiography has been approved for Medicare reimbursement for specific indications when performed by accredited providers. High quality examinations, experience and careful patient selection and preparation are required to ensure optimal results of coronary CT angiography, and to guide clinical decisions. PMID:22024629

  11. Diffraction computed tomography reveals the inner structure of complex biominerals

    NASA Astrophysics Data System (ADS)

    Leemreize, Hanna; Birkbak, Mie; Frølich, Simon; Kenesei, Peter; Almer, Jonathan D.; Stock, Stuart R.; Birkedal, Henrik

    2014-09-01

    Biological materials are complex and their investigation demands advanced characterization tools capable of elucidating their structure in three dimensions without the need for complicated sample preparation. Herein, we discuss our implementation of diffraction/scattering computed tomography (DSCT). DSCT is based on the use of diffraction information for tomographic reconstructions rather than linear attenuation as in regular μ-CT. This provides much additional information on the material under investigation. We illustrate the use of DSCT by discussion of data on a biomineralized attachment organ from a marine mussel. DSCT allowed mapping the spatial distribution of calcium carbonate polymorphs aragonite and calcite even though they were indistinguishable in absorption tomography. Detailed analysis of reconstructed diffraction patterns may provide additional insights as exemplified in the present case by mapping of the degree of chemical substitution in calcite.

  12. Single photon emission computed tomography in AIDS dementia complex

    SciTech Connect

    Pohl, P.; Vogl, G.; Fill, H.; Roessler, H.Z.; Zangerle, R.; Gerstenbrand, F.

    1988-08-01

    Single photon emission computed tomography (SPECT) studies were performed in AIDS dementia complex using IMP in 12 patients (and HM-PAO in four of these same patients). In all patients, SPECT revealed either multiple or focal uptake defects, the latter corresponding with focal signs or symptoms in all but one case. Computerized tomography showed a diffuse cerebral atrophy in eight of 12 patients, magnetic resonance imaging exhibited changes like atrophy and/or leukoencephalopathy in two of five cases. Our data indicate that both disturbance of cerebral amine metabolism and alteration of local perfusion share in the pathogenesis of AIDS dementia complex. SPECT is an important aid in the diagnosis of AIDS dementia complex and contributes to the understanding of the pathophysiological mechanisms of this disorder.

  13. Imaging local brain function with emission computed tomography

    SciTech Connect

    Kuhl, D.E.

    1984-03-01

    Positron emission tomography (PET) using /sup 18/F-fluorodeoxyglucose (FDG) was used to map local cerebral glucose utilization in the study of local cerebral function. This information differs fundamentally from structural assessment by means of computed tomography (CT). In normal human volunteers, the FDG scan was used to determine the cerebral metabolic response to conrolled sensory stimulation and the effects of aging. Cerebral metabolic patterns are distinctive among depressed and demented elderly patients. The FDG scan appears normal in the depressed patient, studded with multiple metabolic defects in patients with multiple infarct dementia, and in the patients with Alzheimer disease, metabolism is particularly reduced in the parietal cortex, but only slightly reduced in the caudate and thalamus. The interictal FDG scan effectively detects hypometabolic brain zones that are sites of onset for seizures in patients with partial epilepsy, even though these zones usually appear normal on CT scans. The future prospects of PET are discussed.

  14. Optical coherence angiography

    PubMed Central

    Wylęgała, Adam; Teper, Sławomir; Dobrowolski, Dariusz; Wylęgała, Edward

    2016-01-01

    Abstract Background: Retinal vascular diseases are one of the most common causes of blindness in the developed world. Optical Coherence Tomography Angiography (OCT-A) is a new noninvasive method that uses several algorithms to detect blood movement. This enables the creation of high-resolution vascular images with contrast depicting motionless tissue. Methods: This review presents the results of articles relevant to age-related macular degeneration (AMD), diabetic retinopathy (DR), and OCT-A. The OCT-A technique can successfully be used in the diagnosis of neovascularization, retinal vein occlusion (RVO) and retinal artery occlusion (RAO), vessel abnormalities and even anterior segment neovascularization. OCT-A can also be applied to compute data such as vessel density, and flow index in both superficial and deep plexuses. Results: Many studies have compared fluorescein angiography with OCT-A. Other studies have reported differences in vascular density in AMD patients and have compared them with people having healthy eyes. Although OCT-A offers rapid picture acquisition, high repeatability and resolution, it also has many drawbacks. The most common are: motion artifacts, projections from overlying vessels and limited field of view. An interesting new application is the possibility to assess changes during antivascular endothelial growth factor (anti-VEGF) therapy. Another function of OCT-A is the possible application in the study of choriocapillaries in many fields of ocular pathology. Conclusion: OCT-A is a new promising method that allows the visualization of the retinal vascular network and the counting of blood flow parameters. This technique provides reliable images useful in clinical routines. PMID:27741104

  15. [The importance of computed tomography and magnetic resonance tomography in shockwave cholelithotripsy].

    PubMed

    Golder, W A; Tempel, U; Gmeinwieser, J

    1989-01-01

    With shockwave-lithotripsy a new method of therapy has been introduced, whose efficiency is essentially determined by that of the accompanying imaging diagnostics. This poses several new problems for the diagnostic radiologist. While sonography and conventional cholegraphy have an important place in connection with shockwave-lithotripsy, the role of computed tomography (CT) and magnetic resonance tomography (MRT) has not yet been established. According to our experiences and experimental data pre-interventional CT improves the accuracy for measurements of the calcium content of concrements and gives the best survey on the topography of the upper abdomen of patients with biliary concrements. MRT before lithotripsy does not yield important additional information. Applied after intervention it at least equals CT. Besides localization and description of the diseased gall-bladder the detection of complications with CT and MRT is one of the tasks of the radiologist in connection with shockwave-lithotripsy.

  16. Extramedullary Plasmacytoma of the Gallbladder Detected on Fluorine 18-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

    PubMed Central

    Fakhri, Asif Ali; Rodrigue, Paul David; Fakhri, Amena Fatima

    2016-01-01

    Extramedullary plasmacytoma is rare in patients with diagnosed multiple myeloma. Soft tissue plasmacytoma of the gallbladder is particularly uncommon and has been described in only a handful of cases. Diagnosis of gallbladder plasmacytoma with fluorine 18-fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (PET/CT) has not previously been reported. We present a 65-year-old female with a history of multiple myeloma who underwent a restaging F18-FDG-PET/CT which showed a focal area of hypermetabolic activity, corresponding to a nodular lesion within the posterior gallbladder wall. The patient underwent successful cholecystectomy, with surgical pathology revealing gallbladder plasmacytoma. A follow-up scan was negative for active malignancy. This is a novel case of gallbladder plasmacytoma diagnosed on whole-body F18-FDG PET/CT – thus demonstrating the clinical value of this imaging modality in staging, restaging, and surveillance for patients with multiple myeloma. PMID:27761300

  17. Unusual case of infantile fibrosarcoma evaluated on F-18 fluorodeoxyglucose positron emission tomography-computed tomography

    PubMed Central

    Bedmutha, Akshay; Singh, Natasha; Shivdasani, Divya; Gupta, Nitin

    2016-01-01

    Infantile fibrosarcoma (IFS) is a rare soft-tissue sarcoma originating from extremities and occasionally from axial soft tissue. The prognosis is good with favorable long-term survival. It is rarely metastasizing tumor, the chances being lesser with IFS originating from extremities. Use of neoadjuvant chemotherapy (NACT) as a treatment regime further reduces the chances of local relapse and distant metastasis. The organs commonly affected in metastatic IFS are lungs and lymph nodes. We report an unusual case of an IFS originating from extremity, which received NACT, yet presented with an early metastatic disease involving soft tissues and sparing lungs and lymph nodes, as demonstrated on fluorodeoxyglucose positron emission tomography-computed tomography. PMID:27385891

  18. A case of sarcoidosis diagnosed by positron emission tomography/computed tomography

    PubMed Central

    Aksoy, Sabire Yilmaz; Özdemir, Elif; Sentürk, Aysegül; Türkölmez, Seyda

    2016-01-01

    Sarcoidosis is a multisystem granulomatous disorder of unknown cause which may affect any organ or system but primarily involve the lungs and the lymphatic system. Extrapulmonary sarcoidosis represents approximately 30-50% of patients. We report the case of a 51-year-old female who presented with increasing complaints of a cough, weakness, weight loss, and chest pain and who was found to have a suspicious lesion on thorax computed tomography(CT). Fluorodeoxyglucose (FDG) positron emission tomography/CT performed for diagnostic purposes demonstrated increased FDG accumulation at the bilateral enlarged parotid and lacrimal gland and in the reticulonodular infiltration area located in the left lung as well as multiple lymphadenopathies with increased FDG accumulation. There were also hepatosplenomegaly and splenic uptake. Skin biopsy showed noncaseating granulomas, and the patient was diagnosed as stage 2 sarcoidosis. PMID:27385890

  19. Quantitative cone beam X-ray luminescence tomography/X-ray computed tomography imaging

    SciTech Connect

    Chen, Dongmei; Zhu, Shouping Chen, Xueli; Chao, Tiantian; Cao, Xu; Zhao, Fengjun; Huang, Liyu; Liang, Jimin

    2014-11-10

    X-ray luminescence tomography (XLT) is an imaging technology based on X-ray-excitable materials. The main purpose of this paper is to obtain quantitative luminescence concentration using the structural information of the X-ray computed tomography (XCT) in the hybrid cone beam XLT/XCT system. A multi-wavelength luminescence cone beam XLT method with the structural a priori information is presented to relieve the severe ill-posedness problem in the cone beam XLT. The nanophosphors and phantom experiments were undertaken to access the linear relationship of the system response. Then, an in vivo mouse experiment was conducted. The in vivo experimental results show that the recovered concentration error as low as 6.67% with the location error of 0.85 mm can be achieved. The results demonstrate that the proposed method can accurately recover the nanophosphor inclusion and realize the quantitative imaging.

  20. Combined positron emission tomography and computed tomography to visualize and quantify fluid flow in sedimentary rocks

    NASA Astrophysics Data System (ADS)

    Fernø, M. A.; Gauteplass, J.; Hauge, L. P.; Abell, G. E.; Adamsen, T. C. H.; Graue, A.

    2015-09-01

    Here we show for the first time the combined positron emission tomography (PET) and computed tomography (CT) imaging of flow processes within porous rocks to quantify the development in local fluid saturations. The coupling between local rock structure and displacement fronts is demonstrated in exploratory experiments using this novel approach. We also compare quantification of 3-D temporal and spatial water saturations in two similar CO2 storage tests in sandstone imaged separately with PET and CT. The applicability of each visualization technique is evaluated for a range of displacement processes, and the favorable implementation of combining PET/CT for laboratory core analysis is discussed. We learn that the signal-to-noise ratio (SNR) is over an order of magnitude higher for PET compared with CT for the studied processes.

  1. A case of sarcoidosis diagnosed by positron emission tomography/computed tomography.

    PubMed

    Aksoy, Sabire Yilmaz; Özdemir, Elif; Sentürk, Aysegül; Türkölmez, Seyda

    2016-01-01

    Sarcoidosis is a multisystem granulomatous disorder of unknown cause which may affect any organ or system but primarily involve the lungs and the lymphatic system. Extrapulmonary sarcoidosis represents approximately 30-50% of patients. We report the case of a 51-year-old female who presented with increasing complaints of a cough, weakness, weight loss, and chest pain and who was found to have a suspicious lesion on thorax computed tomography(CT). Fluorodeoxyglucose (FDG) positron emission tomography/CT performed for diagnostic purposes demonstrated increased FDG accumulation at the bilateral enlarged parotid and lacrimal gland and in the reticulonodular infiltration area located in the left lung as well as multiple lymphadenopathies with increased FDG accumulation. There were also hepatosplenomegaly and splenic uptake. Skin biopsy showed noncaseating granulomas, and the patient was diagnosed as stage 2 sarcoidosis. PMID:27385890

  2. Virtual intraluminal evaluation of aortico-left ventricular tunnel by multislice computed tomography.

    PubMed

    Hsu, Jong-Hau; Wu, Ding-Kwo; Chen, Ying-Fu; Dai, Zen-Kong; Lee, Meng-Hsun; Wu, Jiunn-Ren

    2007-03-20

    The aortico-left ventricular tunnel (ALVT) is a rare abnormal channel that arises from the right coronary sinus through the right ventricular outflow tract to enter the left ventricle below the aortic valve. The unique ability of multislice computed tomography (CT), as applied in the virtual coloscopy, has not been well established in patients with cardiovascular diseases. We herein investigate the virtual intraluminal image in a patient with an ALVT. An 18-year-old male was admitted with a 6-month-long history of progressive exertional dyspnea. He was diagnosed to suffer from ALVT at 5 months of age and received prosthetic patch closure of the aortic opening of the tunnel with mild residual aortic regurgitation. On admission this time, physical examination revealed a grade 3/6 diastolic murmur over the right upper sternal border. A 16-row multislice CT angiography demonstrated an ALVT. In the 3D reconstructed images, the orifice and intraluminal structure of ALVT were clearly visualized at different levels, similar to a real intracardiac endoscopic images. The patient was then referred for aortic valve replacement due to heart failure caused by severe degenerative aortic insufficiency. Our case displayed successfully not only the entire location of ALVT but also demonstrated the virtual intraluminal imaging mimicking endoscopy. This technique provides the virtual visualization of the entire inner image of AVLT, which may not be possible with other imaging modalities.

  3. Does preoperative computed tomography reduce the risks associated with re-do cardiac surgery?

    PubMed

    Khan, Nouman U; Yonan, Nizar

    2009-07-01

    A best evidence topic was written according to the structured protocol. The question addressed was whether preoperative computed tomography (CT) scan reduces the risk associated with re-do cardiac surgery. A Medline search revealed 412 papers, of which seven were deemed relevant to the topic. We conclude that preoperative CT angiography using ECG-gated multi-detector scan enables excellent anatomical details of heart, aorta and previous grafts, and highlights high-risk cases due to adherent grafts or ventricle or aortic atherosclerosis. This allows for better risk stratification and change of surgical strategy to reduce the potential risk in patients coming for re-do cardiac surgery. According to published reports, high-risk CT-scan findings in these patients caused clinicians to cancel surgery in up to 13% of cases, while preventive surgical strategies including non-midline approach, peripheral vascular exposure or establishing cardiopulmonary bypass prior to re-sternotomy have been reported in over two-thirds of patients with significant reduction in the operative risk. The risk of damage to vital structures, including previous grafts, heart or larger vessels is generally reported fewer than 10%, with evidence of significantly lower incidence of intra-operative injuries in patients who had prior CT-scans compared to those who did not. Hence, adequate preoperative imaging using ECG-gated multi-slice CT is essential for optimum planning of re-do cardiac surgery. PMID:19339275

  4. Selective doxorubicin drug eluting beads chemoembolization of hypovascular hepatocellular carcinoma using cone beam computed tomography.

    PubMed

    Kalra, Naveen; Mahajan, Divyesh; Chawla, Yogesh; Khandelwal, N

    2012-10-01

    Hepatocellular carcinoma (HCC) of the liver is the third most common cause of cancer-related deaths in the world. Only one-third of patients with HCC are suitable candidates for hepatic resection. Transarterial chemoembolization (TACE) is performed in unresectable HCC. Drug-eluting beads (DEB) TACE is a modification of TACE, in which doxorubicin beads are used as embolizing material. These beads deliver the drug and embolize the vessels; however, it carries the risk of non-target embolization and it is difficult in cases with absent arterial blush on digital subtraction angiography (DSA). This is resolved using C-arm cone-beam computed tomography in the DSA suite. It identifies the tumor-feeding vessels, their area of supply, and differentiates between tumor and normal liver parenchyma. In addition, it is very useful in the embolization of hypovascular HCC. It helps and guides the radiologist in performing TACE effectively and also prevents non-target embolization of normal liver parenchyma. PMID:23833414

  5. Image processing of liver computed tomography angiographic (CTA) images for laser induced thermotherapy (LITT) planning

    NASA Astrophysics Data System (ADS)

    Li, Yue; Gao, Xiang; Tang, Qingyu; Gao, Shangkai

    2012-02-01

    Analysis of patient images is highly desired for simulating and planning the laser-induced thermotherapy (LITT) to study the cooling effect of big vessels around tumors during the procedure. In this paper, we present an image processing solution for simulating and planning LITT on liver cancer using computed tomography angiography (CTA) images. This includes first performing a 3D anisotropic filtering on the data to remove noise. The liver region is then segmented with a level sets based contour tracking method. A 3D level sets based surface evolution driven by boundary statistics is then used to segment the surfaces of vessels and tumors. Then the medial lines of vessels were extracted by a thinning algorithm. Finally the vessel tree is found on the thinning result, by first constructing a shortest path spanning tree by Dijkstra algorithm and then pruning the unnecessary branches. From the segmentation and vessel skeletonization results, important geometric parameters of the vessels and tumors are calculated for simulation and surgery planning. The proposed methods was applied to a patient's image and the result is shown.

  6. Insights Into Microcirculation Underlying Critical Limb Ischemia by Single-Photon Emission Computed Tomography

    PubMed Central

    Liu, Jung-Tung; Chang, Cheng-Siu; Su, Chen-Hsing; Li, Cho-Shun

    2015-01-01

    Abstract Perfusion difference is used as a parameter to evaluate microcirculation. This study aims to differentiate lower-limb perfusion insufficiency from neuropathy to prevent possible occurrence of failed back surgery syndrome (FBSS). Patients were retrospectively gathered from 134 FBSS cases diagnosed in the past 7 years. Up to 82 cases that were excluded from neuralgia by radiologic imaging, electrodiagnostic electromyography, and nerve conduction velocity were enrolled in this study. Perfusion difference was evaluated by single-photon emission computed tomography, and pain intensities were recorded via visual analog scale (VAS) score. Lower perfusion at the left leg comprises 51.2% (42 of 82) of the patients. The mean perfusion difference of the 82 patients was 0.86 ± 0.05 (range: 0.75–0.93). Patients with systemic vascular diseases exhibited significantly higher perfusion difference than that of patients without these related diseases (P < 0.05), except for renal insufficiency (P = 0.134). Significant correlation was observed between perfusion difference and VAS score (r = −0.78; P < 0.0001; n = 82). In this study, we presented perfusion difference as a parameter for evaluating microcirculation, which cannot be detected by ultrasonography or angiography. PMID:26166084

  7. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease

    PubMed Central

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  8. Pulmonary blood volume imaging with dual-energy computed tomography: spectrum of findings.

    PubMed

    Hagspiel, K D; Flors, L; Housseini, A M; Phull, A; Ali Ahmad, E; Bozlar, U; Norton, P T; Bonatti, H J R

    2012-01-01

    Dual-energy (DE) pulmonary blood volume (PBV) computed tomography (CT) has recently become available on clinical CT systems. The underlying physical principle of DECT is the fact that the photoelectric effect is strongly dependent on the CT energies resulting in different degrees of x-ray attenuation for different materials at different energy levels. DECT thus enables the characterization and quantification of iodine within tissues via imaging at different x-ray energies and analysis of attenuation differences. Technical approaches to DECT include dual-source scanners acquiring two scans with different energy levels simultaneously, and single-source CT scanners using sandwich detectors or rapid voltage switching. DE PBV CT enables the creation of iodine maps of the pulmonary parenchyma. Experience to date shows that these studies can provide additional physiological information in patients with acute or chronic pulmonary embolism beyond the pure morphological assessment a standard CT pulmonary angiography (CTPA) provides. It appears also to be promising for the evaluation of patients with obstructive airways disease. This article reviews the physics and technical aspects of DE PBV CT as well as the appearance of normal and abnormal lung tissue on these studies. Special consideration is given to pitfalls and artefacts.

  9. Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease.

    PubMed

    Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Singh, Dalveer; Pratap, Jit; Watkins, Trevor William

    2016-01-01

    Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping. We discuss the physical principles of DECT and review the clinical applications of DECT for the evaluation of cerebrovascular diseases. PMID:27512615

  10. Image Registration of Cone-Beam Computer Tomography and Preprocedural Computer Tomography Aids in Localization of Adrenal Veins and Decreasing Radiation Dose in Adrenal Vein Sampling

    SciTech Connect

    Busser, Wendy M. H. Arntz, Mark J.; Jenniskens, Sjoerd F. M.; Deinum, Jaap; Hoogeveen, Yvonne L.; Lange, Frank de; Schultze Kool, Leo J.

    2015-08-15

    PurposeWe assessed whether image registration of cone-beam computed tomography (CT) (CBCT) and contrast-enhanced CT (CE-CT) images indicating the locations of the adrenal veins can aid in increasing the success rate of first-attempts adrenal vein sampling (AVS) and therefore decreasing patient radiation dose.Materials and Methods CBCT scans were acquired in the interventional suite (Philips Allura Xper FD20) and rigidly registered to the vertebra in previously acquired CE-CT. Adrenal vein locations were marked on the CT image and superimposed with live fluoroscopy and digital-subtraction angiography (DSA) to guide the AVS. Seventeen first attempts at AVS were performed with image registration and retrospectively compared with 15 first attempts without image registration performed earlier by the same 2 interventional radiologists. First-attempt AVS was considered successful when both adrenal vein samples showed representative cortisol levels. Sampling time, dose-area product (DAP), number of DSA runs, fluoroscopy time, and skin dose were recorded.ResultsWithout image registration, the first attempt at sampling was successful in 8 of 15 procedures indicating a success rate of 53.3 %. This increased to 76.5 % (13 of 17) by adding CBCT and CE-CT image registration to AVS procedures (p = 0.266). DAP values (p = 0.001) and DSA runs (p = 0.026) decreased significantly by adding image registration guidance. Sampling and fluoroscopy times and skin dose showed no significant changes.ConclusionGuidance based on registration of CBCT and previously acquired diagnostic CE-CT can aid in enhancing localization of the adrenal veins thereby increasing the success rate of first-attempt AVS with a significant decrease in the number of used DSA runs and, consequently, radiation dose required.

  11. The challenge of coronary calcium on coronary computed tomographic angiography (CCTA) scans: effect on interpretation and possible solutions.

    PubMed

    Andrew, Makmur; John, Hoe

    2015-12-01

    Coronary calcium seen on coronary computed tomographic angiography (CCTA) scans is a common diagnostic challenge which can make interpretation difficult. It is the most common cause of false positive (FP) results from CCTA compared with invasive coronary angiography (ICA), and affects the positive predictive results. At the same time, coronary calcium can result in false negative (FN) results, and this again can affect the reported diagnostic accuracy of CCTA, as the high negative predictive value of CCTA compared to ICA is one of its strengths. This paper reviews the reasons that coronary calcium can cause FP and FN results, and the effects of the morphologies and sizes of the calcified plaques, with particular regard to their relationship with the visualization of the contrast-filled lumen of the coronary artery. Some possible solutions to overcome the limitations of reading CCTA scans with calcified plaques also are discussed, with a view to improving the accuracy of interpreting and reporting CCTA scans; these solutions include using the degree of residual visible contrast-filled lumen to help assess the likelihood of significant associated coronary stenosis, and applying newer technical developments such as dual-energy imaging and volume calcium subtraction.

  12. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: The Role of Multislice Computed Tomography (MSCT)

    PubMed Central

    Al Umairi, Rashid Saif; Al Kindi, Faiza; Al Busaidi, Fadhila

    2016-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality also known as Bland-White-Garland syndrome. The incidence of ALCAPA is about 1 in every 300,000 live births, and constitutes 0.24% and 0.46% of all congenital cardiac disease. It has a high infant mortality rate reaching up to 90% if left untreated. For many years, the diagnosis of ALCAPA was by angiography or autopsy. However, multislice computed tomography (MSCT) is a non-invasive imaging tool that allows accurate, non-invasive diagnosis of ALCAPA. Here we report a case of ALCAPA in a six-month-old girl who presented with a two-week history of cough, fever, tachypnea, and sweating during feeding. During admission, an echocardiogram was performed that revealed ALCAPA, which was confirmed using CT. We discuss the role of MSCT in its diagnosis. PMID:27602196

  13. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: The Role of Multislice Computed Tomography (MSCT)

    PubMed Central

    Al Umairi, Rashid Saif; Al Kindi, Faiza; Al Busaidi, Fadhila

    2016-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality also known as Bland-White-Garland syndrome. The incidence of ALCAPA is about 1 in every 300,000 live births, and constitutes 0.24% and 0.46% of all congenital cardiac disease. It has a high infant mortality rate reaching up to 90% if left untreated. For many years, the diagnosis of ALCAPA was by angiography or autopsy. However, multislice computed tomography (MSCT) is a non-invasive imaging tool that allows accurate, non-invasive diagnosis of ALCAPA. Here we report a case of ALCAPA in a six-month-old girl who presented with a two-week history of cough, fever, tachypnea, and sweating during feeding. During admission, an echocardiogram was performed that revealed ALCAPA, which was confirmed using CT. We discuss the role of MSCT in its diagnosis.

  14. Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: The Role of Multislice Computed Tomography (MSCT).

    PubMed

    Al Umairi, Rashid Saif; Al Kindi, Faiza; Al Busaidi, Fadhila

    2016-09-01

    Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality also known as Bland-White-Garland syndrome. The incidence of ALCAPA is about 1 in every 300,000 live births, and constitutes 0.24% and 0.46% of all congenital cardiac disease. It has a high infant mortality rate reaching up to 90% if left untreated. For many years, the diagnosis of ALCAPA was by angiography or autopsy. However, multislice computed tomography (MSCT) is a non-invasive imaging tool that allows accurate, non-invasive diagnosis of ALCAPA. Here we report a case of ALCAPA in a six-month-old girl who presented with a two-week history of cough, fever, tachypnea, and sweating during feeding. During admission, an echocardiogram was performed that revealed ALCAPA, which was confirmed using CT. We discuss the role of MSCT in its diagnosis. PMID:27602196

  15. Practical considerations for optimizing cardiac computed tomography protocols for comprehensive acquisition prior to transcatheter aortic valve replacement.

    PubMed

    Khalique, Omar K; Pulerwitz, Todd C; Halliburton, Sandra S; Kodali, Susheel K; Hahn, Rebecca T; Nazif, Tamim M; Vahl, Torsten P; George, Isaac; Leon, Martin B; D'Souza, Belinda; Einstein, Andrew J

    2016-01-01

    Transcatheter aortic valve replacement (TAVR) is performed frequently in patients with severe, symptomatic aortic stenosis who are at high risk or inoperable for open surgical aortic valve replacement. Computed tomography angiography (CTA) has become the gold standard imaging modality for pre-TAVR cardiac anatomic and vascular access assessment. Traditionally, cardiac CTA has been most frequently used for assessment of coronary artery stenosis, and scanning protocols have generally been tailored for this purpose. Pre-TAVR CTA has different goals than coronary CTA and the high prevalence of chronic kidney disease in the TAVR patient population creates a particular need to optimize protocols for a reduction in iodinated contrast volume. This document reviews details which allow the physician to tailor CTA examinations to maximize image quality and minimize harm, while factoring in multiple patient and scanner variables which must be considered in customizing a pre-TAVR protocol.

  16. Clinical application of 320-row multidetector computed tomography for a dynamic three-dimensional vascular study: imaging findings and initial experience.

    PubMed

    Nagamatsu, Shogo; Nakagawa, Masahiro; Kayano, Shuji; Koizumi, Takuya; Akazawa, Satoshi; Onitsuka, Tetsuro; Iida, Yoshiyuki; Endo, Masahiro; Nakaya, Yoshihiro; Urikura, Atsushi

    2010-10-01

    The 320-row multidetector computed tomography (MDCT) is now used by both cardiologists and neurosurgeons. It enables dynamic 3D-CT angiography, because the wide-area detector eliminates helical scanning, thus achieving very fast scanning times for single 3D-CT volume data. Some microvascular surgeons are familiar with 64-row MDCT for perforator studies, but there are few reports of studies using 320-row MDCT. This MDCT system was used to follow the dynamic blood flow of small vessels. It is considered to have a great potential in the clinical field of microvascular surgery. PMID:20399163

  17. Multi-GPU Jacobian Accelerated Computing for Soft Field Tomography

    PubMed Central

    Borsic, A.; Attardo, E. A.; Halter, R. J.

    2012-01-01

    Image reconstruction in soft-field tomography is based on an inverse problem formulation, where a forward model is fitted to the data. In medical applications, where the anatomy presents complex shapes, it is common to use Finite Element Models to represent the volume of interest and to solve a partial differential equation that models the physics of the system. Over the last decade, there has been a shifting interest from 2D modeling to 3D modeling, as the underlying physics of most problems are three-dimensional. Though the increased computational power of modern computers allows working with much larger FEM models, the computational time required to reconstruct 3D images on a fine 3D FEM model can be significant, on the order of hours. For example, in Electrical Impedance Tomography applications using a dense 3D FEM mesh with half a million elements, a single reconstruction iteration takes approximately 15 to 20 minutes with optimized routines running on a modern multi-core PC. It is desirable to accelerate image reconstruction to enable researchers to more easily and rapidly explore data and reconstruction parameters. Further, providing high-speed reconstructions are essential for some promising clinical application of EIT. For 3D problems 70% of the computing time is spent building the Jacobian matrix, and 25% of the time in forward solving. In the present work, we focus on accelerating the Jacobian computation by using single and multiple GPUs. First, we discuss an optimized implementation on a modern multi-core PC architecture and show how computing time is bounded by the CPU-to-memory bandwidth; this factor limits the rate at which data can be fetched by the CPU. Gains associated with use of multiple CPU cores are minimal, since data operands cannot be fetched fast enough to saturate the processing power of even a single CPU core. GPUs have a much faster memory bandwidths compared to CPUs and better parallelism. We are able to obtain acceleration factors of

  18. Reconstruction of limited computed tomography data of fuel cell components using Direct Iterative Reconstruction of Computed Tomography Trajectories

    NASA Astrophysics Data System (ADS)

    Lange, Axel; Kupsch, Andreas; Hentschel, Manfred P.; Manke, Ingo; Kardjilov, Nikolay; Arlt, Tobias; Grothausmann, Roman

    CT (computed tomography) reconstructions of fuel cell components of a yet unrivaled spatial resolution and quality are presented. This is achieved by application of the novel DIRECTT (Direct Iterative Reconstruction of Computed Tomography Trajectories) algorithm. We focus on two different key issues which essentially rule the fuel cell's durability on different length scales and physical interactions. On the resolution scale of some 100 μm agglomerations of condensed water in flow-field channels are detected by means of quasi- in situ neutron CT (after operation). Five orders of magnitude below nanometer sized Ru catalyst particles on carbon black support are visualized by electron tomography. Both types of experiments are especially adapted to the type of material involved but they are accompanied by severe deviations from ideal CT measuring conditions, as well. In order to overcome the tremendous reconstruction artifacts of standard algorithms, we employ DIRECTT which is described in detail. Comparisons of DIRECTT reconstructions to the conventional filtered back projection, prove the significant improvements in both experimental methods.

  19. Detection of lung cancer in patients with pneumoconiosis by fluorodeoxyglucose-positron emission tomography/computed tomography: four cases.

    PubMed

    Yu, Hua; Zhang, Hua; Wang, Yanli; Cui, Xinjian; Han, Jiankui

    2013-01-01

    We report 4 cases of lung cancer in patients with pneumoconiosis detected by F18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), which could differentiate lung cancer and pneumoconiosis. FDG-PET/CT may be useful in cancer screening for patients with pneumoconiosis.

  20. The influence of novel CT reconstruction technique and ECG-gated technique on image quality and patient dose of cardiac computed tomography.

    PubMed

    Dyakov, I; Stoinova, V; Groudeva, V; Vassileva, J

    2015-07-01

    The aim of the present study was to compare image quality and patient dose in cardiac computed tomography angiography (CTA) in terms of volume computed tomography dose index (CTDI vol), dose length product (DLP) and effective dose, when changing from filtered back projection (FBP) to adaptive iterative dose reduction (AIDR) reconstruction techniques. Further aim was to implement prospective electrocardiogram (ECG) gating for patient dose reduction. The study was performed with Aquilion ONE 320-row CT of Toshiba Medical Systems. Analysis of cardiac CT protocols was performed before and after integration of the new software. The AIDR technique showed more than 50 % reduction in CTDIvol values and 57 % in effective dose. The subjective evaluation of clinical images confirmed the adequate image quality acquired by the AIDR technique. The preliminary results indicated significant dose reduction when using prospective ECG gating by keeping the adequate diagnostic quality of clinical images. PMID:25836680