Optimization-based image reconstruction with artifact reduction in C-arm CBCT

NASA Astrophysics Data System (ADS)

Xia, Dan; Langan, David A.; Solomon, Stephen B.; Zhang, Zheng; Chen, Buxin; Lai, Hao; Sidky, Emil Y.; Pan, Xiaochuan

2016-10-01

We investigate an optimization-based reconstruction, with an emphasis on image-artifact reduction, from data collected in C-arm cone-beam computed tomography (CBCT) employed in image-guided interventional procedures. In the study, an image to be reconstructed is formulated as a solution to a convex optimization program in which a weighted data divergence is minimized subject to a constraint on the image total variation (TV); a data-derivative fidelity is introduced in the program specifically for effectively suppressing dominant, low-frequency data artifact caused by, e.g. data truncation; and the Chambolle-Pock (CP) algorithm is tailored to reconstruct an image through solving the program. Like any other reconstructions, the optimization-based reconstruction considered depends upon numerous parameters. We elucidate the parameters, illustrate their determination, and demonstrate their impact on the reconstruction. The optimization-based reconstruction, when applied to data collected from swine and patient subjects, yields images with visibly reduced artifacts in contrast to the reference reconstruction, and it also appears to exhibit a high degree of robustness against distinctively different anatomies of imaged subjects and scanning conditions of clinical significance. Knowledge and insights gained in the study may be exploited for aiding in the design of practical reconstructions of truly clinical-application utility.

Optimization and Clinical Feasibility of Free-breathing Diffusion-weighted Imaging of the Liver: Comparison with Respiratory-Triggered Diffusion-weighted Imaging.

PubMed

Takayama, Yukihisa; Nishie, Akihiro; Asayama, Yoshiki; Ishigami, Kousei; Kakihara, Daisuke; Ushijima, Yasuhiro; Fujita, Nobuhiro; Yoshiura, Takashi; Takemura, Atsushi; Obara, Makoto; Takahara, Taro; Honda, Hiroshi

2015-01-01

We compared the image quality of free-breathing diffusion-weighted imaging (FB-DWI) to that of respiratory-triggered DWI (RT-DWI) after proper optimization. Three healthy subjects were scanned to optimize magnetic resonance (MR) parameters of FB-DWI to improve image quality, including spatial resolution, image noise, and chemical shift artifacts. After this optimization, we scanned 32 patients with liver disease to assess the clinical feasibility of the optimized FB-DWI. Of the 32 patients, 14 had a total of 28 hepatocellular carcinomas (HCCs), four had a total of 15 metastatic liver tumors, and the other 14 had no tumor. Qualitatively, we compared the image quality scores of FB-DWI with those of RT-DWI with the Wilcoxon signed-rank test. Quantitatively, we compared the signal-to-noise ratios (SNRs) of the liver parenchyma, lesion-to-nonlesion contrast-to-noise ratios (CNRs) and apparent diffusion coefficient (ADC) values of the liver parenchyma and liver tumor by the paired t-test. The average scores of image quality for sharpness of liver contour, image noise, and chemical shift artifacts were significantly higher for FB-DWI than RT-DWI (P < 0.05). SNRs, CNRs, and ADC values of the liver parenchyma and tumors did not differ significantly between the 2 DWI methods. Compared with RT-DWI, the optimized FB-DWI provided better spatial resolution, fewer artifacts, and comparable SNRs, lesion-to-nonlesion CNRs, and ADC values.

CR softcopy display presets based on optimum visualization of specific findings

NASA Astrophysics Data System (ADS)

Andriole, Katherine P.; Gould, Robert G.; Webb, W. R.

1999-07-01

The purpose of this research is to assess the utility of providing presets for computed radiography (CR) softcopy display, based not on the window/level settings, but on image processing applied to the image based on optimization for visualization of specific findings, pathologies, etc. Clinical chest images are acquired using an Agfa ADC 70 CR scanner, and transferred over the PACS network to an image processing station which has the capability to perform multiscale contrast equalization. The optimal image processing settings per finding are developed in conjunction with a thoracic radiologist by manipulating the multiscale image contrast amplification algorithm parameters. Softcopy display of images processed with finding-specific settings are compared with the standard default image presentation for fifty cases of each category. Comparison is scored using a five point scale with positive one and two denoting the standard presentation is preferred over the finding-specific presets, negative one and two denoting the finding-specific preset is preferred over the standard presentation, and zero denoting no difference. Presets have been developed for pneumothorax and clinical cases are currently being collected in preparation for formal clinical trials. Subjective assessments indicate a preference for the optimized-preset presentation of images over the standard default, particularly by inexperienced radiology residents and referring clinicians.

Thermography based prescreening software tool for veterinary clinics

NASA Astrophysics Data System (ADS)

Dahal, Rohini; Umbaugh, Scott E.; Mishra, Deependra; Lama, Norsang; Alvandipour, Mehrdad; Umbaugh, David; Marino, Dominic J.; Sackman, Joseph

2017-05-01

Under development is a clinical software tool which can be used in the veterinary clinics as a prescreening tool for these pathologies: anterior cruciate ligament (ACL) disease, bone cancer and feline hyperthyroidism. Currently, veterinary clinical practice uses several imaging techniques including radiology, computed tomography (CT), and magnetic resonance imaging (MRI). But, harmful radiation involved during imaging, expensive equipment setup, excessive time consumption and the need for a cooperative patient during imaging, are major drawbacks of these techniques. In veterinary procedures, it is very difficult for animals to remain still for the time periods necessary for standard imaging without resorting to sedation - which creates another set of complexities. Therefore, clinical application software integrated with a thermal imaging system and the algorithms with high sensitivity and specificity for these pathologies, can address the major drawbacks of the existing imaging techniques. A graphical user interface (GUI) has been created to allow ease of use for the clinical technician. The technician inputs an image, enters patient information, and selects the camera view associated with the image and the pathology to be diagnosed. The software will classify the image using an optimized classification algorithm that has been developed through thousands of experiments. Optimal image features are extracted and the feature vector is then used in conjunction with the stored image database for classification. Classification success rates as high as 88% for bone cancer, 75% for ACL and 90% for feline hyperthyroidism have been achieved. The software is currently undergoing preliminary clinical testing.

[Imaging center - optimization of the imaging process].

PubMed

Busch, H-P

2013-04-01

Hospitals around the world are under increasing pressure to optimize the economic efficiency of treatment processes. Imaging is responsible for a great part of the success but also of the costs of treatment. In routine work an excessive supply of imaging methods leads to an "as well as" strategy up to the limit of the capacity without critical reflection. Exams that have no predictable influence on the clinical outcome are an unjustified burden for the patient. They are useless and threaten the financial situation and existence of the hospital. In recent years the focus of process optimization was exclusively on the quality and efficiency of performed single examinations. In the future critical discussion of the effectiveness of single exams in relation to the clinical outcome will be more important. Unnecessary exams can be avoided, only if in addition to the optimization of single exams (efficiency) there is an optimization strategy for the total imaging process (efficiency and effectiveness). This requires a new definition of processes (Imaging Pathway), new structures for organization (Imaging Center) and a new kind of thinking on the part of the medical staff. Motivation has to be changed from gratification of performed exams to gratification of process quality (medical quality, service quality, economics), including the avoidance of additional (unnecessary) exams. © Georg Thieme Verlag KG Stuttgart · New York.

Comprehensive optimization process of paranasal sinus radiography.

PubMed

Saarakkala, S; Nironen, K; Hermunen, H; Aarnio, J; Heikkinen, J O

2009-04-01

The optimization of radiological examinations is important in order to reduce unnecessary patient radiation exposure. To perform a comprehensive optimization process for paranasal sinus radiography at Mikkeli Central Hospital, Finland. Patients with suspicion of acute sinusitis were imaged with a Kodak computed radiography (CR) system (n=20) and with a Philips digital radiography (DR) system (n=30) using focus-detector distances (FDDs) of 110 cm, 150 cm, or 200 cm. Patients' radiation exposure was determined in terms of entrance surface dose and dose-area product. Furthermore, an anatomical phantom was used for the estimation of point doses inside the head. Clinical image quality was evaluated by an experienced radiologist, and physical image quality was evaluated from the digital radiography phantom. Patient doses were significantly lower and image quality better with the DR system compared to the CR system. The differences in patient dose and physical image quality were small with varying FDD. Clinical image quality of the DR system was lowest with FDD of 200 cm. Further, imaging with FDD of 150 cm was technically easier for the technologist to perform than with FDD of 110 cm. After optimization, it was recommended that the DR system with FDD of 150 cm should always be used at Mikkeli Central Hospital. We recommend this kind of comprehensive approach in all optimization processes of radiological examinations.

Image quality comparison between single energy and dual energy CT protocols for hepatic imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yao, Yuan, E-mail: yuanyao@stanford.edu; Pelc, Nor

Purpose: Multi-detector computed tomography (MDCT) enables volumetric scans in a single breath hold and is clinically useful for hepatic imaging. For simple tasks, conventional single energy (SE) computed tomography (CT) images acquired at the optimal tube potential are known to have better quality than dual energy (DE) blended images. However, liver imaging is complex and often requires imaging of both structures containing iodinated contrast media, where atomic number differences are the primary contrast mechanism, and other structures, where density differences are the primary contrast mechanism. Hence it is conceivable that the broad spectrum used in a dual energy acquisition maymore » be an advantage. In this work we are interested in comparing these two imaging strategies at equal-dose and more complex settings. Methods: We developed numerical anthropomorphic phantoms to mimic realistic clinical CT scans for medium size and large size patients. MDCT images based on the defined phantoms were simulated using various SE and DE protocols at pre- and post-contrast stages. For SE CT, images from 60 kVp through 140 with 10 kVp steps were considered; for DE CT, both 80/140 and 100/140 kVp scans were simulated and linearly blended at the optimal weights. To make a fair comparison, the mAs of each scan was adjusted to match the reference radiation dose (120 kVp, 200 mAs for medium size patients and 140 kVp, 400 mAs for large size patients). Contrast-to-noise ratio (CNR) of liver against other soft tissues was used to evaluate and compare the SE and DE protocols, and multiple pre- and post-contrasted liver-tissue pairs were used to define a composite CNR. To help validate the simulation results, we conducted a small clinical study. Eighty-five 120 kVp images and 81 blended 80/140 kVp images were collected and compared through both quantitative image quality analysis and an observer study. Results: In the simulation study, we found that the CNR of pre-contrast SE image mostly increased with increasing kVp while for post-contrast imaging 90 kVp or lower yielded higher CNR images, depending on the differential iodine concentration of each tissue. Similar trends were seen in DE blended CNR and those from SE protocols. In the presence of differential iodine concentration (i.e., post-contrast), the CNR curves maximize at lower kVps (80–120), with the peak shifted rightward for larger patients. The combined pre- and post-contrast composite CNR study demonstrated that an optimal SE protocol has better performance than blended DE images, and the optimal tube potential for SE scan is around 90 kVp for a medium size patients and between 90 and 120 kVp for large size patients (although low kVp imaging requires high x-ray tube power to avoid photon starvation). Also, a tin filter added to the high kVp beam is not only beneficial for material decomposition but it improves the CNR of the DE blended images as well. The dose adjusted CNR of the clinical images also showed the same trend and radiologists favored the SE scans over blended DE images. Conclusions: Our simulation showed that an optimized SE protocol produces up to 5% higher CNR for a range of clinical tasks. The clinical study also suggested 120 kVp SE scans have better image quality than blended DE images. Hence, blended DE images do not have a fundamental CNR advantage over optimized SE images.« less

Wavelength optimization for in vivo multispectral photoacoustic/ultrasound tomography of hemoglobin oxygenation in ovarian cancer: clinical studies

NASA Astrophysics Data System (ADS)

Salehi, Hassan S.; Li, Hai; Kumavor, Patrick D.; Merkulov, Aleksey; Sanders, Melinda; Brewer, Molly; Zhu, Quing

2015-03-01

In this paper, wavelength selection for multispectral photoacoustic/ultrasound tomography was optimized to obtain accurate images of hemoglobin oxygen saturation (sO2) in vivo. Although wavelengths can be selected by theoretical methods, in practice the accuracy of reconstructed images will be affected by wavelength-specific and system-specific factors such as laser source power and ultrasound transducer sensitivity. By performing photoacoustic spectroscopy of mouse tumor models using 14 different wavelengths between 710 and 840 nm, we were able to identify a wavelength set which most accurately reproduced the results obtained using all 14 wavelengths via selection criteria. In clinical studies, the optimal wavelength set was successfully used to image human ovaries in vivo and noninvasively. Although these results are specific to our co-registered photoacoustic/ultrasound imaging system, the approach we developed can be applied to other functional photoacoustic and optical imaging systems.

Enterprise Imaging Governance: HIMSS-SIIM Collaborative White Paper.

PubMed

Roth, Christopher J; Lannum, Louis M; Joseph, Carol L

2016-10-01

Enterprise imaging governance is an emerging need in health enterprises today. This white paper highlights the decision-making body, framework, and process for optimal enterprise imaging governance inclusive of five areas of focus: program governance, technology governance, information governance, clinical governance, and financial governance. It outlines relevant parallels and differences when forming or optimizing imaging governance as compared with other established broad horizontal governance groups, such as for the electronic health record. It is intended for CMIOs and health informatics leaders looking to grow and govern a program to optimally capture, store, index, distribute, view, exchange, and analyze the images of their enterprise.

Finding-specific display presets for computed radiography soft-copy reading.

PubMed

Andriole, K P; Gould, R G; Webb, W R

1999-05-01

Much work has been done to optimize the display of cross-sectional modality imaging examinations for soft-copy reading (i.e., window/level tissue presets, and format presentations such as tile and stack modes, four-on-one, nine-on-one, etc). Less attention has been paid to the display of digital forms of the conventional projection x-ray. The purpose of this study is to assess the utility of providing presets for computed radiography (CR) soft-copy display, based not on the window/level settings, but on processing applied to the image optimized for visualization of specific findings, pathologies, etc (i.e., pneumothorax, tumor, tube location). It is felt that digital display of CR images based on finding-specific processing presets has the potential to: speed reading of digital projection x-ray examinations on soft copy; improve diagnostic efficacy; standardize display across examination type, clinical scenario, important key findings, and significant negatives; facilitate image comparison; and improve confidence in and acceptance of soft-copy reading. Clinical chest images are acquired using an Agfa-Gevaert (Mortsel, Belgium) ADC 70 CR scanner and Fuji (Stamford, CT) 9000 and AC2 CR scanners. Those demonstrating pertinent findings are transferred over the clinical picture archiving and communications system (PACS) network to a research image processing station (Agfa PS5000), where the optimal image-processing settings per finding, pathologic category, etc, are developed in conjunction with a thoracic radiologist, by manipulating the multiscale image contrast amplification (Agfa MUSICA) algorithm parameters. Soft-copy display of images processed with finding-specific settings are compared with the standard default image presentation for 50 cases of each category. Comparison is scored using a 5-point scale with the positive scale denoting the standard presentation is preferred over the finding-specific processing, the negative scale denoting the finding-specific processing is preferred over the standard presentation, and zero denoting no difference. Processing settings have been developed for several findings including pneumothorax and lung nodules, and clinical cases are currently being collected in preparation for formal clinical trials. Preliminary results indicate a preference for the optimized-processing presentation of images over the standard default, particularly by inexperienced radiology residents and referring clinicians.

An investigation of automatic exposure control calibration for chest imaging with a computed radiography system.

PubMed

Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Beavis, A W; Saunderson, J R

2014-05-07

The purpose of this study was to examine the use of three physical image quality metrics in the calibration of an automatic exposure control (AEC) device for chest radiography with a computed radiography (CR) imaging system. The metrics assessed were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm), all measured using a uniform chest phantom. Subsequent calibration curves were derived to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated chest images with correct detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated chest images contained clinically realistic projected anatomy and anatomical noise and were scored by experienced image evaluators. Constant DDI and CNR curves do not appear to provide optimized performance across the diagnostic energy range. Conversely, constant eNEQm and SNR do appear to provide optimized performance, with the latter being the preferred calibration metric given as it is easier to measure in practice. Medical physicists may use the SNR image quality metric described here when setting up and optimizing AEC devices for chest radiography CR systems with a degree of confidence that resulting clinical image quality will be adequate for the required clinical task. However, this must be done with close cooperation of expert image evaluators, to ensure appropriate levels of detector air kerma.

An investigation of automatic exposure control calibration for chest imaging with a computed radiography system

NASA Astrophysics Data System (ADS)

Moore, C. S.; Wood, T. J.; Avery, G.; Balcam, S.; Needler, L.; Beavis, A. W.; Saunderson, J. R.

2014-05-01

The purpose of this study was to examine the use of three physical image quality metrics in the calibration of an automatic exposure control (AEC) device for chest radiography with a computed radiography (CR) imaging system. The metrics assessed were signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm), all measured using a uniform chest phantom. Subsequent calibration curves were derived to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated chest images with correct detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated chest images contained clinically realistic projected anatomy and anatomical noise and were scored by experienced image evaluators. Constant DDI and CNR curves do not appear to provide optimized performance across the diagnostic energy range. Conversely, constant eNEQm and SNR do appear to provide optimized performance, with the latter being the preferred calibration metric given as it is easier to measure in practice. Medical physicists may use the SNR image quality metric described here when setting up and optimizing AEC devices for chest radiography CR systems with a degree of confidence that resulting clinical image quality will be adequate for the required clinical task. However, this must be done with close cooperation of expert image evaluators, to ensure appropriate levels of detector air kerma.

Automatic optimization high-speed high-resolution OCT retinal imaging at 1μm

NASA Astrophysics Data System (ADS)

Cua, Michelle; Liu, Xiyun; Miao, Dongkai; Lee, Sujin; Lee, Sieun; Bonora, Stefano; Zawadzki, Robert J.; Mackenzie, Paul J.; Jian, Yifan; Sarunic, Marinko V.

2015-03-01

High-resolution OCT retinal imaging is important in providing visualization of various retinal structures to aid researchers in better understanding the pathogenesis of vision-robbing diseases. However, conventional optical coherence tomography (OCT) systems have a trade-off between lateral resolution and depth-of-focus. In this report, we present the development of a focus-stacking optical coherence tomography (OCT) system with automatic optimization for high-resolution, extended-focal-range clinical retinal imaging. A variable-focus liquid lens was added to correct for de-focus in real-time. A GPU-accelerated segmentation and optimization was used to provide real-time layer-specific enface visualization as well as depth-specific focus adjustment. After optimization, multiple volumes focused at different depths were acquired, registered, and stitched together to yield a single, high-resolution focus-stacked dataset. Using this system, we show high-resolution images of the ONH, from which we extracted clinically-relevant parameters such as the nerve fiber layer thickness and lamina cribrosa microarchitecture.

Automatic x-ray image contrast enhancement based on parameter auto-optimization.

PubMed

Qiu, Jianfeng; Harold Li, H; Zhang, Tiezhi; Ma, Fangfang; Yang, Deshan

2017-11-01

Insufficient image contrast associated with radiation therapy daily setup x-ray images could negatively affect accurate patient treatment setup. We developed a method to perform automatic and user-independent contrast enhancement on 2D kilo voltage (kV) and megavoltage (MV) x-ray images. The goal was to provide tissue contrast optimized for each treatment site in order to support accurate patient daily treatment setup and the subsequent offline review. The proposed method processes the 2D x-ray images with an optimized image processing filter chain, which consists of a noise reduction filter and a high-pass filter followed by a contrast limited adaptive histogram equalization (CLAHE) filter. The most important innovation is to optimize the image processing parameters automatically to determine the required image contrast settings per disease site and imaging modality. Three major parameters controlling the image processing chain, i.e., the Gaussian smoothing weighting factor for the high-pass filter, the block size, and the clip limiting parameter for the CLAHE filter, were determined automatically using an interior-point constrained optimization algorithm. Fifty-two kV and MV x-ray images were included in this study. The results were manually evaluated and ranked with scores from 1 (worst, unacceptable) to 5 (significantly better than adequate and visually praise worthy) by physicians and physicists. The average scores for the images processed by the proposed method, the CLAHE, and the best window-level adjustment were 3.92, 2.83, and 2.27, respectively. The percentage of the processed images received a score of 5 were 48, 29, and 18%, respectively. The proposed method is able to outperform the standard image contrast adjustment procedures that are currently used in the commercial clinical systems. When the proposed method is implemented in the clinical systems as an automatic image processing filter, it could be useful for allowing quicker and potentially more accurate treatment setup and facilitating the subsequent offline review and verification. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Use of a channelized Hotelling observer to assess CT image quality and optimize dose reduction for iteratively reconstructed images.

PubMed

Favazza, Christopher P; Ferrero, Andrea; Yu, Lifeng; Leng, Shuai; McMillan, Kyle L; McCollough, Cynthia H

2017-07-01

The use of iterative reconstruction (IR) algorithms in CT generally decreases image noise and enables dose reduction. However, the amount of dose reduction possible using IR without sacrificing diagnostic performance is difficult to assess with conventional image quality metrics. Through this investigation, achievable dose reduction using a commercially available IR algorithm without loss of low contrast spatial resolution was determined with a channelized Hotelling observer (CHO) model and used to optimize a clinical abdomen/pelvis exam protocol. A phantom containing 21 low contrast disks-three different contrast levels and seven different diameters-was imaged at different dose levels. Images were created with filtered backprojection (FBP) and IR. The CHO was tasked with detecting the low contrast disks. CHO performance indicated dose could be reduced by 22% to 25% without compromising low contrast detectability (as compared to full-dose FBP images) whereas 50% or more dose reduction significantly reduced detection performance. Importantly, default settings for the scanner and protocol investigated reduced dose by upward of 75%. Subsequently, CHO-based protocol changes to the default protocol yielded images of higher quality and doses more consistent with values from a larger, dose-optimized scanner fleet. CHO assessment provided objective data to successfully optimize a clinical CT acquisition protocol.

Optimization of a protocol for myocardial perfusion scintigraphy by using an anthropomorphic phantom.

PubMed

Ramos, Susie Medeiros Oliveira; Glavam, Adriana Pereira; Kubo, Tadeu Takao Almodovar; de Sá, Lidia Vasconcellos

2014-01-01

To develop a study aiming at optimizing myocardial perfusion imaging. Imaging of an anthropomorphic thorax phantom with a GE SPECT Ventri gamma camera, with varied activities and acquisition times, in order to evaluate the influence of these parameters on the quality of the reconstructed medical images. The (99m)Tc-sestamibi radiotracer was utilized, and then the images were clinically evaluated on the basis of data such as summed stress score, and on the technical image quality and perfusion. The software ImageJ was utilized in the data quantification. The results demonstrated that for the standard acquisition time utilized in the procedure (15 seconds per angle), the injected activity could be reduced by 33.34%. Additionally, even if the standard scan time is reduced by 53.34% (7 seconds per angle), the standard injected activity could still be reduced by 16.67%, without impairing the image quality and the diagnostic reliability. The described method and respective results provide a basis for the development of a clinical trial of patients in an optimized protocol.

Optimization of a protocol for myocardial perfusion scintigraphy by using an anthropomorphic phantom*

PubMed Central

Ramos, Susie Medeiros Oliveira; Glavam, Adriana Pereira; Kubo, Tadeu Takao Almodovar; de Sá, Lidia Vasconcellos

2014-01-01

Objective To develop a study aiming at optimizing myocardial perfusion imaging. Materials and Methods Imaging of an anthropomorphic thorax phantom with a GE SPECT Ventri gamma camera, with varied activities and acquisition times, in order to evaluate the influence of these parameters on the quality of the reconstructed medical images. The 99mTc-sestamibi radiotracer was utilized, and then the images were clinically evaluated on the basis of data such as summed stress score, and on the technical image quality and perfusion. The software ImageJ was utilized in the data quantification. Results The results demonstrated that for the standard acquisition time utilized in the procedure (15 seconds per angle), the injected activity could be reduced by 33.34%. Additionally, even if the standard scan time is reduced by 53.34% (7 seconds per angle), the standard injected activity could still be reduced by 16.67%, without impairing the image quality and the diagnostic reliability. Conclusion The described method and respective results provide a basis for the development of a clinical trial of patients in an optimized protocol. PMID:25741088

Algorithm-enabled exploration of image-quality potential of cone-beam CT in image-guided radiation therapy

NASA Astrophysics Data System (ADS)

Han, Xiao; Pearson, Erik; Pelizzari, Charles; Al-Hallaq, Hania; Sidky, Emil Y.; Bian, Junguo; Pan, Xiaochuan

2015-06-01

Kilo-voltage (KV) cone-beam computed tomography (CBCT) unit mounted onto a linear accelerator treatment system, often referred to as on-board imager (OBI), plays an increasingly important role in image-guided radiation therapy. While the FDK algorithm is currently used for reconstructing images from clinical OBI data, optimization-based reconstruction has also been investigated for OBI CBCT. An optimization-based reconstruction involves numerous parameters, which can significantly impact reconstruction properties (or utility). The success of an optimization-based reconstruction for a particular class of practical applications thus relies strongly on appropriate selection of parameter values. In the work, we focus on tailoring the constrained-TV-minimization-based reconstruction, an optimization-based reconstruction previously shown of some potential for CBCT imaging conditions of practical interest, to OBI imaging through appropriate selection of parameter values. In particular, for given real data of phantoms and patient collected with OBI CBCT, we first devise utility metrics specific to OBI-quality-assurance tasks and then apply them to guiding the selection of parameter values in constrained-TV-minimization-based reconstruction. The study results show that the reconstructions are with improvement, relative to clinical FDK reconstruction, in both visualization and quantitative assessments in terms of the devised utility metrics.

FluoSTIC: miniaturized fluorescence image-guided surgery system

NASA Astrophysics Data System (ADS)

Gioux, Sylvain; Coutard, Jean-Guillaume; Berger, Michel; Grateau, Henri; Josserand, Véronique; Keramidas, Michelle; Righini, Christian; Coll, Jean-Luc; Dinten, Jean-Marc

2012-10-01

Over the last few years, near-infrared (NIR) fluorescence imaging has witnessed rapid growth and is already used in clinical trials for various procedures. However, most clinically compatible imaging systems are optimized for large, open-surgery procedures. Such systems cannot be employed during head and neck oncologic surgeries because the system is not able to image inside deep cavities or allow the surgeon access to certain tumors due to the large footprint of the system. We describe a miniaturized, low-cost, NIR fluorescence system optimized for clinical use during oral oncologic surgeries. The system, termed FluoSTIC, employs a miniature, high-quality, consumer-grade lipstick camera for collecting fluorescence light and a novel custom circular optical fiber array for illumination that combines both white light and NIR excitation. FluoSTIC maintains fluorescence imaging quality similar to that of current large-size imaging systems and is 22 mm in diameter and 200 mm in height and weighs less than 200 g.

Optimized imaging of the midface and orbits

PubMed Central

Langner, Sönke

2015-01-01

A variety of imaging techniques are available for imaging the midface and orbits. This review article describes the different imaging techniques based on the recent literature and discusses their impact on clinical routine imaging. Imaging protocols are presented for different diseases and the different imaging modalities. PMID:26770279

The Current State and Path Forward For Enterprise Image Viewing: HIMSS-SIIM Collaborative White Paper.

PubMed

Roth, Christopher J; Lannum, Louis M; Dennison, Donald K; Towbin, Alexander J

2016-10-01

Clinical specialties have widely varied needs for diagnostic image interpretation, and clinical image and video image consumption. Enterprise viewers are being deployed as part of electronic health record implementations to present the broad spectrum of clinical imaging and multimedia content created in routine medical practice today. This white paper will describe the enterprise viewer use cases, drivers of recent growth, technical considerations, functionality differences between enterprise and specialty viewers, and likely future states. This white paper is aimed at CMIOs and CIOs interested in optimizing the image-enablement of their electronic health record or those who may be struggling with the many clinical image viewers their enterprises may employ today.

Combining transrectal ultrasound and CT for image-guided adaptive brachytherapy of cervical cancer: Proof of concept.

PubMed

Nesvacil, Nicole; Schmid, Maximilian P; Pötter, Richard; Kronreif, Gernot; Kirisits, Christian

To investigate the feasibility of a treatment planning workflow for three-dimensional image-guided cervix cancer brachytherapy, combining volumetric transrectal ultrasound (TRUS) for target definition with CT for dose optimization to organs at risk (OARs), for settings with no access to MRI. A workflow for TRUS/CT-based volumetric treatment planning was developed, based on a customized system including ultrasound probe, stepper unit, and software for image volume acquisition. A full TRUS/CT-based workflow was simulated in a clinical case and compared with MR- or CT-only delineation. High-risk clinical target volume was delineated on TRUS, and OARs were delineated on CT. Manually defined tandem/ring applicator positions on TRUS and CT were used as a reference for rigid registration of the image volumes. Treatment plan optimization for TRUS target and CT organ volumes was performed and compared to MRI and CT target contours. TRUS/CT-based contouring, applicator reconstruction, image fusion, and treatment planning were feasible, and the full workflow could be successfully demonstrated. The TRUS/CT plan fulfilled all clinical planning aims. Dose-volume histogram evaluation of the TRUS/CT-optimized plan (high-risk clinical target volume D 90 , OARs D 2cm³ for) on different image modalities showed good agreement between dose values reported for TRUS/CT and MRI-only reference contours and large deviations for CT-only target parameters. A TRUS/CT-based workflow for full three-dimensional image-guided cervix brachytherapy treatment planning seems feasible and may be clinically comparable to MRI-based treatment planning. Further development to solve challenges with applicator definition in the TRUS volume is required before systematic applicability of this workflow. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Basic Principles of Magnetic Resonance Imaging—An Update

PubMed Central

Scherzinger, Ann L.; Hendee, William R.

1985-01-01

Magnetic resonance (MR) imaging technology has undergone many technologic advances over the past few years. Many of these advances were stimulated by the wealth of information emerging from nuclear magnetic resonance research in the areas of new and optimal scanning methods and radio-frequency coil design. Other changes arose from the desire to improve image quality, ease siting restrictions and generally facilitate the clinical use of MR equipment. Many questions, however, remain unanswered. Perhaps the most controversial technologic question involves the optimal field strength required for imaging or spectroscopic applications or both. Other issues include safety and clinical efficacy. Technologic issues affect all aspects of MR use including the choice of equipment, examination procedure and image interpretation. Thus, an understanding of recent changes and their theoretic basis is necessary. ImagesFigure 9. PMID:3911591

Role of Positron Emission Tomography in the Treatment of Occult Disease in Head-and-Neck Cancer: A Modeling Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phillips, Mark H., E-mail: markp@u.washington.ed; Smith, Wade P.; Parvathaneni, Upendra

2011-03-15

Purpose: To determine under what conditions positron emission tomography (PET) imaging will be useful in decisions regarding the use of radiotherapy for the treatment of clinically occult lymph node metastases in head-and-neck cancer. Methods and Materials: A decision model of PET imaging and its downstream effects on radiotherapy outcomes was constructed using an influence diagram. This model included the sensitivity and specificity of PET, as well as the type and stage of the primary tumor. These parameters were varied to determine the optimal strategy for imaging and therapy for different clinical situations. Maximum expected utility was the metric by whichmore » different actions were ranked. Results: For primary tumors with a low probability of lymph node metastases, the sensitivity of PET should be maximized, and 50 Gy should be delivered if PET is positive and 0 Gy if negative. As the probability for lymph node metastases increases, PET imaging becomes unnecessary in some situations, and the optimal dose to the lymph nodes increases. The model needed to include the causes of certain health states to predict current clinical practice. Conclusion: The model demonstrated the ability to reproduce expected outcomes for a range of tumors and provided recommendations for different clinical situations. The differences between the optimal policies and current clinical practice are likely due to a disparity between stated clinical decision processes and actual decision making by clinicians.« less

Iterative Reconstruction Techniques in Abdominopelvic CT: Technical Concepts and Clinical Implementation.

PubMed

Patino, Manuel; Fuentes, Jorge M; Singh, Sarabjeet; Hahn, Peter F; Sahani, Dushyant V

2015-07-01

This article discusses the clinical challenge of low-radiation-dose examinations, the commonly used approaches for dose optimization, and their effect on image quality. We emphasize practical aspects of the different iterative reconstruction techniques, along with their benefits, pitfalls, and clinical implementation. The widespread use of CT has raised concerns about potential radiation risks, motivating diverse strategies to reduce the radiation dose associated with CT. CT manufacturers have developed alternative reconstruction algorithms intended to improve image quality on dose-optimized CT studies, mainly through noise and artifact reduction. Iterative reconstruction techniques take unique approaches to noise reduction and provide distinct strength levels or settings.

Dual-energy contrast-enhanced digital mammography (DE-CEDM): optimization on digital subtraction with practical x-ray low/high-energy spectra

NASA Astrophysics Data System (ADS)

Chen, Biao; Jing, Zhenxue; Smith, Andrew P.; Parikh, Samir; Parisky, Yuri

2006-03-01

Dual-energy contrast enhanced digital mammography (DE-CEDM), which is based upon the digital subtraction of low/high-energy image pairs acquired before/after the administration of contrast agents, may provide physicians physiologic and morphologic information of breast lesions and help characterize their probability of malignancy. This paper proposes to use only one pair of post-contrast low / high-energy images to obtain digitally subtracted dual-energy contrast-enhanced images with an optimal weighting factor deduced from simulated characteristics of the imaging chain. Based upon our previous CEDM framework, quantitative characteristics of the materials and imaging components in the x-ray imaging chain, including x-ray tube (tungsten) spectrum, filters, breast tissues / lesions, contrast agents (non-ionized iodine solution), and selenium detector, were systemically modeled. Using the base-material (polyethylene-PMMA) decomposition method based on entrance low / high-energy x-ray spectra and breast thickness, the optimal weighting factor was calculated to cancel the contrast between fatty and glandular tissues while enhancing the contrast of iodized lesions. By contrast, previous work determined the optimal weighting factor through either a calibration step or through acquisition of a pre-contrast low/high-energy image pair. Computer simulations were conducted to determine weighting factors, lesions' contrast signal values, and dose levels as functions of x-ray techniques and breast thicknesses. Phantom and clinical feasibility studies were performed on a modified Selenia full field digital mammography system to verify the proposed method and computer-simulated results. The resultant conclusions from the computer simulations and phantom/clinical feasibility studies will be used in the upcoming clinical study.

An ITK framework for deterministic global optimization for medical image registration

NASA Astrophysics Data System (ADS)

Dru, Florence; Wachowiak, Mark P.; Peters, Terry M.

2006-03-01

Similarity metric optimization is an essential step in intensity-based rigid and nonrigid medical image registration. For clinical applications, such as image guidance of minimally invasive procedures, registration accuracy and efficiency are prime considerations. In addition, clinical utility is enhanced when registration is integrated into image analysis and visualization frameworks, such as the popular Insight Toolkit (ITK). ITK is an open source software environment increasingly used to aid the development, testing, and integration of new imaging algorithms. In this paper, we present a new ITK-based implementation of the DIRECT (Dividing Rectangles) deterministic global optimization algorithm for medical image registration. Previously, it has been shown that DIRECT improves the capture range and accuracy for rigid registration. Our ITK class also contains enhancements over the original DIRECT algorithm by improving stopping criteria, adaptively adjusting a locality parameter, and by incorporating Powell's method for local refinement. 3D-3D registration experiments with ground-truth brain volumes and clinical cardiac volumes show that combining DIRECT with Powell's method improves registration accuracy over Powell's method used alone, is less sensitive to initial misorientation errors, and, with the new stopping criteria, facilitates adequate exploration of the search space without expending expensive iterations on non-improving function evaluations. Finally, in this framework, a new parallel implementation for computing mutual information is presented, resulting in near-linear speedup with two processors.

Optimization of dual-wavelength intravascular photoacoustic imaging of atherosclerotic plaques using Monte Carlo optical modeling

NASA Astrophysics Data System (ADS)

Dana, Nicholas; Sowers, Timothy; Karpiouk, Andrei; Vanderlaan, Donald; Emelianov, Stanislav

2017-10-01

Coronary heart disease (the presence of coronary atherosclerotic plaques) is a significant health problem in the industrialized world. A clinical method to accurately visualize and characterize atherosclerotic plaques is needed. Intravascular photoacoustic (IVPA) imaging is being developed to fill this role, but questions remain regarding optimal imaging wavelengths. We utilized a Monte Carlo optical model to simulate IVPA excitation in coronary tissues, identifying optimal wavelengths for plaque characterization. Near-infrared wavelengths (≤1800 nm) were simulated, and single- and dual-wavelength data were analyzed for accuracy of plaque characterization. Results indicate light penetration is best in the range of 1050 to 1370 nm, where 5% residual fluence can be achieved at clinically relevant depths of ≥2 mm in arteries. Across the arterial wall, fluence may vary by over 10-fold, confounding plaque characterization. For single-wavelength results, plaque segmentation accuracy peaked at 1210 and 1720 nm, though correlation was poor (<0.13). Dual-wavelength analysis proved promising, with 1210 nm as the most successful primary wavelength (≈1.0). Results suggest that, without flushing the luminal blood, a primary and secondary wavelength near 1210 and 1350 nm, respectively, may offer the best implementation of dual-wavelength IVPA imaging. These findings could guide the development of a cost-effective clinical system by highlighting optimal wavelengths and improving plaque characterization.

Digital mammography--DQE versus optimized image quality in clinical environment: an on site study

NASA Astrophysics Data System (ADS)

Oberhofer, Nadia; Fracchetti, Alessandro; Springeth, Margareth; Moroder, Ehrenfried

2010-04-01

The intrinsic quality of the detection system of 7 different digital mammography units (5 direct radiography DR; 2 computed radiography CR), expressed by DQE, has been compared with their image quality/dose performances in clinical use. DQE measurements followed IEC 62220-1-2 using a tungsten test object for MTF determination. For image quality assessment two different methods have been applied: 1) measurement of contrast to noise ratio (CNR) according to the European guidelines and 2) contrast-detail (CD) evaluation. The latter was carried out with the phantom CDMAM ver. 3.4 and the commercial software CDMAM Analyser ver. 1.1 (both Artinis) for automated image analysis. The overall image quality index IQFinv proposed by the software has been validated. Correspondence between the two methods has been shown figuring out a linear correlation between CNR and IQFinv. All systems were optimized with respect to image quality and average glandular dose (AGD) within the constraints of automatic exposure control (AEC). For each equipment, a good image quality level was defined by means of CD analysis, and the corresponding CNR value considered as target value. The goal was to achieve for different PMMA-phantom thicknesses constant image quality, that means the CNR target value, at minimum dose. All DR systems exhibited higher DQE and significantly better image quality compared to CR systems. Generally switching, where available, to a target/filter combination with an x-ray spectrum of higher mean energy permitted dose savings at equal image quality. However, several systems did not allow to modify the AEC in order to apply optimal radiographic technique in clinical use. The best ratio image quality/dose was achieved by a unit with a-Se detector and W anode only recently available on the market.

Method using in vivo quantitative spectroscopy to guide design and optimization of low-cost, compact clinical imaging devices: emulation and evaluation of multispectral imaging systems

NASA Astrophysics Data System (ADS)

Saager, Rolf B.; Baldado, Melissa L.; Rowland, Rebecca A.; Kelly, Kristen M.; Durkin, Anthony J.

2018-04-01

With recent proliferation in compact and/or low-cost clinical multispectral imaging approaches and commercially available components, questions remain whether they adequately capture the requisite spectral content of their applications. We present a method to emulate the spectral range and resolution of a variety of multispectral imagers, based on in-vivo data acquired from spatial frequency domain spectroscopy (SFDS). This approach simulates spectral responses over 400 to 1100 nm. Comparing emulated data with full SFDS spectra of in-vivo tissue affords the opportunity to evaluate whether the sparse spectral content of these imagers can (1) account for all sources of optical contrast present (completeness) and (2) robustly separate and quantify sources of optical contrast (crosstalk). We validate the approach over a range of tissue-simulating phantoms, comparing the SFDS-based emulated spectra against measurements from an independently characterized multispectral imager. Emulated results match the imager across all phantoms (<3 % absorption, <1 % reduced scattering). In-vivo test cases (burn wounds and photoaging) illustrate how SFDS can be used to evaluate different multispectral imagers. This approach provides an in-vivo measurement method to evaluate the performance of multispectral imagers specific to their targeted clinical applications and can assist in the design and optimization of new spectral imaging devices.

Multiparameter optimization of mammography: an update

NASA Astrophysics Data System (ADS)

Jafroudi, Hamid; Muntz, E. P.; Jennings, Robert J.

1994-05-01

Previously in this forum we have reported the application of multiparameter optimization techniques to the design of a minimum dose mammography system. The approach used a reference system to define the physical imaging performance required and the dose to which the dose for the optimized system should be compared. During the course of implementing the resulting design in hardware suitable for laboratory testing, the state of the art in mammographic imaging changed, so that the original reference system, which did not have a grid, was no longer appropriate. A reference system with a grid was selected in response to this change, and at the same time the optimization procedure was modified, to make it more general and to facilitate study of the optimized design under a variety of conditions. We report the changes in the procedure, and the results obtained using the revised procedure and the up- to-date reference system. Our results, which are supported by laboratory measurements, indicate that the optimized design can image small objects as well as the reference system using only about 30% of the dose required by the reference system. Hardware meeting the specification produced by the optimization procedure and suitable for clinical use is currently under evaluation in the Diagnostic Radiology Department at the Clinical Center, NH.

A method to optimize the processing algorithm of a computed radiography system for chest radiography.

PubMed

Moore, C S; Liney, G P; Beavis, A W; Saunderson, J R

2007-09-01

A test methodology using an anthropomorphic-equivalent chest phantom is described for the optimization of the Agfa computed radiography "MUSICA" processing algorithm for chest radiography. The contrast-to-noise ratio (CNR) in the lung, heart and diaphragm regions of the phantom, and the "system modulation transfer function" (sMTF) in the lung region, were measured using test tools embedded in the phantom. Using these parameters the MUSICA processing algorithm was optimized with respect to low-contrast detectability and spatial resolution. Two optimum "MUSICA parameter sets" were derived respectively for maximizing the CNR and sMTF in each region of the phantom. Further work is required to find the relative importance of low-contrast detectability and spatial resolution in chest images, from which the definitive optimum MUSICA parameter set can then be derived. Prior to this further work, a compromised optimum MUSICA parameter set was applied to a range of clinical images. A group of experienced image evaluators scored these images alongside images produced from the same radiographs using the MUSICA parameter set in clinical use at the time. The compromised optimum MUSICA parameter set was shown to produce measurably better images.

Skull removal in MR images using a modified artificial bee colony optimization algorithm.

PubMed

Taherdangkoo, Mohammad

2014-01-01

Removal of the skull from brain Magnetic Resonance (MR) images is an important preprocessing step required for other image analysis techniques such as brain tissue segmentation. In this paper, we propose a new algorithm based on the Artificial Bee Colony (ABC) optimization algorithm to remove the skull region from brain MR images. We modify the ABC algorithm using a different strategy for initializing the coordinates of scout bees and their direction of search. Moreover, we impose an additional constraint to the ABC algorithm to avoid the creation of discontinuous regions. We found that our algorithm successfully removed all bony skull from a sample of de-identified MR brain images acquired from different model scanners. The obtained results of the proposed algorithm compared with those of previously introduced well known optimization algorithms such as Particle Swarm Optimization (PSO) and Ant Colony Optimization (ACO) demonstrate the superior results and computational performance of our algorithm, suggesting its potential for clinical applications.

A Review on Medical Image Registration as an Optimization Problem

PubMed Central

Song, Guoli; Han, Jianda; Zhao, Yiwen; Wang, Zheng; Du, Huibin

2017-01-01

Objective: In the course of clinical treatment, several medical media are required by a phy-sician in order to provide accurate and complete information about a patient. Medical image registra-tion techniques can provide a richer diagnosis and treatment information to doctors and to provide a comprehensive reference source for the researchers involved in image registration as an optimization problem. Methods: The essence of image registration is associating two or more different images spatial asso-ciation, and getting the translation of their spatial relationship. For medical image registration, its pro-cess is not absolute. Its core purpose is finding the conversion relationship between different images. Result: The major step of image registration includes the change of geometrical dimensions, and change of the image of the combination, image similarity measure, iterative optimization and interpo-lation process. Conclusion: The contribution of this review is sort of related image registration research methods, can provide a brief reference for researchers about image registration. PMID:28845149

Optimizing 4DCBCT projection allocation to respiratory bins.

PubMed

O'Brien, Ricky T; Kipritidis, John; Shieh, Chun-Chien; Keall, Paul J

2014-10-07

4D cone beam computed tomography (4DCBCT) is an emerging image guidance strategy used in radiotherapy where projections acquired during a scan are sorted into respiratory bins based on the respiratory phase or displacement. 4DCBCT reduces the motion blur caused by respiratory motion but increases streaking artefacts due to projection under-sampling as a result of the irregular nature of patient breathing and the binning algorithms used. For displacement binning the streak artefacts are so severe that displacement binning is rarely used clinically. The purpose of this study is to investigate if sharing projections between respiratory bins and adjusting the location of respiratory bins in an optimal manner can reduce or eliminate streak artefacts in 4DCBCT images. We introduce a mathematical optimization framework and a heuristic solution method, which we will call the optimized projection allocation algorithm, to determine where to position the respiratory bins and which projections to source from neighbouring respiratory bins. Five 4DCBCT datasets from three patients were used to reconstruct 4DCBCT images. Projections were sorted into respiratory bins using equispaced, equal density and optimized projection allocation. The standard deviation of the angular separation between projections was used to assess streaking and the consistency of the segmented volume of a fiducial gold marker was used to assess motion blur. The standard deviation of the angular separation between projections using displacement binning and optimized projection allocation was 30%-50% smaller than conventional phase based binning and 59%-76% smaller than conventional displacement binning indicating more uniformly spaced projections and fewer streaking artefacts. The standard deviation in the marker volume was 20%-90% smaller when using optimized projection allocation than using conventional phase based binning suggesting more uniform marker segmentation and less motion blur. Images reconstructed using displacement binning and the optimized projection allocation algorithm were clearer, contained visibly fewer streak artefacts and produced more consistent marker segmentation than those reconstructed with either equispaced or equal-density binning. The optimized projection allocation algorithm significantly improves image quality in 4DCBCT images and provides, for the first time, a method to consistently generate high quality displacement binned 4DCBCT images in clinical applications.

Imaging of iatrogenic oesophageal injuries using optimized CT oesophageal leak protocol: pearls and pitfalls.

PubMed

Madan, Rachna; Laur, Olga; Crudup, Breland; Peavy, Latia; Carter, Brett W

2018-02-01

Iatrogenic injury to the oesophagus is a serious complication which is increasingly seen in clinical practice secondary to expansion and greater acceptability of surgical and endoscopic oesophageal procedures. Morbidity and mortality following such injury is high. This is mostly due to an inflammatory response to gastric contents in the mediastinum, and the negative intrathoracic pressures that may further draw out oesophageal contents into the mediastinum leading to mediastinitis. Subsequently, pulmonary complications such as pneumonia or abscess may ensue leading to rapid clinical deterioration. Optimized and timely cross-sectional imaging evaluation is necessary for early and aggressive management of these complications. The goal of this review is to make the radiologist aware of the importance of early and accurate identification of postoperative oesophageal injury using optimized CT imaging protocols and use of oral contrast. Specifically, it is critical to differentiate benign post-operative findings, such as herniated viscus or redundant anastomosis, from clinically significant postoperative complications as this helps guide appropriate management. Advantages and drawbacks of other diagnostic methods, such as contrast oesophagogram, are also discussed.

Review of SPECT collimator selection, optimization, and fabrication for clinical and preclinical imaging

PubMed Central

Van Audenhaege, Karen; Van Holen, Roel; Vandenberghe, Stefaan; Vanhove, Christian; Metzler, Scott D.; Moore, Stephen C.

2015-01-01

In single photon emission computed tomography, the choice of the collimator has a major impact on the sensitivity and resolution of the system. Traditional parallel-hole and fan-beam collimators used in clinical practice, for example, have a relatively poor sensitivity and subcentimeter spatial resolution, while in small-animal imaging, pinhole collimators are used to obtain submillimeter resolution and multiple pinholes are often combined to increase sensitivity. This paper reviews methods for production, sensitivity maximization, and task-based optimization of collimation for both clinical and preclinical imaging applications. New opportunities for improved collimation are now arising primarily because of (i) new collimator-production techniques and (ii) detectors with improved intrinsic spatial resolution that have recently become available. These new technologies are expected to impact the design of collimators in the future. The authors also discuss concepts like septal penetration, high-resolution applications, multiplexing, sampling completeness, and adaptive systems, and the authors conclude with an example of an optimization study for a parallel-hole, fan-beam, cone-beam, and multiple-pinhole collimator for different applications. PMID:26233207

MO-FG-204-08: Optimization-Based Image Reconstruction From Unevenly Distributed Sparse Projection Views

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xie, Huiqiao; Yang, Yi; Tang, Xiangyang

2015-06-15

Purpose: Optimization-based reconstruction has been proposed and investigated for reconstructing CT images from sparse views, as such the radiation dose can be substantially reduced while maintaining acceptable image quality. The investigation has so far focused on reconstruction from evenly distributed sparse views. Recognizing the clinical situations wherein only unevenly sparse views are available, e.g., image guided radiation therapy, CT perfusion and multi-cycle cardiovascular imaging, we investigate the performance of optimization-based image reconstruction from unevenly sparse projection views in this work. Methods: The investigation is carried out using the FORBILD and an anthropomorphic head phantoms. In the study, 82 views, whichmore » are evenly sorted out from a full (360°) axial CT scan consisting of 984 views, form sub-scan I. Another 82 views are sorted out in a similar manner to form sub-scan II. As such, a CT scan with sparse (164) views at 1:6 ratio are formed. By shifting the two sub-scans relatively in view angulation, a CT scan with unevenly distributed sparse (164) views at 1:6 ratio are formed. An optimization-based method is implemented to reconstruct images from the unevenly distributed views. By taking the FBP reconstruction from the full scan (984 views) as the reference, the root mean square (RMS) between the reference and the optimization-based reconstruction is used to evaluate the performance quantitatively. Results: In visual inspection, the optimization-based method outperforms the FBP substantially in the reconstruction from unevenly distributed, which are quantitatively verified by the RMS gauged globally and in ROIs in both the FORBILD and anthropomorphic head phantoms. The RMS increases with increasing severity in the uneven angular distribution, especially in the case of anthropomorphic head phantom. Conclusion: The optimization-based image reconstruction can save radiation dose up to 12-fold while providing acceptable image quality for advanced clinical applications wherein only unevenly distributed sparse views are available. Research Grants: W81XWH-12-1-0138 (DoD), Sinovision Technologies.« less

An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

2012-02-01

Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

Multi-modal and targeted imaging improves automated mid-brain segmentation

NASA Astrophysics Data System (ADS)

Plassard, Andrew J.; D'Haese, Pierre F.; Pallavaram, Srivatsan; Newton, Allen T.; Claassen, Daniel O.; Dawant, Benoit M.; Landman, Bennett A.

2017-02-01

The basal ganglia and limbic system, particularly the thalamus, putamen, internal and external globus pallidus, substantia nigra, and sub-thalamic nucleus, comprise a clinically relevant signal network for Parkinson's disease. In order to manually trace these structures, a combination of high-resolution and specialized sequences at 7T are used, but it is not feasible to scan clinical patients in those scanners. Targeted imaging sequences at 3T such as F-GATIR, and other optimized inversion recovery sequences, have been presented which enhance contrast in a select group of these structures. In this work, we show that a series of atlases generated at 7T can be used to accurately segment these structures at 3T using a combination of standard and optimized imaging sequences, though no one approach provided the best result across all structures. In the thalamus and putamen, a median Dice coefficient over 0.88 and a mean surface distance less than 1.0mm was achieved using a combination of T1 and an optimized inversion recovery imaging sequences. In the internal and external globus pallidus a Dice over 0.75 and a mean surface distance less than 1.2mm was achieved using a combination of T1 and FGATIR imaging sequences. In the substantia nigra and sub-thalamic nucleus a Dice coefficient of over 0.6 and a mean surface distance of less than 1.0mm was achieved using the optimized inversion recovery imaging sequence. On average, using T1 and optimized inversion recovery together produced significantly improved segmentation results than any individual modality (p<0.05 wilcox sign-rank test).

Lower cranial nerves.

PubMed

Soldatos, Theodoros; Batra, Kiran; Blitz, Ari M; Chhabra, Avneesh

2014-02-01

Imaging evaluation of cranial neuropathies requires thorough knowledge of the anatomic, physiologic, and pathologic features of the cranial nerves, as well as detailed clinical information, which is necessary for tailoring the examinations, locating the abnormalities, and interpreting the imaging findings. This article provides clinical, anatomic, and radiological information on lower (7th to 12th) cranial nerves, along with high-resolution magnetic resonance images as a guide for optimal imaging technique, so as to improve the diagnosis of cranial neuropathy. Copyright © 2014 Elsevier Inc. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, E; Yuan, F; Templeton, A

Purpose: The ultimate goal of radiotherapy treatment planning is to find a treatment that will yield a high tumor-control-probability(TCP) with an acceptable normal-tissue-complication probability(NTCP). Yet most treatment planning today is not based upon optimization of TCPs and NTCPs, but rather upon meeting physical dose and volume constraints defined by the planner. We design treatment plans that optimize TCP directly and contrast them with the clinical dose-based plans. PET image is incorporated to evaluate gain in TCP for dose escalation. Methods: We build a nonlinear mixed integer programming optimization model that maximizes TCP directly while satisfying the dose requirements on themore » targeted organ and healthy tissues. The solution strategy first fits the TCP function with a piecewise-linear approximation, then solves the problem that maximizes the piecewise linear approximation of TCP, and finally performs a local neighborhood search to improve the TCP value. To gauge the feasibility, characteristics, and potential benefit of PET-image guided dose escalation, initial validation consists of fifteen cervical cancer HDR patient cases. These patients have all received prior 45Gy of external radiation dose. For both escalated strategies, we consider 35Gy PTV-dose, and two variations (37Gy-boost to BTV vs 40Gy-boost) to PET-image-pockets. Results: TCP for standard clinical plans range from 59.4% - 63.6%. TCP for dose-based PET-guided escalated-dose-plan ranges from 63.8%–98.6% for all patients; whereas TCP-optimized plans achieves over 91% for all patients. There is marginal difference in TCP among those with 37Gy-boosted vs 40Gy-boosted. There is no increase in rectum and bladder dose among all plans. Conclusion: Optimizing TCP directly results in highly conformed treatment plans. The TCP-optimized plan is individualized based on the biological PET-image of the patients. The TCP-optimization framework is generalizable and has been applied successfully to other external-beam delivery modalities. A clinical trial is on-going to gauge the clinical significance. Partially supported by the National Science Foundation.« less

Optimized magnetic resonance diffusion protocol for ex-vivo whole human brain imaging with a clinical scanner

NASA Astrophysics Data System (ADS)

Scherrer, Benoit; Afacan, Onur; Stamm, Aymeric; Singh, Jolene; Warfield, Simon K.

2015-03-01

Diffusion-weighted magnetic resonance imaging (DW-MRI) provides a novel insight into the brain to facilitate our understanding of the brain connectivity and microstructure. While in-vivo DW-MRI enables imaging of living patients and longitudinal studies of brain changes, post-mortem ex-vivo DW-MRI has numerous advantages. Ex-vivo imaging benefits from greater resolution and sensitivity due to the lack of imaging time constraints; the use of tighter fitting coils; and the lack of movement artifacts. This allows characterization of normal and abnormal tissues with unprecedented resolution and sensitivity, facilitating our ability to investigate anatomical structures that are inaccessible in-vivo. This also offers the opportunity to develop today novel imaging biomarkers that will, with tomorrow's MR technology, enable improved in-vivo assessment of the risk of disease in an individual. Post-mortem studies, however, generally rely on the fixation of specimen to inhibit tissue decay which starts as soon as tissue is deprived from its blood supply. Unfortunately, fixation of tissues substantially alters tissue diffusivity profiles. In addition, ex-vivo DW-MRI requires particular care when packaging the specimen because the presence of microscopic air bubbles gives rise to geometric and intensity image distortion. In this work, we considered the specific requirements of post-mortem imaging and designed an optimized protocol for ex-vivo whole brain DW-MRI using a human clinical 3T scanner. Human clinical 3T scanners are available to a large number of researchers and, unlike most animal scanners, have a bore diameter large enough to image a whole human brain. Our optimized protocol will facilitate widespread ex-vivo investigations of large specimen.

Data-driven optimal binning for respiratory motion management in PET.

PubMed

Kesner, Adam L; Meier, Joseph G; Burckhardt, Darrell D; Schwartz, Jazmin; Lynch, David A

2018-01-01

Respiratory gating has been used in PET imaging to reduce the amount of image blurring caused by patient motion. Optimal binning is an approach for using the motion-characterized data by binning it into a single, easy to understand/use, optimal bin. To date, optimal binning protocols have utilized externally driven motion characterization strategies that have been tuned with population-derived assumptions and parameters. In this work, we are proposing a new strategy with which to characterize motion directly from a patient's gated scan, and use that signal to create a patient/instance-specific optimal bin image. Two hundred and nineteen phase-gated FDG PET scans, acquired using data-driven gating as described previously, were used as the input for this study. For each scan, a phase-amplitude motion characterization was generated and normalized using principle component analysis. A patient-specific "optimal bin" window was derived using this characterization, via methods that mirror traditional optimal window binning strategies. The resulting optimal bin images were validated by correlating quantitative and qualitative measurements in the population of PET scans. In 53% (n = 115) of the image population, the optimal bin was determined to include 100% of the image statistics. In the remaining images, the optimal binning windows averaged 60% of the statistics and ranged between 20% and 90%. Tuning the algorithm, through a single acceptance window parameter, allowed for adjustments of the algorithm's performance in the population toward conservation of motion or reduced noise-enabling users to incorporate their definition of optimal. In the population of images that were deemed appropriate for segregation, average lesion SUV max were 7.9, 8.5, and 9.0 for nongated images, optimal bin, and gated images, respectively. The Pearson correlation of FWHM measurements between optimal bin images and gated images were better than with nongated images, 0.89 and 0.85, respectively. Generally, optimal bin images had better resolution than the nongated images and better noise characteristics than the gated images. We extended the concept of optimal binning to a data-driven form, updating a traditionally one-size-fits-all approach to a conformal one that supports adaptive imaging. This automated strategy was implemented easily within a large population and encapsulated motion information in an easy to use 3D image. Its simplicity and practicality may make this, or similar approaches ideal for use in clinical settings. © 2017 American Association of Physicists in Medicine.

Performance optimization of the Varian aS500 EPID system.

PubMed

Berger, Lucie; François, Pascal; Gaboriaud, Geneviève; Rosenwald, Jean-Claude

2006-01-01

Today, electronic portal imaging devices (EPIDs) are widely used as a replacement to portal films for patient position verification, but the image quality is not always optimal. The general aim of this study was to optimize the acquisition parameters of an amorphous silicon EPID commercially available for clinical use in radiation therapy with the view to avoid saturation of the system. Special attention was paid to selection of the parameter corresponding to the number of rows acquired between accelerator pulses (NRP) for various beam energies and dose rates. The image acquisition system (IAS2) has been studied, and portal image acquisition was found to be strongly dependent on the accelerator pulse frequency. This frequency is set for each "energy - dose rate" combination of the linear accelerator. For all combinations, the image acquisition parameters were systematically changed to determine their influence on the performances of the Varian aS500 EPID system. New parameters such as the maximum number of rows (MNR) and the number of pulses per frame (NPF) were introduced to explain portal image acquisition theory. Theoretical and experimental values of MNR and NPF were compared, and they were in good agreement. Other results showed that NRP had a major influence on detector saturation and dose per image. A rule of thumb was established to determine the optimum NRP value to be used. This practical application was illustrated by a clinical example in which the saturation of the aSi EPID was avoided by NRP optimization. Moreover, an additional study showed that image quality was relatively insensitive to this parameter.

MO-C-18A-01: Advances in Model-Based 3D Image Reconstruction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, G; Pan, X; Stayman, J

2014-06-15

Recent years have seen the emergence of CT image reconstruction techniques that exploit physical models of the imaging system, photon statistics, and even the patient to achieve improved 3D image quality and/or reduction of radiation dose. With numerous advantages in comparison to conventional 3D filtered backprojection, such techniques bring a variety of challenges as well, including: a demanding computational load associated with sophisticated forward models and iterative optimization methods; nonlinearity and nonstationarity in image quality characteristics; a complex dependency on multiple free parameters; and the need to understand how best to incorporate prior information (including patient-specific prior images) within themore » reconstruction process. The advantages, however, are even greater – for example: improved image quality; reduced dose; robustness to noise and artifacts; task-specific reconstruction protocols; suitability to novel CT imaging platforms and noncircular orbits; and incorporation of known characteristics of the imager and patient that are conventionally discarded. This symposium features experts in 3D image reconstruction, image quality assessment, and the translation of such methods to emerging clinical applications. Dr. Chen will address novel methods for the incorporation of prior information in 3D and 4D CT reconstruction techniques. Dr. Pan will show recent advances in optimization-based reconstruction that enable potential reduction of dose and sampling requirements. Dr. Stayman will describe a “task-based imaging” approach that leverages models of the imaging system and patient in combination with a specification of the imaging task to optimize both the acquisition and reconstruction process. Dr. Samei will describe the development of methods for image quality assessment in such nonlinear reconstruction techniques and the use of these methods to characterize and optimize image quality and dose in a spectrum of clinical applications. Learning Objectives: Learn the general methodologies associated with model-based 3D image reconstruction. Learn the potential advantages in image quality and dose associated with model-based image reconstruction. Learn the challenges associated with computational load and image quality assessment for such reconstruction methods. Learn how imaging task can be incorporated as a means to drive optimal image acquisition and reconstruction techniques. Learn how model-based reconstruction methods can incorporate prior information to improve image quality, ease sampling requirements, and reduce dose.« less

Spectral imaging using clinical megavoltage beams and a novel multi-layer imager

NASA Astrophysics Data System (ADS)

Myronakis, Marios; Fueglistaller, Rony; Rottmann, Joerg; Hu, Yue-Houng; Wang, Adam; Baturin, Paul; Huber, Pascal; Morf, Daniel; Star-Lack, Josh; Berbeco, Ross

2017-12-01

We assess the feasibility of clinical megavoltage (MV) spectral imaging for material and bone separation with a novel multi-layer imager (MLI) prototype. The MLI provides higher detective quantum efficiency and lower noise than conventional electronic portal imagers. Simulated experiments were performed using a validated Monte Carlo model of the MLI to estimate energy absorption and energy separation between the MLI components. Material separation was evaluated experimentally using solid water and aluminum (Al), copper (Cu) and gold (Au) for 2.5 MV, 6 MV and 6 MV flattening filter free (FFF) clinical photon beams. An anthropomorphic phantom with implanted gold fiducials was utilized to further demonstrate bone/gold separation. Weighted subtraction imaging was employed for material and bone separation. The weighting factor (w) was iteratively estimated, with the optimal w value determined by minimization of the relative signal difference (Δ {{S}R} ) and signal-difference-to-noise ratio (SDNR) between material (or bone) and the background. Energy separation between layers of the MLI was mainly the result of beam hardening between components with an average energy separation between 34 and 47 keV depending on the x-ray beam energy. The minimum average energy of the detected spectrum in the phosphor layer was 123 keV in the top layer of the MLI with the 2.5 MV beam. The w values that minimized Δ {{S}R} and SDNR for Al, Cu and Au were 0.89, 0.76 and 0.64 for 2.5 MV; for 6 MV FFF, w was 0.98, 0.93 and 0.77 respectively. Bone suppression in the anthropomorphic phantom resulted in improved visibility of the gold fiducials with the 2.5 MV beam. Optimization of the MLI design is required to achieve optimal separation at clinical MV beam energies.

Clinical evaluation of a confocal microendoscope system for imaging the ovary

NASA Astrophysics Data System (ADS)

Tanbakuchi, Anthony A.; Rouse, Andrew R.; Hatch, Kenneth D.; Sampliner, Richard E.; Udovich, Josh A.; Gmitro, Arthur F.

2008-02-01

We have developed a mobile confocal microendoscope system that provides live cellular imaging during surgery to aid in diagnosing microscopic abnormalities including cancer. We present initial clinical trial results using the device to image ovaries in-vivo using fluorescein and ex-vivo results using acridine orange. The imaging catheter has improved depth control and localized dye delivery mechanisms than previously presented. A manual control now provides a simple way for the surgeon to adjust and optimize imaging depth during the procedure while a tiny piezo valve in the imaging catheter controls the dye delivery.

Optimizing Diagnostic Imaging in the Emergency Department

PubMed Central

Mills, Angela M.; Raja, Ali S.; Marin, Jennifer R.

2015-01-01

While emergency diagnostic imaging use has increased significantly, there is a lack of evidence for corresponding improvements in patient outcomes. Optimizing emergency department (ED) diagnostic imaging has the potential to improve the quality, safety, and outcomes of ED patients, but to date, there have not been any coordinated efforts to further our evidence-based knowledge in this area. The objective of this article is to discuss six aspects of diagnostic imaging in order to provide background information on the underlying framework for the 2015 Academic Emergency Medicine consensus conference, “Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization.” The consensus conference aims to generate a high priority research agenda for emergency diagnostic imaging that will inform the design of future investigations. The six components herein will serve as the group topics for the conference: 1) patient-centered outcomes research; 2) clinical decision rules; 3) training, education, and competency; 4) knowledge translation and barriers to image optimization; 5) use of administrative data; and 6) comparative effectiveness research: alternatives to traditional CT use. PMID:25731864

Optimizing diagnostic imaging in the emergency department.

PubMed

Mills, Angela M; Raja, Ali S; Marin, Jennifer R

2015-05-01

While emergency diagnostic imaging use has increased significantly, there is a lack of evidence for corresponding improvements in patient outcomes. Optimizing emergency department (ED) diagnostic imaging has the potential to improve the quality, safety, and outcomes of ED patients, but to date, there have not been any coordinated efforts to further our evidence-based knowledge in this area. The objective of this article is to discuss six aspects of diagnostic imaging to provide background information on the underlying framework for the 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The consensus conference aims to generate a high priority research agenda for emergency diagnostic imaging that will inform the design of future investigations. The six components herein will serve as the group topics for the conference: 1) patient-centered outcomes research; 2) clinical decision rules; 3) training, education, and competency; 4) knowledge translation and barriers to image optimization; 5) use of administrative data; and 6) comparative effectiveness research: alternatives to traditional CT use. © 2015 by the Society for Academic Emergency Medicine.

Clinical review: Lung imaging in acute respiratory distress syndrome patients - an update

PubMed Central

2013-01-01

Over the past 30 years lung imaging has greatly contributed to the current understanding of the pathophysiology and the management of acute respiratory distress syndrome (ARDS). In the past few years, in addition to chest X-ray and lung computed tomography, newer functional lung imaging techniques, such as lung ultrasound, positron emission tomography, electrical impedance tomography and magnetic resonance, have been gaining a role as diagnostic tools to optimize lung assessment and ventilator management in ARDS patients. Here we provide an updated clinical review of lung imaging in ARDS over the past few years to offer an overview of the literature on the available imaging techniques from a clinical perspective. PMID:24238477

MO-D-213-06: Quantitative Image Quality Metrics Are for Physicists, Not Radiologists: How to Communicate to Your Radiologists Using Their Language

DOE Office of Scientific and Technical Information (OSTI.GOV)

Szczykutowicz, T; Rubert, N; Ranallo, F

Purpose: A framework for explaining differences in image quality to non-technical audiences in medial imaging is needed. Currently, this task is something that is learned “on the job.” The lack of a formal methodology for communicating optimal acquisition parameters into the clinic effectively mitigates many technological advances. As a community, medical physicists need to be held responsible for not only advancing image science, but also for ensuring its proper use in the clinic. This work outlines a framework that bridges the gap between the results from quantitative image quality metrics like detectability, MTF, and NPS and their effect on specificmore » anatomical structures present in diagnostic imaging tasks. Methods: Specific structures of clinical importance were identified for a body, an extremity, a chest, and a temporal bone protocol. Using these structures, quantitative metrics were used to identify the parameter space that should yield optimal image quality constrained within the confines of clinical logistics and dose considerations. The reading room workflow for presenting the proposed changes for imaging each of these structures is presented. The workflow consists of displaying images for physician review consisting of different combinations of acquisition parameters guided by quantitative metrics. Examples of using detectability index, MTF, NPS, noise and noise non-uniformity are provided. During review, the physician was forced to judge the image quality solely on those features they need for diagnosis, not on the overall “look” of the image. Results: We found that in many cases, use of this framework settled mis-agreements between physicians. Once forced to judge images on the ability to detect specific structures inter reader agreement was obtained. Conclusion: This framework will provide consulting, research/industrial, or in-house physicists with clinically relevant imaging tasks to guide reading room image review. This framework avoids use of the overall “look” or “feel” to dictate acquisition parameter selection. Equipment grants GE Healthcare.« less

Image acquisition optimization of a limited-angle intrafraction verification (LIVE) system for lung radiotherapy.

PubMed

Zhang, Yawei; Deng, Xinchen; Yin, Fang-Fang; Ren, Lei

2018-01-01

Limited-angle intrafraction verification (LIVE) has been previously developed for four-dimensional (4D) intrafraction target verification either during arc delivery or between three-dimensional (3D)/IMRT beams. Preliminary studies showed that LIVE can accurately estimate the target volume using kV/MV projections acquired over orthogonal view 30° scan angles. Currently, the LIVE imaging acquisition requires slow gantry rotation and is not clinically optimized. The goal of this study is to optimize the image acquisition parameters of LIVE for different patient respiratory periods and gantry rotation speeds for the effective clinical implementation of the system. Limited-angle intrafraction verification imaging acquisition was optimized using a digital anthropomorphic phantom (XCAT) with simulated respiratory periods varying from 3 s to 6 s and gantry rotation speeds varying from 1°/s to 6°/s. LIVE scanning time was optimized by minimizing the number of respiratory cycles needed for the four-dimensional scan, and imaging dose was optimized by minimizing the number of kV and MV projections needed for four-dimensional estimation. The estimation accuracy was evaluated by calculating both the center-of-mass-shift (COMS) and three-dimensional volume-percentage-difference (VPD) between the tumor in estimated images and the ground truth images. The robustness of LIVE was evaluated with varied respiratory patterns, tumor sizes, and tumor locations in XCAT simulation. A dynamic thoracic phantom (CIRS) was used to further validate the optimized imaging schemes from XCAT study with changes of respiratory patterns, tumor sizes, and imaging scanning directions. Respiratory periods, gantry rotation speeds, number of respiratory cycles scanned and number of kV/MV projections acquired were all positively correlated with the estimation accuracy of LIVE. Faster gantry rotation speed or longer respiratory period allowed less respiratory cycles to be scanned and less kV/MV projections to be acquired to estimate the target volume accurately. Regarding the scanning time minimization, for patient respiratory periods of 3-4 s, gantry rotation speeds of 1°/s, 2°/s, 3-6°/s required scanning of five, four, and three respiratory cycles, respectively. For patient respiratory periods of 5-6 s, the corresponding respiratory cycles required in the scan changed to four, three, and two cycles, respectively. Regarding the imaging dose minimization, for patient respiratory periods of 3-4 s, gantry rotation speeds of 1°/s, 2-4°/s, 5-6°/s required acquiring of 7, 5, 4 kV and MV projections, respectively. For patient respiratory periods of 5-6 s, 5 kV and 5 MV projections are sufficient for all gantry rotation speeds. The optimized LIVE system was robust against breathing pattern, tumor size and tumor location changes. In the CIRS study, the optimized LIVE system achieved the average center-of-mass-shift (COMS)/volume-percentage-difference (VPD) of 0.3 ± 0.1 mm/7.7 ± 2.0% for the scanning time priority case, 0.2 ± 0.1 mm/6.1 ± 1.2% for the imaging dose priority case, respectively, among all gantry rotation speeds tested. LIVE was robust against different scanning directions investigated. The LIVE system has been preliminarily optimized for different patient respiratory periods and treatment gantry rotation speeds using digital and physical phantoms. The optimized imaging parameters, including number of respiratory cycles scanned and kV/MV projection numbers acquired, provide guidelines for optimizing the scanning time and imaging dose of the LIVE system for its future evaluations and clinical implementations through patient studies. © 2017 American Association of Physicists in Medicine.

A Foundation for Enterprise Imaging: HIMSS-SIIM Collaborative White Paper.

PubMed

Roth, Christopher J; Lannum, Louis M; Persons, Kenneth R

2016-10-01

Care providers today routinely obtain valuable clinical multimedia with mobile devices, scope cameras, ultrasound, and many other modalities at the point of care. Image capture and storage workflows may be heterogeneous across an enterprise, and as a result, they often are not well incorporated in the electronic health record. Enterprise Imaging refers to a set of strategies, initiatives, and workflows implemented across a healthcare enterprise to consistently and optimally capture, index, manage, store, distribute, view, exchange, and analyze all clinical imaging and multimedia content to enhance the electronic health record. This paper is intended to introduce Enterprise Imaging as an important initiative to clinical and informatics leadership, and outline its key elements of governance, strategy, infrastructure, common multimedia content, acquisition workflows, enterprise image viewers, and image exchange services.

Ultrasound transducer selection in clinical imaging practice.

PubMed

Szabo, Thomas L; Lewin, Peter A

2013-04-01

Many types of medical ultrasound transducers are used in clinical practice. They operate at different center frequencies, have different physical dimensions, footprints, and shapes, and provide different image formats. However, little information is available about which transducers are most appropriate for a given application, and the purpose of this article is to address this deficiency. Specifically, the relationship between the transducer, imaging format, and clinical applications is discussed, and systematic selection criteria that allow matching of transducers to specific clinical needs are presented. These criteria include access to and coverage of the region of interest, maximum scan depth, and coverage of essential diagnostic modes required to optimize a patient's diagnosis. Three comprehensive figures organize and summarize the imaging planes, scanning modes, and types of diagnostic transducers to facilitate their selection in clinical diagnosis.

Retinal optical coherence tomography at 1 μm with dynamic focus control and axial motion tracking

NASA Astrophysics Data System (ADS)

Cua, Michelle; Lee, Sujin; Miao, Dongkai; Ju, Myeong Jin; Mackenzie, Paul J.; Jian, Yifan; Sarunic, Marinko V.

2016-02-01

High-resolution optical coherence tomography (OCT) retinal imaging is important to noninvasively visualize the various retinal structures to aid in better understanding of the pathogenesis of vision-robbing diseases. However, conventional OCT systems have a trade-off between lateral resolution and depth-of-focus. In this report, we present the development of a focus-stacking OCT system with automatic focus optimization for high-resolution, extended-focal-range clinical retinal imaging by incorporating a variable-focus liquid lens into the sample arm optics. Retinal layer tracking and selection was performed using a graphics processing unit accelerated processing platform for focus optimization, providing real-time layer-specific en face visualization. After optimization, multiple volumes focused at different depths were acquired, registered, and stitched together to yield a single, high-resolution focus-stacked dataset. Using this system, we show high-resolution images of the retina and optic nerve head, from which we extracted clinically relevant parameters such as the nerve fiber layer thickness and lamina cribrosa microarchitecture.

Retinal optical coherence tomography at 1 μm with dynamic focus control and axial motion tracking.

PubMed

Cua, Michelle; Lee, Sujin; Miao, Dongkai; Ju, Myeong Jin; Mackenzie, Paul J; Jian, Yifan; Sarunic, Marinko V

2016-02-01

High-resolution optical coherence tomography (OCT) retinal imaging is important to noninvasively visualize the various retinal structures to aid in better understanding of the pathogenesis of vision-robbing diseases. However, conventional OCT systems have a trade-off between lateral resolution and depth-of-focus. In this report, we present the development of a focus-stacking OCT system with automatic focus optimization for high-resolution, extended-focal-range clinical retinal imaging by incorporating a variable-focus liquid lens into the sample arm optics. Retinal layer tracking and selection was performed using a graphics processing unit accelerated processing platform for focus optimization, providing real-time layer-specific en face visualization. After optimization, multiple volumes focused at different depths were acquired, registered, and stitched together to yield a single, high-resolution focus-stacked dataset. Using this system, we show high-resolution images of the retina and optic nerve head, from which we extracted clinically relevant parameters such as the nerve fiber layer thickness and lamina cribrosa microarchitecture.

Quantitative multimodality imaging in cancer research and therapy.

PubMed

Yankeelov, Thomas E; Abramson, Richard G; Quarles, C Chad

2014-11-01

Advances in hardware and software have enabled the realization of clinically feasible, quantitative multimodality imaging of tissue pathophysiology. Earlier efforts relating to multimodality imaging of cancer have focused on the integration of anatomical and functional characteristics, such as PET-CT and single-photon emission CT (SPECT-CT), whereas more-recent advances and applications have involved the integration of multiple quantitative, functional measurements (for example, multiple PET tracers, varied MRI contrast mechanisms, and PET-MRI), thereby providing a more-comprehensive characterization of the tumour phenotype. The enormous amount of complementary quantitative data generated by such studies is beginning to offer unique insights into opportunities to optimize care for individual patients. Although important technical optimization and improved biological interpretation of multimodality imaging findings are needed, this approach can already be applied informatively in clinical trials of cancer therapeutics using existing tools. These concepts are discussed herein.

Evaluation of DICOM viewer software for workflow integration in clinical trials

NASA Astrophysics Data System (ADS)

Haak, Daniel; Page, Charles E.; Kabino, Klaus; Deserno, Thomas M.

2015-03-01

The digital imaging and communications in medicine (DICOM) protocol is nowadays the leading standard for capture, exchange and storage of image data in medical applications. A broad range of commercial, free, and open source software tools supporting a variety of DICOM functionality exists. However, different from patient's care in hospital, DICOM has not yet arrived in electronic data capture systems (EDCS) for clinical trials. Due to missing integration, even just the visualization of patient's image data in electronic case report forms (eCRFs) is impossible. Four increasing levels for integration of DICOM components into EDCS are conceivable, raising functionality but also demands on interfaces with each level. Hence, in this paper, a comprehensive evaluation of 27 DICOM viewer software projects is performed, investigating viewing functionality as well as interfaces for integration. Concerning general, integration, and viewing requirements the survey involves the criteria (i) license, (ii) support, (iii) platform, (iv) interfaces, (v) two-dimensional (2D) and (vi) three-dimensional (3D) image viewing functionality. Optimal viewers are suggested for applications in clinical trials for 3D imaging, hospital communication, and workflow. Focusing on open source solutions, the viewers ImageJ and MicroView are superior for 3D visualization, whereas GingkoCADx is advantageous for hospital integration. Concerning workflow optimization in multi-centered clinical trials, we suggest the open source viewer Weasis. Covering most use cases, an EDCS and PACS interconnection with Weasis is suggested.

C-SPECT - a Clinical Cardiac SPECT/Tct Platform: Design Concepts and Performance Potential

PubMed Central

Chang, Wei; Ordonez, Caesar E.; Liang, Haoning; Li, Yusheng; Liu, Jingai

2013-01-01

Because of scarcity of photons emitted from the heart, clinical cardiac SPECT imaging is mainly limited by photon statistics. The sub-optimal detection efficiency of current SPECT systems not only limits the quality of clinical cardiac SPECT imaging but also makes more advanced potential applications difficult to be realized. We propose a high-performance system platform - C-SPECT, which has its sampling geometry optimized for detection of emitted photons in quality and quantity. The C-SPECT has a stationary C-shaped gantry that surrounds the left-front side of a patient’s thorax. The stationary C-shaped collimator and detector systems in the gantry provide effective and efficient detection and sampling of photon emission. For cardiac imaging, the C-SPECT platform could achieve 2 to 4 times the system geometric efficiency of conventional SPECT systems at the same sampling resolution. This platform also includes an integrated transmission CT for attenuation correction. The ability of C-SPECT systems to perform sequential high-quality emission and transmission imaging could bring cost-effective high-performance to clinical imaging. In addition, a C-SPECT system could provide high detection efficiency to accommodate fast acquisition rate for gated and dynamic cardiac imaging. This paper describes the design concepts and performance potential of C-SPECT, and illustrates how these concepts can be implemented in a basic system. PMID:23885129

Hyperspectral wide gap second derivative analysis for in vivo detection of cervical intraepithelial neoplasia

NASA Astrophysics Data System (ADS)

Zheng, Wenli; Wang, Chaojian; Chang, Shufang; Zhang, Shiwu; Xu, Ronald X.

2015-12-01

Hyperspectral reflectance imaging technique has been used for in vivo detection of cervical intraepithelial neoplasia. However, the clinical outcome of this technique is suboptimal owing to multiple limitations such as nonuniform illumination, high-cost and bulky setup, and time-consuming data acquisition and processing. To overcome these limitations, we acquired the hyperspectral data cube in a wavelength ranging from 600 to 800 nm and processed it by a wide gap second derivative analysis method. This method effectively reduced the image artifacts caused by nonuniform illumination and background absorption. Furthermore, with second derivative analysis, only three specific wavelengths (620, 696, and 772 nm) are needed for tissue classification with optimal separability. Clinical feasibility of the proposed image analysis and classification method was tested in a clinical trial where cervical hyperspectral images from three patients were used for classification analysis. Our proposed method successfully classified the cervix tissue into three categories of normal, inflammation and high-grade lesion. These classification results were coincident with those by an experienced gynecology oncologist after applying acetic acid. Our preliminary clinical study has demonstrated the technical feasibility for in vivo and noninvasive detection of cervical neoplasia without acetic acid. Further clinical research is needed in order to establish a large-scale diagnostic database and optimize the tissue classification technique.

Hyperspectral wide gap second derivative analysis for in vivo detection of cervical intraepithelial neoplasia.

PubMed

Zheng, Wenli; Wang, Chaojian; Chang, Shufang; Zhang, Shiwu; Xu, Ronald X

2015-12-01

Hyperspectral reflectance imaging technique has been used for in vivo detection of cervical intraepithelial neoplasia. However, the clinical outcome of this technique is suboptimal owing to multiple limitations such as nonuniform illumination, high-cost and bulky setup, and time-consuming data acquisition and processing. To overcome these limitations, we acquired the hyperspectral data cube in a wavelength ranging from 600 to 800 nm and processed it by a wide gap second derivative analysis method. This method effectively reduced the image artifacts caused by nonuniform illumination and background absorption. Furthermore, with second derivative analysis, only three specific wavelengths (620, 696, and 772 nm) are needed for tissue classification with optimal separability. Clinical feasibility of the proposed image analysis and classification method was tested in a clinical trial where cervical hyperspectral images from three patients were used for classification analysis. Our proposed method successfully classified the cervix tissue into three categories of normal, inflammation and high-grade lesion. These classification results were coincident with those by an experienced gynecology oncologist after applying acetic acid. Our preliminary clinical study has demonstrated the technical feasibility for in vivo and noninvasive detection of cervical neoplasia without acetic acid. Further clinical research is needed in order to establish a large-scale diagnostic database and optimize the tissue classification technique.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

PubMed Central

Choi, Bo-Ram; Choi, Da-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul; Bae, Kwang-Hak

2012-01-01

Purpose The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively. PMID:23071969

A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

PubMed

Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

2017-01-01

This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

Diagnostic and interventional musculoskeletal ultrasound: part 1. Fundamentals.

PubMed

Smith, Jay; Finnoff, Jonathan T

2009-01-01

Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurologic and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared with other available imaging modalities, (2) describe how ultrasound machines produce images using sound waves, (3) discuss the steps necessary to acquire and optimize an ultrasound image, (4) understand the different ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones, and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound in musculoskeletal practice. Part 1 of this 2-part article reviews the fundamentals of clinical ultrasonographic imaging, including relevant physics, equipment, training, image optimization, and scanning principles for diagnostic and interventional purposes.

Dose Optimization in TOF-PET/MR Compared to TOF-PET/CT

PubMed Central

Queiroz, Marcelo A.; Delso, Gaspar; Wollenweber, Scott; Deller, Timothy; Zeimpekis, Konstantinos; Huellner, Martin; de Galiza Barbosa, Felipe; von Schulthess, Gustav; Veit-Haibach, Patrick

2015-01-01

Purpose To evaluate the possible activity reduction in FDG-imaging in a Time-of-Flight (TOF) PET/MR, based on cross-evaluation of patient-based NECR (noise equivalent count rate) measurements in PET/CT, cross referencing with phantom-based NECR curves as well as initial evaluation of TOF-PET/MR with reduced activity. Materials and Methods A total of 75 consecutive patients were evaluated in this study. PET/CT imaging was performed on a PET/CT (time-of-flight (TOF) Discovery D 690 PET/CT). Initial PET/MR imaging was performed on a newly available simultaneous TOF-PET/MR (Signa PET/MR). An optimal NECR for diagnostic purposes was defined in clinical patients (NECRP) in PET/CT. Subsequent optimal activity concentration at the acquisition time ([A]0) and target NECR (NECRT) were obtained. These data were used to predict the theoretical FDG activity requirement of the new TOF-PET/MR system. Twenty-five initial patients were acquired with (retrospectively reconstructed) different imaging times equivalent for different activities on the simultaneous PET/MR for the evaluation of clinically realistic FDG-activities. Results The obtained values for NECRP, [A]0 and NECRT were 114.6 (± 14.2) kcps (Kilocounts per second), 4.0 (± 0.7) kBq/mL and 45 kcps, respectively. Evaluating the NECRT together with the phantom curve of the TOF-PET/MR device, the theoretical optimal activity concentration was found to be approximately 1.3 kBq/mL, which represents 35% of the activity concentration required by the TOF-PET/CT. Initial evaluation on patients in the simultaneous TOF-PET/MR shows clinically realistic activities of 1.8 kBq/mL, which represent 44% of the required activity. Conclusion The new TOF-PET/MR device requires significantly less activity to generate PET-images with good-to-excellent image quality, due to improvements in detector geometry and detector technologies. The theoretically achievable dose reduction accounts for up to 65% but cannot be fully translated into clinical routine based on the coils within the FOV and MR-sequences applied at the same time. The clinically realistic reduction in activity is slightly more than 50%. Further studies in a larger number of patients are needed to confirm our findings. PMID:26147919

Optimization of image quality and dose for Varian aS500 electronic portal imaging devices (EPIDs).

PubMed

McGarry, C K; Grattan, M W D; Cosgrove, V P

2007-12-07

This study was carried out to investigate whether the electronic portal imaging (EPI) acquisition process could be optimized, and as a result tolerance and action levels be set for the PIPSPro QC-3V phantom image quality assessment. The aim of the optimization process was to reduce the dose delivered to the patient while maintaining a clinically acceptable image quality. This is of interest when images are acquired in addition to the planned patient treatment, rather than images being acquired using the treatment field during a patient's treatment. A series of phantoms were used to assess image quality for different acquisition settings relative to the baseline values obtained following acceptance testing. Eight Varian aS500 EPID systems on four matched Varian 600C/D linacs and four matched Varian 2100C/D linacs were compared for consistency of performance and images were acquired at the four main orthogonal gantry angles. Images were acquired using a 6 MV beam operating at 100 MU min(-1) and the low-dose acquisition mode. Doses used in the comparison were measured using a Farmer ionization chamber placed at d(max) in solid water. The results demonstrated that the number of reset frames did not have any influence on the image contrast, but the number of frame averages did. The expected increase in noise with corresponding decrease in contrast was also observed when reducing the number of frame averages. The optimal settings for the low-dose acquisition mode with respect to image quality and dose were found to be one reset frame and three frame averages. All patients at the Northern Ireland Cancer Centre are now imaged using one reset frame and three frame averages in the 6 MV 100 MU min(-1) low-dose acquisition mode. Routine EPID QC contrast tolerance (+/-10) and action (+/-20) levels using the PIPSPro phantom based around expected values of 190 (Varian 600C/D) and 225 (Varian 2100C/D) have been introduced. The dose at dmax from electronic portal imaging has been reduced by approximately 28%, and while the image quality has been reduced, the images produced are still clinically acceptable.

TH-AB-202-09: Direct-Aperture Optimization for Combined MV+kV Dose Planning in Fluoroscopic Real-Time Tumor-Tracking Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, X; Belcher, AH; Grelewicz, Z

Purpose: Real-time kV fluoroscopic tumor tracking has the benefit of direct tumor position monitoring. However, there is clinical concern over the excess kV imaging dose cost to the patient when imaging in continuous fluoroscopic mode. This work addresses this specific issue by proposing a combined MV+kV direct-aperture optimization (DAO) approach to integrate the kV imaging beam into a treatment planning such that the kV radiation is considered as a contributor to the overall dose delivery. Methods: The combined MV+kV DAO approach includes three algorithms. First, a projected Quasi-Newton algorithm (L-BFGS) is used to find optimized fluence with MV+kV dose formore » the best possible dose distribution. Then, Engel’s algorithm is applied to optimize the total number of monitor units and heuristically optimize the number of apertures. Finally, an aperture shape optimization (ASO) algorithm is applied to locally optimize the leaf positions of MLC. Results: Compared to conventional DAO MV plans with continuous kV fluoroscopic tracking, combined MV+kV DAO plan leads to a reduction in the total number of MV monitor units due to inclusion of kV dose as part of the PTV, and was also found to reduce the mean and maximum doses on the organs at risk (OAR). Compared to conventional DAO MV plan without kV tracking, the OAR dose in the combined MV+kV DAO plan was only slightly higher. DVH curves show that combined MV+kV DAO plan provided about the same PTV coverage as that in the conventional DAO plans without kV imaging. Conclusion: We report a combined MV+kV DAO approach that allows real time kV imager tumor tracking with only a trivial increasing on the OAR doses while providing the same coverage to PTV. The approach is suitable for clinic implementation.« less

Optimization of PROPELLER reconstruction for free-breathing T1-weighted cardiac imaging.

PubMed

Huang, Teng-Yi; Tseng, Yu-Shen; Tang, Yu-Wei; Lin, Yi-Ru

2012-08-01

Clinical cardiac MR imaging techniques generally require patients to hold their breath during the scanning process to minimize respiratory motion-related artifacts. However, some patients cannot hold their breath because of illness or limited breath-hold capacity. This study aims to optimize the PROPELLER reconstruction for free-breathing myocardial T1-weighted imaging. Eight healthy volunteers (8 men; mean age 26.4 years) participated in this study after providing institutionally approved consent. The PROPELLER encoding method can reconstruct a low-resolution image from every blade because of k-space center oversampling. This study investigated the feasibility of extracting a respiratory trace from the PROPELLER blades by implementing a fully automatic region of interest selection and introducing a best template index to account for the property of the human respiration cycle. Results demonstrated that the proposed algorithm significantly improves the contrast-to-noise ratio and the image sharpness (p < 0.05). The PROPELLER method is expected to provide a robust tool for clinical application in free-breathing myocardial T1-weighted imaging. It could greatly facilitate the acquisition procedures during such a routine examination.

MO-G-17A-07: Improved Image Quality in Brain F-18 FDG PET Using Penalized-Likelihood Image Reconstruction Via a Generalized Preconditioned Alternating Projection Algorithm: The First Patient Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmidtlein, CR; Beattie, B; Humm, J

2014-06-15

Purpose: To investigate the performance of a new penalized-likelihood PET image reconstruction algorithm using the 1{sub 1}-norm total-variation (TV) sum of the 1st through 4th-order gradients as the penalty. Simulated and brain patient data sets were analyzed. Methods: This work represents an extension of the preconditioned alternating projection algorithm (PAPA) for emission-computed tomography. In this new generalized algorithm (GPAPA), the penalty term is expanded to allow multiple components, in this case the sum of the 1st to 4th order gradients, to reduce artificial piece-wise constant regions (“staircase” artifacts typical for TV) seen in PAPA images penalized with only the 1stmore » order gradient. Simulated data were used to test for “staircase” artifacts and to optimize the penalty hyper-parameter in the root-mean-squared error (RMSE) sense. Patient FDG brain scans were acquired on a GE D690 PET/CT (370 MBq at 1-hour post-injection for 10 minutes) in time-of-flight mode and in all cases were reconstructed using resolution recovery projectors. GPAPA images were compared PAPA and RMSE-optimally filtered OSEM (fully converged) in simulations and to clinical OSEM reconstructions (3 iterations, 32 subsets) with 2.6 mm XYGaussian and standard 3-point axial smoothing post-filters. Results: The results from the simulated data show a significant reduction in the 'staircase' artifact for GPAPA compared to PAPA and lower RMSE (up to 35%) compared to optimally filtered OSEM. A simple power-law relationship between the RMSE-optimal hyper-parameters and the noise equivalent counts (NEC) per voxel is revealed. Qualitatively, the patient images appear much sharper and with less noise than standard clinical images. The convergence rate is similar to OSEM. Conclusions: GPAPA reconstructions using the 1{sub 1}-norm total-variation sum of the 1st through 4th-order gradients as the penalty show great promise for the improvement of image quality over that currently achieved with clinical OSEM reconstructions.« less

Globally optimal tumor segmentation in PET-CT images: a graph-based co-segmentation method.

PubMed

Han, Dongfeng; Bayouth, John; Song, Qi; Taurani, Aakant; Sonka, Milan; Buatti, John; Wu, Xiaodong

2011-01-01

Tumor segmentation in PET and CT images is notoriously challenging due to the low spatial resolution in PET and low contrast in CT images. In this paper, we have proposed a general framework to use both PET and CT images simultaneously for tumor segmentation. Our method utilizes the strength of each imaging modality: the superior contrast of PET and the superior spatial resolution of CT. We formulate this problem as a Markov Random Field (MRF) based segmentation of the image pair with a regularized term that penalizes the segmentation difference between PET and CT. Our method simulates the clinical practice of delineating tumor simultaneously using both PET and CT, and is able to concurrently segment tumor from both modalities, achieving globally optimal solutions in low-order polynomial time by a single maximum flow computation. The method was evaluated on clinically relevant tumor segmentation problems. The results showed that our method can effectively make use of both PET and CT image information, yielding segmentation accuracy of 0.85 in Dice similarity coefficient and the average median hausdorff distance (HD) of 6.4 mm, which is 10% (resp., 16%) improvement compared to the graph cuts method solely using the PET (resp., CT) images.

Dedicated mobile volumetric cone-beam computed tomography for human brain imaging: A phantom study.

PubMed

Ryu, Jong-Hyun; Kim, Tae-Hoon; Jeong, Chang-Won; Jun, Hong-Young; Heo, Dong-Woon; Lee, Jinseok; Kim, Kyong-Woo; Yoon, Kwon-Ha

2015-01-01

Mobile computed tomography (CT) with a cone-beam source is increasingly used in the clinical field. Mobile cone-beam CT (CBCT) has great merits; however, its clinical utility for brain imaging has been limited due to problems including scan time and image quality. The aim of this study was to develop a dedicated mobile volumetric CBCT for obtaining brain images, and to optimize the imaging protocol using a brain phantom. The mobile volumetric CBCT system was evaluated with regards to scan time and image quality, measured as signal-to-noise-ratio (SNR), contrast-to-noise-ratio (CNR), spatial resolution (10% MTF), and effective dose. Brain images were obtained using a CT phantom. The CT scan took 5.14 s at 360 projection views. SNR and CNR were 5.67 and 14.5 at 120 kV/10 mA. SNR and CNR values showed slight improvement as the x-ray voltage and current increased (p < 0.001). Effective dose and 10% MTF were 0.92 mSv and 360 μ m at 120 kV/10 mA. Various intracranial structures were clearly visible in the brain phantom images. Using this CBCT under optimal imaging acquisition conditions, it is possible to obtain human brain images with low radiation dose, reproducible image quality, and fast scan time.

Simulation-Based Joint Estimation of Body Deformation and Elasticity Parameters for Medical Image Analysis

PubMed Central

Foskey, Mark; Niethammer, Marc; Krajcevski, Pavel; Lin, Ming C.

2014-01-01

Estimation of tissue stiffness is an important means of noninvasive cancer detection. Existing elasticity reconstruction methods usually depend on a dense displacement field (inferred from ultrasound or MR images) and known external forces. Many imaging modalities, however, cannot provide details within an organ and therefore cannot provide such a displacement field. Furthermore, force exertion and measurement can be difficult for some internal organs, making boundary forces another missing parameter. We propose a general method for estimating elasticity and boundary forces automatically using an iterative optimization framework, given the desired (target) output surface. During the optimization, the input model is deformed by the simulator, and an objective function based on the distance between the deformed surface and the target surface is minimized numerically. The optimization framework does not depend on a particular simulation method and is therefore suitable for different physical models. We show a positive correlation between clinical prostate cancer stage (a clinical measure of severity) and the recovered elasticity of the organ. Since the surface correspondence is established, our method also provides a non-rigid image registration, where the quality of the deformation fields is guaranteed, as they are computed using a physics-based simulation. PMID:22893381

Brain SPECT Imaging in Complex Psychiatric Cases: An Evidence-Based, Underutilized Tool

PubMed Central

Amen, Daniel G; Trujillo, Manuel; Newberg, Andrew; Willeumier, Kristen; Tarzwell, Robert; Wu, Joseph C; Chaitin, Barry

2011-01-01

Over the past 20 years brain Single Photon Emission Computed Tomography (SPECT) imaging has developed a substantial, evidence-based foundation and is now recommended by professional societies for numerous indications relevant to psychiatric practice. Unfortunately, SPECT in clinical practice is utilized by only a handful of clinicians. This article presents a rationale for a more widespread use of SPECT in clinical practice for complex cases, and includes seven clinical applications where it may help optimize patient care. PMID:21863144

Enabling vendor independent photoacoustic imaging systems with asynchronous laser source

NASA Astrophysics Data System (ADS)

Wu, Yixuan; Zhang, Haichong K.; Boctor, Emad M.

2018-02-01

Channel data acquisition, and synchronization between laser excitation and PA signal acquisition, are two fundamental hardware requirements for photoacoustic (PA) imaging. Unfortunately, however, neither is equipped by most clinical ultrasound scanners. Therefore, less economical specialized research platforms are used in general, which hinders a smooth clinical transition of PA imaging. In previous studies, we have proposed an algorithm to achieve PA imaging using ultrasound post-beamformed (USPB) RF data instead of channel data. This work focuses on enabling clinical ultrasound scanners to implement PA imaging, without requiring synchronization between the laser excitation and PA signal acquisition. Laser synchronization is inherently consisted of two aspects: frequency and phase information. We synchronize without communicating the laser and the ultrasound scanner by investigating USPB images of a point-target phantom in two steps. First, frequency information is estimated by solving a nonlinear optimization problem, under the assumption that the segmented wave-front can only be beamformed into a single spot when synchronization is achieved. Second, after making frequencies of two systems identical, phase delay is estimated by optimizing the image quality while varying phase value. The proposed method is validated through simulation, by manually adding both frequency and phase errors, then applying the proposed algorithm to correct errors and reconstruct PA images. Compared with the ground truth, simulation results indicate that the remaining errors in frequency correction and phase correction are 0.28% and 2.34%, respectively, which affirm the potential of overcoming hardware barriers on PA imaging through software solution.

Clinical development of BLZ-100 for real-time optical imaging of tumors during resection

NASA Astrophysics Data System (ADS)

Franklin, Heather L.; Miller, Dennis M.; Hedges, Teresa; Perry, Jeff; Parrish-Novak, Julia

2016-03-01

Complete initial resection can give cancer patients the best opportunity for long-term survival. There is unmet need in surgical oncology for optical imaging that enables simple and precise visualization of tumors and consistent contrast with surrounding normal tissues. Near-infrared (NIR) contrast agents and camera systems that can detect them represent an area of active research and development. The investigational Tumor Paint agent BLZ-100 is a conjugate of a chlorotoxin peptide and the NIR dye indocyanine green (ICG) that has been shown to specifically bind to a broad range of solid tumors. Clinical efficacy studies with BLZ-100 are in progress, a necessary step in bringing the product into clinical practice. To ensure a product that will be useful for and accepted by surgeons, the early clinical development of BLZ- 100 incorporates multiple tumor types and imaging devices so that surgeon feedback covers the range of anticipated clinical uses. Key contrast agent characteristics include safety, specificity, flexibility in timing between dose and surgery, and breadth of tumor types recognized. Imaging devices should use wavelengths that are optimal for the contrast agent, be sensitive enough that contrast agent dosing can be adjusted for optimal contrast, include real-time video display of fluorescence and white light image, and be simple for surgeons to use with minimal disruption of surgical flow. Rapid entry into clinical studies provides the best opportunity for early surgeon feedback, enabling development of agents and devices that will gain broad acceptance and provide information that helps surgeons achieve more complete and precise resections.

Quantitative comparison of OSEM and penalized likelihood image reconstruction using relative difference penalties for clinical PET

NASA Astrophysics Data System (ADS)

Ahn, Sangtae; Ross, Steven G.; Asma, Evren; Miao, Jun; Jin, Xiao; Cheng, Lishui; Wollenweber, Scott D.; Manjeshwar, Ravindra M.

2015-08-01

Ordered subset expectation maximization (OSEM) is the most widely used algorithm for clinical PET image reconstruction. OSEM is usually stopped early and post-filtered to control image noise and does not necessarily achieve optimal quantitation accuracy. As an alternative to OSEM, we have recently implemented a penalized likelihood (PL) image reconstruction algorithm for clinical PET using the relative difference penalty with the aim of improving quantitation accuracy without compromising visual image quality. Preliminary clinical studies have demonstrated visual image quality including lesion conspicuity in images reconstructed by the PL algorithm is better than or at least as good as that in OSEM images. In this paper we evaluate lesion quantitation accuracy of the PL algorithm with the relative difference penalty compared to OSEM by using various data sets including phantom data acquired with an anthropomorphic torso phantom, an extended oval phantom and the NEMA image quality phantom; clinical data; and hybrid clinical data generated by adding simulated lesion data to clinical data. We focus on mean standardized uptake values and compare them for PL and OSEM using both time-of-flight (TOF) and non-TOF data. The results demonstrate improvements of PL in lesion quantitation accuracy compared to OSEM with a particular improvement in cold background regions such as lungs.

Third version of vendor-specific model-based iterativereconstruction (Veo 3.0): evaluation of CT image quality in the abdomen using new noise reduction presets and varied slice optimization.

PubMed

Telesmanich, Morgan E; Jensen, Corey T; Enriquez, Jose L; Wagner-Bartak, Nicolaus A; Liu, Xinming; Le, Ott; Wei, Wei; Chandler, Adam G; Tamm, Eric P

2017-08-01

To qualitatively and quantitatively compare abdominal CT images reconstructed with a newversion of model-based iterative reconstruction (Veo 3.0; GE Healthcare Waukesha, WI) utilizing varied presetsof resolution preference, noise reduction and slice optimization. This retrospective study was approved by our Institutional Review Board and was Health Insurance Portability and Accountability Act compliant. The raw datafrom 30 consecutive patients who had undergone CT abdomen scanning were used to reconstructfour clinical presets of 3.75mm axial images using Veo 3.0: 5% resolution preference (RP05n), 5%noise reduction (NR05) and 40% noise reduction (NR40) with new 3.75mm "sliceoptimization," as well as one set using RP05 with conventional 0.625mm "slice optimization" (RP05c). The images were reviewed by two independent readers in a blinded, randomized manner using a 5-point Likert scale as well as a 5-point comparative scale. Multiple two-dimensional circular regions of interest were defined for noise and contrast-to-noise ratio measurements. Line profiles were drawn across the 7 lp cm -1 bar pattern of the Catphan 600 phantom for evaluation of spatial resolution. The NR05 image set was ranked as the best series in overall image quality (mean difference inrank 0.48, 95% CI [0.081-0.88], p = 0.01) and with specific reference to liver evaluation (meandifference 0.46, 95% CI [0.030-0.89], p = 0.03), when compared with the secondbest series ineach category. RP05n was ranked as the best for bone evaluation. NR40 was ranked assignificantly inferior across all assessed categories. Although the NR05 and RP05c image setshad nearly the same contrast-to-noise ratio and spatial resolution, NR05 was generally preferred. Image noise and spatial resolution increased along a spectrum with RP05n the highest and NR40the lowest. Compared to RP05n, the average noise was 21.01% lower for NR05, 26.88%lower for RP05c and 50.86% lower for NR40. Veo 3.0 clinical presets allow for selection of image noise and spatial resolution balance; for contrast-enhanced CT evaluation of the abdomen, the 5% noise reduction preset with 3.75 mm slice optimization (NR05) was generally ranked superior qualitatively and, relative to other series, was in the middle of the spectrum with reference to image noise and spatial resolution. Advances in knowledge: To our knowledge, this is the first study of Veo 3.0 noise reduction presets and varied slice optimization. This study provides insight into the behaviour of slice optimization and documents the degree of noise reduction and spatial resolution changes that users can expect across various Veo 3.0 clinical presets. These results provide important parameters to guide preset selection for both clinical and research purposes.

Molecular Imaging in the Era of Personalized Medicine

PubMed Central

Jung, Kyung-Ho; Lee, Kyung-Han

2015-01-01

Clinical imaging creates visual representations of the body interior for disease assessment. The role of clinical imaging significantly overlaps with that of pathology, and diagnostic workflows largely depend on both fields. The field of clinical imaging is presently undergoing a radical change through the emergence of a new field called molecular imaging. This new technology, which lies at the intersection between imaging and molecular biology, enables noninvasive visualization of biochemical processes at the molecular level within living bodies. Molecular imaging differs from traditional anatomical imaging in that biomarkers known as imaging probes are used to visualize target molecules-of-interest. This ability opens up exciting new possibilities for applications in oncologic, neurological and cardiovascular diseases. Molecular imaging is expected to make major contributions to personalized medicine by allowing earlier diagnosis and predicting treatment response. The technique is also making a huge impact on pharmaceutical development by optimizing preclinical and clinical tests for new drug candidates. This review will describe the basic principles of molecular imaging and will briefly touch on three examples (from an immense list of new techniques) that may contribute to personalized medicine: receptor imaging, angiogenesis imaging, and apoptosis imaging. PMID:25812652

Molecular imaging in the era of personalized medicine.

PubMed

Jung, Kyung-Ho; Lee, Kyung-Han

2015-01-01

Clinical imaging creates visual representations of the body interior for disease assessment. The role of clinical imaging significantly overlaps with that of pathology, and diagnostic workflows largely depend on both fields. The field of clinical imaging is presently undergoing a radical change through the emergence of a new field called molecular imaging. This new technology, which lies at the intersection between imaging and molecular biology, enables noninvasive visualization of biochemical processes at the molecular level within living bodies. Molecular imaging differs from traditional anatomical imaging in that biomarkers known as imaging probes are used to visualize target molecules-of-interest. This ability opens up exciting new possibilities for applications in oncologic, neurological and cardiovascular diseases. Molecular imaging is expected to make major contributions to personalized medicine by allowing earlier diagnosis and predicting treatment response. The technique is also making a huge impact on pharmaceutical development by optimizing preclinical and clinical tests for new drug candidates. This review will describe the basic principles of molecular imaging and will briefly touch on three examples (from an immense list of new techniques) that may contribute to personalized medicine: receptor imaging, angiogenesis imaging, and apoptosis imaging.

Contrast-enhanced spectral mammography with a photon-counting detector.

PubMed

Fredenberg, Erik; Hemmendorff, Magnus; Cederström, Björn; Aslund, Magnus; Danielsson, Mats

2010-05-01

Spectral imaging is a method in medical x-ray imaging to extract information about the object constituents by the material-specific energy dependence of x-ray attenuation. The authors have investigated a photon-counting spectral imaging system with two energy bins for contrast-enhanced mammography. System optimization and the potential benefit compared to conventional non-energy-resolved absorption imaging was studied. A framework for system characterization was set up that included quantum and anatomical noise and a theoretical model of the system was benchmarked to phantom measurements. Optimal combination of the energy-resolved images corresponded approximately to minimization of the anatomical noise, which is commonly referred to as energy subtraction. In that case, an ideal-observer detectability index could be improved close to 50% compared to absorption imaging in the phantom study. Optimization with respect to the signal-to-quantum-noise ratio, commonly referred to as energy weighting, yielded only a minute improvement. In a simulation of a clinically more realistic case, spectral imaging was predicted to perform approximately 30% better than absorption imaging for an average glandularity breast with an average level of anatomical noise. For dense breast tissue and a high level of anatomical noise, however, a rise in detectability by a factor of 6 was predicted. Another approximately 70%-90% improvement was found to be within reach for an optimized system. Contrast-enhanced spectral mammography is feasible and beneficial with the current system, and there is room for additional improvements. Inclusion of anatomical noise is essential for optimizing spectral imaging systems.

Optimization of oncological {sup 18}F-FDG PET/CT imaging based on a multiparameter analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Menezes, Vinicius O., E-mail: vinicius@radtec.com.br; Machado, Marcos A. D.; Queiroz, Cleiton C.

2016-02-15

Purpose: This paper describes a method to achieve consistent clinical image quality in {sup 18}F-FDG scans accounting for patient habitus, dose regimen, image acquisition, and processing techniques. Methods: Oncological PET/CT scan data for 58 subjects were evaluated retrospectively to derive analytical curves that predict image quality. Patient noise equivalent count rate and coefficient of variation (CV) were used as metrics in their analysis. Optimized acquisition protocols were identified and prospectively applied to 179 subjects. Results: The adoption of different schemes for three body mass ranges (<60 kg, 60–90 kg, >90 kg) allows improved image quality with both point spread functionmore » and ordered-subsets expectation maximization-3D reconstruction methods. The application of this methodology showed that CV improved significantly (p < 0.0001) in clinical practice. Conclusions: Consistent oncological PET/CT image quality on a high-performance scanner was achieved from an analysis of the relations existing between dose regimen, patient habitus, acquisition, and processing techniques. The proposed methodology may be used by PET/CT centers to develop protocols to standardize PET/CT imaging procedures and achieve better patient management and cost-effective operations.« less

Efficient 3D multi-region prostate MRI segmentation using dual optimization.

PubMed

Qiu, Wu; Yuan, Jing; Ukwatta, Eranga; Sun, Yue; Rajchl, Martin; Fenster, Aaron

2013-01-01

Efficient and accurate extraction of the prostate, in particular its clinically meaningful sub-regions from 3D MR images, is of great interest in image-guided prostate interventions and diagnosis of prostate cancer. In this work, we propose a novel multi-region segmentation approach to simultaneously locating the boundaries of the prostate and its two major sub-regions: the central gland and the peripheral zone. The proposed method utilizes the prior knowledge of the spatial region consistency and employs a customized prostate appearance model to simultaneously segment multiple clinically meaningful regions. We solve the resulted challenging combinatorial optimization problem by means of convex relaxation, for which we introduce a novel spatially continuous flow-maximization model and demonstrate its duality to the investigated convex relaxed optimization problem with the region consistency constraint. Moreover, the proposed continuous max-flow model naturally leads to a new and efficient continuous max-flow based algorithm, which enjoys great advantages in numerics and can be readily implemented on GPUs. Experiments using 15 T2-weighted 3D prostate MR images, by inter- and intra-operator variability, demonstrate the promising performance of the proposed approach.

Toward optimization of imaging system and lymphatic tracer for near-infrared fluorescent sentinel lymph node mapping in breast cancer.

PubMed

Mieog, J Sven D; Troyan, Susan L; Hutteman, Merlijn; Donohoe, Kevin J; van der Vorst, Joost R; Stockdale, Alan; Liefers, Gerrit-Jan; Choi, Hak Soo; Gibbs-Strauss, Summer L; Putter, Hein; Gioux, Sylvain; Kuppen, Peter J K; Ashitate, Yoshitomo; Löwik, Clemens W G M; Smit, Vincent T H B M; Oketokoun, Rafiou; Ngo, Long H; van de Velde, Cornelis J H; Frangioni, John V; Vahrmeijer, Alexander L

2011-09-01

Near-infrared (NIR) fluorescent sentinel lymph node (SLN) mapping in breast cancer requires optimized imaging systems and lymphatic tracers. A small, portable version of the FLARE imaging system, termed Mini-FLARE, was developed for capturing color video and two semi-independent channels of NIR fluorescence (700 and 800 nm) in real time. Initial optimization of lymphatic tracer dose was performed using 35-kg Yorkshire pigs and a 6-patient pilot clinical trial. More refined optimization was performed in 24 consecutive breast cancer patients. All patients received the standard of care using (99m)Technetium-nanocolloid and patent blue. In addition, 1.6 ml of indocyanine green adsorbed to human serum albumin (ICG:HSA) was injected directly after patent blue at the same location. Patients were allocated to 1 of 8 escalating ICG:HSA concentration groups from 50 to 1000 μM. The Mini-FLARE system was positioned easily in the operating room and could be used up to 13 in. from the patient. Mini-FLARE enabled visualization of lymphatic channels and SLNs in all patients. A total of 35 SLNs (mean = 1.45, range 1-3) were detected: 35 radioactive (100%), 30 blue (86%), and 35 NIR fluorescent (100%). Contrast agent quenching at the injection site and dilution within lymphatic channels were major contributors to signal strength of the SLN. Optimal injection dose of ICG:HSA ranged between 400 and 800 μM. No adverse reactions were observed. We describe the clinical translation of a new NIR fluorescence imaging system and define the optimal ICG:HSA dose range for SLN mapping in breast cancer.

LesionTracker: Extensible Open-Source Zero-Footprint Web Viewer for Cancer Imaging Research and Clinical Trials.

PubMed

Urban, Trinity; Ziegler, Erik; Lewis, Rob; Hafey, Chris; Sadow, Cheryl; Van den Abbeele, Annick D; Harris, Gordon J

2017-11-01

Oncology clinical trials have become increasingly dependent upon image-based surrogate endpoints for determining patient eligibility and treatment efficacy. As therapeutics have evolved and multiplied in number, the tumor metrics criteria used to characterize therapeutic response have become progressively more varied and complex. The growing intricacies of image-based response evaluation, together with rising expectations for rapid and consistent results reporting, make it difficult for site radiologists to adequately address local and multicenter imaging demands. These challenges demonstrate the need for advanced cancer imaging informatics tools that can help ensure protocol-compliant image evaluation while simultaneously promoting reviewer efficiency. LesionTracker is a quantitative imaging package optimized for oncology clinical trial workflows. The goal of the project is to create an open source zero-footprint viewer for image analysis that is designed to be extensible as well as capable of being integrated into third-party systems for advanced imaging tools and clinical trials informatics platforms. Cancer Res; 77(21); e119-22. ©2017 AACR . ©2017 American Association for Cancer Research.

Anterior Chest Wall in Axial Spondyloarthritis: Imaging, Interpretation, and Differential Diagnosis.

PubMed

Rennie, Winston J; Jans, Lennart; Jurik, Anne Grethe; Sudoł-Szopińska, Iwona; Schueller-Weidekamm, Claudia; Eshed, Iris

2018-04-01

Anterior chest wall (ACW) inflammation is not an uncommon finding in patients with axial spondyloarthritis (ax-SpA) and reportedly occurs in 26% of these patients. Radiologists may only be familiar with spinal and peripheral joint imaging, possibly due to the inherent challenges of ACW imaging on some cross-sectional imaging modalities. Knowledge of relevant joint anatomy and the location of sites of inflammation allows the interpreting radiologist to better plan appropriate imaging tests and imaging planes. Accurate assessment of disease burden, sometimes in the absence of clinical findings, may alert the treating rheumatologist, allowing a better estimation of disease burden, increased accuracy of potential imaging scoring systems, and optimize assessment and response to treatment. This article reviews salient anatomy and various imaging modalities to optimize diagnosis, important differential diagnoses, and the interpretation of ACW imaging findings in ax-SpA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Order of Magnitude Sensitivity Increase in X-ray Fluorescence Computed Tomography (XFCT) Imaging With an Optimized Spectro-Spatial Detector Configuration: Theory and Simulation

PubMed Central

Ahmad, Moiz; Bazalova, Magdalena; Xiang, Liangzhong

2014-01-01

The purpose of this study was to increase the sensitivity of XFCT imaging by optimizing the data acquisition geometry for reduced scatter X-rays. The placement of detectors and detector energy window were chosen to minimize scatter X-rays. We performed both theoretical calculations and Monte Carlo simulations of this optimized detector configuration on a mouse-sized phantom containing various gold concentrations. The sensitivity limits were determined for three different X-ray spectra: a monoenergetic source, a Gaussian source, and a conventional X-ray tube source. Scatter X-rays were minimized using a backscatter detector orientation (scatter direction > 110° to the primary X-ray beam). The optimized configuration simultaneously reduced the number of detectors and improved the image signal-to-noise ratio. The sensitivity of the optimized configuration was 10 µg/mL (10 pM) at 2 mGy dose with the mono-energetic source, which is an order of magnitude improvement over the unoptimized configuration (102 pM without the optimization). Similar improvements were seen with the Gaussian spectrum source and conventional X-ray tube source. The optimization improvements were predicted in the theoretical model and also demonstrated in simulations. The sensitivity of XFCT imaging can be enhanced by an order of magnitude with the data acquisition optimization, greatly enhancing the potential of this modality for future use in clinical molecular imaging. PMID:24770916

Order of magnitude sensitivity increase in X-ray Fluorescence Computed Tomography (XFCT) imaging with an optimized spectro-spatial detector configuration: theory and simulation.

PubMed

Ahmad, Moiz; Bazalova, Magdalena; Xiang, Liangzhong; Xing, Lei

2014-05-01

The purpose of this study was to increase the sensitivity of XFCT imaging by optimizing the data acquisition geometry for reduced scatter X-rays. The placement of detectors and detector energy window were chosen to minimize scatter X-rays. We performed both theoretical calculations and Monte Carlo simulations of this optimized detector configuration on a mouse-sized phantom containing various gold concentrations. The sensitivity limits were determined for three different X-ray spectra: a monoenergetic source, a Gaussian source, and a conventional X-ray tube source. Scatter X-rays were minimized using a backscatter detector orientation (scatter direction > 110(°) to the primary X-ray beam). The optimized configuration simultaneously reduced the number of detectors and improved the image signal-to-noise ratio. The sensitivity of the optimized configuration was 10 μg/mL (10 pM) at 2 mGy dose with the mono-energetic source, which is an order of magnitude improvement over the unoptimized configuration (102 pM without the optimization). Similar improvements were seen with the Gaussian spectrum source and conventional X-ray tube source. The optimization improvements were predicted in the theoretical model and also demonstrated in simulations. The sensitivity of XFCT imaging can be enhanced by an order of magnitude with the data acquisition optimization, greatly enhancing the potential of this modality for future use in clinical molecular imaging.

Towards in vivo laser coagulation and concurrent optical coherence tomography through double-clad fiber devices

NASA Astrophysics Data System (ADS)

Beaudette, Kathy; Lo, William; Villiger, Martin; Shishkov, Milen; Godbout, Nicolas; Bouma, Brett E.; Boudoux, Caroline

2016-03-01

There is a strong clinical need for an optical coherence tomography (OCT) system capable of delivering concurrent coagulation light enabling image-guided dynamic laser marking for targeted collection of biopsies, as opposed to a random sampling, to reduce false-negative findings. Here, we present a system based on double-clad fiber (DCF) capable of delivering pulsed laser light through the inner cladding while performing OCT through the core. A previously clinically validated commercial OCT system (NVisionVLE, Ninepoint Medical) was adapted to enable in vivo esophageal image-guided dynamic laser marking. An optimized DCF coupler was implemented into the system to couple both modalities into the DCF. A DCF-based rotary joint was used to couple light to the spinning DCF-based catheter for helical scanning. DCF-based OCT catheters, providing a beam waist diameter of 62μm at a working distance of 9.3mm, for use with a 17-mm diameter balloon sheath, were used for ex vivo imaging of a swine esophagus. Imaging results using the DCF-based clinical system show an image quality comparable with a conventional system with minimal crosstalk-induced artifacts. To further optimize DCF catheter optical design in order to achieve single-pulse marking, a Zemax model of the DCF output and its validation are presented.

Exploring silver as a contrast agent for contrast-enhanced dual-energy X-ray breast imaging

PubMed Central

Tsourkas, A; Maidment, A D A

2014-01-01

Objective: Through prior monoenergetic modelling, we have identified silver as a potential alternative to iodine in dual-energy (DE) X-ray breast imaging. The purpose of this study was to compare the performance of silver and iodine contrast agents in a commercially available DE imaging system through a quantitative analysis of signal difference-to-noise ratio (SDNR). Methods: A polyenergetic simulation algorithm was developed to model the signal intensity and noise. The model identified the influence of various technique parameters on SDNR. The model was also used to identify the optimal imaging techniques for silver and iodine, so that the two contrast materials could be objectively compared. Results: The major influences on the SDNR were the low-energy dose fraction and breast thickness. An increase in the value of either of these parameters resulted in a decrease in SDNR. The SDNR for silver was on average 43% higher than that for iodine when imaged at their respective optimal conditions, and 40% higher when both were imaged at the optimal conditions for iodine. Conclusion: A silver contrast agent should provide benefit over iodine, even when translated to the clinic without modification of imaging system or protocol. If the system were slightly modified to reflect the lower k-edge of silver, the difference in SDNR between the two materials would be increased. Advances in knowledge: These data are the first to demonstrate the suitability of silver as a contrast material in a clinical contrast-enhanced DE image acquisition system. PMID:24998157

Image-Guided Surgery using Invisible Near-Infrared Light: Fundamentals of Clinical Translation

PubMed Central

Gioux, Sylvain; Choi, Hak Soo; Frangioni, John V.

2011-01-01

The field of biomedical optics has matured rapidly over the last decade and is poised to make a significant impact on patient care. In particular, wide-field (typically > 5 cm), planar, near-infrared (NIR) fluorescence imaging has the potential to revolutionize human surgery by providing real-time image guidance to surgeons for tissue that needs to be resected, such as tumors, and tissue that needs to be avoided, such as blood vessels and nerves. However, to become a clinical reality, optimized imaging systems and NIR fluorescent contrast agents will be needed. In this review, we introduce the principles of NIR fluorescence imaging, analyze existing NIR fluorescence imaging systems, and discuss the key parameters that guide contrast agent development. We also introduce the complexities surrounding clinical translation using our experience with the Fluorescence-Assisted Resection and Exploration (FLARE™) imaging system as an example. Finally, we introduce state-of-the-art optical imaging techniques that might someday improve image-guided surgery even further. PMID:20868625

Correlation of the clinical and physical image quality in chest radiography for average adults with a computed radiography imaging system.

PubMed

Moore, C S; Wood, T J; Beavis, A W; Saunderson, J R

2013-07-01

The purpose of this study was to examine the correlation between the quality of visually graded patient (clinical) chest images and a quantitative assessment of chest phantom (physical) images acquired with a computed radiography (CR) imaging system. The results of a previously published study, in which four experienced image evaluators graded computer-simulated postero-anterior chest images using a visual grading analysis scoring (VGAS) scheme, were used for the clinical image quality measurement. Contrast-to-noise ratio (CNR) and effective dose efficiency (eDE) were used as physical image quality metrics measured in a uniform chest phantom. Although optimal values of these physical metrics for chest radiography were not derived in this work, their correlation with VGAS in images acquired without an antiscatter grid across the diagnostic range of X-ray tube voltages was determined using Pearson's correlation coefficient. Clinical and physical image quality metrics increased with decreasing tube voltage. Statistically significant correlations between VGAS and CNR (R=0.87, p<0.033) and eDE (R=0.77, p<0.008) were observed. Medical physics experts may use the physical image quality metrics described here in quality assurance programmes and optimisation studies with a degree of confidence that they reflect the clinical image quality in chest CR images acquired without an antiscatter grid. A statistically significant correlation has been found between the clinical and physical image quality in CR chest imaging. The results support the value of using CNR and eDE in the evaluation of quality in clinical thorax radiography.

A comprehensive study on the relationship between the image quality and imaging dose in low-dose cone beam CT

NASA Astrophysics Data System (ADS)

Yan, Hao; Cervino, Laura; Jia, Xun; Jiang, Steve B.

2012-04-01

While compressed sensing (CS)-based algorithms have been developed for the low-dose cone beam CT (CBCT) reconstruction, a clear understanding of the relationship between the image quality and imaging dose at low-dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot both the image quality and imaging dose together as functions of the number of projections and mAs per projection over the whole clinically relevant range. On this basis, a clear understanding of the tradeoff between the image quality and imaging dose can be achieved and optimal low-dose CBCT scan protocols can be developed to maximize the dose reduction while minimizing the image quality loss for various imaging tasks in image-guided radiation therapy (IGRT). Main findings of this work include (1) under the CS-based reconstruction framework, image quality has little degradation over a large range of dose variation. Image quality degradation becomes evident when the imaging dose (approximated with the x-ray tube load) is decreased below 100 total mAs. An imaging dose lower than 40 total mAs leads to a dramatic image degradation, and thus should be used cautiously. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40-100 total mAs, depending on the specific IGRT applications. (2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with the projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with low mAs protocols. (3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. (4) The clinically acceptable lowest imaging dose level is task dependent. In our study, 72.8 mAs is a safe dose level for visualizing low-contrast objects, while 12.2 total mAs is sufficient for detecting high-contrast objects of diameter greater than 3 mm.

MO-G-BRE-03: Automated Continuous Monitoring of Patient Setup with Second-Check Independent Image Registration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, X; Fox, T; Schreibmann, E

2014-06-15

Purpose: To create a non-supervised quality assurance program to monitor image-based patient setup. The system acts a secondary check by independently computing shifts and rotations and interfaces with Varian's database to verify therapist's work and warn against sub-optimal setups. Methods: Temporary digitally-reconstructed radiographs (DRRs) and OBI radiographic image files created by Varian's treatment console during patient setup are intercepted and used as input in an independent registration module customized for accuracy that determines the optimal rotations and shifts. To deal with the poor quality of OBI images, a histogram equalization of the live images to the DDR counterparts is performedmore » as a pre-processing step. A search for the most sensitive metric was performed by plotting search spaces subject to various translations and convergence analysis was applied to ensure the optimizer finds the global minima. Final system configuration uses the NCC metric with 150 histogram bins and a one plus one optimizer running for 2000 iterations with customized scales for translations and rotations in a multi-stage optimization setup that first corrects and translations and subsequently rotations. Results: The system was installed clinically to monitor and provide almost real-time feedback on patient positioning. On a 2 month-basis uncorrected pitch values were of a mean 0.016° with standard deviation of 1.692°, and couch rotations of − 0.090°± 1.547°. The couch shifts were −0.157°±0.466° cm for the vertical, 0.045°±0.286 laterally and 0.084°± 0.501° longitudinally. Uncorrected pitch angles were the most common source of discrepancies. Large variations in the pitch angles were correlated with patient motion inside the mask. Conclusion: A system for automated quality assurance of therapist's registration was designed and tested in clinical practice. The approach complements the clinical software's automated registration in terms of algorithm configuration and performance and constitutes a practical approach to implement safe and cost-effective radiotherapy.« less

SU-E-J-16: Automatic Image Contrast Enhancement Based On Automatic Parameter Optimization for Radiation Therapy Setup Verification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qiu, J; Washington University in St Louis, St Louis, MO; Li, H. Harlod

Purpose: In RT patient setup 2D images, tissues often cannot be seen well due to the lack of image contrast. Contrast enhancement features provided by image reviewing software, e.g. Mosaiq and ARIA, require manual selection of the image processing filters and parameters thus inefficient and cannot be automated. In this work, we developed a novel method to automatically enhance the 2D RT image contrast to allow automatic verification of patient daily setups as a prerequisite step of automatic patient safety assurance. Methods: The new method is based on contrast limited adaptive histogram equalization (CLAHE) and high-pass filtering algorithms. The mostmore » important innovation is to automatically select the optimal parameters by optimizing the image contrast. The image processing procedure includes the following steps: 1) background and noise removal, 2) hi-pass filtering by subtracting the Gaussian smoothed Result, and 3) histogram equalization using CLAHE algorithm. Three parameters were determined through an iterative optimization which was based on the interior-point constrained optimization algorithm: the Gaussian smoothing weighting factor, the CLAHE algorithm block size and clip limiting parameters. The goal of the optimization is to maximize the entropy of the processed Result. Results: A total 42 RT images were processed. The results were visually evaluated by RT physicians and physicists. About 48% of the images processed by the new method were ranked as excellent. In comparison, only 29% and 18% of the images processed by the basic CLAHE algorithm and by the basic window level adjustment process, were ranked as excellent. Conclusion: This new image contrast enhancement method is robust and automatic, and is able to significantly outperform the basic CLAHE algorithm and the manual window-level adjustment process that are currently used in clinical 2D image review software tools.« less

Cancer Imaging: Gene Transcription-Based Imaging and Therapeutic Systems

PubMed Central

Bhang, Hyo-eun C.; Pomper, Martin G.

2012-01-01

Molecular-genetic imaging of cancer is in its infancy. Over the past decade gene reporter systems have been optimized in preclinical models and some have found their way into the clinic. The search is on to find the best combination of gene delivery vehicle and reporter imaging system that can be translated safely and quickly. The goal is to have a combination that can detect a wide variety of cancers with high sensitivity and specificity in a way that rivals the current clinical standard, positron emission tomography with [18F]fluorodeoxyglucose. To do so will require systemic delivery of reporter genes for the detection of micrometastases, and a nontoxic vector, whether viral or based on nanotechnology, to gain widespread acceptance by the oncology community. Merger of molecular-genetic imaging with gene therapy, a strategy that has been employed in the past, will likely be necessary for such imaging to reach widespread clinical use. PMID:22349219

Recent developments in tissue-type imaging (TTI) for planning and monitoring treatment of prostate cancer.

PubMed

Feleppa, Ernest J; Porter, Christopher R; Ketterling, Jeffrey; Lee, Paul; Dasgupta, Shreedevi; Urban, Stella; Kalisz, Andrew

2004-07-01

Because current methods of imaging prostate cancer are inadequate, biopsies cannot be effectively guided and treatment cannot be effectively planned and targeted. Therefore, our research is aimed at ultrasonically characterizing cancerous prostate tissue so that we can image it more effectively and thereby provide improved means of detecting, treating and monitoring prostate cancer. We base our characterization methods on spectrum analysis of radiofrequency (rf) echo signals combined with clinical variables such as prostate-specific antigen (PSA). Tissue typing using these parameters is performed by artificial neural networks. We employed and evaluated different approaches to data partitioning into training, validation, and test sets and different neural network configuration options. In this manner, we sought to determine what neural network configuration is optimal for these data and also to assess possible bias that might exist due to correlations among different data entries among the data for a given patient. The classification efficacy of each neural network configuration and data-partitioning method was measured using relative-operating-characteristic (ROC) methods. Neural network classification based on spectral parameters combined with clinical data generally produced ROC-curve areas of 0.80 compared to curve areas of 0.64 for conventional transrectal ultrasound imaging combined with clinical data. We then used the optimal neural network configuration to generate lookup tables that translate local spectral parameter values and global clinical-variable values into pixel values in tissue-type images (TTIs). TTIs continue to show cancerous regions successfully, and may prove to be particularly useful clinically in combination with other ultrasonic and nonultrasonic methods, e.g., magnetic-resonance spectroscopy.

Recent Developments in Tissue-type Imaging(TTI) for Planning and Monitoring Treatment of Prostate Cancer

PubMed Central

Feleppa, Ernest J.; Porter, Christopher R.; Ketterling, Jeffrey; Lee, Paul; Dasgupta, Shreedevi; Urban, Stella; Kalisz, Andrew

2006-01-01

Because current methods of imaging prostate cancer are inadequate, biopsies cannot be effectively guided and treatment cannot be effectively planned and targeted. Therefore, our research is aimed at ultrasonically characterizing cancerous prostate tissue so that we can image it more effectively and thereby provide improved means of detecting, treating and monitoring prostate cancer. We base our characterization methods on spectrum analysis of radio frequency (rf) echo signals combined with clinical variables such as prostate-specific antigen (PSA). Tissue typing using these parameters is performed by artificial neural networks. We employedand evaluated different approaches to data partitioning into training, validation, and test sets and different neural network configuration options. In this manner, we sought to determine what neural network configuration is optimal for these data and also to assess possible bias that might exist due to correlations among different data entries among the data for a given patient. The classification efficacy of each neural network configuration and data-partitioning method was measured using relative-operating-characteristic (ROC) methods. Neural network classification based on spectral parameters combined with clinical data generally produced ROC-curve areas of 0.80 compared to curve areas of 0.64 for conventional transrectal ultrasound imaging combined with clinical data. We then used the optimal neural network configuration to generate lookup tables that translate local spectral parameter values and global clinical-variable values into pixel values in tissue-type images (TTIs). TTIs continue to show can cerous regions successfully, and may prove to be particularly useful clinically in combination with other ultrasonic and nonultrasonic methods, e.g., magnetic-resonance spectroscopy. PMID:15754797

Technical errors in planar bone scanning.

PubMed

Naddaf, Sleiman Y; Collier, B David; Elgazzar, Abdelhamid H; Khalil, Magdy M

2004-09-01

Optimal technique for planar bone scanning improves image quality, which in turn improves diagnostic efficacy. Because planar bone scanning is one of the most frequently performed nuclear medicine examinations, maintaining high standards for this examination is a daily concern for most nuclear medicine departments. Although some problems such as patient motion are frequently encountered, the degraded images produced by many other deviations from optimal technique are rarely seen in clinical practice and therefore may be difficult to recognize. The objectives of this article are to list optimal techniques for 3-phase and whole-body bone scanning, to describe and illustrate a selection of deviations from these optimal techniques for planar bone scanning, and to explain how to minimize or avoid such technical errors.

Consensus Recommendations of the Multiple Sclerosis Study Group and Portuguese Neuroradiological Society for the Use of the Magnetic Resonance Imaging in Multiple Sclerosis in Clinical Practice: Part 1.

PubMed

Abreu, Pedro; Pedrosa, Rui; Sá, Maria José; Cerqueira, João; Sousa, Lívia; Da Silva, Ana Martins; Pinheiro, Joaquim; De Sá, João; Batista, Sónia; Simões, Rita Moiron; Pereira, Daniela Jardim; Vilela, Pedro; Vale, José

2018-05-30

Magnetic resonance imaging is established as a recognizable tool in the diagnosis and monitoring of multiple sclerosis patients. In the present, among multiple sclerosis centers, there are different magnetic resonance imaging sequences and protocols used to study multiple sclerosis that may hamper the optimal use of magnetic resonance imaging in multiple sclerosis. In this context, the Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. The purpose of this document is to publish the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice. The Group of Studies of Multiple Sclerosis and the Portuguese Society of Neuroradiology, after discussion of the topic in national meetings and after a working group meeting held in Figueira da Foz on May 2017, have appointed a committee of experts that have developed by consensus several standard protocols on the use of magnetic resonance imaging in the diagnosis and follow-up of multiple sclerosis. The document obtained was based on the best scientific evidence and expert opinion. Subsequently, the majority of Portuguese multiple sclerosis consultants and departments of neuroradiology scrutinized and reviewed the consensus paper; comments and suggestions were considered. Technical magnetic resonance imaging protocols regarding diagnostic, monitoring and the recommended information to be included in the magnetic resonance imaging report will be published in a separate paper. We provide some practical guidelines to promote standardized strategies to be applied in the clinical practice setting of Portuguese healthcare professionals regarding the use of magnetic resonance imaging in multiple sclerosis. We hope that these first Portuguese magnetic resonance imaging guidelines, based in the best available clinical evidence and practices, will serve to optimize multiple sclerosis management and improve multiple sclerosis patient care across Portugal.

Energy weighting improves dose efficiency in clinical practice: implementation on a spectral photon-counting mammography system

PubMed Central

Berglund, Johan; Johansson, Henrik; Lundqvist, Mats; Cederström, Björn; Fredenberg, Erik

2014-01-01

Abstract. In x-ray imaging, contrast information content varies with photon energy. It is, therefore, possible to improve image quality by weighting photons according to energy. We have implemented and evaluated so-called energy weighting on a commercially available spectral photon-counting mammography system. The technique was evaluated using computer simulations, phantom experiments, and analysis of screening mammograms. The CNR benefit of energy weighting for a number of relevant target-background combinations measured by the three methods fell in the range of 2.2 to 5.2% when using optimal weight factors. This translates to a potential dose reduction at constant CNR in the range of 4.5 to 11%. We expect the choice of weight factor in practical implementations to be straightforward because (1) the CNR improvement was not very sensitive to weight, (2) the optimal weight was similar for all investigated target-background combinations, (3) aluminum/PMMA phantoms were found to represent clinically relevant tasks well, and (4) the optimal weight could be calculated directly from pixel values in phantom images. Reasonable agreement was found between the simulations and phantom measurements. Manual measurements on microcalcifications and automatic image analysis confirmed that the CNR improvement was detectable in energy-weighted screening mammograms. PMID:26158045

Simultaneous dual-color fluorescence microscope: a characterization study.

PubMed

Li, Zheng; Chen, Xiaodong; Ren, Liqiang; Song, Jie; Li, Yuhua; Zheng, Bin; Liu, Hong

2013-01-01

High spatial resolution and geometric accuracy is crucial for chromosomal analysis of clinical cytogenetic applications. High resolution and rapid simultaneous acquisition of multiple fluorescent wavelengths can be achieved by utilizing concurrent imaging with multiple detectors. However, such class of microscopic systems functions differently from traditional fluorescence microscopes. To develop a practical characterization framework to assess and optimize the performance of a high resolution and dual-color fluorescence microscope designed for clinical chromosomal analysis. A dual-band microscopic imaging system utilizes a dichroic mirror, two sets of specially selected optical filters, and two detectors to simultaneously acquire two fluorescent wavelengths. The system's geometric distortion, linearity, the modulation transfer function, and the dual detectors' alignment were characterized. Experiment results show that the geometric distortion at lens periphery is less than 1%. Both fluorescent channels show linear signal responses, but there exists discrepancy between the two due to the detectors' non-uniform response ratio to different wavelengths. In terms of the spatial resolution, the two contrast transfer function curves trend agreeably with the spatial frequency. The alignment measurement allows quantitatively assessing the cameras' alignment. A result image of adjusted alignment is demonstrated to show the reduced discrepancy by using the alignment measurement method. In this paper, we present a system characterization study and its methods for a specially designed imaging system for clinical cytogenetic applications. The presented characterization methods are not only unique to this dual-color imaging system but also applicable to evaluation and optimization of other similar multi-color microscopic image systems for improving their clinical utilities for future cytogenetic applications.

Electronic workflow for imaging in clinical research.

PubMed

Hedges, Rebecca A; Goodman, Danielle; Sachs, Peter B

2014-08-01

In the transition from paper to electronic workflow, the University of Colorado Health System's implementation of a new electronic health record system (EHR) forced all clinical groups to reevaluate their practices including the infrastructure surrounding clinical trials. Radiological imaging is an important piece of many clinical trials and requires a high level of consistency and standardization. With EHR implementation, paper orders were manually transcribed into the EHR, digitizing an inefficient work flow. A team of schedulers, radiologists, technologists, research personnel, and EHR analysts worked together to optimize the EHR to accommodate the needs of research imaging protocols. The transition to electronic workflow posed several problems: (1) there needed to be effective communication throughout the imaging process from scheduling to radiologist interpretation. (2) The exam ordering process needed to be automated to allow scheduling of specific research studies on specific equipment. (3) The billing process needed to be controlled to accommodate radiologists already supported by grants. (4) There needed to be functionality allowing exams to finalize automatically skipping the PACS and interpretation process. (5) There needed to be a way to alert radiologists that a specialized research interpretation was needed on a given exam. These issues were resolved through the optimization of the "visit type," allowing a high-level control of an exam at the time of scheduling. Additionally, we added columns and fields to work queues displaying grant identification numbers. The build solutions we implemented reduced the mistakes made and increased imaging quality and compliance.

An image-based approach to understanding the physics of MR artifacts.

PubMed

Morelli, John N; Runge, Val M; Ai, Fei; Attenberger, Ulrike; Vu, Lan; Schmeets, Stuart H; Nitz, Wolfgang R; Kirsch, John E

2011-01-01

As clinical magnetic resonance (MR) imaging becomes more versatile and more complex, it is increasingly difficult to develop and maintain a thorough understanding of the physical principles that govern the changing technology. This is particularly true for practicing radiologists, whose primary obligation is to interpret clinical images and not necessarily to understand complex equations describing the underlying physics. Nevertheless, the physics of MR imaging plays an important role in clinical practice because it determines image quality, and suboptimal image quality may hinder accurate diagnosis. This article provides an image-based explanation of the physics underlying common MR imaging artifacts, offering simple solutions for remedying each type of artifact. Solutions that have emerged from recent technologic advances with which radiologists may not yet be familiar are described in detail. Types of artifacts discussed include those resulting from voluntary and involuntary patient motion, magnetic susceptibility, magnetic field inhomogeneities, gradient nonlinearity, standing waves, aliasing, chemical shift, and signal truncation. With an improved awareness and understanding of these artifacts, radiologists will be better able to modify MR imaging protocols so as to optimize clinical image quality, allowing greater confidence in diagnosis. Copyright © RSNA, 2011.

Evaluation of optimized b-value sampling schemas for diffusion kurtosis imaging with an application to stroke patient data

PubMed Central

Yan, Xu; Zhou, Minxiong; Ying, Lingfang; Yin, Dazhi; Fan, Mingxia; Yang, Guang; Zhou, Yongdi; Song, Fan; Xu, Dongrong

2013-01-01

Diffusion kurtosis imaging (DKI) is a new method of magnetic resonance imaging (MRI) that provides non-Gaussian information that is not available in conventional diffusion tensor imaging (DTI). DKI requires data acquisition at multiple b-values for parameter estimation; this process is usually time-consuming. Therefore, fewer b-values are preferable to expedite acquisition. In this study, we carefully evaluated various acquisition schemas using different numbers and combinations of b-values. Acquisition schemas that sampled b-values that were distributed to two ends were optimized. Compared to conventional schemas using equally spaced b-values (ESB), optimized schemas require fewer b-values to minimize fitting errors in parameter estimation and may thus significantly reduce scanning time. Following a ranked list of optimized schemas resulted from the evaluation, we recommend the 3b schema based on its estimation accuracy and time efficiency, which needs data from only 3 b-values at 0, around 800 and around 2600 s/mm2, respectively. Analyses using voxel-based analysis (VBA) and region-of-interest (ROI) analysis with human DKI datasets support the use of the optimized 3b (0, 1000, 2500 s/mm2) DKI schema in practical clinical applications. PMID:23735303

[Research on non-rigid registration of multi-modal medical image based on Demons algorithm].

PubMed

Hao, Peibo; Chen, Zhen; Jiang, Shaofeng; Wang, Yang

2014-02-01

Non-rigid medical image registration is a popular subject in the research areas of the medical image and has an important clinical value. In this paper we put forward an improved algorithm of Demons, together with the conservation of gray model and local structure tensor conservation model, to construct a new energy function processing multi-modal registration problem. We then applied the L-BFGS algorithm to optimize the energy function and solve complex three-dimensional data optimization problem. And finally we used the multi-scale hierarchical refinement ideas to solve large deformation registration. The experimental results showed that the proposed algorithm for large de formation and multi-modal three-dimensional medical image registration had good effects.

Robust optimization methods for cardiac sparing in tangential breast IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahmoudzadeh, Houra, E-mail: houra@mie.utoronto.ca; Lee, Jenny; Chan, Timothy C. Y.

Purpose: In left-sided tangential breast intensity modulated radiation therapy (IMRT), the heart may enter the radiation field and receive excessive radiation while the patient is breathing. The patient’s breathing pattern is often irregular and unpredictable. We verify the clinical applicability of a heart-sparing robust optimization approach for breast IMRT. We compare robust optimized plans with clinical plans at free-breathing and clinical plans at deep inspiration breath-hold (DIBH) using active breathing control (ABC). Methods: Eight patients were included in the study with each patient simulated using 4D-CT. The 4D-CT image acquisition generated ten breathing phase datasets. An average scan was constructedmore » using all the phase datasets. Two of the eight patients were also imaged at breath-hold using ABC. The 4D-CT datasets were used to calculate the accumulated dose for robust optimized and clinical plans based on deformable registration. We generated a set of simulated breathing probability mass functions, which represent the fraction of time patients spend in different breathing phases. The robust optimization method was applied to each patient using a set of dose-influence matrices extracted from the 4D-CT data and a model of the breathing motion uncertainty. The goal of the optimization models was to minimize the dose to the heart while ensuring dose constraints on the target were achieved under breathing motion uncertainty. Results: Robust optimized plans were improved or equivalent to the clinical plans in terms of heart sparing for all patients studied. The robust method reduced the accumulated heart dose (D10cc) by up to 801 cGy compared to the clinical method while also improving the coverage of the accumulated whole breast target volume. On average, the robust method reduced the heart dose (D10cc) by 364 cGy and improved the optBreast dose (D99%) by 477 cGy. In addition, the robust method had smaller deviations from the planned dose to the accumulated dose. The deviation of the accumulated dose from the planned dose for the optBreast (D99%) was 12 cGy for robust versus 445 cGy for clinical. The deviation for the heart (D10cc) was 41 cGy for robust and 320 cGy for clinical. Conclusions: The robust optimization approach can reduce heart dose compared to the clinical method at free-breathing and can potentially reduce the need for breath-hold techniques.« less

Brain imaging predictors and the international study to predict optimized treatment for depression: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Approximately 50% of patients with major depressive disorder (MDD) do not respond optimally to antidepressant treatments. Given this is a large proportion of the patient population, pretreatment tests that predict which patients will respond to which types of treatment could save time, money and patient burden. Brain imaging offers a means to identify treatment predictors that are grounded in the neurobiology of the treatment and the pathophysiology of MDD. Methods/Design The international Study to Predict Optimized Treatment in Depression is a multi-center, parallel model, randomized clinical trial with an embedded imaging sub-study to identify such predictors. We focus on brain circuits implicated in major depressive disorder and its treatment. In the full trial, depressed participants are randomized to receive escitalopram, sertraline or venlafaxine-XR (open-label). They are assessed using standardized multiple clinical, cognitive-emotional behavioral, electroencephalographic and genetic measures at baseline and at eight weeks post-treatment. Overall, 2,016 depressed participants (18 to 65 years old) will enter the study, of whom a target of 10% will be recruited into the brain imaging sub-study (approximately 67 participants in each treatment arm) and 67 controls. The imaging sub-study is conducted at the University of Sydney and at Stanford University. Structural studies include high-resolution three-dimensional T1-weighted, diffusion tensor and T2/Proton Density scans. Functional studies include standardized functional magnetic resonance imaging (MRI) with three cognitive tasks (auditory oddball, a continuous performance task, and Go-NoGo) and two emotion tasks (unmasked conscious and masked non-conscious emotion processing tasks). After eight weeks of treatment, the functional MRI is repeated with the above tasks. We will establish the methods in the first 30 patients. Then we will identify predictors in the first half (n = 102), test the findings in the second half, and then extend the analyses to the total sample. Trial registration International Study to Predict Optimized Treatment - in Depression (iSPOT-D). ClinicalTrials.gov, NCT00693849. PMID:23866851

Brain imaging predictors and the international study to predict optimized treatment for depression: study protocol for a randomized controlled trial.

PubMed

Grieve, Stuart M; Korgaonkar, Mayuresh S; Etkin, Amit; Harris, Anthony; Koslow, Stephen H; Wisniewski, Stephen; Schatzberg, Alan F; Nemeroff, Charles B; Gordon, Evian; Williams, Leanne M

2013-07-18

Approximately 50% of patients with major depressive disorder (MDD) do not respond optimally to antidepressant treatments. Given this is a large proportion of the patient population, pretreatment tests that predict which patients will respond to which types of treatment could save time, money and patient burden. Brain imaging offers a means to identify treatment predictors that are grounded in the neurobiology of the treatment and the pathophysiology of MDD. The international Study to Predict Optimized Treatment in Depression is a multi-center, parallel model, randomized clinical trial with an embedded imaging sub-study to identify such predictors. We focus on brain circuits implicated in major depressive disorder and its treatment. In the full trial, depressed participants are randomized to receive escitalopram, sertraline or venlafaxine-XR (open-label). They are assessed using standardized multiple clinical, cognitive-emotional behavioral, electroencephalographic and genetic measures at baseline and at eight weeks post-treatment. Overall, 2,016 depressed participants (18 to 65 years old) will enter the study, of whom a target of 10% will be recruited into the brain imaging sub-study (approximately 67 participants in each treatment arm) and 67 controls. The imaging sub-study is conducted at the University of Sydney and at Stanford University. Structural studies include high-resolution three-dimensional T1-weighted, diffusion tensor and T2/Proton Density scans. Functional studies include standardized functional magnetic resonance imaging (MRI) with three cognitive tasks (auditory oddball, a continuous performance task, and Go-NoGo) and two emotion tasks (unmasked conscious and masked non-conscious emotion processing tasks). After eight weeks of treatment, the functional MRI is repeated with the above tasks. We will establish the methods in the first 30 patients. Then we will identify predictors in the first half (n=102), test the findings in the second half, and then extend the analyses to the total sample. International Study to Predict Optimized Treatment--in Depression (iSPOT-D). ClinicalTrials.gov, NCT00693849.

Speckle noise reduction in ultrasound images using a discrete wavelet transform-based image fusion technique.

PubMed

Choi, Hyun Ho; Lee, Ju Hwan; Kim, Sung Min; Park, Sung Yun

2015-01-01

Here, the speckle noise in ultrasonic images is removed using an image fusion-based denoising method. To optimize the denoising performance, each discrete wavelet transform (DWT) and filtering technique was analyzed and compared. In addition, the performances were compared in order to derive the optimal input conditions. To evaluate the speckle noise removal performance, an image fusion algorithm was applied to the ultrasound images, and comparatively analyzed with the original image without the algorithm. As a result, applying DWT and filtering techniques caused information loss and noise characteristics, and did not represent the most significant noise reduction performance. Conversely, an image fusion method applying SRAD-original conditions preserved the key information in the original image, and the speckle noise was removed. Based on such characteristics, the input conditions of SRAD-original had the best denoising performance with the ultrasound images. From this study, the best denoising technique proposed based on the results was confirmed to have a high potential for clinical application.

WE-AB-BRA-09: Sensitivity of Plan Re-Optimization to Errors in Deformable Image Registration in Online Adaptive Image-Guided Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

McClain, B; Olsen, J; Green, O

2015-06-15

Purpose: Online adaptive therapy (ART) relies on auto-contouring using deformable image registration (DIR). DIR’s inherent uncertainties require user intervention and manual edits while the patient is on the table. We investigated the dosimetric impact of DIR errors on the quality of re-optimized plans, and used the findings to establish regions for focusing manual edits to where DIR errors can Result in clinically relevant dose differences. Methods: Our clinical implementation of online adaptive MR-IGRT involves using DIR to transfer contours from CT to daily MR, followed by a physicians’ edits. The plan is then re-optimized to meet the organs at riskmore » (OARs) constraints. Re-optimized abdomen and pelvis plans generated based on physician edited OARs were selected as the baseline for evaluation. Plans were then re-optimized on auto-deformed contours with manual edits limited to pre-defined uniform rings (0 to 5cm) around the PTV. A 0cm ring indicates that the auto-deformed OARs were used without editing. The magnitude of the variations caused by the non-deterministic optimizer was quantified by repeat re-optimizations on the same geometry to determine the mean and standard deviation (STD). For each re-optimized plan, various volumetric parameters for the PTV, the OARs were extracted along with DVH and isodose evaluation. A plan was deemed acceptable if the variation from the baseline plan was within one STD. Results: Initial results show that for abdomen and pancreas cases, a minimum of 5cm margin around the PTV is required for contour corrections, while for pelvic and liver cases a 2–3 cm margin is sufficient. Conclusion: Focusing manual contour edits to regions of dosimetric relevance can reduce contouring time in the online ART process while maintaining a clinically comparable plan. Future work will further refine the contouring region by evaluating the path along the beams, dose gradients near the target and OAR dose metrics.« less

Coherent anti-Stokes Raman scattering microscopy: overcoming technical barriers for clinical translation

PubMed Central

Tu, Haohua; Boppart, Stephen A.

2015-01-01

Clinical translation of coherent anti-Stokes Raman scattering microscopy is of great interest because of the advantages of noninvasive label-free imaging, high sensitivity, and chemical specificity. For this to happen, we have identified and review the technical barriers that must be overcome. Prior investigations have developed advanced techniques (features), each of which can be used to effectively overcome one particular technical barrier. However, the implementation of one or a small number of these advanced features in previous attempts for clinical translation has often introduced more tradeoffs than benefits. In this review, we outline a strategy that would integrate multiple advanced features to overcome all the technical barriers simultaneously, effectively reduce tradeoffs, and synergistically optimize CARS microscopy for clinical translation. The operation of the envisioned system incorporates coherent Raman micro-spectroscopy for identifying vibrational biomolecular markers of disease and single-frequency (or hyperspectral) Raman imaging of these specific biomarkers for real-time in vivo diagnostics and monitoring. An optimal scheme of clinical CARS micro-spectroscopy for thin ex vivo tissues. PMID:23674234

Whole brain inhomogeneous magnetization transfer (ihMT) imaging: Sensitivity enhancement within a steady-state gradient echo sequence.

PubMed

Mchinda, Samira; Varma, Gopal; Prevost, Valentin H; Le Troter, Arnaud; Rapacchi, Stanislas; Guye, Maxime; Pelletier, Jean; Ranjeva, Jean-Philippe; Alsop, David C; Duhamel, Guillaume; Girard, Olivier M

2018-05-01

To implement, characterize, and optimize an interleaved inhomogeneous magnetization transfer (ihMT) gradient echo sequence allowing for whole-brain imaging within a clinically compatible scan time. A general framework for ihMT modelling was developed based on the Provotorov theory of radiofrequency saturation, which accounts for the dipolar order underpinning the ihMT effect. Experimental studies and numerical simulations were performed to characterize and optimize the ihMT-gradient echo dependency with sequence timings, saturation power, and offset frequency. The protocol was optimized in terms of maximum signal intensity and the reproducibility assessed for a nominal resolution of 1.5 mm isotropic. All experiments were performed on healthy volunteers at 1.5T. An important mechanism driving signal optimization and leading to strong ihMT signal enhancement that relies on the dynamics of radiofrequency energy deposition has been identified. By taking advantage of the delay allowed for readout between ihMT pulse bursts, it was possible to boost the ihMT signal by almost 2-fold compared to previous implementation. Reproducibility of the optimal protocol was very good, with an intra-individual error < 2%. The proposed sensitivity-boosted and time-efficient steady-state ihMT-gradient echo sequence, implemented and optimized at 1.5T, allowed robust high-resolution 3D ihMT imaging of the whole brain within a clinically compatible scan time. Magn Reson Med 79:2607-2619, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Breast imaging using the Twente photoacoustic mammoscope (PAM): new clinical measurements

NASA Astrophysics Data System (ADS)

Heijblom, Michelle; Piras, Daniele; Ten Tije, Ellen; Xia, Wenfeng; van Hespen, Johan; Klaase, Joost; van den Engh, Frank; van Leeuwen, Ton; Steenbergen, Wiendelt; Manohar, Srirang

2011-07-01

Worldwide, yearly about 450,000 women die from the consequences of breast cancer. Current imaging modalities are not optimal in discriminating benign from malignant tissue. Visualizing the malignancy-associated increased hemoglobin concentration might significantly improve early diagnosis of breast cancer. Since photoacoustic imaging can visualize hemoglobin in tissue with optical contrast and ultrasound-like resolution, it is potentially an ideal method for early breast cancer imaging. The Twente Photoacoustic Mammoscope (PAM) has been developed specifically for breast imaging. Recently, a large clinical study has been started in the Medisch Spectrum Twente in Oldenzaal using PAM. In PAM, the breast is slightly compressed between a window for laser light illumination and a flat array ultrasound detector. The measurements are performed using a Q-switched Nd:YAG laser, pulsed at 1064 nm and a 1 MHz unfocused ultrasound detector array. Three-dimensional data are reconstructed using a delay and sum reconstruction algorithm. Those reconstructed images are compared with conventional imaging and histopathology. In the first phase of the study 12 patients with a malignant lesion and 2 patients with a benign cyst have been measured. The results are used to guide developments in photoacoustic mammography in order to pave the way towards an optimal technique for early diagnosis of breast cancer.

Correlation of the clinical and physical image quality in chest radiography for average adults with a computed radiography imaging system

PubMed Central

Wood, T J; Beavis, A W; Saunderson, J R

2013-01-01

Objective: The purpose of this study was to examine the correlation between the quality of visually graded patient (clinical) chest images and a quantitative assessment of chest phantom (physical) images acquired with a computed radiography (CR) imaging system. Methods: The results of a previously published study, in which four experienced image evaluators graded computer-simulated postero-anterior chest images using a visual grading analysis scoring (VGAS) scheme, were used for the clinical image quality measurement. Contrast-to-noise ratio (CNR) and effective dose efficiency (eDE) were used as physical image quality metrics measured in a uniform chest phantom. Although optimal values of these physical metrics for chest radiography were not derived in this work, their correlation with VGAS in images acquired without an antiscatter grid across the diagnostic range of X-ray tube voltages was determined using Pearson’s correlation coefficient. Results: Clinical and physical image quality metrics increased with decreasing tube voltage. Statistically significant correlations between VGAS and CNR (R=0.87, p<0.033) and eDE (R=0.77, p<0.008) were observed. Conclusion: Medical physics experts may use the physical image quality metrics described here in quality assurance programmes and optimisation studies with a degree of confidence that they reflect the clinical image quality in chest CR images acquired without an antiscatter grid. Advances in knowledge: A statistically significant correlation has been found between the clinical and physical image quality in CR chest imaging. The results support the value of using CNR and eDE in the evaluation of quality in clinical thorax radiography. PMID:23568362

[Carotid plaque assessment using inversion recovery T1 weighted-3 dimensions variable refocus flip angle turbo spin echo sampling perfection with application optimized contrast using different angle evolutions black blood imaging].

PubMed

Inoue, Yuji; Yoneyama, Masami; Nakamura, Masanobu; Ozaki, Satoshi; Ito, Kenjiro; Hiura, Mikio

2012-01-01

Vulnerable plaque can be attributed to induction of ischemic symptoms and magnetic resonance imaging of carotid artery is valuable to detect the plaque. Magnetization prepared rapid acquisition with gradient echo (MPRAGE) method could detect hemorrhagic vulnerable plaque as high intensity signal; however, blood flow is not sufficiently masked by this method. The contrast for plaque in T1 weighted image (T1WI) could not be obtained sufficiently with black blood image (BBI) by sampling perfection with application optimized contrast using different angle evolutions (SPACE) method as turbo spin echo (TSE). In addition, an appearance of artifact by slow flow is a problem. Considering these controversial situations in plaque imaging, we examined the modified BBI inversion recovery (IR)-SPACE in which IR was added for SPACE method so that the contrast for plaque in T1WI was optimized. We investigated the application of this method in plaque imaging. As a result of phantom imaging, the contrast for plaque in T1WI was definitely obtained by choosing an appropriate inversion time (TI) for the corresponding repetition time. In clinical cases, blood flow was sufficiently masked by IR-SPACE method and the plaque imaging was clearly obtained in clinical cases to the same extent as MPRAGE method. Since BBI with IR-SPACE method was derived from both IR pulse and flow void effect, this method could obtain the blood flow masking effect definitely. The present study suggested that SPACE method might be applicable to estimate properties of carotid artery plaque.

A novel applicator design for intracavitary brachytherapy of the nasopharynx: Simulated reconstruction, image-guided adaptive brachytherapy planning, and dosimetry.

PubMed

Bacorro, Warren R; Agas, Ryan Anthony F; Cabrera, Stellar Marie R; Bojador, Maureen R; Sogono, Paolo G; Mejia, Michael Benedict A; Sy Ortin, Teresa T

2018-05-11

In nasopharyngeal cancer, brachytherapy is given as boost in primary treatment or as salvage for recurrent or persistent disease. The Rotterdam nasopharyngeal applicator (RNA) allows for suboptimal reduction of soft palate radiation dose, based on image-guided brachytherapy plans. Building on the RNA, we propose a novel design, the Benavides nasopharyngeal applicator (BNA). The virtual BNA was reconstructed on two cases (one T1, one T2) previously treated with intracavitary brachytherapy using the RNA. Dose was prescribed to the high-risk clinical target volumes (CTVs) and optimization was such that high-risk CTV D90 ≥ 100% of prescribed dose (PD), intermediate-risk-CTV D90 ≥ 75% PD, and soft palate D2cc ≤ 120% PD. The optimized RNA and BNA image-guided brachytherapy plans were compared in terms of CTV coverage and organs-at-risk sparing. Optimization objectives were more easily met with the BNA. For the T1 case, all three planning objectives were easily achieved in both the RNA and BNA, but with 18-19% lower soft palate doses with the BNA. For the T2 case, the CTV planning objectives were achieved in both the RNA and BNA, but the soft palate constraint was only achieved with the BNA, with 38-41% lower soft palate doses. Compared to the RNA, the BNA permits easier optimization and improves therapeutic ratio by a significant reduction of soft palate doses, based on simulation using a proposed system for CTV/organs-at-risk delineation, prescription, and optimization for image-guided adaptive brachytherapy. Clinical piloting using a prototype is necessary to evaluate its feasibility and utility. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Cardiac imaging: working towards fully-automated machine analysis & interpretation.

PubMed

Slomka, Piotr J; Dey, Damini; Sitek, Arkadiusz; Motwani, Manish; Berman, Daniel S; Germano, Guido

2017-03-01

Non-invasive imaging plays a critical role in managing patients with cardiovascular disease. Although subjective visual interpretation remains the clinical mainstay, quantitative analysis facilitates objective, evidence-based management, and advances in clinical research. This has driven developments in computing and software tools aimed at achieving fully automated image processing and quantitative analysis. In parallel, machine learning techniques have been used to rapidly integrate large amounts of clinical and quantitative imaging data to provide highly personalized individual patient-based conclusions. Areas covered: This review summarizes recent advances in automated quantitative imaging in cardiology and describes the latest techniques which incorporate machine learning principles. The review focuses on the cardiac imaging techniques which are in wide clinical use. It also discusses key issues and obstacles for these tools to become utilized in mainstream clinical practice. Expert commentary: Fully-automated processing and high-level computer interpretation of cardiac imaging are becoming a reality. Application of machine learning to the vast amounts of quantitative data generated per scan and integration with clinical data also facilitates a move to more patient-specific interpretation. These developments are unlikely to replace interpreting physicians but will provide them with highly accurate tools to detect disease, risk-stratify, and optimize patient-specific treatment. However, with each technological advance, we move further from human dependence and closer to fully-automated machine interpretation.

Improving best-phase image quality in cardiac CT by motion correction with MAM optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rohkohl, Christopher; Bruder, Herbert; Stierstorfer, Karl

2013-03-15

Purpose: Research in image reconstruction for cardiac CT aims at using motion correction algorithms to improve the image quality of the coronary arteries. The key to those algorithms is motion estimation, which is currently based on 3-D/3-D registration to align the structures of interest in images acquired in multiple heart phases. The need for an extended scan data range covering several heart phases is critical in terms of radiation dose to the patient and limits the clinical potential of the method. Furthermore, literature reports only slight quality improvements of the motion corrected images when compared to the most quiet phasemore » (best-phase) that was actually used for motion estimation. In this paper a motion estimation algorithm is proposed which does not require an extended scan range but works with a short scan data interval, and which markedly improves the best-phase image quality. Methods: Motion estimation is based on the definition of motion artifact metrics (MAM) to quantify motion artifacts in a 3-D reconstructed image volume. The authors use two different MAMs, entropy, and positivity. By adjusting the motion field parameters, the MAM of the resulting motion-compensated reconstruction is optimized using a gradient descent procedure. In this way motion artifacts are minimized. For a fast and practical implementation, only analytical methods are used for motion estimation and compensation. Both the MAM-optimization and a 3-D/3-D registration-based motion estimation algorithm were investigated by means of a computer-simulated vessel with a cardiac motion profile. Image quality was evaluated using normalized cross-correlation (NCC) with the ground truth template and root-mean-square deviation (RMSD). Four coronary CT angiography patient cases were reconstructed to evaluate the clinical performance of the proposed method. Results: For the MAM-approach, the best-phase image quality could be improved for all investigated heart phases, with a maximum improvement of the NCC value by 100% and of the RMSD value by 81%. The corresponding maximum improvements for the registration-based approach were 20% and 40%. In phases with very rapid motion the registration-based algorithm obtained better image quality, while the image quality of the MAM algorithm was superior in phases with less motion. The image quality improvement of the MAM optimization was visually confirmed for the different clinical cases. Conclusions: The proposed method allows a software-based best-phase image quality improvement in coronary CT angiography. A short scan data interval at the target heart phase is sufficient, no additional scan data in other cardiac phases are required. The algorithm is therefore directly applicable to any standard cardiac CT acquisition protocol.« less

Quantitative and qualitative comparison of MR imaging of the temporomandibular joint at 1.5 and 3.0 T using an optimized high-resolution protocol

PubMed Central

Spinner, Georg; Wyss, Michael; Erni, Stefan; Ettlin, Dominik A; Nanz, Daniel; Ulbrich, Erika J; Gallo, Luigi M; Andreisek, Gustav

2016-01-01

Objectives: To quantitatively and qualitatively compare MRI of the temporomandibular joint (TMJ) using an optimized high-resolution protocol at 3.0 T and a clinical standard protocol at 1.5 T. Methods: A phantom and 12 asymptomatic volunteers were MR imaged using a 2-channel surface coil (standard TMJ coil) at 1.5 and 3.0 T (Philips Achieva and Philips Ingenia, respectively; Philips Healthcare, Best, Netherlands). Imaging protocol consisted of coronal and oblique sagittal proton density-weighted turbo spin echo sequences. For quantitative evaluation, a spherical phantom was imaged. Signal-to-noise ratio (SNR) maps were calculated on a voxelwise basis. For qualitative evaluation, all volunteers underwent MRI of the TMJ with the jaw in closed position. Two readers independently assessed visibility and delineation of anatomical structures of the TMJ and overall image quality on a 5-point Likert scale. Quantitative and qualitative measurements were compared between field strengths. Results: The quantitative analysis showed similar SNR for the high-resolution protocol at 3.0 T compared with the clinical protocol at 1.5 T. The qualitative analysis showed significantly better visibility and delineation of clinically relevant anatomical structures of the TMJ, including the TMJ disc and pterygoid muscle as well as better overall image quality at 3.0 T than at 1.5 T. Conclusions: The presented results indicate that expected gains in SNR at 3.0 T can be used to increase the spatial resolution when imaging the TMJ, which translates into increased visibility and delineation of anatomical structures of the TMJ. Therefore, imaging at 3.0 T should be preferred over 1.5 T for imaging the TMJ. PMID:26371077

Quantitative and qualitative comparison of MR imaging of the temporomandibular joint at 1.5 and 3.0 T using an optimized high-resolution protocol.

PubMed

Manoliu, Andrei; Spinner, Georg; Wyss, Michael; Erni, Stefan; Ettlin, Dominik A; Nanz, Daniel; Ulbrich, Erika J; Gallo, Luigi M; Andreisek, Gustav

2016-01-01

To quantitatively and qualitatively compare MRI of the temporomandibular joint (TMJ) using an optimized high-resolution protocol at 3.0 T and a clinical standard protocol at 1.5 T. A phantom and 12 asymptomatic volunteers were MR imaged using a 2-channel surface coil (standard TMJ coil) at 1.5 and 3.0 T (Philips Achieva and Philips Ingenia, respectively; Philips Healthcare, Best, Netherlands). Imaging protocol consisted of coronal and oblique sagittal proton density-weighted turbo spin echo sequences. For quantitative evaluation, a spherical phantom was imaged. Signal-to-noise ratio (SNR) maps were calculated on a voxelwise basis. For qualitative evaluation, all volunteers underwent MRI of the TMJ with the jaw in closed position. Two readers independently assessed visibility and delineation of anatomical structures of the TMJ and overall image quality on a 5-point Likert scale. Quantitative and qualitative measurements were compared between field strengths. The quantitative analysis showed similar SNR for the high-resolution protocol at 3.0 T compared with the clinical protocol at 1.5 T. The qualitative analysis showed significantly better visibility and delineation of clinically relevant anatomical structures of the TMJ, including the TMJ disc and pterygoid muscle as well as better overall image quality at 3.0 T than at 1.5 T. The presented results indicate that expected gains in SNR at 3.0 T can be used to increase the spatial resolution when imaging the TMJ, which translates into increased visibility and delineation of anatomical structures of the TMJ. Therefore, imaging at 3.0 T should be preferred over 1.5 T for imaging the TMJ.

Complications of Whipple surgery: imaging analysis.

PubMed

Bhosale, Priya; Fleming, Jason; Balachandran, Aparna; Charnsangavej, Chuslip; Tamm, Eric P

2013-04-01

The purpose of this article is to describe and illustrate anatomic findings after the Whipple procedure, and the appearance of its complications, on imaging. Knowledge of the cross-sectional anatomy following the Whipple procedure, and clinical findings for associated complications, are essential to rapidly and accurately diagnose such complications on postoperative studies in order to optimize treatment.

The impact of the condenser on cytogenetic image quality in digital microscope system.

PubMed

Ren, Liqiang; Li, Zheng; Li, Yuhua; Zheng, Bin; Li, Shibo; Chen, Xiaodong; Liu, Hong

2013-01-01

Optimizing operational parameters of the digital microscope system is an important technique to acquire high quality cytogenetic images and facilitate the process of karyotyping so that the efficiency and accuracy of diagnosis can be improved. This study investigated the impact of the condenser on cytogenetic image quality and system working performance using a prototype digital microscope image scanning system. Both theoretical analysis and experimental validations through objectively evaluating a resolution test chart and subjectively observing large numbers of specimen were conducted. The results show that the optimal image quality and large depth of field (DOF) are simultaneously obtained when the numerical aperture of condenser is set as 60%-70% of the corresponding objective. Under this condition, more analyzable chromosomes and diagnostic information are obtained. As a result, the system shows higher working stability and less restriction for the implementation of algorithms such as autofocusing especially when the system is designed to achieve high throughput continuous image scanning. Although the above quantitative results were obtained using a specific prototype system under the experimental conditions reported in this paper, the presented evaluation methodologies can provide valuable guidelines for optimizing operational parameters in cytogenetic imaging using the high throughput continuous scanning microscopes in clinical practice.

Segmentation of the Clustered Cells with Optimized Boundary Detection in Negative Phase Contrast Images

PubMed Central

Wang, Yuliang; Zhang, Zaicheng; Wang, Huimin; Bi, Shusheng

2015-01-01

Cell image segmentation plays a central role in numerous biology studies and clinical applications. As a result, the development of cell image segmentation algorithms with high robustness and accuracy is attracting more and more attention. In this study, an automated cell image segmentation algorithm is developed to get improved cell image segmentation with respect to cell boundary detection and segmentation of the clustered cells for all cells in the field of view in negative phase contrast images. A new method which combines the thresholding method and edge based active contour method was proposed to optimize cell boundary detection. In order to segment clustered cells, the geographic peaks of cell light intensity were utilized to detect numbers and locations of the clustered cells. In this paper, the working principles of the algorithms are described. The influence of parameters in cell boundary detection and the selection of the threshold value on the final segmentation results are investigated. At last, the proposed algorithm is applied to the negative phase contrast images from different experiments. The performance of the proposed method is evaluated. Results show that the proposed method can achieve optimized cell boundary detection and highly accurate segmentation for clustered cells. PMID:26066315

Expanding the PACS archive to support clinical review, research, and education missions

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice C.; Frost, Meryll M.; Drane, Walter E.

1999-07-01

Designing an image archive and retrieval system that supports multiple users with many different requirements and patterns of use without compromising the performance and functionality required by diagnostic radiology is an intellectual and technical challenge. A diagnostic archive, optimized for performance when retrieving diagnostic images for radiologists needed to be expanded to support a growing clinical review network, the University of Florida Brain Institute's demands for neuro-imaging, Biomedical Engineering's imaging sciences, and an electronic teaching file. Each of the groups presented a different set of problems for the designers of the system. In addition, the radiologists did not want to see nay loss of performance as new users were added.

TU-C-218-01: Effective Medical Imaging Physics Education.

PubMed

Sprawls, P

2012-06-01

A practical and applied knowledge of physics and the associated technology is required for the clinically effective and safe use of the various medical imaging modalities. This is needed by all involved in the imaging process, including radiologists, especially residents in training, technologists, and physicists who provide consultation on optimum and safe procedures and as educators for the other imaging professionals. This area of education is undergoing considerable change and evolution for three reasons: 1. Increasing capabilities and complexity of medical imaging technology and procedures, 2.Expanding scope and availability of educational resources, especially on the internet, and 3. A significant increase in our knowledge of the mental learning process and the design of learning activities to optimize effectiveness and efficiency, especially for clinically applied physics. This course will address those three issues by providing guidance on establishing appropriate clinically focused learning outcomes, a review of the brain function for enhancing clinically applied physics, and the design and delivery of effective learning activities beginning with the classroom and continuing through learning physics during the clinical practice of radiology. Characteristics of each type of learning activity will be considered with respect to effectiveness and efficiency in achieving appropriate learning outcomes. A variety of available resources will be identified and demonstrated for use in the different phases of learning process. A major focus is on enhancing the role of the medical physicist in clinical radiology both as a resource and educator with contemporary technology being the tool, but not the teacher. 1. Develop physics learning objectives that will support effective and safe medical imaging procedures. 2. Understand specific brain functions that are involved in learning and applying physics. 3. Describe the characteristics and development of mental knowledge structures for applied clinical physics. 4. List the established levels of learning and associate each with specific functions that can be performed. 5. Analyze the different types of learning activities (classroom, individual study, clinical, etc.) with respect to effectiveness and efficiency. 6. Design and Provide a comprehensive physics education program with each activity optimized with respect to outcomes and available resources. © 2012 American Association of Physicists in Medicine.

New Colors for Histology: Optimized Bivariate Color Maps Increase Perceptual Contrast in Histological Images

PubMed Central

Kather, Jakob Nikolas; Weis, Cleo-Aron; Marx, Alexander; Schuster, Alexander K.; Schad, Lothar R.; Zöllner, Frank Gerrit

2015-01-01

Background Accurate evaluation of immunostained histological images is required for reproducible research in many different areas and forms the basis of many clinical decisions. The quality and efficiency of histopathological evaluation is limited by the information content of a histological image, which is primarily encoded as perceivable contrast differences between objects in the image. However, the colors of chromogen and counterstain used for histological samples are not always optimally distinguishable, even under optimal conditions. Methods and Results In this study, we present a method to extract the bivariate color map inherent in a given histological image and to retrospectively optimize this color map. We use a novel, unsupervised approach based on color deconvolution and principal component analysis to show that the commonly used blue and brown color hues in Hematoxylin—3,3’-Diaminobenzidine (DAB) images are poorly suited for human observers. We then demonstrate that it is possible to construct improved color maps according to objective criteria and that these color maps can be used to digitally re-stain histological images. Validation To validate whether this procedure improves distinguishability of objects and background in histological images, we re-stain phantom images and N = 596 large histological images of immunostained samples of human solid tumors. We show that perceptual contrast is improved by a factor of 2.56 in phantom images and up to a factor of 2.17 in sets of histological tumor images. Context Thus, we provide an objective and reliable approach to measure object distinguishability in a given histological image and to maximize visual information available to a human observer. This method could easily be incorporated in digital pathology image viewing systems to improve accuracy and efficiency in research and diagnostics. PMID:26717571

New Colors for Histology: Optimized Bivariate Color Maps Increase Perceptual Contrast in Histological Images.

PubMed

Kather, Jakob Nikolas; Weis, Cleo-Aron; Marx, Alexander; Schuster, Alexander K; Schad, Lothar R; Zöllner, Frank Gerrit

2015-01-01

Accurate evaluation of immunostained histological images is required for reproducible research in many different areas and forms the basis of many clinical decisions. The quality and efficiency of histopathological evaluation is limited by the information content of a histological image, which is primarily encoded as perceivable contrast differences between objects in the image. However, the colors of chromogen and counterstain used for histological samples are not always optimally distinguishable, even under optimal conditions. In this study, we present a method to extract the bivariate color map inherent in a given histological image and to retrospectively optimize this color map. We use a novel, unsupervised approach based on color deconvolution and principal component analysis to show that the commonly used blue and brown color hues in Hematoxylin-3,3'-Diaminobenzidine (DAB) images are poorly suited for human observers. We then demonstrate that it is possible to construct improved color maps according to objective criteria and that these color maps can be used to digitally re-stain histological images. To validate whether this procedure improves distinguishability of objects and background in histological images, we re-stain phantom images and N = 596 large histological images of immunostained samples of human solid tumors. We show that perceptual contrast is improved by a factor of 2.56 in phantom images and up to a factor of 2.17 in sets of histological tumor images. Thus, we provide an objective and reliable approach to measure object distinguishability in a given histological image and to maximize visual information available to a human observer. This method could easily be incorporated in digital pathology image viewing systems to improve accuracy and efficiency in research and diagnostics.

Optimization-based image reconstruction from sparse-view data in offset-detector CBCT

NASA Astrophysics Data System (ADS)

Bian, Junguo; Wang, Jiong; Han, Xiao; Sidky, Emil Y.; Shao, Lingxiong; Pan, Xiaochuan

2013-01-01

The field of view (FOV) of a cone-beam computed tomography (CBCT) unit in a single-photon emission computed tomography (SPECT)/CBCT system can be increased by offsetting the CBCT detector. Analytic-based algorithms have been developed for image reconstruction from data collected at a large number of densely sampled views in offset-detector CBCT. However, the radiation dose involved in a large number of projections can be of a health concern to the imaged subject. CBCT-imaging dose can be reduced by lowering the number of projections. As analytic-based algorithms are unlikely to reconstruct accurate images from sparse-view data, we investigate and characterize in the work optimization-based algorithms, including an adaptive steepest descent-weighted projection onto convex sets (ASD-WPOCS) algorithms, for image reconstruction from sparse-view data collected in offset-detector CBCT. Using simulated data and real data collected from a physical pelvis phantom and patient, we verify and characterize properties of the algorithms under study. Results of our study suggest that optimization-based algorithms such as ASD-WPOCS may be developed for yielding images of potential utility from a number of projections substantially smaller than those used currently in clinical SPECT/CBCT imaging, thus leading to a dose reduction in CBCT imaging.

Application of off-line image processing for optimization in chest computed radiography using a low cost system.

PubMed

Muhogora, Wilbroad E; Msaki, Peter; Padovani, Renato

2015-03-08

 The objective of this study was to improve the visibility of anatomical details by applying off-line postimage processing in chest computed radiography (CR). Four spatial domain-based external image processing techniques were developed by using MATLAB software version 7.0.0.19920 (R14) and image processing tools. The developed techniques were implemented to sample images and their visual appearances confirmed by two consultant radiologists to be clinically adequate. The techniques were then applied to 200 chest clinical images and randomized with other 100 images previously processed online. These 300 images were presented to three experienced radiologists for image quality assessment using standard quality criteria. The mean and ranges of the average scores for three radiologists were characterized for each of the developed technique and imaging system. The Mann-Whitney U-test was used to test the difference of details visibility between the images processed using each of the developed techniques and the corresponding images processed using default algorithms. The results show that the visibility of anatomical features improved significantly (0.005 ≤ p ≤ 0.02) with combinations of intensity values adjustment and/or spatial linear filtering techniques for images acquired using 60 ≤ kVp ≤ 70. However, there was no improvement for images acquired using 102 ≤ kVp ≤ 107 (0.127 ≤ p ≤ 0.48). In conclusion, the use of external image processing for optimization can be effective in chest CR, but should be implemented in consultations with the radiologists.

Application of off‐line image processing for optimization in chest computed radiography using a low cost system

PubMed Central

Msaki, Peter; Padovani, Renato

2015-01-01

The objective of this study was to improve the visibility of anatomical details by applying off‐line postimage processing in chest computed radiography (CR). Four spatial domain‐based external image processing techniques were developed by using MATLAB software version 7.0.0.19920 (R14) and image processing tools. The developed techniques were implemented to sample images and their visual appearances confirmed by two consultant radiologists to be clinically adequate. The techniques were then applied to 200 chest clinical images and randomized with other 100 images previously processed online. These 300 images were presented to three experienced radiologists for image quality assessment using standard quality criteria. The mean and ranges of the average scores for three radiologists were characterized for each of the developed technique and imaging system. The Mann‐Whitney U‐test was used to test the difference of details visibility between the images processed using each of the developed techniques and the corresponding images processed using default algorithms. The results show that the visibility of anatomical features improved significantly (0.005≤p≤0.02) with combinations of intensity values adjustment and/or spatial linear filtering techniques for images acquired using 60≤kVp≤70. However, there was no improvement for images acquired using 102≤kVp≤107 (0.127≤p≤0.48). In conclusion, the use of external image processing for optimization can be effective in chest CR, but should be implemented in consultations with the radiologists. PACS number: 87.59.−e, 87.59.−B, 87.59.−bd PMID:26103165

Imaging: Guiding the Clinical Translation of Cardiac Stem Cell Therapy

PubMed Central

Nguyen, Patricia K.; Lan, Feng; Wang, Yongming; Wu, Joseph C.

2011-01-01

Stem cells have been touted as the holy grail of medical therapy with promises to regenerate cardiac tissue, but it appears the jury is still out on this novel therapy. Using advanced imaging technology, scientists have discovered that these cells do not survive nor engraft long-term. In addition, only marginal benefit has been observed in large animal studies and human trials. However, all is not lost. Further application of advanced imaging technology will help scientists unravel the mysteries of stem cell therapy and address the clinical hurdles facing its routine implementation. In this review, we will discuss how advanced imaging technology will help investigators better define the optimal delivery method, improve survival and engraftment, and evaluate efficacy and safety. Insights gained from this review may direct the development of future preclinical investigations and clinical trials. PMID:21960727

Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials.

PubMed

Van Heertum, Ronald L; Scarimbolo, Robert; Ford, Robert; Berdougo, Eli; O'Neal, Michael

2015-01-01

In the era of personalized medicine, diagnostic approaches are helping pharmaceutical and biotechnology sponsors streamline the clinical trial process. Molecular assays and diagnostic imaging are routinely being used to stratify patients for treatment, monitor disease, and provide reliable early clinical phase assessments. The importance of diagnostic approaches in drug development is highlighted by the rapidly expanding global cancer diagnostics market and the emergent attention of regulatory agencies worldwide, who are beginning to offer more structured platforms and guidance for this area. In this paper, we highlight the key benefits of using companion diagnostics and diagnostic imaging with a focus on oncology clinical trials. Nuclear imaging using widely available radiopharmaceuticals in conjunction with molecular imaging of oncology targets has opened the door to more accurate disease assessment and the modernization of standard criteria for the evaluation, staging, and treatment responses of cancer patients. Furthermore, the introduction and validation of quantitative molecular imaging continues to drive and optimize the field of oncology diagnostics. Given their pivotal role in disease assessment and treatment, the validation and commercialization of diagnostic tools will continue to advance oncology clinical trials, support new oncology drugs, and promote better patient outcomes.

Dynamic whole body PET parametric imaging: II. Task-oriented statistical estimation

PubMed Central

Karakatsanis, Nicolas A.; Lodge, Martin A.; Zhou, Y.; Wahl, Richard L.; Rahmim, Arman

2013-01-01

In the context of oncology, dynamic PET imaging coupled with standard graphical linear analysis has been previously employed to enable quantitative estimation of tracer kinetic parameters of physiological interest at the voxel level, thus, enabling quantitative PET parametric imaging. However, dynamic PET acquisition protocols have been confined to the limited axial field-of-view (~15–20cm) of a single bed position and have not been translated to the whole-body clinical imaging domain. On the contrary, standardized uptake value (SUV) PET imaging, considered as the routine approach in clinical oncology, commonly involves multi-bed acquisitions, but is performed statically, thus not allowing for dynamic tracking of the tracer distribution. Here, we pursue a transition to dynamic whole body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. In a companion study, we presented a novel clinically feasible dynamic (4D) multi-bed PET acquisition protocol as well as the concept of whole body PET parametric imaging employing Patlak ordinary least squares (OLS) regression to estimate the quantitative parameters of tracer uptake rate Ki and total blood distribution volume V. In the present study, we propose an advanced hybrid linear regression framework, driven by Patlak kinetic voxel correlations, to achieve superior trade-off between contrast-to-noise ratio (CNR) and mean squared error (MSE) than provided by OLS for the final Ki parametric images, enabling task-based performance optimization. Overall, whether the observer's task is to detect a tumor or quantitatively assess treatment response, the proposed statistical estimation framework can be adapted to satisfy the specific task performance criteria, by adjusting the Patlak correlation-coefficient (WR) reference value. The multi-bed dynamic acquisition protocol, as optimized in the preceding companion study, was employed along with extensive Monte Carlo simulations and an initial clinical FDG patient dataset to validate and demonstrate the potential of the proposed statistical estimation methods. Both simulated and clinical results suggest that hybrid regression in the context of whole-body Patlak Ki imaging considerably reduces MSE without compromising high CNR. Alternatively, for a given CNR, hybrid regression enables larger reductions than OLS in the number of dynamic frames per bed, allowing for even shorter acquisitions of ~30min, thus further contributing to the clinical adoption of the proposed framework. Compared to the SUV approach, whole body parametric imaging can provide better tumor quantification, and can act as a complement to SUV, for the task of tumor detection. PMID:24080994

Dynamic whole-body PET parametric imaging: II. Task-oriented statistical estimation.

PubMed

Karakatsanis, Nicolas A; Lodge, Martin A; Zhou, Y; Wahl, Richard L; Rahmim, Arman

2013-10-21

In the context of oncology, dynamic PET imaging coupled with standard graphical linear analysis has been previously employed to enable quantitative estimation of tracer kinetic parameters of physiological interest at the voxel level, thus, enabling quantitative PET parametric imaging. However, dynamic PET acquisition protocols have been confined to the limited axial field-of-view (~15-20 cm) of a single-bed position and have not been translated to the whole-body clinical imaging domain. On the contrary, standardized uptake value (SUV) PET imaging, considered as the routine approach in clinical oncology, commonly involves multi-bed acquisitions, but is performed statically, thus not allowing for dynamic tracking of the tracer distribution. Here, we pursue a transition to dynamic whole-body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. In a companion study, we presented a novel clinically feasible dynamic (4D) multi-bed PET acquisition protocol as well as the concept of whole-body PET parametric imaging employing Patlak ordinary least squares (OLS) regression to estimate the quantitative parameters of tracer uptake rate Ki and total blood distribution volume V. In the present study, we propose an advanced hybrid linear regression framework, driven by Patlak kinetic voxel correlations, to achieve superior trade-off between contrast-to-noise ratio (CNR) and mean squared error (MSE) than provided by OLS for the final Ki parametric images, enabling task-based performance optimization. Overall, whether the observer's task is to detect a tumor or quantitatively assess treatment response, the proposed statistical estimation framework can be adapted to satisfy the specific task performance criteria, by adjusting the Patlak correlation-coefficient (WR) reference value. The multi-bed dynamic acquisition protocol, as optimized in the preceding companion study, was employed along with extensive Monte Carlo simulations and an initial clinical (18)F-deoxyglucose patient dataset to validate and demonstrate the potential of the proposed statistical estimation methods. Both simulated and clinical results suggest that hybrid regression in the context of whole-body Patlak Ki imaging considerably reduces MSE without compromising high CNR. Alternatively, for a given CNR, hybrid regression enables larger reductions than OLS in the number of dynamic frames per bed, allowing for even shorter acquisitions of ~30 min, thus further contributing to the clinical adoption of the proposed framework. Compared to the SUV approach, whole-body parametric imaging can provide better tumor quantification, and can act as a complement to SUV, for the task of tumor detection.

TU-H-CAMPUS-JeP1-04: Deformable Image Registration Performances in Pelvis Patients: Impact of CBCT Image Quality

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fusella, M; Loi, G; Fiandra, C

Purpose: To investigate the accuracy and robustness, against image noise and artifacts (typical of CBCT images), of a commercial algorithm for deformable image registration (DIR), to propagate regions of interest (ROIs) in computational phantoms based on real prostate patient images. Methods: The Anaconda DIR algorithm, implemented in RayStation was tested. Two specific Deformation Vector Fields (DVFs) were applied to the reference data set (CTref) using the ImSimQA software, obtaining two deformed CTs. For each dataset twenty-four different level of noise and/or capping artifacts were applied to simulate CBCT images. DIR was performed between CTref and each deformed CTs and CBCTs.more » In order to investigate the relationship between image quality parameters and the DIR results (expressed by a logit transform of the Dice Index) a bilinear regression was defined. Results: More than 550 DIR-mapped ROIs were analyzed. The Statistical analysis states that deformation strenght and artifacts were significant prognostic factors of DIR performances, while noise appeared to have a minor role in DIR process as implemented in RayStation as expected by the image similarity metric built in the registration algorithm. Capping artifacts reveals a determinant role for the accuracy of DIR results. Two optimal values for capping artifacts were found to obtain acceptable DIR results (DICE> 075/ 0.85). Various clinical CBCT acquisition protocol were reported to evaluate the significance of the study. Conclusion: This work illustrates the impact of image quality on DIR performance. Clinical issues like Adaptive Radiation Therapy (ART) and Dose Accumulation need accurate and robust DIR software. The RayStation DIR algorithm resulted robust against noise, but sensitive to image artifacts. This result highlights the need of robustness quality assurance against image noise and artifacts in the commissioning of a DIR commercial system and underlines the importance to adopt optimized protocols for CBCT image acquisitions in ART clinical implementation.« less

[Digital breast tomosynthesis : technical principles, current clinical relevance and future perspectives].

PubMed

Hellerhoff, K

2010-11-01

In recent years digital full field mammography has increasingly replaced conventional film mammography. High quality imaging is guaranteed by high quantum efficiency and very good contrast resolution with optimized dosing even for women with dense glandular tissue. However, digital mammography remains a projection procedure by which overlapping tissue limits the detectability of subtle alterations. Tomosynthesis is a procedure developed from digital mammography for slice examination of breasts which eliminates the effects of overlapping tissue and allows 3D imaging of breasts. A curved movement of the X-ray tube during scanning allows the acquisition of many 2D images from different angles. Subseqently, reconstruction algorithms employing a shift and add method improve the recognition of details at a defined level and at the same time eliminate smear artefacts due to overlapping structures. The total dose corresponds to that of conventional mammography imaging. The technical procedure, including the number of levels, suitable anodes/filter combinations, angle regions of images and selection of reconstruction algorithms, is presently undergoing optimization. Previous studies on the clinical value of tomosynthesis have examined screening parameters, such as recall rate and detection rate as well as information on tumor extent for histologically proven breast tumors. More advanced techniques, such as contrast medium-enhanced tomosynthesis, are presently under development and dual-energy imaging is of particular importance.

JIGSAW: Joint Inhomogeneity estimation via Global Segment Assembly for Water-fat separation.

PubMed

Lu, Wenmiao; Lu, Yi

2011-07-01

Water-fat separation in magnetic resonance imaging (MRI) is of great clinical importance, and the key to uniform water-fat separation lies in field map estimation. This work deals with three-point field map estimation, in which water and fat are modelled as two single-peak spectral lines, and field inhomogeneities shift the spectrum by an unknown amount. Due to the simplified spectrum modelling, there exists inherent ambiguity in forming field maps from multiple locally feasible field map values at each pixel. To resolve such ambiguity, spatial smoothness of field maps has been incorporated as a constraint of an optimization problem. However, there are two issues: the optimization problem is computationally intractable and even when it is solved exactly, it does not always separate water and fat images. Hence, robust field map estimation remains challenging in many clinically important imaging scenarios. This paper proposes a novel field map estimation technique called JIGSAW. It extends a loopy belief propagation (BP) algorithm to obtain an approximate solution to the optimization problem. The solution produces locally smooth segments and avoids error propagation associated with greedy methods. The locally smooth segments are then assembled into a globally consistent field map by exploiting the periodicity of the feasible field map values. In vivo results demonstrate that JIGSAW outperforms existing techniques and produces correct water-fat separation in challenging imaging scenarios.

Effect of injection rate on contrast-enhanced MR angiography image quality: Modulation transfer function analysis.

PubMed

Clark, Toshimasa J; Wilson, Gregory J; Maki, Jeffrey H

2017-07-01

Contrast-enhanced (CE)-MRA optimization involves interactions of sequence duration, bolus timing, contrast recirculation, and both R 1 relaxivity and R2*-related reduction of signal. Prior data suggest superior image quality with slower gadolinium injection rates than typically used. A computer-based model of CE-MRA was developed, with contrast injection, physiologic, and image acquisition parameters varied over a wide gamut. Gadolinium concentration was derived using Verhoeven's model with recirculation, R 1 and R2* calculated at each time point, and modulation transfer curves used to determine injection rates, resulting in optimal resolution and image contrast for renal and carotid artery CE-MRA. Validation was via a vessel stenosis phantom and example patients who underwent carotid CE-MRA with low effective injection rates. Optimal resolution for renal and carotid CE-MRA is achieved with injection rates between 0.5 to 0.9 mL/s and 0.2 to 0.3 mL/s, respectively, dependent on contrast volume. Optimal image contrast requires slightly faster injection rates. Expected signal-to-noise ratio varies with both contrast volume and cardiac output. Simulated vessel phantom and clinical carotid CE-MRA exams at an effective contrast injection rate of 0.4 to 0.5 mL/s demonstrate increased resolution. Optimal image resolution is achieved at intuitively low, effective injection rates (0.2-0.9 mL/s, dependent on imaging parameters and contrast injection volume). Magn Reson Med 78:357-369, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Why Physics in Medicine?

PubMed

Samei, Ehsan; Grist, Thomas M

2018-05-18

Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences. There are three aspects of this clinical role: technology assessment based on metrics as they relate to expected clinical performance, optimized use of technologies for patient-centered clinical outcomes, and retrospective analysis of imaging operations to ensure attainment of expectations in terms of quality and variability. These tasks fuel the drive toward high-quality, consistent practice of medical imaging that is patient centered, evidence based, and safe. While this particular article focuses on imaging, this trajectory and paradigm is equally applicable to the multitudes of the applications of physics in medicine. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Automatic CT simulation optimization for radiation therapy: A general strategy.

PubMed

Li, Hua; Yu, Lifeng; Anastasio, Mark A; Chen, Hsin-Chen; Tan, Jun; Gay, Hiram; Michalski, Jeff M; Low, Daniel A; Mutic, Sasa

2014-03-01

In radiation therapy, x-ray computed tomography (CT) simulation protocol specifications should be driven by the treatment planning requirements in lieu of duplicating diagnostic CT screening protocols. The purpose of this study was to develop a general strategy that allows for automatically, prospectively, and objectively determining the optimal patient-specific CT simulation protocols based on radiation-therapy goals, namely, maintenance of contouring quality and integrity while minimizing patient CT simulation dose. The authors proposed a general prediction strategy that provides automatic optimal CT simulation protocol selection as a function of patient size and treatment planning task. The optimal protocol is the one that delivers the minimum dose required to provide a CT simulation scan that yields accurate contours. Accurate treatment plans depend on accurate contours in order to conform the dose to actual tumor and normal organ positions. An image quality index, defined to characterize how simulation scan quality affects contour delineation, was developed and used to benchmark the contouring accuracy and treatment plan quality within the predication strategy. A clinical workflow was developed to select the optimal CT simulation protocols incorporating patient size, target delineation, and radiation dose efficiency. An experimental study using an anthropomorphic pelvis phantom with added-bolus layers was used to demonstrate how the proposed prediction strategy could be implemented and how the optimal CT simulation protocols could be selected for prostate cancer patients based on patient size and treatment planning task. Clinical IMRT prostate treatment plans for seven CT scans with varied image quality indices were separately optimized and compared to verify the trace of target and organ dosimetry coverage. Based on the phantom study, the optimal image quality index for accurate manual prostate contouring was 4.4. The optimal tube potentials for patient sizes of 38, 43, 48, 53, and 58 cm were 120, 140, 140, 140, and 140 kVp, respectively, and the corresponding minimum CTDIvol for achieving the optimal image quality index 4.4 were 9.8, 32.2, 100.9, 241.4, and 274.1 mGy, respectively. For patients with lateral sizes of 43-58 cm, 120-kVp scan protocols yielded up to 165% greater radiation dose relative to 140-kVp protocols, and 140-kVp protocols always yielded a greater image quality index compared to the same dose-level 120-kVp protocols. The trace of target and organ dosimetry coverage and the γ passing rates of seven IMRT dose distribution pairs indicated the feasibility of the proposed image quality index for the predication strategy. A general strategy to predict the optimal CT simulation protocols in a flexible and quantitative way was developed that takes into account patient size, treatment planning task, and radiation dose. The experimental study indicated that the optimal CT simulation protocol and the corresponding radiation dose varied significantly for different patient sizes, contouring accuracy, and radiation treatment planning tasks.

A report on the Academic Emergency Medicine 2015 consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization".

PubMed

Gunn, Martin L; Marin, Jennifer R; Mills, Angela M; Chong, Suzanne T; Froemming, Adam T; Johnson, Jamlik O; Kumaravel, Manickam; Sodickson, Aaron D

2016-08-01

In May 2015, the Academic Emergency Medicine consensus conference "Diagnostic imaging in the emergency department: a research agenda to optimize utilization" was held. The goal of the conference was to develop a high-priority research agenda regarding emergency diagnostic imaging on which to base future research. In addition to representatives from the Society of Academic Emergency Medicine, the multidisciplinary conference included members of several radiology organizations: American Society for Emergency Radiology, Radiological Society of North America, the American College of Radiology, and the American Association of Physicists in Medicine. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Through a multistep consensus process, participants developed targeted research questions for future research in six content areas within emergency diagnostic imaging: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use.

Multi-segment detector array for hybrid reflection-mode ultrasound and optoacoustic tomography (Conference Presentation)

NASA Astrophysics Data System (ADS)

Merčep, Elena; Burton, Neal C.; Deán-Ben, Xosé Luís.; Razansky, Daniel

2017-02-01

The complementary contrast of the optoacoustic (OA) and pulse-echo ultrasound (US) modalities makes the combined usage of these imaging technologies highly advantageous. Due to the different physical contrast mechanisms development of a detector array optimally suited for both modalities is one of the challenges to efficient implementation of a single OA-US imaging device. We demonstrate imaging performance of the first hybrid detector array whose novel design, incorporating array segments of linear and concave geometry, optimally supports image acquisition in both reflection-mode ultrasonography and optoacoustic tomography modes. Hybrid detector array has a total number of 256 elements and three segments of different geometry and variable pitch size: a central 128-element linear segment with pitch of 0.25mm, ideally suited for pulse-echo US imaging, and two external 64-elements segments with concave geometry and 0.6mm pitch optimized for OA image acquisition. Interleaved OA and US image acquisition with up to 25 fps is facilitated through a custom-made multiplexer unit. Spatial resolution of the transducer was characterized in numerical simulations and validated in phantom experiments and comprises 230 and 300 μm in the respective OA and US imaging modes. Imaging performance of the multi-segment detector array was experimentally shown in a series of imaging sessions with healthy volunteers. Employing mixed array geometries allows at the same time achieving excellent OA contrast with a large field of view, and US contrast for complementary structural features with reduced side-lobes and improved resolution. The newly designed hybrid detector array that comprises segments of linear and concave geometries optimally fulfills requirements for efficient US and OA imaging and may expand the applicability of the developed hybrid OPUS imaging technology and accelerate its clinical translation.

A method for energy window optimization for quantitative tasks that includes the effects of model-mismatch on bias: application to Y-90 bremsstrahlung SPECT imaging.

PubMed

Rong, Xing; Du, Yong; Frey, Eric C

2012-06-21

Quantitative Yttrium-90 ((90)Y) bremsstrahlung single photon emission computed tomography (SPECT) imaging has shown great potential to provide reliable estimates of (90)Y activity distribution for targeted radionuclide therapy dosimetry applications. One factor that potentially affects the reliability of the activity estimates is the choice of the acquisition energy window. In contrast to imaging conventional gamma photon emitters where the acquisition energy windows are usually placed around photopeaks, there has been great variation in the choice of the acquisition energy window for (90)Y imaging due to the continuous and broad energy distribution of the bremsstrahlung photons. In quantitative imaging of conventional gamma photon emitters, previous methods for optimizing the acquisition energy window assumed unbiased estimators and used the variance in the estimates as a figure of merit (FOM). However, for situations, such as (90)Y imaging, where there are errors in the modeling of the image formation process used in the reconstruction there will be bias in the activity estimates. In (90)Y bremsstrahlung imaging this will be especially important due to the high levels of scatter, multiple scatter, and collimator septal penetration and scatter. Thus variance will not be a complete measure of reliability of the estimates and thus is not a complete FOM. To address this, we first aimed to develop a new method to optimize the energy window that accounts for both the bias due to model-mismatch and the variance of the activity estimates. We applied this method to optimize the acquisition energy window for quantitative (90)Y bremsstrahlung SPECT imaging in microsphere brachytherapy. Since absorbed dose is defined as the absorbed energy from the radiation per unit mass of tissues in this new method we proposed a mass-weighted root mean squared error of the volume of interest (VOI) activity estimates as the FOM. To calculate this FOM, two analytical expressions were derived for calculating the bias due to model-mismatch and the variance of the VOI activity estimates, respectively. To obtain the optimal acquisition energy window for general situations of interest in clinical (90)Y microsphere imaging, we generated phantoms with multiple tumors of various sizes and various tumor-to-normal activity concentration ratios using a digital phantom that realistically simulates human anatomy, simulated (90)Y microsphere imaging with a clinical SPECT system and typical imaging parameters using a previously validated Monte Carlo simulation code, and used a previously proposed method for modeling the image degrading effects in quantitative SPECT reconstruction. The obtained optimal acquisition energy window was 100-160 keV. The values of the proposed FOM were much larger than the FOM taking into account only the variance of the activity estimates, thus demonstrating in our experiment that the bias of the activity estimates due to model-mismatch was a more important factor than the variance in terms of limiting the reliability of activity estimates.

Photography in Dermatologic Surgery: Selection of an Appropriate Camera Type for a Particular Clinical Application.

PubMed

Chen, Brian R; Poon, Emily; Alam, Murad

2017-08-01

Photographs are an essential tool for the documentation and sharing of findings in dermatologic surgery, and various camera types are available. To evaluate the currently available camera types in view of the special functional needs of procedural dermatologists. Mobile phone, point and shoot, digital single-lens reflex (DSLR), digital medium format, and 3-dimensional cameras were compared in terms of their usefulness for dermatologic surgeons. For each camera type, the image quality, as well as the other practical benefits and limitations, were evaluated with reference to a set of ideal camera characteristics. Based on these assessments, recommendations were made regarding the specific clinical circumstances in which each camera type would likely be most useful. Mobile photography may be adequate when ease of use, availability, and accessibility are prioritized. Point and shoot cameras and DSLR cameras provide sufficient resolution for a range of clinical circumstances, while providing the added benefit of portability. Digital medium format cameras offer the highest image quality, with accurate color rendition and greater color depth. Three-dimensional imaging may be optimal for the definition of skin contour. The selection of an optimal camera depends on the context in which it will be used.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lakshminarayan, Raghuram, E-mail: raghuram.lakshminarayan@hey.nhs.u; Simpson, James O.; Ettles, Duncan F., E-mail: Duncan.Ettles@hey.nhs.u

Magnetic resonance angiography (MRA) has become an established imaging modality in the management of lower-limb arterial disease, with emerging roles in treatment planning and follow-up. Contrast-enhanced MRA is now the most widely used technique with clinically acceptable results in the majority of patients. Difficulties in imaging and image interpretation are recognised in certain subgroups, including patients with critical limb ischaemia as well as patients with stents. Although newer contrast agents and refined imaging protocols may offer some solutions to these problems, this optimism is balanced by concerns about the toxicity of certain gadolinium chelates. Further development of interventional MRA remainsmore » one of the most significant challenges in the development of magnetic resonance imaging-guided peripheral vascular intervention. The status of MRA in managing patients with lower-limb arterial disease in current clinical practice is reviewed.« less

Acoustic-noise-optimized diffusion-weighted imaging.

PubMed

Ott, Martin; Blaimer, Martin; Grodzki, David M; Breuer, Felix A; Roesch, Julie; Dörfler, Arnd; Heismann, Björn; Jakob, Peter M

2015-12-01

This work was aimed at reducing acoustic noise in diffusion-weighted MR imaging (DWI) that might reach acoustic noise levels of over 100 dB(A) in clinical practice. A diffusion-weighted readout-segmented echo-planar imaging (EPI) sequence was optimized for acoustic noise by utilizing small readout segment widths to obtain low gradient slew rates and amplitudes instead of faster k-space coverage. In addition, all other gradients were optimized for low slew rates. Volunteer and patient imaging experiments were conducted to demonstrate the feasibility of the method. Acoustic noise measurements were performed and analyzed for four different DWI measurement protocols at 1.5T and 3T. An acoustic noise reduction of up to 20 dB(A) was achieved, which corresponds to a fourfold reduction in acoustic perception. The image quality was preserved at the level of a standard single-shot (ss)-EPI sequence, with a 27-54% increase in scan time. The diffusion-weighted imaging technique proposed in this study allowed a substantial reduction in the level of acoustic noise compared to standard single-shot diffusion-weighted EPI. This is expected to afford considerably more patient comfort, but a larger study would be necessary to fully characterize the subjective changes in patient experience.

Quantitative segmentation of fluorescence microscopy images of heterogeneous tissue: Approach for tuning algorithm parameters

NASA Astrophysics Data System (ADS)

Mueller, Jenna L.; Harmany, Zachary T.; Mito, Jeffrey K.; Kennedy, Stephanie A.; Kim, Yongbaek; Dodd, Leslie; Geradts, Joseph; Kirsch, David G.; Willett, Rebecca M.; Brown, J. Quincy; Ramanujam, Nimmi

2013-02-01

The combination of fluorescent contrast agents with microscopy is a powerful technique to obtain real time images of tissue histology without the need for fixing, sectioning, and staining. The potential of this technology lies in the identification of robust methods for image segmentation and quantitation, particularly in heterogeneous tissues. Our solution is to apply sparse decomposition (SD) to monochrome images of fluorescently-stained microanatomy to segment and quantify distinct tissue types. The clinical utility of our approach is demonstrated by imaging excised margins in a cohort of mice after surgical resection of a sarcoma. Representative images of excised margins were used to optimize the formulation of SD and tune parameters associated with the algorithm. Our results demonstrate that SD is a robust solution that can advance vital fluorescence microscopy as a clinically significant technology.

Real-time registration of 3D to 2D ultrasound images for image-guided prostate biopsy.

PubMed

Gillies, Derek J; Gardi, Lori; De Silva, Tharindu; Zhao, Shuang-Ren; Fenster, Aaron

2017-09-01

During image-guided prostate biopsy, needles are targeted at tissues that are suspicious of cancer to obtain specimen for histological examination. Unfortunately, patient motion causes targeting errors when using an MR-transrectal ultrasound (TRUS) fusion approach to augment the conventional biopsy procedure. This study aims to develop an automatic motion correction algorithm approaching the frame rate of an ultrasound system to be used in fusion-based prostate biopsy systems. Two modes of operation have been investigated for the clinical implementation of the algorithm: motion compensation using a single user initiated correction performed prior to biopsy, and real-time continuous motion compensation performed automatically as a background process. Retrospective 2D and 3D TRUS patient images acquired prior to biopsy gun firing were registered using an intensity-based algorithm utilizing normalized cross-correlation and Powell's method for optimization. 2D and 3D images were downsampled and cropped to estimate the optimal amount of image information that would perform registrations quickly and accurately. The optimal search order during optimization was also analyzed to avoid local optima in the search space. Error in the algorithm was computed using target registration errors (TREs) from manually identified homologous fiducials in a clinical patient dataset. The algorithm was evaluated for real-time performance using the two different modes of clinical implementations by way of user initiated and continuous motion compensation methods on a tissue mimicking prostate phantom. After implementation in a TRUS-guided system with an image downsampling factor of 4, the proposed approach resulted in a mean ± std TRE and computation time of 1.6 ± 0.6 mm and 57 ± 20 ms respectively. The user initiated mode performed registrations with in-plane, out-of-plane, and roll motions computation times of 108 ± 38 ms, 60 ± 23 ms, and 89 ± 27 ms, respectively, and corresponding registration errors of 0.4 ± 0.3 mm, 0.2 ± 0.4 mm, and 0.8 ± 0.5°. The continuous method performed registration significantly faster (P < 0.05) than the user initiated method, with observed computation times of 35 ± 8 ms, 43 ± 16 ms, and 27 ± 5 ms for in-plane, out-of-plane, and roll motions, respectively, and corresponding registration errors of 0.2 ± 0.3 mm, 0.7 ± 0.4 mm, and 0.8 ± 1.0°. The presented method encourages real-time implementation of motion compensation algorithms in prostate biopsy with clinically acceptable registration errors. Continuous motion compensation demonstrated registration accuracy with submillimeter and subdegree error, while performing < 50 ms computation times. Image registration technique approaching the frame rate of an ultrasound system offers a key advantage to be smoothly integrated to the clinical workflow. In addition, this technique could be used further for a variety of image-guided interventional procedures to treat and diagnose patients by improving targeting accuracy. © 2017 American Association of Physicists in Medicine.

TH-E-17A-07: Improved Cine Four-Dimensional Computed Tomography (4D CT) Acquisition and Processing Method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castillo, S; Castillo, R; Castillo, E

2014-06-15

Purpose: Artifacts arising from the 4D CT acquisition and post-processing methods add systematic uncertainty to the treatment planning process. We propose an alternate cine 4D CT acquisition and post-processing method to consistently reduce artifacts, and explore patient parameters indicative of image quality. Methods: In an IRB-approved protocol, 18 patients with primary thoracic malignancies received a standard cine 4D CT acquisition followed by an oversampling 4D CT that doubled the number of images acquired. A second cohort of 10 patients received the clinical 4D CT plus 3 oversampling scans for intra-fraction reproducibility. The clinical acquisitions were processed by the standard phasemore » sorting method. The oversampling acquisitions were processed using Dijkstras algorithm to optimize an artifact metric over available image data. Image quality was evaluated with a one-way mixed ANOVA model using a correlation-based artifact metric calculated from the final 4D CT image sets. Spearman correlations and a linear mixed model tested the association between breathing parameters, patient characteristics, and image quality. Results: The oversampling 4D CT scans reduced artifact presence significantly by 27% and 28%, for the first cohort and second cohort respectively. From cohort 2, the inter-replicate deviation for the oversampling method was within approximately 13% of the cross scan average at the 0.05 significance level. Artifact presence for both clinical and oversampling methods was significantly correlated with breathing period (ρ=0.407, p-value<0.032 clinical, ρ=0.296, p-value<0.041 oversampling). Artifact presence in the oversampling method was significantly correlated with amount of data acquired, (ρ=-0.335, p-value<0.02) indicating decreased artifact presence with increased breathing cycles per scan location. Conclusion: The 4D CT oversampling acquisition with optimized sorting reduced artifact presence significantly and reproducibly compared to the phase-sorted clinical acquisition.« less

2D and 3D registration methods for dual-energy contrast-enhanced digital breast tomosynthesis

NASA Astrophysics Data System (ADS)

Lau, Kristen C.; Roth, Susan; Maidment, Andrew D. A.

2014-03-01

Contrast-enhanced digital breast tomosynthesis (CE-DBT) uses an iodinated contrast agent to image the threedimensional breast vasculature. The University of Pennsylvania is conducting a CE-DBT clinical study in patients with known breast cancers. The breast is compressed continuously and imaged at four time points (1 pre-contrast; 3 postcontrast). A hybrid subtraction scheme is proposed. First, dual-energy (DE) images are obtained by a weighted logarithmic subtraction of the high-energy and low-energy image pairs. Then, post-contrast DE images are subtracted from the pre-contrast DE image. This hybrid temporal subtraction of DE images is performed to analyze iodine uptake, but suffers from motion artifacts. Employing image registration further helps to correct for motion, enhancing the evaluation of vascular kinetics. Registration using ANTS (Advanced Normalization Tools) is performed in an iterative manner. Mutual information optimization first corrects large-scale motions. Normalized cross-correlation optimization then iteratively corrects fine-scale misalignment. Two methods have been evaluated: a 2D method using a slice-by-slice approach, and a 3D method using a volumetric approach to account for out-of-plane breast motion. Our results demonstrate that iterative registration qualitatively improves with each iteration (five iterations total). Motion artifacts near the edge of the breast are corrected effectively and structures within the breast (e.g. blood vessels, surgical clip) are better visualized. Statistical and clinical evaluations of registration accuracy in the CE-DBT images are ongoing.

Imaging diagnostics in ovarian cancer: magnetic resonance imaging and a scoring system guiding choice of primary treatment.

PubMed

Kasper, Sigrid M; Dueholm, Margit; Marinovskij, Edvard; Blaakær, Jan

2017-03-01

To analyze the ability of magnetic resonance imaging (MRI) and systematic evaluation at surgery to predict optimal cytoreduction in primary advanced ovarian cancer and to develop a preoperative scoring system for cancer staging. Preoperative MRI and standard laparotomy were performed in 99 women with either ovarian or primary peritoneal cancer. Using univariate and multivariate logistic regression analysis of a systematic description of the tumor in nine abdominal compartments obtained by MRI and during surgery plus clinical parameters, a scoring system was designed that predicted non-optimal cytoreduction. Non-optimal cytoreduction at operation was predicted by the following: (A) presence of comorbidities group 3 or 4 (ASA); (B) tumor presence in multiple numbers of different compartments, and (C) numbers of specified sites of organ involvement. The score includes: number of compartments involved (1-9 points), >1 subdiaphragmal location with presence of tumor (1 point); deep organ involvement of liver (1 point), porta hepatis (1 point), spleen (1 point), mesentery/vessel (1 point), cecum/ileocecal (1 point), rectum/vessels (1 point): ASA groups 3 and 4 (2 points). Use of the scoring system based on operative findings gave an area under the curve (AUC) of 91% (85-98%) for patients in whom optimal cytoreduction could not be achieved. The score AUC obtained by MRI was 84% (76-92%), and 43% of non-optimal cytoreduction patients were identified, with only 8% of potentially operable patients being falsely evaluated as suitable for non-optimal cytoreduction at the most optimal cut-off value. Tumor in individual locations did not predict operability. This systematic scoring system based on operative findings and MRI may predict non-optimal cytoreduction. MRI is able to assess ovarian cancer with peritoneal carcinomatosis with satisfactory concordance with laparotomic findings. This scoring system could be useful as a clinical guideline and should be evaluated and developed further in larger studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Quantitative Diffuse Reflectance Imaging (QDRI) System for Comprehensive Surveillance of the Morphological Landscape in Breast Tumor Margins.

PubMed

Nichols, Brandon S; Schindler, Christine E; Brown, Jonathon Q; Wilke, Lee G; Mulvey, Christine S; Krieger, Marlee S; Gallagher, Jennifer; Geradts, Joseph; Greenup, Rachel A; Von Windheim, Jesko A; Ramanujam, Nirmala

2015-01-01

In an ongoing effort to address the clear clinical unmet needs surrounding breast conserving surgery (BCS), our group has developed a next-generation multiplexed optical-fiber-based tool to assess breast tumor margin status during initial surgeries. Specifically detailed in this work is the performance and clinical validation of a research-grade intra-operative tool for margin assessment based on diffuse optical spectroscopy. Previous work published by our group has illustrated the proof-of-concept generations of this device; here we incorporate a highly optimized quantitative diffuse reflectance imaging (QDRI) system utilizing a wide-field (imaging area = 17 cm(2)) 49-channel multiplexed fiber optic probe, a custom raster-scanning imaging platform, a custom dual-channel white LED source, and an astronomy grade imaging CCD and spectrograph. The system signal to noise ratio (SNR) was found to be greater than 40 dB for all channels. Optical property estimation error was found to be less than 10%, on average, over a wide range of absorption (μa = 0-8.9 cm(-1)) and scattering (μs' = 7.0-9.7 cm(-1)) coefficients. Very low inter-channel and CCD crosstalk was observed (2% max) when used on turbid media (including breast tissue). A raster-scanning mechanism was developed to achieve sub-pixel resolution and was found to be optimally performed at an upsample factor of 8, affording 0.75 mm spatially resolved diffuse reflectance images (λ = 450-600 nm) of an entire margin (area = 17 cm(2)) in 13.8 minutes (1.23 cm(2)/min). Moreover, controlled pressure application at the probe-tissue interface afforded by the imaging platform reduces repeated scan variability, providing <1% variation across repeated scans of clinical specimens. We demonstrate the clinical utility of this device through a pilot 20-patient study of high-resolution optical parameter maps of the ratio of the β-carotene concentration to the reduced scattering coefficient. An empirical cumulative distribution function (eCDF) analysis is used to reduce optical property maps to quantitative distributions representing the morphological landscape of breast tumor margins. The optimizations presented in this work provide an avenue to rapidly survey large tissue areas on intra-operative time scales with improved sensitivity to regions of focal disease that may otherwise be overlooked.

Identification of threshold prostate specific antigen levels to optimize the detection of clinically significant prostate cancer by magnetic resonance imaging/ultrasound fusion guided biopsy.

PubMed

Shakir, Nabeel A; George, Arvin K; Siddiqui, M Minhaj; Rothwax, Jason T; Rais-Bahrami, Soroush; Stamatakis, Lambros; Su, Daniel; Okoro, Chinonyerem; Raskolnikov, Dima; Walton-Diaz, Annerleim; Simon, Richard; Turkbey, Baris; Choyke, Peter L; Merino, Maria J; Wood, Bradford J; Pinto, Peter A

2014-12-01

Prostate specific antigen sensitivity increases with lower threshold values but with a corresponding decrease in specificity. Magnetic resonance imaging/ultrasound targeted biopsy detects prostate cancer more efficiently and of higher grade than standard 12-core transrectal ultrasound biopsy but the optimal population for its use is not well defined. We evaluated the performance of magnetic resonance imaging/ultrasound targeted biopsy vs 12-core biopsy across a prostate specific antigen continuum. We reviewed the records of all patients enrolled in a prospective trial who underwent 12-core transrectal ultrasound and magnetic resonance imaging/ultrasound targeted biopsies from August 2007 through February 2014. Patients were stratified by each of 4 prostate specific antigen cutoffs. The greatest Gleason score using either biopsy method was compared in and across groups as well as across the population prostate specific antigen range. Clinically significant prostate cancer was defined as Gleason 7 (4 + 3) or greater. Univariate and multivariate analyses were performed. A total of 1,003 targeted and 12-core transrectal ultrasound biopsies were performed, of which 564 diagnosed prostate cancer for a 56.2% detection rate. Targeted biopsy led to significantly more upgrading to clinically significant disease compared to 12-core biopsy. This trend increased more with increasing prostate specific antigen, specifically in patients with prostate specific antigen 4 to 10 and greater than 10 ng/ml. Prostate specific antigen 5.2 ng/ml or greater captured 90% of upgrading by targeted biopsy, corresponding to 64% of patients who underwent multiparametric magnetic resonance imaging and subsequent fusion biopsy. Conversely a greater proportion of clinically insignificant disease was detected by 12-core vs targeted biopsy overall. These differences persisted when controlling for potential confounders on multivariate analysis. Prostate cancer upgrading with targeted biopsy increases with an increasing prostate specific antigen cutoff. Above a prostate specific antigen threshold of 5.2 ng/ml most upgrading to clinically significant disease was achieved by targeted biopsy. In our population this corresponded to potentially sparing biopsy in 36% of patients who underwent multiparametric magnetic resonance imaging. Below this value 12-core biopsy detected more clinically insignificant cancer. Thus, the diagnostic usefulness of targeted biopsy is optimized in patients with prostate specific antigen 5.2 ng/ml or greater. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Cardiac imaging: working towards fully-automated machine analysis & interpretation

PubMed Central

Slomka, Piotr J; Dey, Damini; Sitek, Arkadiusz; Motwani, Manish; Berman, Daniel S; Germano, Guido

2017-01-01

Introduction Non-invasive imaging plays a critical role in managing patients with cardiovascular disease. Although subjective visual interpretation remains the clinical mainstay, quantitative analysis facilitates objective, evidence-based management, and advances in clinical research. This has driven developments in computing and software tools aimed at achieving fully automated image processing and quantitative analysis. In parallel, machine learning techniques have been used to rapidly integrate large amounts of clinical and quantitative imaging data to provide highly personalized individual patient-based conclusions. Areas covered This review summarizes recent advances in automated quantitative imaging in cardiology and describes the latest techniques which incorporate machine learning principles. The review focuses on the cardiac imaging techniques which are in wide clinical use. It also discusses key issues and obstacles for these tools to become utilized in mainstream clinical practice. Expert commentary Fully-automated processing and high-level computer interpretation of cardiac imaging are becoming a reality. Application of machine learning to the vast amounts of quantitative data generated per scan and integration with clinical data also facilitates a move to more patient-specific interpretation. These developments are unlikely to replace interpreting physicians but will provide them with highly accurate tools to detect disease, risk-stratify, and optimize patient-specific treatment. However, with each technological advance, we move further from human dependence and closer to fully-automated machine interpretation. PMID:28277804

Approaches to automatic parameter fitting in a microscopy image segmentation pipeline: An exploratory parameter space analysis.

PubMed

Held, Christian; Nattkemper, Tim; Palmisano, Ralf; Wittenberg, Thomas

2013-01-01

Research and diagnosis in medicine and biology often require the assessment of a large amount of microscopy image data. Although on the one hand, digital pathology and new bioimaging technologies find their way into clinical practice and pharmaceutical research, some general methodological issues in automated image analysis are still open. In this study, we address the problem of fitting the parameters in a microscopy image segmentation pipeline. We propose to fit the parameters of the pipeline's modules with optimization algorithms, such as, genetic algorithms or coordinate descents, and show how visual exploration of the parameter space can help to identify sub-optimal parameter settings that need to be avoided. This is of significant help in the design of our automatic parameter fitting framework, which enables us to tune the pipeline for large sets of micrographs. The underlying parameter spaces pose a challenge for manual as well as automated parameter optimization, as the parameter spaces can show several local performance maxima. Hence, optimization strategies that are not able to jump out of local performance maxima, like the hill climbing algorithm, often result in a local maximum.

Approaches to automatic parameter fitting in a microscopy image segmentation pipeline: An exploratory parameter space analysis

PubMed Central

Held, Christian; Nattkemper, Tim; Palmisano, Ralf; Wittenberg, Thomas

2013-01-01

Introduction: Research and diagnosis in medicine and biology often require the assessment of a large amount of microscopy image data. Although on the one hand, digital pathology and new bioimaging technologies find their way into clinical practice and pharmaceutical research, some general methodological issues in automated image analysis are still open. Methods: In this study, we address the problem of fitting the parameters in a microscopy image segmentation pipeline. We propose to fit the parameters of the pipeline's modules with optimization algorithms, such as, genetic algorithms or coordinate descents, and show how visual exploration of the parameter space can help to identify sub-optimal parameter settings that need to be avoided. Results: This is of significant help in the design of our automatic parameter fitting framework, which enables us to tune the pipeline for large sets of micrographs. Conclusion: The underlying parameter spaces pose a challenge for manual as well as automated parameter optimization, as the parameter spaces can show several local performance maxima. Hence, optimization strategies that are not able to jump out of local performance maxima, like the hill climbing algorithm, often result in a local maximum. PMID:23766941

Comparison of fingerprint and facial biometric verification technologies for user access and patient identification in a clinical environment

NASA Astrophysics Data System (ADS)

Guo, Bing; Zhang, Yu; Documet, Jorge; Liu, Brent; Lee, Jasper; Shrestha, Rasu; Wang, Kevin; Huang, H. K.

2007-03-01

As clinical imaging and informatics systems continue to integrate the healthcare enterprise, the need to prevent patient mis-identification and unauthorized access to clinical data becomes more apparent especially under the Health Insurance Portability and Accountability Act (HIPAA) mandate. Last year, we presented a system to track and verify patients and staff within a clinical environment. This year, we further address the biometric verification component in order to determine which Biometric system is the optimal solution for given applications in the complex clinical environment. We install two biometric identification systems including fingerprint and facial recognition systems at an outpatient imaging facility, Healthcare Consultation Center II (HCCII). We evaluated each solution and documented the advantages and pitfalls of each biometric technology in this clinical environment.

Frame average optimization of cine-mode EPID images used for routine clinical in vivo patient dose verification of VMAT deliveries

DOE Office of Scientific and Technical Information (OSTI.GOV)

McCowan, P. M., E-mail: pmccowan@cancercare.mb.ca; McCurdy, B. M. C.; Medical Physics Department, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9

Purpose: The in vivo 3D dose delivered to a patient during volumetric modulated arc therapy (VMAT) delivery can be calculated using electronic portal imaging device (EPID) images. These images must be acquired in cine-mode (i.e., “movie” mode) in order to capture the time-dependent delivery information. The angle subtended by each cine-mode EPID image during an arc can be changed via the frame averaging number selected within the image acquisition software. A large frame average number will decrease the EPID’s angular resolution and will result in a decrease in the accuracy of the dose information contained within each image. Alternatively, lessmore » EPID images acquired per delivery will decrease the overall 3D patient dose calculation time, which is appealing for large-scale clinical implementation. Therefore, the purpose of this study was to determine the optimal frame average value per EPID image, defined as the highest frame averaging that can be used without an appreciable loss in 3D dose reconstruction accuracy for VMAT treatments. Methods: Six different VMAT plans and six different SBRT-VMAT plans were delivered to an anthropomorphic phantom. Delivery was carried out on a Varian 2300ix model linear accelerator (Linac) equipped with an aS1000 EPID running at a frame acquisition rate of 7.5 Hz. An additional PC was set up at the Linac console area, equipped with specialized frame-grabber hardware and software packages allowing continuous acquisition of all EPID frames during delivery. Frames were averaged into “frame-averaged” EPID images using MATLAB. Each frame-averaged data set was used to calculate the in vivo dose to the patient and then compared to the single EPID frame in vivo dose calculation (the single frame calculation represents the highest possible angular resolution per EPID image). A mean percentage dose difference of low dose (<20% prescription dose) and high dose regions (>80% prescription dose) was calculated for each frame averaged scenario for each plan. The authors defined their unacceptable loss of accuracy as no more than a ±1% mean dose difference in the high dose region. Optimal frame average numbers were then determined as a function of the Linac’s average gantry speed and the dose per fraction. Results: The authors found that 9 and 11 frame averages were suitable for all VMAT and SBRT-VMAT treatments, respectively. This resulted in no more than a 1% loss to any of the dose region’s mean percentage difference when compared to the single frame reconstruction. The optimized number was dependent on the treatment’s dose per fraction and was determined to be as high as 14 for 12 Gy/fraction (fx), 15 for 8 Gy/fx, 11 for 6 Gy/fx, and 9 for 2 Gy/fx. Conclusions: The authors have determined an optimal EPID frame averaging number for multiple VMAT-type treatments. These are given as a function of the dose per fraction and average gantry speed. These optimized values are now used in the authors’ clinical, 3D, in vivo patient dosimetry program. This provides a reduction in calculation time while maintaining the authors’ required level of accuracy in the dose reconstruction.« less

Study of clutter origin in in-vivo epi-optoacoustic imaging of human forearms

NASA Astrophysics Data System (ADS)

Preisser, Stefan; Held, Gerrit; Akarçay, Hidayet G.; Jaeger, Michael; Frenz, Martin

2016-09-01

Epi-optoacoustic (OA) imaging offers flexible clinical diagnostics of the human body when the irradiation optic is attached to or directly integrated into the acoustic probe. Epi-OA images, however, encounter clutter that deteriorates contrast and significantly limits imaging depth. This study elaborates clutter origin in clinical epi-optoacoustic imaging using a linear array probe for scanning the human forearm. We demonstrate that the clutter strength strongly varies with the imaging location but stays stable over time, indicating that clutter is caused by anatomical structures. OA transients which are generated by strong optical absorbers located at the irradiation spot were identified to be the main source of clutter. These transients obscure deep in-plane OA signals when detected by the transducer either directly or after being acoustically scattered in the imaging plane. In addition, OA transients generated in the skin below the probe result in acoustic reverberations, which cause problems in image interpretation and limit imaging depth. Understanding clutter origin allows a better interpretation of clinical OA imaging, helps to design clutter compensation techniques and raises the prospect of contrast optimization via the design of the irradiation geometry.

Optimization of parameter values for complex pulse sequences by simulated annealing: application to 3D MP-RAGE imaging of the brain.

PubMed

Epstein, F H; Mugler, J P; Brookeman, J R

1994-02-01

A number of pulse sequence techniques, including magnetization-prepared gradient echo (MP-GRE), segmented GRE, and hybrid RARE, employ a relatively large number of variable pulse sequence parameters and acquire the image data during a transient signal evolution. These sequences have recently been proposed and/or used for clinical applications in the brain, spine, liver, and coronary arteries. Thus, the need for a method of deriving optimal pulse sequence parameter values for this class of sequences now exists. Due to the complexity of these sequences, conventional optimization approaches, such as applying differential calculus to signal difference equations, are inadequate. We have developed a general framework for adapting the simulated annealing algorithm to pulse sequence parameter value optimization, and applied this framework to the specific case of optimizing the white matter-gray matter signal difference for a T1-weighted variable flip angle 3D MP-RAGE sequence. Using our algorithm, the values of 35 sequence parameters, including the magnetization-preparation RF pulse flip angle and delay time, 32 flip angles in the variable flip angle gradient-echo acquisition sequence, and the magnetization recovery time, were derived. Optimized 3D MP-RAGE achieved up to a 130% increase in white matter-gray matter signal difference compared with optimized 3D RF-spoiled FLASH with the same total acquisition time. The simulated annealing approach was effective at deriving optimal parameter values for a specific 3D MP-RAGE imaging objective, and may be useful for other imaging objectives and sequences in this general class.

Quantitative Imaging in Cancer Clinical Trials

PubMed Central

Yankeelov, Thomas E.; Mankoff, David A.; Schwartz, Lawrence H.; Lieberman, Frank S.; Buatti, John M.; Mountz, James M.; Erickson, Bradley J.; Fennessy, Fiona M.M.; Huang, Wei; Kalpathy-Cramer, Jayashree; Wahl, Richard L.; Linden, Hannah M.; Kinahan, Paul; Zhao, Binsheng; Hylton, Nola M.; Gillies, Robert J.; Clarke, Laurence; Nordstrom, Robert; Rubin, Daniel L.

2015-01-01

As anti-cancer therapies designed to target specific molecular pathways have been developed, it has become critical to develop methods to assess the response induced by such agents. While traditional, anatomic CT and MRI exams are useful in many settings, there is increasing evidence that these methods cannot answer the fundamental biological and physiological questions essential for assessment and, eventually, prediction of treatment response in the clinical trial setting, especially in the critical period soon after treatment is initiated. To optimally apply advances in quantitative imaging methods to trials of targeted cancer therapy, new infrastructure improvements are needed that incorporate these emerging techniques into the settings where they are most likely to have impact. In this review, we first elucidate the needs for therapeutic response assessment in the era of molecularly targeted therapy and describe how quantitative imaging can most effectively provide scientifically and clinically relevant data. We then describe the tools and methods required to apply quantitative imaging and provide concrete examples of work making these advances practically available for routine application in clinical trials. We conclude by proposing strategies to surmount barriers to wider incorporation of these quantitative imaging methods into clinical trials and, eventually, clinical practice. Our goal is to encourage and guide the oncology community to deploy standardized quantitative imaging techniques in clinical trials to further personalize care for cancer patients, and to provide a more efficient path for the development of improved targeted therapies. PMID:26773162

Sparse Reconstruction Techniques in MRI: Methods, Applications, and Challenges to Clinical Adoption

PubMed Central

Yang, Alice Chieh-Yu; Kretzler, Madison; Sudarski, Sonja; Gulani, Vikas; Seiberlich, Nicole

2016-01-01

The family of sparse reconstruction techniques, including the recently introduced compressed sensing framework, has been extensively explored to reduce scan times in Magnetic Resonance Imaging (MRI). While there are many different methods that fall under the general umbrella of sparse reconstructions, they all rely on the idea that a priori information about the sparsity of MR images can be employed to reconstruct full images from undersampled data. This review describes the basic ideas behind sparse reconstruction techniques, how they could be applied to improve MR imaging, and the open challenges to their general adoption in a clinical setting. The fundamental principles underlying different classes of sparse reconstructions techniques are examined, and the requirements that each make on the undersampled data outlined. Applications that could potentially benefit from the accelerations that sparse reconstructions could provide are described, and clinical studies using sparse reconstructions reviewed. Lastly, technical and clinical challenges to widespread implementation of sparse reconstruction techniques, including optimization, reconstruction times, artifact appearance, and comparison with current gold-standards, are discussed. PMID:27003227

Image-guided cancer surgery using near-infrared fluorescence

PubMed Central

Vahrmeijer, Alexander L.; Hutteman, Merlijn; van der Vorst, Joost R.; van de Velde, C.J.H.; Frangioni, John V.

2013-01-01

Paradigm shifts in surgery arise when surgeons are empowered to perform surgery faster, better, and/or less expensively. Optical imaging that exploits invisible near-infrared fluorescent light has the potential to improve cancer surgery outcomes while minimizing anesthesia time and lowering healthcare costs. Because of this, the last few years have witnessed an explosion of proof-of-concept clinical trials in the field. In this review, we introduce the concept of near-infrared fluorescence imaging for cancer surgery, review the clinical trial literature to date, outline the key issues pertaining to imaging system and contrast agent optimization, discuss limitations and leverage, and provide a framework for making the technology available for the routine care of cancer patients in the near future. PMID:23881033

A prospective development study of software-guided radio-frequency ablation of primary and secondary liver tumors: Clinical intervention modelling, planning and proof for ablation cancer treatment (ClinicIMPPACT).

PubMed

Reinhardt, Martin; Brandmaier, Philipp; Seider, Daniel; Kolesnik, Marina; Jenniskens, Sjoerd; Sequeiros, Roberto Blanco; Eibisberger, Martin; Voglreiter, Philip; Flanagan, Ronan; Mariappan, Panchatcharam; Busse, Harald; Moche, Michael

2017-12-01

Radio-frequency ablation (RFA) is a promising minimal-invasive treatment option for early liver cancer, however monitoring or predicting the size of the resulting tissue necrosis during the RFA-procedure is a challenging task, potentially resulting in a significant rate of under- or over treatments. Currently there is no reliable lesion size prediction method commercially available. ClinicIMPPACT is designed as multicenter-, prospective-, non-randomized clinical trial to evaluate the accuracy and efficiency of innovative planning and simulation software. 60 patients with early liver cancer will be included at four European clinical institutions and treated with the same RFA system. The preinterventional imaging datasets will be used for computational planning of the RFA treatment. All ablations will be simulated simultaneously to the actual RFA procedure, using the software environment developed in this project. The primary outcome measure is the comparison of the simulated ablation zones with the true lesions shown in follow-up imaging after one month, to assess accuracy of the lesion prediction. This unique multicenter clinical trial aims at the clinical integration of a dedicated software solution to accurately predict lesion size and shape after radiofrequency ablation of liver tumors. Accelerated and optimized workflow integration, and real-time intraoperative image processing, as well as inclusion of patient specific information, e.g. organ perfusion and registration of the real RFA needle position might make the introduced software a powerful tool for interventional radiologists to optimize patient outcomes.

Feasibility of deep-inspiration breath-hold PET/CT with short-time acquisition: detectability for pulmonary lesions compared with respiratory-gated PET/CT.

PubMed

Yamashita, Shozo; Yokoyama, Kunihiko; Onoguchi, Masahisa; Yamamoto, Haruki; Hiko, Shigeaki; Horita, Akihiro; Nakajima, Kenichi

2014-01-01

Deep-inspiration breath-hold (DIBH) PET/CT with short-time acquisition and respiratory-gated (RG) PET/CT are performed for pulmonary lesions to reduce the respiratory motion artifacts, and to obtain more accurate standardized uptake value (SUV). DIBH PET/CT demonstrates significant advantages in terms of rapid examination, good quality of CT images and low radiation exposure. On the other hand, the image quality of DIBH PET is generally inferior to that of RG PET because of short-time acquisition resulting in poor signal-to-noise ratio. In this study, RG PET has been regarded as a gold standard, and its detectability between DIBH and RG PET studies was compared using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were determined. In the clinical study, 19 cases were examined using each of the most optimal reconstruction parameters. In the phantom study, the most optimal reconstruction parameters for DIBH and RG PET were different. Reconstruction parameters of DIBH PET could be obtained by reducing the number of subsets for those of RG PET in the state of fixing the number of iterations. In the clinical study, high correlation in the maximum SUV was observed between DIBH and RG PET studies. The clinical result was consistent with that of the phantom study surrounded by air since most of the lesions were located in the low pulmonary radioactivity. DIBH PET/CT may be the most practical method which can be the first choice to reduce respiratory motion artifacts if the detectability of DIBH PET is equivalent with that of RG PET. Although DIBH PET may have limitations in suboptimal signal-to-noise ratio, most of the lesions surrounded by low background radioactivity could provide nearly equivalent image quality between DIBH and RG PET studies when each of the most optimal reconstruction parameters was used.

Fast l₁-SPIRiT compressed sensing parallel imaging MRI: scalable parallel implementation and clinically feasible runtime.

PubMed

Murphy, Mark; Alley, Marcus; Demmel, James; Keutzer, Kurt; Vasanawala, Shreyas; Lustig, Michael

2012-06-01

We present l₁-SPIRiT, a simple algorithm for auto calibrating parallel imaging (acPI) and compressed sensing (CS) that permits an efficient implementation with clinically-feasible runtimes. We propose a CS objective function that minimizes cross-channel joint sparsity in the wavelet domain. Our reconstruction minimizes this objective via iterative soft-thresholding, and integrates naturally with iterative self-consistent parallel imaging (SPIRiT). Like many iterative magnetic resonance imaging reconstructions, l₁-SPIRiT's image quality comes at a high computational cost. Excessively long runtimes are a barrier to the clinical use of any reconstruction approach, and thus we discuss our approach to efficiently parallelizing l₁-SPIRiT and to achieving clinically-feasible runtimes. We present parallelizations of l₁-SPIRiT for both multi-GPU systems and multi-core CPUs, and discuss the software optimization and parallelization decisions made in our implementation. The performance of these alternatives depends on the processor architecture, the size of the image matrix, and the number of parallel imaging channels. Fundamentally, achieving fast runtime requires the correct trade-off between cache usage and parallelization overheads. We demonstrate image quality via a case from our clinical experimentation, using a custom 3DFT spoiled gradient echo (SPGR) sequence with up to 8× acceleration via Poisson-disc undersampling in the two phase-encoded directions.

Comparative evaluation of two dose optimization methods for image-guided, highly-conformal, tandem and ovoids cervix brachytherapy planning

NASA Astrophysics Data System (ADS)

Ren, Jiyun; Menon, Geetha; Sloboda, Ron

2013-04-01

Although the Manchester system is still extensively used to prescribe dose in brachytherapy (BT) for locally advanced cervix cancer, many radiation oncology centers are transitioning to 3D image-guided BT, owing to the excellent anatomy definition offered by modern imaging modalities. As automatic dose optimization is highly desirable for 3D image-based BT, this study comparatively evaluates the performance of two optimization methods used in BT treatment planning—Nelder-Mead simplex (NMS) and simulated annealing (SA)—for a cervix BT computer simulation model incorporating a Manchester-style applicator. Eight model cases were constructed based on anatomical structure data (for high risk-clinical target volume (HR-CTV), bladder, rectum and sigmoid) obtained from measurements on fused MR-CT images for BT patients. D90 and V100 for HR-CTV, D2cc for organs at risk (OARs), dose to point A, conformation index and the sum of dwell times within the tandem and ovoids were calculated for optimized treatment plans designed to treat the HR-CTV in a highly conformal manner. Compared to the NMS algorithm, SA was found to be superior as it could perform optimization starting from a range of initial dwell times, while the performance of NMS was strongly dependent on their initial choice. SA-optimized plans also exhibited lower D2cc to OARs, especially the bladder and sigmoid, and reduced tandem dwell times. For cases with smaller HR-CTV having good separation from adjoining OARs, multiple SA-optimized solutions were found which differed markedly from each other and were associated with different choices for initial dwell times. Finally and importantly, the SA method yielded plans with lower dwell time variability compared with the NMS method.

SU-G-206-01: A Fully Automated CT Tool to Facilitate Phantom Image QA for Quantitative Imaging in Clinical Trials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wahi-Anwar, M; Lo, P; Kim, H

Purpose: The use of Quantitative Imaging (QI) methods in Clinical Trials requires both verification of adherence to a specified protocol and an assessment of scanner performance under that protocol, which are currently accomplished manually. This work introduces automated phantom identification and image QA measure extraction towards a fully-automated CT phantom QA system to perform these functions and facilitate the use of Quantitative Imaging methods in clinical trials. Methods: This study used a retrospective cohort of CT phantom scans from existing clinical trial protocols - totaling 84 phantoms, across 3 phantom types using various scanners and protocols. The QA system identifiesmore » the input phantom scan through an ensemble of threshold-based classifiers. Each classifier - corresponding to a phantom type - contains a template slice, which is compared to the input scan on a slice-by-slice basis, resulting in slice-wise similarity metric values for each slice compared. Pre-trained thresholds (established from a training set of phantom images matching the template type) are used to filter the similarity distribution, and the slice with the most optimal local mean similarity, with local neighboring slices meeting the threshold requirement, is chosen as the classifier’s matched slice (if it existed). The classifier with the matched slice possessing the most optimal local mean similarity is then chosen as the ensemble’s best matching slice. If the best matching slice exists, image QA algorithm and ROIs corresponding to the matching classifier extracted the image QA measures. Results: Automated phantom identification performed with 84.5% accuracy and 88.8% sensitivity on 84 phantoms. Automated image quality measurements (following standard protocol) on identified water phantoms (n=35) matched user QA decisions with 100% accuracy. Conclusion: We provide a fullyautomated CT phantom QA system consistent with manual QA performance. Further work will include parallel component to automatically verify image acquisition parameters and automated adherence to specifications. Institutional research agreement, Siemens Healthcare; Past recipient, research grant support, Siemens Healthcare; Consultant, Toshiba America Medical Systems; Consultant, Samsung Electronics; NIH Grant support from: U01 CA181156.« less

Highly undersampled contrast-enhanced MRA with iterative reconstruction: Integration in a clinical setting.

PubMed

Stalder, Aurelien F; Schmidt, Michaela; Quick, Harald H; Schlamann, Marc; Maderwald, Stefan; Schmitt, Peter; Wang, Qiu; Nadar, Mariappan S; Zenge, Michael O

2015-12-01

To integrate, optimize, and evaluate a three-dimensional (3D) contrast-enhanced sparse MRA technique with iterative reconstruction on a standard clinical MR system. Data were acquired using a highly undersampled Cartesian spiral phyllotaxis sampling pattern and reconstructed directly on the MR system with an iterative SENSE technique. Undersampling, regularization, and number of iterations of the reconstruction were optimized and validated based on phantom experiments and patient data. Sparse MRA of the whole head (field of view: 265 × 232 × 179 mm(3) ) was investigated in 10 patient examinations. High-quality images with 30-fold undersampling, resulting in 0.7 mm isotropic resolution within 10 s acquisition, were obtained. After optimization of the regularization factor and of the number of iterations of the reconstruction, it was possible to reconstruct images with excellent quality within six minutes per 3D volume. Initial results of sparse contrast-enhanced MRA (CEMRA) in 10 patients demonstrated high-quality whole-head first-pass MRA for both the arterial and venous contrast phases. While sparse MRI techniques have not yet reached clinical routine, this study demonstrates the technical feasibility of high-quality sparse CEMRA of the whole head in a clinical setting. Sparse CEMRA has the potential to become a viable alternative where conventional CEMRA is too slow or does not provide sufficient spatial resolution. © 2014 Wiley Periodicals, Inc.

Device and methods for "gold standard" registration of clinical 3D and 2D cerebral angiograms

NASA Astrophysics Data System (ADS)

Madan, Hennadii; Likar, Boštjan; Pernuš, Franjo; Å piclin, Žiga

2015-03-01

Translation of any novel and existing 3D-2D image registration methods into clinical image-guidance systems is limited due to lack of their objective validation on clinical image datasets. The main reason is that, besides the calibration of the 2D imaging system, a reference or "gold standard" registration is very difficult to obtain on clinical image datasets. In the context of cerebral endovascular image-guided interventions (EIGIs), we present a calibration device in the form of a headband with integrated fiducial markers and, secondly, propose an automated pipeline comprising 3D and 2D image processing, analysis and annotation steps, the result of which is a retrospective calibration of the 2D imaging system and an optimal, i.e., "gold standard" registration of 3D and 2D images. The device and methods were used to create the "gold standard" on 15 datasets of 3D and 2D cerebral angiograms, whereas each dataset was acquired on a patient undergoing EIGI for either aneurysm coiling or embolization of arteriovenous malformation. The use of the device integrated seamlessly in the clinical workflow of EIGI. While the automated pipeline eliminated all manual input or interactive image processing, analysis or annotation. In this way, the time to obtain the "gold standard" was reduced from 30 to less than one minute and the "gold standard" of 3D-2D registration on all 15 datasets of cerebral angiograms was obtained with a sub-0.1 mm accuracy.

The Impact of the Condenser on Cytogenetic Image Quality in Digital Microscope System

PubMed Central

Ren, Liqiang; Li, Zheng; Li, Yuhua; Zheng, Bin; Li, Shibo; Chen, Xiaodong; Liu, Hong

2013-01-01

Background: Optimizing operational parameters of the digital microscope system is an important technique to acquire high quality cytogenetic images and facilitate the process of karyotyping so that the efficiency and accuracy of diagnosis can be improved. OBJECTIVE: This study investigated the impact of the condenser on cytogenetic image quality and system working performance using a prototype digital microscope image scanning system. Methods: Both theoretical analysis and experimental validations through objectively evaluating a resolution test chart and subjectively observing large numbers of specimen were conducted. Results: The results show that the optimal image quality and large depth of field (DOF) are simultaneously obtained when the numerical aperture of condenser is set as 60%–70% of the corresponding objective. Under this condition, more analyzable chromosomes and diagnostic information are obtained. As a result, the system shows higher working stability and less restriction for the implementation of algorithms such as autofocusing especially when the system is designed to achieve high throughput continuous image scanning. Conclusions: Although the above quantitative results were obtained using a specific prototype system under the experimental conditions reported in this paper, the presented evaluation methodologies can provide valuable guidelines for optimizing operational parameters in cytogenetic imaging using the high throughput continuous scanning microscopes in clinical practice. PMID:23676284

Intensity inhomogeneity compensation and tissue segmentation for magnetic resonance imaging with noise-suppressed multiplicative intrinsic component optimization

NASA Astrophysics Data System (ADS)

Dong, Huaipeng; Zhang, Qi; Shi, Jun

2017-12-01

Magnetic resonance (MR) images suffer from intensity inhomogeneity. Segmentation-based approaches can simultaneously achieve both intensity inhomogeneity compensation (IIC) and tissue segmentation for MR images with little noise, but they often fail for images polluted by severe noise. Here, we propose a noise-robust algorithm named noise-suppressed multiplicative intrinsic component optimization (NSMICO) for simultaneous IIC and tissue segmentation. Considering the spatial characteristics in an image, an adaptive nonlocal means filtering term is incorporated into the objective function of NSMICO to decrease image deterioration due to noise. Then, a fuzzy local factor term utilizing the spatial and gray-level relationship among local pixels is embedded into the objective function to reach a balance between noise suppression and detail preservation. Experimental results on synthetic natural and MR images with various levels of intensity inhomogeneity and noise, as well as in vivo clinical MR images, have demonstrated the effectiveness of the NSMICO and its superiority to three competing approaches. The NSMICO could be potentially valuable for MR image IIC and tissue segmentation.

Towards tracer dose reduction in PET studies: Simulation of dose reduction by retrospective randomized undersampling of list-mode data.

PubMed

Gatidis, Sergios; Würslin, Christian; Seith, Ferdinand; Schäfer, Jürgen F; la Fougère, Christian; Nikolaou, Konstantin; Schwenzer, Nina F; Schmidt, Holger

2016-01-01

Optimization of tracer dose regimes in positron emission tomography (PET) imaging is a trade-off between diagnostic image quality and radiation exposure. The challenge lies in defining minimal tracer doses that still result in sufficient diagnostic image quality. In order to find such minimal doses, it would be useful to simulate tracer dose reduction as this would enable to study the effects of tracer dose reduction on image quality in single patients without repeated injections of different amounts of tracer. The aim of our study was to introduce and validate a method for simulation of low-dose PET images enabling direct comparison of different tracer doses in single patients and under constant influencing factors. (18)F-fluoride PET data were acquired on a combined PET/magnetic resonance imaging (MRI) scanner. PET data were stored together with the temporal information of the occurrence of single events (list-mode format). A predefined proportion of PET events were then randomly deleted resulting in undersampled PET data. These data sets were subsequently reconstructed resulting in simulated low-dose PET images (retrospective undersampling of list-mode data). This approach was validated in phantom experiments by visual inspection and by comparison of PET quality metrics contrast recovery coefficient (CRC), background-variability (BV) and signal-to-noise ratio (SNR) of measured and simulated PET images for different activity concentrations. In addition, reduced-dose PET images of a clinical (18)F-FDG PET dataset were simulated using the proposed approach. (18)F-PET image quality degraded with decreasing activity concentrations with comparable visual image characteristics in measured and in corresponding simulated PET images. This result was confirmed by quantification of image quality metrics. CRC, SNR and BV showed concordant behavior with decreasing activity concentrations for measured and for corresponding simulated PET images. Simulation of dose-reduced datasets based on clinical (18)F-FDG PET data demonstrated the clinical applicability of the proposed data. Simulation of PET tracer dose reduction is possible with retrospective undersampling of list-mode data. Resulting simulated low-dose images have equivalent characteristics with PET images actually measured at lower doses and can be used to derive optimal tracer dose regimes.

Markerless motion estimation for motion-compensated clinical brain imaging

NASA Astrophysics Data System (ADS)

Kyme, Andre Z.; Se, Stephen; Meikle, Steven R.; Fulton, Roger R.

2018-05-01

Motion-compensated brain imaging can dramatically reduce the artifacts and quantitative degradation associated with voluntary and involuntary subject head motion during positron emission tomography (PET), single photon emission computed tomography (SPECT) and computed tomography (CT). However, motion-compensated imaging protocols are not in widespread clinical use for these modalities. A key reason for this seems to be the lack of a practical motion tracking technology that allows for smooth and reliable integration of motion-compensated imaging protocols in the clinical setting. We seek to address this problem by investigating the feasibility of a highly versatile optical motion tracking method for PET, SPECT and CT geometries. The method requires no attached markers, relying exclusively on the detection and matching of distinctive facial features. We studied the accuracy of this method in 16 volunteers in a mock imaging scenario by comparing the estimated motion with an accurate marker-based method used in applications such as image guided surgery. A range of techniques to optimize performance of the method were also studied. Our results show that the markerless motion tracking method is highly accurate (<2 mm discrepancy against a benchmarking system) on an ethnically diverse range of subjects and, moreover, exhibits lower jitter and estimation of motion over a greater range than some marker-based methods. Our optimization tests indicate that the basic pose estimation algorithm is very robust but generally benefits from rudimentary background masking. Further marginal gains in accuracy can be achieved by accounting for non-rigid motion of features. Efficiency gains can be achieved by capping the number of features used for pose estimation provided that these features adequately sample the range of head motion encountered in the study. These proof-of-principle data suggest that markerless motion tracking is amenable to motion-compensated brain imaging and holds good promise for a practical implementation in clinical PET, SPECT and CT systems.

Comparison of low-light nonmydriatic digital imaging with 35-mm ETDRS seven-standard field stereo color fundus photographs and clinical examination.

PubMed

Silva, Paolo S; Walia, Saloni; Cavallerano, Jerry D; Sun, Jennifer K; Dunn, Cheri; Bursell, Sven-Erik; Aiello, Lloyd M; Aiello, Lloyd Paul

2012-09-01

To compare agreement between diagnosis of clinical level of diabetic retinopathy (DR) and diabetic macular edema (DME) derived from nonmydriatic fundus images using a digital camera back optimized for low-flash image capture (MegaVision) compared with standard seven-field Early Treatment Diabetic Retinopathy Study (ETDRS) photographs and dilated clinical examination. Subject comfort and image acquisition time were also evaluated. In total, 126 eyes from 67 subjects with diabetes underwent Joslin Vision Network nonmydriatic retinal imaging. ETDRS photographs were obtained after pupillary dilation, and fundus examination was performed by a retina specialist. There was near-perfect agreement between MegaVision and ETDRS photographs (κ=0.81, 95% confidence interval [CI] 0.73-0.89) for clinical DR severity levels. Substantial agreement was observed with clinical examination (κ=0.71, 95% CI 0.62-0.80). For DME severity level there was near-perfect agreement with ETDRS photographs (κ=0.92, 95% CI 0.87-0.98) and moderate agreement with clinical examination (κ=0.58, 95% CI 0.46-0.71). The wider MegaVision 45° field led to identification of nonproliferative changes in areas not imaged by the 30° field of ETDRS photos. Field area unique to ETDRS photographs identified proliferative changes not visualized with MegaVision. Mean MegaVision acquisition time was 9:52 min. After imaging, 60% of subjects preferred the MegaVision lower flash settings. When evaluated using a rigorous protocol, images captured using a low-light digital camera compared favorably with ETDRS photography and clinical examination for grading level of DR and DME. Furthermore, these data suggest the importance of more extensive peripheral images and suggest that utilization of wide-field retinal imaging may further improve accuracy of DR assessment.

Breast ultrasonography: state of the art.

PubMed

Hooley, Regina J; Scoutt, Leslie M; Philpotts, Liane E

2013-09-01

Ultrasonography (US) is an indispensable tool in breast imaging and is complementary to both mammography and magnetic resonance (MR) imaging of the breast. Advances in US technology allow confident characterization of not only benign cysts but also benign and malignant solid masses. Knowledge and understanding of current and emerging US technology, along with the application of meticulous scanning technique, is imperative for image optimization and diagnosis. The ability to synthesize breast US findings with multiple imaging modalities and clinical information is also necessary to ensure the best patient care. US is routinely used to guide breast biopsies and is also emerging as a supplemental screening tool in women with dense breasts and a negative mammogram. This review provides a summary of current state-of-the-art US technology, including elastography, and applications of US in clinical practice as an adjuvant technique to mammography, MR imaging, and the clinical breast examination. The use of breast US for screening, preoperative staging for breast cancer, and breast intervention will also be discussed.

Defining Quality in Cardiovascular Imaging: A Scientific Statement From the American Heart Association.

PubMed

Shaw, Leslee J; Blankstein, Ron; Jacobs, Jill E; Leipsic, Jonathon A; Kwong, Raymond Y; Taqueti, Viviany R; Beanlands, Rob S B; Mieres, Jennifer H; Flamm, Scott D; Gerber, Thomas C; Spertus, John; Di Carli, Marcelo F

2017-12-01

The aims of the current statement are to refine the definition of quality in cardiovascular imaging and to propose novel methodological approaches to inform the demonstration of quality in imaging in future clinical trials and registries. We propose defining quality in cardiovascular imaging using an analytical framework put forth by the Institute of Medicine whereby quality was defined as testing being safe, effective, patient-centered, timely, equitable, and efficient. The implications of each of these components of quality health care are as essential for cardiovascular imaging as they are for other areas within health care. Our proposed statement may serve as the foundation for integrating these quality indicators into establishing designations of quality laboratory practices and developing standards for value-based payment reform for imaging services. We also include recommendations for future clinical research to fulfill quality aims within cardiovascular imaging, including clinical hypotheses of improving patient outcomes, the importance of health status as an end point, and deferred testing options. Future research should evolve to define novel methods optimized for the role of cardiovascular imaging for detecting disease and guiding treatment and to demonstrate the role of cardiovascular imaging in facilitating healthcare quality. © 2017 American Heart Association, Inc.

Availability of color calibration for consistent color display in medical images and optimization of reference brightness for clinical use

NASA Astrophysics Data System (ADS)

Iwai, Daiki; Suganami, Haruka; Hosoba, Minoru; Ohno, Kazuko; Emoto, Yutaka; Tabata, Yoshito; Matsui, Norihisa

2013-03-01

Color image consistency has not been accomplished yet except the Digital Imaging and Communication in Medicine (DICOM) Supplement 100 for implementing a color reproduction pipeline and device independent color spaces. Thus, most healthcare enterprises could not check monitor degradation routinely. To ensure color consistency in medical color imaging, monitor color calibration should be introduced. Using simple color calibration device . chromaticity of colors including typical color (Red, Green, Blue, Green and White) are measured as device independent profile connection space value called u'v' before and after calibration. In addition, clinical color images are displayed and visual differences are observed. In color calibration, monitor brightness level has to be set to quite lower value 80 cd/m2 according to sRGB standard. As Maximum brightness of most color monitors available currently for medical use have much higher brightness than 80 cd/m2, it is not seemed to be appropriate to use 80 cd/m2 level for calibration. Therefore, we propose that new brightness standard should be introduced while maintaining the color representation in clinical use. To evaluate effects of brightness to chromaticity experimentally, brightness level is changed in two monitors from 80 to 270cd/m2 and chromaticity value are compared with each brightness levels. As a result, there are no significant differences in chromaticity diagram when brightness levels are changed. In conclusion, chromaticity is close to theoretical value after color calibration. Moreover, chromaticity isn't moved when brightness is changed. The results indicate optimized reference brightness level for clinical use could be set at high brightness in current monitors .

Adaptive photoacoustic imaging quality optimization with EMD and reconstruction

NASA Astrophysics Data System (ADS)

Guo, Chengwen; Ding, Yao; Yuan, Jie; Xu, Guan; Wang, Xueding; Carson, Paul L.

2016-10-01

Biomedical photoacoustic (PA) signal is characterized with extremely low signal to noise ratio which will yield significant artifacts in photoacoustic tomography (PAT) images. Since PA signals acquired by ultrasound transducers are non-linear and non-stationary, traditional data analysis methods such as Fourier and wavelet method cannot give useful information for further research. In this paper, we introduce an adaptive method to improve the quality of PA imaging based on empirical mode decomposition (EMD) and reconstruction. Data acquired by ultrasound transducers are adaptively decomposed into several intrinsic mode functions (IMFs) after a sifting pre-process. Since noise is randomly distributed in different IMFs, depressing IMFs with more noise while enhancing IMFs with less noise can effectively enhance the quality of reconstructed PAT images. However, searching optimal parameters by means of brute force searching algorithms will cost too much time, which prevent this method from practical use. To find parameters within reasonable time, heuristic algorithms, which are designed for finding good solutions more efficiently when traditional methods are too slow, are adopted in our method. Two of the heuristic algorithms, Simulated Annealing Algorithm, a probabilistic method to approximate the global optimal solution, and Artificial Bee Colony Algorithm, an optimization method inspired by the foraging behavior of bee swarm, are selected to search optimal parameters of IMFs in this paper. The effectiveness of our proposed method is proved both on simulated data and PA signals from real biomedical tissue, which might bear the potential for future clinical PA imaging de-noising.

SU-F-I-57: Evaluate and Optimize PET Acquisition Overlap in 18F-FDG Oncology Wholebody PET/CT: Can We Scan PET Faster?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, J; Natwa, M; Hall, NC

Purpose: The longer patient has to remain on the table during PET imaging, the higher the likelihood of motion artifacts due to patient discomfort. This study was to investigate and optimize PET acquisition overlap in 18F-FDG oncology wholebody PET/CT to speed up PET acquisition and improve patient comfort. Methods: Wholebody 18F-FDG PET/CT of phantoms, 8 pre-clinical patients (beagles) and 5 clinical oncology patients were performed in 90s/bed on a time-of-flight Gemini TF 64 system. Imaging of phantoms and beagles was acquired with reduced PET overlaps (40%, 33%, 27%, 20%, 13% and no overlap) in addition to the system default (53%).more » In human studies, 1 or 2 reduced overlaps from the listed options were used to acquire PET/CT sweeps right after the default standard of care imaging. Image quality was blindly reviewed using visual scoring criteria and quantitative SUV assessment. NEMA PET sensitivity was performed under different overlaps. Results: All PET exams demonstrated no significant impact on the visual grades for overlaps >20%. Blinded reviews assigned the best visual scores to PET using overlaps 53%–27%. Reducing overlap to 27% for oncology patients (12-bed) saved an average of ∼40% acquisition time (11min) compared to using the default overlap (18min). No significant SUV variances were found when reducing overlap to half of default for cerebellum, lung, heart, aorta, liver, fat, muscle, bone marrow, thighs and target lesions (p>0.05), except expected variability in urinary system. Conclusion: This study demonstrated by combined phantom, pre-clinical and clinical PET/CT scans that PET acquisition overlap in axial of today’s systems can be reduced and optimized. It showed that a reduction of PET acquisition overlap to 27% (half of system default) can be implemented to reduce table time by ∼40% to improve patient comfort and minimize potential motion artifacts, without prominently degrading image quality or compromising PET quantification.« less

MO-DE-BRA-04: Hands-On Fluoroscopy Safety Training with Real-Time Patient and Staff Dosimetry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vanderhoek, M; Bevins, N

Purpose: Fluoroscopically guided interventions (FGI) are routinely performed across many different hospital departments. However, many involved staff members have minimal training regarding safe and optimal use of fluoroscopy systems. We developed and taught a hands-on fluoroscopy safety class incorporating real-time patient and staff dosimetry in order to promote safer and more optimal use of fluoroscopy during FGI. Methods: The hands-on fluoroscopy safety class is taught in an FGI suite, unique to each department. A patient equivalent phantom is set on the patient table with an ion chamber positioned at the x-ray beam entrance to the phantom. This provides a surrogatemore » measure of patient entrance dose. Multiple solid state dosimeters (RaySafe i2 dosimetry systemTM) are deployed at different distances from the phantom (0.1, 1, 3 meters), which provide surrogate measures of staff dose. Instructors direct participating clinical staff to operate the fluoroscopy system as they view live fluoroscopic images, patient entrance dose, and staff doses in real-time. During class, instructors work with clinical staff to investigate how patient entrance dose, staff doses, and image quality are affected by different parameters, including pulse rate, magnification, collimation, beam angulation, imaging mode, system geometry, distance, and shielding. Results: Real-time dose visualization enables clinical staff to directly see and learn how to optimize their use of their own fluoroscopy system to minimize patient and staff dose, yet maintain sufficient image quality for FGI. As a direct result of the class, multiple hospital departments have implemented changes to their imaging protocols, including reduction of the default fluoroscopy pulse rate and increased use of collimation and lower dose fluoroscopy modes. Conclusion: Hands-on fluoroscopy safety training substantially benefits from real-time patient and staff dosimetry incorporated into the class. Real-time dose display helps clinical staff visualize, internalize, and ultimately utilize the safety techniques learned during the training. RaySafe/Unfors/Fluke lent us a portable version of their RaySafe i2 Dosimetry System for 6 months.« less

Placement of implantable cardioverter-defibrillators in paediatric and congenital heart defect patients: a pipeline for model generation and simulation prediction of optimal configurations

PubMed Central

Rantner, Lukas J; Vadakkumpadan, Fijoy; Spevak, Philip J; Crosson, Jane E; Trayanova, Natalia A

2013-01-01

There is currently no reliable way of predicting the optimal implantable cardioverter-defibrillator (ICD) placement in paediatric and congenital heart defect (CHD) patients. This study aimed to: (1) develop a new image processing pipeline for constructing patient-specific heart–torso models from clinical magnetic resonance images (MRIs); (2) use the pipeline to determine the optimal ICD configuration in a paediatric tricuspid valve atresia patient; (3) establish whether the widely used criterion of shock-induced extracellular potential (Φe) gradients ≥5 V cm−1 in ≥95% of ventricular volume predicts defibrillation success. A biophysically detailed heart–torso model was generated from patient MRIs. Because transvenous access was impossible, three subcutaneous and three epicardial lead placement sites were identified along with five ICD scan locations. Ventricular fibrillation was induced, and defibrillation shocks were applied from 11 ICD configurations to determine defibrillation thresholds (DFTs). Two configurations with epicardial leads resulted in the lowest DFTs overall and were thus considered optimal. Three configurations shared the lowest DFT among subcutaneous lead ICDs. The Φe gradient criterion was an inadequate predictor of defibrillation success, as defibrillation failed in numerous instances even when 100% of the myocardium experienced such gradients. In conclusion, we have developed a new image processing pipeline and applied it to a CHD patient to construct the first active heart–torso model from clinical MRIs. PMID:23798492

SU-F-J-211: Scatter Correction for Clinical Cone-Beam CT System Using An Optimized Stationary Beam Blocker with a Single Scan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liang, X; Zhang, Z; Xie, Y

Purpose: X-ray scatter photons result in significant image quality degradation of cone-beam CT (CBCT). Measurement based algorithms using beam blocker directly acquire the scatter samples and achieve significant improvement on the quality of CBCT image. Within existing algorithms, single-scan and stationary beam blocker proposed previously is promising due to its simplicity and practicability. Although demonstrated effectively on tabletop system, the blocker fails to estimate the scatter distribution on clinical CBCT system mainly due to the gantry wobble. In addition, the uniform distributed blocker strips in our previous design results in primary data loss in the CBCT system and leads tomore » the image artifacts due to data insufficiency. Methods: We investigate the motion behavior of the beam blocker in each projection and design an optimized non-uniform blocker strip distribution which accounts for the data insufficiency issue. An accurate scatter estimation is then achieved from the wobble modeling. Blocker wobble curve is estimated using threshold-based segmentation algorithms in each projection. In the blocker design optimization, the quality of final image is quantified using the number of the primary data loss voxels and the mesh adaptive direct search algorithm is applied to minimize the objective function. Scatter-corrected CT images are obtained using the optimized blocker. Results: The proposed method is evaluated using Catphan@504 phantom and a head patient. On the Catphan©504, our approach reduces the average CT number error from 115 Hounsfield unit (HU) to 11 HU in the selected regions of interest, and improves the image contrast by a factor of 1.45 in the high-contrast regions. On the head patient, the CT number error is reduced from 97 HU to 6 HU in the soft tissue region and image spatial non-uniformity is decreased from 27% to 5% after correction. Conclusion: The proposed optimized blocker design is practical and attractive for CBCT guided radiation therapy. This work is supported by grants from Guangdong Innovative Research Team Program of China (Grant No. 2011S013), National 863 Programs of China (Grant Nos. 2012AA02A604 and 2015AA043203), the National High-tech R&D Program for Young Scientists by the Ministry of Science and Technology of China (Grant No. 2015AA020917)« less

Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

NASA Astrophysics Data System (ADS)

Wang, Chu

Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence correction factors for the MOSFET organ dose measurements in the following studies. Minor angular dependence (< +/-20% at all angles tested, < +/-10% at clinically relevant angles in cardiac catheterization) was observed. Second, the cardiac dose for common fluoroscopic imaging techniques for pediatric patients in the two age groups was measured. Imaging technique settings with variations of individual key imaging parameters were tested to observe the quantitative effect of imaging optimization or lack thereof. Along with each measurement, the two standard system output indices, the Air Kerma (AK) and Dose-Area Product (DAP), were also recorded and compared to the measured cardiac and skin doses -- the lack of correlation between the indices and the organ doses shed light to the substantial limitation of the indices in representing patient radiation dose, at least within the scope of this dissertation. Third, the effective dose (ED) for Posterior-Anterior and Lateral fluoroscopic imaging techniques for pediatric patients in the two age groups was determined. In addition, the dosimetric effect of removing the anti-scatter grid was studied, for which a factor-of-two ED rate reduction was observed for the imaging techniques. The Clinical Component involved analytical research to develop a validated retrospective cardiac dose reconstruction formulation and to propose the new Optimization Index which evaluates the level of optimization of the clinician's imaging usage during a procedure; and small sample group of actual procedures were used to demonstrate applicability of these formulations. In its entirety, the research represents a first-of-its-kind comprehensive approach in radiation dosimetry for pediatric cardiac catheterization; and separately, it is also modular enough that each individual section can serve as study templates for small-scale dosimetric studies of similar purposes. The data collected and algorithmic formulations developed can be of use in areas of personalized patient dosimetry, clinician training, image quality studies and radiation-associated health effect research.

Clinical Perspective of 3D Total Body Photography for Early Detection and Screening of Melanoma.

PubMed

Rayner, Jenna E; Laino, Antonia M; Nufer, Kaitlin L; Adams, Laura; Raphael, Anthony P; Menzies, Scott W; Soyer, H Peter

2018-01-01

Melanoma incidence continues to increase across many populations globally and there is significant mortality associated with advanced disease. However, if detected early, patients have a very promising prognosis. The methods that have been utilized for early detection include clinician and patient skin examinations, dermoscopy (static and sequential imaging), and total body photography via 2D imaging. Total body photography has recently witnessed an evolution from 2D imaging with the ability to now create a 3D representation of the patient linked with dermoscopy images of individual lesions. 3D total body photography is a particularly beneficial screening tool for patients at high risk due to their personal or family history or those with multiple dysplastic naevi-the latter can make monitoring especially difficult without the assistance of technology. In this perspective, we discuss clinical examples utilizing 3D total body photography, associated advantages and limitations, and future directions of the technology. The optimal system for melanoma screening should improve diagnostic accuracy, be time and cost efficient, and accessible to patients across all demographic and socioeconomic groups. 3D total body photography has the potential to address these criteria and, most importantly, optimize crucial early detection.

Identification of optimal mask size parameter for noise filtering in 99mTc-methylene diphosphonate bone scintigraphy images.

PubMed

Pandey, Anil K; Bisht, Chandan S; Sharma, Param D; ArunRaj, Sreedharan Thankarajan; Taywade, Sameer; Patel, Chetan; Bal, Chandrashekhar; Kumar, Rakesh

2017-11-01

Tc-methylene diphosphonate (Tc-MDP) bone scintigraphy images have limited number of counts per pixel. A noise filtering method based on local statistics of the image produces better results than a linear filter. However, the mask size has a significant effect on image quality. In this study, we have identified the optimal mask size that yields a good smooth bone scan image. Forty four bone scan images were processed using mask sizes 3, 5, 7, 9, 11, 13, and 15 pixels. The input and processed images were reviewed in two steps. In the first step, the images were inspected and the mask sizes that produced images with significant loss of clinical details in comparison with the input image were excluded. In the second step, the image quality of the 40 sets of images (each set had input image, and its corresponding three processed images with 3, 5, and 7-pixel masks) was assessed by two nuclear medicine physicians. They selected one good smooth image from each set of images. The image quality was also assessed quantitatively with a line profile. Fisher's exact test was used to find statistically significant differences in image quality processed with 5 and 7-pixel mask at a 5% cut-off. A statistically significant difference was found between the image quality processed with 5 and 7-pixel mask at P=0.00528. The identified optimal mask size to produce a good smooth image was found to be 7 pixels. The best mask size for the John-Sen Lee filter was found to be 7×7 pixels, which yielded Tc-methylene diphosphonate bone scan images with the highest acceptable smoothness.

First-in-human pilot study of a spatial frequency domain oxygenation imaging system

NASA Astrophysics Data System (ADS)

Gioux, Sylvain; Mazhar, Amaan; Lee, Bernard T.; Lin, Samuel J.; Tobias, Adam M.; Cuccia, David J.; Stockdale, Alan; Oketokoun, Rafiou; Ashitate, Yoshitomo; Kelly, Edward; Weinmann, Maxwell; Durr, Nicholas J.; Moffitt, Lorissa A.; Durkin, Anthony J.; Tromberg, Bruce J.; Frangioni, John V.

2011-08-01

Oxygenation measurements are widely used in patient care. However, most clinically available instruments currently consist of contact probes that only provide global monitoring of the patient (e.g., pulse oximetry probes) or local monitoring of small areas (e.g., spectroscopy-based probes). Visualization of oxygenation over large areas of tissue, without a priori knowledge of the location of defects, has the potential to improve patient management in many surgical and critical care applications. In this study, we present a clinically compatible multispectral spatial frequency domain imaging (SFDI) system optimized for surgical oxygenation imaging. This system was used to image tissue oxygenation over a large area (16×12 cm) and was validated during preclinical studies by comparing results obtained with an FDA-approved clinical oxygenation probe. Skin flap, bowel, and liver vascular occlusion experiments were performed on Yorkshire pigs and demonstrated that over the course of the experiment, relative changes in oxygen saturation measured using SFDI had an accuracy within 10% of those made using the FDA-approved device. Finally, the new SFDI system was translated to the clinic in a first-in-human pilot study that imaged skin flap oxygenation during reconstructive breast surgery. Overall, this study lays the foundation for clinical translation of endogenous contrast imaging using SFDI.

First-in-human pilot study of a spatial frequency domain oxygenation imaging system

PubMed Central

Gioux, Sylvain; Mazhar, Amaan; Lee, Bernard T.; Lin, Samuel J.; Tobias, Adam M.; Cuccia, David J.; Stockdale, Alan; Oketokoun, Rafiou; Ashitate, Yoshitomo; Kelly, Edward; Weinmann, Maxwell; Durr, Nicholas J.; Moffitt, Lorissa A.; Durkin, Anthony J.; Tromberg, Bruce J.; Frangioni, John V.

2011-01-01

Oxygenation measurements are widely used in patient care. However, most clinically available instruments currently consist of contact probes that only provide global monitoring of the patient (e.g., pulse oximetry probes) or local monitoring of small areas (e.g., spectroscopy-based probes). Visualization of oxygenation over large areas of tissue, without a priori knowledge of the location of defects, has the potential to improve patient management in many surgical and critical care applications. In this study, we present a clinically compatible multispectral spatial frequency domain imaging (SFDI) system optimized for surgical oxygenation imaging. This system was used to image tissue oxygenation over a large area (16×12 cm) and was validated during preclinical studies by comparing results obtained with an FDA-approved clinical oxygenation probe. Skin flap, bowel, and liver vascular occlusion experiments were performed on Yorkshire pigs and demonstrated that over the course of the experiment, relative changes in oxygen saturation measured using SFDI had an accuracy within 10% of those made using the FDA-approved device. Finally, the new SFDI system was translated to the clinic in a first-in-human pilot study that imaged skin flap oxygenation during reconstructive breast surgery. Overall, this study lays the foundation for clinical translation of endogenous contrast imaging using SFDI. PMID:21895327

Towards a successful clinical implementation of fluorescence-guided surgery.

PubMed

Snoeks, T J A; van Driel, P B A A; Keereweer, S; Aime, S; Brindle, K M; van Dam, G M; Löwik, C W G M; Ntziachristos, V; Vahrmeijer, A L

2014-04-01

During the European Molecular Imaging Meeting (EMIM) 2013, the fluorescence-guided surgery study group held its inaugural session to discuss the clinical implementation of fluorescence-guided surgery. The general aim of this study group is to discuss and identify the steps required to successfully and safely bring intraoperative fluorescence imaging to the clinics. The focus group intends to use synergies between interested groups as a tool to address regulatory and implementation hurdles in Europe and operates within the intraoperative focus group of the World Molecular Imaging Society (WMIS) that promotes the same interests at the WMIS level. The major topics on the critical path of implementation identified within the study group were quality controls and standards for ensuring accurate imaging and the ability to compare results from different studies, regulatory affairs, and strategies to increase awareness among physicians, regulators, insurance companies, and a broader audience. These hurdles, and the possible actions discussed to overcome them, are summarized in this report. Furthermore, a number of recommendations for the future shape of the fluorescence-guided study group are discussed. A main driving conclusion remains that intraoperative imaging has great clinical potential and that many of the solutions required are best addressed with the community working together to optimally promote and accelerate the clinical implementation of fluorescence imaging towards improving surgical procedures.

Multispectral breast imaging using a ten-wavelength, 64 x 64 source/detector channels silicon photodiode-based diffuse optical tomography system.

PubMed

Li, Changqing; Zhao, Hongzhi; Anderson, Bonnie; Jiang, Huabei

2006-03-01

We describe a compact diffuse optical tomography system specifically designed for breast imaging. The system consists of 64 silicon photodiode detectors, 64 excitation points, and 10 diode lasers in the near-infrared region, allowing multispectral, three-dimensional optical imaging of breast tissue. We also detail the system performance and optimization through a calibration procedure. The system is evaluated using tissue-like phantom experiments and an in vivo clinic experiment. Quantitative two-dimensional (2D) and three-dimensional (3D) images of absorption and reduced scattering coefficients are obtained from these experiments. The ten-wavelength spectra of the extracted reduced scattering coefficient enable quantitative morphological images to be reconstructed with this system. From the in vivo clinic experiment, functional images including deoxyhemoglobin, oxyhemoglobin, and water concentration are recovered and tumors are detected with correct size and position compared with the mammography.

Whole-body direct 4D parametric PET imaging employing nested generalized Patlak expectation-maximization reconstruction

PubMed Central

Karakatsanis, Nicolas A.; Casey, Michael E.; Lodge, Martin A.; Rahmim, Arman; Zaidi, Habib

2016-01-01

Whole-body (WB) dynamic PET has recently demonstrated its potential in translating the quantitative benefits of parametric imaging to the clinic. Post-reconstruction standard Patlak (sPatlak) WB graphical analysis utilizes multi-bed multi-pass PET acquisition to produce quantitative WB images of the tracer influx rate Ki as a complimentary metric to the semi-quantitative standardized uptake value (SUV). The resulting Ki images may suffer from high noise due to the need for short acquisition frames. Meanwhile, a generalized Patlak (gPatlak) WB post-reconstruction method had been suggested to limit Ki bias of sPatlak analysis at regions with non-negligible 18F-FDG uptake reversibility; however, gPatlak analysis is non-linear and thus can further amplify noise. In the present study, we implemented, within the open-source Software for Tomographic Image Reconstruction (STIR) platform, a clinically adoptable 4D WB reconstruction framework enabling efficient estimation of sPatlak and gPatlak images directly from dynamic multi-bed PET raw data with substantial noise reduction. Furthermore, we employed the optimization transfer methodology to accelerate 4D expectation-maximization (EM) convergence by nesting the fast image-based estimation of Patlak parameters within each iteration cycle of the slower projection-based estimation of dynamic PET images. The novel gPatlak 4D method was initialized from an optimized set of sPatlak ML-EM iterations to facilitate EM convergence. Initially, realistic simulations were conducted utilizing published 18F-FDG kinetic parameters coupled with the XCAT phantom. Quantitative analyses illustrated enhanced Ki target-to-background ratio (TBR) and especially contrast-to-noise ratio (CNR) performance for the 4D vs. the indirect methods and static SUV. Furthermore, considerable convergence acceleration was observed for the nested algorithms involving 10–20 sub-iterations. Moreover, systematic reduction in Ki % bias and improved TBR were observed for gPatlak vs. sPatlak. Finally, validation on clinical WB dynamic data demonstrated the clinical feasibility and superior Ki CNR performance for the proposed 4D framework compared to indirect Patlak and SUV imaging. PMID:27383991

Whole-body direct 4D parametric PET imaging employing nested generalized Patlak expectation-maximization reconstruction

NASA Astrophysics Data System (ADS)

Karakatsanis, Nicolas A.; Casey, Michael E.; Lodge, Martin A.; Rahmim, Arman; Zaidi, Habib

2016-08-01

Whole-body (WB) dynamic PET has recently demonstrated its potential in translating the quantitative benefits of parametric imaging to the clinic. Post-reconstruction standard Patlak (sPatlak) WB graphical analysis utilizes multi-bed multi-pass PET acquisition to produce quantitative WB images of the tracer influx rate K i as a complimentary metric to the semi-quantitative standardized uptake value (SUV). The resulting K i images may suffer from high noise due to the need for short acquisition frames. Meanwhile, a generalized Patlak (gPatlak) WB post-reconstruction method had been suggested to limit K i bias of sPatlak analysis at regions with non-negligible 18F-FDG uptake reversibility; however, gPatlak analysis is non-linear and thus can further amplify noise. In the present study, we implemented, within the open-source software for tomographic image reconstruction platform, a clinically adoptable 4D WB reconstruction framework enabling efficient estimation of sPatlak and gPatlak images directly from dynamic multi-bed PET raw data with substantial noise reduction. Furthermore, we employed the optimization transfer methodology to accelerate 4D expectation-maximization (EM) convergence by nesting the fast image-based estimation of Patlak parameters within each iteration cycle of the slower projection-based estimation of dynamic PET images. The novel gPatlak 4D method was initialized from an optimized set of sPatlak ML-EM iterations to facilitate EM convergence. Initially, realistic simulations were conducted utilizing published 18F-FDG kinetic parameters coupled with the XCAT phantom. Quantitative analyses illustrated enhanced K i target-to-background ratio (TBR) and especially contrast-to-noise ratio (CNR) performance for the 4D versus the indirect methods and static SUV. Furthermore, considerable convergence acceleration was observed for the nested algorithms involving 10-20 sub-iterations. Moreover, systematic reduction in K i % bias and improved TBR were observed for gPatlak versus sPatlak. Finally, validation on clinical WB dynamic data demonstrated the clinical feasibility and superior K i CNR performance for the proposed 4D framework compared to indirect Patlak and SUV imaging.

In vivo imaging of human photoreceptor mosaic with wavefront sensorless adaptive optics optical coherence tomography.

PubMed

Wong, Kevin S K; Jian, Yifan; Cua, Michelle; Bonora, Stefano; Zawadzki, Robert J; Sarunic, Marinko V

2015-02-01

Wavefront sensorless adaptive optics optical coherence tomography (WSAO-OCT) is a novel imaging technique for in vivo high-resolution depth-resolved imaging that mitigates some of the challenges encountered with the use of sensor-based adaptive optics designs. This technique replaces the Hartmann Shack wavefront sensor used to measure aberrations with a depth-resolved image-driven optimization algorithm, with the metric based on the OCT volumes acquired in real-time. The custom-built ultrahigh-speed GPU processing platform and fast modal optimization algorithm presented in this paper was essential in enabling real-time, in vivo imaging of human retinas with wavefront sensorless AO correction. WSAO-OCT is especially advantageous for developing a clinical high-resolution retinal imaging system as it enables the use of a compact, low-cost and robust lens-based adaptive optics design. In this report, we describe our WSAO-OCT system for imaging the human photoreceptor mosaic in vivo. We validated our system performance by imaging the retina at several eccentricities, and demonstrated the improvement in photoreceptor visibility with WSAO compensation.

"On the other hand ...": the evidence does not support the use of hand-carried ultrasound by hospitalists.

PubMed

Feldman, Mitchell D; Petersen, Amy Jean; Tice, Jeffrey A

2010-03-01

In the right hands, ultrasound is a safe and helpful diagnostic imaging tool. However, evidence supporting the use of hand-carried ultrasound (HCU) by hospitalist physicians has not kept pace with expanding application of these devices. In spite of its strategic point-of-care benefit, use of this technology by hospitalists may not ultimately translate into improved efficiency and better clinical outcomes. Optimal levels of training in image acquisition and interpretation remain to be established. Novelty, availability, and the results of a few small studies lacking patient-centered outcomes remain insufficient grounds to justify the expanded clinical utilization of these medical imaging devices by nonspecialists.

Fast ℓ1-SPIRiT Compressed Sensing Parallel Imaging MRI: Scalable Parallel Implementation and Clinically Feasible Runtime

PubMed Central

Murphy, Mark; Alley, Marcus; Demmel, James; Keutzer, Kurt; Vasanawala, Shreyas; Lustig, Michael

2012-01-01

We present ℓ1-SPIRiT, a simple algorithm for auto calibrating parallel imaging (acPI) and compressed sensing (CS) that permits an efficient implementation with clinically-feasible runtimes. We propose a CS objective function that minimizes cross-channel joint sparsity in the Wavelet domain. Our reconstruction minimizes this objective via iterative soft-thresholding, and integrates naturally with iterative Self-Consistent Parallel Imaging (SPIRiT). Like many iterative MRI reconstructions, ℓ1-SPIRiT’s image quality comes at a high computational cost. Excessively long runtimes are a barrier to the clinical use of any reconstruction approach, and thus we discuss our approach to efficiently parallelizing ℓ1-SPIRiT and to achieving clinically-feasible runtimes. We present parallelizations of ℓ1-SPIRiT for both multi-GPU systems and multi-core CPUs, and discuss the software optimization and parallelization decisions made in our implementation. The performance of these alternatives depends on the processor architecture, the size of the image matrix, and the number of parallel imaging channels. Fundamentally, achieving fast runtime requires the correct trade-off between cache usage and parallelization overheads. We demonstrate image quality via a case from our clinical experimentation, using a custom 3DFT Spoiled Gradient Echo (SPGR) sequence with up to 8× acceleration via poisson-disc undersampling in the two phase-encoded directions. PMID:22345529

Treatment Planning and Image Guidance for Radiofrequency Ablations of Large Tumors

PubMed Central

Ren, Hongliang; Campos-Nanez, Enrique; Yaniv, Ziv; Banovac, Filip; Abeledo, Hernan; Hata, Nobuhiko; Cleary, Kevin

2014-01-01

This article addresses the two key challenges in computer-assisted percutaneous tumor ablation: planning multiple overlapping ablations for large tumors while avoiding critical structures, and executing the prescribed plan. Towards semi-automatic treatment planning for image-guided surgical interventions, we develop a systematic approach to the needle-based ablation placement task, ranging from pre-operative planning algorithms to an intra-operative execution platform. The planning system incorporates clinical constraints on ablations and trajectories using a multiple objective optimization formulation, which consists of optimal path selection and ablation coverage optimization based on integer programming. The system implementation is presented and validated in phantom studies and on an animal model. The presented system can potentially be further extended for other ablation techniques such as cryotherapy. PMID:24235279

Iterative Structural and Functional Synergistic Resolution Recovery (iSFS-RR) Applied to PET-MR Images in Epilepsy

NASA Astrophysics Data System (ADS)

Silva-Rodríguez, J.; Cortés, J.; Rodríguez-Osorio, X.; López-Urdaneta, J.; Pardo-Montero, J.; Aguiar, P.; Tsoumpas, C.

2016-10-01

Structural Functional Synergistic Resolution Recovery (SFS-RR) is a technique that uses supplementary structural information from MR or CT to improve the spatial resolution of PET or SPECT images. This wavelet-based method may have a potential impact on the clinical decision-making of brain focal disorders such as refractory epilepsy, since it can produce images with better quantitative accuracy and enhanced detectability. In this work, a method for the iterative application of SFS-RR (iSFS-RR) was firstly developed and optimized in terms of convergence and input voxel size, and the corrected images were used for the diagnosis of 18 patients with refractory epilepsy. To this end, PET/MR images were clinically evaluated through visual inspection, atlas-based asymmetry indices (AIs) and SPM (Statistical Parametric Mapping) analysis, using uncorrected images and images corrected with SFS-RR and iSFS-RR. Our results showed that the sensitivity can be increased from 78% for uncorrected images, to 84% for SFS-RR and 94% for the proposed iSFS-RR. Thus, the proposed methodology has demonstrated the potential to improve the management of refractory epilepsy patients in the clinical routine.

In vivo targeted peripheral nerve imaging with a nerve-specific nanoscale magnetic resonance probe.

PubMed

Zheng, Linfeng; Li, Kangan; Han, Yuedong; Wei, Wei; Zheng, Sujuan; Zhang, Guixiang

2014-11-01

Neuroimaging plays a pivotal role in clinical practice. Currently, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, and positron emission tomography (PET) are applied in the clinical setting as neuroimaging modalities. There is no optimal imaging modality for clinical peripheral nerve imaging even though fluorescence/bioluminescence imaging has been used for preclinical studies on the nervous system. Some studies have shown that molecular and cellular MRI (MCMRI) can be used to visualize and image the cellular and molecular level of the nervous system. Other studies revealed that there are different pathological/molecular changes in the proximal and distal sites after peripheral nerve injury (PNI). Therefore, we hypothesized that in vivo peripheral nerve targets can be imaged using MCMRI with specific MRI probes. Specific probes should have higher penetrability for the blood-nerve barrier (BNB) in vivo. Here, a functional nanometre MRI probe that is based on nerve-specific proteins as targets, specifically, using a molecular antibody (mAb) fragment conjugated to iron nanoparticles as an MRI probe, was constructed for further study. The MRI probe allows for imaging the peripheral nerve targets in vivo. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fast automatic correction of motion artifacts in shoulder MRI

NASA Astrophysics Data System (ADS)

Manduca, Armando; McGee, Kiaran P.; Welch, Edward B.; Felmlee, Joel P.; Ehman, Richard L.

2001-07-01

The ability to correct certain types of MR images for motion artifacts from the raw data alone by iterative optimization of an image quality measure has recently been demonstrated. In the first study on a large data set of clinical images, we showed that such an autocorrection technique significantly improved the quality of clinical rotator cuff images, and performed almost as well as navigator echo correction while never degrading an image. One major criticism of such techniques is that they are computationally intensive, and reports of the processing time required have ranged form a few minutes to tens of minutes per slice. In this paper we describe a variety of improvements to our algorithm as well as approaches to correct sets of adjacent slices efficiently. The resulting algorithm is able to correct 256x256x20 clinical shoulder data sets for motion at an effective rate of 1 second/image on a standard commercial workstation. Future improvements in processor speeds and/or the use of specialized hardware will translate directly to corresponding reductions in this calculation time.

Model based LV-reconstruction in bi-plane x-ray angiography

NASA Astrophysics Data System (ADS)

Backfrieder, Werner; Carpella, Martin; Swoboda, Roland; Steinwender, Clemens; Gabriel, Christian; Leisch, Franz

2005-04-01

Interventional x-ray angiography is state of the art in diagnosis and therapy of severe diseases of the cardiovascular system. Diagnosis is based on contrast enhanced dynamic projection images of the left ventricle. A new model based algorithm for three dimensional reconstruction of the left ventricle from bi-planar angiograms was developed. Parametric super ellipses are deformed until their projection profiles optimally fit measured ventricular projections. Deformation is controlled by a simplex optimization procedure. A resulting optimized parameter set builds the initial guess for neighboring slices. A three dimensional surface model of the ventricle is built from stacked contours. The accuracy of the algorithm has been tested with mathematical phantom data and clinical data. Results show conformance with provided projection data and high convergence speed makes the algorithm useful for clinical application. Fully three dimensional reconstruction of the left ventricle has a high potential for improvements of clinical findings in interventional cardiology.

System Optimization and Iterative Image Reconstruction in Photoacoustic Computed Tomography for Breast Imaging

NASA Astrophysics Data System (ADS)

Lou, Yang

Photoacoustic computed tomography(PACT), also known as optoacoustic tomography (OAT), is an emerging imaging technique that has developed rapidly in recent years. The combination of the high optical contrast and the high acoustic resolution of this hybrid imaging technique makes it a promising candidate for human breast imaging, where conventional imaging techniques including X-ray mammography, B-mode ultrasound, and MRI suffer from low contrast, low specificity for certain breast types, and additional risks related to ionizing radiation. Though significant works have been done to push the frontier of PACT breast imaging, it is still challenging to successfully build a PACT breast imaging system and apply it to wide clinical use because of various practical reasons. First, computer simulation studies are often conducted to guide imaging system designs, but the numerical phantoms employed in most previous works consist of simple geometries and do not reflect the true anatomical structures within the breast. Therefore the effectiveness of such simulation-guided PACT system in clinical experiments will be compromised. Second, it is challenging to design a system to simultaneously illuminate the entire breast with limited laser power. Some heuristic designs have been proposed where the illumination is non-stationary during the imaging procedure, but the impact of employing such a design has not been carefully studied. Third, current PACT imaging systems are often optimized with respect to physical measures such as resolution or signal-to-noise ratio (SNR). It would be desirable to establish an assessing framework where the detectability of breast tumor can be directly quantified, therefore the images produced by such optimized imaging systems are not only visually appealing, but most informative in terms of the tumor detection task. Fourth, when imaging a large three-dimensional (3D) object such as the breast, iterative reconstruction algorithms are often utilized to alleviate the need to collect densely sampled measurement data hence a long scanning time. However, the heavy computation burden associated with iterative algorithms largely hinders its application in PACT breast imaging. This dissertation is dedicated to address these aforementioned problems in PACT breast imaging. A method that generates anatomically realistic numerical breast phantoms is first proposed to facilitate computer simulation studies in PACT. The non-stationary illumination designs for PACT breast imaging are then systematically investigated in terms of its impact on reconstructed images. We then apply signal detection theory to assess different system designs to demonstrate how an objective, task-based measure can be established for PACT breast imaging. To address the slow computation time of iterative algorithms for PACT imaging, we propose an acceleration method that employs an approximated but much faster adjoint operator during iterations, which can reduce the computation time by a factor of six without significantly compromising image quality. Finally, some clinical results are presented to demonstrate that the PACT breast imaging can resolve most major and fine vascular structures within the breast, along with some pathological biomarkers that may indicate tumor development.

Investigation of cone-beam CT image quality trade-off for image-guided radiation therapy

NASA Astrophysics Data System (ADS)

Bian, Junguo; Sharp, Gregory C.; Park, Yang-Kyun; Ouyang, Jinsong; Bortfeld, Thomas; El Fakhri, Georges

2016-05-01

It is well-known that projections acquired over an angular range slightly over 180° (so-called short scan) are sufficient for fan-beam reconstruction. However, due to practical imaging conditions (projection data and reconstruction image discretization, physical factors, and data noise), the short-scan reconstructions may have different appearances and properties from the full-scan (scans over 360°) reconstructions. Nevertheless, short-scan configurations have been used in applications such as cone-beam CT (CBCT) for head-neck-cancer image-guided radiation therapy (IGRT) that only requires a small field of view due to the potential reduced imaging time and dose. In this work, we studied the image quality trade-off for full, short, and full/short scan configurations with both conventional filtered-backprojection (FBP) reconstruction and iterative reconstruction algorithms based on total-variation (TV) minimization for head-neck-cancer IGRT. Anthropomorphic and Catphan phantoms were scanned at different exposure levels with a clinical scanner used in IGRT. Both visualization- and numerical-metric-based evaluation studies were performed. The results indicate that the optimal exposure level and number of views are in the middle range for both FBP and TV-based iterative algorithms and the optimization is object-dependent and task-dependent. The optimal view numbers decrease with the total exposure levels for both FBP and TV-based algorithms. The results also indicate there are slight differences between FBP and TV-based iterative algorithms for the image quality trade-off: FBP seems to be more in favor of larger number of views while the TV-based algorithm is more robust to different data conditions (number of views and exposure levels) than the FBP algorithm. The studies can provide a general guideline for image-quality optimization for CBCT used in IGRT and other applications.

Investigation of cone-beam CT image quality trade-off for image-guided radiation therapy.

PubMed

Bian, Junguo; Sharp, Gregory C; Park, Yang-Kyun; Ouyang, Jinsong; Bortfeld, Thomas; El Fakhri, Georges

2016-05-07

It is well-known that projections acquired over an angular range slightly over 180° (so-called short scan) are sufficient for fan-beam reconstruction. However, due to practical imaging conditions (projection data and reconstruction image discretization, physical factors, and data noise), the short-scan reconstructions may have different appearances and properties from the full-scan (scans over 360°) reconstructions. Nevertheless, short-scan configurations have been used in applications such as cone-beam CT (CBCT) for head-neck-cancer image-guided radiation therapy (IGRT) that only requires a small field of view due to the potential reduced imaging time and dose. In this work, we studied the image quality trade-off for full, short, and full/short scan configurations with both conventional filtered-backprojection (FBP) reconstruction and iterative reconstruction algorithms based on total-variation (TV) minimization for head-neck-cancer IGRT. Anthropomorphic and Catphan phantoms were scanned at different exposure levels with a clinical scanner used in IGRT. Both visualization- and numerical-metric-based evaluation studies were performed. The results indicate that the optimal exposure level and number of views are in the middle range for both FBP and TV-based iterative algorithms and the optimization is object-dependent and task-dependent. The optimal view numbers decrease with the total exposure levels for both FBP and TV-based algorithms. The results also indicate there are slight differences between FBP and TV-based iterative algorithms for the image quality trade-off: FBP seems to be more in favor of larger number of views while the TV-based algorithm is more robust to different data conditions (number of views and exposure levels) than the FBP algorithm. The studies can provide a general guideline for image-quality optimization for CBCT used in IGRT and other applications.

A fast inverse treatment planning strategy facilitating optimized catheter selection in image-guided high-dose-rate interstitial gynecologic brachytherapy.

PubMed

Guthier, Christian V; Damato, Antonio L; Hesser, Juergen W; Viswanathan, Akila N; Cormack, Robert A

2017-12-01

Interstitial high-dose rate (HDR) brachytherapy is an important therapeutic strategy for the treatment of locally advanced gynecologic (GYN) cancers. The outcome of this therapy is determined by the quality of dose distribution achieved. This paper focuses on a novel yet simple heuristic for catheter selection for GYN HDR brachytherapy and their comparison against state of the art optimization strategies. The proposed technique is intended to act as a decision-supporting tool to select a favorable needle configuration. The presented heuristic for catheter optimization is based on a shrinkage-type algorithm (SACO). It is compared against state of the art planning in a retrospective study of 20 patients who previously received image-guided interstitial HDR brachytherapy using a Syed Neblett template. From those plans, template orientation and position are estimated via a rigid registration of the template with the actual catheter trajectories. All potential straight trajectories intersecting the contoured clinical target volume (CTV) are considered for catheter optimization. Retrospectively generated plans and clinical plans are compared with respect to dosimetric performance and optimization time. All plans were generated with one single run of the optimizer lasting 0.6-97.4 s. Compared to manual optimization, SACO yields a statistically significant (P ≤ 0.05) improved target coverage while at the same time fulfilling all dosimetric constraints for organs at risk (OARs). Comparing inverse planning strategies, dosimetric evaluation for SACO and "hybrid inverse planning and optimization" (HIPO), as gold standard, shows no statistically significant difference (P > 0.05). However, SACO provides the potential to reduce the number of used catheters without compromising plan quality. The proposed heuristic for needle selection provides fast catheter selection with optimization times suited for intraoperative treatment planning. Compared to manual optimization, the proposed methodology results in fewer catheters without a clinically significant loss in plan quality. The proposed approach can be used as a decision support tool that guides the user to find the ideal number and configuration of catheters. © 2017 American Association of Physicists in Medicine.

Comparative study of protoporphyrin IX fluorescence image enhancement methods to improve an optical imaging system for oral cancer detection

NASA Astrophysics Data System (ADS)

Jiang, Ching-Fen; Wang, Chih-Yu; Chiang, Chun-Ping

2011-07-01

Optoelectronics techniques to induce protoporphyrin IX fluorescence with topically applied 5-aminolevulinic acid on the oral mucosa have been developed to noninvasively detect oral cancer. Fluorescence imaging enables wide-area screening for oral premalignancy, but the lack of an adequate fluorescence enhancement method restricts the clinical imaging application of these techniques. This study aimed to develop a reliable fluorescence enhancement method to improve PpIX fluorescence imaging systems for oral cancer detection. Three contrast features, red-green-blue reflectance difference, R/B ratio, and R/G ratio, were developed first based on the optical properties of the fluorescence images. A comparative study was then carried out with one negative control and four biopsy confirmed clinical cases to validate the optimal image processing method for the detection of the distribution of malignancy. The results showed the superiority of the R/G ratio in terms of yielding a better contrast between normal and neoplastic tissue, and this method was less prone to errors in detection. Quantitative comparison with the clinical diagnoses in the four neoplastic cases showed that the regions of premalignancy obtained using the proposed method accorded with the expert's determination, suggesting the potential clinical application of this method for the detection of oral cancer.

Nuclear Molecular and Theranostic Imaging for Differentiated Thyroid Cancer

PubMed Central

Sheikh, Arif; Polack, Berna; Rodriguez, Yvette; Kuker, Russ

2017-01-01

Traditional nuclear medicine is rapidly being transformed by the evolving concepts in molecular imaging and theranostics. The utility of new approaches in differentiated thyroid cancer (DTC) diagnostics and therapy has not been fully appreciated. The clinical information, relevant to disease management and patient care, obtained by scintigraphy is still being underestimated. There has been a trend towards moving away from the use of radioactive iodine (RAI) imaging in the management of the disease. This paradigm shift is supported by the 2015 American Thyroid Association Guidelines (1). A more systematic and comprehensive understanding of disease pathophysiology and imaging methodologies is needed for optimal utilization of different imaging modalities in the management of DTC. There have been significant developments in radiotracer and imaging technology, clinically proven to contribute to the understanding of tumor biology and the clinical assessment of patients with DTC. The research and development in the field continues to evolve, with expected emergence of many novel diagnostic and therapeutic techniques. The role for nuclear imaging applications will continue to evolve and be reconfigured in the changing paradigm. This article aims to review the clinical uses and controversies surrounding the use of scintigraphy, and the information it can provide in assisting in the management and treatment of DTC. PMID:28117289

[Diagnostic imaging of urolithiais. Current recommendations and new developments].

PubMed

Thalgott, M; Kurtz, F; Gschwend, J E; Straub, M

2015-07-01

Prevalence of urolithiasis is increasing in industrialized countries--in both adults and children, representing a unique diagnostic and therapeutic challenge. Risk-adapted diagnostic imaging currently means assessment with maximized sensitivity and specificity together with minimal radiation exposure. In clinical routine, imaging is performed by sonography, unenhanced computed tomography (NCCT) or intravenous urography (IVU) as well as plain kidney-ureter-bladder (KUB) radiographs. The aim of the present review is a critical guideline-based and therapy-aligned presentation of diagnostic imaging procedures for optimized treatment of urolithiasis considering the specifics in children and pregnant women.

Resolution and throughput optimized intraoperative spectrally encoded coherence tomography and reflectometry (iSECTR) for multimodal imaging during ophthalmic microsurgery

NASA Astrophysics Data System (ADS)

Malone, Joseph D.; El-Haddad, Mohamed T.; Leeburg, Kelsey C.; Terrones, Benjamin D.; Tao, Yuankai K.

2018-02-01

Limited visualization of semi-transparent structures in the eye remains a critical barrier to improving clinical outcomes and developing novel surgical techniques. While increases in imaging speed has enabled intraoperative optical coherence tomography (iOCT) imaging of surgical dynamics, several critical barriers to clinical adoption remain. Specifically, these include (1) static field-of-views (FOVs) requiring manual instrument-tracking; (2) high frame-rates require sparse sampling, which limits FOV; and (3) small iOCT FOV also limits the ability to co-register data with surgical microscopy. We previously addressed these limitations in image-guided ophthalmic microsurgery by developing microscope-integrated multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography. Complementary en face images enabled orientation and coregistration with the widefield surgical microscope view while OCT imaging enabled depth-resolved visualization of surgical instrument positions relative to anatomic structures-of-interest. In addition, we demonstrated novel integrated segmentation overlays for augmented-reality surgical guidance. Unfortunately, our previous system lacked the resolution and optical throughput for in vivo retinal imaging and necessitated removal of cornea and lens. These limitations were predominately a result of optical aberrations from imaging through a shared surgical microscope objective lens, which was modeled as a paraxial surface. Here, we present an optimized intraoperative spectrally encoded coherence tomography and reflectometry (iSECTR) system. We use a novel lens characterization method to develop an accurate model of surgical microscope objective performance and balance out inherent aberrations using iSECTR relay optics. Using this system, we demonstrate in vivo multimodal ophthalmic imaging through a surgical microscope

Optimization of medical imaging display systems: using the channelized Hotelling observer for detecting lung nodules: experimental study

NASA Astrophysics Data System (ADS)

Platisa, Ljiljana; Vansteenkiste, Ewout; Goossens, Bart; Marchessoux, Cédric; Kimpe, Tom; Philips, Wilfried

2009-02-01

Medical-imaging systems are designed to aid medical specialists in a specific task. Therefore, the physical parameters of a system need to optimize the task performance of a human observer. This requires measurements of human performance in a given task during the system optimization. Typically, psychophysical studies are conducted for this purpose. Numerical observer models have been successfully used to predict human performance in several detection tasks. Especially, the task of signal detection using a channelized Hotelling observer (CHO) in simulated images has been widely explored. However, there are few studies done for clinically acquired images that also contain anatomic noise. In this paper, we investigate the performance of a CHO in the task of detecting lung nodules in real radiographic images of the chest. To evaluate variability introduced by the limited available data, we employ a commonly used study of a multi-reader multi-case (MRMC) scenario. It accounts for both case and reader variability. Finally, we use the "oneshot" methods to estimate the MRMC variance of the area under the ROC curve (AUC). The obtained AUC compares well to those reported for human observer study on a similar data set. Furthermore, the "one-shot" analysis implies a fairly consistent performance of the CHO with the variance of AUC below 0.002. This indicates promising potential for numerical observers in optimization of medical imaging displays and encourages further investigation on the subject.

Computed tomography angiography-fluoroscopy image fusion allows visceral vessel cannulation without angiography during fenestrated endovascular aneurysm repair.

PubMed

Schwein, Adeline; Chinnadurai, Ponraj; Behler, Greg; Lumsden, Alan B; Bismuth, Jean; Bechara, Carlos F

2018-07-01

Fenestrated endovascular aneurysm repair (FEVAR) is an evolving technique to treat juxtarenal abdominal aortic aneurysms (AAAs). Catheterization of visceral and renal vessels after the deployment of the fenestrated main body device is often challenging, usually requiring additional fluoroscopy and multiple digital subtraction angiograms. The aim of this study was to assess the clinical utility and accuracy of a computed tomography angiography (CTA)-fluoroscopy image fusion technique in guiding visceral vessel cannulation during FEVAR. Between August 2014 and September 2016, all consecutive patients who underwent FEVAR at our institution using image fusion guidance were included. Preoperative CTA images were fused with intraoperative fluoroscopy after coregistering with non-contrast-enhanced cone beam computed tomography (syngo 3D3D image fusion; Siemens Healthcare, Forchheim, Germany). The ostia of the visceral vessels were electronically marked on CTA images (syngo iGuide Toolbox) and overlaid on live fluoroscopy to guide vessel cannulation after fenestrated device deployment. Clinical utility of image fusion was evaluated by assessing the number of dedicated angiograms required for each visceral or renal vessel cannulation and the use of optimized C-arm angulation. Accuracy of image fusion was evaluated from video recordings by three raters using a binary qualitative assessment scale. A total of 26 patients (17 men; mean age, 73.8 years) underwent FEVAR during the study period for juxtarenal AAA (17), pararenal AAA (6), and thoracoabdominal aortic aneurysm (3). Video recordings of fluoroscopy from 19 cases were available for review and assessment. A total of 46 vessels were cannulated; 38 of 46 (83%) of these vessels were cannulated without angiography but based only on image fusion guidance: 9 of 11 superior mesenteric artery cannulations and 29 of 35 renal artery cannulations. Binary qualitative assessment showed that 90% (36/40) of the virtual ostia overlaid on live fluoroscopy were accurate. Optimized C-arm angulations were achieved in 35% of vessel cannulations (0/9 for superior mesenteric artery cannulation, 12/25 for renal arteries). Preoperative CTA-fluoroscopy image fusion guidance during FEVAR is a valuable and accurate tool that allows visceral and renal vessel cannulation without the need of dedicated angiograms, thus avoiding additional injection of contrast material and radiation exposure. Further refinements, such as accounting for device-induced aortic deformation and automating the image fusion workflow, will bolster this technology toward optimal routine clinical use. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Optimization of exposure index values for the antero-posterior pelvis and antero-posterior knee examination

NASA Astrophysics Data System (ADS)

Butler, M. L.; Rainford, L.; Last, J.; Brennan, P. C.

2009-02-01

Introduction The American Association of Medical Physicists is currently standardizing the exposure index (EI) value. Recent studies have questioned whether the EI value offered by manufacturers is optimal. This current work establishes optimum EIs for the antero-posterior (AP) projections of a pelvis and knee on a Carestream Health (Kodak) CR system and compares these with manufacturers recommended EI values from a patient dose and image quality perspective. Methodology Human cadavers were used to produce images of clinically relevant standards. Several exposures were taken to achieve various EI values and corresponding entrance surface doses (ESD) were measured using thermoluminescent dosimeters. Image quality was assessed by 5 experienced clinicians using anatomical criteria judged against a reference image. Visualization of image specific common abnormalities was also analyzed to establish diagnostic efficacy. Results A rise in ESD for both examinations, consistent with increasing EI was shown. Anatomic image quality was deemed to be acceptable at an EI of 1560 for the AP pelvis and 1590 for the AP knee. From manufacturers recommended values, a significant reduction in ESD (p=0.02) of 38% and 33% for the pelvis and knee respectively was noted. Initial pathological analysis suggests that diagnostic efficacy at lower EI values may be projection-specific. Conclusion The data in this study emphasize the need for clinical centres to consider establishing their own EI guidelines, and not necessarily relying on manufacturers recommendations. Normal and abnormal images must be used in this process.

Does the choice of display system influence perception and visibility of clinically relevant features in digital pathology images?

NASA Astrophysics Data System (ADS)

Kimpe, Tom; Rostang, Johan; Avanaki, Ali; Espig, Kathryn; Xthona, Albert; Cocuranu, Ioan; Parwani, Anil V.; Pantanowitz, Liron

2014-03-01

Digital pathology systems typically consist of a slide scanner, processing software, visualization software, and finally a workstation with display for visualization of the digital slide images. This paper studies whether digital pathology images can look different when presenting them on different display systems, and whether these visual differences can result in different perceived contrast of clinically relevant features. By analyzing a set of four digital pathology images of different subspecialties on three different display systems, it was concluded that pathology images look different when visualized on different display systems. The importance of these visual differences is elucidated when they are located in areas of the digital slide that contain clinically relevant features. Based on a calculation of dE2000 differences between background and clinically relevant features, it was clear that perceived contrast of clinically relevant features is influenced by the choice of display system. Furthermore, it seems that the specific calibration target chosen for the display system has an important effect on the perceived contrast of clinically relevant features. Preliminary results suggest that calibrating to DICOM GSDF calibration performed slightly worse than sRGB, while a new experimental calibration target CSDF performed better than both DICOM GSDF and sRGB. This result is promising as it suggests that further research work could lead to better definition of an optimized calibration target for digital pathology images resulting in a positive effect on clinical performance.

Optimization of prostate biopsy: the role of magnetic resonance imaging targeted biopsy in detection, localization and risk assessment.

PubMed

Bjurlin, Marc A; Meng, Xiaosong; Le Nobin, Julien; Wysock, James S; Lepor, Herbert; Rosenkrantz, Andrew B; Taneja, Samir S

2014-09-01

Optimization of prostate biopsy requires addressing the shortcomings of standard systematic transrectal ultrasound guided biopsy, including false-negative rates, incorrect risk stratification, detection of clinically insignificant disease and the need for repeat biopsy. Magnetic resonance imaging is an evolving noninvasive imaging modality that increases the accurate localization of prostate cancer at the time of biopsy, and thereby enhances clinical risk assessment and improves the ability to appropriately counsel patients regarding therapy. In this review we 1) summarize the various sequences that comprise a prostate multiparametric magnetic resonance imaging examination along with its performance characteristics in cancer detection, localization and reporting standards; 2) evaluate potential applications of magnetic resonance imaging targeting in prostate biopsy among men with no previous biopsy, a negative previous biopsy and those with low stage cancer; and 3) describe the techniques of magnetic resonance imaging targeted biopsy and comparative study outcomes. A bibliographic search covering the period up to October 2013 was conducted using MEDLINE®/PubMed®. Articles were reviewed and categorized based on which of the 3 objectives of this review was addressed. Data were extracted, analyzed and summarized. Multiparametric magnetic resonance imaging consists of anatomical T2-weighted imaging coupled with at least 2 functional imaging techniques. It has demonstrated improved prostate cancer detection sensitivity up to 80% in the peripheral zone and 81% in the transition zone. A prostate cancer magnetic resonance imaging suspicion score has been developed, and is depicted using the Likert or PI-RADS (Prostate Imaging Reporting and Data System) scale for better standardization of magnetic resonance imaging interpretation and reporting. Among men with no previous biopsy, magnetic resonance imaging increases the frequency of significant cancer detection to 50% in low risk and 71% in high risk patients. In low risk men the negative predictive value of a combination of negative magnetic resonance imaging with prostate volume parameters is nearly 98%, suggesting a potential role in avoiding biopsy and reducing over detection/overtreatment. Among men with a previous negative biopsy 72% to 87% of cancers detected by magnetic resonance imaging guidance are clinically significant. Among men with a known low risk cancer, repeat biopsy using magnetic resonance targeting demonstrates a high likelihood of confirming low risk disease in low suspicion score lesions and of upgrading in high suspicion score lesions. Techniques of magnetic resonance imaging targeted biopsy include visual estimation transrectal ultrasound guided biopsy; software co-registered magnetic resonance imaging-ultrasound, transrectal ultrasound guided biopsy; and in-bore magnetic resonance imaging guided biopsy. Although the improvement in accuracy and efficiency of visual estimation biopsy compared to systematic appears limited, co-registered magnetic resonance imaging-ultrasound biopsy as well as in-bore magnetic resonance imaging guided biopsy appear to increase cancer detection rates in conjunction with increasing suspicion score. Use of magnetic resonance imaging for targeting prostate biopsies has the potential to reduce the sampling error associated with conventional biopsy by providing better disease localization and sampling. More accurate risk stratification through improved cancer sampling may impact therapeutic decision making. Optimal clinical application of magnetic resonance imaging targeted biopsy remains under investigation. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Automated removal of spurious intermediate cerebral blood flow volumes improves image quality among older patients: A clinical arterial spin labeling investigation.

PubMed

Shirzadi, Zahra; Crane, David E; Robertson, Andrew D; Maralani, Pejman J; Aviv, Richard I; Chappell, Michael A; Goldstein, Benjamin I; Black, Sandra E; MacIntosh, Bradley J

2015-11-01

To evaluate the impact of rejecting intermediate cerebral blood flow (CBF) images that are adversely affected by head motion during an arterial spin labeling (ASL) acquisition. Eighty participants were recruited, representing a wide age range (14-90 years) and heterogeneous cerebrovascular health conditions including bipolar disorder, chronic stroke, and moderate to severe white matter hyperintensities of presumed vascular origin. Pseudocontinuous ASL and T1 -weigthed anatomical images were acquired on a 3T scanner. ASL intermediate CBF images were included based on their contribution to the mean estimate, with the goal to maximize CBF detectability in gray matter (GM). Simulations were conducted to evaluate the performance of the proposed optimization procedure relative to other ASL postprocessing approaches. Clinical CBF images were also assessed visually by two experienced neuroradiologists. Optimized CBF images (CBFopt ) had significantly greater agreement with a synthetic ground truth CBF image and greater CBF detectability relative to the other ASL analysis methods (P < 0.05). Moreover, empirical CBFopt images showed a significantly improved signal-to-noise ratio relative to CBF images obtained from other postprocessing approaches (mean: 12.6%; range 1% to 56%; P < 0.001), and this improvement was age-dependent (P = 0.03). Differences between CBF images from different analysis procedures were not perceptible by visual inspection, while there was a moderate agreement between the ratings (κ = 0.44, P < 0.001). This study developed an automated head motion threshold-free procedure to improve the detection of CBF in GM. The improvement in CBF image quality was larger when considering older participants. © 2015 Wiley Periodicals, Inc.

Enabling Histopathological Annotations on Immunofluorescent Images through Virtualization of Hematoxylin and Eosin

PubMed Central

Lahiani, Amal; Klaiman, Eldad; Grimm, Oliver

2018-01-01

Context: Medical diagnosis and clinical decisions rely heavily on the histopathological evaluation of tissue samples, especially in oncology. Historically, classical histopathology has been the gold standard for tissue evaluation and assessment by pathologists. The most widely and commonly used dyes in histopathology are hematoxylin and eosin (H&E) as most malignancies diagnosis is largely based on this protocol. H&E staining has been used for more than a century to identify tissue characteristics and structures morphologies that are needed for tumor diagnosis. In many cases, as tissue is scarce in clinical studies, fluorescence imaging is necessary to allow staining of the same specimen with multiple biomarkers simultaneously. Since fluorescence imaging is a relatively new technology in the pathology landscape, histopathologists are not used to or trained in annotating or interpreting these images. Aims, Settings and Design: To allow pathologists to annotate these images without the need for additional training, we designed an algorithm for the conversion of fluorescence images to brightfield H&E images. Subjects and Methods: In this algorithm, we use fluorescent nuclei staining to reproduce the hematoxylin information and natural tissue autofluorescence to reproduce the eosin information avoiding the necessity to specifically stain the proteins or intracellular structures with an additional fluorescence stain. Statistical Analysis Used: Our method is based on optimizing a transform function from fluorescence to H&E images using least mean square optimization. Results: It results in high quality virtual H&E digital images that can easily and efficiently be analyzed by pathologists. We validated our results with pathologists by making them annotate tumor in real and virtual H&E whole slide images and we obtained promising results. Conclusions: Hence, we provide a solution that enables pathologists to assess tissue and annotate specific structures based on multiplexed fluorescence images. PMID:29531846

Enabling Histopathological Annotations on Immunofluorescent Images through Virtualization of Hematoxylin and Eosin.

PubMed

Lahiani, Amal; Klaiman, Eldad; Grimm, Oliver

2018-01-01

Medical diagnosis and clinical decisions rely heavily on the histopathological evaluation of tissue samples, especially in oncology. Historically, classical histopathology has been the gold standard for tissue evaluation and assessment by pathologists. The most widely and commonly used dyes in histopathology are hematoxylin and eosin (H&E) as most malignancies diagnosis is largely based on this protocol. H&E staining has been used for more than a century to identify tissue characteristics and structures morphologies that are needed for tumor diagnosis. In many cases, as tissue is scarce in clinical studies, fluorescence imaging is necessary to allow staining of the same specimen with multiple biomarkers simultaneously. Since fluorescence imaging is a relatively new technology in the pathology landscape, histopathologists are not used to or trained in annotating or interpreting these images. To allow pathologists to annotate these images without the need for additional training, we designed an algorithm for the conversion of fluorescence images to brightfield H&E images. In this algorithm, we use fluorescent nuclei staining to reproduce the hematoxylin information and natural tissue autofluorescence to reproduce the eosin information avoiding the necessity to specifically stain the proteins or intracellular structures with an additional fluorescence stain. Our method is based on optimizing a transform function from fluorescence to H&E images using least mean square optimization. It results in high quality virtual H&E digital images that can easily and efficiently be analyzed by pathologists. We validated our results with pathologists by making them annotate tumor in real and virtual H&E whole slide images and we obtained promising results. Hence, we provide a solution that enables pathologists to assess tissue and annotate specific structures based on multiplexed fluorescence images.

Technical considerations for implementation of x-ray CT polymer gel dosimetry.

PubMed

Hilts, M; Jirasek, A; Duzenli, C

2005-04-21

Gel dosimetry is the most promising 3D dosimetry technique in current radiation therapy practice. X-ray CT has been shown to be a feasible method of reading out polymer gel dosimeters and, with the high accessibility of CT scanners to cancer hospitals, presents an exciting possibility for clinical implementation of gel dosimetry. In this study we report on technical considerations for implementation of x-ray CT polymer gel dosimetry. Specifically phantom design, CT imaging methods, imaging time requirements and gel dose response are investigated. Where possible, recommendations are made for optimizing parameters to enhance system performance. The dose resolution achievable with an optimized system is calculated given voxel size and imaging time constraints. Results are compared with MRI and optical CT polymer gel dosimetry results available in the literature.

Hybrid ANN optimized artificial fish swarm algorithm based classifier for classification of suspicious lesions in breast DCE-MRI

NASA Astrophysics Data System (ADS)

Janaki Sathya, D.; Geetha, K.

2017-12-01

Automatic mass or lesion classification systems are developed to aid in distinguishing between malignant and benign lesions present in the breast DCE-MR images, the systems need to improve both the sensitivity and specificity of DCE-MR image interpretation in order to be successful for clinical use. A new classifier (a set of features together with a classification method) based on artificial neural networks trained using artificial fish swarm optimization (AFSO) algorithm is proposed in this paper. The basic idea behind the proposed classifier is to use AFSO algorithm for searching the best combination of synaptic weights for the neural network. An optimal set of features based on the statistical textural features is presented. The investigational outcomes of the proposed suspicious lesion classifier algorithm therefore confirm that the resulting classifier performs better than other such classifiers reported in the literature. Therefore this classifier demonstrates that the improvement in both the sensitivity and specificity are possible through automated image analysis.

In vivo multiphoton-microscopy of picosecond-laser-induced optical breakdown in human skin.

PubMed

Balu, Mihaela; Lentsch, Griffin; Korta, Dorota Z; König, Karsten; Kelly, Kristen M; Tromberg, Bruce J; Zachary, Christopher B

2017-08-01

Improvements in skin appearance resulting from treatment with fractionated picosecond-lasers have been noted, but optimizing the treatment efficacy depends on a thorough understanding of the specific skin response. The development of non-invasive laser imaging techniques in conjunction with laser therapy can potentially provide feedback for guidance and optimizing clinical outcome. The purpose of this study was to demonstrate the capability of multiphoton microscopy (MPM), a high-resolution, label-free imaging technique, to characterize in vivo the skin response to a fractionated non-ablative picosecond-laser treatment. Two areas on the arm of a volunteer were treated with a fractionated picosecond laser at the Dermatology Clinic, UC Irvine. The skin response to treatment was imaged in vivo with a clinical MPM-based tomograph at 3 hours and 24 hours after treatment and seven additional time points over a 4-week period. MPM revealed micro-injuries present in the epidermis. Pigmented cells were particularly damaged in the process, suggesting that melanin is likely the main absorber for laser induced optical breakdown. Damaged individual cells were distinguished as early as 3 hours post pico-laser treatment with the 532 nm wavelength, and 24 hours post-treatment with both 532 and 1064 nm wavelengths. At later time points, clusters of cellular necrotic debris were imaged across the treated epidermis. After 24 hours of treatment, inflammatory cells were imaged in the proximity of epidermal micro-injuries. The epidermal injuries were exfoliated over a 4-week period. This observational and descriptive pilot study demonstrates that in vivo MPM imaging can be used non-invasively to provide label-free contrast for describing changes in human skin following a fractionated non-ablative laser treatment. The results presented in this study represent the groundwork for future longitudinal investigations on an expanded number of subjects to understand the response to treatment in different skin types with different laser parameters, critical factors in optimizing treatment outcome. Lasers Surg. Med. 49:555-562, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Reducing acquisition time in clinical MRI by data undersampling and compressed sensing reconstruction

NASA Astrophysics Data System (ADS)

Hollingsworth, Kieren Grant

2015-11-01

MRI is often the most sensitive or appropriate technique for important measurements in clinical diagnosis and research, but lengthy acquisition times limit its use due to cost and considerations of patient comfort and compliance. Once an image field of view and resolution is chosen, the minimum scan acquisition time is normally fixed by the amount of raw data that must be acquired to meet the Nyquist criteria. Recently, there has been research interest in using the theory of compressed sensing (CS) in MR imaging to reduce scan acquisition times. The theory argues that if our target MR image is sparse, having signal information in only a small proportion of pixels (like an angiogram), or if the image can be mathematically transformed to be sparse then it is possible to use that sparsity to recover a high definition image from substantially less acquired data. This review starts by considering methods of k-space undersampling which have already been incorporated into routine clinical imaging (partial Fourier imaging and parallel imaging), and then explains the basis of using compressed sensing in MRI. The practical considerations of applying CS to MRI acquisitions are discussed, such as designing k-space undersampling schemes, optimizing adjustable parameters in reconstructions and exploiting the power of combined compressed sensing and parallel imaging (CS-PI). A selection of clinical applications that have used CS and CS-PI prospectively are considered. The review concludes by signposting other imaging acceleration techniques under present development before concluding with a consideration of the potential impact and obstacles to bringing compressed sensing into routine use in clinical MRI.

Performance evaluation of photoacoustic oximetry imaging systems using a dynamic blood flow phantom with tunable oxygen saturation

NASA Astrophysics Data System (ADS)

Vogt, William C.; Zhou, Xuewen; Andriani, Rudy; Wear, Keith A.; Garra, Brian S.; Pfefer, Joshua

2018-02-01

Photoacoustic Imaging (PAI) is an emerging technology with strong potential for broad clinical applications from breast cancer detection to cerebral monitoring due to its ability to compute maps of blood oxygen saturation (SO2) distribution in deep tissues using multispectral imaging. However, no well-validated consensus test methods currently exist for evaluating oximetry-specific performance characteristics of PAI devices. We have developed a phantombased flow system capable of rapid SO2 adjustment to serve as a test bed for elucidation of factors impacting SO2 measurement and quantitative characterization of device performance. The flow system is comprised of a peristaltic pump, membrane oxygenator, oxygen and nitrogen gas, and in-line oxygen, pH, and temperature sensors that enable real-time estimation of SO2 reference values. Bovine blood was delivered through breast-relevant tissue phantoms containing vessel-mimicking fluid channels, which were imaged using a custom multispectral PAI system. Blood was periodically drawn for SO2 measurement in a clinical-grade CO-oximeter. We used this flow phantom system to evaluate the impact of device parameters (e.g.,wavelength-dependent fluence corrections) and tissue parameters (e.g. fluid channel depth, blood SO2, spectral coloring artifacts) on oximetry measurement accuracy. Results elucidated key challenges in PAI oximetry and device design trade-offs, which subsequently allowed for optimization of system performance. This approach provides a robust benchtop test platform that can support PAI oximetry device optimization, performance validation, and clinical translation, and may inform future development of consensus test methods for performance assessment of photoacoustic oximetry imaging systems.

Meeting report from the Prostate Cancer Foundation PSMA-directed radionuclide scientific working group.

PubMed

Miyahira, Andrea K; Pienta, Kenneth J; Morris, Michael J; Bander, Neil H; Baum, Richard P; Fendler, Wolfgang P; Goeckeler, William; Gorin, Michael A; Hennekes, Hartwig; Pomper, Martin G; Sartor, Oliver; Tagawa, Scott T; Williams, Scott; Soule, Howard R

2018-05-01

The Prostate Cancer Foundation (PCF) convened a PSMA-Directed Radionuclide Scientific Working Group on November 14, 2017, at Weill Cornell Medicine, New York, NY. The meeting was attended by 35 global investigators with expertise in prostate cancer biology, radionuclide therapy, molecular imaging, prostate-specific membrane antigen (PSMA)-targeted agents, drug development, and prostate cancer clinical trials. The goal of this meeting was to discuss the potential for using PSMA-targeted radionuclide agents for the treatment of advanced prostate cancer and to define the studies and clinical trials necessary for validating and optimizing the use of these agents. Several major topic areas were discussed including the overview of PSMA biology, lessons and applications of PSMA-targeted PET imaging, the nuances of designing PSMA-targeted radionuclide agents, clinical experiences with PSMA-targeted radionuclides, PCF-funded projects to accelerate PSMA-targeted radionuclide therapy, and barriers to the use of radionuclide treatments in widespread clinical practice. This article reviews the major topics discussed at the meeting with the goal of promoting research that will validate and optimize the use of PSMA-targeted radionuclide therapies for the treatment of advanced prostate cancer. © 2018 Wiley Periodicals, Inc.

Clinical performance of a prototype flat-panel digital detector for general radiography

NASA Astrophysics Data System (ADS)

Huda, Walter; Scalzetti, Ernest M.; Roskopf, Marsha L.; Geiger, Robert

2001-08-01

Digital radiographs obtained using a prototype Digital Radiography System (Stingray) were compared with those obtained using conventional screen-film. Forty adult volunteers each had two identical radiographs taken at the same level of radiation exposure, one using screen-film and the other the digital detector. Each digital image was processed by hand to ensure that the printed quality was optimal. Ten radiologists compared the diagnostic image quality of the digital images with the corresponding film radiographs using a seven point ranking scheme.

Liver imaging with ferumoxides (Feridex): fundamentals, controversies, and practical aspects.

PubMed

Clément, O; Siauve, N; Cuénod, C A; Frija, G

1998-06-01

Superparamagnetic nanoparticles (Feridex) have been recently made available to the radiological community as a contrast agent for MR imaging of the liver. This article reviews the principal physicochemical characteristics of this new compound, with an emphasis on the explanation of the contrast obtained (either positive or negative enhancement) that depends on the local concentration and the sequence used. The clinical use of Feridex is detailed, both for lesion detection and characterization. Finally, some guidelines for image optimization are given.

Improved dose-volume histogram estimates for radiopharmaceutical therapy by optimizing quantitative SPECT reconstruction parameters

NASA Astrophysics Data System (ADS)

Cheng, Lishui; Hobbs, Robert F.; Segars, Paul W.; Sgouros, George; Frey, Eric C.

2013-06-01

In radiopharmaceutical therapy, an understanding of the dose distribution in normal and target tissues is important for optimizing treatment. Three-dimensional (3D) dosimetry takes into account patient anatomy and the nonuniform uptake of radiopharmaceuticals in tissues. Dose-volume histograms (DVHs) provide a useful summary representation of the 3D dose distribution and have been widely used for external beam treatment planning. Reliable 3D dosimetry requires an accurate 3D radioactivity distribution as the input. However, activity distribution estimates from SPECT are corrupted by noise and partial volume effects (PVEs). In this work, we systematically investigated OS-EM based quantitative SPECT (QSPECT) image reconstruction in terms of its effect on DVHs estimates. A modified 3D NURBS-based Cardiac-Torso (NCAT) phantom that incorporated a non-uniform kidney model and clinically realistic organ activities and biokinetics was used. Projections were generated using a Monte Carlo (MC) simulation; noise effects were studied using 50 noise realizations with clinical count levels. Activity images were reconstructed using QSPECT with compensation for attenuation, scatter and collimator-detector response (CDR). Dose rate distributions were estimated by convolution of the activity image with a voxel S kernel. Cumulative DVHs were calculated from the phantom and QSPECT images and compared both qualitatively and quantitatively. We found that noise, PVEs, and ringing artifacts due to CDR compensation all degraded histogram estimates. Low-pass filtering and early termination of the iterative process were needed to reduce the effects of noise and ringing artifacts on DVHs, but resulted in increased degradations due to PVEs. Large objects with few features, such as the liver, had more accurate histogram estimates and required fewer iterations and more smoothing for optimal results. Smaller objects with fine details, such as the kidneys, required more iterations and less smoothing at early time points post-radiopharmaceutical administration but more smoothing and fewer iterations at later time points when the total organ activity was lower. The results of this study demonstrate the importance of using optimal reconstruction and regularization parameters. Optimal results were obtained with different parameters at each time point, but using a single set of parameters for all time points produced near-optimal dose-volume histograms.

Optimization and comparison of simultaneous and separate acquisition protocols for dual isotope myocardial perfusion SPECT.

PubMed

Ghaly, Michael; Links, Jonathan M; Frey, Eric C

2015-07-07

Dual-isotope simultaneous-acquisition (DISA) rest-stress myocardial perfusion SPECT (MPS) protocols offer a number of advantages over separate acquisition. However, crosstalk contamination due to scatter in the patient and interactions in the collimator degrade image quality. Compensation can reduce the effects of crosstalk, but does not entirely eliminate image degradations. Optimizing acquisition parameters could further reduce the impact of crosstalk. In this paper we investigate the optimization of the rest Tl-201 energy window width and relative injected activities using the ideal observer (IO), a realistic digital phantom population and Monte Carlo (MC) simulated Tc-99m and Tl-201 projections as a means to improve image quality. We compared performance on a perfusion defect detection task for Tl-201 acquisition energy window widths varying from 4 to 40 keV centered at 72 keV for a camera with a 9% energy resolution. We also investigated 7 different relative injected activities, defined as the ratio of Tc-99m and Tl-201 activities, while keeping the total effective dose constant at 13.5 mSv. For each energy window and relative injected activity, we computed the IO test statistics using a Markov chain Monte Carlo (MCMC) method for an ensemble of 1,620 triplets of fixed and reversible defect-present, and defect-absent noisy images modeling realistic background variations. The volume under the 3-class receiver operating characteristic (ROC) surface (VUS) was estimated and served as the figure of merit. For simultaneous acquisition, the IO suggested that relative Tc-to-Tl injected activity ratios of 2.6-5 and acquisition energy window widths of 16-22% were optimal. For separate acquisition, we observed a broad range of optimal relative injected activities from 2.6 to 12.1 and acquisition energy window of widths 16-22%. A negative correlation between Tl-201 injected activity and the width of the Tl-201 energy window was observed in these ranges. The results also suggested that DISA methods could potentially provide image quality as good as that obtained with separate acquisition protocols. We compared observer performance for the optimized protocols and the current clinical protocol using separate acquisition. The current clinical protocols provided better performance at a cost of injecting the patient with approximately double the injected activity of Tc-99m and Tl-201, resulting in substantially increased radiation dose.

Challenges in pediatric neuroanesthesia: awake craniotomy, intraoperative magnetic resonance imaging, and interventional neuroradiology.

PubMed

McClain, Craig D; Landrigan-Ossar, Mary

2014-03-01

This article gives a review of 3 challenges in caring for children undergoing neurosurgical and neurointerventional procedures. Anesthesiologists may have experience with certain aspects of these situations but may not have extensive experience with each clinical setting. This review addresses issues with awake craniotomy, intraoperative magnetic resonance imaging, and neurointerventional procedures in children with neurologic disease. Familiarization with these complex clinical scenarios and their unique considerations allows the anesthesiologist to deliver optimal care and helps facilitate the best possible outcome for these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical experience with a high-performance ATM-connected DICOM archive for cardiology

NASA Astrophysics Data System (ADS)

Solomon, Harry P.

1997-05-01

A system to archive large image sets, such as cardiac cine runs, with near realtime response must address several functional and performance issues, including efficient use of a high performance network connection with standard protocols, an architecture which effectively integrates both short- and long-term mass storage devices, and a flexible data management policy which allows optimization of image distribution and retrieval strategies based on modality and site-specific operational use. Clinical experience with such as archive has allowed evaluation of these systems issues and refinement of a traffic model for cardiac angiography.

Continuous Shape Estimation of Continuum Robots Using X-ray Images

PubMed Central

Lobaton, Edgar J.; Fu, Jinghua; Torres, Luis G.; Alterovitz, Ron

2015-01-01

We present a new method for continuously and accurately estimating the shape of a continuum robot during a medical procedure using a small number of X-ray projection images (e.g., radiographs or fluoroscopy images). Continuum robots have curvilinear structure, enabling them to maneuver through constrained spaces by bending around obstacles. Accurately estimating the robot’s shape continuously over time is crucial for the success of procedures that require avoidance of anatomical obstacles and sensitive tissues. Online shape estimation of a continuum robot is complicated by uncertainty in its kinematic model, movement of the robot during the procedure, noise in X-ray images, and the clinical need to minimize the number of X-ray images acquired. Our new method integrates kinematics models of the robot with data extracted from an optimally selected set of X-ray projection images. Our method represents the shape of the continuum robot over time as a deformable surface which can be described as a linear combination of time and space basis functions. We take advantage of probabilistic priors and numeric optimization to select optimal camera configurations, thus minimizing the expected shape estimation error. We evaluate our method using simulated concentric tube robot procedures and demonstrate that obtaining between 3 and 10 images from viewpoints selected by our method enables online shape estimation with errors significantly lower than using the kinematic model alone or using randomly spaced viewpoints. PMID:26279960

Continuous Shape Estimation of Continuum Robots Using X-ray Images.

PubMed

Lobaton, Edgar J; Fu, Jinghua; Torres, Luis G; Alterovitz, Ron

2013-05-06

We present a new method for continuously and accurately estimating the shape of a continuum robot during a medical procedure using a small number of X-ray projection images (e.g., radiographs or fluoroscopy images). Continuum robots have curvilinear structure, enabling them to maneuver through constrained spaces by bending around obstacles. Accurately estimating the robot's shape continuously over time is crucial for the success of procedures that require avoidance of anatomical obstacles and sensitive tissues. Online shape estimation of a continuum robot is complicated by uncertainty in its kinematic model, movement of the robot during the procedure, noise in X-ray images, and the clinical need to minimize the number of X-ray images acquired. Our new method integrates kinematics models of the robot with data extracted from an optimally selected set of X-ray projection images. Our method represents the shape of the continuum robot over time as a deformable surface which can be described as a linear combination of time and space basis functions. We take advantage of probabilistic priors and numeric optimization to select optimal camera configurations, thus minimizing the expected shape estimation error. We evaluate our method using simulated concentric tube robot procedures and demonstrate that obtaining between 3 and 10 images from viewpoints selected by our method enables online shape estimation with errors significantly lower than using the kinematic model alone or using randomly spaced viewpoints.

Optimizing the interpretation of CT for appendicitis: modeling health utilities for clinical practice.

PubMed

Blackmore, C Craig; Terasawa, Teruhiko

2006-02-01

Error in radiology can be reduced by standardizing the interpretation of imaging studies to the optimum sensitivity and specificity. In this report, the authors demonstrate how the optimal interpretation of appendiceal computed tomography (CT) can be determined and how it varies in different clinical scenarios. Utility analysis and receiver operating characteristic (ROC) curve modeling were used to determine the trade-off between false-positive and false-negative test results to determine the optimal operating point on the ROC curve for the interpretation of appendicitis CT. Modeling was based on a previous meta-analysis for the accuracy of CT and on literature estimates of the utilities of various health states. The posttest probability of appendicitis was derived using Bayes's theorem. At a low prevalence of disease (screening), appendicitis CT should be interpreted at high specificity (97.7%), even at the expense of lower sensitivity (75%). Conversely, at a high probability of disease, high sensitivity (97.4%) is preferred (specificity 77.8%). When the clinical diagnosis of appendicitis is equivocal, CT interpretation should emphasize both sensitivity and specificity (sensitivity 92.3%, specificity 91.5%). Radiologists can potentially decrease medical error and improve patient health by varying the interpretation of appendiceal CT on the basis of the clinical probability of appendicitis. This report is an example of how utility analysis can be used to guide radiologists in the interpretation of imaging studies and provide guidance on appropriate targets for the standardization of interpretation.

MO-FG-207-00: Technological Advances in PET/MR Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2015-06-15

The use of integrated PET/MRI systems in clinical applications can best benefit from understanding their technological advances and limitations. The currently available clinical PET/MRI systems have their own characteristics. Thorough analyses of existing technical data and evaluation of necessary performance metrics for quality assurances could be conducted to optimize application-specific PET/MRI protocols. This Symposium will focus on technical advances and limitations of clinical PET/MRI systems, and how this exciting imaging modality can be utilized in applications that can benefit from both PET and MRI. Learning Objectives: To understand the technological advances of clinical PET/MRI systems To correctly identify clinical applicationsmore » that can benefit from PET/MRI To understand ongoing work to further improve the current PET/MRI technology Floris Jansen is a GE Healthcare employee.« less

[Optimal beam quality for chest digital radiography].

PubMed

Oda, Nobuhiro; Tabata, Yoshito; Nakano, Tsutomu

2014-11-01

To investigate the optimal beam quality for chest computed radiography (CR), we measured the radiographic contrast and evaluated the image quality of chest CR using various X-ray tube voltages. The contrast between lung and rib or heart increased on CR images obtained by lowering the tube voltage from 140 to 60 kV, but the degree of increase was less. Scattered radiation was reduced on CR images with a lower tube voltage. The Wiener spectrum of CR images with a low tube voltage showed a low value under identical conditions of amount of light stimulated emission. The quality of chest CR images obtained using a lower tube voltage (80 kV and 100 kV) was evaluated as being superior to those obtained with a higher tube voltage (120 kV and 140 kV). Considering the problem of tube loading and exposure in clinical applications, a tube voltage of 90 to 100 kV (0.1 mm copper filter backed by 0.5 mm aluminum) is recommended for chest CR.

Optimization of transmission scan duration for 15O PET study with sequential dual tracer administration using N-index.

PubMed

Kudomi, Nobuyuki; Watabe, Hiroshi; Hayashi, Takuya; Oka, Hisashi; Miyake, Yoshinori; Iida, Hidehiro

2010-06-01

Cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of O(2) (CMRO(2)) can be quantified by PET with the administration of H (2) (15) O and (15)O(2). Recently, a shortening in the duration of these measurements was achieved by the sequential administration of dual tracers of (15)O(2) and H (2) (15) O with PET acquisition and integration method (DARG method). A transmission scan is generally required for correcting photon attenuation in advance of PET scan. Although the DARG method can shorten the total study duration to around 30 min, the transmission scan duration has not been optimized and has possibility to shorten its duration. Our aim of this study was to determine the optimal duration for the transmission scan. We introduced 'N-index', which estimates the noise level on an image obtained by subtracting two statistically independent and physiologically equivalent images. The relationship between noise on functional images and duration of the transmission scan was investigated by N-index. We performed phantom studies to test whether the N-index reflects the pixel noise in a PET image. We also estimated the noise level by the N-index on CBF, OEF and CMRO(2) images from DARG method in clinical patients, and investigated an optimal true count of the transmission scan. We found tight correlation between pixel noise and N-index in the phantom study. By investigating relationship between the transmission scan duration and N-index value for the functional images by DARG method, we revealed that the transmission data with true counts of more than 40 Mcounts results in CBF, OEF, and CMRO(2) images of reasonable quantitative accuracy and quality. The present study suggests that further shortening of DARG measurement is possible by abridging the transmission scan. The N-index could be used to determine the optimal measurement condition when examining the quality of image.

Technical Note: FreeCT_ICD: An Open Source Implementation of a Model-Based Iterative Reconstruction Method using Coordinate Descent Optimization for CT Imaging Investigations.

PubMed

Hoffman, John M; Noo, Frédéric; Young, Stefano; Hsieh, Scott S; McNitt-Gray, Michael

2018-06-01

To facilitate investigations into the impacts of acquisition and reconstruction parameters on quantitative imaging, radiomics and CAD using CT imaging, we previously released an open source implementation of a conventional weighted filtered backprojection reconstruction called FreeCT_wFBP. Our purpose was to extend that work by providing an open-source implementation of a model-based iterative reconstruction method using coordinate descent optimization, called FreeCT_ICD. Model-based iterative reconstruction offers the potential for substantial radiation dose reduction, but can impose substantial computational processing and storage requirements. FreeCT_ICD is an open source implementation of a model-based iterative reconstruction method that provides a reasonable tradeoff between these requirements. This was accomplished by adapting a previously proposed method that allows the system matrix to be stored with a reasonable memory requirement. The method amounts to describing the attenuation coefficient using rotating slices that follow the helical geometry. In the initially-proposed version, the rotating slices are themselves described using blobs. We have replaced this description by a unique model that relies on tri-linear interpolation together with the principles of Joseph's method. This model offers an improvement in memory requirement while still allowing highly accurate reconstruction for conventional CT geometries. The system matrix is stored column-wise and combined with an iterative coordinate descent (ICD) optimization. The result is FreeCT_ICD, which is a reconstruction program developed on the Linux platform using C++ libraries and the open source GNU GPL v2.0 license. The software is capable of reconstructing raw projection data of helical CT scans. In this work, the software has been described and evaluated by reconstructing datasets exported from a clinical scanner which consisted of an ACR accreditation phantom dataset and a clinical pediatric thoracic scan. For the ACR phantom, image quality was comparable to clinical reconstructions as well as reconstructions using open-source FreeCT_wFBP software. The pediatric thoracic scan also yielded acceptable results. In addition, we did not observe any deleterious impact in image quality associated with the utilization of rotating slices. These evaluations also demonstrated reasonable tradeoffs in storage requirements and computational demands. FreeCT_ICD is an open-source implementation of a model-based iterative reconstruction method that extends the capabilities of previously released open source reconstruction software and provides the ability to perform vendor-independent reconstructions of clinically acquired raw projection data. This implementation represents a reasonable tradeoff between storage and computational requirements and has demonstrated acceptable image quality in both simulated and clinical image datasets. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Dose responses in a normoxic polymethacrylic acid gel dosimeter using optimal CT scanning parameters

NASA Astrophysics Data System (ADS)

Cho, K. H.; Cho, S. J.; Lee, S.; Lee, S. H.; Min, C. K.; Kim, Y. H.; Moon, S. K.; Kim, E. S.; Chang, A. R.; Kwon, S. I.

2012-05-01

The dosimetric characteristics of normoxic polymethacrylic acid gels are investigated using optimal CT scanning parameters and the possibility of their clinical application is also considered. The effects of CT scanning parameters (tube voltage, tube current, scan time, slick thickness, field of view, and reconstruction algorithm) are experimentally investigated to determine the optimal parameters for minimizing the amount of noise in images obtained using normoxic polymethacrylic acid gel. In addition, the dose sensitivity, dose response, accuracy, and reproducibility of the normoxic polymethacrylic acid gel are evaluated. CT images are obtained using a head phantom that is fabricated for clinical applications. In addition, IMRT treatment planning is performed using a Tomotherapy radiation treatment planning system. A program for analyzing the results is produced using Visual C. A comparison between the treatment planning and the CT images of irradiated gels is performed. The dose sensitivity is found to be 2.41±0.04 HGy-1. The accuracies of dose evaluation at doses of 2 Gy and 4 Gy are 3.0% and 2.6%, respectively, and their reproducibilities are 2.0% and 2.1%, respectively. In the comparison of gel and Tomotherpay planning, the pass rate of the γ-index, based on the reference values of a dose error of 3% and a DTA of 3 mm, is 93.7%.

Building Imaging Institutes of Patient Care Outcomes: Imaging as a Nidus for Innovation in Clinical Care, Research, and Education.

PubMed

Petrou, Myria; Cronin, Paul; Altaee, Duaa K; Kelly, Aine M; Foerster, Bradley R

2018-05-01

Traditionally, radiologists have been responsible for the protocol of imaging studies, imaging acquisition, supervision of imaging technologists, and interpretation and reporting of imaging findings. In this article, we outline how radiology needs to change and adapt to a role of providing value-based, integrated health-care delivery. We believe that the way to best serve our specialty and our patients is to undertake a fundamental paradigm shift in how we practice. We describe the need for imaging institutes centered on disease entities (eg, lung cancer, multiple sclerosis) to not only optimize clinical care and patient outcomes, but also spur the development of a new educational focus, which will increase opportunities for medical trainees and other health professionals. These institutes will also serve as unique environments for testing and implementing new technologies and for generating new ideas for research and health-care delivery. We propose that the imaging institutes focus on how imaging practices-including new innovations-improve patient care outcomes within a specific disease framework. These institutes will allow our specialty to lead patient care, provide the necessary infrastructure for state-of-the art-education of trainees, and stimulate innovative and clinically relevant research. Copyright © 2018 The Association of University Radiologists. All rights reserved.

Integrating Soluble Biomarkers and Imaging Technologies in the Identification of Vulnerable Atherosclerotic Patients

PubMed Central

Páramo, José A.; Rodríguez JA, José A.; Orbe, Josune

2006-01-01

The clinical utility of a biomarker depends on its ability to identify high-risk individuals to optimally manage the patient. A new biomarker would be of clinical value if it is accurate and reliable, provides good sensitivity and specificity, and is available for widespread application. Data are accumulating on the potential clinical utility of integrating imaging technologies and circulating biomarkers for the identification of vulnerable (high-risk) cardiovascular patients. A multi-biomarker strategy consisting of markers of inflammation, hemostasis and thrombosis, proteolysis and oxidative stress, combined with new imaging modalities (optical coherence tomography, virtual histology plus IVUS, PET) can increase our ability to identify such thombosis-prone patients. In an ideal scenario, cardiovascular biomarkers and imaging combined will provide a better diagnostic tool to identify high-risk individuals and also more efficient methods for effective therapies to reduce such cardiovascular risk. However, additional studies are required in order to show that this approach can contribute to improved diagnostic and therapeutic of atherosclerotic disease. PMID:19690647

Integrating soluble biomarkers and imaging technologies in the identification of vulnerable atherosclerotic patients.

PubMed

Páramo, José A; Rodríguez Ja, José A; Orbe, Josune

2007-02-07

The clinical utility of a biomarker depends on its ability to identify high-risk individuals to optimally manage the patient. A new biomarker would be of clinical value if it is accurate and reliable, provides good sensitivity and specificity, and is available for widespread application. Data are accumulating on the potential clinical utility of integrating imaging technologies and circulating biomarkers for the identification of vulnerable (high-risk) cardiovascular patients. A multi-biomarker strategy consisting of markers of inflammation, hemostasis and thrombosis, proteolysis and oxidative stress, combined with new imaging modalities (optical coherence tomography, virtual histology plus IVUS, PET) can increase our ability to identify such thombosis-prone patients. In an ideal scenario, cardiovascular biomarkers and imaging combined will provide a better diagnostic tool to identify high-risk individuals and also more efficient methods for effective therapies to reduce such cardiovascular risk. However, additional studies are required in order to show that this approach can contribute to improved diagnostic and therapeutic of atherosclerotic disease.

An Automatic Assessment System of Diabetic Foot Ulcers Based on Wound Area Determination, Color Segmentation, and Healing Score Evaluation.

PubMed

Wang, Lei; Pedersen, Peder C; Strong, Diane M; Tulu, Bengisu; Agu, Emmanuel; Ignotz, Ron; He, Qian

2015-08-07

For individuals with type 2 diabetes, foot ulcers represent a significant health issue. The aim of this study is to design and evaluate a wound assessment system to help wound clinics assess patients with foot ulcers in a way that complements their current visual examination and manual measurements of their foot ulcers. The physical components of the system consist of an image capture box, a smartphone for wound image capture and a laptop for analyzing the wound image. The wound image assessment algorithms calculate the overall wound area, color segmented wound areas, and a healing score, to provide a quantitative assessment of the wound healing status both for a single wound image and comparisons of subsequent images to an initial wound image. The system was evaluated by assessing foot ulcers for 12 patients in the Wound Clinic at University of Massachusetts Medical School. As performance measures, the Matthews correlation coefficient (MCC) value for the wound area determination algorithm tested on 32 foot ulcer images was .68. The clinical validity of our healing score algorithm relative to the experienced clinicians was measured by Krippendorff's alpha coefficient (KAC) and ranged from .42 to .81. Our system provides a promising real-time method for wound assessment based on image analysis. Clinical comparisons indicate that the optimized mean-shift-based algorithm is well suited for wound area determination. Clinical evaluation of our healing score algorithm shows its potential to provide clinicians with a quantitative method for evaluating wound healing status. © 2015 Diabetes Technology Society.

Recent Development of Inorganic Nanoparticles for Biomedical Imaging

PubMed Central

2018-01-01

Inorganic nanoparticle-based biomedical imaging probes have been studied extensively as a potential alternative to conventional molecular imaging probes. Not only can they provide better imaging performance but they can also offer greater versatility of multimodal, stimuli-responsive, and targeted imaging. However, inorganic nanoparticle-based probes are still far from practical use in clinics due to safety concerns and less-optimized efficiency. In this context, it would be valuable to look over the underlying issues. This outlook highlights the recent advances in the development of inorganic nanoparticle-based probes for MRI, CT, and anti-Stokes shift-based optical imaging. Various issues and possibilities regarding the construction of imaging probes are discussed, and future research directions are suggested. PMID:29632878

Near-infrared fluorescent nanoprobes for cancer molecular imaging: status and challenges

PubMed Central

He, Xiaoxiao; Gao, Jinhao; Gambhir, Sanjiv Sam; Cheng, Zhen

2010-01-01

Near-infrared fluorescence (NIRF) imaging promises to improve cancer imaging and management; advances in nanomaterials allow scientists to combine new nanoparticles with NIRF imaging techniques, thereby fulfilling this promise. Here, we present a synopsis of current developments in NIRF nanoprobes, their use in imaging small living subjects, their pharmacokinetics and toxicity and finally their integration into multimodal imaging strategies. We also discuss challenges impeding the clinical translation of NIRF nanoprobes for molecular imaging of cancer. Whereas utilization of most NIRF nanoprobes remains at a proof-of-principle stage, optimizing the impact of nanomedicine in cancer patient diagnosis and management will likely be realized through persistent interdisciplinary amalgamation of diverse research fields. PMID:20870460

Method for inserting noise in digital mammography to simulate reduction in radiation dose

NASA Astrophysics Data System (ADS)

Borges, Lucas R.; de Oliveira, Helder C. R.; Nunes, Polyana F.; Vieira, Marcelo A. C.

2015-03-01

The quality of clinical x-ray images is closely related to the radiation dose used in the imaging study. The general principle for selecting the radiation is ALARA ("as low as reasonably achievable"). The practical optimization, however, remains challenging. It is well known that reducing the radiation dose increases the quantum noise, which could compromise the image quality. In order to conduct studies about dose reduction in mammography, it would be necessary to acquire repeated clinical images, from the same patient, with different dose levels. However, such practice would be unethical due to radiation related risks. One solution is to simulate the effects of dose reduction in clinical images. This work proposes a new method, based on the Anscombe transformation, which simulates dose reduction in digital mammography by inserting quantum noise into clinical mammograms acquired with the standard radiation dose. Thus, it is possible to simulate different levels of radiation doses without exposing the patient to new levels of radiation. Results showed that the achieved quality of simulated images generated with our method is the same as when using other methods found in the literature, with the novelty of using the Anscombe transformation for converting signal-independent Gaussian noise into signal-dependent quantum noise.

Comparison of methods for quantitative evaluation of endoscopic distortion

NASA Astrophysics Data System (ADS)

Wang, Quanzeng; Castro, Kurt; Desai, Viraj N.; Cheng, Wei-Chung; Pfefer, Joshua

2015-03-01

Endoscopy is a well-established paradigm in medical imaging, and emerging endoscopic technologies such as high resolution, capsule and disposable endoscopes promise significant improvements in effectiveness, as well as patient safety and acceptance of endoscopy. However, the field lacks practical standardized test methods to evaluate key optical performance characteristics (OPCs), in particular the geometric distortion caused by fisheye lens effects in clinical endoscopic systems. As a result, it has been difficult to evaluate an endoscope's image quality or assess its changes over time. The goal of this work was to identify optimal techniques for objective, quantitative characterization of distortion that are effective and not burdensome. Specifically, distortion measurements from a commercially available distortion evaluation/correction software package were compared with a custom algorithm based on a local magnification (ML) approach. Measurements were performed using a clinical gastroscope to image square grid targets. Recorded images were analyzed with the ML approach and the commercial software where the results were used to obtain corrected images. Corrected images based on the ML approach and the software were compared. The study showed that the ML method could assess distortion patterns more accurately than the commercial software. Overall, the development of standardized test methods for characterizing distortion and other OPCs will facilitate development, clinical translation, manufacturing quality and assurance of performance during clinical use of endoscopic technologies.

Image-guided urologic surgery: intraoperative optical imaging and tissue interrogation (Conference Presentation)

NASA Astrophysics Data System (ADS)

Liao, Joseph C.

2017-02-01

Emerging optical imaging technologies can be integrated in the operating room environment during minimally invasive and open urologic surgery, including oncologic surgery of the bladder, prostate, and kidney. These technologies include macroscopic fluorescence imaging that provides contrast enhancement between normal and diseased tissue and microscopic imaging that provides tissue characterization. Optical imaging technologies that have reached the clinical arena in urologic surgery are reviewed, including photodynamic diagnosis, near infrared fluorescence imaging, optical coherence tomography, and confocal laser endomicroscopy. Molecular imaging represents an exciting future arena in conjugating cancer-specific contrast agents to fluorophores to improve the specificity of disease detection. Ongoing efforts are underway to translate optimal targeting agents and imaging modalities, with the goal to improve cancer-specific and functional outcomes.

A Practical Cone-beam CT Scatter Correction Method with Optimized Monte Carlo Simulations for Image-Guided Radiation Therapy

PubMed Central

Xu, Yuan; Bai, Ti; Yan, Hao; Ouyang, Luo; Pompos, Arnold; Wang, Jing; Zhou, Linghong; Jiang, Steve B.; Jia, Xun

2015-01-01

Cone-beam CT (CBCT) has become the standard image guidance tool for patient setup in image-guided radiation therapy. However, due to its large illumination field, scattered photons severely degrade its image quality. While kernel-based scatter correction methods have been used routinely in the clinic, it is still desirable to develop Monte Carlo (MC) simulation-based methods due to their accuracy. However, the high computational burden of the MC method has prevented routine clinical application. This paper reports our recent development of a practical method of MC-based scatter estimation and removal for CBCT. In contrast with conventional MC approaches that estimate scatter signals using a scatter-contaminated CBCT image, our method used a planning CT image for MC simulation, which has the advantages of accurate image intensity and absence of image truncation. In our method, the planning CT was first rigidly registered with the CBCT. Scatter signals were then estimated via MC simulation. After scatter signals were removed from the raw CBCT projections, a corrected CBCT image was reconstructed. The entire workflow was implemented on a GPU platform for high computational efficiency. Strategies such as projection denoising, CT image downsampling, and interpolation along the angular direction were employed to further enhance the calculation speed. We studied the impact of key parameters in the workflow on the resulting accuracy and efficiency, based on which the optimal parameter values were determined. Our method was evaluated in numerical simulation, phantom, and real patient cases. In the simulation cases, our method reduced mean HU errors from 44 HU to 3 HU and from 78 HU to 9 HU in the full-fan and the half-fan cases, respectively. In both the phantom and the patient cases, image artifacts caused by scatter, such as ring artifacts around the bowtie area, were reduced. With all the techniques employed, we achieved computation time of less than 30 sec including the time for both the scatter estimation and CBCT reconstruction steps. The efficacy of our method and its high computational efficiency make our method attractive for clinical use. PMID:25860299

Determination of left ventricular volume, ejection fraction, and myocardial mass by real-time three-dimensional echocardiography

NASA Technical Reports Server (NTRS)

Qin, J. X.; Shiota, T.; Thomas, J. D.

2000-01-01

Reconstructed three-dimensional (3-D) echocardiography is an accurate and reproducible method of assessing left ventricular (LV) functions. However, it has limitations for clinical study due to the requirement of complex computer and echocardiographic analysis systems, electrocardiographic/respiratory gating, and prolonged imaging times. Real-time 3-D echocardiography has a major advantage of conveniently visualizing the entire cardiac anatomy in three dimensions and of potentially accurately quantifying LV volumes, ejection fractions, and myocardial mass in patients even in the presence of an LV aneurysm. Although the image quality of the current real-time 3-D echocardiographic methods is not optimal, its widespread clinical application is possible because of the convenient and fast image acquisition. We review real-time 3-D echocardiographic image acquisition and quantitative analysis for the evaluation of LV function and LV mass.

Determination of left ventricular volume, ejection fraction, and myocardial mass by real-time three-dimensional echocardiography.

PubMed

Qin, J X; Shiota, T; Thomas, J D

2000-11-01

Reconstructed three-dimensional (3-D) echocardiography is an accurate and reproducible method of assessing left ventricular (LV) functions. However, it has limitations for clinical study due to the requirement of complex computer and echocardiographic analysis systems, electrocardiographic/respiratory gating, and prolonged imaging times. Real-time 3-D echocardiography has a major advantage of conveniently visualizing the entire cardiac anatomy in three dimensions and of potentially accurately quantifying LV volumes, ejection fractions, and myocardial mass in patients even in the presence of an LV aneurysm. Although the image quality of the current real-time 3-D echocardiographic methods is not optimal, its widespread clinical application is possible because of the convenient and fast image acquisition. We review real-time 3-D echocardiographic image acquisition and quantitative analysis for the evaluation of LV function and LV mass.

Long-term evaluation of TiO2-based 68Ge/68Ga generators and optimized automation of [68Ga]DOTATOC radiosynthesis.

PubMed

Lin, Mai; Ranganathan, David; Mori, Tetsuya; Hagooly, Aviv; Rossin, Raffaella; Welch, Michael J; Lapi, Suzanne E

2012-10-01

Interest in using (68)Ga is rapidly increasing for clinical PET applications due to its favorable imaging characteristics and increased accessibility. The focus of this study was to provide our long-term evaluations of the two TiO(2)-based (68)Ge/(68)Ga generators and develop an optimized automation strategy to synthesize [(68)Ga]DOTATOC by using HEPES as a buffer system. This data will be useful in standardizing the evaluation of (68)Ge/(68)Ga generators and automation strategies to comply with regulatory issues for clinical use. Copyright © 2012 Elsevier Ltd. All rights reserved.

Traceable working standards with SI units of radiance for characterizing the measurement performance of investigational clinical NIRF imaging devices

NASA Astrophysics Data System (ADS)

Zhu, Banghe; Rasmussen, John C.; Litorja, Maritoni; Sevick-Muraca, Eva M.

2017-03-01

All medical devices for Food and Drug market approval require specifications of performance based upon International System of Units (SI) or units derived from SI for reasons of traceability. Recently, near-infrared fluorescence (NIRF) imaging devices of a variety of designs have emerged on the market and in investigational clinical studies. Yet the design of devices used in the clinical studies vary widely, suggesting variable device performance. Device performance depends upon optimal excitation of NIRF imaging agents, rejection of backscattered excitation and ambient light, and selective collection of fluorescence emanating from the fluorophore. There remains no traceable working standards with SI units of radiance to enable prediction that a given molecular imaging agent can be detected in humans by a given NIRF imaging device. Furthermore, as technologies evolve and as NIRF imaging device components change, there remains no standardized means to track device improvements over time and establish clinical performance without involving clinical trials, often costly. In this study, we deployed a methodology to calibrate luminescent radiance of a stable, solid phantom in SI units of mW/cm2/sr for characterizing the measurement performance of ICCD and IsCMOS camera based NIRF imaging devices, such as signal-to-noise ratio (SNR) and contrast. The methodology allowed determination of superior SNR of the ICCD over the IsCMOS system; comparable contrast of ICCD and IsCMOS depending upon binning strategies.

Toxicity of inorganic nanomaterials in biomedical imaging.

PubMed

Li, Jinxia; Chang, Xueling; Chen, Xiaoxia; Gu, Zhanjun; Zhao, Feng; Chai, Zhifang; Zhao, Yuliang

2014-01-01

Inorganic nanoparticles have shown promising potentials as novel biomedical imaging agents with high sensitivity, high spatial and temporal resolution. To translate the laboratory innovations into clinical applications, their potential toxicities are highly concerned and have to be evaluated comprehensively both in vitro and in vivo before their clinical applications. In this review, we first summarized the in vivo and in vitro toxicities of the representative inorganic nanoparticles used in biomedical imagings. Then we further discuss the origin of nanotoxicity of inorganic nanomaterials, including ROS generation and oxidative stress, chemical instability, chemical composition, the surface modification, dissolution of nanoparticles to release excess free ions of metals, metal redox state, and left-over chemicals from synthesis, etc. We intend to provide the readers a better understanding of the toxicology aspects of inorganic nanomaterials and knowledge for achieving optimized designs of safer inorganic nanomaterials for clinical applications. Copyright © 2014 Elsevier Inc. All rights reserved.

State of the art: dual-energy CT of the abdomen.

PubMed

Marin, Daniele; Boll, Daniel T; Mileto, Achille; Nelson, Rendon C

2014-05-01

Recent technologic advances in computed tomography (CT)--enabling the nearly simultaneous acquisition of clinical images using two different x-ray energy spectra--have sparked renewed interest in dual-energy CT. By interrogating the unique characteristics of different materials at different x-ray energies, dual-energy CT can be used to provide quantitative information about tissue composition, overcoming the limitations of attenuation-based conventional single-energy CT imaging. In the past few years, intensive research efforts have been devoted to exploiting the unique and powerful opportunities of dual-energy CT for a variety of clinical applications. This has led to CT protocol modifications for radiation dose reduction, improved diagnostic performance for detection and characterization of diseases, as well as image quality optimization. In this review, the authors discuss the basic principles, instrumentation and design, examples of current clinical applications in the abdomen and pelvis, and future opportunities of dual-energy CT.

Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research.

PubMed

Bornstein, Michael M; Horner, Keith; Jacobs, Reinhilde

2017-02-01

Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

SU-G-BRA-03: PCA Based Imaging Angle Optimization for 2D Cine MRI Based Radiotherapy Guidance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, T; Yue, N; Jabbour, S

2016-06-15

Purpose: To develop an imaging angle optimization methodology for orthogonal 2D cine MRI based radiotherapy guidance using Principal Component Analysis (PCA) of target motion retrieved from 4DCT. Methods: We retrospectively analyzed 4DCT of 6 patients with lung tumor. A radiation oncologist manually contoured the target volume at the maximal inhalation phase of the respiratory cycle. An object constrained deformable image registration (DIR) method has been developed to track the target motion along the respiration at ten phases. The motion of the center of the target mass has been analyzed using the PCA to find out the principal motion components thatmore » were uncorrelated with each other. Two orthogonal image planes for cineMRI have been determined using this method to minimize the through plane motion during MRI based radiotherapy guidance. Results: 3D target respiratory motion for all 6 patients has been efficiently retrieved from 4DCT. In this process, the object constrained DIR demonstrated satisfactory accuracy and efficiency to enable the automatic motion tracking for clinical application. The average motion amplitude in the AP, lateral, and longitudinal directions were 3.6mm (min: 1.6mm, max: 5.6mm), 1.7mm (min: 0.6mm, max: 2.7mm), and 5.6mm (min: 1.8mm, max: 16.1mm), respectively. Based on PCA, the optimal orthogonal imaging planes were determined for cineMRI. The average angular difference between the PCA determined imaging planes and the traditional AP and lateral imaging planes were 47 and 31 degrees, respectively. After optimization, the average amplitude of through plane motion reduced from 3.6mm in AP images to 2.5mm (min:1.3mm, max:3.9mm); and from 1.7mm in lateral images to 0.6mm (min: 0.2mm, max:1.5mm), while the principal in plane motion amplitude increased from 5.6mm to 6.5mm (min: 2.8mm, max: 17mm). Conclusion: DIR and PCA can be used to optimize the orthogonal image planes of cineMRI to minimize the through plane motion during radiotherapy guidance.« less

Interpreting CARS images of tissue within the C-H-stretching region

NASA Astrophysics Data System (ADS)

Dietzek, Benjamin; Meyer, Tobias; Medyukhina, Anna; Bergner, Norbert; Krafft, Christoph; Romeike, Bernd F. M.; Reichart, Rupert; Kalff, Rolf; Schmitt, Michael; Popp, Jürgen

2014-03-01

Single band coherent anti-Stokes Raman scattering (CARS) microscopy within the CH-stretching region is applied to detect individual cells and nuclei of human brain tissue and brain tumors - an information which allows for histopathologic grading of the tissue. The CARS image contrast within the C-H-stretching region correlated to the tissue composition. Based on the specific application example of identifying nuclei within (coherent) Raman images of neurotissue sections, we shall derive general design parameters for lasers optimally suited to serve in a clinical environment and discuss the potential of recently developed methods to analyze spectrally resolved CARS images and image segmentation algorithms.

Multimodality imaging of ovarian cystic lesions: Review with an imaging based algorithmic approach

PubMed Central

Wasnik, Ashish P; Menias, Christine O; Platt, Joel F; Lalchandani, Usha R; Bedi, Deepak G; Elsayes, Khaled M

2013-01-01

Ovarian cystic masses include a spectrum of benign, borderline and high grade malignant neoplasms. Imaging plays a crucial role in characterization and pretreatment planning of incidentally detected or suspected adnexal masses, as diagnosis of ovarian malignancy at an early stage is correlated with a better prognosis. Knowledge of differential diagnosis, imaging features, management trends and an algorithmic approach of such lesions is important for optimal clinical management. This article illustrates a multi-modality approach in the diagnosis of a spectrum of ovarian cystic masses and also proposes an algorithmic approach for the diagnosis of these lesions. PMID:23671748

Cardiac multidetector computed tomography: basic physics of image acquisition and clinical applications.

PubMed

Bardo, Dianna M E; Brown, Paul

2008-08-01

Cardiac MDCT is here to stay. And, it is more than just imaging coronary arteries. Understanding the differences in and the benefits of one CT scanner from another will help you to optimize the capabilities of the scanner, but requires a basic understanding of the MDCT imaging physics.This review provides key information needed to understand the differences in the types of MDCT scanners, from 64 - 320 detectors, flat panels, single and dual source configurations, step and shoot prospective and retrospective gating, and how each factor influences radiation dose, spatial and temporal resolution, and image noise.

Diffuse reflectance imaging: a tool for guided biopsy

NASA Astrophysics Data System (ADS)

Jayanthi, Jayaraj L.; Subhash, Narayanan; Manju, Stephen; Nisha, Unni G.; Beena, Valappil T.

2012-01-01

Accurate diagnosis of premalignant or malignant oral lesions depends on the quality of the biopsy, adequate clinical information and correct interpretation of the biopsy results. The major clinical challenge is to precisely locate the biopsy site in a clinically suspicious lesion. Dips due to oxygenated hemoglobin absorption have been noticed at 545 and 575 nm in the diffusely reflected white light spectra of oral mucosa and the intensity ratio R545/R575 has been found suited for early detection of oral pre-cancers. A multi-spectral diffuse reflectance (DR) imaging system has been developed consisting of an electron multiplying charge coupled device (EMCCD) camera and a liquid crystal tunable filter for guiding the clinician to an optimal biopsy site. Towards this DR images were recorded from 27 patients with potentially malignant lesions on their tongue (dorsal, lateral and ventral sides) and from 44 healthy controls at 545 and 575 nm with the DR imaging system. False colored ratio image R545/R575 of the lesion provides a visual discerning capability that helps in locating the most malignant site for biopsy. Histopathological report of guided biopsy showed that out of the 27 patients 16 were cancers, 9 pre-cancers and 2 lichen planus. In this clinical trial DR imaging has correctly guided 25 biopsy sites, yielding a sensitivity of 93% and a specificity of 98%, thereby establishing the potential of DR imaging as a tool for guided biopsy.

Urinary bladder cancer T-staging from T2-weighted MR images using an optimal biomarker approach

NASA Astrophysics Data System (ADS)

Wang, Chuang; Udupa, Jayaram K.; Tong, Yubing; Chen, Jerry; Venigalla, Sriram; Odhner, Dewey; Guzzo, Thomas J.; Christodouleas, John; Torigian, Drew A.

2018-02-01

Magnetic resonance imaging (MRI) is often used in clinical practice to stage patients with bladder cancer to help plan treatment. However, qualitative assessment of MR images is prone to inaccuracies, adversely affecting patient outcomes. In this paper, T2-weighted MR image-based quantitative features were extracted from the bladder wall in 65 patients with bladder cancer to classify them into two primary tumor (T) stage groups: group 1 - T stage < T2, with primary tumor locally confined to the bladder, and group 2 - T stage < T2, with primary tumor locally extending beyond the bladder. The bladder was divided into 8 sectors in the axial plane, where each sector has a corresponding reference standard T stage that is based on expert radiology qualitative MR image review and histopathologic results. The performance of the classification for correct assignment of T stage grouping was then evaluated at both the patient level and the sector level. Each bladder sector was divided into 3 shells (inner, middle, and outer), and 15,834 features including intensity features and texture features from local binary pattern and gray-level co-occurrence matrix were extracted from the 3 shells of each sector. An optimal feature set was selected from all features using an optimal biomarker approach. Nine optimal biomarker features were derived based on texture properties from the middle shell, with an area under the ROC curve of AUC value at the sector and patient level of 0.813 and 0.806, respectively.

Optimization of OSEM parameters in myocardial perfusion imaging reconstruction as a function of body mass index: a clinical approach*

PubMed Central

de Barros, Pietro Paolo; Metello, Luis F.; Camozzato, Tatiane Sabriela Cagol; Vieira, Domingos Manuel da Silva

2015-01-01

Objective The present study is aimed at contributing to identify the most appropriate OSEM parameters to generate myocardial perfusion imaging reconstructions with the best diagnostic quality, correlating them with patients’ body mass index. Materials and Methods The present study included 28 adult patients submitted to myocardial perfusion imaging in a public hospital. The OSEM method was utilized in the images reconstruction with six different combinations of iterations and subsets numbers. The images were analyzed by nuclear cardiology specialists taking their diagnostic value into consideration and indicating the most appropriate images in terms of diagnostic quality. Results An overall scoring analysis demonstrated that the combination of four iterations and four subsets has generated the most appropriate images in terms of diagnostic quality for all the classes of body mass index; however, the role played by the combination of six iterations and four subsets is highlighted in relation to the higher body mass index classes. Conclusion The use of optimized parameters seems to play a relevant role in the generation of images with better diagnostic quality, ensuring the diagnosis and consequential appropriate and effective treatment for the patient. PMID:26543282

Assessment of automatic exposure control performance in digital mammography using a no-reference anisotropic quality index

NASA Astrophysics Data System (ADS)

Barufaldi, Bruno; Borges, Lucas R.; Bakic, Predrag R.; Vieira, Marcelo A. C.; Schiabel, Homero; Maidment, Andrew D. A.

2017-03-01

Automatic exposure control (AEC) is used in mammography to obtain acceptable radiation dose and adequate image quality regardless of breast thickness and composition. Although there are physics methods for assessing the AEC, it is not clear whether mammography systems operate with optimal dose and image quality in clinical practice. In this work, we propose the use of a normalized anisotropic quality index (NAQI), validated in previous studies, to evaluate the quality of mammograms acquired using AEC. The authors used a clinical dataset that consists of 561 patients and 1,046 mammograms (craniocaudal breast views). The results show that image quality is often maintained, even at various radiation levels (mean NAQI = 0.14 +/- 0.02). However, a more careful analysis of NAQI reveals that the average image quality decreases as breast thickness increases. The NAQI is reduced by 32% on average, when the breast thickness increases from 31 to 71 mm. NAQI also decreases with lower breast density. The variation in breast parenchyma alone cannot fully account for the decrease of NAQI with thickness. Examination of images shows that images of large, fatty breasts are often inadequately processed. This work shows that NAQI can be applied in clinical mammograms to assess mammographic image quality, and highlights the limitations of the automatic exposure control for some images.

Dual-Modality PET/Ultrasound imaging of the Prostate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huber, Jennifer S.; Moses, William W.; Pouliot, Jean

2005-11-11

Functional imaging with positron emission tomography (PET)will detect malignant tumors in the prostate and/or prostate bed, as well as possibly help determine tumor ''aggressiveness''. However, the relative uptake in a prostate tumor can be so great that few other anatomical landmarks are visible in a PET image. Ultrasound imaging with a transrectal probe provides anatomical detail in the prostate region that can be co-registered with the sensitive functional information from the PET imaging. Imaging the prostate with both PET and transrectal ultrasound (TRUS) will help determine the location of any cancer within the prostate region. This dual-modality imaging should helpmore » provide better detection and treatment of prostate cancer. LBNL has built a high performance positron emission tomograph optimized to image the prostate.Compared to a standard whole-body PET camera, our prostate-optimized PET camera has the same sensitivity and resolution, less backgrounds and lower cost. We plan to develop the hardware and software tools needed for a validated dual PET/TRUS prostate imaging system. We also plan to develop dual prostate imaging with PET and external transabdominal ultrasound, in case the TRUS system is too uncomfortable for some patients. We present the design and intended clinical uses for these dual imaging systems.« less

WE-FG-206-08: Pulmonary Functional Imaging Biomarkers of NSCLC to Guide and Optimize Functional Lung Avoidance Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheikh, Khadija; Capaldi, Dante PI; Parraga, Grace

Purpose: Functional lung avoidance radiotherapy promises optimized therapy planning by minimizing dose to well-functioning lung and maximizing dose to the rest of the lung. Patients with NSCLC commonly present with co-morbid COPD and heterogeneously distributed ventilation abnormalities stemming from emphysema, airways disease, and tumour burden. We hypothesized that pulmonary functional imaging methods may be used to optimize radiotherapy plans to avoid regions of well-functioning lung and significantly improve outcomes like quality-of-life and survival. To ascertain the utility of functional lung avoidance therapy in clinical practice, we measured COPD phenotypes in NSCLC patients enrolled in a randomized-controlled-clinical-trial prior to curative intentmore » therapy. Methods: Thirty stage IIIA/IIIB NSCLC patients provided written informed consent to a randomized-controlled-clinical-trial ( http://clinicaltrials.gov/ct2/show/NCT02002052 ) comparing outcomes in patients randomized to standard or image-guided radiotherapy. Hyperpolarized noble gas MRI ventilation-defect-percent (VDP) (Kirby et al, Acad Radiol, 2012) as well as CT-emphysema measurements were determined. Patients were stratified based on quantitative imaging evidence of ventilation-defects and emphysema into two subgroups: 1) tumour-specific ventilation defects only (TSD), and, 2) tumour-specific and other ventilation defects with and without emphysema (TSD{sub VE}). Receiver-operating-characteristic (ROC) curves were used to characterize the performance of clinical measures as predictors of the presence of non-tumour specific ventilation defects. Results: Twenty-one out of thirty subjects (70%) had non-tumour specific ventilation defects (TSD{sub VE}) and nine subjects had ONLY tumour-specific defects (TSD). Subjects in the TSD{sub VE} group had significantly greater smoking-history (p=.006) and airflow obstruction (FEV{sub 1}/FVC) (p=.001). ROC analysis demonstrated an 87% classification rate for smoking pack-years, 90% for FEV{sub 1}/FVC, and 56% for tumour RECIST measurements for identifying patients with non-tumour and tumour-specific ventilation abnormalities. Conclusion: 70% of NSCLC patients had ventilation abnormalities stemming from emphysema, airways disease and tumour burden. Smoking-history and airflow obstruction, but not RECIST, identified NSCLC patients with ventilation abnormalities appropriate for functional lung avoidance therapy.« less

Improved identification of cranial nerves using paired-agent imaging: topical staining protocol optimization through experimentation and simulation

NASA Astrophysics Data System (ADS)

Torres, Veronica C.; Wilson, Todd; Staneviciute, Austeja; Byrne, Richard W.; Tichauer, Kenneth M.

2018-03-01

Skull base tumors are particularly difficult to visualize and access for surgeons because of the crowded environment and close proximity of vital structures, such as cranial nerves. As a result, accidental nerve damage is a significant concern and the likelihood of tumor recurrence is increased because of more conservative resections that attempt to avoid injuring these structures. In this study, a paired-agent imaging method with direct administration of fluorophores is applied to enhance cranial nerve identification. Here, a control imaging agent (ICG) accounts for non-specific uptake of the nerve-targeting agent (Oxazine 4), and ratiometric data analysis is employed to approximate binding potential (BP, a surrogate of targeted biomolecule concentration). For clinical relevance, animal experiments and simulations were conducted to identify parameters for an optimized stain and rinse protocol using the developed paired-agent method. Numerical methods were used to model the diffusive and kinetic behavior of the imaging agents in tissue, and simulation results revealed that there are various combinations of stain time and rinse number that provide improved contrast of cranial nerves, as suggested by optimal measures of BP and contrast-to-noise ratio.

Model observer design for multi-signal detection in the presence of anatomical noise

NASA Astrophysics Data System (ADS)

Wen, Gezheng; Markey, Mia K.; Park, Subok

2017-02-01

As psychophysical studies are resource-intensive to conduct, model observers are commonly used to assess and optimize medical imaging quality. Model observers are typically designed to detect at most one signal. However, in clinical practice, there may be multiple abnormalities in a single image set (e.g. multifocal multicentric (MFMC) breast cancer), which can impact treatment planning. Prevalence of signals can be different across anatomical regions, and human observers do not know the number or location of signals a priori. As new imaging techniques have the potential to improve multiple-signal detection (e.g. digital breast tomosynthesis may be more effective for diagnosis of MFMC than mammography), image quality assessment approaches addressing such tasks are needed. In this study, we present a model observer to detect multiple signals in an image dataset. A novel implementation of partial least squares (PLS) was developed to estimate different sets of efficient channels directly from the images. The PLS channels are adaptive to the characteristics of signals and the background, and they capture the interactions among signal locations. Corresponding linear decision templates are employed to generate both image-level and location-specific scores on the presence of signals. Our results show that: (1) the model observer can achieve high performance with a reasonably small number of channels; (2) the model observer with PLS channels outperforms that with benchmark modified Laguerre-Gauss channels, especially when realistic signal shapes and complex background statistics are involved; (3) the tasks of clinical interest, and other constraints such as sample size would alter the optimal design of the model observer.

SU-G-JeP2-07: Fusion Optimization of Multi-Contrast MRI Scans for MR-Based Treatment Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, L; Yin, F; Liang, X

Purpose: To develop an image fusion method using multiple contrast MRI scans for MR-based treatment planning. Methods: T1 weighted (T1-w), T2 weighted (T2-w) and diffusion weighted images (DWI) were acquired from liver cancer patient with breath-holding. Image fade correction and deformable image registration were performed using VelocityAI (Varian Medical Systems, CA). Registered images were normalized to mean voxel intensity for each image dataset. Contrast to noise ratio (CNR) between tumor and liver was quantified. Tumor area was defined as the GTV contoured by physicians. Normal liver area with equivalent dimension was used as background. Noise was defined by the standardmore » deviation of voxel intensities in the same liver area. Linear weightings were applied to T1-w, T2-w and DWI images to generate composite image and CNR was calculated for each composite image. Optimization process were performed to achieve different clinical goals. Results: With a goal of maximizing tumor contrast, the composite image achieved a 7–12 fold increase in tumor CNR (142.8 vs. −2.3, 11.4 and 20.6 for T1-w, T2-w and DWI only, respectively), while anatomical details were largely invisible. With a weighting combination of 100%, −10% and −10%, respectively, tumor contrast was enhanced from −2.3 to −5.4, while the anatomical details were clear. With a weighting combination of 25%, 20% and 55%, balanced tumor contrast and anatomy was achieved. Conclusion: We have investigated the feasibility of performing image fusion optimization on multiple contrast MRI images. This mechanism could help utilize multiple contrast MRI scans to potentially facilitate future MR-based treatment planning.« less

Veterinary diagnostic imaging: Probability, accuracy and impact.

PubMed

Lamb, Christopher R

2016-09-01

Diagnostic imaging is essential for diagnosis and management of many common problems in veterinary medicine, but imaging is not 100% accurate and does not always benefit the animal in the way intended. When assessing the need for imaging, the probability that the animal has a morphological lesion, the accuracy of the imaging and the likelihood of a beneficial impact on the animal must all be considered. Few imaging tests are sufficiently accurate that they enable a diagnosis to be ruled in or out; instead, the results of imaging only modify the probability of a diagnosis. Potential problems with excessive use of imaging include false positive diagnoses, detection of incidental findings and over-diagnosis, all of which may contribute to a negative benefit to the animal. Veterinary clinicians must be selective in their use of imaging, use existing clinical information when interpreting images and sensibly apply the results of imaging in the context of the needs of individual animals. There is a need for more clinical research to assess the impact of diagnostic imaging for animals with common conditions to help clinicians make decisions conducive to optimal patient care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Real time optimization algorithm for wavefront sensorless adaptive optics OCT (Conference Presentation)

NASA Astrophysics Data System (ADS)

Verstraete, Hans R. G. W.; Heisler, Morgan; Ju, Myeong Jin; Wahl, Daniel J.; Bliek, Laurens; Kalkman, Jeroen; Bonora, Stefano; Sarunic, Marinko V.; Verhaegen, Michel; Jian, Yifan

2017-02-01

Optical Coherence Tomography (OCT) has revolutionized modern ophthalmology, providing depth resolved images of the retinal layers in a system that is suited to a clinical environment. A limitation of the performance and utilization of the OCT systems has been the lateral resolution. Through the combination of wavefront sensorless adaptive optics with dual variable optical elements, we present a compact lens based OCT system that is capable of imaging the photoreceptor mosaic. We utilized a commercially available variable focal length lens to correct for a wide range of defocus commonly found in patient eyes, and a multi-actuator adaptive lens after linearization of the hysteresis in the piezoelectric actuators for aberration correction to obtain near diffraction limited imaging at the retina. A parallel processing computational platform permitted real-time image acquisition and display. The Data-based Online Nonlinear Extremum seeker (DONE) algorithm was used for real time optimization of the wavefront sensorless adaptive optics OCT, and the performance was compared with a coordinate search algorithm. Cross sectional images of the retinal layers and en face images of the cone photoreceptor mosaic acquired in vivo from research volunteers before and after WSAO optimization are presented. Applying the DONE algorithm in vivo for wavefront sensorless AO-OCT demonstrates that the DONE algorithm succeeds in drastically improving the signal while achieving a computational time of 1 ms per iteration, making it applicable for high speed real time applications.

Investigation of optimal parameters for penalized maximum-likelihood reconstruction applied to iodinated contrast-enhanced breast CT

NASA Astrophysics Data System (ADS)

Makeev, Andrey; Ikejimba, Lynda; Lo, Joseph Y.; Glick, Stephen J.

2016-03-01

Although digital mammography has reduced breast cancer mortality by approximately 30%, sensitivity and specificity are still far from perfect. In particular, the performance of mammography is especially limited for women with dense breast tissue. Two out of every three biopsies performed in the U.S. are unnecessary, thereby resulting in increased patient anxiety, pain, and possible complications. One promising tomographic breast imaging method that has recently been approved by the FDA is dedicated breast computed tomography (BCT). However, visualizing lesions with BCT can still be challenging for women with dense breast tissue due to the minimal contrast for lesions surrounded by fibroglandular tissue. In recent years there has been renewed interest in improving lesion conspicuity in x-ray breast imaging by administration of an iodinated contrast agent. Due to the fully 3-D imaging nature of BCT, as well as sub-optimal contrast enhancement while the breast is under compression with mammography and breast tomosynthesis, dedicated BCT of the uncompressed breast is likely to offer the best solution for injected contrast-enhanced x-ray breast imaging. It is well known that use of statistically-based iterative reconstruction in CT results in improved image quality at lower radiation dose. Here we investigate possible improvements in image reconstruction for BCT, by optimizing free regularization parameter in method of maximum likelihood and comparing its performance with clinical cone-beam filtered backprojection (FBP) algorithm.

Automated Detection of Clinically Significant Prostate Cancer in mp-MRI Images Based on an End-to-End Deep Neural Network.

PubMed

Wang, Zhiwei; Liu, Chaoyue; Cheng, Danpeng; Wang, Liang; Yang, Xin; Cheng, Kwang-Ting

2018-05-01

Automated methods for detecting clinically significant (CS) prostate cancer (PCa) in multi-parameter magnetic resonance images (mp-MRI) are of high demand. Existing methods typically employ several separate steps, each of which is optimized individually without considering the error tolerance of other steps. As a result, they could either involve unnecessary computational cost or suffer from errors accumulated over steps. In this paper, we present an automated CS PCa detection system, where all steps are optimized jointly in an end-to-end trainable deep neural network. The proposed neural network consists of concatenated subnets: 1) a novel tissue deformation network (TDN) for automated prostate detection and multimodal registration and 2) a dual-path convolutional neural network (CNN) for CS PCa detection. Three types of loss functions, i.e., classification loss, inconsistency loss, and overlap loss, are employed for optimizing all parameters of the proposed TDN and CNN. In the training phase, the two nets mutually affect each other and effectively guide registration and extraction of representative CS PCa-relevant features to achieve results with sufficient accuracy. The entire network is trained in a weakly supervised manner by providing only image-level annotations (i.e., presence/absence of PCa) without exact priors of lesions' locations. Compared with most existing systems which require supervised labels, e.g., manual delineation of PCa lesions, it is much more convenient for clinical usage. Comprehensive evaluation based on fivefold cross validation using 360 patient data demonstrates that our system achieves a high accuracy for CS PCa detection, i.e., a sensitivity of 0.6374 and 0.8978 at 0.1 and 1 false positives per normal/benign patient.

Highly accelerated cardiovascular MR imaging using many channel technology: concepts and clinical applications

PubMed Central

Sodickson, Daniel K.

2010-01-01

Cardiovascular magnetic resonance imaging (CVMRI) is of proven clinical value in the non-invasive imaging of cardiovascular diseases. CVMRI requires rapid image acquisition, but acquisition speed is fundamentally limited in conventional MRI. Parallel imaging provides a means for increasing acquisition speed and efficiency. However, signal-to-noise (SNR) limitations and the limited number of receiver channels available on most MR systems have in the past imposed practical constraints, which dictated the use of moderate accelerations in CVMRI. High levels of acceleration, which were unattainable previously, have become possible with many-receiver MR systems and many-element, cardiac-optimized RF-coil arrays. The resulting imaging speed improvements can be exploited in a number of ways, ranging from enhancement of spatial and temporal resolution to efficient whole heart coverage to streamlining of CVMRI work flow. In this review, examples of these strategies are provided, following an outline of the fundamentals of the highly accelerated imaging approaches employed in CVMRI. Topics discussed include basic principles of parallel imaging; key requirements for MR systems and RF-coil design; practical considerations of SNR management, supported by multi-dimensional accelerations, 3D noise averaging and high field imaging; highly accelerated clinical state-of-the art cardiovascular imaging applications spanning the range from SNR-rich to SNR-limited; and current trends and future directions. PMID:17562047

Comprehensive MRI simulation methodology using a dedicated MRI scanner in radiation oncology for external beam radiation treatment planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paulson, Eric S., E-mail: epaulson@mcw.edu; Erickson, Beth; Schultz, Chris

Purpose: The use of magnetic resonance imaging (MRI) in radiation oncology is expanding rapidly, and more clinics are integrating MRI into their radiation therapy workflows. However, radiation therapy presents a new set of challenges and places additional constraints on MRI compared to diagnostic radiology that, if not properly addressed, can undermine the advantages MRI offers for radiation treatment planning (RTP). The authors introduce here strategies to manage several challenges of using MRI for virtual simulation in external beam RTP. Methods: A total of 810 clinical MRI simulation exams were performed using a dedicated MRI scanner for external beam RTP ofmore » brain, breast, cervix, head and neck, liver, pancreas, prostate, and sarcoma cancers. Patients were imaged in treatment position using MRI-optimal immobilization devices. Radiofrequency (RF) coil configurations and scan protocols were optimized based on RTP constraints. Off-resonance and gradient nonlinearity-induced geometric distortions were minimized or corrected prior to using images for RTP. A multidisciplinary MRI simulation guide, along with window width and level presets, was created to standardize use of MR images during RTP. A quality assurance program was implemented to maintain accuracy and repeatability of MRI simulation exams. Results: The combination of a large bore scanner, high field strength, and circumferentially wrapped, flexible phased array RF receive coils permitted acquisition of thin slice images with high contrast-to-noise ratio (CNR) and image intensity uniformity, while simultaneously accommodating patient setup and immobilization devices. Postprocessing corrections and alternative acquisition methods were required to reduce or correct off-resonance and gradient nonlinearity induced geometric distortions. Conclusions: The methodology described herein contains practical strategies the authors have implemented through lessons learned performing clinical MRI simulation exams. In their experience, these strategies provide robust, high fidelity, high contrast MR images suitable for external beam RTP.« less

Recent Trends in Antibody-based Oncologic Imaging

PubMed Central

Kaur, Sukhwinder; Venktaraman, Ganesh; Jain, Maneesh; Senapati, Shantibhusan; Garg, Pradeep K.; Batra, Surinder K.

2011-01-01

Antibodies, with their unmatched ability for selective binding to any target, are considered as potentially the most specific probes for imaging. Their clinical utility, however, has been limited chiefly due to their slow clearance from the circulation, longer retention in non-targeted tissues and the extensive optimization required for each antibody-tracer. The development of newer contrast agents, combined with improved conjugation strategies and novel engineered forms of antibodies (diabodies, minibodies, single chain variable fragments, and nanobodies), have triggered a new wave of antibody-based imaging approaches. Apart from their conventional use with nuclear imaging probes, antibodies and their modified forms are increasingly being employed with non-radioisotopic contrast agents (MRI and ultrasound) as well as newer imaging modalities, such as quantum dots, near infra red (NIR) probes, nanoshells and surface enhanced Raman spectroscopy (SERS). The review article provides new developments in the usage of antibodies and their modified forms in conjunction with probes of various imaging modalities such as nuclear imaging, optical imaging, ultrasound, MRI, SERS and nanoshells in preclinical and clinical studies on the diagnosis, prognosis and therapeutic responses of cancer. PMID:22104729

Task-Driven Orbit Design and Implementation on a Robotic C-Arm System for Cone-Beam CT.

PubMed

Ouadah, S; Jacobson, M; Stayman, J W; Ehtiati, T; Weiss, C; Siewerdsen, J H

2017-03-01

This work applies task-driven optimization to the design of non-circular orbits that maximize imaging performance for a particular imaging task. First implementation of task-driven imaging on a clinical robotic C-arm system is demonstrated, and a framework for orbit calculation is described and evaluated. We implemented a task-driven imaging framework to optimize orbit parameters that maximize detectability index d '. This framework utilizes a specified Fourier domain task function and an analytical model for system spatial resolution and noise. Two experiments were conducted to test the framework. First, a simple task was considered consisting of frequencies lying entirely on the f z -axis (e.g., discrimination of structures oriented parallel to the central axial plane), and a "circle + arc" orbit was incorporated into the framework as a means to improve sampling of these frequencies, and thereby increase task-based detectability. The orbit was implemented on a robotic C-arm (Artis Zeego, Siemens Healthcare). A second task considered visualization of a cochlear implant simulated within a head phantom, with spatial frequency response emphasizing high-frequency content in the ( f y , f z ) plane of the cochlea. An optimal orbit was computed using the task-driven framework, and the resulting image was compared to that for a circular orbit. For the f z -axis task, the circle + arc orbit was shown to increase d ' by a factor of 1.20, with an improvement of 0.71 mm in a 3D edge-spread measurement for edges located far from the central plane and a decrease in streak artifacts compared to a circular orbit. For the cochlear implant task, the resulting orbit favored complementary views of high tilt angles in a 360° orbit, and d ' was increased by a factor of 1.83. This work shows that a prospective definition of imaging task can be used to optimize source-detector orbit and improve imaging performance. The method was implemented for execution of non-circular, task-driven orbits on a clinical robotic C-arm system. The framework is sufficiently general to include both acquisition parameters (e.g., orbit, kV, and mA selection) and reconstruction parameters (e.g., a spatially varying regularizer).

Task-driven orbit design and implementation on a robotic C-arm system for cone-beam CT

NASA Astrophysics Data System (ADS)

Ouadah, S.; Jacobson, M.; Stayman, J. W.; Ehtiati, T.; Weiss, C.; Siewerdsen, J. H.

2017-03-01

Purpose: This work applies task-driven optimization to the design of non-circular orbits that maximize imaging performance for a particular imaging task. First implementation of task-driven imaging on a clinical robotic C-arm system is demonstrated, and a framework for orbit calculation is described and evaluated. Methods: We implemented a task-driven imaging framework to optimize orbit parameters that maximize detectability index d'. This framework utilizes a specified Fourier domain task function and an analytical model for system spatial resolution and noise. Two experiments were conducted to test the framework. First, a simple task was considered consisting of frequencies lying entirely on the fz-axis (e.g., discrimination of structures oriented parallel to the central axial plane), and a "circle + arc" orbit was incorporated into the framework as a means to improve sampling of these frequencies, and thereby increase task-based detectability. The orbit was implemented on a robotic C-arm (Artis Zeego, Siemens Healthcare). A second task considered visualization of a cochlear implant simulated within a head phantom, with spatial frequency response emphasizing high-frequency content in the (fy, fz) plane of the cochlea. An optimal orbit was computed using the task-driven framework, and the resulting image was compared to that for a circular orbit. Results: For the fz-axis task, the circle + arc orbit was shown to increase d' by a factor of 1.20, with an improvement of 0.71 mm in a 3D edge-spread measurement for edges located far from the central plane and a decrease in streak artifacts compared to a circular orbit. For the cochlear implant task, the resulting orbit favored complementary views of high tilt angles in a 360° orbit, and d' was increased by a factor of 1.83. Conclusions: This work shows that a prospective definition of imaging task can be used to optimize source-detector orbit and improve imaging performance. The method was implemented for execution of non-circular, task-driven orbits on a clinical robotic C-arm system. The framework is sufficiently general to include both acquisition parameters (e.g., orbit, kV, and mA selection) and reconstruction parameters (e.g., a spatially varying regularizer).

Design and validation of a mathematical breast phantom for contrast-enhanced digital mammography

NASA Astrophysics Data System (ADS)

Hill, Melissa L.; Mainprize, James G.; Jong, Roberta A.; Yaffe, Martin J.

2011-03-01

In contrast-enhanced digital mammography (CEDM) an iodinated contrast agent is employed to increase lesion contrast and to provide tissue functional information. Here, we present the details of a software phantom that can be used as a tool for the simulation of CEDM images, and compare the degree of anatomic noise present in images simulated using the phantom to that associated with breast parenchyma in clinical CEDM images. Such a phantom could be useful for multiparametric investigations including characterization of CEDM imaging performance and system optimization. The phantom has a realistic mammographic appearance based on a clustered lumpy background and models contrast agent uptake according to breast tissue physiology. Fifty unique phantoms were generated and used to simulate regions of interest (ROI) of pre-contrast images and logarithmically subtracted CEDM images using monoenergetic ray tracing. Power law exponents, β, were used as a measure of anatomic noise and were determined using a linear least-squares fit to log-log plots of the square of the modulus of radially averaged image power spectra versus spatial frequency. The power spectra for ROI selected from regions of normal parenchyma in 10 pairs of clinical CEDM pre-contrast and subtracted images were also measured for comparison with the simulated images. There was good agreement between the measured β in the simulated CEDM images and the clinical images. The values of β were consistently lower for the logarithmically subtracted CEDM images compared to the pre-contrast images, indicating that the subtraction process reduced anatomical noise.

High-performance dual-energy imaging with a flat-panel detector: imaging physics from blackboard to benchtop to bedside

NASA Astrophysics Data System (ADS)

Siewerdsen, J. H.; Shkumat, N. A.; Dhanantwari, A. C.; Williams, D. B.; Richard, S.; Daly, M. J.; Paul, N. S.; Moseley, D. J.; Jaffray, D. A.; Yorkston, J.; Van Metter, R.

2006-03-01

The application of high-performance flat-panel detectors (FPDs) to dual-energy (DE) imaging offers the potential for dramatically improved detection and characterization of subtle lesions through reduction of "anatomical noise," with applications ranging from thoracic imaging to image-guided interventions. In this work, we investigate DE imaging performance from first principles of image science to preclinical implementation, including: 1.) generalized task-based formulation of NEQ and detectability as a guide to system optimization; 2.) measurements of imaging performance on a DE imaging benchtop; and 3.) a preclinical system developed in our laboratory for cardiac-gated DE chest imaging in a research cohort of 160 patients. Theoretical and benchtop studies directly guide clinical implementation, including the advantages of double-shot versus single-shot DE imaging, the value of differential added filtration between low- and high-kVp projections, and optimal selection of kVp pairs, filtration, and dose allocation. Evaluation of task-based NEQ indicates that the detectability of subtle lung nodules in double-shot DE imaging can exceed that of single-shot DE imaging by a factor of 4 or greater. Filter materials are investigated that not only harden the high-kVp beam (e.g., Cu or Ag) but also soften the low-kVp beam (e.g., Ce or Gd), leading to significantly increased contrast in DE images. A preclinical imaging system suitable for human studies has been constructed based upon insights gained from these theoretical and experimental studies. An important component of the system is a simple and robust means of cardiac-gated DE image acquisition, implemented here using a fingertip pulse oximeter. Timing schemes that provide cardiac-gated image acquisition on the same or successive heartbeats is described. Preclinical DE images to be acquired under research protocol will afford valuable testing of optimal deployment, facilitate the development of DE CAD, and support comparison of DE diagnostic imaging performance to low-dose CT and radiography.

Demons deformable registration for CBCT-guided procedures in the head and neck: Convergence and accuracy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nithiananthan, S.; Brock, K. K.; Daly, M. J.

2009-10-15

Purpose: The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Methods: Using an open-source ''symmetric'' Demons registration algorithm, a convergence criterion basedmore » on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. Results: The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8{+-}0.3) mm and NCC=0.99 in the cadaveric head compared to TRE=(2.6{+-}1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6{+-}0.9) mm compared to rigid registration TRE=(3.6{+-}1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1x1x2 mm{sup 3}). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Conclusions: Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies.« less

Demons deformable registration for CBCT-guided procedures in the head and neck: convergence and accuracy.

PubMed

Nithiananthan, S; Brock, K K; Daly, M J; Chan, H; Irish, J C; Siewerdsen, J H

2009-10-01

The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Using an open-source "symmetric" Demons registration algorithm, a convergence criterion based on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8+/-0.3) mm and NCC =0.99 in the cadaveric head compared to TRE=(2.6+/-1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6+/-0.9) mm compared to rigid registration TRE=(3.6+/-1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1 x 1 x 2 mm3). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies.

Demons deformable registration for CBCT-guided procedures in the head and neck: Convergence and accuracy

PubMed Central

Nithiananthan, S.; Brock, K. K.; Daly, M. J.; Chan, H.; Irish, J. C.; Siewerdsen, J. H.

2009-01-01

Purpose: The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Methods: Using an open-source “symmetric” Demons registration algorithm, a convergence criterion based on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. Results: The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8±0.3) mm and NCC=0.99 in the cadaveric head compared to TRE=(2.6±1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6±0.9) mm compared to rigid registration TRE=(3.6±1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1×1×2 mm3). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Conclusions: Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies. PMID:19928106

An efficient intensity-based ready-to-use X-ray image stitcher.

PubMed

Wang, Junchen; Zhang, Xiaohui; Sun, Zhen; Yuan, Fuzhen

2018-06-14

The limited field of view of the X-ray image intensifier makes it difficult to cover a large target area with a single X-ray image. X-ray image stitching techniques have been proposed to produce a panoramic X-ray image. This paper presents an efficient intensity-based X-ray image stitcher, which does not rely on accurate C-arm motion control or auxiliary devices and hence is ready to use in clinic. The stitcher consumes sequentially captured X-ray images with overlap areas and automatically produces a panoramic image. The gradient information for optimization of image alignment is obtained using a back-propagation scheme so that it is convenient to adopt various image warping models. The proposed stitcher has the following advantages over existing methods: (1) no additional hardware modification or auxiliary markers are needed; (2) it is robust against feature-based approaches; (3) arbitrary warping models and shapes of the region of interest are supported; (4) seamless stitching is achieved using multi-band blending. Experiments have been performed to confirm the effectiveness of the proposed method. The proposed X-ray image stitcher is efficient, accurate and ready to use in clinic. Copyright © 2018 John Wiley & Sons, Ltd.

Surveillance imaging for lymphoma: pros and cons.

PubMed

Lynch, Ryan C; Zelenetz, Andrew D; Armitage, James O; Carson, Kenneth R

2014-01-01

There is no international consensus on the optimal frequency or duration of computed tomography or positron emission tomography scanning for surveillance in patients who achieve complete remission after initial therapy for lymphoma. Although some clinical practice guidelines suggest periodic imaging is reasonable, others suggest little or no benefit to this practice. From a theoretical perspective, the frequency and duration of surveillance imaging is largely dependent upon the lymphoma subtype. Aggressive lymphomas with a fast growth rate will require surveillance more frequently and for a shorter duration compared to the indolent lymphomas. Historically, relapse has been detected in a majority of patients based upon clinically evident signs and symptoms. Currently, no study has demonstrated an overall survival difference for patients with relapse detected by imaging as opposed to clinical evaluation, although one study did demonstrate a lower second-line International Prognostic Index in patients with relapse detected by surveillance imaging. Enthusiasm for this finding has been tempered by recent studies highlighting the potential long-term risk of secondary malignancies because of ionizing radiation exposure from diagnostic imaging. These factors along with the significant costs associated with diagnostic imaging have contributed to an ongoing debate regarding the relative costs, risks, and benefits of radiographic surveillance. Herein we present perspectives for and against routine surveillance imaging in an effort to facilitate a better understanding of the issues relevant to what is ultimately a clinical decision made by an oncologist and his or her patient.

Technical experiences of implementing a wireless tracking and facial biometric verification system for a clinical environment

NASA Astrophysics Data System (ADS)

Liu, Brent; Lee, Jasper; Documet, Jorge; Guo, Bing; King, Nelson; Huang, H. K.

2006-03-01

By implementing a tracking and verification system, clinical facilities can effectively monitor workflow and heighten information security in today's growing demand towards digital imaging informatics. This paper presents the technical design and implementation experiences encountered during the development of a Location Tracking and Verification System (LTVS) for a clinical environment. LTVS integrates facial biometrics with wireless tracking so that administrators can manage and monitor patient and staff through a web-based application. Implementation challenges fall into three main areas: 1) Development and Integration, 2) Calibration and Optimization of Wi-Fi Tracking System, and 3) Clinical Implementation. An initial prototype LTVS has been implemented within USC's Healthcare Consultation Center II Outpatient Facility, which currently has a fully digital imaging department environment with integrated HIS/RIS/PACS/VR (Voice Recognition).

Validation of no-reference image quality index for the assessment of digital mammographic images

NASA Astrophysics Data System (ADS)

de Oliveira, Helder C. R.; Barufaldi, Bruno; Borges, Lucas R.; Gabarda, Salvador; Bakic, Predrag R.; Maidment, Andrew D. A.; Schiabel, Homero; Vieira, Marcelo A. C.

2016-03-01

To ensure optimal clinical performance of digital mammography, it is necessary to obtain images with high spatial resolution and low noise, keeping radiation exposure as low as possible. These requirements directly affect the interpretation of radiologists. The quality of a digital image should be assessed using objective measurements. In general, these methods measure the similarity between a degraded image and an ideal image without degradation (ground-truth), used as a reference. These methods are called Full-Reference Image Quality Assessment (FR-IQA). However, for digital mammography, an image without degradation is not available in clinical practice; thus, an objective method to assess the quality of mammograms must be performed without reference. The purpose of this study is to present a Normalized Anisotropic Quality Index (NAQI), based on the Rényi entropy in the pseudo-Wigner domain, to assess mammography images in terms of spatial resolution and noise without any reference. The method was validated using synthetic images acquired through an anthropomorphic breast software phantom, and the clinical exposures on anthropomorphic breast physical phantoms and patient's mammograms. The results reported by this noreference index follow the same behavior as other well-established full-reference metrics, e.g., the peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM). Reductions of 50% on the radiation dose in phantom images were translated as a decrease of 4dB on the PSNR, 25% on the SSIM and 33% on the NAQI, evidencing that the proposed metric is sensitive to the noise resulted from dose reduction. The clinical results showed that images reduced to 53% and 30% of the standard radiation dose reported reductions of 15% and 25% on the NAQI, respectively. Thus, this index may be used in clinical practice as an image quality indicator to improve the quality assurance programs in mammography; hence, the proposed method reduces the subjectivity inter-observers in the reporting of image quality assessment.

SU-F-18C-01: Minimum Detectability Analysis for Comprehensive Sized Based Optimization of Image Quality and Radiation Dose Across CT Protocols

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smitherman, C; Chen, B; Samei, E

2014-06-15

Purpose: This work involved a comprehensive modeling of task-based performance of CT across a wide range of protocols. The approach was used for optimization and consistency of dose and image quality within a large multi-vendor clinical facility. Methods: 150 adult protocols from the Duke University Medical Center were grouped into sub-protocols with similar acquisition characteristics. A size based image quality phantom (Duke Mercury Phantom) was imaged using these sub-protocols for a range of clinically relevant doses on two CT manufacturer platforms (Siemens, GE). The images were analyzed to extract task-based image quality metrics such as the Task Transfer Function (TTF),more » Noise Power Spectrum, and Az based on designer nodule task functions. The data were analyzed in terms of the detectability of a lesion size/contrast as a function of dose, patient size, and protocol. A graphical user interface (GUI) was developed to predict image quality and dose to achieve a minimum level of detectability. Results: Image quality trends with variations in dose, patient size, and lesion contrast/size were evaluated and calculated data behaved as predicted. The GUI proved effective to predict the Az values representing radiologist confidence for a targeted lesion, patient size, and dose. As an example, an abdomen pelvis exam for the GE scanner, with a task size/contrast of 5-mm/50-HU, and an Az of 0.9 requires a dose of 4.0, 8.9, and 16.9 mGy for patient diameters of 25, 30, and 35 cm, respectively. For a constant patient diameter of 30 cm, the minimum detected lesion size at those dose levels would be 8.4, 5, and 3.9 mm, respectively. Conclusion: The designed CT protocol optimization platform can be used to evaluate minimum detectability across dose levels and patient diameters. The method can be used to improve individual protocols as well as to improve protocol consistency across CT scanners.« less

Enhancement of dynamic myocardial perfusion PET images based on low-rank plus sparse decomposition.

PubMed

Lu, Lijun; Ma, Xiaomian; Mohy-Ud-Din, Hassan; Ma, Jianhua; Feng, Qianjin; Rahmim, Arman; Chen, Wufan

2018-02-01

The absolute quantification of dynamic myocardial perfusion (MP) PET imaging is challenged by the limited spatial resolution of individual frame images due to division of the data into shorter frames. This study aims to develop a method for restoration and enhancement of dynamic PET images. We propose that the image restoration model should be based on multiple constraints rather than a single constraint, given the fact that the image characteristic is hardly described by a single constraint alone. At the same time, it may be possible, but not optimal, to regularize the image with multiple constraints simultaneously. Fortunately, MP PET images can be decomposed into a superposition of background vs. dynamic components via low-rank plus sparse (L + S) decomposition. Thus, we propose an L + S decomposition based MP PET image restoration model and express it as a convex optimization problem. An iterative soft thresholding algorithm was developed to solve the problem. Using realistic dynamic 82 Rb MP PET scan data, we optimized and compared its performance with other restoration methods. The proposed method resulted in substantial visual as well as quantitative accuracy improvements in terms of noise versus bias performance, as demonstrated in extensive 82 Rb MP PET simulations. In particular, the myocardium defect in the MP PET images had improved visual as well as contrast versus noise tradeoff. The proposed algorithm was also applied on an 8-min clinical cardiac 82 Rb MP PET study performed on the GE Discovery PET/CT, and demonstrated improved quantitative accuracy (CNR and SNR) compared to other algorithms. The proposed method is effective for restoration and enhancement of dynamic PET images. Copyright © 2017 Elsevier B.V. All rights reserved.

Application of Magnetic Resonance Imaging and Three-Dimensional Treatment Planning in the Treatment of Orbital Lymphoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rudoltz, Marc S.; Ayyangar, Komanduri; Mohiuddin, Mohammed

Radiotherapy for lymphoma of the orbit must be individualized for each patient and clinical setting. Most techniques focus on optimizing the dose to the tumor while sparing the lens. This study describes a technique utilizing magnetic resonance imaging (MRI) and three dimensional (3D) planning in the treatment of orbital lymphoma. A patient presented with an intermediate grade lymphoma of the right orbit. The prescribed tumor dose was 4050 cGy in 18 fractions. Three D planning was carried out and tumor volumes, retina, and lens were subsequently outlined. Dose calculations including dose volume histograms of the target, retina, and lens weremore » then performed. Part of the retina was outside of the treatment volume while 50% of the retina received 90% or more of the prescribed dose. The patient was clinically NED when last seen 2 years following therapy with no treatment-related morbidity. Patients with lymphomas of the orbit can be optimally treated using MRI based 3D treatment planning.« less

Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

PubMed

Marin, Jennifer R; Mills, Angela M

2015-12-01

The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to (1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging use and identify key opportunities, limitations, and gaps in knowledge; (2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and (3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified before the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with the planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were a total of 164 individuals involved in the conference and spanned various specialties, including general emergency medicine, pediatric emergency medicine, radiology, surgery, medical physics, and the decision sciences.

Role of functional imaging in treatment plan optimization of stereotactic body radiation therapy for liver cancer.

PubMed

De Bari, Berardino; Jumeau, Raphael; Deantonio, Letizia; Adib, Salim; Godin, Sarah; Zeverino, Michele; Moeckli, Raphael; Bourhis, Jean; Prior, John O; Ozsahin, Mahmut

2016-10-13

We report the first known instance of the clinical use of 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) for the optimization of radiotherapy treatment planning and for the follow-up of acute toxicity in a patient undergoing stereotactic body radiation therapy for hepatocellular carcinoma. In our experience, HBS allowed the identification and the sparing of more functioning liver areas, thus potentially reducing the risk of radiation-induced liver toxicity.

Dynamic whole-body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application.

PubMed

Karakatsanis, Nicolas A; Lodge, Martin A; Tahari, Abdel K; Zhou, Y; Wahl, Richard L; Rahmim, Arman

2013-10-21

Static whole-body PET/CT, employing the standardized uptake value (SUV), is considered the standard clinical approach to diagnosis and treatment response monitoring for a wide range of oncologic malignancies. Alternative PET protocols involving dynamic acquisition of temporal images have been implemented in the research setting, allowing quantification of tracer dynamics, an important capability for tumor characterization and treatment response monitoring. Nonetheless, dynamic protocols have been confined to single-bed-coverage limiting the axial field-of-view to ~15-20 cm, and have not been translated to the routine clinical context of whole-body PET imaging for the inspection of disseminated disease. Here, we pursue a transition to dynamic whole-body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. We investigate solutions to address the challenges of: (i) long acquisitions, (ii) small number of dynamic frames per bed, and (iii) non-invasive quantification of kinetics in the plasma. In the present study, a novel dynamic (4D) whole-body PET acquisition protocol of ~45 min total length is presented, composed of (i) an initial 6 min dynamic PET scan (24 frames) over the heart, followed by (ii) a sequence of multi-pass multi-bed PET scans (six passes × seven bed positions, each scanned for 45 s). Standard Patlak linear graphical analysis modeling was employed, coupled with image-derived plasma input function measurements. Ordinary least squares Patlak estimation was used as the baseline regression method to quantify the physiological parameters of tracer uptake rate Ki and total blood distribution volume V on an individual voxel basis. Extensive Monte Carlo simulation studies, using a wide set of published kinetic FDG parameters and GATE and XCAT platforms, were conducted to optimize the acquisition protocol from a range of ten different clinically acceptable sampling schedules examined. The framework was also applied to six FDG PET patient studies, demonstrating clinical feasibility. Both simulated and clinical results indicated enhanced contrast-to-noise ratios (CNRs) for Ki images in tumor regions with notable background FDG concentration, such as the liver, where SUV performed relatively poorly. Overall, the proposed framework enables enhanced quantification of physiological parameters across the whole body. In addition, the total acquisition length can be reduced from 45 to ~35 min and still achieve improved or equivalent CNR compared to SUV, provided the true Ki contrast is sufficiently high. In the follow-up companion paper, a set of advanced linear regression schemes is presented to particularly address the presence of noise, and attempt to achieve a better trade-off between the mean-squared error and the CNR metrics, resulting in enhanced task-based imaging.

Dynamic whole body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application

PubMed Central

Karakatsanis, Nicolas A.; Lodge, Martin A.; Tahari, Abdel K.; Zhou, Y.; Wahl, Richard L.; Rahmim, Arman

2013-01-01

Static whole body PET/CT, employing the standardized uptake value (SUV), is considered the standard clinical approach to diagnosis and treatment response monitoring for a wide range of oncologic malignancies. Alternative PET protocols involving dynamic acquisition of temporal images have been implemented in the research setting, allowing quantification of tracer dynamics, an important capability for tumor characterization and treatment response monitoring. Nonetheless, dynamic protocols have been confined to single bed-coverage limiting the axial field-of-view to ~15–20 cm, and have not been translated to the routine clinical context of whole-body PET imaging for the inspection of disseminated disease. Here, we pursue a transition to dynamic whole body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. We investigate solutions to address the challenges of: (i) long acquisitions, (ii) small number of dynamic frames per bed, and (iii) non-invasive quantification of kinetics in the plasma. In the present study, a novel dynamic (4D) whole body PET acquisition protocol of ~45min total length is presented, composed of (i) an initial 6-min dynamic PET scan (24 frames) over the heart, followed by (ii) a sequence of multi-pass multi-bed PET scans (6 passes x 7 bed positions, each scanned for 45sec). Standard Patlak linear graphical analysis modeling was employed, coupled with image-derived plasma input function measurements. Ordinary least squares (OLS) Patlak estimation was used as the baseline regression method to quantify the physiological parameters of tracer uptake rate Ki and total blood distribution volume V on an individual voxel basis. Extensive Monte Carlo simulation studies, using a wide set of published kinetic FDG parameters and GATE and XCAT platforms, were conducted to optimize the acquisition protocol from a range of 10 different clinically acceptable sampling schedules examined. The framework was also applied to six FDG PET patient studies, demonstrating clinical feasibility. Both simulated and clinical results indicated enhanced contrast-to-noise ratios (CNRs) for Ki images in tumor regions with notable background FDG concentration, such as the liver, where SUV performed relatively poorly. Overall, the proposed framework enables enhanced quantification of physiological parameters across the whole-body. In addition, the total acquisition length can be reduced from 45min to ~35min and still achieve improved or equivalent CNR compared to SUV, provided the true Ki contrast is sufficiently high. In the follow-up companion paper, a set of advanced linear regression schemes is presented to particularly address the presence of noise, and attempt to achieve a better trade-off between the mean-squared error (MSE) and the CNR metrics, resulting in enhanced task-based imaging. PMID:24080962

Dynamic whole-body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application

NASA Astrophysics Data System (ADS)

Karakatsanis, Nicolas A.; Lodge, Martin A.; Tahari, Abdel K.; Zhou, Y.; Wahl, Richard L.; Rahmim, Arman

2013-10-01

Static whole-body PET/CT, employing the standardized uptake value (SUV), is considered the standard clinical approach to diagnosis and treatment response monitoring for a wide range of oncologic malignancies. Alternative PET protocols involving dynamic acquisition of temporal images have been implemented in the research setting, allowing quantification of tracer dynamics, an important capability for tumor characterization and treatment response monitoring. Nonetheless, dynamic protocols have been confined to single-bed-coverage limiting the axial field-of-view to ˜15-20 cm, and have not been translated to the routine clinical context of whole-body PET imaging for the inspection of disseminated disease. Here, we pursue a transition to dynamic whole-body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. We investigate solutions to address the challenges of: (i) long acquisitions, (ii) small number of dynamic frames per bed, and (iii) non-invasive quantification of kinetics in the plasma. In the present study, a novel dynamic (4D) whole-body PET acquisition protocol of ˜45 min total length is presented, composed of (i) an initial 6 min dynamic PET scan (24 frames) over the heart, followed by (ii) a sequence of multi-pass multi-bed PET scans (six passes × seven bed positions, each scanned for 45 s). Standard Patlak linear graphical analysis modeling was employed, coupled with image-derived plasma input function measurements. Ordinary least squares Patlak estimation was used as the baseline regression method to quantify the physiological parameters of tracer uptake rate Ki and total blood distribution volume V on an individual voxel basis. Extensive Monte Carlo simulation studies, using a wide set of published kinetic FDG parameters and GATE and XCAT platforms, were conducted to optimize the acquisition protocol from a range of ten different clinically acceptable sampling schedules examined. The framework was also applied to six FDG PET patient studies, demonstrating clinical feasibility. Both simulated and clinical results indicated enhanced contrast-to-noise ratios (CNRs) for Ki images in tumor regions with notable background FDG concentration, such as the liver, where SUV performed relatively poorly. Overall, the proposed framework enables enhanced quantification of physiological parameters across the whole body. In addition, the total acquisition length can be reduced from 45 to ˜35 min and still achieve improved or equivalent CNR compared to SUV, provided the true Ki contrast is sufficiently high. In the follow-up companion paper, a set of advanced linear regression schemes is presented to particularly address the presence of noise, and attempt to achieve a better trade-off between the mean-squared error and the CNR metrics, resulting in enhanced task-based imaging.

Dynamic nuclear polarization and optimal control spatial-selective 13C MRI and MRS

NASA Astrophysics Data System (ADS)

Vinding, Mads S.; Laustsen, Christoffer; Maximov, Ivan I.; Søgaard, Lise Vejby; Ardenkjær-Larsen, Jan H.; Nielsen, Niels Chr.

2013-02-01

Aimed at 13C metabolic magnetic resonance imaging (MRI) and spectroscopy (MRS) applications, we demonstrate that dynamic nuclear polarization (DNP) may be combined with optimal control 2D spatial selection to simultaneously obtain high sensitivity and well-defined spatial restriction. This is achieved through the development of spatial-selective single-shot spiral-readout MRI and MRS experiments combined with dynamic nuclear polarization hyperpolarized [1-13C]pyruvate on a 4.7 T pre-clinical MR scanner. The method stands out from related techniques by facilitating anatomic shaped region-of-interest (ROI) single metabolite signals available for higher image resolution or single-peak spectra. The 2D spatial-selective rf pulses were designed using a novel Krotov-based optimal control approach capable of iteratively fast providing successful pulse sequences in the absence of qualified initial guesses. The technique may be important for early detection of abnormal metabolism, monitoring disease progression, and drug research.

Thickness optimization of auricular silicone scaffold based on finite element analysis.

PubMed

Jiang, Tao; Shang, Jianzhong; Tang, Li; Wang, Zhuo

2016-01-01

An optimized thickness of a transplantable auricular silicone scaffold was researched. The original image data were acquired from CT scans, and reverse modeling technology was used to build a digital 3D model of an auricle. The transplant process was simulated in ANSYS Workbench by finite element analysis (FEA), solid scaffolds were manufactured based on the FEA results, and the transplantable artificial auricle was finally obtained with an optimized thickness, as well as sufficient intensity and hardness. This paper provides a reference for clinical transplant surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

A fast multiparameter MRI approach for acute stroke assessment on a 3T clinical scanner: preliminary results in a non-human primate model with transient ischemic occlusion.

PubMed

Zhang, Xiaodong; Tong, Frank; Li, Chun-Xia; Yan, Yumei; Nair, Govind; Nagaoka, Tsukasa; Tanaka, Yoji; Zola, Stuart; Howell, Leonard

2014-04-01

Many MRI parameters have been explored and demonstrated the capability or potential to evaluate acute stroke injury, providing anatomical, microstructural, functional, or neurochemical information for diagnostic purposes and therapeutic development. However, the application of multiparameter MRI approach is hindered in clinic due to the very limited time window after stroke insult. Parallel imaging technique can accelerate MRI data acquisition dramatically and has been incorporated in modern clinical scanners and increasingly applied for various diagnostic purposes. In the present study, a fast multiparameter MRI approach including structural T1-weighted imaging (T1W), T2-weighted imaging (T2W), diffusion tensor imaging (DTI), T2-mapping, proton magnetic resonance spectroscopy, cerebral blood flow (CBF), and magnetization transfer (MT) imaging, was implemented and optimized for assessing acute stroke injury on a 3T clinical scanner. A macaque model of transient ischemic stroke induced by a minimal interventional approach was utilized for evaluating the multiparameter MRI approach. The preliminary results indicate the surgical procedure successfully induced ischemic occlusion in the cortex and/or subcortex in adult macaque monkeys (n=4). Application of parallel imaging technique substantially reduced the scanning duration of most MRI data acquisitions, allowing for fast and repeated evaluation of acute stroke injury. Hence, the use of the multiparameter MRI approach with up to five quantitative measures can provide significant advantages in preclinical or clinical studies of stroke disease.

Principal component analysis-based imaging angle determination for 3D motion monitoring using single-slice on-board imaging.

PubMed

Chen, Ting; Zhang, Miao; Jabbour, Salma; Wang, Hesheng; Barbee, David; Das, Indra J; Yue, Ning

2018-04-10

Through-plane motion introduces uncertainty in three-dimensional (3D) motion monitoring when using single-slice on-board imaging (OBI) modalities such as cine MRI. We propose a principal component analysis (PCA)-based framework to determine the optimal imaging plane to minimize the through-plane motion for single-slice imaging-based motion monitoring. Four-dimensional computed tomography (4DCT) images of eight thoracic cancer patients were retrospectively analyzed. The target volumes were manually delineated at different respiratory phases of 4DCT. We performed automated image registration to establish the 4D respiratory target motion trajectories for all patients. PCA was conducted using the motion information to define the three principal components of the respiratory motion trajectories. Two imaging planes were determined perpendicular to the second and third principal component, respectively, to avoid imaging with the primary principal component of the through-plane motion. Single-slice images were reconstructed from 4DCT in the PCA-derived orthogonal imaging planes and were compared against the traditional AP/Lateral image pairs on through-plane motion, residual error in motion monitoring, absolute motion amplitude error and the similarity between target segmentations at different phases. We evaluated the significance of the proposed motion monitoring improvement using paired t test analysis. The PCA-determined imaging planes had overall less through-plane motion compared against the AP/Lateral image pairs. For all patients, the average through-plane motion was 3.6 mm (range: 1.6-5.6 mm) for the AP view and 1.7 mm (range: 0.6-2.7 mm) for the Lateral view. With PCA optimization, the average through-plane motion was 2.5 mm (range: 1.3-3.9 mm) and 0.6 mm (range: 0.2-1.5 mm) for the two imaging planes, respectively. The absolute residual error of the reconstructed max-exhale-to-inhale motion averaged 0.7 mm (range: 0.4-1.3 mm, 95% CI: 0.4-1.1 mm) using optimized imaging planes, averaged 0.5 mm (range: 0.3-1.0 mm, 95% CI: 0.2-0.8 mm) using an imaging plane perpendicular to the minimal motion component only and averaged 1.3 mm (range: 0.4-2.8 mm, 95% CI: 0.4-2.3 mm) in AP/Lateral orthogonal image pairs. The root-mean-square error of reconstructed displacement was 0.8 mm for optimized imaging planes, 0.6 mm for imaging plane perpendicular to the minimal motion component only, and 1.6 mm for AP/Lateral orthogonal image pairs. When using the optimized imaging planes for motion monitoring, there was no significant absolute amplitude error of the reconstructed motion (P = 0.0988), while AP/Lateral images had significant error (P = 0.0097) with a paired t test. The average surface distance (ASD) between overlaid two-dimensional (2D) tumor segmentation at end-of-inhale and end-of-exhale for all eight patients was 0.6 ± 0.2 mm in optimized imaging planes and 1.4 ± 0.8 mm in AP/Lateral images. The Dice similarity coefficient (DSC) between overlaid 2D tumor segmentation at end-of-inhale and end-of-exhale for all eight patients was 0.96 ± 0.03 in optimized imaging planes and 0.89 ± 0.05 in AP/Lateral images. Both ASD (P = 0.034) and DSC (P = 0.022) were significantly improved in the optimized imaging planes. Motion monitoring using imaging planes determined by the proposed PCA-based framework had significantly improved performance. Single-slice image-based motion tracking can be used for clinical implementations such as MR image-guided radiation therapy (MR-IGRT). © 2018 American Association of Physicists in Medicine.

Effect of a Noise-Optimized Second-Generation Monoenergetic Algorithm on Image Noise and Conspicuity of Hypervascular Liver Tumors: An In Vitro and In Vivo Study.

PubMed

Marin, Daniele; Ramirez-Giraldo, Juan Carlos; Gupta, Sonia; Fu, Wanyi; Stinnett, Sandra S; Mileto, Achille; Bellini, Davide; Patel, Bhavik; Samei, Ehsan; Nelson, Rendon C

2016-06-01

The purpose of this study is to investigate whether the reduction in noise using a second-generation monoenergetic algorithm can improve the conspicuity of hypervascular liver tumors on dual-energy CT (DECT) images of the liver. An anthropomorphic liver phantom in three body sizes and iodine-containing inserts simulating hypervascular lesions was imaged with DECT and single-energy CT at various energy levels (80-140 kV). In addition, a retrospective clinical study was performed in 31 patients with 66 hypervascular liver tumors who underwent DECT during the late hepatic arterial phase. Datasets at energy levels ranging from 40 to 80 keV were reconstructed using first- and second-generation monoenergetic algorithms. Noise, tumor-to-liver contrast-to-noise ratio (CNR), and CNR with a noise constraint (CNRNC) set with a maximum noise increase of 50% were calculated and compared among the different reconstructed datasets. The maximum CNR for the second-generation monoenergetic algorithm, which was attained at 40 keV in both phantom and clinical datasets, was statistically significantly higher than the maximum CNR for the first-generation monoenergetic algorithm (p < 0.001) or single-energy CT acquisitions across a wide range of kilovoltage values. With the second-generation monoenergetic algorithm, the optimal CNRNC occurred at 55 keV, corresponding to lower energy levels compared with first-generation algorithm (predominantly at 70 keV). Patient body size did not substantially affect the selection of the optimal energy level to attain maximal CNR and CNRNC using the second-generation monoenergetic algorithm. A noise-optimized second-generation monoenergetic algorithm significantly improves the conspicuity of hypervascular liver tumors.

PET AND SPECT STUDIES IN CHILDREN WITH HEMISPHERIC LOW-GRADE GLIOMAS

PubMed Central

Juhász, Csaba; Bosnyák, Edit

2016-01-01

Molecular imaging is playing an increasing role in the pre-treatment evaluation of low-grade gliomas. While glucose positron emission tomography (PET) can be helpful to differentiate low-grade from high-grade tumors, PET imaging with amino acid radiotracers has several advantages, such as better differentiation between tumors and non-tumorous lesions, optimized biopsy targeting and improved detection of tumor recurrence. This review provides a brief overview of single photon emission computed tomography (SPECT) studies followed by a more detailed review of clinical applications of glucose and amino acid PET imaging in low-grade hemispheric gliomas. We discuss key differences in the performance of the most commonly utilized PET radiotracers and highlight the advantage of PET/MRI fusion to obtain optimal information about tumor extent, heterogeneity and metabolism. Recent data also suggest that simultaneous acquisition of PET/MR images and the combination of advanced MRI techniques with quantitative PET can further improve the pre- and post-treatment evaluation of pediatric brain tumors. PMID:27659825

PET and SPECT studies in children with hemispheric low-grade gliomas.

PubMed

Juhász, Csaba; Bosnyák, Edit

2016-10-01

Molecular imaging is playing an increasing role in the pretreatment evaluation of low-grade gliomas. While glucose positron emission tomography (PET) can be helpful to differentiate low-grade from high-grade tumors, PET imaging with amino acid radiotracers has several advantages, such as better differentiation between tumors and non-tumorous lesions, optimized biopsy targeting, and improved detection of tumor recurrence. This review provides a brief overview of single-photon emission computed tomography (SPECT) studies followed by a more detailed review of the clinical applications of glucose and amino acid PET imaging in low-grade hemispheric gliomas. We discuss key differences in the performance of the most commonly utilized PET radiotracers and highlight the advantage of PET/MRI fusion to obtain optimal information about tumor extent, heterogeneity, and metabolism. Recent data also suggest that simultaneous acquisition of PET/MR images and the combination of advanced MRI techniques with quantitative PET can further improve the pretreatment and post-treatment evaluation of pediatric brain tumors.

Closed-form expressions for flip angle variation that maximize total signal in T1-weighted rapid gradient echo MRI.

PubMed

Drobnitzky, Matthias; Klose, Uwe

2017-03-01

Magnetization-prepared rapid gradient-echo (MPRAGE) sequences are commonly employed for T1-weighted structural brain imaging. Following a contrast preparation radiofrequency (RF) pulse, the data acquisition proceeds under nonequilibrium conditions of the relaxing longitudinal magnetization. Variation of the flip angle can be used to maximize total available signal. Simulated annealing or greedy algorithms have so far been published to numerically solve this problem, with signal-to-noise ratios optimized for clinical imaging scenarios by adhering to a predefined shape of the signal evolution. We propose an unconstrained optimization of the MPRAGE experiment that employs techniques from resource allocation theory. A new dynamic programming solution is introduced that yields closed-form expressions for optimal flip angle variation. Flip angle series are proposed that maximize total transverse magnetization (Mxy) for a range of physiologic T1 values. A 3D MPRAGE sequence is modified to allow for a controlled variation of the excitation angle. Experiments employing a T1 contrast phantom are performed at 3T. 1D acquisitions without phase encoding permit measurement of the temporal development of Mxy. Image mean signal and standard deviation for reference flip angle trains are compared in 2D measurements. Signal profiles at sharp phantom edges are acquired to access image blurring related to nonuniform Mxy development. A novel closed-form expression for flip angle variation is found that constitutes the optimal policy to reach maximum total signal. It numerically equals previously published results of other authors when evaluated under their simplifying assumptions. Longitudinal magnetization (Mz) is exhaustively used without causing abrupt changes in the measured MR signal, which is a prerequisite for artifact free images. Phantom experiments at 3T verify the expected benefit for total accumulated k-space signal when compared with published flip angle series. Describing the MR signal collection in MPRAGE sequences as a Bellman problem is a new concept. By means of recursively solving a series of overlapping subproblems, this leads to an elegant solution for the problem of maximizing total available MR signal in k-space. A closed-form expression for flip angle variation avoids the complexity of numerical optimization and eases access to controlled variation in an attempt to identify potential clinical applications. © 2017 American Association of Physicists in Medicine.

A novel 1050nm handheld OCT imaging system for pediatric retinoblastoma patients: technology development and clinical study (Conference Presentation)

NASA Astrophysics Data System (ADS)

Nadiarnykh, Oleg; Moll, Annette C.; de Boer, Johannes F.

2016-03-01

We demonstrate a novel optical coherence tomography system specifically developed and validated for clinical imaging of retinoblastoma tumors in pediatric patients. The existing treatment options for this malignant tumor of the retina aim at reduction of tumor (re)growth risks, and vision preservation. The choice of optimal treatment strongly depends on skilled and detailed clinical assessment. Due to the limitations of the existing real-time diagnostic tools the patients at risk are periodically monitored with retinal imaging to confirm the absence of new tumor seedings. Three-dimensional visualization of tissue layer and microvasculature at improved axial and lateral resolution of interference-based OCT imaging provides sensitivity for detection of vital tumor tissue concurrent with local treatment. Our METC-approved system accommodates for the range of optical parameters of infants' eyes, and uses the 1050nm wavelength to access the deeper choroid layers of retina. The prototype is designed for patients in supine position under general anesthesia, where ergonomic handheld module is connected to fiber-based optical setup via umbilical cord. The system conforms to clinical safety requirements, including fully isolated low-voltage electric circuit. Focusing is performed with a mechanically tunable lens, where resolution is 6 µm axially, and varies with focusing at 10-18µm laterally. We will present optical design, performance limitations, and results of the ongoing clinical study, including the increased OCT diagnostic sensitivity in three dimensions in comparison with the established clinical imaging modalities. We will discuss images of early, active, and treated tumors, as well as follow-up on patients after local and systemic treatments.

[Development of an ophthalmological clinical information system for inpatient eye clinics].

PubMed

Kortüm, K U; Müller, M; Babenko, A; Kampik, A; Kreutzer, T C

2015-12-01

In times of increased digitalization in healthcare, departments of ophthalmology are faced with the challenge of introducing electronic clinical health records (EHR); however, specialized software for ophthalmology is not available with most major EHR sytems. The aim of this project was to create specific ophthalmological user interfaces for large inpatient eye care providers within a hospitalwide EHR. Additionally the integration of ophthalmic imaging systems, scheduling and surgical documentation should be achieved. The existing EHR i.s.h.med (Siemens, Germany) was modified using advanced business application programming (ABAP) language to create specific ophthalmological user interfaces for reproduction and moreover optimization of the clinical workflow. A user interface for documentation of ambulatory patients with eight tabs was designed. From June 2013 to October 2014 a total of 61,551 patient contact details were documented. For surgical documentation a separate user interface was set up. Digital clinical orders for documentation of registration and scheduling of operations user interfaces were also set up. A direct integration of ophthalmic imaging modalities could be established. An ophthalmologist-orientated EHR for outpatient and surgical documentation for inpatient clinics was created and successfully implemented. By incorporation of imaging procedures the foundation of future smart/big data analyses was created.

TH-E-9A-01: Medical Physics 1.0 to 2.0, Session 4: Computed Tomography, Ultrasound and Nuclear Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samei, E; Nelson, J; Hangiandreou, N

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidencebased medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. CT 2.0: CT has been undergoing a dramatic transition in themore » last few decades. While the changes in the technology merits discussions of their own, an important question is how clinical medical physicists are expected to effectively engage with the new realities of CT technology and practice. Consistent with the upcoming paradigm of Medical Physics 2.0, this CT presentation aims to provide definitions and demonstration of the components of the new clinical medical physics practice pertaining CT. The topics covered include physics metrics and analytics that aim to provide higher order clinicallyrelevant quantification of system performance as pertains to new (and not so new) technologies. That will include the new radiation and dose metrics (SSDE, organ dose, risk indices), image quality metrology (MTF/NPS/d’), task-based phantoms, and the effect of patient size. That will follow with a discussion of the testing implication of new CT hardware (detectors, tubes), acquisition methods (innovative helical geometries, AEC, wide beam CT, dual energy, inverse geometry, application specialties), and image processing and analysis (iterative reconstructions, quantitative CT, advanced renditions). The presentation will conclude with a discussion of clinical and operational aspects of Medical Physics 2.0 including training and communication, use optimization (dose and technique factors), automated analysis and data management (automated QC methods, protocol tracking, dose monitoring, issue tracking), and meaningful QC considerations. US 2.0: Ultrasound imaging is evolving at a rapid pace, adding new imaging functions and modes that continue to enhance its clinical utility and benefits to patients. The ultrasound talk will look ahead 10–15 years and consider how medical physicists can bring maximal value to the clinical ultrasound practices of the future. The roles of physics in accreditation and regulatory compliance, image quality and exam optimization, clinical innovation, and education of staff and trainees will all be considered. A detailed examination of expected technology evolution and impact on image quality metrics will be presented. Clinical implementation of comprehensive physics services will also be discussed. Nuclear Medicine 2.0: Although the basic science of nuclear imaging has remained relatively unchanged since its inception, advances in instrumentation continue to advance the field into new territories. With a great number of these advances occurring over the past decade, the role and testing strategies of clinical nuclear medicine physicists must evolve in parallel. The Nuclear Medicine 2.0 presentation is designed to highlight some of the recent advances from a clinical medical physicist perspective and provide ideas and motivation for designing better evaluation strategies. Topics include improvement of traditional physics metrics and analytics, testing implications of hybrid imaging and advanced detector technologies, and strategies for effective implementation into the clinic. Learning Objectives: Become familiar with new physics metrics and analytics in nuclear medicine, CT, and ultrasound. To become familiar with the major new developments of clinical physics support. To understand the physics testing implications of new technologies, hardware, software, and applications. Identify approaches for implementing comprehensive medical physics services in future imaging practices.« less

Clinical application of 'Justification' and 'Optimization' principle of ALARA in pediatric CT imaging: "How many children can be protected from unnecessary radiation?".

PubMed

Sodhi, Kushaljit S; Krishna, Satheesh; Saxena, Akshay K; Sinha, Anindita; Khandelwal, Niranjan; Lee, Edward Y

2015-09-01

Practice of ALARA (as low as reasonably achievable) principle in the developed world is currently well established. However, there is striking lack of published data regarding such experience in the developing countries. Therefore, the goal of this study is to prospectively evaluate CT request forms to assess how many children could be protected from harmful radiation exposure if 'Justification' and 'Optimization' principles of ALARA are applied before obtaining CT imaging in a developing country. This can save children from potential radiation risks including development of brain cancer and leukemia. Consecutive CT request forms over a six month study period (May 16, 2013 to November 15, 2013) in a tertiary pediatric children's hospital in India were prospectively reviewed by two pediatric radiologists before obtaining CT imaging. First, 'Justification' of CT was evaluated and then 'Optimization' was applied for evaluation of appropriateness of the requested CT studies. The number (and percentage) of CT studies avoided by applying 'Justification' and 'Optimization' principle of ALARA were calculated. The difference in number of declined and optimized CT requests between CT requests from inpatient and outpatient departments was compared using Chi-Square test. A total of 1302 consecutive CT request forms were received during the study period. Some of the request forms (n=86; 6.61%) had requests for more than one (multiple) anatomical regions, hence, a total of 1392 different anatomical CT requests were received. Based on evaluation of the CT request forms for 'Justification' and 'Optimization' principle of ALARA by pediatric radiology reviewers, 111 individual anatomic part CT requests from 105 pediatric patients were avoided. Therefore, 8.06% (105 out of 1302 pediatric patients) were protected from unnecessary or additional radiation exposure.The rates of declined or optimized CT requests from inpatient department was significantly higher than that from outpatient departments (p<0.05). A substantial number of pediatric patients, particularly coming from outpatient departments, can be protected from unnecessary or additional radiation exposure from CT imaging when 'Justification' and 'Optimization' principle of ALARA are applied before obtaining CT imaging in a developing country. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Optimization of CT image reconstruction algorithms for the lung tissue research consortium (LTRC)

NASA Astrophysics Data System (ADS)

McCollough, Cynthia; Zhang, Jie; Bruesewitz, Michael; Bartholmai, Brian

2006-03-01

To create a repository of clinical data, CT images and tissue samples and to more clearly understand the pathogenetic features of pulmonary fibrosis and emphysema, the National Heart, Lung, and Blood Institute (NHLBI) launched a cooperative effort known as the Lung Tissue Resource Consortium (LTRC). The CT images for the LTRC effort must contain accurate CT numbers in order to characterize tissues, and must have high-spatial resolution to show fine anatomic structures. This study was performed to optimize the CT image reconstruction algorithms to achieve these criteria. Quantitative analyses of phantom and clinical images were conducted. The ACR CT accreditation phantom containing five regions of distinct CT attenuations (CT numbers of approximately -1000 HU, -80 HU, 0 HU, 130 HU and 900 HU), and a high-contrast spatial resolution test pattern, was scanned using CT systems from two manufacturers (General Electric (GE) Healthcare and Siemens Medical Solutions). Phantom images were reconstructed using all relevant reconstruction algorithms. Mean CT numbers and image noise (standard deviation) were measured and compared for the five materials. Clinical high-resolution chest CT images acquired on a GE CT system for a patient with diffuse lung disease were reconstructed using BONE and STANDARD algorithms and evaluated by a thoracic radiologist in terms of image quality and disease extent. The clinical BONE images were processed with a 3 x 3 x 3 median filter to simulate a thicker slice reconstructed in smoother algorithms, which have traditionally been proven to provide an accurate estimation of emphysema extent in the lungs. Using a threshold technique, the volume of emphysema (defined as the percentage of lung voxels having a CT number lower than -950 HU) was computed for the STANDARD, BONE, and BONE filtered. The CT numbers measured in the ACR CT Phantom images were accurate for all reconstruction kernels for both manufacturers. As expected, visual evaluation of the spatial resolution bar patterns demonstrated that the BONE (GE) and B46f (Siemens) showed higher spatial resolution compared to the STANDARD (GE) or B30f (Siemens) reconstruction algorithms typically used for routine body CT imaging. Only the sharper images were deemed clinically acceptable for the evaluation of diffuse lung disease (e.g. emphysema). Quantitative analyses of the extent of emphysema in patient data showed the percent volumes above the -950 HU threshold as 9.4% for the BONE reconstruction, 5.9% for the STANDARD reconstruction, and 4.7% for the BONE filtered images. Contrary to the practice of using standard resolution CT images for the quantitation of diffuse lung disease, these data demonstrate that a single sharp reconstruction (BONE/B46f) should be used for both the qualitative and quantitative evaluation of diffuse lung disease. The sharper reconstruction images, which are required for diagnostic interpretation, provide accurate CT numbers over the range of -1000 to +900 HU and preserve the fidelity of small structures in the reconstructed images. A filtered version of the sharper images can be accurately substituted for images reconstructed with smoother kernels for comparison to previously published results.

Optimization and comparison of simultaneous and separate acquisition protocols for dual isotope myocardial perfusion SPECT

PubMed Central

Ghaly, Michael; Links, Jonathan M; Frey, Eric C

2015-01-01

Dual-isotope simultaneous-acquisition (DISA) rest-stress myocardial perfusion SPECT (MPS) protocols offer a number of advantages over separate acquisition. However, crosstalk contamination due to scatter in the patient and interactions in the collimator degrade image quality. Compensation can reduce the effects of crosstalk, but does not entirely eliminate image degradations. Optimizing acquisition parameters could further reduce the impact of crosstalk. In this paper we investigate the optimization of the rest Tl-201 energy window width and relative injected activities using the ideal observer (IO), a realistic digital phantom population and Monte Carlo (MC) simulated Tc-99m and Tl-201 projections as a means to improve image quality. We compared performance on a perfusion defect detection task for Tl-201 acquisition energy window widths varying from 4 to 40 keV centered at 72 keV for a camera with a 9% energy resolution. We also investigated 7 different relative injected activities, defined as the ratio of Tc-99m and Tl-201 activities, while keeping the total effective dose constant at 13.5 mSv. For each energy window and relative injected activity, we computed the IO test statistics using a Markov chain Monte Carlo (MCMC) method for an ensemble of 1,620 triplets of fixed and reversible defect-present, and defect-absent noisy images modeling realistic background variations. The volume under the 3-class receiver operating characteristic (ROC) surface (VUS) was estimated and served as the figure of merit. For simultaneous acquisition, the IO suggested that relative Tc-to-Tl injected activity ratios of 2.6–5 and acquisition energy window widths of 16–22% were optimal. For separate acquisition, we observed a broad range of optimal relative injected activities from 2.6 to 12.1 and acquisition energy window of widths 16–22%. A negative correlation between Tl-201 injected activity and the width of the Tl-201 energy window was observed in these ranges. The results also suggested that DISA methods could potentially provide image quality as good as that obtained with separate acquisition protocols. We compared observer performance for the optimized protocols and the current clinical protocol using separate acquisition. The current clinical protocols provided better performance at a cost of injecting the patient with approximately double the injected activity of Tc-99m and Tl-201, resulting in substantially increased radiation dose. PMID:26083239

Diagnostic and interventional musculoskeletal ultrasound: part 2. Clinical applications.

PubMed

Smith, Jay; Finnoff, Jonathan T

2009-02-01

Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurological and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared to other available imaging modalities; (2) describe how ultrasound machines produce images using sound waves; (3) discuss the steps necessary to acquire and optimize an ultrasound image; (4) understand the difference ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones; and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound. Part 2 of this 2-part article will focus on the clinical applications of musculoskeletal ultrasound in clinical practice, including the ultrasonographic appearance of normal and abnormal tissues as well as specific diagnostic and interventional applications in major body regions.

Matching CT and ultrasound data of the liver by landmark constrained image registration

NASA Astrophysics Data System (ADS)

Olesch, Janine; Papenberg, Nils; Lange, Thomas; Conrad, Matthias; Fischer, Bernd

2009-02-01

In navigated liver surgery the key challenge is the registration of pre-operative planing and intra-operative navigation data. Due to the patients individual anatomy the planning is based on segmented, pre-operative CT scans whereas ultrasound captures the actual intra-operative situation. In this paper we derive a novel method based on variational image registration methods and additional given anatomic landmarks. For the first time we embed the landmark information as inequality hard constraints and thereby allowing for inaccurately placed landmarks. The yielding optimization problem allows to ensure the accuracy of the landmark fit by simultaneous intensity based image registration. Following the discretize-then-optimize approach the overall problem is solved by a generalized Gauss-Newton-method. The upcoming linear system is attacked by the MinRes solver. We demonstrate the applicability of the new approach for clinical data which lead to convincing results.

Statistical image quantification toward optimal scan fusion and change quantification

NASA Astrophysics Data System (ADS)

Potesil, Vaclav; Zhou, Xiang Sean

2007-03-01

Recent advance of imaging technology has brought new challenges and opportunities for automatic and quantitative analysis of medical images. With broader accessibility of more imaging modalities for more patients, fusion of modalities/scans from one time point and longitudinal analysis of changes across time points have become the two most critical differentiators to support more informed, more reliable and more reproducible diagnosis and therapy decisions. Unfortunately, scan fusion and longitudinal analysis are both inherently plagued with increased levels of statistical errors. A lack of comprehensive analysis by imaging scientists and a lack of full awareness by physicians pose potential risks in clinical practice. In this paper, we discuss several key error factors affecting imaging quantification, studying their interactions, and introducing a simulation strategy to establish general error bounds for change quantification across time. We quantitatively show that image resolution, voxel anisotropy, lesion size, eccentricity, and orientation are all contributing factors to quantification error; and there is an intricate relationship between voxel anisotropy and lesion shape in affecting quantification error. Specifically, when two or more scans are to be fused at feature level, optimal linear fusion analysis reveals that scans with voxel anisotropy aligned with lesion elongation should receive a higher weight than other scans. As a result of such optimal linear fusion, we will achieve a lower variance than naïve averaging. Simulated experiments are used to validate theoretical predictions. Future work based on the proposed simulation methods may lead to general guidelines and error lower bounds for quantitative image analysis and change detection.

Evaluation of the Painful Dual Taper Modular Neck Stem Total Hip Arthroplasty: Do They All Require Revision?

PubMed

Kwon, Young-Min

2016-07-01

Although dual taper modular-neck total hip arthroplasty (THA) design with additional neck-stem modularity has the potential to optimize hip biomechanical parameters by facilitating adjustments of leg length, femoral neck version and offset, there is increasing concern regarding this stem design as a result of the growing numbers of adverse local tissue reactions due to fretting and corrosion at the neck-stem taper junction. Implant factors such as taper cone angle, taper surface roughness, taper contact area, modular neck taper metallurgy, and femoral head size play important roles in influencing extent of taper corrosion. There should be a low threshold to conduct a systematic clinical evaluation of patients with dual-taper modular-neck stem THA using systematic risk stratification algorithms as early recognition and diagnosis will ensure prompt and appropriate treatment. Although specialized tests such as metal ion analysis and cross-sectional imaging modalities such as metal artifact reduction sequence magnetic resonance imaging (MARS MRI) are useful in optimizing clinical decision-making, overreliance on any single investigative tool in the clinical decision-making process for revision surgery should be avoided. Copyright © 2016 Elsevier Inc. All rights reserved.

MO-G-9A-01: Imaging Refresher for Standard of Care Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Labby, Z; Sensakovic, W; Hipp, E

2014-06-15

Imaging techniques and technology which were previously the domain of diagnostic medicine are becoming increasingly integrated and utilized in radiation therapy (RT) clinical practice. As such, there are a number of specific imaging topics that are highly applicable to modern radiation therapy physics. As imaging becomes more widely integrated into standard clinical radiation oncology practice, the impetus is on RT physicists to be informed and up-to-date on those imaging modalities relevant to the design and delivery of therapeutic radiation treatments. For example, knowing that, for a given situation, a fluid attenuated inversion recovery (FLAIR) image set is most likely whatmore » the physician would like to import and contour is helpful, but may not be sufficient to providing the best quality of care. Understanding the physics of how that pulse sequence works and why it is used could help assess its utility and determine if it is the optimal sequence for aiding in that specific clinical situation. It is thus important that clinical medical physicists be able to understand and explain the physics behind the imaging techniques used in all aspects of clinical radiation oncology practice. This session will provide the basic physics for a variety of imaging modalities for applications that are highly relevant to radiation oncology practice: computed tomography (CT) (including kV, MV, cone beam CT [CBCT], and 4DCT), positron emission tomography (PET)/CT, magnetic resonance imaging (MRI), and imaging specific to brachytherapy (including ultrasound and some brachytherapy specific topics in MR). For each unique modality, the image formation process will be reviewed, trade-offs between image quality and other factors (e.g. imaging time or radiation dose) will be clarified, and typically used cases for each modality will be introduced. The current and near-future uses of these modalities and techniques in radiation oncology clinical practice will also be discussed. Learning Objectives: To review the basic physical science principles of CT, PET, MR, and ultrasound imaging. To understand how the images are created, and present their specific role in patient management and treatment planning for therapeutic radiation (both external beam and brachytherapy). To discuss when and how each specific imaging modality is currently used in clinical practice, as well as how they may come to be used in the near future.« less

SU-D-206-01: Employing a Novel Consensus Optimization Strategy to Achieve Iterative Cone Beam CT Reconstruction On a Multi-GPU Platform

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, B; Southern Medical University, Guangzhou, Guangdong; Tian, Z

Purpose: While compressed sensing-based cone-beam CT (CBCT) iterative reconstruction techniques have demonstrated tremendous capability of reconstructing high-quality images from undersampled noisy data, its long computation time still hinders wide application in routine clinic. The purpose of this study is to develop a reconstruction framework that employs modern consensus optimization techniques to achieve CBCT reconstruction on a multi-GPU platform for improved computational efficiency. Methods: Total projection data were evenly distributed to multiple GPUs. Each GPU performed reconstruction using its own projection data with a conventional total variation regularization approach to ensure image quality. In addition, the solutions from GPUs were subjectmore » to a consistency constraint that they should be identical. We solved the optimization problem with all the constraints considered rigorously using an alternating direction method of multipliers (ADMM) algorithm. The reconstruction framework was implemented using OpenCL on a platform with two Nvidia GTX590 GPU cards, each with two GPUs. We studied the performance of our method and demonstrated its advantages through a simulation case with a NCAT phantom and an experimental case with a Catphan phantom. Result: Compared with the CBCT images reconstructed using conventional FDK method with full projection datasets, our proposed method achieved comparable image quality with about one third projection numbers. The computation time on the multi-GPU platform was ∼55 s and ∼ 35 s in the two cases respectively, achieving a speedup factor of ∼ 3.0 compared with single GPU reconstruction. Conclusion: We have developed a consensus ADMM-based CBCT reconstruction method which enabled performing reconstruction on a multi-GPU platform. The achieved efficiency made this method clinically attractive.« less

A 3D Freehand Ultrasound System for Multi-view Reconstructions from Sparse 2D Scanning Planes

PubMed Central

2011-01-01

Background A significant limitation of existing 3D ultrasound systems comes from the fact that the majority of them work with fixed acquisition geometries. As a result, the users have very limited control over the geometry of the 2D scanning planes. Methods We present a low-cost and flexible ultrasound imaging system that integrates several image processing components to allow for 3D reconstructions from limited numbers of 2D image planes and multiple acoustic views. Our approach is based on a 3D freehand ultrasound system that allows users to control the 2D acquisition imaging using conventional 2D probes. For reliable performance, we develop new methods for image segmentation and robust multi-view registration. We first present a new hybrid geometric level-set approach that provides reliable segmentation performance with relatively simple initializations and minimum edge leakage. Optimization of the segmentation model parameters and its effect on performance is carefully discussed. Second, using the segmented images, a new coarse to fine automatic multi-view registration method is introduced. The approach uses a 3D Hotelling transform to initialize an optimization search. Then, the fine scale feature-based registration is performed using a robust, non-linear least squares algorithm. The robustness of the multi-view registration system allows for accurate 3D reconstructions from sparse 2D image planes. Results Volume measurements from multi-view 3D reconstructions are found to be consistently and significantly more accurate than measurements from single view reconstructions. The volume error of multi-view reconstruction is measured to be less than 5% of the true volume. We show that volume reconstruction accuracy is a function of the total number of 2D image planes and the number of views for calibrated phantom. In clinical in-vivo cardiac experiments, we show that volume estimates of the left ventricle from multi-view reconstructions are found to be in better agreement with clinical measures than measures from single view reconstructions. Conclusions Multi-view 3D reconstruction from sparse 2D freehand B-mode images leads to more accurate volume quantification compared to single view systems. The flexibility and low-cost of the proposed system allow for fine control of the image acquisition planes for optimal 3D reconstructions from multiple views. PMID:21251284

A 3D freehand ultrasound system for multi-view reconstructions from sparse 2D scanning planes.

PubMed

Yu, Honggang; Pattichis, Marios S; Agurto, Carla; Beth Goens, M

2011-01-20

A significant limitation of existing 3D ultrasound systems comes from the fact that the majority of them work with fixed acquisition geometries. As a result, the users have very limited control over the geometry of the 2D scanning planes. We present a low-cost and flexible ultrasound imaging system that integrates several image processing components to allow for 3D reconstructions from limited numbers of 2D image planes and multiple acoustic views. Our approach is based on a 3D freehand ultrasound system that allows users to control the 2D acquisition imaging using conventional 2D probes.For reliable performance, we develop new methods for image segmentation and robust multi-view registration. We first present a new hybrid geometric level-set approach that provides reliable segmentation performance with relatively simple initializations and minimum edge leakage. Optimization of the segmentation model parameters and its effect on performance is carefully discussed. Second, using the segmented images, a new coarse to fine automatic multi-view registration method is introduced. The approach uses a 3D Hotelling transform to initialize an optimization search. Then, the fine scale feature-based registration is performed using a robust, non-linear least squares algorithm. The robustness of the multi-view registration system allows for accurate 3D reconstructions from sparse 2D image planes. Volume measurements from multi-view 3D reconstructions are found to be consistently and significantly more accurate than measurements from single view reconstructions. The volume error of multi-view reconstruction is measured to be less than 5% of the true volume. We show that volume reconstruction accuracy is a function of the total number of 2D image planes and the number of views for calibrated phantom. In clinical in-vivo cardiac experiments, we show that volume estimates of the left ventricle from multi-view reconstructions are found to be in better agreement with clinical measures than measures from single view reconstructions. Multi-view 3D reconstruction from sparse 2D freehand B-mode images leads to more accurate volume quantification compared to single view systems. The flexibility and low-cost of the proposed system allow for fine control of the image acquisition planes for optimal 3D reconstructions from multiple views.

Optimizing the optical wavelength for the photoacoustic imaging of inflammatory arthritis

NASA Astrophysics Data System (ADS)

Jo, Janggun; Xu, Guan; Hu, Jack; Francis, Sheeja; Marquardt, April; Yuan, Jie; Girish, Gandikota; Wang, Xueding

2015-03-01

With the capability of assessing high resolution optical information in soft tissues at imaging depth up to several centimeters, innovative biomedical photoacoustic imaging (PAI) offers benefits to diagnosis and treatment monitoring of inflammatory arthritis, particularly in combination with more established ultrasonography (US). In this work, a PAI and US dual-modality system facilitating both imaging functions in a real-time fashion was developed and initially tested for its clinical performance on patients with active inflammatory arthritis. Photoacoustic (PA) images of metacarpophalangeal (MCP) joints were acquired at 580-nm wavelength that provides a desired balance between optical absorption of blood and attenuation in background tissue. The results from six patients and six normal volunteers used as a control demonstrated the satisfactory sensitivity of PAI in assessing the physiological changes in the joints, specifically enhanced blood flow as a result of active synovitis. This preliminary study suggests that PAI, by revealing vascular features suggestive of joint inflammation, could be a valuable supplement to musculoskeletal US for rheumatology clinic.

Assessing the Dosimetric Accuracy of Magnetic Resonance-Generated Synthetic CT Images for Focal Brain VMAT Radiation Therapy.

PubMed

Paradis, Eric; Cao, Yue; Lawrence, Theodore S; Tsien, Christina; Feng, Mary; Vineberg, Karen; Balter, James M

2015-12-01

The purpose of this study was to assess the dosimetric accuracy of synthetic CT (MRCT) volumes generated from magnetic resonance imaging (MRI) data for focal brain radiation therapy. A study was conducted in 12 patients with gliomas who underwent both MR and CT imaging as part of their simulation for external beam treatment planning. MRCT volumes were generated from MR images. Patients' clinical treatment planning directives were used to create 12 individual volumetric modulated arc therapy (VMAT) plans, which were then optimized 10 times on each of their respective CT and MRCT-derived electron density maps. Dose metrics derived from optimization criteria, as well as monitor units and gamma analyses, were evaluated to quantify differences between the imaging modalities. Mean differences between planning target volume (PTV) doses on MRCT and CT plans across all patients were 0.0% (range: -0.1 to 0.2%) for D(95%); 0.0% (-0.7 to 0.6%) for D(5%); and -0.2% (-1.0 to 0.2%) for D(max). MRCT plans showed no significant changes in monitor units (-0.4%) compared to CT plans. Organs at risk (OARs) had average D(max) differences of 0.0 Gy (-2.2 to 1.9 Gy) over 85 structures across all 12 patients, with no significant differences when calculated doses approached planning constraints. Focal brain VMAT plans optimized on MRCT images show excellent dosimetric agreement with standard CT-optimized plans. PTVs show equivalent coverage, and OARs do not show any overdose. These results indicate that MRI-derived synthetic CT volumes can be used to support treatment planning of most patients treated for intracranial lesions. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing the Dosimetric Accuracy of Magnetic Resonance-Generated Synthetic CT Images for Focal Brain VMAT Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paradis, Eric, E-mail: eparadis@umich.edu; Cao, Yue; Department of Radiology, University of Michigan Hospital and Health Systems, Ann Arbor, Michigan

2015-12-01

Purpose: The purpose of this study was to assess the dosimetric accuracy of synthetic CT (MRCT) volumes generated from magnetic resonance imaging (MRI) data for focal brain radiation therapy. Methods and Materials: A study was conducted in 12 patients with gliomas who underwent both MR and CT imaging as part of their simulation for external beam treatment planning. MRCT volumes were generated from MR images. Patients' clinical treatment planning directives were used to create 12 individual volumetric modulated arc therapy (VMAT) plans, which were then optimized 10 times on each of their respective CT and MRCT-derived electron density maps. Dosemore » metrics derived from optimization criteria, as well as monitor units and gamma analyses, were evaluated to quantify differences between the imaging modalities. Results: Mean differences between planning target volume (PTV) doses on MRCT and CT plans across all patients were 0.0% (range: −0.1 to 0.2%) for D{sub 95%}; 0.0% (−0.7 to 0.6%) for D{sub 5%}; and −0.2% (−1.0 to 0.2%) for D{sub max}. MRCT plans showed no significant changes in monitor units (−0.4%) compared to CT plans. Organs at risk (OARs) had average D{sub max} differences of 0.0 Gy (−2.2 to 1.9 Gy) over 85 structures across all 12 patients, with no significant differences when calculated doses approached planning constraints. Conclusions: Focal brain VMAT plans optimized on MRCT images show excellent dosimetric agreement with standard CT-optimized plans. PTVs show equivalent coverage, and OARs do not show any overdose. These results indicate that MRI-derived synthetic CT volumes can be used to support treatment planning of most patients treated for intracranial lesions.« less

SU-F-J-16: Planar KV Imaging Dose Reduction Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gershkevitsh, E; Zolotuhhin, D

Purpose: IGRT has become an indispensable tool in modern radiotherapy with kV imaging used in many departments due to superior image quality and lower dose when compared to MV imaging. Many departments use manufacturer supplied protocols for imaging which are not always optimised between image quality and radiation dose (ALARA). Methods: Whole body phantom PBU-50 (Kyoto Kagaku ltd., Japan) for imaging in radiology has been imaged on Varian iX accelerator (Varian Medical Systems, USA) with OBI 1.5 system. Manufacturer’s default protocols were adapted by modifying kV and mAs values when imaging different anatomical regions of the phantom (head, thorax, abdomen,more » pelvis, extremities). Images with different settings were independently reviewed by two persons and their suitability for IGRT set-up correction protocols were evaluated. The suitable images with the lowest mAs were then selected. The entrance surface dose (ESD) for manufacturer’s default protocols and modified protocols were measured with RTI Black Piranha (RTI Group, Sweden) and compared. Image quality was also measured with kVQC phantom (Standard Imaging, USA) for different protocols. The modified protocols have been applied for clinical work. Results: For most cases optimized protocols reduced the ESD on average by a factor of 3(range 0.9–8.5). Further reduction in ESD has been observed by applying bow-tie filter designed for CBCT. The largest reduction in dose (12.2 times) was observed for Thorax lateral protocol. The dose was slightly increased (by 10%) for large pelvis AP protocol. Conclusion: Manufacturer’s default IGRT protocols could be optimised to reduce the ESD to the patient without losing the necessary image quality for patient set-up correction. For patient set-up with planar kV imaging the bony anatomy is mostly used and optimization should focus on this aspect. Therefore, the current approach with anthropomorphic phantom is more advantageous in optimization over standard kV quality control phantoms and SNR metrics.« less

WE-G-204-08: Optimized Digital Radiographic Technique for Lost Surgical Devices/Needle Identification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gorman, A; Seabrook, G; Brakken, A

Purpose: Small surgical devices and needles are used in many surgical procedures. Conventionally, an x-ray film is taken to identify missing devices/needles if post procedure count is incorrect. There is no data to indicate smallest surgical devices/needles that can be identified with digital radiography (DR), and its optimized acquisition technique. Methods: In this study, the DR equipment used is a Canon RadPro mobile with CXDI-70c wireless DR plate, and the same DR plate on a fixed Siemens Multix unit. Small surgical devices and needles tested include Rubber Shod, Bulldog, Fogarty Hydrogrip, and needles with sizes 3-0 C-T1 through 8-0 BV175-6.more » They are imaged with PMMA block phantoms with thickness of 2–8 inch, and an abdomen phantom. Various DR techniques are used. Images are reviewed on the portable x-ray acquisition display, a clinical workstation, and a diagnostic workstation. Results: all small surgical devices and needles are visible in portable DR images with 2–8 inch of PMMA. However, when they are imaged with the abdomen phantom plus 2 inch of PMMA, needles smaller than 9.3 mm length can not be visualized at the optimized technique of 81 kV and 16 mAs. There is no significant difference in visualization with various techniques, or between mobile and fixed radiography unit. However, there is noticeable difference in visualizing the smallest needle on a diagnostic reading workstation compared to the acquisition display on a portable x-ray unit. Conclusion: DR images should be reviewed on a diagnostic reading workstation. Using optimized DR techniques, the smallest needle that can be identified on all phantom studies is 9.3 mm. Sample DR images of various small surgical devices/needles available on diagnostic workstation for comparison may improve their identification. Further in vivo study is needed to confirm the optimized digital radiography technique for identification of lost small surgical devices and needles.« less

Automatic motion correction of clinical shoulder MR images

NASA Astrophysics Data System (ADS)

Manduca, Armando; McGee, Kiaran P.; Welch, Edward B.; Felmlee, Joel P.; Ehman, Richard L.

1999-05-01

A technique for the automatic correction of motion artifacts in MR images was developed. The algorithm uses only the raw (complex) data from the MR scanner, and requires no knowledge of the patient motion during the acquisition. It operates by searching over the space of possible patient motions and determining the motion which, when used to correct the image, optimizes the image quality. The performance of this algorithm was tested in coronal images of the rotator cuff in a series of 144 patients. A four observer comparison of the autocorrelated images with the uncorrected images demonstrated that motion artifacts were significantly reduced in 48% of the cases. The improvements in image quality were similar to those achieved with a previously reported navigator echo-based adaptive motion correction. The results demonstrate that autocorrelation is a practical technique for retrospectively reducing motion artifacts in a demanding clinical MRI application. It achieves performance comparable to a navigator based correction technique, which is significant because autocorrection does not require an imaging sequence that has been modified to explicitly track motion during acquisition. The approach is flexible and should be readily extensible to other types of MR acquisitions that are corrupted by global motion.

WE-D-BRB-02: Proton Treatment Planning and Beam Optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pankuch, M.

2016-06-15

The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. Itmore » introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.« less

Myocardial Infarct Segmentation from Magnetic Resonance Images for Personalized Modeling of Cardiac Electrophysiology

PubMed Central

Ukwatta, Eranga; Arevalo, Hermenegild; Li, Kristina; Yuan, Jing; Qiu, Wu; Malamas, Peter; Wu, Katherine C.

2016-01-01

Accurate representation of myocardial infarct geometry is crucial to patient-specific computational modeling of the heart in ischemic cardiomyopathy. We have developed a methodology for segmentation of left ventricular (LV) infarct from clinically acquired, two-dimensional (2D), late-gadolinium enhanced cardiac magnetic resonance (LGE-CMR) images, for personalized modeling of ventricular electrophysiology. The infarct segmentation was expressed as a continuous min-cut optimization problem, which was solved using its dual formulation, the continuous max-flow (CMF). The optimization objective comprised of a smoothness term, and a data term that quantified the similarity between image intensity histograms of segmented regions and those of a set of training images. A manual segmentation of the LV myocardium was used to initialize and constrain the developed method. The three-dimensional geometry of infarct was reconstructed from its segmentation using an implicit, shape-based interpolation method. The proposed methodology was extensively evaluated using metrics based on geometry, and outcomes of individualized electrophysiological simulations of cardiac dys(function). Several existing LV infarct segmentation approaches were implemented, and compared with the proposed method. Our results demonstrated that the CMF method was more accurate than the existing approaches in reproducing expert manual LV infarct segmentations, and in electrophysiological simulations. The infarct segmentation method we have developed and comprehensively evaluated in this study constitutes an important step in advancing clinical applications of personalized simulations of cardiac electrophysiology. PMID:26731693

Optimization of 31P magnetic resonance spectroscopy in vivo

NASA Astrophysics Data System (ADS)

Manzhurtsev, A. V.; Akhadov, T. A.; Semenova, N. A.

2018-01-01

The main problem of magnetic resonance spectroscopy on phosphorus nuclei (31P MRS) is low signal-to-noise ratio (SNR) of spectra acquired on clinical (3T) scanners. This makes quantitative processing of spectra difficult. The optimization of method on a single-voxel model reported in current work implicates an impact of the spin-lattice (T1) relaxation on SNR, and also evaluates the effectiveness of Image Selected InVivo Spectroscopy (ISIS) pulse sequence modification for the increase of SNR.

Optimizing care for the obese patient in interventional radiology

PubMed Central

Aberle, Dwight; Charles, Hearns; Hodak, Steven; O’Neill, Daniel; Oklu, Rahmi; Deipolyi, Amy R.

2017-01-01

With the rising epidemic of obesity, interventional radiologists are treating increasing numbers of obese patients, as comorbidities associated with obesity preclude more invasive treatments. These patients are at heightened risk of vascular and oncologic disease, both of which often require interventional radiology care. Obese patients pose unique challenges in imaging, technical feasibility, and periprocedural monitoring. This review describes the technical and clinical challenges posed by this population, with proposed methods to mitigate these challenges and optimize care. PMID:28082253

SU-E-I-23: A General KV Constrained Optimization of CNR for CT Abdominal Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weir, V; Zhang, J

Purpose: While Tube current modulation has been well accepted for CT dose reduction, kV adjusting in clinical settings is still at its early stage. This is mainly due to the limited kV options of most current CT scanners. kV adjusting can potentially reduce radiation dose and optimize image quality. This study is to optimize CT abdomen imaging acquisition based on the assumption of a continuous kV, with the goal to provide the best contrast to noise ratio (CNR). Methods: For a given dose (CTDIvol) level, the CNRs at different kV and pitches were measured with an ACR GAMMEX phantom. Themore » phantom was scanned in a Siemens Sensation 64 scanner and a GE VCT 64 scanner. A constrained mathematical optimization was used to find the kV which led to the highest CNR for the anatomy and pitch setting. Parametric equations were obtained from polynomial fitting of plots of kVs vs CNRs. A suitable constraint region for optimization was chosen. Subsequent optimization yielded a peak CNR at a particular kV for different collimations and pitch setting. Results: The constrained mathematical optimization approach yields kV of 114.83 and 113.46, with CNRs of 1.27 and 1.11 at the pitch of 1.2 and 1.4, respectively, for the Siemens Sensation 64 scanner with the collimation of 32 x 0.625mm. An optimized kV of 134.25 and 1.51 CNR is obtained for a GE VCT 64 slice scanner with a collimation of 32 x 0.625mm and a pitch of 0.969. At 0.516 pitch and 32 x 0.625 mm an optimized kV of 133.75 and a CNR of 1.14 was found for the GE VCT 64 slice scanner. Conclusion: CNR in CT image acquisition can be further optimized with a continuous kV option instead of current discrete or fixed kV settings. A continuous kV option is a key for individualized CT protocols.« less

Geodesic denoising for optical coherence tomography images

NASA Astrophysics Data System (ADS)

Shahrian Varnousfaderani, Ehsan; Vogl, Wolf-Dieter; Wu, Jing; Gerendas, Bianca S.; Simader, Christian; Langs, Georg; Waldstein, Sebastian M.; Schmidt-Erfurth, Ursula

2016-03-01

Optical coherence tomography (OCT) is an optical signal acquisition method capturing micrometer resolution, cross-sectional three-dimensional images. OCT images are used widely in ophthalmology to diagnose and monitor retinal diseases such as age-related macular degeneration (AMD) and Glaucoma. While OCT allows the visualization of retinal structures such as vessels and retinal layers, image quality and contrast is reduced by speckle noise, obfuscating small, low intensity structures and structural boundaries. Existing denoising methods for OCT images may remove clinically significant image features such as texture and boundaries of anomalies. In this paper, we propose a novel patch based denoising method, Geodesic Denoising. The method reduces noise in OCT images while preserving clinically significant, although small, pathological structures, such as fluid-filled cysts in diseased retinas. Our method selects optimal image patch distribution representations based on geodesic patch similarity to noisy samples. Patch distributions are then randomly sampled to build a set of best matching candidates for every noisy sample, and the denoised value is computed based on a geodesic weighted average of the best candidate samples. Our method is evaluated qualitatively on real pathological OCT scans and quantitatively on a proposed set of ground truth, noise free synthetic OCT scans with artificially added noise and pathologies. Experimental results show that performance of our method is comparable with state of the art denoising methods while outperforming them in preserving the critical clinically relevant structures.

Computation of physiological human vocal fold parameters by mathematical optimization of a biomechanical model

PubMed Central

Yang, Anxiong; Stingl, Michael; Berry, David A.; Lohscheller, Jörg; Voigt, Daniel; Eysholdt, Ulrich; Döllinger, Michael

2011-01-01

With the use of an endoscopic, high-speed camera, vocal fold dynamics may be observed clinically during phonation. However, observation and subjective judgment alone may be insufficient for clinical diagnosis and documentation of improved vocal function, especially when the laryngeal disease lacks any clear morphological presentation. In this study, biomechanical parameters of the vocal folds are computed by adjusting the corresponding parameters of a three-dimensional model until the dynamics of both systems are similar. First, a mathematical optimization method is presented. Next, model parameters (such as pressure, tension and masses) are adjusted to reproduce vocal fold dynamics, and the deduced parameters are physiologically interpreted. Various combinations of global and local optimization techniques are attempted. Evaluation of the optimization procedure is performed using 50 synthetically generated data sets. The results show sufficient reliability, including 0.07 normalized error, 96% correlation, and 91% accuracy. The technique is also demonstrated on data from human hemilarynx experiments, in which a low normalized error (0.16) and high correlation (84%) values were achieved. In the future, this technique may be applied to clinical high-speed images, yielding objective measures with which to document improved vocal function of patients with voice disorders. PMID:21877808

Optimal Co-segmentation of Tumor in PET-CT Images with Context Information

PubMed Central

Song, Qi; Bai, Junjie; Han, Dongfeng; Bhatia, Sudershan; Sun, Wenqing; Rockey, William; Bayouth, John E.; Buatti, John M.

2014-01-01

PET-CT images have been widely used in clinical practice for radiotherapy treatment planning of the radiotherapy. Many existing segmentation approaches only work for a single imaging modality, which suffer from the low spatial resolution in PET or low contrast in CT. In this work we propose a novel method for the co-segmentation of the tumor in both PET and CT images, which makes use of advantages from each modality: the functionality information from PET and the anatomical structure information from CT. The approach formulates the segmentation problem as a minimization problem of a Markov Random Field (MRF) model, which encodes the information from both modalities. The optimization is solved using a graph-cut based method. Two sub-graphs are constructed for the segmentation of the PET and the CT images, respectively. To achieve consistent results in two modalities, an adaptive context cost is enforced by adding context arcs between the two subgraphs. An optimal solution can be obtained by solving a single maximum flow problem, which leads to simultaneous segmentation of the tumor volumes in both modalities. The proposed algorithm was validated in robust delineation of lung tumors on 23 PET-CT datasets and two head-and-neck cancer subjects. Both qualitative and quantitative results show significant improvement compared to the graph cut methods solely using PET or CT. PMID:23693127

Good manufacturing practice production of [68Ga]Ga-ABY-025 for HER2 specific breast cancer imaging

PubMed Central

Velikyan, Irina; Wennborg, Anders; Feldwisch, Joachim; Lindman, Henrik; Carlsson, Jörgen; Sörensen, Jens

2016-01-01

Therapies targeting human epidermal growth factor receptor type 2 (HER2) have revolutionized breast cancer treatment, but require invasive biopsies and rigorous histopathology for optimal patient stratification. A non-invasive and quantitative diagnostic method such as positron emission tomography (PET) for the pre-therapeutic determination of the presence and density of the HER2 would significantly improve patient management efficacy and treatment cost. The essential part of the PET methodology is the production of the radiopharmaceutical in compliance with good manufacturing practice (GMP). The use of generator produced positron emitting 68Ga radionuclide would provide worldwide accessibility of the agent. GMP compliant, reliable and highly reproducible production of [68Ga]Ga-ABY-025 with control over the product peptide concentration and amount of radioactivity was accomplished within one hour. Two radiopharmaceuticals were developed differing in the total peptide content and were validated independently. The specific radioactivity could be kept similar throughout the study, and it was 6-fold higher for the low peptide content radiopharmaceutical. Intrapatient comparison of the two peptide doses allowed imaging optimization. The high peptide content decreased the uptake in healthy tissue, in particular liver, improving image contrast. The later imaging time points enhanced the contrast. The combination of high peptide content radiopharmaceutical and whole-body imaging at 2 hours post injection appeared to be optimal for routine clinical use. PMID:27186441

Contrast-enhanced digital mammography (CEDM): imaging modeling, computer simulations, and phantom study

NASA Astrophysics Data System (ADS)

Chen, Biao; Jing, Zhenxue; Smith, Andrew

2005-04-01

Contrast enhanced digital mammography (CEDM), which is based upon the analysis of a series of x-ray projection images acquired before/after the administration of contrast agents, may provide physicians critical physiologic and morphologic information of breast lesions to determine the malignancy of lesions. This paper proposes to combine the kinetic analysis (KA) of contrast agent uptake/washout process and the dual-energy (DE) contrast enhancement together to formulate a hybrid contrast enhanced breast-imaging framework. The quantitative characteristics of materials and imaging components in the x-ray imaging chain, including x-ray tube (tungsten) spectrum, filter, breast tissues/lesions, contrast agents (non-ionized iodine solution), and selenium detector, were systematically modeled. The contrast-noise-ration (CNR) of iodinated lesions and mean absorbed glandular dose were estimated mathematically. The x-ray techniques optimization was conducted through a series of computer simulations to find the optimal tube voltage, filter thickness, and exposure levels for various breast thicknesses, breast density, and detectable contrast agent concentration levels in terms of detection efficiency (CNR2/dose). A phantom study was performed on a modified Selenia full field digital mammography system to verify the simulated results. The dose level was comparable to the dose in diagnostic mode (less than 4 mGy for an average 4.2 cm compressed breast). The results from the computer simulations and phantom study are being used to optimize an ongoing clinical study.

SU-E-I-57: Evaluation and Optimization of Effective-Dose Using Different Beam-Hardening Filters in Clinical Pediatric Shunt CT Protocol

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gill, K; Aldoohan, S; Collier, J

Purpose: Study image optimization and radiation dose reduction in pediatric shunt CT scanning protocol through the use of different beam-hardening filters Methods: A 64-slice CT scanner at OU Childrens Hospital has been used to evaluate CT image contrast-to-noise ratio (CNR) and measure effective-doses based on the concept of CT dose index (CTDIvol) using the pediatric head shunt scanning protocol. The routine axial pediatric head shunt scanning protocol that has been optimized for the intrinsic x-ray tube filter has been used to evaluate CNR by acquiring images using the ACR approved CT-phantom and radiation dose CTphantom, which was used to measuremore » CTDIvol. These results were set as reference points to study and evaluate the effects of adding different filtering materials (i.e. Tungsten, Tantalum, Titanium, Nickel and Copper filters) to the existing filter on image quality and radiation dose. To ensure optimal image quality, the scanner routine air calibration was run for each added filter. The image CNR was evaluated for different kVps and wide range of mAs values using above mentioned beam-hardening filters. These scanning protocols were run under axial as well as under helical techniques. The CTDIvol and the effective-dose were measured and calculated for all scanning protocols and added filtration, including the intrinsic x-ray tube filter. Results: Beam-hardening filter shapes energy spectrum, which reduces the dose by 27%. No noticeable changes in image low contrast detectability Conclusion: Effective-dose is very much dependent on the CTDIVol, which is further very much dependent on beam-hardening filters. Substantial reduction in effective-dose is realized using beam-hardening filters as compare to the intrinsic filter. This phantom study showed that significant radiation dose reduction could be achieved in CT pediatric shunt scanning protocols without compromising in diagnostic value of image quality.« less

Granulomatous mastitis: changing clinical and imaging features with image-guided biopsy correlation.

PubMed

Handa, Priyanka; Leibman, A Jill; Sun, Derek; Abadi, Maria; Goldberg, Aryeh

2014-10-01

To review clinical presentation, revisit patient demographics and imaging findings in granulomatous mastitis and determine the optimal biopsy method for diagnosis. A retrospective study was performed to review the clinical presentation, imaging findings and biopsy methods in patients with granulomatous mastitis. Twenty-seven patients with pathology-proven granulomatous mastitis were included. The average age at presentation was 38.0 years (range, 21-73 years). Seven patients were between 48 and 73 years old. Twenty-four patients presented with symptoms and three patients were asymptomatic. Nineteen patients were imaged with mammography demonstrating mammographically occult lesions as the predominant finding. Twenty-six patients were imaged with ultrasound and the most common finding was a mass lesion. Pathological diagnosis was made by image-guided biopsy in 44 % of patients. The imaging features of granulomatous mastitis on mammography are infrequently described. Our study demonstrates that granulomatous mastitis can occur in postmenopausal or asymptomatic patients, although previously reported exclusively in young women with palpable findings. Presentation on mammography as calcifications requiring mammographically guided vacuum-assisted biopsy has not been previously described. The diagnosis of granulomatous mastitis can easily be made by image-guided biopsy and surgical excision should be reserved for definitive treatment. • Characterizes radiographic appearance of granulomatous mastitis in postmenopausal or asymptomatic patients. • Granulomatous mastitis can present exclusively as calcifications on mammography. • The diagnosis of granulomatous mastitis is made by image-guided biopsy techniques.

Dual-modality brain PET-CT image segmentation based on adaptive use of functional and anatomical information.

PubMed

Xia, Yong; Eberl, Stefan; Wen, Lingfeng; Fulham, Michael; Feng, David Dagan

2012-01-01

Dual medical imaging modalities, such as PET-CT, are now a routine component of clinical practice. Medical image segmentation methods, however, have generally only been applied to single modality images. In this paper, we propose the dual-modality image segmentation model to segment brain PET-CT images into gray matter, white matter and cerebrospinal fluid. This model converts PET-CT image segmentation into an optimization process controlled simultaneously by PET and CT voxel values and spatial constraints. It is innovative in the creation and application of the modality discriminatory power (MDP) coefficient as a weighting scheme to adaptively combine the functional (PET) and anatomical (CT) information on a voxel-by-voxel basis. Our approach relies upon allowing the modality with higher discriminatory power to play a more important role in the segmentation process. We compared the proposed approach to three other image segmentation strategies, including PET-only based segmentation, combination of the results of independent PET image segmentation and CT image segmentation, and simultaneous segmentation of joint PET and CT images without an adaptive weighting scheme. Our results in 21 clinical studies showed that our approach provides the most accurate and reliable segmentation for brain PET-CT images. Copyright © 2011 Elsevier Ltd. All rights reserved.

Multimodality Image Fusion-Guided Procedures: Technique, Accuracy, and Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abi-Jaoudeh, Nadine, E-mail: naj@mail.nih.gov; Kruecker, Jochen, E-mail: jochen.kruecker@philips.com; Kadoury, Samuel, E-mail: samuel.kadoury@polymtl.ca

2012-10-15

Personalized therapies play an increasingly critical role in cancer care: Image guidance with multimodality image fusion facilitates the targeting of specific tissue for tissue characterization and plays a role in drug discovery and optimization of tailored therapies. Positron-emission tomography (PET), magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CT) may offer additional information not otherwise available to the operator during minimally invasive image-guided procedures, such as biopsy and ablation. With use of multimodality image fusion for image-guided interventions, navigation with advanced modalities does not require the physical presence of the PET, MRI, or CT imaging system. Several commercially available methodsmore » of image-fusion and device navigation are reviewed along with an explanation of common tracking hardware and software. An overview of current clinical applications for multimodality navigation is provided.« less

SU-F-J-214: Dose Reduction by Spatially Optimized Image Quality Via Fluence Modulated Proton CT (FMpCT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

De Angelis, L; Landry, G; Dedes, G

Purpose: Proton CT (pCT) is a promising imaging modality for reducing range uncertainty in image-guided proton therapy. Range uncertainties partially originate from X-ray CT number conversion to stopping power ratio (SPR) and are limiting the exploitation of the full potential of proton therapy. In this study we explore the concept of spatially dependent fluence modulated proton CT (FMpCT), for achieving optimal image quality in a clinical region of interest (ROI), while reducing significantly the imaging dose to the patient. Methods: The study was based on simulated ideal pCT using pencil beam (PB) scanning. A set of 250 MeV protons PBsmore » was used to create 360 projections of a cylindrical water phantom and a head and neck cancer patient. The tomographic images were reconstructed using a filtered backprojection (FBP) as well as an iterative algorithm (ITR). Different fluence modulation levels were investigated and their impact on the image was quantified in terms of SPR accuracy as well as noise within and outside selected ROIs, as a function of imaging dose. The unmodulated image served as reference. Results: Both FBP reconstruction and ITR without total variation (TV) yielded image quality in the ROIs similar to the reference images, for modulation down to 0.1 of the full proton fluence. The average dose was reduced by 75% for the water phantom and by 40% for the patient. FMpCT does not improve the noise for ITR with TV and modulation 0.1. Conclusion: This is the first work proposing and investigating FMpCT for producing optimal image quality for treatment planning and image guidance, while simultaneously reducing imaging dose. Future work will address spatial resolution effects and the impact of FMpCT on the quality of proton treatment plans for a prototype pCT scanner capable of list mode data acquisition. Acknowledgement: DFG-MAP DFG - Munich-Centre for Advanced Photonics (MAP)« less

Optimization of a secondary VOI protocol for lung imaging in a clinical CT scanner.

PubMed

Larsen, Thomas C; Gopalakrishnan, Vissagan; Yao, Jianhua; Nguyen, Catherine P; Chen, Marcus Y; Moss, Joel; Wen, Han

2018-05-21

We present a solution to meet an unmet clinical need of an in-situ "close look" at a pulmonary nodule or at the margins of a pulmonary cyst revealed by a primary (screening) chest CT while the patient is still in the scanner. We first evaluated options available on current whole-body CT scanners for high resolution screening scans, including ROI reconstruction of the primary scan data and HRCT, but found them to have insufficient SNR in lung tissue or discontinuous slice coverage. Within the capabilities of current clinical CT systems, we opted for the solution of a secondary, volume-of-interest (VOI) protocol where the radiation dose is focused into a short-beam axial scan at the z position of interest, combined with a small-FOV reconstruction at the xy position of interest. The objective of this work was to design a VOI protocol that is optimized for targeted lung imaging in a clinical whole-body CT system. Using a chest phantom containing a lung-mimicking foam insert with a simulated cyst, we identified the appropriate scan mode and optimized both the scan and recon parameters. The VOI protocol yielded 3.2 times the texture amplitude-to-noise ratio in the lung-mimicking foam when compared to the standard chest CT, and 8.4 times the texture difference between the lung mimicking and reference foams. It improved details of the wall of the simulated cyst and better resolution in a line-pair insert. The Effective Dose of the secondary VOI protocol was 42% on average and up to 100% in the worst-case scenario of VOI positioning relative to the standard chest CT. The optimized protocol will be used to obtain detailed CT textures of pulmonary lesions, which are biomarkers for the type and stage of lung diseases. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Collimator design for a multipinhole brain SPECT insert for MRI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Audenhaege, Karen; Van Holen, Roel; Vanhove, Christian

Purpose: Brain single photon emission computed tomography (SPECT) imaging is an important clinical tool, with unique tracers for studying neurological diseases. Nowadays, most commercial SPECT systems are combined with x-ray computed tomography (CT) in so-called SPECT/CT systems to obtain an anatomical background for the functional information. However, while CT images have a high spatial resolution, they have a low soft-tissue contrast, which is an important disadvantage for brain imaging. Magnetic resonance imaging (MRI), on the other hand, has a very high soft-tissue contrast and does not involve extra ionizing radiation. Therefore, the authors designed a brain SPECT insert that canmore » operate inside a clinical MRI. Methods: The authors designed and simulated a compact stationary multipinhole SPECT insert based on digital silicon photomultiplier detector modules, which have shown to be MR-compatible and have an excellent intrinsic resolution (0.5 mm) when combined with a monolithic 2 mm thick LYSO crystal. First, the authors optimized the different parameters of the SPECT system to maximize sensitivity for a given target resolution of 7.2 mm in the center of the field-of-view, given the spatial constraints of the MR system. Second, the authors performed noiseless simulations of two multipinhole configurations to evaluate sampling and reconstructed resolution. Finally, the authors performed Monte Carlo simulations and compared the SPECT insert with a clinical system with ultrahigh-resolution (UHR) fan beam collimators, based on contrast-to-noise ratio and a visual comparison of a Hoffman phantom with a 9 mm cold lesion. Results: The optimization resulted in a stationary multipinhole system with a collimator radius of 150.2 mm and a detector radius of 172.67 mm, which corresponds to four rings of 34 diSPM detector modules. This allows the authors to include eight rings of 24 pinholes, which results in a system volume sensitivity of 395 cps/MBq. Noiseless simulations show sufficient axial sampling (in a Defrise phantom) and a reconstructed resolution of 5.0 mm (in a cold-rod phantom). The authors compared the 24-pinhole setup with a 34-pinhole system (with the same detector radius but a collimator radius of 156.63 mm) and found that 34 pinholes result in better uniformity but a worse reconstruction of the cold-rod phantom. The authors also compared the 24-pinhole system with a clinical triple-head UHR fan beam system based on contrast-to-noise ratio and found that the 24-pinhole setup performs better for the 6 mm hot and the 16 mm cold lesions and worse for the 8 and 10 mm hot lesions. Finally, the authors reconstructed noisy projection data of a Hoffman phantom with a 9 mm cold lesion and found that the lesion was slightly better visible on the multipinhole image compared to the fan beam image. Conclusions: The authors have optimized a stationary multipinhole SPECT insert for MRI and showed the feasibility of doing brain SPECT imaging inside a MRI with an image quality similar to the best clinical SPECT systems available.« less

Clinical Decision Rules for Diagnostic Imaging in the Emergency Department: A Research Agenda.

PubMed

Finnerty, Nathan M; Rodriguez, Robert M; Carpenter, Christopher R; Sun, Benjamin C; Theyyunni, Nik; Ohle, Robert; Dodd, Kenneth W; Schoenfeld, Elizabeth M; Elm, Kendra D; Kline, Jeffrey A; Holmes, James F; Kuppermann, Nathan

2015-12-01

Major gaps persist in the development, validation, and implementation of clinical decision rules (CDRs) for diagnostic imaging. The objective of this working group and article was to generate a consensus-based research agenda for the development and implementation of CDRs for diagnostic imaging in the emergency department (ED). The authors followed consensus methodology, as outlined by the journal Academic Emergency Medicine (AEM), combining literature review, electronic surveys, telephonic communications, and a modified nominal group technique. Final discussions occurred in person at the 2015 AEM consensus conference. A research agenda was developed, prioritizing the following questions: 1) what are the optimal methods to justify the derivation and validation of diagnostic imaging CDRs, 2) what level of evidence is required before disseminating CDRs for widespread implementation, 3) what defines a successful CDR, 4) how should investigators best compare CDRs to clinical judgment, and 5) what disease states are amenable (and highest priority) to development of CDRs for diagnostic imaging in the ED? The concepts discussed herein demonstrate the need for further research on CDR development and implementation regarding diagnostic imaging in the ED. Addressing this research agenda should have direct applicability to patients, clinicians, and health care systems. © 2015 by the Society for Academic Emergency Medicine.

Radiolabeled inorganic nanoparticles for positron emission tomography imaging of cancer: an overview

PubMed Central

CHAKRAVARTY, Rubel; GOEL, Shreya; DASH, Ashutosh; CAI, Weibo

2017-01-01

Over the last few years, a plethora of radiolabeled inorganic nanoparticles have been developed and evaluated for their potential use as probes in positron emission tomography (PET) imaging of a wide variety of cancers. Inorganic nanoparticles represent an emerging paradigm in molecular imaging probe design, allowing the incorporation of various imaging modalities, targeting ligands, and therapeutic payloads into a single vector. A major challenge in this endeavor is to develop disease-specific nanoparticles with facile and robust radiolabeling strategies. Also, the radiolabeled nanoparticles should demonstrate adequate in vitro and in vivo stability, enhanced sensitivity for detection of disease at an early stage, optimized in vivo pharmacokinetics for reduced non-specific organ uptake, and improved targeting for achieving high efficacy. Owing to these challenges and other technological and regulatory issues, only a single radiolabeled nanoparticle formulation, namely “C-dots” (Cornell dots), has found its way into clinical trials thus far. This review describes the available options for radiolabeling of nanoparticles and summarizes the recent developments in PET imaging of cancer in preclinical and clinical settings using radiolabeled nanoparticles as probes. The key considerations toward clinical translation of these novel PET imaging probes are discussed, which will be beneficial for advancement of the field. PMID:28124549

TU-A-17A-02: In Memoriam of Ben Galkin: Virtual Tools for Validation of X-Ray Breast Imaging Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Myers, K; Bakic, P; Abbey, C

2014-06-15

This symposium will explore simulation methods for the preclinical evaluation of novel 3D and 4D x-ray breast imaging systems – the subject of AAPM taskgroup TG234. Given the complex design of modern imaging systems, simulations offer significant advantages over long and costly clinical studies in terms of reproducibility, reduced radiation exposures, a known reference standard, and the capability for studying patient and disease subpopulations through appropriate choice of simulation parameters. Our focus will be on testing the realism of software anthropomorphic phantoms and virtual clinical trials tools developed for the optimization and validation of breast imaging systems. The symposium willmore » review the stateof- the-science, as well as the advantages and limitations of various approaches to testing realism of phantoms and simulated breast images. Approaches based upon the visual assessment of synthetic breast images by expert observers will be contrasted with approaches based upon comparing statistical properties between synthetic and clinical images. The role of observer models in the assessment of realism will be considered. Finally, an industry perspective will be presented, summarizing the role and importance of virtual tools and simulation methods in product development. The challenges and conditions that must be satisfied in order for computational modeling and simulation to play a significantly increased role in the design and evaluation of novel breast imaging systems will be addressed. Learning Objectives: Review the state-of-the science in testing realism of software anthropomorphic phantoms and virtual clinical trials tools; Compare approaches based upon the visual assessment by expert observers vs. the analysis of statistical properties of synthetic images; Discuss the role of observer models in the assessment of realism; Summarize the industry perspective to virtual methods for breast imaging.« less

High-resolution multimodal clinical multiphoton tomography of skin

NASA Astrophysics Data System (ADS)

König, Karsten

2011-03-01

This review focuses on multimodal multiphoton tomography based on near infrared femtosecond lasers. Clinical multiphoton tomographs for 3D high-resolution in vivo imaging have been placed into the market several years ago. The second generation of this Prism-Award winning High-Tech skin imaging tool (MPTflex) was introduced in 2010. The same year, the world's first clinical CARS studies have been performed with a hybrid multimodal multiphoton tomograph. In particular, non-fluorescent lipids and water as well as mitochondrial fluorescent NAD(P)H, fluorescent elastin, keratin, and melanin as well as SHG-active collagen has been imaged with submicron resolution in patients suffering from psoriasis. Further multimodal approaches include the combination of multiphoton tomographs with low-resolution wide-field systems such as ultrasound, optoacoustical, OCT, and dermoscopy systems. Multiphoton tomographs are currently employed in Australia, Japan, the US, and in several European countries for early diagnosis of skin cancer, optimization of treatment strategies, and cosmetic research including long-term testing of sunscreen nanoparticles as well as anti-aging products.

Clinical and imaging services for TIA and minor stroke: results of two surveys of practice across the UK

PubMed Central

Brazzelli, Miriam; Shuler, Kirsten; Quayyum, Zahid; Hadley, Donald; Muir, Keith; McNamee, Paul; De Wilde, Janet; Dennis, Martin; Sandercock, Peter; Wardlaw, Joanna M

2013-01-01

Objectives Transient ischaemic attack (TIA) is a medical emergency requiring rapid access to effective, organised, stroke prevention. There are about 90 000 TIAs per year in the UK. We assessed whether stroke-prevention services in the UK meet Government targets. Design Cross-sectional survey. Setting All UK clinical and imaging stroke-prevention services. Intervention Electronic structured survey delivered over the web with automatic recording of responses into a database; reminders to non-respondents. The survey sought information on clinic frequency, staff, case-mix, details of brain and carotid artery imaging, medical and surgical treatments. Results 114 stroke clinical and 146 imaging surveys were completed (both response rates 45%). Stroke-prevention services were available in most (97%) centres but only 31% operated 7 days/week. Half of the clinic referrals were TIA mimics, most patients (75%) were prescribed secondary prevention prior to clinic referral, and nurses performed the medical assessment in 28% of centres. CT was the most common and fastest first-line investigation; MR, used in 51% of centres, mostly after CT, was delayed up to 2 weeks in 26%; 51% of centres omitted blood-sensitive (GRE/T2*) MR sequences. Carotid imaging was with ultrasound in 95% of centres and 59% performed endarterectomy within 1 week of deciding to operate. Conclusions Stroke-prevention services are widely available in the UK. Delays to MRI, its use in addition to CT while omitting key sequences to diagnose haemorrhage, limit the potential benefit of MRI in stroke prevention, but inflate costs. Assessing TIA mimics requires clinical neurology expertise yet nurses run 28% of clinics. Further improvements are still required for optimal stroke prevention. PMID:23929917

Pathogenesis, imaging and clinical characteristics of CF and non-CF bronchiectasis.

PubMed

Schäfer, Jürgen; Griese, Matthias; Chandrasekaran, Ravishankar; Chotirmall, Sanjay H; Hartl, Dominik

2018-05-22

Bronchiectasis is a common feature of severe inherited and acquired pulmonary disease conditions. Among inherited diseases, cystic fibrosis (CF) is the major disorder associated with bronchiectasis, while acquired conditions frequently featuring bronchiectasis include post-infective bronchiectasis and chronic obstructive pulmonary disease (COPD). Mechanistically, bronchiectasis is driven by a complex interplay of inflammation and infection with neutrophilic inflammation playing a predominant role. The clinical characterization and management of bronchiectasis should involve a precise diagnostic workup, tailored therapeutic strategies and pulmonary imaging that has become an essential tool for the diagnosis and follow-up of bronchiectasis. Prospective future studies are required to optimize the diagnostic and therapeutic management of bronchiectasis, particularly in heterogeneous non-CF bronchiectasis populations.

The usefulness of three-dimensional imaging in the diagnosis and treatment of clinically ambiguous gingival swelling.

PubMed

Kabashima, Hiroaki; Mizobe, Kunitaka; Nakamuta, Hiroyoshi; Fujiwara, Hiroaki; Okamura, Kazutoshi; Unemori, Masako; Akamine, Akifumi; Yoshiura, Kazunori; Maeda, Katsumasa

2011-06-01

We evaluated and treated a 54-year-old woman with gingival swelling. Conventional intraoral and panoramic radiography did not provide sufficient information for either determining the cause of gingival swelling or planning treatment of clinical symptoms. The 3D Accuitomo XYZ Slice View Tomograph (3DX) is a compact dental computed tomography device that allowed for accurate identification and optimal treatment of the causes of gingival swelling. At four years after treatment, 3DX radiographs showed no abnormalities in treated teeth or healing of surrounding structures. We conclude that high-resolution 3D images obtained with 3DX promise to be very effective for diagnosing oral diseases and determining effective treatment.

Effect of clinical decision rules, patient cost and malpractice information on clinician brain CT image ordering: a randomized controlled trial.

PubMed

Gimbel, Ronald W; Pirrallo, Ronald G; Lowe, Steven C; Wright, David W; Zhang, Lu; Woo, Min-Jae; Fontelo, Paul; Liu, Fang; Connor, Zachary

2018-03-12

The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether the presentation of a clinical decision rule (i.e. Canadian CT Head Rule - CCHR), findings from malpractice cases related to clinicians not ordering CT imaging in mild head trauma cases, and estimated patient out-of-pocket cost might influence clinician brain CT ordering. Understanding what type and how information may influence clinical decision making in the ordering advanced medical imaging is important in shaping the optimal design and implementation of related clinical decision support systems. Multi-center, double-blinded simulation-based randomized controlled trial. Following standardized clinical vignette presentation, clinicians made an initial imaging decision for the patient. This was followed by additional information on decision support rules, malpractice outcome review, and patient cost; each with opportunity to modify their initial order. The malpractice and cost information differed by assigned group to test the any temporal relationship. The simulation closed with a second vignette and an imaging decision. One hundred sixteen of the 167 participants (66.9%) initially ordered a brain CT scan. After CCHR presentation, the number of clinicians ordering a CT dropped to 76 (45.8%), representing a 21.1% reduction in CT ordering (P = 0.002). This reduction in CT ordering was maintained, in comparison to initial imaging orders, when presented with malpractice review information (p = 0.002) and patient cost information (p = 0.002). About 57% of clinicians changed their order during study, while 43% never modified their imaging order. This study suggests that ED clinician brain CT imaging decisions may be influenced by clinical decision support rules, patient out-of-pocket cost information and findings from malpractice case review. NCT03449862 , February 27, 2018, Retrospectively registered.

Handheld Fluorescence Microscopy based Flow Analyzer.

PubMed

Saxena, Manish; Jayakumar, Nitin; Gorthi, Sai Siva

2016-03-01

Fluorescence microscopy has the intrinsic advantages of favourable contrast characteristics and high degree of specificity. Consequently, it has been a mainstay in modern biological inquiry and clinical diagnostics. Despite its reliable nature, fluorescence based clinical microscopy and diagnostics is a manual, labour intensive and time consuming procedure. The article outlines a cost-effective, high throughput alternative to conventional fluorescence imaging techniques. With system level integration of custom-designed microfluidics and optics, we demonstrate fluorescence microscopy based imaging flow analyzer. Using this system we have imaged more than 2900 FITC labeled fluorescent beads per minute. This demonstrates high-throughput characteristics of our flow analyzer in comparison to conventional fluorescence microscopy. The issue of motion blur at high flow rates limits the achievable throughput in image based flow analyzers. Here we address the issue by computationally deblurring the images and show that this restores the morphological features otherwise affected by motion blur. By further optimizing concentration of the sample solution and flow speeds, along with imaging multiple channels simultaneously, the system is capable of providing throughput of about 480 beads per second.

3.0 Tesla magnetic resonance imaging: A new standard in liver imaging?

PubMed Central

Girometti, Rossano

2015-01-01

An ever-increasing number of 3.0 Tesla (T) magnets are installed worldwide. Moving from the standard of 1.5 T to higher field strength implies a number of potential advantage and drawbacks, requiring careful optimization of imaging protocols or implementation of novel hardware components. Clinical practice and literature review suggest that state-of-the-art 3.0 T is equivalent to 1.5 T in the assessment of focal liver lesions and diffuse liver disease. Therefore, further technical improvements are needed in order to fully exploit the potential of higher field strength. PMID:26244063

3.0 Tesla magnetic resonance imaging: A new standard in liver imaging?

PubMed

Girometti, Rossano

2015-07-28

An ever-increasing number of 3.0 Tesla (T) magnets are installed worldwide. Moving from the standard of 1.5 T to higher field strength implies a number of potential advantage and drawbacks, requiring careful optimization of imaging protocols or implementation of novel hardware components. Clinical practice and literature review suggest that state-of-the-art 3.0 T is equivalent to 1.5 T in the assessment of focal liver lesions and diffuse liver disease. Therefore, further technical improvements are needed in order to fully exploit the potential of higher field strength.

Development of a stationary digital breast tomosynthesis system for clinical applications

NASA Astrophysics Data System (ADS)

Tucker, Andrew Wallace

Digital breast tomosynthesis (DBT) has been shown to be a very beneficial tool in the fight against breast cancer. However, current DBT systems have poor spatial resolution compared to full field digital mammography (FFDM), the current gold standard for screening mammography. The poor spatial resolution of DBT systems is a result of the single X-ray source design. In DBT systems a single X-ray source is rotated over an angular span in order to acquire the images needed for 3D reconstruction. The rotation of the X-ray source degrades the spatial resolution of the images. DBT systems which are approved for use in the United States for screening mammography are required to also take a full field digital mammogram with every DBT acquisition in order to compensate for the poor spatial resolution. This double exposure essentially doubles the radiation dose to patients. Over the past few years our research group has developed a carbon nanotube (CNT) based X-ray source technology. The unique nature of CNT X-ray sources allows for multiple X-ray focal spots in a single X-ray source. Using this technology we have recently developed a stationary DBT system (s-DBT) system which is capable of producing a full tomosynthesis image dataset with zero motion of the X-ray source. This system has been shown to have increased spatial resolution over other DBT systems in a laboratory setting. The goal of this thesis work was to optimize the s-DBT system, demonstrate its usefulness over other systems, and finally implement it into the clinic for a clinical trial. The s-DBT system was optimized using different image quality measurements. The optimized system was then used in a breast specimen imaging trial which compared s-DBT to magnified 2D mammography and a conventional single source DBT system. Readers preferred s-DBT to magnified 2D mammography for specimen margin delineation and mass detection, these results were not significant. Using physical measures for spatial resolution the s-DBT system was shown to have improved image quality over conventional single source DBT systems in breast tissue. A separate study showed that s-DBT could be a feasible alternative to FFDM for screening patients with breast implants. Finally, a second s-DBT system was constructed and implemented into the Department of Mammography at UNC hospitals. The first patient was imaged on the system in December of 2013.

Biomedical imaging and therapy with physically and physiologically tailored magnetic nanoparticles

NASA Astrophysics Data System (ADS)

Khandhar, Amit Praful

Magnetic particle imaging (MPI) and magnetic fluid hyperthermia (MFH) are emerging imaging and therapy approaches that have the potential to improve diagnostic safety and disease management of heart disease and cancer - the number 1 and 2 leading causes of deaths in the United States. MPI promises real-time, tomographic and quantitative imaging of superparamagnetic iron oxide nanoparticle (SPION) tracers distributed in vivo, and is targeted to offer a safer angiography alternative for its first clinical application. MFH uses ac-fields to dissipate heat from SPIONs that can be delivered locally to promote hyperthermia therapy (~42°C) in cancer cells. Both technologies use safe radiofrequency magnetic fields to exploit the fundamental magnetic relaxation properties of superparamagnetic iron oxide nanoparticles (SPIONs), which must be tailored for optimal imaging in the case of MPI, and maximum hyperthermia potency in the case of MFH. Furthermore, the magnetic core and shell of SPIONs are both central to the optimization process; the shell, in particular, bridges the translational gap between the optimized core and its safe and effective use in the physiological environment. Unfortunately, existing SPIONs that were originally designed as MRI contrast agents lack the basic physical properties that enable the clinical translation of MPI and MFH. In this work, the core and shell of monodisperse SPIONs were optimized in concert to accomplish two equally important objectives: (1) biocompatibility, and (2) MPI and MFH efficacy of SPIONs in physiological environments. Critically, it was found that the physical and physiological responses of SPIONs are coupled, and impacting one can have consequences on the other. It was shown that the poly(ethylene glycol) (PEG)-based shell when properly optimized reduced protein adsorption to SPION surface and phagocytic uptake in macrophages - both prerequisites for designing long-circulating SPIONs. In MPI, tailoring the surface coating reduced protein adsorption and improved colloidal stability, which were critical in retaining the magnetization relaxation properties of the SPIONs. The improvements in surface coatings enabled the use of larger SPION cores (> 20 nm core diameter), which were used to demonstrate benchmark-imaging performance in some of the world's first MPI scanners at Philips Medical Imaging and University of California, Berkeley. In MFH, it was shown for the first time that optimization of heat loss from SPIONs (W/g) is possible by tailoring the core size and size distribution for the given ac-field conditions. Biodistribution and blood circulation studies in mice showed that SPIONs accumulated primarily in the liver and spleen with minimal renal involvement, and demonstrated gradual clearance. Circulation time was evaluated using the MPI signal detected over time in blood, which offered insight on the relevant circulation time for angiography applications. In comparison with carboxy-dextran coated ResovistRTM SPIONs, the PEG-coated SPIONs developed in this work circulated substantially longer; furthermore, reducing the hydrodynamic diameter showed a 4.5x improvement in blood half-life. The work presented in this thesis demonstrates that the combined effort in optimizing the core and shell properties of SPIONs enhances biocompatibility and efficacy, with the in vivo studies providing critical feedback on the success (or failure) of the optimization process. Future work will entail designing functionalized SPIONs for targeting specific disease sites, which will further enable the molecular level diagnosis and therapy of diseases.

Imaging evidence and recommendations for traumatic brain injury: advanced neuro- and neurovascular imaging techniques.

PubMed

Wintermark, M; Sanelli, P C; Anzai, Y; Tsiouris, A J; Whitlow, C T

2015-02-01

Neuroimaging plays a critical role in the evaluation of patients with traumatic brain injury, with NCCT as the first-line of imaging for patients with traumatic brain injury and MR imaging being recommended in specific settings. Advanced neuroimaging techniques, including MR imaging DTI, blood oxygen level-dependent fMRI, MR spectroscopy, perfusion imaging, PET/SPECT, and magnetoencephalography, are of particular interest in identifying further injury in patients with traumatic brain injury when conventional NCCT and MR imaging findings are normal, as well as for prognostication in patients with persistent symptoms. These advanced neuroimaging techniques are currently under investigation in an attempt to optimize them and substantiate their clinical relevance in individual patients. However, the data currently available confine their use to the research arena for group comparisons, and there remains insufficient evidence at the time of this writing to conclude that these advanced techniques can be used for routine clinical use at the individual patient level. TBI imaging is a rapidly evolving field, and a number of the recommendations presented will be updated in the future to reflect the advances in medical knowledge. © 2015 by American Journal of Neuroradiology.

Clinical utility of wavelet compression for resolution-enhanced chest radiography

NASA Astrophysics Data System (ADS)

Andriole, Katherine P.; Hovanes, Michael E.; Rowberg, Alan H.

2000-05-01

This study evaluates the usefulness of wavelet compression for resolution-enhanced storage phosphor chest radiographs in the detection of subtle interstitial disease, pneumothorax and other abnormalities. A wavelet compression technique, MrSIDTM (LizardTech, Inc., Seattle, WA), is implemented which compresses the images from their original 2,000 by 2,000 (2K) matrix size, and then decompresses the image data for display at optimal resolution by matching the spatial frequency characteristics of image objects using a 4,000- square matrix. The 2K-matrix computed radiography (CR) chest images are magnified to a 4K-matrix using wavelet series expansion. The magnified images are compared with the original uncompressed 2K radiographs and with two-times magnification of the original images. Preliminary results show radiologist preference for MrSIDTM wavelet-based magnification over magnification of original data, and suggest that the compressed/decompressed images may provide an enhancement to the original. Data collection for clinical trials of 100 chest radiographs including subtle interstitial abnormalities and/or subtle pneumothoraces and normal cases, are in progress. Three experienced thoracic radiologists will view images side-by- side on calibrated softcopy workstations under controlled viewing conditions, and rank order preference tests will be performed. This technique combines image compression with image enhancement, and suggests that compressed/decompressed images can actually improve the originals.

Targeted delivery of antibody-based therapeutic and imaging agents to CNS tumors: Crossing the blood-brain-barrier divide

PubMed Central

Chacko, Ann-Marie; Li, Chunsheng; Pryma, Daniel A.; Brem, Steven; Coukos, George; Muzykantov, Vladimir R.

2014-01-01

Introduction Brain tumors are inherently difficult to treat in large part due to the cellular blood-brain barriers (BBB) that limit the delivery of therapeutics to the tumor tissue from the systemic circulation. Virtually no large-molecules, including antibody-based proteins, can penetrate the BBB. With antibodies fast becoming attractive ligands for highly specific molecular targeting to tumor antigens, a variety of methods are being investigated to enhance the access of these agents to intracranial tumors for imaging or therapeutic applications. Areas covered This review describes the characteristics of the BBB and the vasculature in brain tumors, described as the blood-brain tumor barrier (BBTB). Antibodies targeted to molecular markers of CNS tumors will be highlighted, and current strategies for enhancing the delivery of antibodies across these cellular barriers into the brain parenchyma to the tumor will be discussed. Non-invasive imaging approaches to assess BBB/BBTB permeability and/or antibody targeting will be presented as a means of guiding the optimal delivery of targeted agents to brain tumors. Expert Opinion Pre-clinical and clinical studies highlight the potential of several approaches in increasing brain tumor delivery across the blood-brain barrier divide. However, each carries its own risks and challenges. There is tremendous potential in using neuroimaging strategies to assist in understanding and defining the challenges to translating and optimizing molecularly-targeted antibody delivery to CNS tumors to improve clinical outcomes. PMID:23751126

Factors influencing accuracy of cortical thickness in the diagnosis of Alzheimer's disease.

PubMed

Belathur Suresh, Mahanand; Fischl, Bruce; Salat, David H

2018-04-01

There is great value to use of structural neuroimaging in the assessment of Alzheimer's disease (AD). However, to date, predictive value of structural imaging tend to range between 80% and 90% in accuracy and it is unclear why this is the case given that structural imaging should parallel the pathologic processes of AD. There is a possibility that clinical misdiagnosis relative to the gold standard pathologic diagnosis and/or additional brain pathologies are confounding factors contributing to reduced structural imaging classification accuracy. We examined potential factors contributing to misclassification of individuals with clinically diagnosed AD purely from cortical thickness measures. Correctly classified and incorrectly classified groups were compared across a range of demographic, biological, and neuropsychological data including cerebrospinal fluid biomarkers, amyloid imaging, white matter hyperintensity (WMH) volume, cognitive, and genetic factors. Individual subject analyses suggested that at least a portion of the control individuals misclassified as AD from structural imaging additionally harbor substantial AD biomarker pathology and risk, yet are relatively resistant to cognitive symptoms, likely due to "cognitive reserve," and therefore clinically unimpaired. In contrast, certain clinical control individuals misclassified as AD from cortical thickness had increased WMH volume relative to other controls in the sample, suggesting that vascular conditions may contribute to classification accuracy from cortical thickness measures. These results provide examples of factors that contribute to the accuracy of structural imaging in predicting a clinical diagnosis of AD, and provide important information about considerations for future work aimed at optimizing structural based diagnostic classifiers for AD. © 2017 Wiley Periodicals, Inc.

Development, validation, and implementation of a patient-specific Monte Carlo 3D internal dosimetry platform

NASA Astrophysics Data System (ADS)

Besemer, Abigail E.

Targeted radionuclide therapy is emerging as an attractive treatment option for a broad spectrum of tumor types because it has the potential to simultaneously eradicate both the primary tumor site as well as the metastatic disease throughout the body. Patient-specific absorbed dose calculations for radionuclide therapies are important for reducing the risk of normal tissue complications and optimizing tumor response. However, the only FDA approved software for internal dosimetry calculates doses based on the MIRD methodology which estimates mean organ doses using activity-to-dose scaling factors tabulated from standard phantom geometries. Despite the improved dosimetric accuracy afforded by direct Monte Carlo dosimetry methods these methods are not widely used in routine clinical practice because of the complexity of implementation, lack of relevant standard protocols, and longer dose calculation times. The main goal of this work was to develop a Monte Carlo internal dosimetry platform in order to (1) calculate patient-specific voxelized dose distributions in a clinically feasible time frame, (2) examine and quantify the dosimetric impact of various parameters and methodologies used in 3D internal dosimetry methods, and (3) develop a multi-criteria treatment planning optimization framework for multi-radiopharmaceutical combination therapies. This platform utilizes serial PET/CT or SPECT/CT images to calculate voxelized 3D internal dose distributions with the Monte Carlo code Geant4. Dosimetry can be computed for any diagnostic or therapeutic radiopharmaceutical and for both pre-clinical and clinical applications. In this work, the platform's dosimetry calculations were successfully validated against previously published reference doses values calculated in standard phantoms for a variety of radionuclides, over a wide range of photon and electron energies, and for many different organs and tumor sizes. Retrospective dosimetry was also calculated for various pre-clinical and clinical patients and large dosimetric differences resulted when using conventional organ-level methods and the patient-specific voxelized methods described in this work. The dosimetric impact of various steps in the 3D voxelized dosimetry process were evaluated including quantitative imaging acquisition, image coregistration, voxel resampling, ROI contouring, CT-based material segmentation, and pharmacokinetic fitting. Finally, a multi-objective treatment planning optimization framework was developed for multi-radiopharmaceutical combination therapies.

A novel 1050nm handheld OCT imaging system for pediatric retinoblastoma patients: translation from laboratory bench to clinical study (Conference Presentation)

NASA Astrophysics Data System (ADS)

Nadiarnykh, Oleg; Moll, Annette C.; de Boer, Johannes F.

2016-03-01

We demonstrate a novel optical coherence tomography system specifically developed and validated for clinical imaging of retinoblastoma tumors in pediatric patients. The existing treatment options for this malignant tumor of the retina aim at reduction of tumor (re)growth risks, and vision preservation. The choice of optimal treatment strongly depends on skilled and detailed clinical assessment. Currently, the patients at risk are periodically monitored with retinal imaging for possible morphological changes over time, and new tumor seedings, as the existing real-time diagnostic tools are limited. Three-dimensional visualization of tissue layer and microvasculature at improved axial and lateral resolution of interference-based OCT imaging provides sensitivity for detection of vital tumor tissue concurrent with local treatment. Our METC-approved system accommodates for the range of optical parameters of infants' eyes, and uses the 1050nm wavelength to access the deeper choroid layers of retina. The prototype is designed for patients in supine position under general anesthesia, where ergonomic handheld module is connected to fiber-based optical setup via umbilical cord. The system conforms to clinical safety requirements, including fully isolated low-voltage electric circuit. Focusing is performed with a mechanically tunable lens, where resolution is 6 µm axially, and varies with focusing at 10-18µm laterally. We will present optical design, performance limitations, and results of the ongoing clinical study, including the increased OCT diagnostic sensitivity in three dimensions in comparison with the established clinical imaging modalities. We will discuss images of early, active, and treated tumors, as well as follow-up on patients after local and systemic treatments.

Enhanced interfaces for web-based enterprise-wide image distribution.

PubMed

Jost, R Gilbert; Blaine, G James; Fritz, Kevin; Blume, Hartwig; Sadhra, Sarbjit

2002-01-01

Modern Web browsers support image distribution with two shortcomings: (1) image grayscale presentation at client workstations is often sub-optimal and generally inconsistent with the presentation state on diagnostic workstations and (2) an Electronic Patient Record (EPR) application usually cannot directly access images with an integrated viewer. We have modified our EPR and our Web-based image-distribution system to allow access to images from within the EPR. In addition, at the client workstation, a grayscale transformation is performed that consists of two components: a client-display-specific component based on the characteristic display function of the class of display system, and a modality-specific transformation that is downloaded with every image. The described techniques have been implemented in our institution and currently support enterprise-wide clinical image distribution. The effectiveness of the techniques is reviewed.

Characterizing the Utility and Limitations of Repurposing an Open-Field Optical Imaging Device for Fluorescence-Guided Surgery in Head and Neck Cancer Patients.

PubMed

Moore, Lindsay S; Rosenthal, Eben L; Chung, Thomas K; de Boer, Esther; Patel, Neel; Prince, Andrew C; Korb, Melissa L; Walsh, Erika M; Young, E Scott; Stevens, Todd M; Withrow, Kirk P; Morlandt, Anthony B; Richman, Joshua S; Carroll, William R; Zinn, Kurt R; Warram, Jason M

2017-02-01

The purpose of this study was to assess the potential of U.S. Food and Drug Administration-cleared devices designed for indocyanine green-based perfusion imaging to identify cancer-specific bioconjugates with overlapping excitation and emission wavelengths. Recent clinical trials have demonstrated potential for fluorescence-guided surgery, but the time and cost of the approval process may impede clinical translation. To expedite this translation, we explored the feasibility of repurposing existing optical imaging devices for fluorescence-guided surgery. Consenting patients (n = 15) scheduled for curative resection were enrolled in a clinical trial evaluating the safety and specificity of cetuximab-IRDye800 (NCT01987375). Open-field fluorescence imaging was performed preoperatively and during the surgical resection. Fluorescence intensity was quantified using integrated instrument software, and the tumor-to-background ratio characterized fluorescence contrast. In the preoperative clinic, the open-field device demonstrated potential to guide preoperative mapping of tumor borders, optimize the day of surgery, and identify occult lesions. Intraoperatively, the device demonstrated robust potential to guide surgical resections, as all peak tumor-to-background ratios were greater than 2 (range, 2.2-14.1). Postresection wound bed fluorescence was significantly less than preresection tumor fluorescence (P < 0.001). The repurposed device also successfully identified positive margins. The open-field imaging device was successfully repurposed to distinguish cancer from normal tissue in the preoperative clinic and throughout surgical resection. This study illuminated the potential for existing open-field optical imaging devices with overlapping excitation and emission spectra to be used for fluorescence-guided surgery. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

A Delphic consensus assessment: imaging and biomarkers in gastroenteropancreatic neuroendocrine tumor disease management.

PubMed

Oberg, Kjell; Krenning, Eric; Sundin, Anders; Bodei, Lisa; Kidd, Mark; Tesselaar, Margot; Ambrosini, Valentina; Baum, Richard P; Kulke, Matthew; Pavel, Marianne; Cwikla, Jaroslaw; Drozdov, Ignat; Falconi, Massimo; Fazio, Nicola; Frilling, Andrea; Jensen, Robert; Koopmans, Klaus; Korse, Tiny; Kwekkeboom, Dik; Maecke, Helmut; Paganelli, Giovanni; Salazar, Ramon; Severi, Stefano; Strosberg, Jonathan; Prasad, Vikas; Scarpa, Aldo; Grossman, Ashley; Walenkamp, Annemeik; Cives, Mauro; Virgolini, Irene; Kjaer, Andreas; Modlin, Irvin M

2016-09-01

The complexity of the clinical management of neuroendocrine neoplasia (NEN) is exacerbated by limitations in imaging modalities and a paucity of clinically useful biomarkers. Limitations in currently available imaging modalities reflect difficulties in measuring an intrinsically indolent disease, resolution inadequacies and inter-/intra-facility device variability and that RECIST (Response Evaluation Criteria in Solid Tumors) criteria are not optimal for NEN. Limitations of currently used biomarkers are that they are secretory biomarkers (chromogranin A, serotonin, neuron-specific enolase and pancreastatin); monoanalyte measurements; and lack sensitivity, specificity and predictive capacity. None of them meet the NIH metrics for clinical usage. A multinational, multidisciplinary Delphi consensus meeting of NEN experts (n = 33) assessed current imaging strategies and biomarkers in NEN management. Consensus (>75%) was achieved for 78% of the 142 questions. The panel concluded that morphological imaging has a diagnostic value. However, both imaging and current single-analyte biomarkers exhibit substantial limitations in measuring the disease status and predicting the therapeutic efficacy. RECIST remains suboptimal as a metric. A critical unmet need is the development of a clinico-biological tool to provide enhanced information regarding precise disease status and treatment response. The group considered that circulating RNA was better than current general NEN biomarkers and preliminary clinical data were considered promising. It was resolved that circulating multianalyte mRNA (NETest) had clinical utility in both diagnosis and monitoring disease status and therapeutic efficacy. Overall, it was concluded that a combination of tumor spatial and functional imaging with circulating transcripts (mRNA) would represent the future strategy for real-time monitoring of disease progress and therapeutic efficacy. © 2016 The authors.

Salicylic acid for the treatment of melasma: new acquisitions for monitoring the clinical improvement.

PubMed

Fabbrocini, Gabriella; De Vita, Valerio; Marasca, Claudio; Palmisano, Franco; Monfrecola, Giuseppe

2013-11-01

The Melasma Area and Severity Index (MASI) and the Melasma Severity Score (MSS) are calculated on the basis of only a subjective clinical assessment. This raises the need to have an objective score, uniform in the evaluation by different clinicians. The purpose of this study was to establish if the images by Canfield Reveal Imager can be correlated to MASI score to better evaluate the clinical efficacy of salicylic acid 33% peeling in the treatment of melasma respect to the clinical observation. The study was a voluntary observational study. Twenty female patients affected with melasma, aged between 30 and 60 years, were included in the study. Treatment with salicylic acid 33% was performed once a month, for a total of four times. The dermatologist (Doc A) examined each patient's melasma areas using MASI score, at the face-to-face observation and at Reveal images evaluation during the first (T0) and the end point time (T4). Digital photographs were also evaluated by another experienced dermatologist (Doc B), who has never seen clinically the patients before and who evaluated MASI score by Reveal images at time T0 and T4. Student's t-test and linear regression test were performed, showing statistically significant values comparing MASI score obtained by digital photo and MASI score obtained clinically. The monitoring of the improvement by Reveal images can optimize the treatment approach and the efficacy of same dermocosmetics procedures can be revised following standard criteria. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Automated cassette-based production of high specific activity [203/212Pb]peptide-based theranostic radiopharmaceuticals for image-guided radionuclide therapy for cancer.

PubMed

Li, Mengshi; Zhang, Xiuli; Quinn, Thomas P; Lee, Dongyoul; Liu, Dijie; Kunkel, Falk; Zimmerman, Brian E; McAlister, Daniel; Olewein, Keith; Menda, Yusuf; Mirzadeh, Saed; Copping, Roy; Johnson, Frances L; Schultz, Michael K

2017-09-01

A method for preparation of Pb-212 and Pb-203 labeled chelator-modified peptide-based radiopharmaceuticals for cancer imaging and radionuclide therapy has been developed and adapted for automated clinical production. Pre-concentration and isolation of radioactive Pb2+ from interfering metals in dilute hydrochloric acid was optimized using a commercially-available Pb-specific chromatography resin packed in disposable plastic columns. The pre-concentrated radioactive Pb2+ is eluted in NaOAc buffer directly to the reaction vessel containing chelator-modified peptides. Radiolabeling was found to proceed efficiently at 85°C (45min; pH 5.5). The specific activity of radiolabeled conjugates was optimized by separation of radiolabeled conjugates from unlabeled peptide via HPLC. Preservation of bioactivity was confirmed by in vivo biodistribution of Pb-203 and Pb-212 labeled peptides in melanoma-tumor-bearing mice. The approach has been found to be robustly adaptable to automation and a cassette-based fluid-handling system (Modular Lab Pharm Tracer) has been customized for clinical radiopharmaceutical production. Our findings demonstrate that the Pb-203/Pb-212 combination is a promising elementally-matched radionuclide pair for image-guided radionuclide therapy for melanoma, neuroendocrine tumors, and potentially other cancers. Copyright © 2017 Elsevier Ltd. All rights reserved.

A 3D-printed anatomical pancreas and kidney phantom for optimizing SPECT/CT reconstruction settings in beta cell imaging using 111In-exendin.

PubMed

Woliner-van der Weg, Wietske; Deden, Laura N; Meeuwis, Antoi P W; Koenrades, Maaike; Peeters, Laura H C; Kuipers, Henny; Laanstra, Geert Jan; Gotthardt, Martin; Slump, Cornelis H; Visser, Eric P

2016-12-01

Quantitative single photon emission computed tomography (SPECT) is challenging, especially for pancreatic beta cell imaging with 111 In-exendin due to high uptake in the kidneys versus much lower uptake in the nearby pancreas. Therefore, we designed a three-dimensionally (3D) printed phantom representing the pancreas and kidneys to mimic the human situation in beta cell imaging. The phantom was used to assess the effect of different reconstruction settings on the quantification of the pancreas uptake for two different, commercially available software packages. 3D-printed, hollow pancreas and kidney compartments were inserted into the National Electrical Manufacturers Association (NEMA) NU2 image quality phantom casing. These organs and the background compartment were filled with activities simulating relatively high and low pancreatic 111 In-exendin uptake for, respectively, healthy humans and type 1 diabetes patients. Images were reconstructed using Siemens Flash 3D and Hermes Hybrid Recon, with varying numbers of iterations and subsets and corrections. Images were visually assessed on homogeneity and artefacts, and quantitatively by the pancreas-to-kidney activity concentration ratio. Phantom images were similar to clinical images and showed comparable artefacts. All corrections were required to clearly visualize the pancreas. Increased numbers of subsets and iterations improved the quantitative performance but decreased homogeneity both in the pancreas and the background. Based on the phantom analyses, the Hybrid Recon reconstruction with 6 iterations and 16 subsets was found to be most suitable for clinical use. This work strongly contributed to quantification of pancreatic 111 In-exendin uptake. It showed how clinical images of 111 In-exendin can be interpreted and enabled selection of the most appropriate protocol for clinical use.

MR imaging for diagnostic evaluation of encephalopathy in the newborn.

PubMed

Shroff, Manohar M; Soares-Fernandes, João P; Whyte, Hilary; Raybaud, Charles

2010-05-01

Magnetic resonance (MR) imaging is used with increasing frequency to evaluate the neonatal brain because it can provide important diagnostic and prognostic information that is needed for optimal treatment and appropriate counseling. Special care must be taken in preparing encephalopathic neonates for an MR study, transporting them from the intensive care unit, monitoring their vital signs, and optimizing MR sequences and protocols. Moreover, to accurately interpret the findings, specific knowledge is needed about the normal MR imaging appearances of the physiologic processes of myelination, cell migration, and sulcation, as well as patterns of injury, in the neonatal brain at various stages of gestational development. Hypoxic-ischemic injury, the most common cause of neonatal encephalopathy, has characteristic appearances that depend on the severity and duration of the insult as well as the stage of brain development. Diffusion-weighted MR imaging and MR spectroscopy depict abnormalities earlier than do conventional MR imaging sequences. However, diffusion-weighted imaging, if performed in the first 24 hours after the insult, might lead to underestimation of the extent of injury. When the MR findings are atypical, the differential diagnosis of neonatal encephalopathy also should include congenital and metabolic disorders and infectious diseases. Despite recent advances in the MR imaging-based characterization of these conditions, the clinical history must be borne in mind to achieve an accurate diagnosis.

Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

PubMed

Marin, Jennifer R; Mills, Angela M

2015-12-01

The 2015 Academic Emergency Medicine (AEM) consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to: 1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; 2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and 3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified prior to the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were 164 individuals involved in the conference spanning various specialties, including emergency medicine (EM), radiology, surgery, medical physics, and the decision sciences. This issue of AEM is dedicated to the proceedings of the 16th annual AEM consensus conference as well as original research related to emergency diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

TU-FG-201-01: 18-Month Clinical Experience of a Linac Daily Quality Assurance (QA) Solution Using Only EPID and OBI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cai, B; Sun, B; Yaddanapudi, S

Purpose: To describe the clinical use of a Linear Accelerator (Linac) DailyQA system with only EPID and OBI. To assess the reliability over an 18-month period and improve the robustness of this system based on QA failure analysis. Methods: A DailyQA solution utilizing an in-house designed phantom, combined EPID and OBI image acquisitions, and a web-based data analysis and reporting system was commissioned and used in our clinic to measure geometric, dosimetry and imaging components of a Varian Truebeam Linac. During an 18-month period (335 working days), the Daily QA results, including the output constancy, beam flatness and symmetry, uniformity,more » TPR20/10, MV and KV imaging quality, were collected and analyzed. For output constancy measurement, an independent monthly QA system with an ionization chamber (IC) and annual/incidental TG51 measurements with ADCL IC were performed and cross-compared to Daily QA system. Thorough analyses were performed on the recorded QA failures to evaluate the machine performance, optimize the data analysis algorithm, adjust the tolerance setting and improve the training procedure to prevent future failures. Results: A clinical workflow including beam delivery, data analysis, QA report generation and physics approval was established and optimized to suit daily clinical operation. The output tests over the 335 working day period cross-correlated with the monthly QA system within 1.3% and TG51 results within 1%. QA passed with one attempt on 236 days out of 335 days. Based on the QA failures analysis, the Gamma criteria is revised from (1%, 1mm) to (2%, 1mm) considering both QA accuracy and efficiency. Data analysis algorithm is improved to handle multiple entries for a repeating test. Conclusion: We described our 18-month clinical experience on a novel DailyQA system using only EPID and OBI. The long term data presented demonstrated the system is suitable and reliable for Linac daily QA.« less

Convenient Preparation of [(68)Ga]DKFZ-PSMA-11 Using a Robust Single-Vial Kit and Demonstration of Its Clinical Efficacy.

PubMed

Satpati, Drishty; Shinto, Ajit; Kamaleshwaran, K K; Sane, Surekha; Banerjee, Sharmila

2016-06-01

[(68)Ga]DKFZ-PSMA-11 has proved to be an important diagnostic radiotracer for targeting prostate-specific membrane antigen (PSMA) overexpression in both recurrent prostate cancer (PC) and relevant metastatic sites. However, the widespread, routine clinical use of such a potential radiopharmaceutical demands availability of a ready-to-use kit formulation to enable convenient radiopharmaceutical preparation. Herein, we report the development of a freeze-dried kit vial for the formulation of [(68)Ga]DKFZ-PSMA-11 and its clinical use in patients using a "shake-bake-inject" methodology. The freeze-dried kit vial was developed after optimization of ligand content (PSMA-11) and pH conditions. The kit was formulated using (68)Ga from two different commercially available generators. Positron emission tomography/X-ray computed tomography (PET/CT) images of PC patients were obtained using the kit-formulated radiotracer. [(68)Ga]DKFZ-PSMA-11 was prepared in >98 % radiochemical yield and purity using the freeze-dried kit vials. Kits were optimized for the preparation of four patient doses. The clinical utility was evaluated in patients with histologically confirmed prostate cancer, and the images were of good quality as well as conforming to tumor marker and clinical expectations. The development of a simple and ready-to-use freeze-dried DKFZ-PSMA-11 kit for the preparation of Ga-68-based radiotracers constitutes a major step towards the expedition of the widespread and economical screening of PC patients.

Value of monoenergetic dual-energy CT (DECT) for artefact reduction from metallic orthopedic implants in post-mortem studies.

PubMed

Filograna, Laura; Magarelli, Nicola; Leone, Antonio; Guggenberger, Roman; Winklhofer, Sebastian; Thali, Michael John; Bonomo, Lorenzo

2015-09-01

The aim of this ex vivo study was to assess the performance of monoenergetic dual-energy CT (DECT) reconstructions to reduce metal artefacts in bodies with orthopedic devices in comparison with standard single-energy CT (SECT) examinations in forensic imaging. Forensic and clinical impacts of this study are also discussed. Thirty metallic implants in 20 consecutive cadavers with metallic implants underwent both SECT and DECT with a clinically suitable scanning protocol. Extrapolated monoenergetic DECT images at 64, 69, 88, 105, 120, and 130 keV and individually adjusted monoenergy for optimized image quality (OPTkeV) were generated. Image quality of the seven monoenergetic images and of the corresponding SECT image was assessed qualitatively and quantitatively by visual rating and measurements of attenuation changes induced by streak artefact. Qualitative and quantitative analyses showed statistically significant differences between monoenergetic DECT extrapolated images and SECT, with improvements in diagnostic assessment in monoenergetic DECT at higher monoenergies. The mean value of OPTkeV was 137.6 ± 4.9 with a range of 130 to 148 keV. This study demonstrates that monoenergetic DECT images extrapolated at high energy levels significantly reduce metallic artefacts from orthopedic implants and improve image quality compared to SECT examination in forensic imaging.

GPU-based relative fuzzy connectedness image segmentation.

PubMed

Zhuge, Ying; Ciesielski, Krzysztof C; Udupa, Jayaram K; Miller, Robert W

2013-01-01

Recently, clinical radiological research and practice are becoming increasingly quantitative. Further, images continue to increase in size and volume. For quantitative radiology to become practical, it is crucial that image segmentation algorithms and their implementations are rapid and yield practical run time on very large data sets. The purpose of this paper is to present a parallel version of an algorithm that belongs to the family of fuzzy connectedness (FC) algorithms, to achieve an interactive speed for segmenting large medical image data sets. The most common FC segmentations, optimizing an [script-l](∞)-based energy, are known as relative fuzzy connectedness (RFC) and iterative relative fuzzy connectedness (IRFC). Both RFC and IRFC objects (of which IRFC contains RFC) can be found via linear time algorithms, linear with respect to the image size. The new algorithm, P-ORFC (for parallel optimal RFC), which is implemented by using NVIDIA's Compute Unified Device Architecture (CUDA) platform, considerably improves the computational speed of the above mentioned CPU based IRFC algorithm. Experiments based on four data sets of small, medium, large, and super data size, achieved speedup factors of 32.8×, 22.9×, 20.9×, and 17.5×, correspondingly, on the NVIDIA Tesla C1060 platform. Although the output of P-ORFC need not precisely match that of IRFC output, it is very close to it and, as the authors prove, always lies between the RFC and IRFC objects. A parallel version of a top-of-the-line algorithm in the family of FC has been developed on the NVIDIA GPUs. An interactive speed of segmentation has been achieved, even for the largest medical image data set. Such GPU implementations may play a crucial role in automatic anatomy recognition in clinical radiology.

GPU-based relative fuzzy connectedness image segmentation

PubMed Central

Zhuge, Ying; Ciesielski, Krzysztof C.; Udupa, Jayaram K.; Miller, Robert W.

2013-01-01

Purpose: Recently, clinical radiological research and practice are becoming increasingly quantitative. Further, images continue to increase in size and volume. For quantitative radiology to become practical, it is crucial that image segmentation algorithms and their implementations are rapid and yield practical run time on very large data sets. The purpose of this paper is to present a parallel version of an algorithm that belongs to the family of fuzzy connectedness (FC) algorithms, to achieve an interactive speed for segmenting large medical image data sets. Methods: The most common FC segmentations, optimizing an ℓ∞-based energy, are known as relative fuzzy connectedness (RFC) and iterative relative fuzzy connectedness (IRFC). Both RFC and IRFC objects (of which IRFC contains RFC) can be found via linear time algorithms, linear with respect to the image size. The new algorithm, P-ORFC (for parallel optimal RFC), which is implemented by using NVIDIA’s Compute Unified Device Architecture (CUDA) platform, considerably improves the computational speed of the above mentioned CPU based IRFC algorithm. Results: Experiments based on four data sets of small, medium, large, and super data size, achieved speedup factors of 32.8×, 22.9×, 20.9×, and 17.5×, correspondingly, on the NVIDIA Tesla C1060 platform. Although the output of P-ORFC need not precisely match that of IRFC output, it is very close to it and, as the authors prove, always lies between the RFC and IRFC objects. Conclusions: A parallel version of a top-of-the-line algorithm in the family of FC has been developed on the NVIDIA GPUs. An interactive speed of segmentation has been achieved, even for the largest medical image data set. Such GPU implementations may play a crucial role in automatic anatomy recognition in clinical radiology. PMID:23298094

Optimization and validation of accelerated golden-angle radial sparse MRI reconstruction with self-calibrating GRAPPA operator gridding.

PubMed

Benkert, Thomas; Tian, Ye; Huang, Chenchan; DiBella, Edward V R; Chandarana, Hersh; Feng, Li

2018-07-01

Golden-angle radial sparse parallel (GRASP) MRI reconstruction requires gridding and regridding to transform data between radial and Cartesian k-space. These operations are repeatedly performed in each iteration, which makes the reconstruction computationally demanding. This work aimed to accelerate GRASP reconstruction using self-calibrating GRAPPA operator gridding (GROG) and to validate its performance in clinical imaging. GROG is an alternative gridding approach based on parallel imaging, in which k-space data acquired on a non-Cartesian grid are shifted onto a Cartesian k-space grid using information from multicoil arrays. For iterative non-Cartesian image reconstruction, GROG is performed only once as a preprocessing step. Therefore, the subsequent iterative reconstruction can be performed directly in Cartesian space, which significantly reduces computational burden. Here, a framework combining GROG with GRASP (GROG-GRASP) is first optimized and then compared with standard GRASP reconstruction in 22 prostate patients. GROG-GRASP achieved approximately 4.2-fold reduction in reconstruction time compared with GRASP (∼333 min versus ∼78 min) while maintaining image quality (structural similarity index ≈ 0.97 and root mean square error ≈ 0.007). Visual image quality assessment by two experienced radiologists did not show significant differences between the two reconstruction schemes. With a graphics processing unit implementation, image reconstruction time can be further reduced to approximately 14 min. The GRASP reconstruction can be substantially accelerated using GROG. This framework is promising toward broader clinical application of GRASP and other iterative non-Cartesian reconstruction methods. Magn Reson Med 80:286-293, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Leveraging unsupervised training sets for multi-scale compartmentalization in renal pathology

NASA Astrophysics Data System (ADS)

Lutnick, Brendon; Tomaszewski, John E.; Sarder, Pinaki

2017-03-01

Clinical pathology relies on manual compartmentalization and quantification of biological structures, which is time consuming and often error-prone. Application of computer vision segmentation algorithms to histopathological image analysis, in contrast, can offer fast, reproducible, and accurate quantitative analysis to aid pathologists. Algorithms tunable to different biologically relevant structures can allow accurate, precise, and reproducible estimates of disease states. In this direction, we have developed a fast, unsupervised computational method for simultaneously separating all biologically relevant structures from histopathological images in multi-scale. Segmentation is achieved by solving an energy optimization problem. Representing the image as a graph, nodes (pixels) are grouped by minimizing a Potts model Hamiltonian, adopted from theoretical physics, modeling interacting electron spins. Pixel relationships (modeled as edges) are used to update the energy of the partitioned graph. By iteratively improving the clustering, the optimal number of segments is revealed. To reduce computational time, the graph is simplified using a Cantor pairing function to intelligently reduce the number of included nodes. The classified nodes are then used to train a multiclass support vector machine to apply the segmentation over the full image. Accurate segmentations of images with as many as 106 pixels can be completed only in 5 sec, allowing for attainable multi-scale visualization. To establish clinical potential, we employed our method in renal biopsies to quantitatively visualize for the first time scale variant compartments of heterogeneous intra- and extraglomerular structures simultaneously. Implications of the utility of our method extend to fields such as oncology, genomics, and non-biological problems.

MIND Demons: Symmetric Diffeomorphic Deformable Registration of MR and CT for Image-Guided Spine Surgery.

PubMed

Reaungamornrat, Sureerat; De Silva, Tharindu; Uneri, Ali; Vogt, Sebastian; Kleinszig, Gerhard; Khanna, Akhil J; Wolinsky, Jean-Paul; Prince, Jerry L; Siewerdsen, Jeffrey H

2016-11-01

Intraoperative localization of target anatomy and critical structures defined in preoperative MR/CT images can be achieved through the use of multimodality deformable registration. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality-independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration. The method, called MIND Demons, finds a deformation field between two images by optimizing an energy functional that incorporates both the forward and inverse deformations, smoothness on the integrated velocity fields, a modality-insensitive similarity function suitable to multimodality images, and smoothness on the diffeomorphisms themselves. Direct optimization without relying on the exponential map and stationary velocity field approximation used in conventional diffeomorphic Demons is carried out using a Gauss-Newton method for fast convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, normalized MI (NMI) Demons, and MIND with a diffusion-based registration method (MIND-elastic). The method yielded sub-voxel invertibility (0.008 mm) and nonzero-positive Jacobian determinants. It also showed improved registration accuracy in comparison to the reference methods, with mean target registration error (TRE) of 1.7 mm compared to 11.3, 3.1, 5.6, and 2.4 mm for MI FFD, LMI FFD, NMI Demons, and MIND-elastic methods, respectively. Validation in clinical studies demonstrated realistic deformations with sub-voxel TRE in cases of cervical, thoracic, and lumbar spine.

MIND Demons: Symmetric Diffeomorphic Deformable Registration of MR and CT for Image-Guided Spine Surgery

PubMed Central

Reaungamornrat, Sureerat; De Silva, Tharindu; Uneri, Ali; Vogt, Sebastian; Kleinszig, Gerhard; Khanna, Akhil J; Wolinsky, Jean-Paul; Prince, Jerry L.

2016-01-01

Intraoperative localization of target anatomy and critical structures defined in preoperative MR/CT images can be achieved through the use of multimodality deformable registration. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality-independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration. The method, called MIND Demons, finds a deformation field between two images by optimizing an energy functional that incorporates both the forward and inverse deformations, smoothness on the integrated velocity fields, a modality-insensitive similarity function suitable to multimodality images, and smoothness on the diffeomorphisms themselves. Direct optimization without relying on the exponential map and stationary velocity field approximation used in conventional diffeomorphic Demons is carried out using a Gauss-Newton method for fast convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, normalized MI (NMI) Demons, and MIND with a diffusion-based registration method (MIND-elastic). The method yielded sub-voxel invertibility (0.008 mm) and nonzero-positive Jacobian determinants. It also showed improved registration accuracy in comparison to the reference methods, with mean target registration error (TRE) of 1.7 mm compared to 11.3, 3.1, 5.6, and 2.4 mm for MI FFD, LMI FFD, NMI Demons, and MIND-elastic methods, respectively. Validation in clinical studies demonstrated realistic deformations with sub-voxel TRE in cases of cervical, thoracic, and lumbar spine. PMID:27295656

The use of kernel local Fisher discriminant analysis for the channelization of the Hotelling model observer

NASA Astrophysics Data System (ADS)

Wen, Gezheng; Markey, Mia K.

2015-03-01

It is resource-intensive to conduct human studies for task-based assessment of medical image quality and system optimization. Thus, numerical model observers have been developed as a surrogate for human observers. The Hotelling observer (HO) is the optimal linear observer for signal-detection tasks, but the high dimensionality of imaging data results in a heavy computational burden. Channelization is often used to approximate the HO through a dimensionality reduction step, but how to produce channelized images without losing significant image information remains a key challenge. Kernel local Fisher discriminant analysis (KLFDA) uses kernel techniques to perform supervised dimensionality reduction, which finds an embedding transformation that maximizes betweenclass separability and preserves within-class local structure in the low-dimensional manifold. It is powerful for classification tasks, especially when the distribution of a class is multimodal. Such multimodality could be observed in many practical clinical tasks. For example, primary and metastatic lesions may both appear in medical imaging studies, but the distributions of their typical characteristics (e.g., size) may be very different. In this study, we propose to use KLFDA as a novel channelization method. The dimension of the embedded manifold (i.e., the result of KLFDA) is a counterpart to the number of channels in the state-of-art linear channelization. We present a simulation study to demonstrate the potential usefulness of KLFDA for building the channelized HOs (CHOs) and generating reliable decision statistics for clinical tasks. We show that the performance of the CHO with KLFDA channels is comparable to that of the benchmark CHOs.

Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system.

PubMed

Moore, C S; Wood, T J; Avery, G; Balcam, S; Needler, L; Joshi, H; Saunderson, J R; Beavis, A W

2016-11-07

The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQ m ) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQ m and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

Automatic exposure control calibration and optimisation for abdomen, pelvis and lumbar spine imaging with an Agfa computed radiography system

NASA Astrophysics Data System (ADS)

Moore, C. S.; Wood, T. J.; Avery, G.; Balcam, S.; Needler, L.; Joshi, H.; Saunderson, J. R.; Beavis, A. W.

2016-11-01

The use of three physical image quality metrics, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and mean effective noise equivalent quanta (eNEQm) have recently been examined by our group for their appropriateness in the calibration of an automatic exposure control (AEC) device for chest radiography with an Agfa computed radiography (CR) imaging system. This study uses the same methodology but investigates AEC calibration for abdomen, pelvis and spine CR imaging. AEC calibration curves were derived using a simple uniform phantom (equivalent to 20 cm water) to ensure each metric was held constant across the tube voltage range. Each curve was assessed for its clinical appropriateness by generating computer simulated abdomen, pelvis and spine images (created from real patient CT datasets) with appropriate detector air kermas for each tube voltage, and grading these against reference images which were reconstructed at detector air kermas correct for the constant detector dose indicator (DDI) curve currently programmed into the AEC device. All simulated images contained clinically realistic projected anatomy and were scored by experienced image evaluators. Constant DDI and CNR curves did not provide optimized performance but constant eNEQm and SNR did, with the latter being the preferred calibration metric given that it is easier to measure in practice. This result was consistent with the previous investigation for chest imaging with AEC devices. Medical physicists may therefore use a simple and easily accessible uniform water equivalent phantom to measure the SNR image quality metric described here when calibrating AEC devices for abdomen, pelvis and spine imaging with Agfa CR systems, in the confidence that clinical image quality will be sufficient for the required clinical task. However, to ensure appropriate levels of detector air kerma the advice of expert image evaluators must be sought.

Photography in Dermatologic Surgery: Selection of an Appropriate Lighting Solution for a Particular Clinical Application.

PubMed

Chen, Brian R; Poon, Emily; Alam, Murad

2018-01-01

Lighting is an important component of consistent, high-quality dermatologic photography. There are different types of lighting solutions available. To evaluate currently available lighting equipment and methods suitable for procedural dermatology. Overhead lighting, built-in camera flashes, external flash units, studio strobes, and light-emitting diode (LED) light panels were evaluated with regard to their utility for dermatologic surgeons. A set of ideal lighting characteristics was used to examine the capabilities and limitations of each type of lighting solution. Recommendations regarding lighting solutions and optimal usage configurations were made in terms of the context of the clinical environment and the purpose of the image. Overhead lighting may be a convenient option for general documentation. An on-camera lighting solution using a built-in camera flash or a camera-mounted external flash unit provides portability and consistent lighting with minimal training. An off-camera lighting solution with studio strobes, external flash units, or LED light panels provides versatility and even lighting with minimal shadows and glare. The selection of an optimal lighting solution is contingent on practical considerations and the purpose of the image.

A Convex Formulation for Magnetic Particle Imaging X-Space Reconstruction.

PubMed

Konkle, Justin J; Goodwill, Patrick W; Hensley, Daniel W; Orendorff, Ryan D; Lustig, Michael; Conolly, Steven M

2015-01-01

Magnetic Particle Imaging (mpi) is an emerging imaging modality with exceptional promise for clinical applications in rapid angiography, cell therapy tracking, cancer imaging, and inflammation imaging. Recent publications have demonstrated quantitative mpi across rat sized fields of view with x-space reconstruction methods. Critical to any medical imaging technology is the reliability and accuracy of image reconstruction. Because the average value of the mpi signal is lost during direct-feedthrough signal filtering, mpi reconstruction algorithms must recover this zero-frequency value. Prior x-space mpi recovery techniques were limited to 1d approaches which could introduce artifacts when reconstructing a 3d image. In this paper, we formulate x-space reconstruction as a 3d convex optimization problem and apply robust a priori knowledge of image smoothness and non-negativity to reduce non-physical banding and haze artifacts. We conclude with a discussion of the powerful extensibility of the presented formulation for future applications.

Evaluation of non-rigid registration parameters for atlas-based segmentation of CT images of human cochlea

NASA Astrophysics Data System (ADS)

Elfarnawany, Mai; Alam, S. Riyahi; Agrawal, Sumit K.; Ladak, Hanif M.

2017-02-01

Cochlear implant surgery is a hearing restoration procedure for patients with profound hearing loss. In this surgery, an electrode is inserted into the cochlea to stimulate the auditory nerve and restore the patient's hearing. Clinical computed tomography (CT) images are used for planning and evaluation of electrode placement, but their low resolution limits the visualization of internal cochlear structures. Therefore, high resolution micro-CT images are used to develop atlas-based segmentation methods to extract these nonvisible anatomical features in clinical CT images. Accurate registration of the high and low resolution CT images is a prerequisite for reliable atlas-based segmentation. In this study, we evaluate and compare different non-rigid B-spline registration parameters using micro-CT and clinical CT images of five cadaveric human cochleae. The varying registration parameters are cost function (normalized correlation (NC), mutual information and mean square error), interpolation method (linear, windowed-sinc and B-spline) and sampling percentage (1%, 10% and 100%). We compare the registration results visually and quantitatively using the Dice similarity coefficient (DSC), Hausdorff distance (HD) and absolute percentage error in cochlear volume. Using MI or MSE cost functions and linear or windowed-sinc interpolation resulted in visually undesirable deformation of internal cochlear structures. Quantitatively, the transforms using 100% sampling percentage yielded the highest DSC and smallest HD (0.828+/-0.021 and 0.25+/-0.09mm respectively). Therefore, B-spline registration with cost function: NC, interpolation: B-spline and sampling percentage: moments 100% can be the foundation of developing an optimized atlas-based segmentation algorithm of intracochlear structures in clinical CT images.

Prospective PET image quality gain calculation method by optimizing detector parameters.

PubMed

Theodorakis, Lampros; Loudos, George; Prassopoulos, Vasilios; Kappas, Constantine; Tsougos, Ioannis; Georgoulias, Panagiotis

2015-12-01

Lutetium-based scintillators with high-performance electronics introduced time-of-flight (TOF) reconstruction in the clinical setting. Let G' be the total signal to noise ratio gain in a reconstructed image using the TOF kernel compared with conventional reconstruction modes. G' is then the product of G1 gain arising from the reconstruction process itself and (n-1) other gain factors (G2, G3, … Gn) arising from the inherent properties of the detector. We calculated G2 and G3 gains resulting from the optimization of the coincidence and energy window width for prompts and singles, respectively. Both quantitative and image-based validated Monte Carlo models of Lu2SiO5 (LSO) TOF-permitting and Bi4Ge3O12 (BGO) TOF-nonpermitting detectors were used for the calculations. G2 and G3 values were 1.05 and 1.08 for the BGO detector and G3 was 1.07 for the LSO. A value of almost unity for G2 of the LSO detector indicated a nonsignificant optimization by altering the energy window setting. G' was found to be ∼1.4 times higher for the TOF-permitting detector after reconstruction and optimization of the coincidence and energy windows. The method described could potentially predict image noise variations by altering detector acquisition parameters. It could also further contribute toward a long-lasting debate related to cost-efficiency issues of TOF scanners versus the non-TOF ones. Some vendors re-engage nowadays to non-TOF product line designs in an effort to reduce crystal costs. Therefore, exploring the limits of image quality gain by altering the parameters of these detectors remains a topical issue.

Understanding nonresponders of cardiac resynchronization therapy--current and future perspectives.

PubMed

Yu, Cheuk-Man; Wing-Hong Fung, Jeffrey; Zhang, Qing; Sanderson, John E

2005-10-01

Cardiac resynchronization therapy (CRT) is now an established nonpharmacologic therapy for advanced heart failure with electromechanical delay. Despite compelling evidence of the benefits of CRT, one troubling issue is the lack of a favorable response in about one-third of patients. Currently, there is no unifying definition of responders, and published data were based on acute hemodynamic changes, chronic left ventricular reverse remodeling, as well as the intermediate or long-term clinical response. The lack of improvement with CRT can be due to many factors including the placement of the left ventricular pacing lead in an inappropriate location, the absence of electrical conduction delay or mechanical dyssynchrony despite wide QRS complexes, and possibly failure to optimize the CRT settings after device implantation. In acute hemodynamic studies, placing the left ventricular leads at the free wall region has been suggested to generate the best pulse pressure and positive dp/dt. The degree of mechanical dyssynchrony has recently been assessed noninvasively in CRT patients by echocardiography and in particular by tissue Doppler imaging. These studies suggested that responders of left ventricular reverse remodeling or systolic function had more severe systolic dyssynchrony. However, further studies are needed to examine the clinical utility of these parameters when applied to the standardized anatomic or functional endpoints. Optimization of atrioventricular and interventricular pacing intervals may also reduce the number of nonresponders, though newer methods, especially interventricular pacing intervals, are still under clinical investigation. With the adjunctive use of imaging technology, physicians are able to characterize the response to CRT objectively, and cardiac imaging is an important clinical tool for determining more precisely the presence and degree of mechanical dyssynchrony.

Review at a multidisciplinary tumor board impacts critical management decisions of pediatric patients with cancer.

PubMed

Thenappan, Arun; Halaweish, Ihab; Mody, Rajen J; Smith, Ethan A; Geiger, James D; Ehrlich, Peter F; Jasty Rao, Rama; Hutchinson, Raymond; Yanik, Gregory; Rabah, Raja M; Heider, Amer; Stoll, Tammy; Newman, Erika A

2017-02-01

Optimal cancer care requires a multidisciplinary approach. The purpose of the current study was to evaluate the impact of a multidisciplinary tumor board on the treatment plans of children with solid tumors. The records of 158 consecutive patients discussed at a formal multidisciplinary pediatric tumor board between July 2012 and April 2014 were reviewed. Treatment plans were based on clinical practice guidelines and on current Children's Oncology Group protocols. Alterations in radiologic, pathologic, surgical, and medical interpretations were analyzed to determine the impact on changes in recommendations for clinical management. Overall, 55 of 158 children (35%) had alterations in radiologic, pathologic, medical, or surgical interpretation of clinical data following multidisciplinary discussion. Of these, 64% had changes to the initial recommendation for clinical management. Review of imaging studies resulted in interpretation changes in 30 of 158 patients studied (19%), with 12 clinical management changes. Six of 158 patients (3.9%) had changes in pathologic interpretation, with four patients (2.5%) requiring treatment changes. In eight patients (5%), a change in medical management was recommended, while in 11 patients (7%) there were changes in surgical management that were based solely on discussion and not on interpretation of imaging or pathology. Formal multidisciplinary review led to alterations in interpretation of clinical data in 35% of patients, and the majority led to changes in recommendations for treatment. Comprehensive multidisciplinary tumor board incorporated into the care of children with cancer provides additional perspectives for families and care providers when delineating optimal treatment plans. © 2016 Wiley Periodicals, Inc.

Analytical optimization of digital subtraction mammography with contrast medium using a commercial unit.

PubMed

Rosado-Méndez, I; Palma, B A; Brandan, M E

2008-12-01

Contrast-medium-enhanced digital mammography (CEDM) is an image subtraction technique which might help unmasking lesions embedded in very dense breasts. Previous works have stated the feasibility of CEDM and the imperative need of radiological optimization. This work presents an extension of a former analytical formalism to predict contrast-to-noise ratio (CNR) in subtracted mammograms. The goal is to optimize radiological parameters available in a clinical mammographic unit (x-ray tube anode/filter combination, voltage, and loading) by maximizing CNR and minimizing total mean glandular dose (D(gT)), simulating the experimental application of an iodine-based contrast medium and the image subtraction under dual-energy nontemporal, and single- or dual-energy temporal modalities. Total breast-entrance air kerma is limited to a fixed 8.76 mGy (1 R, similar to screening studies). Mathematical expressions obtained from the formalism are evaluated using computed mammographic x-ray spectra attenuated by an adipose/glandular breast containing an elongated structure filled with an iodinated solution in various concentrations. A systematic study of contrast, its associated variance, and CNR for different spectral combinations is performed, concluding in the proposal of optimum x-ray spectra. The linearity between contrast in subtracted images and iodine mass thickness is proven, including the determination of iodine visualization limits based on Rose's detection criterion. Finally, total breast-entrance air kerma is distributed between both images in various proportions in order to maximize the figure of merit CNR2/D(gT). Predicted results indicate the advantage of temporal subtraction (either single- or dual-energy modalities) with optimum parameters corresponding to high-voltage, strongly hardened Rh/Rh spectra. For temporal techniques, CNR was found to depend mostly on the energy of the iodinated image, and thus reduction in D(gT) could be achieved if the spectral energy of the noniodinated image is decreased and the breast-entrance air kerma is evenly distributed between both acquisitions. Predicted limits, in terms of iodine concentration, are found to guarantee the visualization of common clinical angiogenic concentrations in the breast.

Falcon: automated optimization method for arbitrary assessment criteria

DOEpatents

Yang, Tser-Yuan; Moses, Edward I.; Hartmann-Siantar, Christine

2001-01-01

FALCON is a method for automatic multivariable optimization for arbitrary assessment criteria that can be applied to numerous fields where outcome simulation is combined with optimization and assessment criteria. A specific implementation of FALCON is for automatic radiation therapy treatment planning. In this application, FALCON implements dose calculations into the planning process and optimizes available beam delivery modifier parameters to determine the treatment plan that best meets clinical decision-making criteria. FALCON is described in the context of the optimization of external-beam radiation therapy and intensity modulated radiation therapy (IMRT), but the concepts could also be applied to internal (brachytherapy) radiotherapy. The radiation beams could consist of photons or any charged or uncharged particles. The concept of optimizing source distributions can be applied to complex radiography (e.g. flash x-ray or proton) to improve the imaging capabilities of facilities proposed for science-based stockpile stewardship.

Imaging of all three coronary arteries by transthoracic echocardiography. an illustrated guide

PubMed Central

Krzanowski, Marek; Bodzoń, Wojciech; Dimitrow, Paweł Petkow

2003-01-01

Background Improvements in ultrasound technology has enabled direct, transthoracic visualization of long portions of coronary arteries : the left anterior descending (LAD), circumflex (Cx) and right coronary artery (RCA). Transthoracic measurements of coronary flow velocity were proved to be highly reproducible and correlated with invasive measurements. While clinical applications of transthoracic echocardiography (TTE) of principal coronary arteries are still very limited they will likely grow. The echocardiographers may therefore be interested to know the ultrasonic views, technique of examination and be aware where to look for coronary arteries and how to optimize the images. Methods A step-by-step approach to direct, transthoracic visualization of the LAD, Cx and RCA is presented. The technique of examination is discussed, correlations with basic coronary angiography views and heart anatomy are shown and extensively illustrated with photographs and movie-pictures. Hints concerning optimization of ultrasound images are presented and artifacts of imaging are discussed. Conclusions Direct, transthoracic examination of the LAD, Cx and RCA in adults is possible and may become a useful adjunct to other methods of coronary artery examination but studies are needed to establish its role. PMID:14622441

An optimized workflow for the integration of biological information into radiotherapy planning: experiences with T1w DCE-MRI

NASA Astrophysics Data System (ADS)

Neff, T.; Kiessling, F.; Brix, G.; Baudendistel, K.; Zechmann, C.; Giesel, F. L.; Bendl, R.

2005-09-01

Planning of radiotherapy is often difficult due to restrictions on morphological images. New imaging techniques enable the integration of biological information into treatment planning and help to improve the detection of vital and aggressive tumour areas. This might improve clinical outcome. However, nowadays morphological data sets are still the gold standard in the planning of radiotherapy. In this paper, we introduce an in-house software platform enabling us to combine images from different imaging modalities yielding biological and morphological information in a workflow driven approach. This is demonstrated for the combination of morphological CT, MRI, functional DCE-MRI and PET data. Data of patients with a tumour of the prostate and with a meningioma were examined with DCE-MRI by applying pharmacokinetic two-compartment models for post-processing. The results were compared with the clinical plans for radiation therapy. Generated parameter maps give additional information about tumour spread, which can be incorporated in the definition of safety margins.

White Paper Report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: Integrating Multidisciplinary Strategies for Imaging Services in the Developing World

PubMed Central

Mazal, Jonathan; Lexa, Frank; Starikovsky, Anna; Jimenez, Pablo; Jain, Sanjay; DeStigter, Kristen K.; Nathan, Robert; Krebs, Elizabeth; Noble, Vicki; Marks, William; Hirsh, Richard N.; Short, Brad; Sydnor, Ryan; Timmreck-Jackson, Emily; Lungren, Matthew P.; Maxfield, Charles; Azene, Ezana M.; Garra, Brian S.; Choi, Brian G.; Lewin, Jonathan S.; Mollura, Daniel J.

2016-01-01

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparity. This white paper from the 2011 RAD-AID Conference represents consensus advocacy of multidisciplinary strategies to improve planning, accessibility and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and healthcare disparities including: (1) economic development for radiology service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. PMID:22748790

White paper report of the 2011 RAD-AID Conference on International Radiology for Developing Countries: integrating multidisciplinary strategies for imaging services in the developing world.

PubMed

Everton, Kathryn L; Mazal, Jonathan; Mollura, Daniel J

2012-07-01

The 2011 RAD-AID Conference on International Radiology for Developing Countries discussed data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services significantly reduce health care quality and increase health care disparities. This white paper from the 2011 RAD-AID conference represents consensus advocacy of multidisciplinary strategies to improve the planning, accessibility, and quality of imaging services in the developing world. Conference presenters and participants discussed numerous solutions to imaging and health care disparities, including (1) economic development for radiologic service planning, (2) public health mechanisms to address disease and prevention at the population and community levels, (3) comparative clinical models to implement various clinical and workflow strategies adapted to unique developing world community contexts, (4) education to improve training and optimize service quality, and (5) technology innovation to bring new technical capabilities to limited-resource regions. Published by Elsevier Inc.

Joint sparse reconstruction of multi-contrast MRI images with graph based redundant wavelet transform.

PubMed

Lai, Zongying; Zhang, Xinlin; Guo, Di; Du, Xiaofeng; Yang, Yonggui; Guo, Gang; Chen, Zhong; Qu, Xiaobo

2018-05-03

Multi-contrast images in magnetic resonance imaging (MRI) provide abundant contrast information reflecting the characteristics of the internal tissues of human bodies, and thus have been widely utilized in clinical diagnosis. However, long acquisition time limits the application of multi-contrast MRI. One efficient way to accelerate data acquisition is to under-sample the k-space data and then reconstruct images with sparsity constraint. However, images are compromised at high acceleration factor if images are reconstructed individually. We aim to improve the images with a jointly sparse reconstruction and Graph-based redundant wavelet transform (GBRWT). First, a sparsifying transform, GBRWT, is trained to reflect the similarity of tissue structures in multi-contrast images. Second, joint multi-contrast image reconstruction is formulated as a ℓ 2, 1 norm optimization problem under GBRWT representations. Third, the optimization problem is numerically solved using a derived alternating direction method. Experimental results in synthetic and in vivo MRI data demonstrate that the proposed joint reconstruction method can achieve lower reconstruction errors and better preserve image structures than the compared joint reconstruction methods. Besides, the proposed method outperforms single image reconstruction with joint sparsity constraint of multi-contrast images. The proposed method explores the joint sparsity of multi-contrast MRI images under graph-based redundant wavelet transform and realizes joint sparse reconstruction of multi-contrast images. Experiment demonstrate that the proposed method outperforms the compared joint reconstruction methods as well as individual reconstructions. With this high quality image reconstruction method, it is possible to achieve the high acceleration factors by exploring the complementary information provided by multi-contrast MRI.

Temporal lobe epilepsy: quantitative MR volumetry in detection of hippocampal atrophy.

PubMed

Farid, Nikdokht; Girard, Holly M; Kemmotsu, Nobuko; Smith, Michael E; Magda, Sebastian W; Lim, Wei Y; Lee, Roland R; McDonald, Carrie R

2012-08-01

To determine the ability of fully automated volumetric magnetic resonance (MR) imaging to depict hippocampal atrophy (HA) and to help correctly lateralize the seizure focus in patients with temporal lobe epilepsy (TLE). This study was conducted with institutional review board approval and in compliance with HIPAA regulations. Volumetric MR imaging data were analyzed for 34 patients with TLE and 116 control subjects. Structural volumes were calculated by using U.S. Food and Drug Administration-cleared software for automated quantitative MR imaging analysis (NeuroQuant). Results of quantitative MR imaging were compared with visual detection of atrophy, and, when available, with histologic specimens. Receiver operating characteristic analyses were performed to determine the optimal sensitivity and specificity of quantitative MR imaging for detecting HA and asymmetry. A linear classifier with cross validation was used to estimate the ability of quantitative MR imaging to help lateralize the seizure focus. Quantitative MR imaging-derived hippocampal asymmetries discriminated patients with TLE from control subjects with high sensitivity (86.7%-89.5%) and specificity (92.2%-94.1%). When a linear classifier was used to discriminate left versus right TLE, hippocampal asymmetry achieved 94% classification accuracy. Volumetric asymmetries of other subcortical structures did not improve classification. Compared with invasive video electroencephalographic recordings, lateralization accuracy was 88% with quantitative MR imaging and 85% with visual inspection of volumetric MR imaging studies but only 76% with visual inspection of clinical MR imaging studies. Quantitative MR imaging can depict the presence and laterality of HA in TLE with accuracy rates that may exceed those achieved with visual inspection of clinical MR imaging studies. Thus, quantitative MR imaging may enhance standard visual analysis, providing a useful and viable means for translating volumetric analysis into clinical practice.

Low-dose computed tomography scans with automatic exposure control for patients of different ages undergoing cardiac PET/CT and SPECT/CT.

PubMed

Yang, Ching-Ching; Yang, Bang-Hung; Tu, Chun-Yuan; Wu, Tung-Hsin; Liu, Shu-Hsin

2017-06-01

This study aimed to evaluate the efficacy of automatic exposure control (AEC) in order to optimize low-dose computed tomography (CT) protocols for patients of different ages undergoing cardiac PET/CT and single-photon emission computed tomography/computed tomography (SPECT/CT). One PET/CT and one SPECT/CT were used to acquire CT images for four anthropomorphic phantoms representative of 1-year-old, 5-year-old and 10-year-old children and an adult. For the hybrid systems investigated in this study, the radiation dose and image quality of cardiac CT scans performed with AEC activated depend mainly on the selection of a predefined image quality index. Multiple linear regression methods were used to analyse image data from anthropomorphic phantom studies to investigate the effects of body size and predefined image quality index on CT radiation dose in cardiac PET/CT and SPECT/CT scans. The regression relationships have a coefficient of determination larger than 0.9, indicating a good fit to the data. According to the regression models, low-dose protocols using the AEC technique were optimized for patients of different ages. In comparison with the standard protocol with AEC activated for adult cardiac examinations used in our clinical routine practice, the optimized paediatric protocols in PET/CT allow 32.2, 63.7 and 79.2% CT dose reductions for anthropomorphic phantoms simulating 10-year-old, 5-year-old and 1-year-old children, respectively. The corresponding results for cardiac SPECT/CT are 8.4, 51.5 and 72.7%. AEC is a practical way to reduce CT radiation dose in cardiac PET/CT and SPECT/CT, but the AEC settings should be determined properly for optimal effect. Our results show that AEC does not eliminate the need for paediatric protocols and CT examinations using the AEC technique should be optimized for paediatric patients to reduce the radiation dose as low as reasonably achievable.

Motion correction of PET brain images through deconvolution: II. Practical implementation and algorithm optimization

NASA Astrophysics Data System (ADS)

Raghunath, N.; Faber, T. L.; Suryanarayanan, S.; Votaw, J. R.

2009-02-01

Image quality is significantly degraded even by small amounts of patient motion in very high-resolution PET scanners. When patient motion is known, deconvolution methods can be used to correct the reconstructed image and reduce motion blur. This paper describes the implementation and optimization of an iterative deconvolution method that uses an ordered subset approach to make it practical and clinically viable. We performed ten separate FDG PET scans using the Hoffman brain phantom and simultaneously measured its motion using the Polaris Vicra tracking system (Northern Digital Inc., Ontario, Canada). The feasibility and effectiveness of the technique was studied by performing scans with different motion and deconvolution parameters. Deconvolution resulted in visually better images and significant improvement as quantified by the Universal Quality Index (UQI) and contrast measures. Finally, the technique was applied to human studies to demonstrate marked improvement. Thus, the deconvolution technique presented here appears promising as a valid alternative to existing motion correction methods for PET. It has the potential for deblurring an image from any modality if the causative motion is known and its effect can be represented in a system matrix.

Teaching learning based optimization-functional link artificial neural network filter for mixed noise reduction from magnetic resonance image.

PubMed

Kumar, M; Mishra, S K

2017-01-01

The clinical magnetic resonance imaging (MRI) images may get corrupted due to the presence of the mixture of different types of noises such as Rician, Gaussian, impulse, etc. Most of the available filtering algorithms are noise specific, linear, and non-adaptive. There is a need to develop a nonlinear adaptive filter that adapts itself according to the requirement and effectively applied for suppression of mixed noise from different MRI images. In view of this, a novel nonlinear neural network based adaptive filter i.e. functional link artificial neural network (FLANN) whose weights are trained by a recently developed derivative free meta-heuristic technique i.e. teaching learning based optimization (TLBO) is proposed and implemented. The performance of the proposed filter is compared with five other adaptive filters and analyzed by considering quantitative metrics and evaluating the nonparametric statistical test. The convergence curve and computational time are also included for investigating the efficiency of the proposed as well as competitive filters. The simulation outcomes of proposed filter outperform the other adaptive filters. The proposed filter can be hybridized with other evolutionary technique and utilized for removing different noise and artifacts from others medical images more competently.

Prostate Brachytherapy Seed Reconstruction with Gaussian Blurring and Optimal Coverage Cost

PubMed Central

Lee, Junghoon; Liu, Xiaofeng; Jain, Ameet K.; Song, Danny Y.; Burdette, E. Clif; Prince, Jerry L.; Fichtinger, Gabor

2009-01-01

Intraoperative dosimetry in prostate brachytherapy requires localization of the implanted radioactive seeds. A tomosynthesis-based seed reconstruction method is proposed. A three-dimensional volume is reconstructed from Gaussian-blurred projection images and candidate seed locations are computed from the reconstructed volume. A false positive seed removal process, formulated as an optimal coverage problem, iteratively removes “ghost” seeds that are created by tomosynthesis reconstruction. In an effort to minimize pose errors that are common in conventional C-arms, initial pose parameter estimates are iteratively corrected by using the detected candidate seeds as fiducials, which automatically “focuses” the collected images and improves successive reconstructed volumes. Simulation results imply that the implanted seed locations can be estimated with a detection rate of ≥ 97.9% and ≥ 99.3% from three and four images, respectively, when the C-arm is calibrated and the pose of the C-arm is known. The algorithm was also validated on phantom data sets successfully localizing the implanted seeds from four or five images. In a Phase-1 clinical trial, we were able to localize the implanted seeds from five intraoperative fluoroscopy images with 98.8% (STD=1.6) overall detection rate. PMID:19605321

Repeat analysis of intraoral digital imaging performed by undergraduate students using a complementary metal oxide semiconductor sensor: An institutional case study.

PubMed

Yusof, Mohd Yusmiaidil Putera Mohd; Rahman, Nur Liyana Abdul; Asri, Amiza Aqiela Ahmad; Othman, Noor Ilyani; Wan Mokhtar, Ilham

2017-12-01

This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor. A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved. The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients.

Dual optimization based prostate zonal segmentation in 3D MR images.

PubMed

Qiu, Wu; Yuan, Jing; Ukwatta, Eranga; Sun, Yue; Rajchl, Martin; Fenster, Aaron

2014-05-01

Efficient and accurate segmentation of the prostate and two of its clinically meaningful sub-regions: the central gland (CG) and peripheral zone (PZ), from 3D MR images, is of great interest in image-guided prostate interventions and diagnosis of prostate cancer. In this work, a novel multi-region segmentation approach is proposed to simultaneously segment the prostate and its two major sub-regions from only a single 3D T2-weighted (T2w) MR image, which makes use of the prior spatial region consistency and incorporates a customized prostate appearance model into the segmentation task. The formulated challenging combinatorial optimization problem is solved by means of convex relaxation, for which a novel spatially continuous max-flow model is introduced as the dual optimization formulation to the studied convex relaxed optimization problem with region consistency constraints. The proposed continuous max-flow model derives an efficient duality-based algorithm that enjoys numerical advantages and can be easily implemented on GPUs. The proposed approach was validated using 18 3D prostate T2w MR images with a body-coil and 25 images with an endo-rectal coil. Experimental results demonstrate that the proposed method is capable of efficiently and accurately extracting both the prostate zones: CG and PZ, and the whole prostate gland from the input 3D prostate MR images, with a mean Dice similarity coefficient (DSC) of 89.3±3.2% for the whole gland (WG), 82.2±3.0% for the CG, and 69.1±6.9% for the PZ in 3D body-coil MR images; 89.2±3.3% for the WG, 83.0±2.4% for the CG, and 70.0±6.5% for the PZ in 3D endo-rectal coil MR images. In addition, the experiments of intra- and inter-observer variability introduced by user initialization indicate a good reproducibility of the proposed approach in terms of volume difference (VD) and coefficient-of-variation (CV) of DSC. Copyright © 2014 Elsevier B.V. All rights reserved.

Imaging technique for the complete edentulous patient treated conventionally or with mini implant overdenture

PubMed Central

Meleşcanu Imre, M; Preoteasa, E; Țâncu, AM; Preoteasa, CT

2013-01-01

Rationale. The imaging methods are more and more used in the clinical process of modern dentistry. Once the implant based treatment alternatives are nowadays seen as being the standard of care in edentulous patients, these techniques must be integrated in the complete denture treatment. Aim. The study presents some evaluation techniques for the edentulous patient treated by conventional dentures or mini dental implants (mini SKY Bredent) overdentures, using the profile teleradiography. These offer data useful for an optimal positioning of the artificial teeth and the mini dental implants, favoring to obtain an esthetic and functional treatment outcome. We proposed also a method to conceive a simple surgical guide that allows the prosthetically driven implants placement. Material and method. Clinical case reports were made, highlighting the importance of cephalometric evaluation on lateral teleradiographs in complete edentulous patients. A clinical case that gradually reports the surgical guide preparation (Bredent silicon radio opaque), in order to place the mini dental implants in the best prosthetic and anatomic conditions, was presented. Conclusions. The profile teleradiograph is a useful tool for the practitioner. It allows establishing the optimal site for implant placement, in a good relation with the overdenture. The conventional denture can be easily and relatively costless transformed in a surgical guide used during implant placement. PMID:23599828

Facile synthesis, pharmacokinetic and systemic clearance evaluation, and positron emission tomography cancer imaging of 64Cu-Au alloy nanoclusters

NASA Astrophysics Data System (ADS)

Zhao, Yongfeng; Sultan, Deborah; Detering, Lisa; Luehmann, Hannah; Liu, Yongjian

2014-10-01

Gold nanoparticles have been widely used for oncological applications including diagnosis and therapy. However, the non-specific mononuclear phagocyte system accumulation and potential long-term toxicity have significantly limited clinical translation. One strategy to overcome these shortcomings is to reduce the size of gold nanoparticles to allow renal clearance. Herein, we report the preparation of 64Cu alloyed gold nanoclusters (64CuAuNCs) for in vivo evaluation of pharmacokinetics, systemic clearance, and positron emission tomography (PET) imaging in a mouse prostate cancer model. The facile synthesis in acqueous solution allowed precisely controlled 64Cu incorporation for high radiolabeling specific activity and stability for sensitive and accurate detection. Through surface pegylation with 350 Da polyethylene glycol (PEG), the 64CuAuNCs-PEG350 afforded optimal biodistribution and significant renal and hepatobiliary excretion. PET imaging showed low non-specific tumor uptake, indicating its potential for active targeting of clinically relevant biomarkers in tumor and metastatic organs.Gold nanoparticles have been widely used for oncological applications including diagnosis and therapy. However, the non-specific mononuclear phagocyte system accumulation and potential long-term toxicity have significantly limited clinical translation. One strategy to overcome these shortcomings is to reduce the size of gold nanoparticles to allow renal clearance. Herein, we report the preparation of 64Cu alloyed gold nanoclusters (64CuAuNCs) for in vivo evaluation of pharmacokinetics, systemic clearance, and positron emission tomography (PET) imaging in a mouse prostate cancer model. The facile synthesis in acqueous solution allowed precisely controlled 64Cu incorporation for high radiolabeling specific activity and stability for sensitive and accurate detection. Through surface pegylation with 350 Da polyethylene glycol (PEG), the 64CuAuNCs-PEG350 afforded optimal biodistribution and significant renal and hepatobiliary excretion. PET imaging showed low non-specific tumor uptake, indicating its potential for active targeting of clinically relevant biomarkers in tumor and metastatic organs. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr04569f

Recent developments in fast kurtosis imaging

NASA Astrophysics Data System (ADS)

Hansen, Brian; Jespersen, Sune N.

2017-09-01

Diffusion kurtosis imaging (DKI) is an extension of the popular diffusion tensor imaging (DTI) technique. DKI takes into account leading deviations from Gaussian diffusion stemming from a number of effects related to the microarchitecture and compartmentalization in biological tissues. DKI therefore offers increased sensitivity to subtle microstructural alterations over conventional diffusion imaging such as DTI, as has been demonstrated in numerous reports. For this reason, interest in routine clinical application of DKI is growing rapidly. In an effort to facilitate more widespread use of DKI, recent work by our group has focused on developing experimentally fast and robust estimates of DKI metrics. A significant increase in speed is made possible by a reduction in data demand achieved through rigorous analysis of the relation between the DKI signal and the kurtosis tensor based metrics. The fast DKI methods therefore need only 13 or 19 images for DKI parameter estimation compared to more than 60 for the most modest DKI protocols applied today. Closed form solutions also ensure rapid calculation of most DKI metrics. Some parameters can even be reconstructed in real time, which may be valuable in the clinic. The fast techniques are based on conventional diffusion sequences and are therefore easily implemented on almost any clinical system, in contrast to a range of other recently proposed advanced diffusion techniques. In addition to its general applicability, this also ensures that any acceleration achieved in conventional DKI through sequence or hardware optimization will also translate directly to fast DKI acquisitions. In this review, we recapitulate the theoretical basis for the fast kurtosis techniques and their relation to conventional DKI. We then discuss the currently available variants of the fast DKI methods, their strengths and weaknesses, as well as their respective realms of application. These range from whole body applications to methods mostly suited for spinal cord or peripheral nerve, and analysis specific to brain white matter. Having covered these technical aspects, we proceed to review the fast kurtosis literature including validation studies, organ specific optimization studies and results from clinical applications.

Experimental evaluation and basis function optimization of the spatially variant image-space PSF on the Ingenuity PET/MR scanner

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kotasidis, Fotis A., E-mail: Fotis.Kotasidis@unige.ch; Zaidi, Habib; Geneva Neuroscience Centre, Geneva University, CH-1205 Geneva

2014-06-15

Purpose: The Ingenuity time-of-flight (TF) PET/MR is a recently developed hybrid scanner combining the molecular imaging capabilities of PET with the excellent soft tissue contrast of MRI. It is becoming common practice to characterize the system's point spread function (PSF) and understand its variation under spatial transformations to guide clinical studies and potentially use it within resolution recovery image reconstruction algorithms. Furthermore, due to the system's utilization of overlapping and spherical symmetric Kaiser-Bessel basis functions during image reconstruction, its image space PSF and reconstructed spatial resolution could be affected by the selection of the basis function parameters. Hence, a detailedmore » investigation into the multidimensional basis function parameter space is needed to evaluate the impact of these parameters on spatial resolution. Methods: Using an array of 12 × 7 printed point sources, along with a custom made phantom, and with the MR magnet on, the system's spatially variant image-based PSF was characterized in detail. Moreover, basis function parameters were systematically varied during reconstruction (list-mode TF OSEM) to evaluate their impact on the reconstructed resolution and the image space PSF. Following the spatial resolution optimization, phantom, and clinical studies were subsequently reconstructed using representative basis function parameters. Results: Based on the analysis and under standard basis function parameters, the axial and tangential components of the PSF were found to be almost invariant under spatial transformations (∼4 mm) while the radial component varied modestly from 4 to 6.7 mm. Using a systematic investigation into the basis function parameter space, the spatial resolution was found to degrade for basis functions with a large radius and small shape parameter. However, it was found that optimizing the spatial resolution in the reconstructed PET images, while having a good basis function superposition and keeping the image representation error to a minimum, is feasible, with the parameter combination range depending upon the scanner's intrinsic resolution characteristics. Conclusions: Using the printed point source array as a MR compatible methodology for experimentally measuring the scanner's PSF, the system's spatially variant resolution properties were successfully evaluated in image space. Overall the PET subsystem exhibits excellent resolution characteristics mainly due to the fact that the raw data are not under-sampled/rebinned, enabling the spatial resolution to be dictated by the scanner's intrinsic resolution and the image reconstruction parameters. Due to the impact of these parameters on the resolution properties of the reconstructed images, the image space PSF varies both under spatial transformations and due to basis function parameter selection. Nonetheless, for a range of basis function parameters, the image space PSF remains unaffected, with the range depending on the scanner's intrinsic resolution properties.« less

Coupling of EIT with computational lung modeling for predicting patient-specific ventilatory responses.

PubMed

Roth, Christian J; Becher, Tobias; Frerichs, Inéz; Weiler, Norbert; Wall, Wolfgang A

2017-04-01

Providing optimal personalized mechanical ventilation for patients with acute or chronic respiratory failure is still a challenge within a clinical setting for each case anew. In this article, we integrate electrical impedance tomography (EIT) monitoring into a powerful patient-specific computational lung model to create an approach for personalizing protective ventilatory treatment. The underlying computational lung model is based on a single computed tomography scan and able to predict global airflow quantities, as well as local tissue aeration and strains for any ventilation maneuver. For validation, a novel "virtual EIT" module is added to our computational lung model, allowing to simulate EIT images based on the patient's thorax geometry and the results of our numerically predicted tissue aeration. Clinically measured EIT images are not used to calibrate the computational model. Thus they provide an independent method to validate the computational predictions at high temporal resolution. The performance of this coupling approach has been tested in an example patient with acute respiratory distress syndrome. The method shows good agreement between computationally predicted and clinically measured airflow data and EIT images. These results imply that the proposed framework can be used for numerical prediction of patient-specific responses to certain therapeutic measures before applying them to an actual patient. In the long run, definition of patient-specific optimal ventilation protocols might be assisted by computational modeling. NEW & NOTEWORTHY In this work, we present a patient-specific computational lung model that is able to predict global and local ventilatory quantities for a given patient and any selected ventilation protocol. For the first time, such a predictive lung model is equipped with a virtual electrical impedance tomography module allowing real-time validation of the computed results with the patient measurements. First promising results obtained in an acute respiratory distress syndrome patient show the potential of this approach for personalized computationally guided optimization of mechanical ventilation in future. Copyright © 2017 the American Physiological Society.

Clinical Implementation of a Model-Based In Vivo Dose Verification System for Stereotactic Body Radiation Therapy-Volumetric Modulated Arc Therapy Treatments Using the Electronic Portal Imaging Device.

PubMed

McCowan, Peter M; Asuni, Ganiyu; Van Uytven, Eric; VanBeek, Timothy; McCurdy, Boyd M C; Loewen, Shaun K; Ahmed, Naseer; Bashir, Bashir; Butler, James B; Chowdhury, Amitava; Dubey, Arbind; Leylek, Ahmet; Nashed, Maged

2017-04-01

To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. From December 2013 to July 2016, 117 stereotactic body radiation therapy-volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events. A developed model-based dose reconstruction algorithm calculates the 3-dimensional dose distribution to the patient by back-projecting the primary fluence measured by the EPID during treatment. The EPID frame-averaging was optimized in June 2015. For each treatment, a 3%/3-mm γ comparison between our EPID-derived dose and the Eclipse AcurosXB-predicted dose to the planning target volume (PTV) and the ≥20% isodose volume were performed. Alert levels were defined as γ pass rates <85% (lung and liver) and <80% (spine). Investigations were carried out for all fractions exceeding the alert level and were classified as follows: EPID-related, algorithmic, patient setup, anatomic change, or unknown/unidentified errors. The percentages of fractions exceeding the alert levels were 22.6% for lung before frame-average optimization and 8.0% for lung, 20.0% for spine, and 10.0% for liver after frame-average optimization. Overall, mean (± standard deviation) planning target volume γ pass rates were 90.7% ± 9.2%, 87.0% ± 9.3%, and 91.2% ± 3.4% for the lung, spine, and liver patients, respectively. Results from the clinical implementation of our model-based in vivo dose verification method using on-treatment EPID images is reported. The method is demonstrated to be valuable for routine clinical use for verifying delivered dose as well as for detecting errors. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical Implementation of a Model-Based In Vivo Dose Verification System for Stereotactic Body Radiation Therapy–Volumetric Modulated Arc Therapy Treatments Using the Electronic Portal Imaging Device

DOE Office of Scientific and Technical Information (OSTI.GOV)

McCowan, Peter M., E-mail: pmccowan@cancercare.mb.ca; Asuni, Ganiyu; Van Uytven, Eric

Purpose: To report findings from an in vivo dosimetry program implemented for all stereotactic body radiation therapy patients over a 31-month period and discuss the value and challenges of utilizing in vivo electronic portal imaging device (EPID) dosimetry clinically. Methods and Materials: From December 2013 to July 2016, 117 stereotactic body radiation therapy–volumetric modulated arc therapy patients (100 lung, 15 spine, and 2 liver) underwent 602 EPID-based in vivo dose verification events. A developed model-based dose reconstruction algorithm calculates the 3-dimensional dose distribution to the patient by back-projecting the primary fluence measured by the EPID during treatment. The EPID frame-averaging was optimized in Junemore » 2015. For each treatment, a 3%/3-mm γ comparison between our EPID-derived dose and the Eclipse AcurosXB–predicted dose to the planning target volume (PTV) and the ≥20% isodose volume were performed. Alert levels were defined as γ pass rates <85% (lung and liver) and <80% (spine). Investigations were carried out for all fractions exceeding the alert level and were classified as follows: EPID-related, algorithmic, patient setup, anatomic change, or unknown/unidentified errors. Results: The percentages of fractions exceeding the alert levels were 22.6% for lung before frame-average optimization and 8.0% for lung, 20.0% for spine, and 10.0% for liver after frame-average optimization. Overall, mean (± standard deviation) planning target volume γ pass rates were 90.7% ± 9.2%, 87.0% ± 9.3%, and 91.2% ± 3.4% for the lung, spine, and liver patients, respectively. Conclusions: Results from the clinical implementation of our model-based in vivo dose verification method using on-treatment EPID images is reported. The method is demonstrated to be valuable for routine clinical use for verifying delivered dose as well as for detecting errors.« less

A novel fully automatic multilevel thresholding technique based on optimized intuitionistic fuzzy sets and tsallis entropy for MR brain tumor image segmentation.

PubMed

Kaur, Taranjit; Saini, Barjinder Singh; Gupta, Savita

2018-03-01

In the present paper, a hybrid multilevel thresholding technique that combines intuitionistic fuzzy sets and tsallis entropy has been proposed for the automatic delineation of the tumor from magnetic resonance images having vague boundaries and poor contrast. This novel technique takes into account both the image histogram and the uncertainty information for the computation of multiple thresholds. The benefit of the methodology is that it provides fast and improved segmentation for the complex tumorous images with imprecise gray levels. To further boost the computational speed, the mutation based particle swarm optimization is used that selects the most optimal threshold combination. The accuracy of the proposed segmentation approach has been validated on simulated, real low-grade glioma tumor volumes taken from MICCAI brain tumor segmentation (BRATS) challenge 2012 dataset and the clinical tumor images, so as to corroborate its generality and novelty. The designed technique achieves an average Dice overlap equal to 0.82010, 0.78610 and 0.94170 for three datasets. Further, a comparative analysis has also been made between the eight existing multilevel thresholding implementations so as to show the superiority of the designed technique. In comparison, the results indicate a mean improvement in Dice by an amount equal to 4.00% (p < 0.005), 9.60% (p < 0.005) and 3.58% (p < 0.005), respectively in contrast to the fuzzy tsallis approach.

A guide to SPECT equipment for brain imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hoffer, P.B.; Zubal, G.

1991-12-31

Single photon emission computed tomography (SPECT) was started by Kuhl and Edwards about 30 years ago. Their original instrument consisted of four focused Nal probes mounted on a moving gantry. During the 1980s, clinical SPECT imaging was most frequently performed using single-headed Anger-type cameras which were modified for rotational as well as static imaging. Such instruments are still available and may be useful in settings where there are few patients and SPECT is used only occasionally. More frequently, however, dedicated SPECT devices are purchased which optimize equipment potential while being user-friendly. Modern SPECT instrumentation incorporates improvements in the detector, computers,more » mathematical formulations, electronics and display systems. A comprehensive discussion of all aspects of SPECT is beyond the scope of this article. The authors, however, discuss general concepts of SPECT, the current state-of-the-art in clinical SPECT instrumentation, and areas of common misunderstanding. 9 refs.« less

A Semiautomatic Method for Multiple Sclerosis Lesion Segmentation on Dual-Echo MR Imaging: Application in a Multicenter Context.

PubMed

Storelli, L; Pagani, E; Rocca, M A; Horsfield, M A; Gallo, A; Bisecco, A; Battaglini, M; De Stefano, N; Vrenken, H; Thomas, D L; Mancini, L; Ropele, S; Enzinger, C; Preziosa, P; Filippi, M

2016-07-21

The automatic segmentation of MS lesions could reduce time required for image processing together with inter- and intraoperator variability for research and clinical trials. A multicenter validation of a proposed semiautomatic method for hyperintense MS lesion segmentation on dual-echo MR imaging is presented. The classification technique used is based on a region-growing approach starting from manual lesion identification by an expert observer with a final segmentation-refinement step. The method was validated in a cohort of 52 patients with relapsing-remitting MS, with dual-echo images acquired in 6 different European centers. We found a mathematic expression that made the optimization of the method independent of the need for a training dataset. The automatic segmentation was in good agreement with the manual segmentation (dice similarity coefficient = 0.62 and root mean square error = 2 mL). Assessment of the segmentation errors showed no significant differences in algorithm performance between the different MR scanner manufacturers (P > .05). The method proved to be robust, and no center-specific training of the algorithm was required, offering the possibility for application in a clinical setting. Adoption of the method should lead to improved reliability and less operator time required for image analysis in research and clinical trials in MS. © 2016 American Society of Neuroradiology.

A GPU-accelerated and Monte Carlo-based intensity modulated proton therapy optimization system.

PubMed

Ma, Jiasen; Beltran, Chris; Seum Wan Chan Tseung, Hok; Herman, Michael G

2014-12-01

Conventional spot scanning intensity modulated proton therapy (IMPT) treatment planning systems (TPSs) optimize proton spot weights based on analytical dose calculations. These analytical dose calculations have been shown to have severe limitations in heterogeneous materials. Monte Carlo (MC) methods do not have these limitations; however, MC-based systems have been of limited clinical use due to the large number of beam spots in IMPT and the extremely long calculation time of traditional MC techniques. In this work, the authors present a clinically applicable IMPT TPS that utilizes a very fast MC calculation. An in-house graphics processing unit (GPU)-based MC dose calculation engine was employed to generate the dose influence map for each proton spot. With the MC generated influence map, a modified least-squares optimization method was used to achieve the desired dose volume histograms (DVHs). The intrinsic CT image resolution was adopted for voxelization in simulation and optimization to preserve spatial resolution. The optimizations were computed on a multi-GPU framework to mitigate the memory limitation issues for the large dose influence maps that resulted from maintaining the intrinsic CT resolution. The effects of tail cutoff and starting condition were studied and minimized in this work. For relatively large and complex three-field head and neck cases, i.e., >100,000 spots with a target volume of ∼ 1000 cm(3) and multiple surrounding critical structures, the optimization together with the initial MC dose influence map calculation was done in a clinically viable time frame (less than 30 min) on a GPU cluster consisting of 24 Nvidia GeForce GTX Titan cards. The in-house MC TPS plans were comparable to a commercial TPS plans based on DVH comparisons. A MC-based treatment planning system was developed. The treatment planning can be performed in a clinically viable time frame on a hardware system costing around 45,000 dollars. The fast calculation and optimization make the system easily expandable to robust and multicriteria optimization.

CT dose minimization using personalized protocol optimization and aggressive bowtie

NASA Astrophysics Data System (ADS)

Wang, Hui; Yin, Zhye; Jin, Yannan; Wu, Mingye; Yao, Yangyang; Tao, Kun; Kalra, Mannudeep K.; De Man, Bruno

2016-03-01

In this study, we propose to use patient-specific x-ray fluence control to reduce the radiation dose to sensitive organs while still achieving the desired image quality (IQ) in the region of interest (ROI). The mA modulation profile is optimized view by view, based on the sensitive organs and the ROI, which are obtained from an ultra-low-dose volumetric CT scout scan [1]. We use a clinical chest CT scan to demonstrate the feasibility of the proposed concept: the breast region is selected as the sensitive organ region while the cardiac region is selected as IQ ROI. Two groups of simulations are performed based on the clinical CT dataset: (1) a constant mA scan adjusted based on the patient attenuation (120 kVp, 300 mA), which serves as baseline; (2) an optimized scan with aggressive bowtie and ROI centering combined with patient-specific mA modulation. The results shows that the combination of the aggressive bowtie and the optimized mA modulation can result in 40% dose reduction in the breast region, while the IQ in the cardiac region is maintained. More generally, this paper demonstrates the general concept of using a 3D scout scan for optimal scan planning.

Assessment of pituitary micro-lesions using 3D sampling perfection with application-optimized contrasts using different flip-angle evolutions.

PubMed

Wang, Jing; Wu, Yue; Yao, Zhenwei; Yang, Zhong

2014-12-01

The aim of this study was to explore the value of three-dimensional sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) sequence in assessment of pituitary micro-lesions. Coronal 3D-SPACE as well as routine T1- and dynamic contrast-enhanced (DCE) T1-weighted images of the pituitary gland were acquired in 52 patients (48 women and four men; mean age, 32 years; age range, 17-50 years) with clinically suspected pituitary abnormality at 3.0 T, retrospectively. The interobserver agreement of assessment results was analyzed with K-statistics. Qualitative analyses were compared using Wilcoxon signed-rank test. There was good interobserver agreement of the independent evaluations for 3D-SPACE images (k = 0.892), fair for routine MR images (k = 0.649). At 3.0 T, 3D-SPACE provided significantly better images than routine MR images in terms of the boundary of pituitary gland, definition of pituitary lesions, and overall image quality. The evaluation of pituitary micro-lesions using combined routine and 3D-SPACE MR imaging was superior to that using only routine or 3D-SPACE imaging. The 3D-SPACE sequence can be used for appropriate and successful evaluation of the pituitary gland. We suggest 3D-SPACE sequence to be a powerful supplemental sequence in MR examinations with suspected pituitary micro-lesions.

Digital liver biopsy: Bio-imaging of fatty liver for translational and clinical research.

PubMed

Mancini, Marcello; Summers, Paul; Faita, Francesco; Brunetto, Maurizia R; Callea, Francesco; De Nicola, Andrea; Di Lascio, Nicole; Farinati, Fabio; Gastaldelli, Amalia; Gridelli, Bruno; Mirabelli, Peppino; Neri, Emanuele; Salvadori, Piero A; Rebelos, Eleni; Tiribelli, Claudio; Valenti, Luca; Salvatore, Marco; Bonino, Ferruccio

2018-02-27

The rapidly growing field of functional, molecular and structural bio-imaging is providing an extraordinary new opportunity to overcome the limits of invasive liver biopsy and introduce a "digital biopsy" for in vivo study of liver pathophysiology. To foster the application of bio-imaging in clinical and translational research, there is a need to standardize the methods of both acquisition and the storage of the bio-images of the liver. It can be hoped that the combination of digital, liquid and histologic liver biopsies will provide an innovative synergistic tri-dimensional approach to identifying new aetiologies, diagnostic and prognostic biomarkers and therapeutic targets for the optimization of personalized therapy of liver diseases and liver cancer. A group of experts of different disciplines (Special Interest Group for Personalized Hepatology of the Italian Association for the Study of the Liver, Institute for Biostructures and Bio-imaging of the National Research Council and Bio-banking and Biomolecular Resources Research Infrastructure) discussed criteria, methods and guidelines for facilitating the requisite application of data collection. This manuscript provides a multi-Author review of the issue with special focus on fatty liver.

Superparamagnetic iron oxide nanoparticles for MRI: contrast media pharmaceutical company R&D perspective.

PubMed

Corot, Claire; Warlin, David

2013-01-01

Superparamagnetic iron oxide (SPIO) nanoparticles are a relatively large class of contrast agents for magnetic resonance imaging. According to their biodistribution, distinct classes of SPIO nanoparticles have been investigated for clinical applications either as macrophage imaging agents or blood pool agents. Contrast agents which are pharmaceutics followed the same development rules as therapeutic drugs. Several drawbacks such as clinical development difficulties, organization of market access and imaging technological developments have limited the widespread use of these products. SPIO nanoparticles that are composed of thousands iron atoms providing large T2* effects are particularly suitable for theranostic. Stem cell migration and immune cell trafficking, as well as targeted SPIO nanoparticles for molecular imaging studies are mainly at the stage of proof of concept. A major economic challenge in the development of molecular imaging associated with a therapeutic treatment/procedure is to define innovative business models compatible with the needs of all players taking into account that theranostic solutions are promising to optimize resource allocation and ensure that expensive treatments are prescribed to responding patients. © 2013 Wiley Periodicals, Inc.

New generation of magnetic and luminescent nanoparticles for in vivo real-time imaging

PubMed Central

Lacroix, Lise-Marie; Delpech, Fabien; Nayral, Céline; Lachaize, Sébastien; Chaudret, Bruno

2013-01-01

A new generation of optimized contrast agents is emerging, based on metallic nanoparticles (NPs) and semiconductor nanocrystals for, respectively, magnetic resonance imaging (MRI) and near-infrared (NIR) fluorescent imaging techniques. Compared with established contrast agents, such as iron oxide NPs or organic dyes, these NPs benefit from several advantages: their magnetic and optical properties can be tuned through size, shape and composition engineering, their efficiency can exceed by several orders of magnitude that of contrast agents clinically used, their surface can be modified to incorporate specific targeting agents and antifolding polymers to increase blood circulation time and tumour recognition, and they can possibly be integrated in complex architecture to yield multi-modal imaging agents. In this review, we will report the materials of choice based on the understanding of the basic physics of NIR and MRI techniques and their corresponding syntheses as NPs. Surface engineering, water transfer and specific targeting will be highlighted prior to their first use for in vivo real-time imaging. Highly efficient NPs that are safer and target specific are likely to enter clinical application in a near future. PMID:24427542

Gadolinium-Based Contrast Agents for MR Cancer Imaging

PubMed Central

Zhou, Zhuxian; Lu, Zheng-Rong

2013-01-01

Magnetic resonance imaging (MRI) is a clinical imaging modality effective for anatomical and functional imaging of diseased soft tissues, including solid tumors. MRI contrast agents have been routinely used for detecting tumor at an early stage. Gadolinium based contrast agents are the most commonly used contrast agents in clinical MRI. There have been significant efforts to design and develop novel Gd(III) contrast agents with high relaxivity, low toxicity and specific tumor binding. The relaxivity of the Gd(III) contrast agents can be increased by proper chemical modification. The toxicity of Gd(III) contrast agents can be reduced by increasing the agents’ thermodynamic and kinetic stability, as well as optimizing their pharmacokinetic properties. The increasing knowledge in the field of cancer genomics and biology provides an opportunity for designing tumor-specific contrast agents. Various new Gd(III) chelates have been designed and evaluated in animal models for more effective cancer MRI. This review outlines the design and development, physicochemical properties, and in vivo properties of several classes of Gd(III)-based MR contrast agents for tumor imaging. PMID:23047730

Preparing images for publication: part 1.

PubMed

Devigus, Alessandro; Paul, Stefan

2006-04-01

Images play a vital role in the publication and presentation of clinical and scientific work. Within clinical photography, color reproduction has always been a contentious issue. With the development of new technologies, the variables affecting color reproduction have changed, and photographers have moved away from film-based to digital photographic imaging systems. To develop an understanding of color, knowledge about the basic principles of light and vision is important. An object's color is determined by which wavelengths of light it reflects. Colors of light and colors of pigment behave differently. Due to technical limitations, monitors and printers are unable to reproduce all the colors we can see with our eyes, also called the LAB color space. In order to optimize the output of digital clinical images, color management solutions need to be integrated in the photographic workflow; however, their use is still limited in the medical field. As described in part 2 of this article, calibrating your computer monitor and using an 18% gray background card are easy ways to enable more consistent color reproduction for publication. In addition, some basic information about the various camera settings is given to facilitate the use of this new digital equipment in daily practice.

Optimized image acquisition for breast tomosynthesis in projection and reconstruction space.

PubMed

Chawla, Amarpreet S; Lo, Joseph Y; Baker, Jay A; Samei, Ehsan

2009-11-01

Breast tomosynthesis has been an exciting new development in the field of breast imaging. While the diagnostic improvement via tomosynthesis is notable, the full potential of tomosynthesis has not yet been realized. This may be attributed to the dependency of the diagnostic quality of tomosynthesis on multiple variables, each of which needs to be optimized. Those include dose, number of angular projections, and the total angular span of those projections. In this study, the authors investigated the effects of these acquisition parameters on the overall diagnostic image quality of breast tomosynthesis in both the projection and reconstruction space. Five mastectomy specimens were imaged using a prototype tomosynthesis system. 25 angular projections of each specimen were acquired at 6.2 times typical single-view clinical dose level. Images at lower dose levels were then simulated using a noise modification routine. Each projection image was supplemented with 84 simulated 3 mm 3D lesions embedded at the center of 84 nonoverlapping ROIs. The projection images were then reconstructed using a filtered backprojection algorithm at different combinations of acquisition parameters to investigate which of the many possible combinations maximizes the performance. Performance was evaluated in terms of a Laguerre-Gauss channelized Hotelling observer model-based measure of lesion detectability. The analysis was also performed without reconstruction by combining the model results from projection images using Bayesian decision fusion algorithm. The effect of acquisition parameters on projection images and reconstructed slices were then compared to derive an optimization rule for tomosynthesis. The results indicated that projection images yield comparable but higher performance than reconstructed images. Both modes, however, offered similar trends: Performance improved with an increase in the total acquisition dose level and the angular span. Using a constant dose level and angular span, the performance rolled off beyond a certain number of projections, indicating that simply increasing the number of projections in tomosynthesis may not necessarily improve its performance. The best performance for both projection images and tomosynthesis slices was obtained for 15-17 projections spanning an angular are of approximately 45 degrees--the maximum tested in our study, and for an acquisition dose equal to single-view mammography. The optimization framework developed in this framework is applicable to other reconstruction techniques and other multiprojection systems.

Transthoracic ultrasound guided balloon dilation of cor triatriatum dexter in 2 Rottweiler puppies.

PubMed

Birettoni, F; Caivano, D; Bufalari, A; Giorgi, M E; Miglio, A; Paradies, P; Porciello, F

2016-12-01

Balloon dilation was performed in two Rottweiler puppies with cor triatriatum dexter and clinical signs of ascites using transthoracic echocardiographic guidance. The dogs were positioned on a standard echocardiography table in right lateral recumbency, and guide wires and balloon catheters were imaged by echocardiographic views optimized to allow visualization of the defect. The procedures were performed successfully without complications and clinical signs were resolved completely in both cases. Guide wires and balloon catheters appeared hyperechoic on transthoracic echocardiography image and could be clearly monitored and guided in real-time. These two cases demonstrate that it is possible to perform balloon catheter dilation of cor triatriatum dexter under transthoracic guidance alone. Copyright © 2016 Elsevier B.V. All rights reserved.

SU-E-J-07: IGRT Gently: Evaluating Imaging Dose in Phantoms of Different Sizes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morris, B; Duggar, W; Stanford, J

Purpose: IGRT imaging procedures have emerged as a common method of patient position verification in radiotherapy, though imaging dose is generally neglected in the treatment plan. Consequently, evaluating and optimizing the dose from these procedures is worthwhile. This process is especially important for children, who are more radiosensitive than adults. The aim of this work was to gain some understanding of the relative doses involved with various XVI-preset parameters for an “adult” and “child” phantom set, with the hopes that imaging dose for a child can be reduced. Methods: 32 and 16cm CTDI-phantoms were used as surrogates for adult andmore » child torsos, respectively. Dose was measured in the central and peripheral chamber positions of the phantoms. CBCT scans were made for both phantoms using Elekta’s Chest-preset to establish a dose baseline. The child-phantom was then scanned using the Elekta Head and Neck (HN) preset. A modified HN-preset (named Peds Abd-pelvis) was also created with a doubled mAs to maintain a reduction in dose to the child-phantom (relative to the baseline), while providing clinically-usable image quality. Results: The baseline dose to the child-phantom from the Chest-preset was 310% that of the adult-phantom for the center chamber position and 150% at the periphery. An average dose reduction of 97% was obtained in the childphantom by switching from the Chest-preset to the HN-preset, while the Peds Abd-pelvis-preset similarly reduced the dose by an average of 92%. Conclusion: XVI-preset parameters significantly affect dose, and should be optimized to reduce dose, while ensuring clinically-usable image quality. Using a modified imaging preset (Peds Abd-pelvis-preset) greatly reduced the dose to the child-phantom compared to the dose for the Chest-preset for both the child and adult-phantoms. This outcome provides support for the development of child-specific protocols for IGRT imaging in pediatric patients.« less

A boosted optimal linear learner for retinal vessel segmentation

NASA Astrophysics Data System (ADS)

Poletti, E.; Grisan, E.

2014-03-01

Ocular fundus images provide important information about retinal degeneration, which may be related to acute pathologies or to early signs of systemic diseases. An automatic and quantitative assessment of vessel morphological features, such as diameters and tortuosity, can improve clinical diagnosis and evaluation of retinopathy. At variance with available methods, we propose a data-driven approach, in which the system learns a set of optimal discriminative convolution kernels (linear learner). The set is progressively built based on an ADA-boost sample weighting scheme, providing seamless integration between linear learner estimation and classification. In order to capture the vessel appearance changes at different scales, the kernels are estimated on a pyramidal decomposition of the training samples. The set is employed as a rotating bank of matched filters, whose response is used by the boosted linear classifier to provide a classification of each image pixel into the two classes of interest (vessel/background). We tested the approach fundus images available from the DRIVE dataset. We show that the segmentation performance yields an accuracy of 0.94.

Optimization of the Energy Window for PETbox4, a Preclinical PET Tomograph With a Small Inner Diameter

NASA Astrophysics Data System (ADS)

Gu, Z.; Bao, Q.; Taschereau, R.; Wang, H.; Bai, B.; Chatziioannou, A. F.

2014-06-01

Small animal positron emission tomography (PET) systems are often designed by employing close geometry configurations. Due to the different characteristics caused by geometrical factors, these tomographs require data acquisition protocols that differ from those optimized for conventional large diameter ring systems. In this work we optimized the energy window for data acquisitions with PETbox4, a 50 mm detector separation (box-like geometry) pre-clinical PET scanner, using the Geant4 Application for Tomographic Emission (GATE). The fractions of different types of events were estimated using a voxelized phantom including a mouse as well as its supporting chamber, mimicking a realistic mouse imaging environment. Separate code was developed to extract additional information about the gamma interactions for more accurate event type classification. Three types of detector backscatter events were identified in addition to the trues, phantom scatters and randoms. The energy window was optimized based on the noise equivalent count rate (NECR) and scatter fraction (SF) with lower-level discriminators (LLD) corresponding to energies from 150 keV to 450 keV. The results were validated based on the calculated image uniformity, spillover ratio (SOR) and recovery coefficient (RC) from physical measurements using the National Electrical Manufacturers Association (NEMA) NU-4 image quality phantom. These results indicate that when PETbox4 is operated with a more narrow energy window (350-650 keV), detector backscatter rejection is unnecessary. For the NEMA NU-4 image quality phantom, the SOR for the water chamber decreases by about 45% from 15.1% to 8.3%, and the SOR for the air chamber decreases by 31% from 12.0% to 8.3% at the LLDs of 150 and 350 keV, without obvious change in uniformity, further supporting the simulation based optimization. The optimization described in this work is not limited to PETbox4, but also applicable or helpful to other small inner diameter geometry scanners.

TRANSCULTURALIZATION RECOMMENDATIONS FOR DEVELOPING LATIN AMERICAN CLINICAL PRACTICE ALGORITHMS IN ENDOCRINOLOGY--PROCEEDINGS OF THE 2015 PAN-AMERICAN WORKSHOP BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY.

PubMed

Mechanick, Jeffrey I; Harrell, R Mack; Allende-Vigo, Myriam Z; Alvayero, Carlos; Arita-Melzer, Onix; Aschner, Pablo; Camacho, Pauline M; Castillo, Rogelio Zacarias; Cerdas, Sonia; Coutinho, Walmir F; Davidson, Jaime A; Garber, Jeffrey R; Garvey, W Timothy; González, Fernando Javier Lavalle; Granados, Denis O; Hamdy, Osama; Handelsman, Yehuda; Jiménez-Navarrete, Manuel Francisco; Lupo, Mark A; Mendoza, Enrique J; Jiménez-Montero, José G; Zangeneh, Farhad

2016-04-01

The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) convened their first Workshop for recommendations to optimize Clinical Practice Algorithm (CPA) development for Latin America (LA) in diabetes (focusing on glycemic control), obesity (focusing on weight loss), thyroid (focusing on thyroid nodule diagnostics), and bone (focusing on postmenopausal osteoporosis) on February 28, 2015, in San Jose, Costa Rica. A standardized methodology is presented incorporating various transculturalization factors: resource availability (including imaging equipment and approved pharmaceuticals), health care professional and patient preferences, lifestyle variables, socio-economic parameters, web-based global accessibility, electronic implementation, and need for validation protocols. A standardized CPA template with node-specific recommendations to assist the local transculturalization process is provided. Participants unanimously agreed on the following five overarching principles for LA: (1) there is only one level of optimal endocrine care, (2) hemoglobin A1C should be utilized at every level of diabetes care, (3) nutrition education and increased pharmaceutical options are necessary to optimize the obesity care model, (4) quality neck ultrasound must be part of an optimal thyroid nodule care model, and (5) more scientific evidence is needed on osteoporosis prevalence and cost to justify intervention by governmental health care authorities. This 2015 AACE/ACE Workshop marks the beginning of a structured activity that assists local experts in creating culturally sensitive, evidence-based, and easy-to-implement tools for optimizing endocrine care on a global scale.

Photoacoustic imaging optimization with raw signal deconvolution and empirical mode decomposition

NASA Astrophysics Data System (ADS)

Guo, Chengwen; Wang, Jing; Qin, Yu; Zhan, Hongchen; Yuan, Jie; Cheng, Qian; Wang, Xueding

2018-02-01

Photoacoustic (PA) signal of an ideal optical absorb particle is a single N-shape wave. PA signals of a complicated biological tissue can be considered as the combination of individual N-shape waves. However, the N-shape wave basis not only complicates the subsequent work, but also results in aliasing between adjacent micro-structures, which deteriorates the quality of the final PA images. In this paper, we propose a method to improve PA image quality through signal processing method directly working on raw signals, which including deconvolution and empirical mode decomposition (EMD). During the deconvolution procedure, the raw PA signals are de-convolved with a system dependent point spread function (PSF) which is measured in advance. Then, EMD is adopted to adaptively re-shape the PA signals with two constraints, positive polarity and spectrum consistence. With our proposed method, the built PA images can yield more detail structural information. Micro-structures are clearly separated and revealed. To validate the effectiveness of this method, we present numerical simulations and phantom studies consist of a densely distributed point sources model and a blood vessel model. In the future, our study might hold the potential for clinical PA imaging as it can help to distinguish micro-structures from the optimized images and even measure the size of objects from deconvolved signals.

Multicenter evaluation of stress-first myocardial perfusion image triage by nuclear technologists and automated quantification.

PubMed

Chaudhry, Waseem; Hussain, Nasir; Ahlberg, Alan W; Croft, Lori B; Fernandez, Antonio B; Parker, Mathew W; Swales, Heather H; Slomka, Piotr J; Henzlova, Milena J; Duvall, W Lane

2017-06-01

A stress-first myocardial perfusion imaging (MPI) protocol saves time, is cost effective, and decreases radiation exposure. A limitation of this protocol is the requirement for physician review of the stress images to determine the need for rest images. This hurdle could be eliminated if an experienced technologist and/or automated computer quantification could make this determination. Images from consecutive patients who were undergoing a stress-first MPI with attenuation correction at two tertiary care medical centers were prospectively reviewed independently by a technologist and cardiologist blinded to clinical and stress test data. Their decision on the need for rest imaging along with automated computer quantification of perfusion results was compared with the clinical reference standard of an assessment of perfusion images by a board-certified nuclear cardiologist that included clinical and stress test data. A total of 250 patients (mean age 61 years and 55% female) who underwent a stress-first MPI were studied. According to the clinical reference standard, 42 (16.8%) and 208 (83.2%) stress-first images were interpreted as "needing" and "not needing" rest images, respectively. The technologists correctly classified 229 (91.6%) stress-first images as either "needing" (n = 28) or "not needing" (n = 201) rest images. Their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 66.7%, 96.6%, 80.0%, and 93.5%, respectively. An automated stress TPD score ≥1.2 was associated with optimal sensitivity and specificity and correctly classified 179 (71.6%) stress-first images as either "needing" (n = 31) or "not needing" (n = 148) rest images. Its sensitivity, specificity, PPV, and NPV were 73.8%, 71.2%, 34.1%, and 93.1%, respectively. In a model whereby the computer or technologist could correct for the other's incorrect classification, 242 (96.8%) stress-first images were correctly classified. The composite sensitivity, specificity, PPV, and NPV were 83.3%, 99.5%, 97.2%, and 96.7%, respectively. Technologists and automated quantification software had a high degree of agreement with the clinical reference standard for determining the need for rest images in a stress-first imaging protocol. Utilizing an experienced technologist and automated systems to screen stress-first images could expand the use of stress-first MPI to sites where the cardiologist is not immediately available for interpretation.

Establishing Quantitative Within-Subject Confidence Limits For Clinical Stereoroentgenographs

NASA Astrophysics Data System (ADS)

Korn, Edward L.; Baumrind, Sheldon; Chafetz, Neil; Curry, Sean; Moffitt, Francis

1983-07-01

It is now quite clear that under ideal conditions, discrete points can be located on x-ray films with standard deviations of less than 50 i. However, under routine clinical conditions, such considerations as individual variation in anatomy, movement of the subject between exposures, and variations in image quality combine to produce considerable reductions in the confidence which can be placed in quantitative assessments made from stereoroentgenographic films. This paper discusses some considerations involved in designing mathematical models in such a way as to optimize the use of imperfect data in answering specific clinical questions.

MO-FG-209-05: Towards a Feature-Based Anthropomorphic Model Observer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Avanaki, A.

2016-06-15

This symposium will review recent advances in the simulation methods for evaluation of novel breast imaging systems – the subject of AAPM Task Group TG234. Our focus will be on the various approaches to development and validation of software anthropomorphic phantoms and their use in the statistical assessment of novel imaging systems using such phantoms along with computational models for the x-ray image formation process. Due to the dynamic development and complex design of modern medical imaging systems, the simulation of anatomical structures, image acquisition modalities, and the image perception and analysis offers substantial benefits of reduced cost, duration, andmore » radiation exposure, as well as the known ground-truth and wide variability in simulated anatomies. For these reasons, Virtual Clinical Trials (VCTs) have been increasingly accepted as a viable tool for preclinical assessment of x-ray and other breast imaging methods. Activities of TG234 have encompassed the optimization of protocols for simulation studies, including phantom specifications, the simulated data representation, models of the imaging process, and statistical assessment of simulated images. The symposium will discuss the state-of-the-science of VCTs for novel breast imaging systems, emphasizing recent developments and future directions. Presentations will discuss virtual phantoms for intermodality breast imaging performance comparisons, extension of the breast anatomy simulation to the cellular level, optimized integration of the simulated imaging chain, and the novel directions in the observer models design. Learning Objectives: Review novel results in developing and applying virtual phantoms for inter-modality breast imaging performance comparisons; Discuss the efforts to extend the computer simulation of breast anatomy and pathology to the cellular level; Summarize the state of the science in optimized integration of modules in the simulated imaging chain; Compare novel directions in the design of observer models for task based validation of imaging systems. PB: Research funding support from the NIH, NSF, and Komen for the Cure; NIH funded collaboration with Barco, Inc. and Hologic, Inc.; Consultant to Delaware State Univ. and NCCPM, UK. AA: Employed at Barco Healthcare.; P. Bakic, NIH: (NIGMS P20 #GM103446, NCI R01 #CA154444); M. Das, NIH Research grants.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Graff, C.

This symposium will review recent advances in the simulation methods for evaluation of novel breast imaging systems – the subject of AAPM Task Group TG234. Our focus will be on the various approaches to development and validation of software anthropomorphic phantoms and their use in the statistical assessment of novel imaging systems using such phantoms along with computational models for the x-ray image formation process. Due to the dynamic development and complex design of modern medical imaging systems, the simulation of anatomical structures, image acquisition modalities, and the image perception and analysis offers substantial benefits of reduced cost, duration, andmore » radiation exposure, as well as the known ground-truth and wide variability in simulated anatomies. For these reasons, Virtual Clinical Trials (VCTs) have been increasingly accepted as a viable tool for preclinical assessment of x-ray and other breast imaging methods. Activities of TG234 have encompassed the optimization of protocols for simulation studies, including phantom specifications, the simulated data representation, models of the imaging process, and statistical assessment of simulated images. The symposium will discuss the state-of-the-science of VCTs for novel breast imaging systems, emphasizing recent developments and future directions. Presentations will discuss virtual phantoms for intermodality breast imaging performance comparisons, extension of the breast anatomy simulation to the cellular level, optimized integration of the simulated imaging chain, and the novel directions in the observer models design. Learning Objectives: Review novel results in developing and applying virtual phantoms for inter-modality breast imaging performance comparisons; Discuss the efforts to extend the computer simulation of breast anatomy and pathology to the cellular level; Summarize the state of the science in optimized integration of modules in the simulated imaging chain; Compare novel directions in the design of observer models for task based validation of imaging systems. PB: Research funding support from the NIH, NSF, and Komen for the Cure; NIH funded collaboration with Barco, Inc. and Hologic, Inc.; Consultant to Delaware State Univ. and NCCPM, UK. AA: Employed at Barco Healthcare.; P. Bakic, NIH: (NIGMS P20 #GM103446, NCI R01 #CA154444); M. Das, NIH Research grants.« less

Automated brain tumor segmentation using spatial accuracy-weighted hidden Markov Random Field.

PubMed

Nie, Jingxin; Xue, Zhong; Liu, Tianming; Young, Geoffrey S; Setayesh, Kian; Guo, Lei; Wong, Stephen T C

2009-09-01

A variety of algorithms have been proposed for brain tumor segmentation from multi-channel sequences, however, most of them require isotropic or pseudo-isotropic resolution of the MR images. Although co-registration and interpolation of low-resolution sequences, such as T2-weighted images, onto the space of the high-resolution image, such as T1-weighted image, can be performed prior to the segmentation, the results are usually limited by partial volume effects due to interpolation of low-resolution images. To improve the quality of tumor segmentation in clinical applications where low-resolution sequences are commonly used together with high-resolution images, we propose the algorithm based on Spatial accuracy-weighted Hidden Markov random field and Expectation maximization (SHE) approach for both automated tumor and enhanced-tumor segmentation. SHE incorporates the spatial interpolation accuracy of low-resolution images into the optimization procedure of the Hidden Markov Random Field (HMRF) to segment tumor using multi-channel MR images with different resolutions, e.g., high-resolution T1-weighted and low-resolution T2-weighted images. In experiments, we evaluated this algorithm using a set of simulated multi-channel brain MR images with known ground-truth tissue segmentation and also applied it to a dataset of MR images obtained during clinical trials of brain tumor chemotherapy. The results show that more accurate tumor segmentation results can be obtained by comparing with conventional multi-channel segmentation algorithms.

A MULTICORE BASED PARALLEL IMAGE REGISTRATION METHOD

PubMed Central

Yang, Lin; Gong, Leiguang; Zhang, Hong; Nosher, John L.; Foran, David J.

2012-01-01

Image registration is a crucial step for many image-assisted clinical applications such as surgery planning and treatment evaluation. In this paper we proposed a landmark based nonlinear image registration algorithm for matching 2D image pairs. The algorithm was shown to be effective and robust under conditions of large deformations. In landmark based registration, the most important step is establishing the correspondence among the selected landmark points. This usually requires an extensive search which is often computationally expensive. We introduced a nonregular data partition algorithm using the K-means clustering algorithm to group the landmarks based on the number of available processing cores. The step optimizes the memory usage and data transfer. We have tested our method using IBM Cell Broadband Engine (Cell/B.E.) platform. PMID:19964921

A hybrid reconstruction algorithm for fast and accurate 4D cone-beam CT imaging.

PubMed

Yan, Hao; Zhen, Xin; Folkerts, Michael; Li, Yongbao; Pan, Tinsu; Cervino, Laura; Jiang, Steve B; Jia, Xun

2014-07-01

4D cone beam CT (4D-CBCT) has been utilized in radiation therapy to provide 4D image guidance in lung and upper abdomen area. However, clinical application of 4D-CBCT is currently limited due to the long scan time and low image quality. The purpose of this paper is to develop a new 4D-CBCT reconstruction method that restores volumetric images based on the 1-min scan data acquired with a standard 3D-CBCT protocol. The model optimizes a deformation vector field that deforms a patient-specific planning CT (p-CT), so that the calculated 4D-CBCT projections match measurements. A forward-backward splitting (FBS) method is invented to solve the optimization problem. It splits the original problem into two well-studied subproblems, i.e., image reconstruction and deformable image registration. By iteratively solving the two subproblems, FBS gradually yields correct deformation information, while maintaining high image quality. The whole workflow is implemented on a graphic-processing-unit to improve efficiency. Comprehensive evaluations have been conducted on a moving phantom and three real patient cases regarding the accuracy and quality of the reconstructed images, as well as the algorithm robustness and efficiency. The proposed algorithm reconstructs 4D-CBCT images from highly under-sampled projection data acquired with 1-min scans. Regarding the anatomical structure location accuracy, 0.204 mm average differences and 0.484 mm maximum difference are found for the phantom case, and the maximum differences of 0.3-0.5 mm for patients 1-3 are observed. As for the image quality, intensity errors below 5 and 20 HU compared to the planning CT are achieved for the phantom and the patient cases, respectively. Signal-noise-ratio values are improved by 12.74 and 5.12 times compared to results from FDK algorithm using the 1-min data and 4-min data, respectively. The computation time of the algorithm on a NVIDIA GTX590 card is 1-1.5 min per phase. High-quality 4D-CBCT imaging based on the clinically standard 1-min 3D CBCT scanning protocol is feasible via the proposed hybrid reconstruction algorithm.

Hyperspectral small animal fluorescence imaging: spectral selection imaging

NASA Astrophysics Data System (ADS)

Leavesley, Silas; Jiang, Yanan; Patsekin, Valery; Hall, Heidi; Vizard, Douglas; Robinson, J. Paul

2008-02-01

Molecular imaging is a rapidly growing area of research, fueled by needs in pharmaceutical drug-development for methods for high-throughput screening, pre-clinical and clinical screening for visualizing tumor growth and drug targeting, and a growing number of applications in the molecular biology fields. Small animal fluorescence imaging employs fluorescent probes to target molecular events in vivo, with a large number of molecular targeting probes readily available. The ease at which new targeting compounds can be developed, the short acquisition times, and the low cost (compared to microCT, MRI, or PET) makes fluorescence imaging attractive. However, small animal fluorescence imaging suffers from high optical scattering, absorption, and autofluorescence. Much of these problems can be overcome through multispectral imaging techniques, which collect images at different fluorescence emission wavelengths, followed by analysis, classification, and spectral deconvolution methods to isolate signals from fluorescence emission. We present an alternative to the current method, using hyperspectral excitation scanning (spectral selection imaging), a technique that allows excitation at any wavelength in the visible and near-infrared wavelength range. In many cases, excitation imaging may be more effective at identifying specific fluorescence signals because of the higher complexity of the fluorophore excitation spectrum. Because the excitation is filtered and not the emission, the resolution limit and image shift imposed by acousto-optic tunable filters have no effect on imager performance. We will discuss design of the imager, optimizing the imager for use in small animal fluorescence imaging, and application of spectral analysis and classification methods for identifying specific fluorescence signals.

Performance characteristics of magnetic resonance imaging without contrast agents or sedation in pediatric appendicitis.

PubMed

Didier, Ryne A; Hopkins, Katharine L; Coakley, Fergus V; Krishnaswami, Sanjay; Spiro, David M; Foster, Bryan R

2017-09-01

Magnetic resonance imaging (MRI) has emerged as a promising modality for evaluating pediatric appendicitis. However optimal imaging protocols, including roles of contrast agents and sedation, have not been established and diagnostic criteria have not been fully evaluated. To investigate performance characteristics of rapid MRI without contrast agents or sedation in the diagnosis of pediatric appendicitis. We included patients ages 4-18 years with suspicion of appendicitis who underwent rapid MRI between October 2013 and March 2015 without contrast agent or sedation. After two-radiologist review, we determined performance characteristics of individual diagnostic criteria and aggregate diagnostic criteria by comparing MRI results to clinical outcomes. We used receiver operating characteristic (ROC) curves to determine cut-points for appendiceal diameter and wall thickness for optimization of predictive power, and we calculated area under the curve (AUC) as a measure of test accuracy. Ninety-eight MRI examinations were performed in 97 subjects. Overall, MRI had a 94% sensitivity, 95% specificity, 91% positive predictive value and 97% negative predictive value. Optimal cut-points for appendiceal diameter and wall thickness were ≥7 mm and ≥2 mm, respectively. Independently, those cut-points produced sensitivities of 91% and 84% and specificities of 84% and 43%. Presence of intraluminal fluid (30/33) or localized periappendiceal fluid (32/33) showed a significant association with acute appendicitis (P<0.01), with sensitivities of 91% and 97% and specificities of 60% and 50%. For examinations in which the appendix was not identified by one or both reviewers (23/98), the clinical outcome was negative. Rapid MRI without contrast agents or sedation is accurate for diagnosis of pediatric appendicitis when multiple diagnostic criteria are considered in aggregate. Individual diagnostic criteria including optimized cut-points of ≥7 mm for diameter and ≥2 mm for wall thickness demonstrate high sensitivities but relatively low specificities. Nonvisualization of the appendix favors a negative diagnosis.

TOPICAL REVIEW: Digital x-ray tomosynthesis: current state of the art and clinical potential

NASA Astrophysics Data System (ADS)

Dobbins, James T., III; Godfrey, Devon J.

2003-10-01

Digital x-ray tomosynthesis is a technique for producing slice images using conventional x-ray systems. It is a refinement of conventional geometric tomography, which has been known since the 1930s. In conventional geometric tomography, the x-ray tube and image receptor move in synchrony on opposite sides of the patient to produce a plane of structures in sharp focus at the plane containing the fulcrum of the motion; all other structures above and below the fulcrum plane are blurred and thus less visible in the resulting image. Tomosynthesis improves upon conventional geometric tomography in that it allows an arbitrary number of in-focus planes to be generated retrospectively from a sequence of projection radiographs that are acquired during a single motion of the x-ray tube. By shifting and adding these projection radiographs, specific planes may be reconstructed. This topical review describes the various reconstruction algorithms used to produce tomosynthesis images, as well as approaches used to minimize the residual blur from out-of-plane structures. Historical background and mathematical details are given for the various approaches described. Approaches for optimizing the tomosynthesis image are given. Applications of tomosynthesis to various clinical tasks, including angiography, chest imaging, mammography, dental imaging and orthopaedic imaging, are also described.

Hybrid model based unified scheme for endoscopic Cerenkov and radio-luminescence tomography: Simulation demonstration

NASA Astrophysics Data System (ADS)

Wang, Lin; Cao, Xin; Ren, Qingyun; Chen, Xueli; He, Xiaowei

2018-05-01

Cerenkov luminescence imaging (CLI) is an imaging method that uses an optical imaging scheme to probe a radioactive tracer. Application of CLI with clinically approved radioactive tracers has opened an opportunity for translating optical imaging from preclinical to clinical applications. Such translation was further improved by developing an endoscopic CLI system. However, two-dimensional endoscopic imaging cannot identify accurate depth and obtain quantitative information. Here, we present an imaging scheme to retrieve the depth and quantitative information from endoscopic Cerenkov luminescence tomography, which can also be applied for endoscopic radio-luminescence tomography. In the scheme, we first constructed a physical model for image collection, and then a mathematical model for characterizing the luminescent light propagation from tracer to the endoscopic detector. The mathematical model is a hybrid light transport model combined with the 3rd order simplified spherical harmonics approximation, diffusion, and radiosity equations to warrant accuracy and speed. The mathematical model integrates finite element discretization, regularization, and primal-dual interior-point optimization to retrieve the depth and the quantitative information of the tracer. A heterogeneous-geometry-based numerical simulation was used to explore the feasibility of the unified scheme, which demonstrated that it can provide a satisfactory balance between imaging accuracy and computational burden.

Optimization of Spiral-Based Pulse Sequences for First Pass Myocardial Perfusion Imaging

PubMed Central

Salerno, Michael; Sica, Christopher T.; Kramer, Christopher M.; Meyer, Craig H.

2010-01-01

While spiral trajectories have multiple attractive features such as their isotropic resolution, acquisition efficiency, and robustness to motion, there has been limited application of these techniques to first pass perfusion imaging because of potential off-resonance and inconsistent data artifacts. Spiral trajectories may also be less sensitive to dark-rim artifacts (DRA) that are caused, at least in part, by cardiac motion. By careful consideration of the spiral trajectory readout duration, flip angle strategy, and image reconstruction strategy, spiral artifacts can be abated to create high quality first pass myocardial perfusion images with high SNR. The goal of this paper was to design interleaved spiral pulse sequences for first-pass myocardial perfusion imaging, and to evaluate them clinically for image quality and the presence of dark-rim, blurring, and dropout artifacts. PMID:21590802

Ultrasonographic imaging of inflammatory bowel disease in pediatric patients

PubMed Central

Chiorean, Liliana; Schreiber-Dietrich, Dagmar; Braden, Barbara; Cui, Xin-Wu; Buchhorn, Reiner; Chang, Jian-Min; Dietrich, Christoph F

2015-01-01

Inflammatory bowel disease (IBD) is one of the most common chronic gastrointestinal diseases in pediatric patients. Choosing the optimal imaging modality for the assessment of gastrointestinal disease in pediatric patients can be challenging. The invasiveness and patient acceptance, the radiation exposure and the quality performance of the diagnostic test need to be considered. By reviewing the literature regarding imaging in inflammatory bowel disease the value of ultrasound in the clinical management of pediatric patients is highlighted. Transabdominal ultrasound is a useful, noninvasive method for the initial diagnosis of IBD in children; it also provides guidance for therapeutic decisions and helps to characterize and predict the course of the disease in individual patients. Ultrasound techniques including color Doppler imaging and contrast-enhanced ultrasound are promising imaging tools to determine disease activity and complications. Comparative studies between different imaging methods are needed. PMID:25954096

DOE Office of Scientific and Technical Information (OSTI.GOV)

Siman, W.; Mikell, J. K.; Kappadath, S. C., E-mail

Purpose: To develop a practical background compensation (BC) technique to improve quantitative {sup 90}Y-bremsstrahlung single-photon emission computed tomography (SPECT)/computed tomography (CT) using a commercially available imaging system. Methods: All images were acquired using medium-energy collimation in six energy windows (EWs), ranging from 70 to 410 keV. The EWs were determined based on the signal-to-background ratio in planar images of an acrylic phantom of different thicknesses (2–16 cm) positioned below a {sup 90}Y source and set at different distances (15–35 cm) from a gamma camera. The authors adapted the widely used EW-based scatter-correction technique by modeling the BC as scaled images.more » The BC EW was determined empirically in SPECT/CT studies using an IEC phantom based on the sphere activity recovery and residual activity in the cold lung insert. The scaling factor was calculated from 20 clinical planar {sup 90}Y images. Reconstruction parameters were optimized in the same SPECT images for improved image quantification and contrast. A count-to-activity calibration factor was calculated from 30 clinical {sup 90}Y images. Results: The authors found that the most appropriate imaging EW range was 90–125 keV. BC was modeled as 0.53× images in the EW of 310–410 keV. The background-compensated clinical images had higher image contrast than uncompensated images. The maximum deviation of their SPECT calibration in clinical studies was lowest (<10%) for SPECT with attenuation correction (AC) and SPECT with AC + BC. Using the proposed SPECT-with-AC + BC reconstruction protocol, the authors found that the recovery coefficient of a 37-mm sphere (in a 10-mm volume of interest) increased from 39% to 90% and that the residual activity in the lung insert decreased from 44% to 14% over that of SPECT images with AC alone. Conclusions: The proposed EW-based BC model was developed for {sup 90}Y bremsstrahlung imaging. SPECT with AC + BC gave improved lesion detectability and activity quantification compared to SPECT with AC only. The proposed methodology can readily be used to tailor {sup 90}Y SPECT/CT acquisition and reconstruction protocols with different SPECT/CT systems for quantification and improved image quality in clinical settings.« less

Structure and properties of clinical coralline implants measured via 3D imaging and analysis.

PubMed

Knackstedt, Mark Alexander; Arns, Christoph H; Senden, Tim J; Gross, Karlis

2006-05-01

The development and design of advanced porous materials for biomedical applications requires a thorough understanding of how material structure impacts on mechanical and transport properties. This paper illustrates a 3D imaging and analysis study of two clinically proven coral bone graft samples (Porites and Goniopora). Images are obtained from X-ray micro-computed tomography (micro-CT) at a resolution of 16.8 microm. A visual comparison of the two images shows very different structure; Porites has a homogeneous structure and consistent pore size while Goniopora has a bimodal pore size and a strongly disordered structure. A number of 3D structural characteristics are measured directly on the images including pore volume-to-surface-area, pore and solid size distributions, chord length measurements and tortuosity. Computational results made directly on the digitized tomographic images are presented for the permeability, diffusivity and elastic modulus of the coral samples. The results allow one to quantify differences between the two samples. 3D digital analysis can provide a more thorough assessment of biomaterial structure including the pore wall thickness, local flow, mechanical properties and diffusion pathways. We discuss the implications of these results to the development of optimal scaffold design for tissue ingrowth.

Turboprop IDEAL: a motion-resistant fat-water separation technique.

PubMed

Huo, Donglai; Li, Zhiqiang; Aboussouan, Eric; Karis, John P; Pipe, James G

2009-01-01

Suppression of the fat signal in MRI is very important for many clinical applications. Multi-point water-fat separation methods, such as IDEAL (Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation), can robustly separate water and fat signal, but inevitably increase scan time, making separated images more easily affected by patient motions. PROPELLER (Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction) and Turboprop techniques offer an effective approach to correct for motion artifacts. By combining these techniques together, we demonstrate that the new TP-IDEAL method can provide reliable water-fat separation with robust motion correction. The Turboprop sequence was modified to acquire source images, and motion correction algorithms were adjusted to assure the registration between different echo images. Theoretical calculations were performed to predict the optimal shift and spacing of the gradient echoes. Phantom images were acquired, and results were compared with regular FSE-IDEAL. Both T1- and T2-weighted images of the human brain were used to demonstrate the effectiveness of motion correction. TP-IDEAL images were also acquired for pelvis, knee, and foot, showing great potential of this technique for general clinical applications.

Low contrast detection in abdominal CT: comparing single-slice and multi-slice tasks

NASA Astrophysics Data System (ADS)

Ba, Alexandre; Racine, Damien; Viry, Anaïs.; Verdun, Francis R.; Schmidt, Sabine; Bochud, François O.

2017-03-01

Image quality assessment is crucial for the optimization of computed tomography (CT) protocols. Human and mathematical model observers are increasingly used for the detection of low contrast signal in abdominal CT, but are frequently limited to the use of a single image slice. Another limitation is that most of them only consider the detection of a signal embedded in a uniform background phantom. The purpose of this paper was to test if human observer performance is significantly different in CT images read in single or multiple slice modes and if these differences are the same for anatomical and uniform clinical images. We investigated detection performance and scrolling trends of human observers of a simulated liver lesion embedded in anatomical and uniform CT backgrounds. Results show that observers don't take significantly benefit of additional information provided in multi-slice reading mode. Regarding the background, performances are moderately higher for uniform than for anatomical images. Our results suggest that for low contrast detection in abdominal CT, the use of multi-slice model observers would probably only add a marginal benefit. On the other hand, the quality of a CT image is more accurately estimated with clinical anatomical backgrounds.

Magnetic resonance-transcranial ultrasound fusion imaging: A novel tool for brain electrode location.

PubMed

Walter, Uwe; Müller, Jan-Uwe; Rösche, Johannes; Kirsch, Michael; Grossmann, Annette; Benecke, Reiner; Wittstock, Matthias; Wolters, Alexander

2016-03-01

A combination of preoperative magnetic resonance imaging (MRI) with real-time transcranial ultrasound, known as fusion imaging, may improve postoperative control of deep brain stimulation (DBS) electrode location. Fusion imaging, however, employs a weak magnetic field for tracking the position of the ultrasound transducer and the patient's head. Here we assessed its feasibility, safety, and clinical relevance in patients with DBS. Eighteen imaging sessions were conducted in 15 patients (7 women; aged 52.4 ± 14.4 y) with DBS of subthalamic nucleus (n = 6), globus pallidus interna (n = 5), ventro-intermediate (n = 3), or anterior (n = 1) thalamic nucleus and clinically suspected lead displacement. Minimum distance between DBS generator and magnetic field transmitter was kept at 65 cm. The pre-implantation MRI dataset was loaded into the ultrasound system for the fusion imaging examination. The DBS lead position was rated using validated criteria. Generator DBS parameters and neurological state of patients were monitored. Magnetic resonance-ultrasound fusion imaging and volume navigation were feasible in all cases and provided with real-time imaging capabilities of DBS lead and its location within the superimposed magnetic resonance images. Of 35 assessed lead locations, 30 were rated optimal, three suboptimal, and two displaced. In two cases, electrodes were re-implanted after confirming their inappropriate location on computed tomography (CT) scan. No influence of fusion imaging on clinical state of patients, or on DBS implantable pulse generator function, was found. Magnetic resonance-ultrasound real-time fusion imaging of DBS electrodes is safe with distinct precautions and improves assessment of electrode location. It may lower the need for repeated CT or MRI scans in DBS patients. © 2015 International Parkinson and Movement Disorder Society.

Brain MR imaging at ultra-low radiofrequency power.

PubMed

Sarkar, Subhendra N; Alsop, David C; Madhuranthakam, Ananth J; Busse, Reed F; Robson, Philip M; Rofsky, Neil M; Hackney, David B

2011-05-01

To explore the lower limits for radiofrequency (RF) power-induced specific absorption rate (SAR) achievable at 1.5 T for brain magnetic resonance (MR) imaging without loss of tissue signal or contrast present in high-SAR clinical imaging in order to create a potentially viable MR method at ultra-low RF power to image tissues containing implanted devices. An institutional review board-approved HIPAA-compliant prospective MR study design was used, with written informed consent from all subjects prior to MR sessions. Seven healthy subjects were imaged prospectively at 1.5 T with ultra-low-SAR optimized three-dimensional (3D) fast spin-echo (FSE) and fluid-attenuated inversion-recovery (FLAIR) T2-weighted sequences and an ultra-low-SAR 3D spoiled gradient-recalled acquisition in the steady state T1-weighted sequence. Corresponding high-SAR two-dimensional (2D) clinical sequences were also performed. In addition to qualitative comparisons, absolute signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) for multicoil, parallel imaging acquisitions were generated by using a Monte Carlo method for quantitative comparison between ultra-low-SAR and high-SAR results. There were minor to moderate differences in the absolute tissue SNR and CNR values and in qualitative appearance of brain images obtained by using ultra-low-SAR and high-SAR techniques. High-SAR 2D T2-weighted imaging produced slightly higher SNR, while ultra-low-SAR 3D technique not only produced higher SNR for T1-weighted and FLAIR images but also higher CNRs for all three sequences for most of the brain tissues. The 3D techniques adopted here led to a decrease in the absorbed RF power by two orders of magnitude at 1.5 T, and still the image quality was preserved within clinically acceptable imaging times. RSNA, 2011

Cherenkov imaging method for rapid optimization of clinical treatment geometry in total skin electron beam therapy

PubMed Central

Zhang, Rongxiao; Gladstone, David J.; Williams, Benjamin B.; Glaser, Adam K.; Pogue, Brian W.; Jarvis, Lesley A.

2016-01-01

Purpose: A method was developed utilizing Cherenkov imaging for rapid and thorough determination of the two gantry angles that produce the most uniform treatment plane during dual-field total skin electron beam therapy (TSET). Methods: Cherenkov imaging was implemented to gather 2D measurements of relative surface dose from 6 MeV electron beams on a white polyethylene sheet. An intensified charge-coupled device camera time-gated to the Linac was used for Cherenkov emission imaging at sixty-two different gantry angles (1° increments, from 239.5° to 300.5°). Following a modified Stanford TSET technique, which uses two fields per patient position for full body coverage, composite images were created as the sum of two beam images on the sheet; each angle pair was evaluated for minimum variation across the patient region of interest. Cherenkov versus dose correlation was verified with ionization chamber measurements. The process was repeated at source to surface distance (SSD) = 441, 370.5, and 300 cm to determine optimal angle spread for varying room geometries. In addition, three patients receiving TSET using a modified Stanford six-dual field technique with 6 MeV electron beams at SSD = 441 cm were imaged during treatment. Results: As in previous studies, Cherenkov intensity was shown to directly correlate with dose for homogenous flat phantoms (R2 = 0.93), making Cherenkov imaging an appropriate candidate to assess and optimize TSET setup geometry. This method provided dense 2D images allowing 1891 possible treatment geometries to be comprehensively analyzed from one data set of 62 single images. Gantry angles historically used for TSET at their institution were 255.5° and 284.5° at SSD = 441 cm; however, the angles optimized for maximum homogeneity were found to be 252.5° and 287.5° (+6° increase in angle spread). Ionization chamber measurements confirmed improvement in dose homogeneity across the treatment field from a range of 24.4% at the initial angles, to only 9.8% with the angles optimized. A linear relationship between angle spread and SSD was observed, ranging from 35° at 441 cm, to 39° at 300 cm, with no significant variation in percent-depth dose at midline (R2 = 0.998). For patient studies, factors influencing in vivo correlation between Cherenkov intensity and measured surface dose are still being investigated. Conclusions: Cherenkov intensity correlates to relative dose measured at depth of maximum dose in a uniform, flat phantom. Imaging of phantoms can thus be used to analyze and optimize TSET treatment geometry more extensively and rapidly than thermoluminescent dosimeters or ionization chambers. This work suggests that there could be an expanded role for Cherenkov imaging as a tool to efficiently improve treatment protocols and as a potential verification tool for routine monitoring of unique patient treatments. PMID:26843259

Cherenkov imaging method for rapid optimization of clinical treatment geometry in total skin electron beam therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andreozzi, Jacqueline M., E-mail: Jacqueline.M.Andreozzi.th@dartmouth.edu, E-mail: Lesley.A.Jarvis@hitchcock.org; Glaser, Adam K.; Zhang, Rongxiao

2016-02-15

Purpose: A method was developed utilizing Cherenkov imaging for rapid and thorough determination of the two gantry angles that produce the most uniform treatment plane during dual-field total skin electron beam therapy (TSET). Methods: Cherenkov imaging was implemented to gather 2D measurements of relative surface dose from 6 MeV electron beams on a white polyethylene sheet. An intensified charge-coupled device camera time-gated to the Linac was used for Cherenkov emission imaging at sixty-two different gantry angles (1° increments, from 239.5° to 300.5°). Following a modified Stanford TSET technique, which uses two fields per patient position for full body coverage, compositemore » images were created as the sum of two beam images on the sheet; each angle pair was evaluated for minimum variation across the patient region of interest. Cherenkov versus dose correlation was verified with ionization chamber measurements. The process was repeated at source to surface distance (SSD) = 441, 370.5, and 300 cm to determine optimal angle spread for varying room geometries. In addition, three patients receiving TSET using a modified Stanford six-dual field technique with 6 MeV electron beams at SSD = 441 cm were imaged during treatment. Results: As in previous studies, Cherenkov intensity was shown to directly correlate with dose for homogenous flat phantoms (R{sup 2} = 0.93), making Cherenkov imaging an appropriate candidate to assess and optimize TSET setup geometry. This method provided dense 2D images allowing 1891 possible treatment geometries to be comprehensively analyzed from one data set of 62 single images. Gantry angles historically used for TSET at their institution were 255.5° and 284.5° at SSD = 441 cm; however, the angles optimized for maximum homogeneity were found to be 252.5° and 287.5° (+6° increase in angle spread). Ionization chamber measurements confirmed improvement in dose homogeneity across the treatment field from a range of 24.4% at the initial angles, to only 9.8% with the angles optimized. A linear relationship between angle spread and SSD was observed, ranging from 35° at 441 cm, to 39° at 300 cm, with no significant variation in percent-depth dose at midline (R{sup 2} = 0.998). For patient studies, factors influencing in vivo correlation between Cherenkov intensity and measured surface dose are still being investigated. Conclusions: Cherenkov intensity correlates to relative dose measured at depth of maximum dose in a uniform, flat phantom. Imaging of phantoms can thus be used to analyze and optimize TSET treatment geometry more extensively and rapidly than thermoluminescent dosimeters or ionization chambers. This work suggests that there could be an expanded role for Cherenkov imaging as a tool to efficiently improve treatment protocols and as a potential verification tool for routine monitoring of unique patient treatments.« less

3D automatic anatomy recognition based on iterative graph-cut-ASM

NASA Astrophysics Data System (ADS)

Chen, Xinjian; Udupa, Jayaram K.; Bagci, Ulas; Alavi, Abass; Torigian, Drew A.

2010-02-01

We call the computerized assistive process of recognizing, delineating, and quantifying organs and tissue regions in medical imaging, occurring automatically during clinical image interpretation, automatic anatomy recognition (AAR). The AAR system we are developing includes five main parts: model building, object recognition, object delineation, pathology detection, and organ system quantification. In this paper, we focus on the delineation part. For the modeling part, we employ the active shape model (ASM) strategy. For recognition and delineation, we integrate several hybrid strategies of combining purely image based methods with ASM. In this paper, an iterative Graph-Cut ASM (IGCASM) method is proposed for object delineation. An algorithm called GC-ASM was presented at this symposium last year for object delineation in 2D images which attempted to combine synergistically ASM and GC. Here, we extend this method to 3D medical image delineation. The IGCASM method effectively combines the rich statistical shape information embodied in ASM with the globally optimal delineation capability of the GC method. We propose a new GC cost function, which effectively integrates the specific image information with the ASM shape model information. The proposed methods are tested on a clinical abdominal CT data set. The preliminary results show that: (a) it is feasible to explicitly bring prior 3D statistical shape information into the GC framework; (b) the 3D IGCASM delineation method improves on ASM and GC and can provide practical operational time on clinical images.

TU-PIS-Exhibit Hall-3: Simultaneous tracking of patient and real time staff dose to optimize interventional workflow

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boon, S.

The current clinical standard of organ respiratory imaging, 4D-CT, is fundamentally limited by poor soft-tissue contrast and imaging dose. These limitations are potential barriers to beneficial “4D” radiotherapy methods which optimize the target and OAR dose-volume considering breathing motion but rely on a robust motion characterization. Conversely, MRI imparts no known radiation risk and has excellent soft-tissue contrast. MRI-based motion management is therefore highly desirable and holds great promise to improve radiotherapy of moving cancers, particularly in the abdomen. Over the past decade, MRI techniques have improved significantly, making MR-based motion management clinically feasible. For example, cine MRI has highmore » temporal resolution up to 10 f/s and has been used to track and/or characterize tumor motion, study correlation between external and internal motions. New MR technologies, such as 4D-MRI and MRI hybrid treatment machines (i.e. MR-linac or MR-Co60), have been recently developed. These technologies can lead to more accurate target volume determination and more precise radiation dose delivery via direct tumor gating or tracking. Despite all these promises, great challenges exist and the achievable clinical benefit of MRI-based tumor motion management has yet to be fully explored, much less realized. In this proposal, we will review novel MR-based motion management methods and technologies, the state-of-the-art concerning MRI development and clinical application and the barriers to more widespread adoption. Learning Objectives: Discuss the need of MR-based motion management for improving patient care in radiotherapy. Understand MR techniques for motion imaging and tumor motion characterization. Understand the current state of the art and future steps for clinical integration. Henry Ford Health System holds research agreements with Philips Healthcare. Research sponsored in part by a Henry Ford Health System Internal Mentored Grant.« less

Optimized protocols for cardiac magnetic resonance imaging in patients with thoracic metallic implants.

PubMed

Olivieri, Laura J; Cross, Russell R; O'Brien, Kendall E; Ratnayaka, Kanishka; Hansen, Michael S

2015-09-01

Cardiac magnetic resonance (MR) imaging is a valuable tool in congenital heart disease; however patients frequently have metal devices in the chest from the treatment of their disease that complicate imaging. Methods are needed to improve imaging around metal implants near the heart. Basic sequence parameter manipulations have the potential to minimize artifact while limiting effects on image resolution and quality. Our objective was to design cine and static cardiac imaging sequences to minimize metal artifact while maintaining image quality. Using systematic variation of standard imaging parameters on a fluid-filled phantom containing commonly used metal cardiac devices, we developed optimized sequences for steady-state free precession (SSFP), gradient recalled echo (GRE) cine imaging, and turbo spin-echo (TSE) black-blood imaging. We imaged 17 consecutive patients undergoing routine cardiac MR with 25 metal implants of various origins using both standard and optimized imaging protocols for a given slice position. We rated images for quality and metal artifact size by measuring metal artifact in two orthogonal planes within the image. All metal artifacts were reduced with optimized imaging. The average metal artifact reduction for the optimized SSFP cine was 1.5+/-1.8 mm, and for the optimized GRE cine the reduction was 4.6+/-4.5 mm (P < 0.05). Quality ratings favored the optimized GRE cine. Similarly, the average metal artifact reduction for the optimized TSE images was 1.6+/-1.7 mm (P < 0.05), and quality ratings favored the optimized TSE imaging. Imaging sequences tailored to minimize metal artifact are easily created by modifying basic sequence parameters, and images are superior to standard imaging sequences in both quality and artifact size. Specifically, for optimized cine imaging a GRE sequence should be used with settings that favor short echo time, i.e. flow compensation off, weak asymmetrical echo and a relatively high receiver bandwidth. For static black-blood imaging, a TSE sequence should be used with fat saturation turned off and high receiver bandwidth.

Phantom evaluation of the effect of film processing on mammographic screen-film combinations.

PubMed

McLean, D; Rickard, M T

1994-08-01

Mammographic image quality should be optimal for diagnosis, and the film contrast can be manipulated by altering development parameters. In this study phantom test objects were radiographed and processed for a given range of developer temperatures and times for four film-screen systems. Radiologists scored the phantom test objects on the resultant films to evaluate the effect on diagnosis of varying image contrast. While for three film-screen systems processing led to appreciable contrast differences, for only one film system did maximum contrast correspond with optimal phantom test object scoring. The inability to show an effect on diagnosis in all cases is possibly due to the variation in radiologist responses found in this study and in normal clinical circumstances. Other technical factors such as changes in film fog, grain and mottle may contribute to the study findings.

Methods of Hematoxylin and Erosin Image Information Acquisition and Optimization in Confocal Microscopy

PubMed Central

Yoon, Woong Bae; Kim, Hyunjin; Kim, Kwang Gi; Choi, Yongdoo; Chang, Hee Jin

2016-01-01

Objectives We produced hematoxylin and eosin (H&E) staining-like color images by using confocal laser scanning microscopy (CLSM), which can obtain the same or more information in comparison to conventional tissue staining. Methods We improved images by using several image converting techniques, including morphological methods, color space conversion methods, and segmentation methods. Results An image obtained after image processing showed coloring very similar to that in images produced by H&E staining, and it is advantageous to conduct analysis through fluorescent dye imaging and microscopy rather than analysis based on single microscopic imaging. Conclusions The colors used in CLSM are different from those seen in H&E staining, which is the method most widely used for pathologic diagnosis and is familiar to pathologists. Computer technology can facilitate the conversion of images by CLSM to be very similar to H&E staining images. We believe that the technique used in this study has great potential for application in clinical tissue analysis. PMID:27525165

Methods of Hematoxylin and Erosin Image Information Acquisition and Optimization in Confocal Microscopy.

PubMed

Yoon, Woong Bae; Kim, Hyunjin; Kim, Kwang Gi; Choi, Yongdoo; Chang, Hee Jin; Sohn, Dae Kyung

2016-07-01

We produced hematoxylin and eosin (H&E) staining-like color images by using confocal laser scanning microscopy (CLSM), which can obtain the same or more information in comparison to conventional tissue staining. We improved images by using several image converting techniques, including morphological methods, color space conversion methods, and segmentation methods. An image obtained after image processing showed coloring very similar to that in images produced by H&E staining, and it is advantageous to conduct analysis through fluorescent dye imaging and microscopy rather than analysis based on single microscopic imaging. The colors used in CLSM are different from those seen in H&E staining, which is the method most widely used for pathologic diagnosis and is familiar to pathologists. Computer technology can facilitate the conversion of images by CLSM to be very similar to H&E staining images. We believe that the technique used in this study has great potential for application in clinical tissue analysis.

Volumetric wireless coil based on periodically coupled split-loop resonators for clinical wrist imaging.

PubMed

Shchelokova, Alena V; van den Berg, Cornelis A T; Dobrykh, Dmitry A; Glybovski, Stanislav B; Zubkov, Mikhail A; Brui, Ekaterina A; Dmitriev, Dmitry S; Kozachenko, Alexander V; Efimtcev, Alexander Y; Sokolov, Andrey V; Fokin, Vladimir A; Melchakova, Irina V; Belov, Pavel A

2018-02-09

Design and characterization of a new inductively driven wireless coil (WLC) for wrist imaging at 1.5 T with high homogeneity operating due to focusing the B 1 field of a birdcage body coil. The WLC design has been proposed based on a volumetric self-resonant periodic structure of inductively coupled split-loop resonators with structural capacitance. The WLC was optimized and studied regarding radiofrequency fields and interaction to the birdcage coil (BC) by electromagnetic simulations. The manufactured WLC was characterized by on-bench measurements and in vivo and phantom study in comparison to a standard cable-connected receive-only coil. The WLC placed into BC gave the measured B1+ increase of the latter by 8.6 times for the same accepted power. The phantom and in vivo wrist imaging showed that the BC in receiving with the WLC inside reached equal or higher signal-to-noise ratio than the conventional clinical setup comprising the transmit-only BC and a commercial receive-only flex-coil and created no artifacts. Simulations and on-bench measurements proved safety in terms of specific absorption rate and reflected transmit power. The results showed that the proposed WLC could be an alternative to standard cable-connected receive coils in clinical magnetic resonance imaging. As an example, with no cable connection, the WLC allowed wrist imaging on a 1.5 T clinical machine using a full-body BC for transmitting and receive with the desired signal-to-noise ratio, image quality, and safety. © 2018 International Society for Magnetic Resonance in Medicine.

Evaluation of automatic image quality assessment in chest CT - A human cadaver study.

PubMed

Franck, Caro; De Crop, An; De Roo, Bieke; Smeets, Peter; Vergauwen, Merel; Dewaele, Tom; Van Borsel, Mathias; Achten, Eric; Van Hoof, Tom; Bacher, Klaus

2017-04-01

The evaluation of clinical image quality (IQ) is important to optimize CT protocols and to keep patient doses as low as reasonably achievable. Considering the significant amount of effort needed for human observer studies, automatic IQ tools are a promising alternative. The purpose of this study was to evaluate automatic IQ assessment in chest CT using Thiel embalmed cadavers. Chest CT's of Thiel embalmed cadavers were acquired at different exposures. Clinical IQ was determined by performing a visual grading analysis. Physical-technical IQ (noise, contrast-to-noise and contrast-detail) was assessed in a Catphan phantom. Soft and sharp reconstructions were made with filtered back projection and two strengths of iterative reconstruction. In addition to the classical IQ metrics, an automatic algorithm was used to calculate image quality scores (IQs). To be able to compare datasets reconstructed with different kernels, the IQs values were normalized. Good correlations were found between IQs and the measured physical-technical image quality: noise (ρ=-1.00), contrast-to-noise (ρ=1.00) and contrast-detail (ρ=0.96). The correlation coefficients between IQs and the observed clinical image quality of soft and sharp reconstructions were 0.88 and 0.93, respectively. The automatic scoring algorithm is a promising tool for the evaluation of thoracic CT scans in daily clinical practice. It allows monitoring of the image quality of a chest protocol over time, without human intervention. Different reconstruction kernels can be compared after normalization of the IQs. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Innovation in diagnostic imaging services: assessing the potential for value-based reimbursement.

PubMed

Garrison, Louis P; Bresnahan, Brian W; Higashi, Mitchell K; Hollingworth, William; Jarvik, Jeffrey G

2011-09-01

Innovation in the field of diagnostic imaging is based primarily on the availability of new and improved equipment that opens the door for new clinical applications. Payments for these imaging procedures are subject to complex Medicare price control schemes, affecting incentives for appropriate use and innovation. Achieving a "dynamically efficient" health care system-one that elicits a socially optimal amount of innovation-requires that innovators be rewarded in relation to the value they add and can demonstrate with evidence. The authors examine how and whether value-based reimbursement for diagnostic imaging services might better reward innovation explicitly for expected improvements in health and economic outcomes. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Hyperpolarized Magnetic Resonance: A Novel Technique for the In Vivo Assessment of Cardiovascular Disease

PubMed Central

Schroeder, Marie A.; Clarke, Kieran; Neubauer, Stefan; Tyler, Damian J.

2011-01-01

Non-invasive imaging plays a central role in cardiovascular disease for determining diagnosis, prognosis, and optimizing patient management. Recent experimental studies have demonstrated that monitoring hyperpolarized 13C-labelled tracers with magnetic resonance imaging and spectroscopy (MRI and MRS) offers a new way to investigate the normal and diseased heart, and that the technology may be useful in patients with heart disease. In this review, we show how hyperpolarized 13C-labelled tracers are generated and have been applied experimentally, and outline the methodological advances currently underway to enable translation of hyperpolarized 13C MRI and MRS into the clinic. Using hyperpolarized 13C-labelled metabolites and metabolic MRI and MRS could help assessment of many human cardiovascular diseases, including coronary artery disease, heart failure and metabolic cardiomyopathies. We discuss the clinical areas in which the technology may, in the future, aid in the diagnosis and management of patients with cardiovascular diseases, including dynamic investigations of in vivo metabolism, coronary angiography and quantitative perfusion imaging. It is possible that, in the future, hyperpolarized magnetic resonance will play a major role in clinical cardiology. PMID:21969318

PubMed-supported clinical term weighting approach for improving inter-patient similarity measure in diagnosis prediction.

PubMed

Chan, Lawrence Wc; Liu, Ying; Chan, Tao; Law, Helen Kw; Wong, S C Cesar; Yeung, Andy Ph; Lo, K F; Yeung, S W; Kwok, K Y; Chan, William Yl; Lau, Thomas Yh; Shyu, Chi-Ren

2015-06-02

Similarity-based retrieval of Electronic Health Records (EHRs) from large clinical information systems provides physicians the evidence support in making diagnoses or referring examinations for the suspected cases. Clinical Terms in EHRs represent high-level conceptual information and the similarity measure established based on these terms reflects the chance of inter-patient disease co-occurrence. The assumption that clinical terms are equally relevant to a disease is unrealistic, reducing the prediction accuracy. Here we propose a term weighting approach supported by PubMed search engine to address this issue. We collected and studied 112 abdominal computed tomography imaging examination reports from four hospitals in Hong Kong. Clinical terms, which are the image findings related to hepatocellular carcinoma (HCC), were extracted from the reports. Through two systematic PubMed search methods, the generic and specific term weightings were established by estimating the conditional probabilities of clinical terms given HCC. Each report was characterized by an ontological feature vector and there were totally 6216 vector pairs. We optimized the modified direction cosine (mDC) with respect to a regularization constant embedded into the feature vector. Equal, generic and specific term weighting approaches were applied to measure the similarity of each pair and their performances for predicting inter-patient co-occurrence of HCC diagnoses were compared by using Receiver Operating Characteristics (ROC) analysis. The Areas under the curves (AUROCs) of similarity scores based on equal, generic and specific term weighting approaches were 0.735, 0.728 and 0.743 respectively (p < 0.01). In comparison with equal term weighting, the performance was significantly improved by specific term weighting (p < 0.01) but not by generic term weighting. The clinical terms "Dysplastic nodule", "nodule of liver" and "equal density (isodense) lesion" were found the top three image findings associated with HCC in PubMed. Our findings suggest that the optimized similarity measure with specific term weighting to EHRs can improve significantly the accuracy for predicting the inter-patient co-occurrence of diagnosis when compared with equal and generic term weighting approaches.

Production of an 15O beam using a stable oxygen ion beam for in-beam PET imaging

NASA Astrophysics Data System (ADS)

Mohammadi, Akram; Yoshida, Eiji; Tashima, Hideaki; Nishikido, Fumihiko; Inaniwa, Taku; Kitagawa, Atsushi; Yamaya, Taiga

2017-03-01

In advanced ion therapy, the 15O ion beam is a promising candidate to treat hypoxic tumors and simultaneously monitor the delivered dose to a patient using PET imaging. This study aimed at production of an 15O beam by projectile fragmentation of a stable 16O beam in an optimal material, followed by in-beam PET imaging using a prototype OpenPET system, which was developed in the authors' group. The study was carried out in three steps: selection of the optimal target based on the highest production rate of 15O fragments; experimental production of the beam using the optimal target in the Heavy Ion Medical Accelerator Chiba (HIMAC) secondary beam course; and realization of in-beam PET imaging for the produced beam. The optimal target evaluations were done using the Monte Carlo simulation code PHITS. The fluence and mean energy of the secondary particles were simulated and the optimal target was selected based on the production rate of 15O fragments. The highest production rate of 15O was observed for a liquid hydrogen target, 3.27% for a 53 cm thick target from the 16O beam of 430 MeV/u. Since liquid hydrogen is not practically applicable in the HIMAC secondary beam course a hydrogen-rich polyethylene material, which was the second optimal target from the simulation results, was selected as the experimental target. Three polyethylene targets with thicknesses of 5, 11 or 14 cm were used to produce the 15O beam without any degrader in the beam course. The highest production rate was measured as around 0.87% for the 11 cm thick polyethylene target from the 16O beam of 430 MeV/u when the angular acceptance and momentum acceptance were set at ±13 mrad and ±2.5%, respectively. The purity of the produced beam for the three targets were around 75%, insufficient for clinical application, but it was increased to 97% by inserting a wedge shape aluminum degrader with a thickness of 1.76 cm into the beam course and that is sufficiently high. In-beam PET imaging was also performed for all produced beams using the OpenPET system. The purity improvement of the produced 15O beams was confirmed from the PET images.

Gaussian processes with optimal kernel construction for neuro-degenerative clinical onset prediction

NASA Astrophysics Data System (ADS)

Canas, Liane S.; Yvernault, Benjamin; Cash, David M.; Molteni, Erika; Veale, Tom; Benzinger, Tammie; Ourselin, Sébastien; Mead, Simon; Modat, Marc

2018-02-01

Gaussian Processes (GP) are a powerful tool to capture the complex time-variations of a dataset. In the context of medical imaging analysis, they allow a robust modelling even in case of highly uncertain or incomplete datasets. Predictions from GP are dependent of the covariance kernel function selected to explain the data variance. To overcome this limitation, we propose a framework to identify the optimal covariance kernel function to model the data.The optimal kernel is defined as a composition of base kernel functions used to identify correlation patterns between data points. Our approach includes a modified version of the Compositional Kernel Learning (CKL) algorithm, in which we score the kernel families using a new energy function that depends both the Bayesian Information Criterion (BIC) and the explained variance score. We applied the proposed framework to model the progression of neurodegenerative diseases over time, in particular the progression of autosomal dominantly-inherited Alzheimer's disease, and use it to predict the time to clinical onset of subjects carrying genetic mutation.

Potential clinical impact of radionuclide imaging technologies: highlights of the ITBS 2003 meeting

NASA Astrophysics Data System (ADS)

Itti, Roland

2004-07-01

Radiopharmaceuticals are major determinants of progress in Nuclear Medicine. Besides 18FDG, the most common PET tracer, several other molecules are under evaluation, such as 18F-fluoride for bone studies, numerous ligands for neurotransmission, 18F-DOPA for neuro-endocrine tumors or generator produced 68Ga-peptides for various cancers. Nuclear medicine gradually changes for "molecular imaging" and medical imaging, which was at the beginning mainly anatomic, has progressed in the direction of functional and metabolic imaging. The present challenge is to achieve some degree of "in vivo" biochemistry or even histology or genetics. The importance of anatomic/functional image fusion justifies the development of combined PET-CT instrumentation, whose objectives have to be discussed in terms of anatomical landmarks and/or additional clinical information. The question of "hard" or "soft" image co-registration remains open, involving not only CT, but also SPECT or MRI. Development of dedicated imaging devices, whether single photon or positron, is of major interest for breast imaging, allowing optimal imaging conditions, with results definitely superior to classical gamma-cameras or PET. The patient population concerned with scintimammography is still controversial, as well as the imaging modalities: FDG or sestaMIBI, planar or tomographic, scintillators or semi-conductors, and the research field remains open. This is also valid for external or per-operative probe systems for tumor or lymph nodes localization.

Computer-aided diagnosis for classifying benign versus malignant thyroid nodules based on ultrasound images: A comparison with radiologist-based assessments.

PubMed

Chang, Yongjun; Paul, Anjan Kumar; Kim, Namkug; Baek, Jung Hwan; Choi, Young Jun; Ha, Eun Ju; Lee, Kang Dae; Lee, Hyoung Shin; Shin, DaeSeock; Kim, Nakyoung

2016-01-01

To develop a semiautomated computer-aided diagnosis (cad) system for thyroid cancer using two-dimensional ultrasound images that can be used to yield a second opinion in the clinic to differentiate malignant and benign lesions. A total of 118 ultrasound images that included axial and longitudinal images from patients with biopsy-confirmed malignant (n = 30) and benign (n = 29) nodules were collected. Thyroid cad software was developed to extract quantitative features from these images based on thyroid nodule segmentation in which adaptive diffusion flow for active contours was used. Various features, including histogram, intensity differences, elliptical fit, gray-level co-occurrence matrixes, and gray-level run-length matrixes, were evaluated for each region imaged. Based on these imaging features, a support vector machine (SVM) classifier was used to differentiate benign and malignant nodules. Leave-one-out cross-validation with sequential forward feature selection was performed to evaluate the overall accuracy of this method. Additionally, analyses with contingency tables and receiver operating characteristic (ROC) curves were performed to compare the performance of cad with visual inspection by expert radiologists based on established gold standards. Most univariate features for this proposed cad system attained accuracies that ranged from 78.0% to 83.1%. When optimal SVM parameters that were established using a grid search method with features that radiologists use for visual inspection were employed, the authors could attain rates of accuracy that ranged from 72.9% to 84.7%. Using leave-one-out cross-validation results in a multivariate analysis of various features, the highest accuracy achieved using the proposed cad system was 98.3%, whereas visual inspection by radiologists reached 94.9% accuracy. To obtain the highest accuracies, "axial ratio" and "max probability" in axial images were most frequently included in the optimal feature sets for the authors' proposed cad system, while "shape" and "calcification" in longitudinal images were most frequently included in the optimal feature sets for visual inspection by radiologists. The computed areas under curves in the ROC analysis were 0.986 and 0.979 for the proposed cad system and visual inspection by radiologists, respectively; no significant difference was detected between these groups. The use of thyroid cad to differentiate malignant from benign lesions shows accuracy similar to that obtained via visual inspection by radiologists. Thyroid cad might be considered a viable way to generate a second opinion for radiologists in clinical practice.

Computer-aided diagnosis for classifying benign versus malignant thyroid nodules based on ultrasound images: A comparison with radiologist-based assessments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, Yongjun; Paul, Anjan Kumar; Kim, Namkug, E-mail: namkugkim@gmail.com

Purpose: To develop a semiautomated computer-aided diagnosis (CAD) system for thyroid cancer using two-dimensional ultrasound images that can be used to yield a second opinion in the clinic to differentiate malignant and benign lesions. Methods: A total of 118 ultrasound images that included axial and longitudinal images from patients with biopsy-confirmed malignant (n = 30) and benign (n = 29) nodules were collected. Thyroid CAD software was developed to extract quantitative features from these images based on thyroid nodule segmentation in which adaptive diffusion flow for active contours was used. Various features, including histogram, intensity differences, elliptical fit, gray-level co-occurrencemore » matrixes, and gray-level run-length matrixes, were evaluated for each region imaged. Based on these imaging features, a support vector machine (SVM) classifier was used to differentiate benign and malignant nodules. Leave-one-out cross-validation with sequential forward feature selection was performed to evaluate the overall accuracy of this method. Additionally, analyses with contingency tables and receiver operating characteristic (ROC) curves were performed to compare the performance of CAD with visual inspection by expert radiologists based on established gold standards. Results: Most univariate features for this proposed CAD system attained accuracies that ranged from 78.0% to 83.1%. When optimal SVM parameters that were established using a grid search method with features that radiologists use for visual inspection were employed, the authors could attain rates of accuracy that ranged from 72.9% to 84.7%. Using leave-one-out cross-validation results in a multivariate analysis of various features, the highest accuracy achieved using the proposed CAD system was 98.3%, whereas visual inspection by radiologists reached 94.9% accuracy. To obtain the highest accuracies, “axial ratio” and “max probability” in axial images were most frequently included in the optimal feature sets for the authors’ proposed CAD system, while “shape” and “calcification” in longitudinal images were most frequently included in the optimal feature sets for visual inspection by radiologists. The computed areas under curves in the ROC analysis were 0.986 and 0.979 for the proposed CAD system and visual inspection by radiologists, respectively; no significant difference was detected between these groups. Conclusions: The use of thyroid CAD to differentiate malignant from benign lesions shows accuracy similar to that obtained via visual inspection by radiologists. Thyroid CAD might be considered a viable way to generate a second opinion for radiologists in clinical practice.« less

High resolution multimodal clinical ophthalmic imaging system

PubMed Central

Mujat, Mircea; Ferguson, R. Daniel; Patel, Ankit H.; Iftimia, Nicusor; Lue, Niyom; Hammer, Daniel X.

2010-01-01

We developed a multimodal adaptive optics (AO) retinal imager which is the first to combine high performance AO-corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a single compact clinical prototype platform. Such systems are becoming ever more essential to vision research and are expected to prove their clinical value for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa. The SSOCT channel operates at a wavelength of 1 µm for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD. This AO system is designed for use in clinical populations; a dual deformable mirror (DM) configuration allows simultaneous low- and high-order aberration correction over a large range of refractions and ocular media quality. The system also includes a wide field (33 deg.) line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation, an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of lateral eye motion, and a high-resolution LCD-based fixation target for presentation of visual cues. The system was tested in human subjects without retinal disease for performance optimization and validation. We were able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 µm) of the fovea, image and delineate ten retinal layers, and penetrate to resolve features deep into the choroid. The prototype presented here is the first of a new class of powerful flexible imaging platforms that will provide clinicians and researchers with high-resolution, high performance adaptive optics imaging to help guide therapies, develop new drugs, and improve patient outcomes. PMID:20589021

Optimization of beam quality for photon-counting spectral computed tomography in head imaging: simulation study

PubMed Central

Chen, Han; Xu, Cheng; Persson, Mats; Danielsson, Mats

2015-01-01

Abstract. Head computed tomography (CT) plays an important role in the comprehensive evaluation of acute stroke. Photon-counting spectral detectors, as promising candidates for use in the next generation of x-ray CT systems, allow for assigning more weight to low-energy x-rays that generally contain more contrast information. Most importantly, the spectral information can be utilized to decompose the original set of energy-selective images into several basis function images that are inherently free of beam-hardening artifacts, a potential advantage for further improving the diagnosis accuracy. We are developing a photon-counting spectral detector for CT applications. The purpose of this work is to determine the optimal beam quality for material decomposition in two head imaging cases: nonenhanced imaging and K-edge imaging. A cylindrical brain tissue of 16-cm diameter, coated by a 6-mm-thick bone layer and 2-mm-thick skin layer, was used as a head phantom. The imaging target was a 5-mm-thick blood vessel centered in the head phantom. In K-edge imaging, two contrast agents, iodine and gadolinium, with the same concentration (5  mg/mL) were studied. Three parameters that affect beam quality were evaluated: kVp settings (50 to 130 kVp), filter materials (Z=13 to 83), and filter thicknesses [0 to 2 half-value layer (HVL)]. The image qualities resulting from the varying x-ray beams were compared in terms of two figures of merit (FOMs): squared signal-difference-to-noise ratio normalized by brain dose (SDNR2/BD) and that normalized by skin dose (SDNR2/SD). For nonenhanced imaging, the results show that the use of the 120-kVp spectrum filtered by 2 HVL copper (Z=29) provides the best performance in both FOMs. When iodine is used in K-edge imaging, the optimal filter is 2 HVL iodine (Z=53) and the optimal kVps are 60 kVp in terms of SDNR2/BD and 75 kVp in terms of SDNR2/SD. A tradeoff of 65 kVp was proposed to lower the potential risk of skin injuries if a relatively long exposure time is necessarily performed in the iodinated imaging. In the case of gadolinium imaging, both SD and BD can be minimized at 120 kVp filtered with 2 HVL thulium (Z=69). The results also indicate that with the same concentration and their respective optimal spectrum, the values of SDNR2/BD and SDNR2/SD in gadolinium imaging are, respectively, around 3 and 10 times larger than those in iodine imaging. However, since gadolinium is used in much lower concentrations than iodine in the clinic, iodine may be a preferable candidate for K-edge imaging. PMID:26835495

European radiographers' challenges from mammography education and clinical practice - an integrative review.

PubMed

Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

2017-06-01

This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

Shading correction assisted iterative cone-beam CT reconstruction

NASA Astrophysics Data System (ADS)

Yang, Chunlin; Wu, Pengwei; Gong, Shutao; Wang, Jing; Lyu, Qihui; Tang, Xiangyang; Niu, Tianye

2017-11-01

Recent advances in total variation (TV) technology enable accurate CT image reconstruction from highly under-sampled and noisy projection data. The standard iterative reconstruction algorithms, which work well in conventional CT imaging, fail to perform as expected in cone beam CT (CBCT) applications, wherein the non-ideal physics issues, including scatter and beam hardening, are more severe. These physics issues result in large areas of shading artifacts and cause deterioration to the piecewise constant property assumed in reconstructed images. To overcome this obstacle, we incorporate a shading correction scheme into low-dose CBCT reconstruction and propose a clinically acceptable and stable three-dimensional iterative reconstruction method that is referred to as the shading correction assisted iterative reconstruction. In the proposed method, we modify the TV regularization term by adding a shading compensation image to the reconstructed image to compensate for the shading artifacts while leaving the data fidelity term intact. This compensation image is generated empirically, using image segmentation and low-pass filtering, and updated in the iterative process whenever necessary. When the compensation image is determined, the objective function is minimized using the fast iterative shrinkage-thresholding algorithm accelerated on a graphic processing unit. The proposed method is evaluated using CBCT projection data of the Catphan© 600 phantom and two pelvis patients. Compared with the iterative reconstruction without shading correction, the proposed method reduces the overall CT number error from around 200 HU to be around 25 HU and increases the spatial uniformity by a factor of 20 percent, given the same number of sparsely sampled projections. A clinically acceptable and stable iterative reconstruction algorithm for CBCT is proposed in this paper. Differing from the existing algorithms, this algorithm incorporates a shading correction scheme into the low-dose CBCT reconstruction and achieves more stable optimization path and more clinically acceptable reconstructed image. The method proposed by us does not rely on prior information and thus is practically attractive to the applications of low-dose CBCT imaging in the clinic.

WE-H-207A-06: Hypoxia Quantification in Static PET Images: The Signal in the Noise

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keller, H; Yeung, I; Milosevic, M

2016-06-15

Purpose: Quantification of hypoxia from PET images is of considerable clinical interest. In the absence of dynamic PET imaging the hypoxic fraction (HF) of a tumor has to be estimated from voxel values of activity concentration of a radioactive hypoxia tracer. This work is part of an effort to standardize quantification of tumor hypoxic fraction from PET images. Methods: A simple hypoxia imaging model in the tumor was developed. The distribution of the tracer activity was described as the sum of two different probability distributions, one for the normoxic (and necrotic), the other for the hypoxic voxels. The widths ofmore » the distributions arise due to variability of the transport, tumor tissue inhomogeneity, tracer binding kinetics, and due to PET image noise. Quantification of HF was performed for various levels of variability using two different methodologies: a) classification thresholds between normoxic and hypoxic voxels based on a non-hypoxic surrogate (muscle), and b) estimation of the (posterior) probability distributions based on maximizing likelihood optimization that does not require a surrogate. Data from the hypoxia imaging model and from 27 cervical cancer patients enrolled in a FAZA PET study were analyzed. Results: In the model, where the true value of HF is known, thresholds usually underestimate the value for large variability. For the patients, a significant uncertainty of the HF values (an average intra-patient range of 17%) was caused by spatial non-uniformity of image noise which is a hallmark of all PET images. Maximum likelihood estimation (MLE) is able to directly optimize for the weights of both distributions, however, may suffer from poor optimization convergence. For some patients, MLE-based HF values showed significant differences to threshold-based HF-values. Conclusion: HF-values depend critically on the magnitude of the different sources of tracer uptake variability. A measure of confidence should also be reported.« less

Monoplane 3D-2D registration of cerebral angiograms based on multi-objective stratified optimization

NASA Astrophysics Data System (ADS)

Aksoy, T.; Špiclin, Ž.; Pernuš, F.; Unal, G.

2017-12-01

Registration of 3D pre-interventional to 2D intra-interventional medical images has an increasingly important role in surgical planning, navigation and treatment, because it enables the physician to co-locate depth information given by pre-interventional 3D images with the live information in intra-interventional 2D images such as x-ray. Most tasks during image-guided interventions are carried out under a monoplane x-ray, which is a highly ill-posed problem for state-of-the-art 3D to 2D registration methods. To address the problem of rigid 3D-2D monoplane registration we propose a novel multi-objective stratified parameter optimization, wherein a small set of high-magnitude intensity gradients are matched between the 3D and 2D images. The stratified parameter optimization matches rotation templates to depth templates, first sampled from projected 3D gradients and second from the 2D image gradients, so as to recover 3D rigid-body rotations and out-of-plane translation. The objective for matching was the gradient magnitude correlation coefficient, which is invariant to in-plane translation. The in-plane translations are then found by locating the maximum of the gradient phase correlation between the best matching pair of rotation and depth templates. On twenty pairs of 3D and 2D images of ten patients undergoing cerebral endovascular image-guided intervention the 3D to monoplane 2D registration experiments were setup with a rather high range of initial mean target registration error from 0 to 100 mm. The proposed method effectively reduced the registration error to below 2 mm, which was further refined by a fast iterative method and resulted in a high final registration accuracy (0.40 mm) and high success rate (> 96%). Taking into account a fast execution time below 10 s, the observed performance of the proposed method shows a high potential for application into clinical image-guidance systems.

Virtual 3D bladder reconstruction for augmented medical records from white light cystoscopy (Conference Presentation)

NASA Astrophysics Data System (ADS)

Lurie, Kristen L.; Zlatev, Dimitar V.; Angst, Roland; Liao, Joseph C.; Ellerbee, Audrey K.

2016-02-01

Bladder cancer has a high recurrence rate that necessitates lifelong surveillance to detect mucosal lesions. Examination with white light cystoscopy (WLC), the standard of care, is inherently subjective and data storage limited to clinical notes, diagrams, and still images. A visual history of the bladder wall can enhance clinical and surgical management. To address this clinical need, we developed a tool to transform in vivo WLC videos into virtual 3-dimensional (3D) bladder models using advanced computer vision techniques. WLC videos from rigid cystoscopies (1280 x 720 pixels) were recorded at 30 Hz followed by immediate camera calibration to control for image distortions. Video data were fed into an automated structure-from-motion algorithm that generated a 3D point cloud followed by a 3D mesh to approximate the bladder surface. The highest quality cystoscopic images were projected onto the approximated bladder surface to generate a virtual 3D bladder reconstruction. In intraoperative WLC videos from 36 patients undergoing transurethral resection of suspected bladder tumors, optimal reconstruction was achieved from frames depicting well-focused vasculature, when the bladder was maintained at constant volume with minimal debris, and when regions of the bladder wall were imaged multiple times. A significant innovation of this work is the ability to perform the reconstruction using video from a clinical procedure collected with standard equipment, thereby facilitating rapid clinical translation, application to other forms of endoscopy and new opportunities for longitudinal studies of cancer recurrence.

Potential of dosage reduction in cone-beam-computed tomography (CBCT) for radiological diagnostics of the paranasal sinuses.

PubMed

Güldner, C; Ningo, A; Voigt, J; Diogo, I; Heinrichs, J; Weber, R; Wilhelm, T; Fiebich, M

2013-03-01

More than 10 years ago, cone-beam-computed tomography (CBCT) was introduced in ENT radiology. Until now, the focus of research was to evaluate clinical limits of this technique. The aim of this work is the evaluation of specific dosages and the identification of potential optimization in the performance of CBCT of the paranasal sinuses. Based on different tube parameters (tube current, tube voltage, and rotation angles), images of the nose and the paranasal sinuses were taken on a phantom head with the Accu-I-tomo F17 (Morita, Kyoto, Japan). The dosages applied to the lens and parotid gland were measured with OSL dosimetry. The imaging quality was evaluated by independent observers. All datasets were reviewed according to a checklist of surgically important anatomic structures. Even for lowest radiation exposure (4 mA, 76 kV, 180°, computed tomography dosage index (CTDI) = 1.8 mGy), the imaging quality was sufficient. Of course a significant reduction of the imaging quality could be seen, so a reliable mean was set for 4 mA, 84 kV, and 180° rotation angle (CTDI = 2.4 mGy). In this combination, a reduction of 92 % in lens-dose and of 77 % of dosage at the parotid gland was observed in comparison to the maximal possible adjustments (8 mA, 90 kV, 360°, CTDI = 10.9 mGy). There is potential for optimization in CBCT. Changing the rotation angle (180° instead of 360°) leads to a dose reduction of 50 %. Furthermore from clinical point of view in case of chronic rhinosinusitis a relevant reduction of dosage is possible. Therefore, it is necessary to intensify the interdisciplinary discussion about the disease specifics required quality of imaging.

Methodological approach for the assessment of ultrasound reproducibility of cardiac structure and function: a proposal of the study group of Echocardiography of the Italian Society of Cardiology (Ultra Cardia SIC) Part I

PubMed Central

2011-01-01

When applying echo-Doppler imaging for either clinical or research purposes it is very important to select the most adequate modality/technology and choose the most reliable and reproducible measurements. Quality control is a mainstay to reduce variability among institutions and operators and must be obtained by using appropriate procedures for data acquisition, storage and interpretation of echo-Doppler data. This goal can be achieved by employing an echo core laboratory (ECL), with the responsibility for standardizing image acquisition processes (performed at the peripheral echo-labs) and analysis (by monitoring and optimizing the internal intra- and inter-reader variability of measurements). Accordingly, the Working Group of Echocardiography of the Italian Society of Cardiology decided to design standardized procedures for imaging acquisition in peripheral laboratories and reading procedures and to propose a methodological approach to assess the reproducibility of echo-Doppler parameters of cardiac structure and function by using both standard and advanced technologies. A number of cardiologists experienced in cardiac ultrasound was involved to set up an ECL available for future studies involving complex imaging or including echo-Doppler measures as primary or secondary efficacy or safety end-points. The present manuscript describes the methodology of the procedures (imaging acquisition and measurement reading) and provides the documentation of the work done so far to test the reproducibility of the different echo-Doppler modalities (standard and advanced). These procedures can be suggested for utilization also in non referall echocardiographic laboratories as an "inside" quality check, with the aim at optimizing clinical consistency of echo-Doppler data. PMID:21943283

Methods and reproducibility of grading optimized digital color fundus photographs in the Age-Related Eye Disease Study 2 (AREDS2 Report Number 2).

PubMed

Danis, Ronald P; Domalpally, Amitha; Chew, Emily Y; Clemons, Traci E; Armstrong, Jane; SanGiovanni, John Paul; Ferris, Frederick L

2013-07-08

To establish continuity with the grading procedures and outcomes from the historical data of the Age-Related Eye Disease Study (AREDS), color photographic imaging and evaluation procedures for the assessment of age-related macular degeneration (AMD) were modified for digital imaging in the AREDS2. The reproducibility of the grading of index AMD lesion components and for the AREDS severity scale was tested at the AREDS2 reading center. Digital color stereoscopic fundus photographs from 4203 AREDS2 subjects collected at baseline and annual follow-up visits were optimized for tonal balance and graded according to a standard protocol slightly modified from AREDS. The reproducibility of digital grading of AREDS2 images was assessed by reproducibility exercises, temporal drift (regrading a subset of baseline annually, n = 88), and contemporaneous masked regrading (ongoing, monthly regrade on 5% of submissions, n = 1335 eyes). In AREDS2, 91% and 96% of images received replicate grades within two steps of the baseline value on the AREDS severity scale for temporal drift and contemporaneous assessment, respectively (weighted Kappa of 0.73 and 0.76). Historical data for temporal drift in replicate gradings on the AREDS film-based images were 88% within two steps (weighted Kappa = 0.88). There was no difference in AREDS2-AREDS concordance for temporal drift (exact P = 0.57). Digital color grading has nearly the same reproducibility as historical film grading. There is substantial agreement for testing the predictive utility of the AREDS severity scale in AREDS2 as a clinical trial outcome. (ClinicalTrials.gov number, NCT00345176.)

Generalized PSF modeling for optimized quantitation in PET imaging.

PubMed

Ashrafinia, Saeed; Mohy-Ud-Din, Hassan; Karakatsanis, Nicolas A; Jha, Abhinav K; Casey, Michael E; Kadrmas, Dan J; Rahmim, Arman

2017-06-21

Point-spread function (PSF) modeling offers the ability to account for resolution degrading phenomena within the PET image generation framework. PSF modeling improves resolution and enhances contrast, but at the same time significantly alters image noise properties and induces edge overshoot effect. Thus, studying the effect of PSF modeling on quantitation task performance can be very important. Frameworks explored in the past involved a dichotomy of PSF versus no-PSF modeling. By contrast, the present work focuses on quantitative performance evaluation of standard uptake value (SUV) PET images, while incorporating a wide spectrum of PSF models, including those that under- and over-estimate the true PSF, for the potential of enhanced quantitation of SUVs. The developed framework first analytically models the true PSF, considering a range of resolution degradation phenomena (including photon non-collinearity, inter-crystal penetration and scattering) as present in data acquisitions with modern commercial PET systems. In the context of oncologic liver FDG PET imaging, we generated 200 noisy datasets per image-set (with clinically realistic noise levels) using an XCAT anthropomorphic phantom with liver tumours of varying sizes. These were subsequently reconstructed using the OS-EM algorithm with varying PSF modelled kernels. We focused on quantitation of both SUV mean and SUV max , including assessment of contrast recovery coefficients, as well as noise-bias characteristics (including both image roughness and coefficient of-variability), for different tumours/iterations/PSF kernels. It was observed that overestimated PSF yielded more accurate contrast recovery for a range of tumours, and typically improved quantitative performance. For a clinically reasonable number of iterations, edge enhancement due to PSF modeling (especially due to over-estimated PSF) was in fact seen to lower SUV mean bias in small tumours. Overall, the results indicate that exactly matched PSF modeling does not offer optimized PET quantitation, and that PSF overestimation may provide enhanced SUV quantitation. Furthermore, generalized PSF modeling may provide a valuable approach for quantitative tasks such as treatment-response assessment and prognostication.

MIND Demons for MR-to-CT Deformable Image Registration In Image-Guided Spine Surgery

PubMed Central

Reaungamornrat, S.; De Silva, T.; Uneri, A.; Wolinsky, J.-P.; Khanna, A. J.; Kleinszig, G.; Vogt, S.; Prince, J. L.; Siewerdsen, J. H.

2016-01-01

Purpose Localization of target anatomy and critical structures defined in preoperative MR images can be achieved by means of multi-modality deformable registration to intraoperative CT. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration. Method The method, called MIND Demons, solves for the deformation field between two images by optimizing an energy functional that incorporates both the forward and inverse deformations, smoothness on the velocity fields and the diffeomorphisms, a modality-insensitive similarity function suitable to multi-modality images, and constraints on geodesics in Lagrangian coordinates. Direct optimization (without relying on an exponential map of stationary velocity fields used in conventional diffeomorphic Demons) is carried out using a Gauss-Newton method for fast convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, in phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to conventional mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, and normalized MI (NMI) Demons. Result The method yielded sub-voxel invertibility (0.006 mm) and nonsingular spatial Jacobians with capability to preserve local orientation and topology. It demonstrated improved registration accuracy in comparison to the reference methods, with mean target registration error (TRE) of 1.5 mm compared to 10.9, 2.3, and 4.6 mm for MI FFD, LMI FFD, and NMI Demons methods, respectively. Validation in clinical studies demonstrated realistic deformation with sub-voxel TRE in cases of cervical, thoracic, and lumbar spine. Conclusions A modality-independent deformable registration method has been developed to estimate a viscoelastic diffeomorphic map between preoperative MR and intraoperative CT. The method yields registration accuracy suitable to application in image-guided spine surgery across a broad range of anatomical sites and modes of deformation. PMID:27330239

MIND Demons for MR-to-CT deformable image registration in image-guided spine surgery

NASA Astrophysics Data System (ADS)

Reaungamornrat, S.; De Silva, T.; Uneri, A.; Wolinsky, J.-P.; Khanna, A. J.; Kleinszig, G.; Vogt, S.; Prince, J. L.; Siewerdsen, J. H.

2016-03-01

Purpose: Localization of target anatomy and critical structures defined in preoperative MR images can be achieved by means of multi-modality deformable registration to intraoperative CT. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration. Method: The method, called MIND Demons, solves for the deformation field between two images by optimizing an energy functional that incorporates both the forward and inverse deformations, smoothness on the velocity fields and the diffeomorphisms, a modality-insensitive similarity function suitable to multi-modality images, and constraints on geodesics in Lagrangian coordinates. Direct optimization (without relying on an exponential map of stationary velocity fields used in conventional diffeomorphic Demons) is carried out using a Gauss-Newton method for fast convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, in phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to conventional mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, and normalized MI (NMI) Demons. Result: The method yielded sub-voxel invertibility (0.006 mm) and nonsingular spatial Jacobians with capability to preserve local orientation and topology. It demonstrated improved registration accuracy in comparison to the reference methods, with mean target registration error (TRE) of 1.5 mm compared to 10.9, 2.3, and 4.6 mm for MI FFD, LMI FFD, and NMI Demons methods, respectively. Validation in clinical studies demonstrated realistic deformation with sub-voxel TRE in cases of cervical, thoracic, and lumbar spine. Conclusions: A modality-independent deformable registration method has been developed to estimate a viscoelastic diffeomorphic map between preoperative MR and intraoperative CT. The method yields registration accuracy suitable to application in image-guided spine surgery across a broad range of anatomical sites and modes of deformation.

MIND Demons for MR-to-CT Deformable Image Registration In Image-Guided Spine Surgery.

PubMed

Reaungamornrat, S; De Silva, T; Uneri, A; Wolinsky, J-P; Khanna, A J; Kleinszig, G; Vogt, S; Prince, J L; Siewerdsen, J H

2016-02-27

Localization of target anatomy and critical structures defined in preoperative MR images can be achieved by means of multi-modality deformable registration to intraoperative CT. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration. The method, called MIND Demons, solves for the deformation field between two images by optimizing an energy functional that incorporates both the forward and inverse deformations, smoothness on the velocity fields and the diffeomorphisms, a modality-insensitive similarity function suitable to multi-modality images, and constraints on geodesics in Lagrangian coordinates. Direct optimization (without relying on an exponential map of stationary velocity fields used in conventional diffeomorphic Demons) is carried out using a Gauss-Newton method for fast convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, in phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to conventional mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, and normalized MI (NMI) Demons. The method yielded sub-voxel invertibility (0.006 mm) and nonsingular spatial Jacobians with capability to preserve local orientation and topology. It demonstrated improved registration accuracy in comparison to the reference methods, with mean target registration error (TRE) of 1.5 mm compared to 10.9, 2.3, and 4.6 mm for MI FFD, LMI FFD, and NMI Demons methods, respectively. Validation in clinical studies demonstrated realistic deformation with sub-voxel TRE in cases of cervical, thoracic, and lumbar spine. A modality-independent deformable registration method has been developed to estimate a viscoelastic diffeomorphic map between preoperative MR and intraoperative CT. The method yields registration accuracy suitable to application in image-guided spine surgery across a broad range of anatomical sites and modes of deformation.

THz imaging system for in vivo human cornea.

PubMed

Sung, Shijun; Selvin, Skyler; Bajwa, Neha; Chantra, Somporn; Nowroozi, Bryan; Garritano, James; Goell, Jacob; Li, Alex; Deng, Sophie X; Brown, Elliott; Grundfest, Warren S; Taylor, Zachary D

2018-01-01

Terahertz (THz) imaging of corneal tissue water content (CTWC) is a proposed method for early, accurate detection and study of corneal diseases. Despite promising results from ex vivo and in vivo cornea studies, interpretation of the reflectivity data is confounded by the contact between corneal tissue and rigid dielectric window used to flatten the imaging field. This work develops a novel imaging system and image reconstruction methods specifically for nearly spherical targets such as human cornea. A prototype system was constructed using a 650 GHz multiplier source and Schottky diode detector. Resolution and imaging field strength measurement from characterization targets correlate well with those predicted by the quasioptical theory and physical optics analysis. Imaging experiments with corneal phantoms and ex vivo corneas demonstrate the hydration sensitivity of the imaging system and reliable measurement of CTWC. We present successful acquisition of non-contact THz images of in vivo human cornea, and discuss strategies for optimizing the imaging system design for clinical use.

Repeat analysis of intraoral digital imaging performed by undergraduate students using a complementary metal oxide semiconductor sensor: An institutional case study

PubMed Central

Rahman, Nur Liyana Abdul; Asri, Amiza Aqiela Ahmad; Othman, Noor Ilyani; Wan Mokhtar, Ilham

2017-01-01

Purpose This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor (CMOS) intraoral sensor. Materials and Methods A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and interobserver agreement was achieved. Conclusion The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients. PMID:29279822

Detection of Head and Neck Cancer in Surgical Specimens Using Quantitative Hyperspectral Imaging.

PubMed

Lu, Guolan; Little, James V; Wang, Xu; Zhang, Hongzheng; Patel, Mihir R; Griffith, Christopher C; El-Deiry, Mark W; Chen, Amy Y; Fei, Baowei

2017-09-15

Purpose: This study intends to investigate the feasibility of using hyperspectral imaging (HSI) to detect and delineate cancers in fresh, surgical specimens of patients with head and neck cancers. Experimental Design: A clinical study was conducted in order to collect and image fresh, surgical specimens from patients ( N = 36) with head and neck cancers undergoing surgical resection. A set of machine-learning tools were developed to quantify hyperspectral images of the resected tissue in order to detect and delineate cancerous regions which were validated by histopathologic diagnosis. More than two million reflectance spectral signatures were obtained by HSI and analyzed using machine-learning methods. The detection results of HSI were compared with autofluorescence imaging and fluorescence imaging of two vital-dyes of the same specimens. Results: Quantitative HSI differentiated cancerous tissue from normal tissue in ex vivo surgical specimens with a sensitivity and specificity of 91% and 91%, respectively, and which was more accurate than autofluorescence imaging ( P < 0.05) or fluorescence imaging of 2-NBDG ( P < 0.05) and proflavine ( P < 0.05). The proposed quantification tools also generated cancer probability maps with the tumor border demarcated and which could provide real-time guidance for surgeons regarding optimal tumor resection. Conclusions: This study highlights the feasibility of using quantitative HSI as a diagnostic tool to delineate the cancer boundaries in surgical specimens, and which could be translated into the clinic application with the hope of improving clinical outcomes in the future. Clin Cancer Res; 23(18); 5426-36. ©2017 AACR . ©2017 American Association for Cancer Research.

Cloud GPU-based simulations for SQUAREMR.

PubMed

Kantasis, George; Xanthis, Christos G; Haris, Kostas; Heiberg, Einar; Aletras, Anthony H

2017-01-01

Quantitative Magnetic Resonance Imaging (MRI) is a research tool, used more and more in clinical practice, as it provides objective information with respect to the tissues being imaged. Pixel-wise T 1 quantification (T 1 mapping) of the myocardium is one such application with diagnostic significance. A number of mapping sequences have been developed for myocardial T 1 mapping with a wide range in terms of measurement accuracy and precision. Furthermore, measurement results obtained with these pulse sequences are affected by errors introduced by the particular acquisition parameters used. SQUAREMR is a new method which has the potential of improving the accuracy of these mapping sequences through the use of massively parallel simulations on Graphical Processing Units (GPUs) by taking into account different acquisition parameter sets. This method has been shown to be effective in myocardial T 1 mapping; however, execution times may exceed 30min which is prohibitively long for clinical applications. The purpose of this study was to accelerate the construction of SQUAREMR's multi-parametric database to more clinically acceptable levels. The aim of this study was to develop a cloud-based cluster in order to distribute the computational load to several GPU-enabled nodes and accelerate SQUAREMR. This would accommodate high demands for computational resources without the need for major upfront equipment investment. Moreover, the parameter space explored by the simulations was optimized in order to reduce the computational load without compromising the T 1 estimates compared to a non-optimized parameter space approach. A cloud-based cluster with 16 nodes resulted in a speedup of up to 13.5 times compared to a single-node execution. Finally, the optimized parameter set approach allowed for an execution time of 28s using the 16-node cluster, without compromising the T 1 estimates by more than 10ms. The developed cloud-based cluster and optimization of the parameter set reduced the execution time of the simulations involved in constructing the SQUAREMR multi-parametric database thus bringing SQUAREMR's applicability within time frames that would be likely acceptable in the clinic. Copyright © 2016 Elsevier Inc. All rights reserved.

A dedicated cone-beam CT system for musculoskeletal extremities imaging: design, optimization, and initial performance characterization.

PubMed

Zbijewski, W; De Jean, P; Prakash, P; Ding, Y; Stayman, J W; Packard, N; Senn, R; Yang, D; Yorkston, J; Machado, A; Carrino, J A; Siewerdsen, J H

2011-08-01

This paper reports on the design and initial imaging performance of a dedicated cone-beam CT (CBCT) system for musculoskeletal (MSK) extremities. The system complements conventional CT and MR and offers a variety of potential clinical and logistical advantages that are likely to be of benefit to diagnosis, treatment planning, and assessment of therapy response in MSK radiology, orthopaedic surgery, and rheumatology. The scanner design incorporated a host of clinical requirements (e.g., ability to scan the weight-bearing knee in a natural stance) and was guided by theoretical and experimental analysis of image quality and dose. Such criteria identified the following basic scanner components and system configuration: a flat-panel detector (FPD, Varian 3030+, 0.194 mm pixels); and a low-power, fixed anode x-ray source with 0.5 mm focal spot (SourceRay XRS-125-7K-P, 0.875 kW) mounted on a retractable C-arm allowing for two scanning orientations with the capability for side entry, viz. a standing configuration for imaging of weight-bearing lower extremities and a sitting configuration for imaging of tensioned upper extremity and unloaded lower extremity. Theoretical modeling employed cascaded systems analysis of modulation transfer function (MTF) and detective quantum efficiency (DQE) computed as a function of system geometry, kVp and filtration, dose, source power, etc. Physical experimentation utilized an imaging bench simulating the scanner geometry for verification of theoretical results and investigation of other factors, such as antiscatter grid selection and 3D image quality in phantom and cadaver, including qualitative comparison to conventional CT. Theoretical modeling and benchtop experimentation confirmed the basic suitability of the FPD and x-ray source mentioned above. Clinical requirements combined with analysis of MTF and DQE yielded the following system geometry: a -55 cm source-to-detector distance; 1.3 magnification; a 20 cm diameter bore (20 x 20 x 20 cm3 field of view); total acquisition arc of -240 degrees. The system MTF declines to 50% at -1.3 mm(-1) and to 10% at -2.7 mm(-1), consistent with sub-millimeter spatial resolution. Analysis of DQE suggested a nominal technique of 90 kVp (+0.3 mm Cu added filtration) to provide high imaging performance from -500 projections at less than -0.5 kW power, implying -6.4 mGy (0.064 mSv) for low-dose protocols and -15 mGy (0.15 mSv) for high-quality protocols. The experimental studies show improved image uniformity and contrast-to-noise ratio (without increase in dose) through incorporation of a custom 10:1 GR antiscatter grid. Cadaver images demonstrate exquisite bone detail, visualization of articular morphology, and soft-tissue visibility comparable to diagnostic CT (10-20 HU contrast resolution). The results indicate that the proposed system will deliver volumetric images of the extremities with soft-tissue contrast resolution comparable to diagnostic CT and improved spatial resolution at potentially reduced dose. Cascaded systems analysis provided a useful basis for system design and optimization without costly repeated experimentation. A combined process of design specification, image quality analysis, clinical feedback, and revision yielded a prototype that is now awaiting clinical pilot studies. Potential advantages of the proposed system include reduced space and cost, imaging of load-bearing extremities, and combined volumetric imaging with real-time fluoroscopy and digital radiography.

A dedicated cone-beam CT system for musculoskeletal extremities imaging: Design, optimization, and initial performance characterization

PubMed Central

Zbijewski, W.; De Jean, P.; Prakash, P.; Ding, Y.; Stayman, J. W.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Machado, A.; Carrino, J. A.; Siewerdsen, J. H.

2011-01-01

Purpose: This paper reports on the design and initial imaging performance of a dedicated cone-beam CT (CBCT) system for musculoskeletal (MSK) extremities. The system complements conventional CT and MR and offers a variety of potential clinical and logistical advantages that are likely to be of benefit to diagnosis, treatment planning, and assessment of therapy response in MSK radiology, orthopaedic surgery, and rheumatology. Methods: The scanner design incorporated a host of clinical requirements (e.g., ability to scan the weight-bearing knee in a natural stance) and was guided by theoretical and experimental analysis of image quality and dose. Such criteria identified the following basic scanner components and system configuration: a flat-panel detector (FPD, Varian 3030+, 0.194 mm pixels); and a low-power, fixed anode x-ray source with 0.5 mm focal spot (SourceRay XRS-125-7K-P, 0.875 kW) mounted on a retractable C-arm allowing for two scanning orientations with the capability for side entry, viz. a standing configuration for imaging of weight-bearing lower extremities and a sitting configuration for imaging of tensioned upper extremity and unloaded lower extremity. Theoretical modeling employed cascaded systems analysis of modulation transfer function (MTF) and detective quantum efficiency (DQE) computed as a function of system geometry, kVp and filtration, dose, source power, etc. Physical experimentation utilized an imaging bench simulating the scanner geometry for verification of theoretical results and investigation of other factors, such as antiscatter grid selection and 3D image quality in phantom and cadaver, including qualitative comparison to conventional CT. Results: Theoretical modeling and benchtop experimentation confirmed the basic suitability of the FPD and x-ray source mentioned above. Clinical requirements combined with analysis of MTF and DQE yielded the following system geometry: a ∼55 cm source-to-detector distance; 1.3 magnification; a 20 cm diameter bore (20 × 20 × 20 cm3 field of view); total acquisition arc of ∼240°. The system MTF declines to 50% at ∼1.3 mm−1 and to 10% at ∼2.7 mm−1, consistent with sub-millimeter spatial resolution. Analysis of DQE suggested a nominal technique of 90 kVp (+0.3 mm Cu added filtration) to provide high imaging performance from ∼500 projections at less than ∼0.5 kW power, implying ∼6.4 mGy (0.064 mSv) for low-dose protocols and ∼15 mGy (0.15 mSv) for high-quality protocols. The experimental studies show improved image uniformity and contrast-to-noise ratio (without increase in dose) through incorporation of a custom 10:1 GR antiscatter grid. Cadaver images demonstrate exquisite bone detail, visualization of articular morphology, and soft-tissue visibility comparable to diagnostic CT (10–20 HU contrast resolution). Conclusions: The results indicate that the proposed system will deliver volumetric images of the extremities with soft-tissue contrast resolution comparable to diagnostic CT and improved spatial resolution at potentially reduced dose. Cascaded systems analysis provided a useful basis for system design and optimization without costly repeated experimentation. A combined process of design specification, image quality analysis, clinical feedback, and revision yielded a prototype that is now awaiting clinical pilot studies. Potential advantages of the proposed system include reduced space and cost, imaging of load-bearing extremities, and combined volumetric imaging with real-time fluoroscopy and digital radiography. PMID:21928644

A dedicated cone-beam CT system for musculoskeletal extremities imaging: Design, optimization, and initial performance characterization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zbijewski, W.; De Jean, P.; Prakash, P.

2011-08-15

Purpose: This paper reports on the design and initial imaging performance of a dedicated cone-beam CT (CBCT) system for musculoskeletal (MSK) extremities. The system complements conventional CT and MR and offers a variety of potential clinical and logistical advantages that are likely to be of benefit to diagnosis, treatment planning, and assessment of therapy response in MSK radiology, orthopaedic surgery, and rheumatology. Methods: The scanner design incorporated a host of clinical requirements (e.g., ability to scan the weight-bearing knee in a natural stance) and was guided by theoretical and experimental analysis of image quality and dose. Such criteria identified themore » following basic scanner components and system configuration: a flat-panel detector (FPD, Varian 3030+, 0.194 mm pixels); and a low-power, fixed anode x-ray source with 0.5 mm focal spot (SourceRay XRS-125-7K-P, 0.875 kW) mounted on a retractable C-arm allowing for two scanning orientations with the capability for side entry, viz. a standing configuration for imaging of weight-bearing lower extremities and a sitting configuration for imaging of tensioned upper extremity and unloaded lower extremity. Theoretical modeling employed cascaded systems analysis of modulation transfer function (MTF) and detective quantum efficiency (DQE) computed as a function of system geometry, kVp and filtration, dose, source power, etc. Physical experimentation utilized an imaging bench simulating the scanner geometry for verification of theoretical results and investigation of other factors, such as antiscatter grid selection and 3D image quality in phantom and cadaver, including qualitative comparison to conventional CT. Results: Theoretical modeling and benchtop experimentation confirmed the basic suitability of the FPD and x-ray source mentioned above. Clinical requirements combined with analysis of MTF and DQE yielded the following system geometry: a {approx}55 cm source-to-detector distance; 1.3 magnification; a 20 cm diameter bore (20 x 20 x 20 cm{sup 3} field of view); total acquisition arc of {approx}240 deg. The system MTF declines to 50% at {approx}1.3 mm{sup -1} and to 10% at {approx}2.7 mm{sup -1}, consistent with sub-millimeter spatial resolution. Analysis of DQE suggested a nominal technique of 90 kVp (+0.3 mm Cu added filtration) to provide high imaging performance from {approx}500 projections at less than {approx}0.5 kW power, implying {approx}6.4 mGy (0.064 mSv) for low-dose protocols and {approx}15 mGy (0.15 mSv) for high-quality protocols. The experimental studies show improved image uniformity and contrast-to-noise ratio (without increase in dose) through incorporation of a custom 10:1 GR antiscatter grid. Cadaver images demonstrate exquisite bone detail, visualization of articular morphology, and soft-tissue visibility comparable to diagnostic CT (10-20 HU contrast resolution). Conclusions: The results indicate that the proposed system will deliver volumetric images of the extremities with soft-tissue contrast resolution comparable to diagnostic CT and improved spatial resolution at potentially reduced dose. Cascaded systems analysis provided a useful basis for system design and optimization without costly repeated experimentation. A combined process of design specification, image quality analysis, clinical feedback, and revision yielded a prototype that is now awaiting clinical pilot studies. Potential advantages of the proposed system include reduced space and cost, imaging of load-bearing extremities, and combined volumetric imaging with real-time fluoroscopy and digital radiography.« less