Quantitative CT Evaluation of Small Pulmonary Vessels in Patients with Acute Pulmonary Embolism.

PubMed

Matsuoka, Shin; Kotoku, Akiyuki; Yamashiro, Tsuneo; Matsushita, Shoichiro; Fujikawa, Atsuko; Yagihashi, Kunihiro; Nakajima, Yasuo

2018-05-01

The objective of this study was to investigate the correlation between the computed tomography (CT) cross-sectional area (CSA) of small pulmonary vessels and the CT obstruction index in patients with acute pulmonary embolism (PE) and the correlation between the changes in these measurements after anticoagulant therapy. Fifty-two patients with acute PE were selected for this study. We measured the CSA less than 5 mm 2 on coronal reconstructed images to obtain the percentage of the CSA (%CSA < 5). CT angiographic index was obtained based on the Qanadli method for the evaluation of the degree of pulmonary arterial obstruction. Spearman rank correlation analysis was used to evaluate the relationship between the initial and the follow-up values and changes in the %CSA < 5 and the CT obstruction index. There was no significant correlation between the %CSA < 5 and CT obstruction index on both initial (ρ = -0.03, P = 0.84) and follow-up (ρ = -0.03, P = 0.82) assessments. In contrast, there was a significant negative correlation between the changes in %CSA < 5 and the CT obstruction index (ρ = -0.59, P < 0.0001). Although the absolute %CSA < 5 and CT obstruction index were not significantly correlated, the changes in the values of the two parameters had a significant correlation. Changes in %CSA < 5, which can be obtained easily, can be used as biomarker of therapeutic response in patients with acute PE. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

A carbon CT system: how to obtain accurate stopping power ratio using a Bragg peak reduction technique

NASA Astrophysics Data System (ADS)

Lee, Sung Hyun; Sunaguchi, Naoki; Hirano, Yoshiyuki; Kano, Yosuke; Liu, Chang; Torikoshi, Masami; Ohno, Tatsuya; Nakano, Takashi; Kanai, Tatsuaki

2018-02-01

In this study, we investigate the performance of the Gunma University Heavy Ion Medical Center’s ion computed tomography (CT) system, which measures the residual range of a carbon-ion beam using a fluoroscopy screen, a charge-coupled-device camera, and a moving wedge absorber and collects CT reconstruction images from each projection angle. Each 2D image was obtained by changing the polymethyl methacrylate (PMMA) thickness, such that all images for one projection could be expressed as the depth distribution in PMMA. The residual range as a function of PMMA depth was related to the range in water through a calibration factor, which was determined by comparing the PMMA-equivalent thickness measured by the ion CT system to the water-equivalent thickness measured by a water column. Aluminium, graphite, PMMA, and five biological phantoms were placed in a sample holder, and the residual range for each was quantified simultaneously. A novel method of CT reconstruction to correct for the angular deflection of incident carbon ions in the heterogeneous region utilising the Bragg peak reduction (BPR) is also introduced in this paper, and its performance is compared with other methods present in the literature such as the decomposition and differential methods. Stopping power ratio values derived with the BPR method from carbon-ion CT images matched closely with the true water-equivalent length values obtained from the validation slab experiment.

Evaluation of dosimetry and image of very low-dose computed tomography attenuation correction for pediatric positron emission tomography/computed tomography: phantom study

NASA Astrophysics Data System (ADS)

Bahn, Y. K.; Park, H. H.; Lee, C. H.; Kim, H. S.; Lyu, K. Y.; Dong, K. R.; Chung, W. K.; Cho, J. H.

2014-04-01

In this study, phantom was used to evaluate attenuation correction computed tomography (CT) dose and image in case of pediatric positron emission tomography (PET)/CT scan. Three PET/CT scanners were used along with acryl phantom in the size for infant and ion-chamber dosimeter. The CT image acquisition conditions were changed from 10 to 20, 40, 80, 100 and 160 mA and from 80 to 100, 120 and 140 kVp, which aimed at evaluating penetrate dose and computed tomography dose indexvolume (CTDIvol) value. And NEMA PET Phantom™ was used to obtain PET image under the same CT conditions in order to evaluate each attenuation-corrected PET image based on standard uptake value (SUV) value and signal-to-noise ratio (SNR). In general, the penetrate dose was reduced by around 92% under the minimum CT conditions (80 kVp and 10 mA) with the decrease in CTDIvol value by around 88%, compared with the pediatric abdomen CT conditions (100 kVp and 100 mA). The PET image with its attenuation corrected according to each CT condition showed no change in SUV value and no influence on the SNR. In conclusion, if the minimum dose CT that is properly applied to body of pediatric patient is corrected for attenuation to ensure that the effective dose is reduced by around 90% or more compared with that for adult patient, this will be useful to reduce radiation exposure level.

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT

PubMed Central

Zhang, Xirong; Duan, Haifeng; Yu, Yong; Ma, Chunling; Ren, Zhanli; Lei, Yuxin

2018-01-01

Purpose To investigate the value of spectral CT in the differential diagnosis of benign from malignant pleural effusion. Method and materials 14 patients with benign pleural effusion and 15 patients with malignant pleural effusion underwent non-contrast spectral CT imaging. These patients were later verified by the combination of disease history, clinical signs and other information with the consensus of surgeons and radiologists. Various Spectral CT image parameters measured for the effusion were as follows: CT numbers of the polychromatic 140kVp images, monochromatic images at 40keV and 100keV, the material density contents from the water, fat and blood-based material decomposition images, the effective atomic number and the spectral curve slope. These values were statistically compared with t test and logistic regression analysis between benign and malignant pleural effusion. Results The CT value of benign and malignant pleural effusion in the polychromatic 140kVp images showed no differences (12.61±3.39HU vs. 14.71±5.03HU) (P>0.05), however, they were statistically different on the monochromatic images at 40keV (43.15±3.79 vs. 39.42±2.60, p = 0.005) and 100keV (9.11±1.38 vs. 6.52±2.04, p<0.001). There was difference in the effective atomic number value between the benign (7.87±0.08) and malignant pleural effusion (7.90±0.02) (P = 0.02). Using 6.32HU as the threshold for CT value measurement at 100keV, one could obtain sensitivity of 100% and specificity of 66.7% with area-under-curve of 0.843 for differentiating benign from malignant effusion. In addition, age and disease history were potential confounding factors for differentiating malignant pleural effusion from benign, since the older age (61.13±12.51 year-old vs48.57±12.33 year-old) as well as longer disease history (70.00±49.28 day vs.28.36±21.64 day) were more easily to be found in the malignant pleural effusion group than those in the benign pleural effusion group. By combining above five factors, one could obtain sensitivity of 100% and specificity of 71.4% with area-under-curve of 0.933 for differentiating benign from malignant effusion. Conclusion The CT value measurement at both high and low energy levels and the effective atomic number obtained in a single spectral CT scan can assist the differential diagnosis of benign from malignant pleural effusion.Combining them with patient age and disease history can further improve diagnostic performance. Clinical relevance/Application Clinical findings and Spectral CT imaging can provide significant evidences about the nature of pleural effusion. PMID:29641601

Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT.

PubMed

Zhang, Xirong; Duan, Haifeng; Yu, Yong; Ma, Chunling; Ren, Zhanli; Lei, Yuxin; He, Taiping; Zhang, Ming

2018-01-01

To investigate the value of spectral CT in the differential diagnosis of benign from malignant pleural effusion. 14 patients with benign pleural effusion and 15 patients with malignant pleural effusion underwent non-contrast spectral CT imaging. These patients were later verified by the combination of disease history, clinical signs and other information with the consensus of surgeons and radiologists. Various Spectral CT image parameters measured for the effusion were as follows: CT numbers of the polychromatic 140kVp images, monochromatic images at 40keV and 100keV, the material density contents from the water, fat and blood-based material decomposition images, the effective atomic number and the spectral curve slope. These values were statistically compared with t test and logistic regression analysis between benign and malignant pleural effusion. The CT value of benign and malignant pleural effusion in the polychromatic 140kVp images showed no differences (12.61±3.39HU vs. 14.71±5.03HU) (P>0.05), however, they were statistically different on the monochromatic images at 40keV (43.15±3.79 vs. 39.42±2.60, p = 0.005) and 100keV (9.11±1.38 vs. 6.52±2.04, p<0.001). There was difference in the effective atomic number value between the benign (7.87±0.08) and malignant pleural effusion (7.90±0.02) (P = 0.02). Using 6.32HU as the threshold for CT value measurement at 100keV, one could obtain sensitivity of 100% and specificity of 66.7% with area-under-curve of 0.843 for differentiating benign from malignant effusion. In addition, age and disease history were potential confounding factors for differentiating malignant pleural effusion from benign, since the older age (61.13±12.51 year-old vs48.57±12.33 year-old) as well as longer disease history (70.00±49.28 day vs.28.36±21.64 day) were more easily to be found in the malignant pleural effusion group than those in the benign pleural effusion group. By combining above five factors, one could obtain sensitivity of 100% and specificity of 71.4% with area-under-curve of 0.933 for differentiating benign from malignant effusion. The CT value measurement at both high and low energy levels and the effective atomic number obtained in a single spectral CT scan can assist the differential diagnosis of benign from malignant pleural effusion.Combining them with patient age and disease history can further improve diagnostic performance. Clinical findings and Spectral CT imaging can provide significant evidences about the nature of pleural effusion.

Acceptance test of a commercially available software for automatic image registration of computed tomography (CT), magnetic resonance imaging (MRI) and 99mTc-methoxyisobutylisonitrile (MIBI) single-photon emission computed tomography (SPECT) brain images.

PubMed

Loi, Gianfranco; Dominietto, Marco; Manfredda, Irene; Mones, Eleonora; Carriero, Alessandro; Inglese, Eugenio; Krengli, Marco; Brambilla, Marco

2008-09-01

This note describes a method to characterize the performances of image fusion software (Syntegra) with respect to accuracy and robustness. Computed tomography (CT), magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT) studies were acquired from two phantoms and 10 patients. Image registration was performed independently by two couples composed of one radiotherapist and one physicist by means of superposition of anatomic landmarks. Each couple performed jointly and saved the registration. The two solutions were averaged to obtain the gold standard registration. A new set of estimators was defined to identify translation and rotation errors in the coordinate axes, independently from point position in image field of view (FOV). Algorithms evaluated were local correlation (LC) for CT-MRI, normalized mutual information (MI) for CT-MRI, and CT-SPECT registrations. To evaluate accuracy, estimator values were compared to limiting values for the algorithms employed, both in phantoms and in patients. To evaluate robustness, different alignments between images taken from a sample patient were produced and registration errors determined. LC algorithm resulted accurate in CT-MRI registrations in phantoms, but exceeded limiting values in 3 of 10 patients. MI algorithm resulted accurate in CT-MRI and CT-SPECT registrations in phantoms; limiting values were exceeded in one case in CT-MRI and never reached in CT-SPECT registrations. Thus, the evaluation of robustness was restricted to the algorithm of MI both for CT-MRI and CT-SPECT registrations. The algorithm of MI proved to be robust: limiting values were not exceeded with translation perturbations up to 2.5 cm, rotation perturbations up to 10 degrees and roto-translational perturbation up to 3 cm and 5 degrees.

Single energy micro CT SkyScan 1173 for the characterization of urinary stone

NASA Astrophysics Data System (ADS)

Fitri, L. A.; Asyana, V.; Ridwan, T.; Anwary, F.; Soekersi, H.; Latief, F. D. E.; Haryanto, F.

2016-08-01

A urinary stone is a solid piece of material produced from crystallization of excreted substances in the urine. Knowledge of the composition of urinary stones is essential to determine the suitable treatment for the patient. The aim of this research was to characterize urinary stones using single energy micro CT SkyScan 1173. Six human urinary stones were scanned in vitro using 80 kV in micro CT SkyScan 1173. The produced projection, images, were reconstructed using NRecon (in-house software from SkyScan). The images of urinary stones were analyzed using CT Analyser (CT An) to obtain information of the internal structure and the Hounsfield Unit (HU) value to determine the information regarding the composition of the urinary stones, respectively. The average HU values from certain region of interests in the same slice were compared with spectral curves of known materials from National Institute of Standards and Technology (NIST). From the analysis, the composition of the six scanned stones were obtained. Two stones are composed of cystine, two are composed of struvite, two other stones are composed of struvite+cystine. In conclusion, the single energy micro CT with 80 kV can be used identifying cystine and struvite urinary stone.

Coronary artery calcium scoring does not add prognostic value to standard 64-section CT angiography protocol in low-risk patients suspected of having coronary artery disease.

PubMed

Kwon, Sung Woo; Kim, Young Jin; Shim, Jaemin; Sung, Ji Min; Han, Mi Eun; Kang, Dong Won; Kim, Ji-Ye; Choi, Byoung Wook; Chang, Hyuk-Jae

2011-04-01

To evaluate the prognostic outcome of cardiac computed tomography (CT) for prediction of major adverse cardiac events (MACEs) in low-risk patients suspected of having coronary artery disease (CAD) and to explore the differential prognostic values of coronary artery calcium (CAC) scoring and coronary CT angiography. Institutional review committee approval and informed consent were obtained. In 4338 patients who underwent 64-section CT for evaluation of suspected CAD, both CAC scoring and CT angiography were concurrently performed by using standard scanning protocols. Follow-up clinical outcome data regarding composite MACEs were procured. Multivariable Cox proportional hazards models were developed to predict MACEs. Risk-adjusted models incorporated traditional risk factors for CAC scoring and coronary CT angiography. During the mean follow-up of 828 days ± 380, there were 105 MACEs, for an event rate of 3%. The presence of obstructive CAD at coronary CT angiography had independent prognostic value, which escalated according to the number of stenosed vessels (P < .001). In the receiver operating characteristic curve (ROC) analysis, the superiority of coronary CT angiography to CAC scoring was demonstrated by a significantly greater area under the ROC curve (AUC) (0.892 vs 0.810, P < .001), whereas no significant incremental value for the addition of CAC scoring to coronary CT angiography was established (AUC = 0.892 for coronary CT angiography alone vs 0.902 with addition of CAC scoring, P = .198). Coronary CT angiography is better than CAC scoring in predicting MACEs in low-risk patients suspected of having CAD. Furthermore, the current standard multisection CT protocol (coronary CT angiography combined with CAC scoring) has no incremental prognostic value compared with coronary CT angiography alone. Therefore, in terms of determining prognosis, CAC scoring may no longer need to be incorporated in the cardiac CT protocol in this population. © RSNA, 2011.

Identification of infusion strategy for achieving repeatable nanoparticle distribution and quantification of thermal dosage using micro-CT Hounsfield unit in magnetic nanoparticle hyperthermia.

PubMed

LeBrun, Alexander; Joglekar, Tejashree; Bieberich, Charles; Ma, Ronghui; Zhu, Liang

2016-01-01

The objective of this study was to identify an injection strategy leading to repeatable nanoparticle deposition patterns in tumours and to quantify volumetric heat generation rate distribution based on micro-CT Hounsfield unit (HU) in magnetic nanoparticle hyperthermia. In vivo animal experiments were performed on graft prostatic cancer (PC3) tumours in immunodeficient mice to investigate whether lowering ferrofluid infusion rate improves control of the distribution of magnetic nanoparticles in tumour tissue. Nanoparticle distribution volume obtained from micro-CT scan was used to evaluate spreading of the nanoparticles from the injection site in tumours. Heating experiments were performed to quantify relationships among micro-CT HU values, local nanoparticle concentrations in the tumours, and the ferrofluid-induced volumetric heat generation rate (q(MNH)) when nanoparticles were subject to an alternating magnetic field. An infusion rate of 3 µL/min was identified to result in the most repeatable nanoparticle distribution in PC3 tumours. Linear relationships have been obtained to first convert micro-CT greyscale values to HU values, then to local nanoparticle concentrations, and finally to nanoparticle-induced q(MNH) values. The total energy deposition rate in tumours was calculated and the observed similarity in total energy deposition rates in all three infusion rate groups suggests improvement in minimising nanoparticle leakage from the tumours. The results of this study demonstrate that micro-CT generated q(MNH) distribution and tumour physical models improve predicting capability of heat transfer simulation for designing reliable treatment protocols using magnetic nanoparticle hyperthermia.

Quantitative analysis applied to contrast medium extravasation by using the computed-tomography number within the region of interest

NASA Astrophysics Data System (ADS)

Lee, Jae-Seung; Im, In-Chul; Kim, Moon-Jib; Goo, Eun-Hoe; Kim, Sun-Ju; Kim, Kwang; Kwak, Byung-Joon

2014-02-01

The present study was carried out to present a method to analyze extravasation quantitatively by measuring the computed tomography (CT) number after determining the region of interest (ROI) in the CT images obtained from patients suspected of extravasation induced by contrast medium auto-injection. To achieve this, we divided the study subjects into a group of patients who incurred extravasation and a group of patients who underwent routine scans without incurring extravasation. The CT numbers at IV sites were obtained as reference values, and CT numbers at extravasation sites and hepatic portal veins, respectively, were obtained as relative values. Thereupon, the predicted time for extravasation ( T EP ) and the predicted ratio for extravasation ( R EP ) of an extravasation site were obtained and analyzed quantitatively. In the case of extravasation induced by a dual auto-injector, the values of the CT numbers were confirmed to be lower and the extravasation site to be enlarged when compared to the extravasation induced by a single autoinjector. This is because the physiological saline introduced after the injection of the contrast agent diluted the concentration of the extravasated contrast agent. Additionally, the T EP caused by the auto-injector was about 40 seconds, and we could perform a precise quantitative assessment of the site suspected of extravasation. In conclusion, the dual auto-injection method, despite its advantage of reducing the volume of contrast agent and improving the quality of images for patients with good vascular integrity, was judged to be likely to increase the risk of extravasation and aggravate outcomes for patients with poor vascular integrity by enlarging extravasation sites.

Reliability of voxel gray values in cone beam computed tomography for preoperative implant planning assessment.

PubMed

Parsa, Azin; Ibrahim, Norliza; Hassan, Bassam; Motroni, Alessandro; van der Stelt, Paul; Wismeijer, Daniel

2012-01-01

To assess the reliability of cone beam computed tomography (CBCT) voxel gray value measurements using Hounsfield units (HU) derived from multislice computed tomography (MSCT) as a clinical reference (gold standard). Ten partially edentulous human mandibular cadavers were scanned by two types of computed tomography (CT) modalities: multislice CT and cone beam CT. On MSCT scans, eight regions of interest (ROI) designating the site for preoperative implant placement were selected in each mandible. The datasets from both CT systems were matched using a three-dimensional (3D) registration algorithm. The mean voxel gray values of the region around the implant sites were compared between MSCT and CBCT. Significant differences between the mean gray values obtained by CBCT and HU by MSCT were found. In all the selected ROIs, CBCT showed higher mean values than MSCT. A strong correlation (R=0.968) between mean voxel gray values of CBCT and mean HU of MSCT was determined. Voxel gray values from CBCT deviate from actual HU units. However, a strong linear correlation exists, which may permit deriving actual HU units from CBCT using linear regression models.

[Decision process of Notification Value by the Dose Index Registry system in X-ray computed tomography].

PubMed

Shinozaki, Masafumi; Muramatsu, Yoshihisa; Sasaki, Toru

2014-01-01

A new technical standard for X-ray computed tomography (CT) has been published by the National Electrical Manufacturers Association (NEMA) that allows the Alert Value and Notification Value for cumulative dose to be configurable by CT systems operators in conjunction with the XR-25 (Dose check) standard. In this study, a decision method of the Notification Values for reducing the radiation dose was examined using the dose index registry (DIR) system, during 122 continuous days from August 1, 2012 to November 30, 2012. CT images were obtained using the Discovery CT 750HD (GE Healthcare) and the dose index was calculated using the DoseWatch DIR system. The CT dose index-volume (CTDIvol) and dose-length product (DLP) were output from the DIR system in comma-separated value (CSV) file format for each examination protocol. All data were shown as a schematic boxplot using statistical processing software. The CTDIvol of a routine chest examination showed the following values (maximum: 23.84 mGy; minimum: 2.55 mGy; median: 7.60 mGy; 75% tile: 10.01 mGy; 25% tile: 6.54 mGy). DLP showed the following values (maximum: 944.56 mGy·cm; minimum: 97.25 mGy·cm; median: 307.35 mGy·cm; 75% tile: 406.87 mGy·cm; 25% tile: 255.75 mGy·cm). These results indicate that the 75% tile of CTDIvol and DLP as an initial value proved to be safe and efficient for CT examination and operation. We have thus established one way of determining the Notification Value from the output of the DIR system. Transfer back to the protocol of the CT and automated processing each numeric value in the DIR system is desired.

Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

PubMed Central

Hasseine, L.; Gari-Toussaint, M.; Casanova, V.; Marty, P. M.; Pomares, C.

2016-01-01

Pneumocystis jirovecii pneumonia (PCP) is an acute and life-threatening lung disease caused by the fungus Pneumocystis jirovecii. The presentation of PCP in HIV-positive patients is well-known and consists of a triad of dyspnea, fever, and cough, whereas the presentation of PCP in HIV-negative patients is atypical and consists of a sudden outbreak, O2 desaturation, and a rapid lethal outcome without therapy. Despite the availability of direct and indirect identification methods, the diagnosis of PCP remains difficult. The cycle threshold (CT) values obtained by quantitative PCR (qPCR) allow estimation of the fungal burden. The more elevated that the fungal burden is, the higher the probability that the diagnosis is pneumonia. The purposes of the present study were to evaluate the CT values to differentiate colonization and pneumonia in a population of immunocompromised patients overall and patients stratified on the basis of their HIV infection status. Testing of bronchoalveolar lavage (BAL) fluid samples from the whole population of qPCR-positive patients showed a mean CT value for patients with PCP of 28 (95% confidence interval [CI], 26 to 30) and a mean CT value for colonized patients of 35 (95% CI, 34 to 36) (P < 10−3). For the subgroup of HIV-positive patients, we demonstrated that a CT value below 27 excluded colonization and a CT value above 30 excluded PCP with a specificity of 100% and a sensitivity of 80%, respectively. In the subgroup of HIV-negative patients, we demonstrated that a CT value below 31 excluded colonization and a CT value above 35 excluded PCP with a specificity of 80% and a sensitivity of 80%, respectively. Thus, qPCR of BAL fluid samples is an important tool for the differentiation of colonization and pneumonia in P. jirovecii-infected immunocompromised patients and patients stratified on the basis of HIV infection status with different CT values. PMID:27008872

Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients.

PubMed

Fauchier, T; Hasseine, L; Gari-Toussaint, M; Casanova, V; Marty, P M; Pomares, C

2016-06-01

Pneumocystis jirovecii pneumonia (PCP) is an acute and life-threatening lung disease caused by the fungus Pneumocystis jirovecii The presentation of PCP in HIV-positive patients is well-known and consists of a triad of dyspnea, fever, and cough, whereas the presentation of PCP in HIV-negative patients is atypical and consists of a sudden outbreak, O2 desaturation, and a rapid lethal outcome without therapy. Despite the availability of direct and indirect identification methods, the diagnosis of PCP remains difficult. The cycle threshold (CT) values obtained by quantitative PCR (qPCR) allow estimation of the fungal burden. The more elevated that the fungal burden is, the higher the probability that the diagnosis is pneumonia. The purposes of the present study were to evaluate the CT values to differentiate colonization and pneumonia in a population of immunocompromised patients overall and patients stratified on the basis of their HIV infection status. Testing of bronchoalveolar lavage (BAL) fluid samples from the whole population of qPCR-positive patients showed a mean CT value for patients with PCP of 28 (95% confidence interval [CI], 26 to 30) and a mean CT value for colonized patients of 35 (95% CI, 34 to 36) (P < 10(-3)). For the subgroup of HIV-positive patients, we demonstrated that a CT value below 27 excluded colonization and a CT value above 30 excluded PCP with a specificity of 100% and a sensitivity of 80%, respectively. In the subgroup of HIV-negative patients, we demonstrated that a CT value below 31 excluded colonization and a CT value above 35 excluded PCP with a specificity of 80% and a sensitivity of 80%, respectively. Thus, qPCR of BAL fluid samples is an important tool for the differentiation of colonization and pneumonia in P. jirovecii-infected immunocompromised patients and patients stratified on the basis of HIV infection status with different CT values. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Radiochromic film calibration for the RQT9 quality beam

NASA Astrophysics Data System (ADS)

Costa, K. C.; Gomez, A. M. L.; Alonso, T. C.; Mourao, A. P.

2017-11-01

When ionizing radiation interacts with matter it generates energy deposition. Radiation dosimetry is important for medical applications of ionizing radiation due to the increasing demand for diagnostic radiology and radiotherapy. Different dosimetry methods are used and each one has its advantages and disadvantages. The film is a dose measurement method that records the energy deposition by the darkening of its emulsion. Radiochromic films have a little visible light sensitivity and respond better to ionizing radiation exposure. The aim of this study is to obtain the resulting calibration curve by the irradiation of radiochromic film strips, making it possible to relate the darkening of the film with the absorbed dose, in order to measure doses in experiments with X-ray beam of 120 kV, in computed tomography (CT). Film strips of GAFCHROMIC XR-QA2 were exposed according to RQT9 reference radiation, which defines an X-ray beam generated from a voltage of 120 kV. Strips were irradiated in "Laboratório de Calibração de Dosímetros do Centro de Desenvolvimento da Tecnologia Nuclear" (LCD / CDTN) at a dose range of 5-30 mGy, corresponding to the range values commonly used in CT scans. Digital images of the irradiated films were analyzed by using the ImageJ software. The darkening responses on film strips according to the doses were observed and they allowed obtaining the corresponding numeric values to the darkening for each specific dose value. From the numerical values of darkening, a calibration curve was obtained, which correlates the darkening of the film strip with dose values in mGy. The calibration curve equation is a simplified method for obtaining absorbed dose values using digital images of radiochromic films irradiated. With the calibration curve, radiochromic films may be applied on dosimetry in experiments on CT scans using X-ray beam of 120 kV, in order to improve CT acquisition image processes.

Dual-energy CT for detection of contrast enhancement or leakage within high-density haematomas in patients with intracranial haemorrhage.

PubMed

Watanabe, Yoshiyuki; Tsukabe, Akio; Kunitomi, Yuki; Nishizawa, Mitsuo; Arisawa, Atsuko; Tanaka, Hisashi; Yoshiya, Kazuhisa; Shimazu, Takeshi; Tomiyama, Noriyuki

2014-04-01

Our study aimed to elucidate the diagnostic performance of dual-energy CT (DECT) in the detection of contrast enhancement in intracranial haematomas (ICrH) with early phase dual-energy computed tomography angiography (CTA) and compare the results with those obtained by delayed CT enhancement. Thirty-six patients with ICrH were retrospectively included in this study. All patients had undergone single-energy non-contrast CT and contrast-enhanced dual-source DECT. DECT images were post-processed with commercial software, followed by obtaining iodine images and virtual non-contrast images and generating combined images that created the impression of 120-kVp images. Two neuroradiologists, blinded to the patients' data, reviewed two reading sessions: session A (non-contrast CT and combined CT) and session B (non-contrast CT, combined CT, and iodine images) for detection of contrast enhancement in the haematomas. Contrast leakage or enhancement was detected in 23 (57.5 %) out of 40 haemorrhagic lesions in 36 patients on delayed CT. Three enhanced lesions were depicted only in the DECT iodine images. The sensitivity, specificity, positive predictive value, and negative predictive value of session A were 82.6, 94.1, 95.0, and 80.0 %, respectively, and those of session B were 95.7, 94.1, 95.7, and 94.1 %, respectively. DECT emphasised the iodine enhancement and facilitated the detection of contrast enhancement or leakage.

A comparative analysis of the dependences of the hemodynamic parameters on changes in ROI's position in perfusion CT scans

NASA Astrophysics Data System (ADS)

Choi, Yong-Seok; Cho, Jae-Hwan; Namgung, Jang-Sun; Kim, Hyo-Jin; Yoon, Dae-Young; Lee, Han-Joo

2013-05-01

This study performed a comparative analysis of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and mean time-to-peak (TTP) obtained by changing the region of interest's (ROI) anatomical positions, during CT brain perfusion. We acquired axial source images of perfusion CT from 20 patients undergoing CT perfusion exams due to brain trauma. Subsequently, the CBV, CBF, MTT, and TTP values were calculated through data-processing of the perfusion CT images. The color scales for the CBV, CBF, MTT, and TTP maps were obtained using the image data. Anterior cerebral artery (ACA) was taken as the standard ROI for the calculations of the perfusion values. Differences in the hemodynamic average values were compared in a quantitative analysis by placing ROI and the dividing axial images into proximal, middle, and distal segments anatomically. By performing the qualitative analysis using a blind test, we observed changes in the sensory characteristics by using the color scales of the CBV, CBF, and MTT maps in the proximal, middle, and distal segments. According to the qualitative analysis, no differences were found in CBV, CBF, MTT, and TTP values of the proximal, middle, and distal segments and no changes were detected in the color scales of the the CBV, CBF, MTT, and TTP maps in the proximal, middle, and distal segments. We anticipate that the results of the study will useful in assessing brain trauma patients using by perfusion imaging.

Role of multidetector computed tomography in evaluating incidentally detected breast lesions.

PubMed

Moschetta, Marco; Scardapane, Arnaldo; Lorusso, Valentina; Rella, Leonarda; Telegrafo, Michele; Serio, Gabriella; Angelelli, Giuseppe; Ianora, Amato Antonio Stabile

2015-01-01

Computed tomography (CT) does not represent the primary method for the evaluation of breast lesions; however, it can detect breast abnormalities, even when performed for other reasons related to thoracic structures. The aim of this study is to evaluate the potential benefits of 320-row multidetector CT (MDCT) in evaluating and differentiating incidentally detected breast lesions by using vessel probe and 3D analysis software with net enhancement value. Sixty-two breast lesions in 46 patients who underwent 320-row chest CT examination were retrospectively evaluated. CT scans were assessed searching for the presence, location, number, morphological features, and density of breast nodules. Net enhancement was calculated by subtracting precontrast density from the density obtained by postcontrast values. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CT were calculated for morphological features and net enhancement. Thirty of 62 lesions were found to be malignant at histological examination and 32 were found to be benign. When morphological features were considered, the sensitivity, specificity, accuracy, PPV, and NPV of CT were 87%, 100%, 88%, 100%, and 50%, respectively. Based on net enhancement, CT reached a sensitivity, specificity, accuracy, PPV, and NPV of 100%, 94%, 97%, 94%, and 100%, respectively. MDCT allows to recognize and characterize breast lesions based on morphological features. Net enhancement can be proposed as an additional accurate feature of CT.

Variability of dental cone beam CT grey values for density estimations

PubMed Central

Pauwels, R; Nackaerts, O; Bellaiche, N; Stamatakis, H; Tsiklakis, K; Walker, A; Bosmans, H; Bogaerts, R; Jacobs, R; Horner, K

2013-01-01

Objective The aim of this study was to investigate the use of dental cone beam CT (CBCT) grey values for density estimations by calculating the correlation with multislice CT (MSCT) values and the grey value error after recalibration. Methods A polymethyl methacrylate (PMMA) phantom was developed containing inserts of different density: air, PMMA, hydroxyapatite (HA) 50 mg cm−3, HA 100, HA 200 and aluminium. The phantom was scanned on 13 CBCT devices and 1 MSCT device. Correlation between CBCT grey values and CT numbers was calculated, and the average error of the CBCT values was estimated in the medium-density range after recalibration. Results Pearson correlation coefficients ranged between 0.7014 and 0.9996 in the full-density range and between 0.5620 and 0.9991 in the medium-density range. The average error of CBCT voxel values in the medium-density range was between 35 and 1562. Conclusion Even though most CBCT devices showed a good overall correlation with CT numbers, large errors can be seen when using the grey values in a quantitative way. Although it could be possible to obtain pseudo-Hounsfield units from certain CBCTs, alternative methods of assessing bone tissue should be further investigated. Advances in knowledge The suitability of dental CBCT for density estimations was assessed, involving a large number of devices and protocols. The possibility for grey value calibration was thoroughly investigated. PMID:23255537

Usage of CT data in biomechanical research

NASA Astrophysics Data System (ADS)

Safonov, Roman A.; Golyadkina, Anastasiya A.; Kirillova, Irina V.; Kossovich, Leonid Y.

2017-02-01

Object of study: The investigation is focused on development of personalized medicine. The determination of mechanical properties of bone tissues based on in vivo data was considered. Methods: CT, MRI, natural experiments on versatile test machine Instron 5944, numerical experiments using Python programs. Results: The medical diagnostics methods, which allows determination of mechanical properties of bone tissues based on in vivo data. The series of experiments to define the values of mechanical parameters of bone tissues. For one and the same sample, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonic investigations and mechanical experiments on single-column test machine Instron 5944 were carried out. The computer program for comparison of CT and MRI images was created. The grayscale values in the same points of the samples were determined on both CT and MRI images. The Haunsfield grayscale values were used to determine rigidity (Young module) and tensile strength of the samples. The obtained data was compared to natural experiments results for verification.

SU-G-206-08: How Should Focal Spot Be Chosen for Optimized CT Imaging with Dose Modulation?

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

Bache, S; Liu, X; Rong, J

Purpose: To choose the preferred focal spot for achieving optimized CT image quality with balanced tube heating considerations. Methods: An anthropomorphic pelvic phantom was scanned using a GE Discovery CT750 HD at 120 and 140kVp, 0.8s rotation time, and pitch of 0.984. “Smart mA” was enabled to simulate a routine abdomen–pelvis CT scan. Permissible mA values at 120 and 140 kVp were obtained from the Serial Load Rating table (for mimicking a busy CT clinical operation) in the scanner Technical Reference Manual. At each kVp station and two Noise Index levels, the mA Upper Limit was set above/below the permissiblemore » mA values. Scanned mA values and focal spot (FS) used were obtained from the DICOM header of each image, and the FS-mA relationship was analyzed. For visual confirmation beyond recorded FS information, a CatPhan with a fat-ring attached for mimicking patient size/shape was scanned at 120kVp. A group of radiologists/physicists compared a pair of CatPhan images qualitatively. Lastly, a number of patient cases were evaluated to confirm the FS-mA relationship. Results: When preset Upper Limit values were above the permissible mA values, the Large FS (labeled 1.2) was used in scans, even if the maximum scanned mA values were much lower than the permissible values at both 120 and 140 kVp. Otherwise the Small FS (labeled 0.7) was used. Visual evaluation of the high contrast module of CatPhan and additional analysis of patient cases further confirmed that the preset Upper Limit determines which focal spot is to be used, not the actual maximum mA value to be scanned. Conclusion: Specific FS can be selected by setting up appropriate mA Upper Limit in a protocol. CT protocols could be optimized by selecting appropriate FS for improving patient image quality, especially benefiting the small size and pediatric patients.« less

Method of Individual Adjustment for 3D CT Analysis: Linear Measurement.

PubMed

Kim, Dong Kyu; Choi, Dong Hun; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

2016-01-01

Introduction . We aim to regularize measurement values in three-dimensional (3D) computed tomography (CT) reconstructed images for higher-precision 3D analysis, focusing on length-based 3D cephalometric examinations. Methods . We measure the linear distances between points on different skull models using Vernier calipers (real values). We use 10 differently tilted CT scans for 3D CT reconstruction of the models and measure the same linear distances from the picture archiving and communication system (PACS). In both cases, each measurement is performed three times by three doctors, yielding nine measurements. The real values are compared with the PACS values. Each PACS measurement is revised based on the display field of view (DFOV) values and compared with the real values. Results . The real values and the PACS measurement changes according to tilt value have no significant correlations ( p > 0.05). However, significant correlations appear between the real values and DFOV-adjusted PACS measurements ( p < 0.001). Hence, we obtain a correlation expression that can yield real physical values from PACS measurements. The DFOV value intervals for various age groups are also verified. Conclusion . Precise confirmation of individual preoperative length and precise analysis of postoperative improvements through 3D analysis is possible, which is helpful for facial-bone-surgery symmetry correction.

Examination of the dental cone-beam CT equipped with flat-panel-detector (FPD)

NASA Astrophysics Data System (ADS)

Ito, Rieko; Fujita, Naotoshi; Kodera, Yoshie

2011-03-01

In dentistry, computed tomography (CT) is essential for diagnosis. Recently, cone-beam CT has come into use. We used an "Alphard 3030" cone-beam CT equipped with an FPD system. This system can obtain fluoroscopic and CT images. Moreover, the Alphard has 4 exposure modes for CT, and each mode has a different field of view (FOV) and voxel size. We examined the image quality of kinetic and CT images obtained using the cone-beam CT system. To evaluate kinetic image quality, we calculated the Wiener spectrum (WS) and modulation transfer function (MTF). We then analyzed the lag images and exposed a phantom. To evaluate CT image quality, we calculated WS and MTF at various places in the FOV and examined the influence of extension of the cone beam X-ray on voxel size. Furthermore, we compared the WS and MTF values of cone-beam CT to those of another CT system. Evaluation of the kinetic images showed that cone-beam CT is sufficient for clinical diagnosis and provides better image quality than the other system tested. However, during exposure of a CT image, the distance from the center influences image quality (especially MTF). Further, differences in voxel size affect image quality. It is therefore necessary to carefully position the region of interest and select an appropriate mode.

[Preoperative CT Scan in middle ear cholesteatoma].

PubMed

Sethom, Anissa; Akkari, Khemaies; Dridi, Inès; Tmimi, S; Mardassi, Ali; Benzarti, Sonia; Miled, Imed; Chebbi, Mohamed Kamel

2011-03-01

To compare preoperative CT scan finding and per-operative lesions in patients operated for middle ear cholesteatoma, A retrospective study including 60 patients with cholesteatoma otitis diagnosed and treated within a period of 5 years, from 2001 to 2005, at ENT department of Military Hospital of Tunis. All patients had computed tomography of the middle and inner ear. High resolution CT scan imaging was performed using millimetric incidences (3 to 5 millimetres). All patients had surgical removal of their cholesteatoma using down wall technic. We evaluated sensitivity, specificity and predictive value of CT-scan comparing otitic damages and CT finding, in order to examine the real contribution of computed tomography in cholesteatoma otitis. CT scan analysis of middle ear bone structures shows satisfaction (with 83% of sensibility). The rate of sensibility decrease (63%) for the tympanic raff. Predictive value of CT scan for the diagnosis of cholesteatoma was low. However, we have noticed an excellent sensibility in the analysis of ossicular damages (90%). Comparative frontal incidence seems to be less sensible for the detection of facial nerve lesions (42%). But when evident on CT scan findings, lesions of facial nerve were usually observed preoperatively (spécificity 78%). Predictive value of computed tomography for the diagnosis of perilymphatic fistulae (FL) was low. In fact, CT scan imaging have showed FL only for four patients among eight. Best results can be obtained if using inframillimetric incidences with performed high resolution computed tomography. Preoperative computed tomography is necessary for the diagnosis and the evaluation of chronic middle ear cholesteatoma in order to show extending lesion and to detect complications. This CT analysis and surgical correlation have showed that sensibility, specificity and predictive value of CT-scan depend on the anatomic structure implicated in cholesteatoma damages.

Patent foramen ovale: diagnosis with multidetector CT--comparison with transesophageal echocardiography.

PubMed

Kim, Young Jin; Hur, Jin; Shim, Chi-Young; Lee, Hye-Jeong; Ha, Jong-Won; Choe, Kyu Ok; Heo, Ji Hoe; Choi, Eui-Young; Choi, Byoung Wook

2009-01-01

To evaluate the clinical feasibility and accuracy of 64-section multidetector computed tomography (CT) compared with transesophageal echocardiography (TEE) for diagnosis of a patent foramen ovale (PFO). Institutional review board approval was obtained for this retrospective study. The study included 152 consecutive stroke patients (mean age, 61.7 years; 98 men, 54 women) who underwent both cardiac multidetector CT and TEE. Electrocardiographically gated cardiac CT was performed with a 64-section CT scanner by using a saline-chaser contrast agent injection technique. A contrast agent jet from the contrast agent-filled left atrium (LA) to the saline-filled right atrium (RA) and channel-like appearance of the interatrial septum (IAS) were evaluated on axial and oblique sagittal CT images. Two-dimensional and Doppler TEE were performed to detect PFO. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT were obtained with TEE as the reference standard. A PFO was present in 26 patients at TEE. On CT images, a left-to-right contrast agent jet toward the inferior vena cava was noted in 21 patients (sensitivity, 73.1%; specificity, 98.4%; PPV, 90.5%; NPV, 94.7%). Channel-like appearance of the IAS was detected in 38 patients (sensitivity, 76.9%; specificity, 85.7%; PPV, 52.6%; NPV, 94.7%). Channel-like appearance of the IAS was noted in all patients who had a contrast agent jet. A contrast agent jet from LA to RA toward the inferior vena cava with channel-like appearance of the IAS on CT images confirms the presence of a PFO. (c) RSNA, 2008.

Accuracy of Dual-Energy Virtual Monochromatic CT Numbers: Comparison between the Single-Source Projection-Based and Dual-Source Image-Based Methods.

PubMed

Ueguchi, Takashi; Ogihara, Ryota; Yamada, Sachiko

2018-03-21

To investigate the accuracy of dual-energy virtual monochromatic computed tomography (CT) numbers obtained by two typical hardware and software implementations: the single-source projection-based method and the dual-source image-based method. A phantom with different tissue equivalent inserts was scanned with both single-source and dual-source scanners. A fast kVp-switching feature was used on the single-source scanner, whereas a tin filter was used on the dual-source scanner. Virtual monochromatic CT images of the phantom at energy levels of 60, 100, and 140 keV were obtained by both projection-based (on the single-source scanner) and image-based (on the dual-source scanner) methods. The accuracy of virtual monochromatic CT numbers for all inserts was assessed by comparing measured values to their corresponding true values. Linear regression analysis was performed to evaluate the dependency of measured CT numbers on tissue attenuation, method, and their interaction. Root mean square values of systematic error over all inserts at 60, 100, and 140 keV were approximately 53, 21, and 29 Hounsfield unit (HU) with the single-source projection-based method, and 46, 7, and 6 HU with the dual-source image-based method, respectively. Linear regression analysis revealed that the interaction between the attenuation and the method had a statistically significant effect on the measured CT numbers at 100 and 140 keV. There were attenuation-, method-, and energy level-dependent systematic errors in the measured virtual monochromatic CT numbers. CT number reproducibility was comparable between the two scanners, and CT numbers had better accuracy with the dual-source image-based method at 100 and 140 keV. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

A comparison study of different facial soft tissue analysis methods.

PubMed

Kook, Min-Suk; Jung, Seunggon; Park, Hong-Ju; Oh, Hee-Kyun; Ryu, Sun-Youl; Cho, Jin-Hyoung; Lee, Jae-Seo; Yoon, Suk-Ja; Kim, Min-Soo; Shin, Hyo-Keun

2014-07-01

The purpose of this study was to evaluate several different facial soft tissue measurement methods. After marking 15 landmarks in the facial area of 12 mannequin heads of different sizes and shapes, facial soft tissue measurements were performed by the following 5 methods: Direct anthropometry, Digitizer, 3D CT, 3D scanner, and DI3D system. With these measurement methods, 10 measurement values representing the facial width, height, and depth were determined twice with a one week interval by one examiner. These data were analyzed with the SPSS program. The position created based on multi-dimensional scaling showed that direct anthropometry, 3D CT, digitizer, 3D scanner demonstrated relatively similar values, while the DI3D system showed slightly different values. All 5 methods demonstrated good accuracy and had a high coefficient of reliability (>0.92) and a low technical error (<0.9 mm). The measured value of the distance between the right and left medial canthus obtained by using the DI3D system was statistically significantly different from that obtained by using the digital caliper, digitizer and laser scanner (p < 0.05), but the other measured values were not significantly different. On evaluating the reproducibility of measurement methods, two measurement values (Ls-Li, G-Pg) obtained by using direct anthropometry, one measurement value (N'-Prn) obtained by using the digitizer, and four measurement values (EnRt-EnLt, AlaRt-AlaLt, ChRt-ChLt, Sn-Pg) obtained by using the DI3D system, were statistically significantly different. However, the mean measurement error in every measurement method was low (<0.7 mm). All measurement values obtained by using the 3D CT and 3D scanner did not show any statistically significant difference. The results of this study show that all 3D facial soft tissue analysis methods demonstrate favorable accuracy and reproducibility, and hence they can be used in clinical practice and research studies. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

High dose microCT does not contribute towards improved microPET/CT image quantitative accuracy and can limit longitudinal scanning of small animals

NASA Astrophysics Data System (ADS)

McDougald, Wendy A.; Collins, Richard; Green, Mark; Tavares, Adriana A. S.

2017-10-01

Obtaining accurate quantitative measurements in preclinical Positron Emission Tomography/Computed Tomography (PET/CT) imaging is of paramount importance in biomedical research and helps supporting efficient translation of preclinical results to the clinic. The purpose of this study was two-fold: (1) to investigate the effects of different CT acquisition protocols on PET/CT image quality and data quantification; and (2) to evaluate the absorbed dose associated with varying CT parameters. Methods: An air/water quality control CT phantom, tissue equivalent material phantom, an in-house 3D printed phantom and an image quality PET/CT phantom were imaged using a Mediso nanoPET/CT scanner. Collected data was analyzed using PMOD software, VivoQuant software and National Electric Manufactures Association (NEMA) software implemented by Mediso. Measured Hounsfield Unit (HU) in collected CT images were compared to the known HU values and image noise was quantified. PET recovery coefficients (RC), uniformity and quantitative bias were also measured. Results: Only less than 2% and 1% of CT acquisition protocols yielded water HU values < -80 and air HU values < -840, respectively. Four out of eleven CT protocols resulted in more than 100 mGy absorbed dose. Different CT protocols did not impact PET uniformity and RC, and resulted in <4% overall bias relative to expected radioactive concentration. Conclusion: Preclinical CT protocols with increased exposure times can result in high absorbed doses to the small animals. These should be avoided, as they do not contributed towards improved microPET/CT image quantitative accuracy and could limit longitudinal scanning of small animals.

Dose profile variation with voltage in head CT scans using radiochromic films

NASA Astrophysics Data System (ADS)

Mourão, A. P.; Alonso, T. C.; DaSilva, T. A.

2014-02-01

The voltage source used in an X-ray tube is an important part of defining the generated beam spectrum energy profile. The X-ray spectrum energy defines the X-ray beam absorption as well as the characteristics of the energy deposition in an irradiated object. Although CT scanners allow one to choose between four different voltage values, most of them employ a voltage of 120 kV in their scanning protocols, regardless of the patient characteristics. Based on this fact, this work investigated the deposited dose in a polymethyl methacrylate (PMMA) cylindrical head phantom. The entire volume was irradiated twice. Two CT scanning protocols were used with two different voltage values: 100 and 120 kV. The phantom volume was irradiated, and radiochromic films were employed to record dose profiles. Measurements were conducted with a calibrated pencil ionization chamber, which was positioned in the center and in four peripheral bores of the head PMMA phantom, to calibrate the radiochromic films. The central slice was then irradiated. This procedure allowed us to find the conversion factors necessary to obtain dose values recorded in the films. The data obtained allowed us to observe the dose variation profile inside the phantom head as well as in the peripheral and central regions. The peripheral region showed higher dose values than those of the central region for scans using both voltage values: approximately 31% higher for scanning with 120 kV and 25% higher with 100 kV. Doses recorded with the highest voltage are significantly higher, approximately 50% higher in the peripheral region and 40% higher in the central region. A longitudinal variation could be observed, and the maximum dose was recorded at the peripheral region, at the midpoint of the longitudinal axis. The obtained results will most likely contribute to the dissemination of proper procedure as well as to optimize dosimetry and tests of quality control in CT because the choice of protocols with different voltage values can be a way to optimize the CT scans.

Age and sex based reference values for incidental coronary artery and thoracic aorta calcifications on routine clinical chest CT: a powerful tool to appreciate available imaging findings.

PubMed

Jairam, Pushpa M; de Jong, Pim A; Mali, Willem P Th M; Gondrie, Martijn J A; Jacobs, Peter C A; van der Graaf, Yolanda

2014-08-01

To establish age and gender specific reference values for incidental coronary artery and thoracic aorta calcification scores on routine diagnostic CT scans. These reference values can aid in structured reporting and interpretation of readily available imaging data by chest CT readers in routine practice. A random sample of 1572 (57% male, median age 61 years) was taken from a study population of 12,063 subjects who underwent diagnostic chest CT for non-cardiovascular indications between January 2002 and December 2005. Coronary artery and thoracic aorta calcifications were graded using a validated ordinal score. The 25th, 50th and 75th percentile cut points were calculated for the coronary artery and thoracic aorta calcification scores within each age/gender stratum. The 75th percentile cut points for coronary artery calcification scores were higher for men than for women across all age groups, with the exception of the lowest age group. The 75th percentile cut points for thoracic aorta calcifications scores were comparable for both genders across all age groups. Based on the obtained age and gender reference values a calculation tool is provided, that allows one to enter an individual's age, gender and calcification scores to obtain the corresponding estimated percentiles. The calculation tool as provided in this study can be used in daily practice by CT readers to examine whether a subject has high calcifications scores relative to others with the same age and gender. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Handling Density Conversion in TPS.

PubMed

Isobe, Tomonori; Mori, Yutaro; Takei, Hideyuki; Sato, Eisuke; Tadano, Kiichi; Kobayashi, Daisuke; Tomita, Tetsuya; Sakae, Takeji

2016-01-01

Conversion from CT value to density is essential to a radiation treatment planning system. Generally CT value is converted to the electron density in photon therapy. In the energy range of therapeutic photon, interactions between photons and materials are dominated with Compton scattering which the cross-section depends on the electron density. The dose distribution is obtained by calculating TERMA and kernel using electron density where TERMA is the energy transferred from primary photons and kernel is a volume considering spread electrons. Recently, a new method was introduced which uses the physical density. This method is expected to be faster and more accurate than that using the electron density. As for particle therapy, dose can be calculated with CT-to-stopping power conversion since the stopping power depends on the electron density. CT-to-stopping power conversion table is also called as CT-to-water-equivalent range and is an essential concept for the particle therapy.

PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients.

PubMed

Burger, C; Goerres, G; Schoenes, S; Buck, A; Lonn, A H R; Von Schulthess, G K

2002-07-01

The CT data acquired in combined PET/CT studies provide a fast and essentially noiseless source for the correction of photon attenuation in PET emission data. To this end, the CT values relating to attenuation of photons in the range of 40-140 keV must be transformed into linear attenuation coefficients at the PET energy of 511 keV. As attenuation depends on photon energy and the absorbing material, an accurate theoretical relation cannot be devised. The transformation implemented in the Discovery LS PET/CT scanner (GE Medical Systems, Milwaukee, Wis.) uses a bilinear function based on the attenuation of water and cortical bone at the CT and PET energies. The purpose of this study was to compare this transformation with experimental CT values and corresponding PET attenuation coefficients. In 14 patients, quantitative PET attenuation maps were calculated from germanium-68 transmission scans, and resolution-matched CT images were generated. A total of 114 volumes of interest were defined and the average PET attenuation coefficients and CT values measured. From the CT values the predicted PET attenuation coefficients were calculated using the bilinear transformation. When the transformation was based on the narrow-beam attenuation coefficient of water at 511 keV (0.096 cm(-1)), the predicted attenuation coefficients were higher in soft tissue than the measured values. This bias was reduced by replacing 0.096 cm(-1) in the transformation by the linear attenuation coefficient of 0.093 cm(-1) obtained from germanium-68 transmission scans. An analysis of the corrected emission activities shows that the resulting transformation is essentially equivalent to the transmission-based attenuation correction for human tissue. For non-human material, however, it may assign inaccurate attenuation coefficients which will also affect the correction in neighbouring tissue.

Assessment of BoneTtissue Mineralization by Conventional X-ray Microcomputed tomography: Comparison with Synchrotron Radiation Microcomputed Tomography and Ash Measurements

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

Kazakia,G.; Burghardt, A.; Cheung, S.

2008-01-01

Assessment of bone tissue mineral density (TMD) may provide information critical to the understanding of mineralization processes and bone biomechanics. High-resolution three-dimensional assessment of TMD has recently been demonstrated using synchrotron radiation microcomputed tomography (SR{mu}CT); however, this imaging modality is relatively inaccessible due to the scarcity of SR facilities. Conventional desktop {mu}CT systems are widely available and have been used extensively to assess bone microarchitecture. However, the polychromatic source and cone-shaped beam geometry complicate assessment of TMD by conventional {mu}CT. The goal of this study was to evaluate {mu}CT-based measurement of degree and distribution of tissue mineralization in a quantitative,more » spatially resolved manner. Specifically, {mu}CT measures of bone mineral content (BMC) and TMD were compared to those obtained by SR{mu}CT and gravimetric methods. Cylinders of trabecular bone were machined from human femoral heads (n=5), vertebrae (n=5), and proximal tibiae (n=4). Cylinders were imaged in saline on a polychromatic {mu}CT system at an isotropic voxel size of 8 {mu}m. Volumes were reconstructed using beam hardening correction algorithms based on hydroxyapatite (HA)-resin wedge phantoms of 200 and 1200 mgHA/cm3. SR{mu}CT imaging was performed at an isotropic voxel size of 7.50 {mu}m at the National Synchrotron Light Source. Attenuation values were converted to HA concentration using a linear regression derived by imaging a calibration phantom. Architecture and mineralization parameters were calculated from the image data. Specimens were processed using gravimetric methods to determine ash mass and density. {mu}CT-based BMC values were not affected by altering the beam hardening correction. Volume-averaged TMD values calculated by the two corrections were significantly different (p=0.008) in high volume fraction specimens only, with the 1200 mgHA/cm3 correction resulting in a 4.7% higher TMD value. {mu}CT and SR{mu}CT provided significantly different measurements of both BMC and TMD (p<0.05). In high volume fraction specimens, {mu}CT with 1200 mgHA/cm3 correction resulted in BMC and TMD values 16.7% and 15.0% lower, respectively, than SR{mu}CT values. In low volume fraction specimens, {mu}CT with 1200 mgHA/cm3 correction resulted in BMC and TMD values 12.8% and 12.9% lower, respectively, than SR{mu}CT values. {mu}CT and SR{mu}CT values were well-correlated when volume fraction groups were considered individually (BMC R2=0.97-1.00; TMD R2=0.78-0.99). Ash mass and density were higher than the SR{mu}CT equivalents by 8.6% in high volume fraction specimens and 10.9% in low volume fraction specimens (p<0.05). BMC values calculated by tomography were highly correlated with ash mass (ash versus {mu}CT R2=0.96-1.00; ash versus SR{mu}CT R2=0.99-1.00). TMD values calculated by tomography were moderately correlated with ash density (ash versus {mu}CT R2=0.64-0.72; ash versus SR{mu}CT R2=0.64). Spatially resolved comparisons highlighted substantial geometric nonuniformity in the {mu}CT data, which were reduced (but not eliminated) using the 1200 mg HA/cm3 beam hardening correction, and did not exist in the SR{mu}CT data. This study represents the first quantitative comparison of {mu}CT mineralization evaluation against SR{mu}CT and gravimetry. Our results indicate that {mu}CT mineralization measures are underestimated but well-correlated with SR{mu}CT and gravimetric data, particularly when volume fraction groups are considered individually.« less

Assessment of bone tissue mineralization by conventional x-ray microcomputed tomography: Comparison with synchrotron radiation microcomputed tomography and ash measurements

PubMed Central

Kazakia, G. J.; Burghardt, A. J.; Cheung, S.; Majumdar, S.

2008-01-01

Assessment of bone tissue mineral density (TMD) may provide information critical to the understanding of mineralization processes and bone biomechanics. High-resolution three-dimensional assessment of TMD has recently been demonstrated using synchrotron radiation microcomputed tomography (SRμCT); however, this imaging modality is relatively inaccessible due to the scarcity of SR facilities. Conventional desktop μCT systems are widely available and have been used extensively to assess bone microarchitecture. However, the polychromatic source and cone-shaped beam geometry complicate assessment of TMD by conventional μCT. The goal of this study was to evaluate μCT-based measurement of degree and distribution of tissue mineralization in a quantitative, spatially resolved manner. Specifically, μCT measures of bone mineral content (BMC) and TMD were compared to those obtained by SRμCT and gravimetric methods. Cylinders of trabecular bone were machined from human femoral heads (n=5), vertebrae (n=5), and proximal tibiae (n=4). Cylinders were imaged in saline on a polychromatic μCT system at an isotropic voxel size of 8 μm. Volumes were reconstructed using beam hardening correction algorithms based on hydroxyapatite (HA)-resin wedge phantoms of 200 and 1200 mg HA∕cm3. SRμCT imaging was performed at an isotropic voxel size of 7.50 μm at the National Synchrotron Light Source. Attenuation values were converted to HA concentration using a linear regression derived by imaging a calibration phantom. Architecture and mineralization parameters were calculated from the image data. Specimens were processed using gravimetric methods to determine ash mass and density. μCT-based BMC values were not affected by altering the beam hardening correction. Volume-averaged TMD values calculated by the two corrections were significantly different (p=0.008) in high volume fraction specimens only, with the 1200 mg HA∕cm3 correction resulting in a 4.7% higher TMD value. μCT and SRμCT provided significantly different measurements of both BMC and TMD (p<0.05). In high volume fraction specimens, μCT with 1200 mg HA∕cm3 correction resulted in BMC and TMD values 16.7% and 15.0% lower, respectively, than SRμCT values. In low volume fraction specimens, μCT with 1200 mg HA∕cm3 correction resulted in BMC and TMD values 12.8% and 12.9% lower, respectively, than SRμCT values. μCT and SRμCT values were well-correlated when volume fraction groups were considered individually (BMC R2=0.97−1.00; TMD R2=0.78−0.99). Ash mass and density were higher than the SRμCT equivalents by 8.6% in high volume fraction specimens and 10.9% in low volume fraction specimens (p<0.05). BMC values calculated by tomography were highly correlated with ash mass (ash versus μCT R2=0.96−1.00; ash versus SRμCT R2=0.99−1.00). TMD values calculated by tomography were moderately correlated with ash density (ash versus μCT R2=0.64−0.72; ash versus SRμCT R2=0.64). Spatially resolved comparisons highlighted substantial geometric nonuniformity in the μCT data, which were reduced (but not eliminated) using the 1200 mg HA∕cm3 beam hardening correction, and did not exist in the SRμCT data. This study represents the first quantitative comparison of μCT mineralization evaluation against SRμCT and gravimetry. Our results indicate that μCT mineralization measures are underestimated but well-correlated with SRμCT and gravimetric data, particularly when volume fraction groups are considered individually. PMID:18697542

Tactile sensor is useful for estimating liver hardness and liver fibrosis compared with ultrasonography and computed tomography.

PubMed

Suzuki, Satoshi; Watanabe, Yohei; Yazawa, Takashi; Ishigame, Teruhide; Sassa, Motoki; Monma, Tomoyuki; Takawa, Tadashi; Kumamoto, Kensuke; Nakamura, Izumi; Ohoki, Shinji; Hatakeyama, Yuichi; Sakuma, Hiroshi; Ono, Toshiyuki; Omata, Sadao; Takenoshita, Seiichi

2014-01-01

We examined whether conventional ultrasonography (US) and computed tomography (CT) were useful to evaluate liver hardness and hepatic fibrosis by comparing the results with those obtained by a tactile sensor using rats with liver fibrosis. We used 44 Wistar rats in which liver fibrosis was induced by intraperitoneal administration of thioacetamide. The CT and US values of each liver were measured before laparotomy. After laparotomy, a tactile sensor was used to measure liver hardness. We prepared Azan stained sections of each excised liver specimen and calculated the degree of liver fibrosis (HFI: hepatic fibrosis index) by computed color image analysis. The stiffness values and HFI showed a positive correlation (r=0.690, p<0.001), as did the tactile values and HFI (r=0.709, p<0.001).In addition, the stiffness and tactile values correlated positively with each other (r=0.814, p<0.001). There was no correlation between the CT values and HFI, as well as no correlation between the US values and HFI. We confirmed that it was difficult to evaluate liver hardness and HFI by CT or US examination, and considered that, at present, a tactile sensor is useful method for evaluating HFI.

Semiautomated thyroid volumetry using 3D CT: prospective comparison with measurements obtained using 2D ultrasound, 2D CT, and water displacement method of specimen.

PubMed

Lee, Sun Jin; Chong, Semin; Kang, Kyung Ho; Hur, Joonho; Hong, Byung-Woo; Kim, Hyun Jung; Kim, Soo Jin

2014-11-01

The objective of our study was to measure thyroid volumes using semiautomated 3D CT and to compare the 3D CT volumes with volumes measured using 2D ultrasound, 2D CT, and the water displacement method. In 47 patients, 2D ultrasound volumes and 2D CT volumes of the thyroid gland were estimated using the ellipsoid volume formula, and 3D CT volumes were calculated using semiautomated reconstructive techniques. All volume data were compared with thyroid specimen volumes obtained using the water displacement method and were statistically analyzed using the one-way ANOVA, the Pearson correlation coefficient (R), linear regression, and the concordance correlation coefficient (CCC). The processing time of semiautomated 3D CT thyroid volumetry was measured. The paired mean differences ± SD between the three imaging-determined volumes and the specimen volumes were 0.8 ± 3.1 mL for 2D ultrasound, 4.0 ± 4.7 mL for 2D CT, and 0.2 ± 2.5 mL for 3D CT. A significant difference in the mean thyroid volume was found between 2D CT and specimen volumes (p = 0.016) compared with the other pairs (p = 0.937 for 2D ultrasound mean volume vs specimen mean volume, and p = 0.999 for 3D CT mean volume vs specimen mean volume). Between specimen volume and 2D ultrasound volume, specimen volume and 2D CT volume, and specimen volume and 3D CT volume, R values were 0.885, 0.724, and 0.929, respectively, and CCC values were 0.876, 0.598, and 0.925, respectively. The mean processing time of semiautomated 3D CT thyroid volumetry was 7.0 minutes. Thyroid volumes measured using 2D ultrasound or semiautomated 3D CT are substantially close to thyroid specimen volumes measured using the water displacement method. Semiautomated 3D CT thyroid volumetry can provide a more reliable measure of thyroid volume than 2D ultrasound.

Metal artifact reduction through MVCBCT and kVCT in radiotherapy

NASA Astrophysics Data System (ADS)

Liugang, Gao; Hongfei, Sun; Xinye, Ni; Mingming, Fang; Zheng, Cao; Tao, Lin

2016-11-01

This study proposes a new method for removal of metal artifacts from megavoltage cone beam computed tomography (MVCBCT) and kilovoltage CT (kVCT) images. Both images were combined to obtain prior image, which was forward projected to obtain surrogate data and replace metal trace in the uncorrected kVCT image. The corrected image was then reconstructed through filtered back projection. A similar radiotherapy plan was designed using the theoretical CT image, the uncorrected kVCT image, and the corrected image. The corrected images removed most metal artifacts, and the CT values were accurate. The corrected image also distinguished the hollow circular hole at the center of the metal. The uncorrected kVCT image did not display the internal structure of the metal, and the hole was misclassified as metal portion. Dose distribution calculated based on the corrected image was similar to that based on the theoretical CT image. The calculated dose distribution also evidently differed between the uncorrected kVCT image and the theoretical CT image. The use of the combined kVCT and MVCBCT to obtain the prior image can distinctly improve the quality of CT images containing large metal implants.

Accuracy of CT-based attenuation correction in PET/CT bone imaging

NASA Astrophysics Data System (ADS)

Abella, Monica; Alessio, Adam M.; Mankoff, David A.; MacDonald, Lawrence R.; Vaquero, Juan Jose; Desco, Manuel; Kinahan, Paul E.

2012-05-01

We evaluate the accuracy of scaling CT images for attenuation correction of PET data measured for bone. While the standard tri-linear approach has been well tested for soft tissues, the impact of CT-based attenuation correction on the accuracy of tracer uptake in bone has not been reported in detail. We measured the accuracy of attenuation coefficients of bovine femur segments and patient data using a tri-linear method applied to CT images obtained at different kVp settings. Attenuation values at 511 keV obtained with a 68Ga/68Ge transmission scan were used as a reference standard. The impact of inaccurate attenuation images on PET standardized uptake values (SUVs) was then evaluated using simulated emission images and emission images from five patients with elevated levels of FDG uptake in bone at disease sites. The CT-based linear attenuation images of the bovine femur segments underestimated the true values by 2.9 ± 0.3% for cancellous bone regardless of kVp. For compact bone the underestimation ranged from 1.3% at 140 kVp to 14.1% at 80 kVp. In the patient scans at 140 kVp the underestimation was approximately 2% averaged over all bony regions. The sensitivity analysis indicated that errors in PET SUVs in bone are approximately proportional to errors in the estimated attenuation coefficients for the same regions. The variability in SUV bias also increased approximately linearly with the error in linear attenuation coefficients. These results suggest that bias in bone uptake SUVs of PET tracers ranges from 2.4% to 5.9% when using CT scans at 140 and 120 kVp for attenuation correction. Lower kVp scans have the potential for considerably more error in dense bone. This bias is present in any PET tracer with bone uptake but may be clinically insignificant for many imaging tasks. However, errors from CT-based attenuation correction methods should be carefully evaluated if quantitation of tracer uptake in bone is important.

Comparison of SUL values in oncological 18F-FDG PET/CT; The effect of new LBM formulas.

PubMed

Halsne, Trygve; Müller, Ebba Glørsen; Spiten, Ann-Eli; Sherwani, Alexander Gul; Mikalsen, Lars Tore Gyland; Rootwelt-Revheim, Mona-Elisabeth; Stokke, Caroline

2018-03-29

Due to better precision and intercompatibility, the use of lean body mass (LBM) as mass estimate in the calculation of standardized uptake values (SUV) has become more common in research and clinical studies today. Thus, the equations deciding this quantity have to be verified in order to choose the ones that best represents the actual body composition. Methods: LBM was calculated for 44 patients examined with 18 F-FDG PET/CT scans by means of James' and Janmahasatians' sex specific predictive equations and the results validated using a CT based methods. The latter method makes use of the eyes-to-thighs CT from the PET/CT acquisition protocol and segments the voxels according to Hounsfield Units. Intraclass correlation coefficients (ICC) and Bland-Altman plots have been used to assess agreement between the various methods. Results: A mean difference of 6.3kg (-15.1 kg to 2.5 kg LOA) between LBM james and LBM CT1 was found. This is higher than the observed mean difference of 3.8kg (-12.5 kg to 4.9 kg LOA) between LBM jan and LBM CT1 In addition, LBM jan had higher ICC with LBM CT1 of r I = 0.87 ( r L = 0.60, r U = 0.94) than LBM james with r I = 0.77 ( r L = 0.11, r U = 0.91). Thus, we obtained better agreement between and LBM jan and LBM CT1 Although there were exceptions, the overall effect on SUL values was that SULjames values were greater than SULjan values. Conclusion: From our results, we have verified the reliability of the LBM jan suggested formulas with a CT derived reference standard. Compared with the more traditional and available set of equations LBM james the LBM jan formulas tend to yield better agreement. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Comparison of three-view thoracic radiography and computed tomography for detection of pulmonary nodules in dogs with neoplasia.

PubMed

Armbrust, Laura J; Biller, David S; Bamford, Aubrey; Chun, Ruthanne; Garrett, Laura D; Sanderson, Michael W

2012-05-01

To compare the detection of pulmonary nodules by use of 3-view thoracic radiography and CT in dogs with confirmed neoplasia. Prospective case series. 33 dogs of various breeds. 3 interpreters independently evaluated 3-view thoracic radiography images. The location and size of pulmonary nodules were recorded. Computed tomographic scans of the thorax were obtained and evaluated by a single interpreter. The location, size, margin, internal architecture, and density of pulmonary nodules were recorded. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for thoracic radiography (with CT as the gold standard). 21 of 33 (64%) dogs had pulmonary nodules or masses detected on CT. Of the dogs that had positive CT findings, 17 of 21 (81%) had pulmonary nodules or masses detected on radiographs by at least 1 interpreter. Sensitivity of radiography ranged from 71% to 95%, and specificity ranged from 67% to 92%. Radiography had a positive predictive value of 83% to 94% and a negative predictive value of 65% to 89%. The 4 dogs that were negative for nodules on thoracic radiography but positive on CT were all large-breed to giant-breed dogs with osteosarcoma. CT was more sensitive than radiography for detection of pulmonary nodules. This was particularly evident in large-breed to giant-breed dogs. Thoracic CT is recommended in large-breed to giant-breed dogs with osteosarcoma if the detection of pulmonary nodules will change treatment.

In Vivo Evaluation of Chemical Composition of Eight Types of Urinary Calculi Using Spiral Computerized Tomography in a Chinese Population.

PubMed

Huo, Jun; Liu, Zhong-Yuan; Wang, Ke-Feng; Xu, Zhen-Qun

2015-09-01

This study was conducted to evaluate the chemical composition of eight types of urinary calculi using spiral computerized tomography (CT) in vivo. From October 2011 to February 2013, upper urinary tract calculi were obtained from 122 patients in the department of urinary surgery of the First Affiliated Hospital of Soochow University. All patients were scanned with a 64-detector row helical CT scanner using 6.50 mm collimation before ureterorenoscopy. Data from the preoperative spiral CT scans and postoperative chemical composition of urinary calculi were collected. The chemical composition analysis indicates that there were five types of pure calculi and three types of mixed calculi, including 39 calcium oxalate calculi, 12 calcium phosphate calculi, 10 calcium carbonate calculi, 8 magnesium ammonium phosphate calculi, 6 carbonated apatite, 21 uric acid/ammonium urate calculi, 10 uric acid/calcium oxalate calculi, and 16 calcium oxalate/calcium phosphate calculi. There were significant differences in the mean CT values among the five types of pure calculi (P < 0.001). Furthermore, we also observed significant differences in the mean CT values among three types of mixed calculi (P < 0.001). Significant differences in the mean CT values were also found among eight types of urinary calculi (P < 0.001). However, no statistically significant difference was observed between the mean CT values of magnesium ammonium phosphate calculi and uric acid/calcium oxalate calculi (P = 0.262). Our findings suggest that spiral CT could be a promising tool for determining the chemical composition of upper urinary tract calculi. © 2014 Wiley Periodicals, Inc.

Age- and gender-specific estimates of cumulative CT dose over 5 years using real radiation dose tracking data in children.

PubMed

Lee, Eunsol; Goo, Hyun Woo; Lee, Jae-Yeong

2015-08-01

It is necessary to develop a mechanism to estimate and analyze cumulative radiation risks from multiple CT exams in various clinical scenarios in children. To identify major contributors to high cumulative CT dose estimates using actual dose-length product values collected for 5 years in children. Between August 2006 and July 2011 we reviewed 26,937 CT exams in 13,803 children. Among them, we included 931 children (median age 3.5 years, age range 0 days-15 years; M:F = 533:398) who had 5,339 CT exams. Each child underwent at least three CT scans and had accessible radiation dose reports. Dose-length product values were automatically extracted from DICOM files and we used recently updated conversion factors for age, gender, anatomical region and tube voltage to estimate CT radiation dose. We tracked the calculated CT dose estimates to obtain a 5-year cumulative value for each child. The study population was divided into three groups according to the cumulative CT dose estimates: high, ≥30 mSv; moderate, 10-30 mSv; and low, <10 mSv. We reviewed clinical data and CT protocols to identify major contributors to high and moderate cumulative CT dose estimates. Median cumulative CT dose estimate was 5.4 mSv (range 0.5-71.1 mSv), and median number of CT scans was 4 (range 3-36). High cumulative CT dose estimates were most common in children with malignant tumors (57.9%, 11/19). High frequency of CT scans was attributed to high cumulative CT dose estimates in children with ventriculoperitoneal shunt (35 in 1 child) and malignant tumors (range 18-49). Moreover, high-dose CT protocols, such as multiphase abdomen CT (median 4.7 mSv) contributed to high cumulative CT dose estimates even in children with a low number of CT scans. Disease group, number of CT scans, and high-dose CT protocols are major contributors to higher cumulative CT dose estimates in children.

SU-E-J-242: Volume-Dependence of Quantitative Imaging Features From CT and CE-CT Images of NSCLC

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

Fave, X; Fried, D; UT Health Science Center Graduate School of Biomedical Sciences, Houston, TX

Purpose: To determine whether tumor volume plays a significant role in the values obtained for texture features when they are extracted from computed tomography (CT) images of non-small cell lung cancer (NSCLC). We also sought to identify whether features can be reliably measured at all volumes or if a minimum volume threshold should be recommended. Methods: Eleven features were measured on 40 CT and 32 contrast-enhanced CT (CECT) patient images for this study. Features were selected for their prognostic/diagnostic value in previous publications. Direct correlations between these textures and volume were evaluated using the Spearman correlation coefficient. Any texture thatmore » the Wilcoxon rank-sum test was used to compare the variation above and below a volume cutoff. Four different volume thresholds (5, 10, 15, and 20 cm{sup 3}) were tested. Results: Four textures were found to be significantly correlated with volume in both the CT and CE-CT images. These were busyness, coarseness, gray-level nonuniformity, and run-length nonuniformity with correlation coefficients of 0.92, −0.96, 0.94, and 0.98 for the CT images and 0.95, −0.97, 0.98, and 0.98 for the CE-CT images. After volume normalization, the correlation coefficients decreased substantially. For the data obtained from the CT images, the results of the Wilcoxon rank-sum test were significant when volume thresholds of 5–15 cm3 were used. No volume threshold was shown to be significant for the CE-CT data. Conclusion: Equations for four features that have been used in several published studies were found to be volume-dependent. Future studies should consider implementing normalization factors or removing these features entirely to prevent this potential source of redundancy or bias. This work was supported in part by National Cancer Institute grant R03CA178495-01. Xenia Fave is a recipient of the American Association of Physicists in Medicine Graduate Fellowship.« less

Comparison of clinical tools for measurements of regional stress and rest myocardial blood flow assessed with 13N-ammonia PET/CT.

PubMed

Slomka, Piotr J; Alexanderson, Erick; Jácome, Rodrigo; Jiménez, Moises; Romero, Edgar; Meave, Aloha; Le Meunier, Ludovic; Dalhbom, Magnus; Berman, Daniel S; Germano, Guido; Schelbert, Heinrich

2012-02-01

Several models for the quantitative analysis of myocardial blood flow (MBF) at stress and rest and myocardial flow reserve (MFR) with (13)N-ammonia myocardial perfusion PET have been implemented for clinical use. We aimed to compare quantitative results obtained from 3 software tools (QPET, syngo MBF, and PMOD), which perform PET MBF quantification with either a 2-compartment model (QPET and syngo MBF) or a 1-compartment model (PMOD). We considered 33 adenosine stress and rest (13)N-ammonia studies (22 men and 11 women). Average age was 54.5 ± 15 y, and average body mass index was 26 ± 4.2. Eighteen patients had a very low likelihood of disease, with no chest pain, normal relative perfusion results, and normal function. All data were obtained on a PET/CT scanner in list mode with CT attenuation maps. Sixteen dynamic frames were reconstructed (twelve 10-s, two 30-s, one 1-min, and one 6-min frames). Global and regional stress and rest MBF and MFR values were obtained with each tool. Left ventricular contours and input function region were obtained automatically in system QPET and syngo MBF and manually in PMOD. The flow values and MFR values were highly correlated among the 3 packages (R(2) ranging from 0.88 to 0.92 for global values and from 0.78 to 0.94 for regional values. Mean reference MFR values were similar for QPET, syngo MBF, and PMOD (3.39 ± 1.22, 3.41 ± 0.76, and 3.66 ± 1.19, respectively) by 1-way ANOVA (P = 0.74). The lowest MFR in very low likelihood patients in any given vascular territory was 2.25 for QPET, 2.13 for syngo MBF, and 2.23 for PMOD. Different implementations of 1- and 2-compartment models demonstrate an excellent correlation in MFR for each vascular territory, with similar mean MFR values.

Measurement of lung expansion with computed tomography and comparison with quantitative histology.

PubMed

Coxson, H O; Mayo, J R; Behzad, H; Moore, B J; Verburgt, L M; Staples, C A; Paré, P D; Hogg, J C

1995-11-01

The total and regional lung volumes were estimated from computed tomography (CT), and the pleural pressure gradient was determined by using the milliliters of gas per gram of tissue estimated from the X-ray attenuation values and the pressure-volume curve of the lung. The data show that CT accurately estimated the volume of the resected lobe but overestimated its weight by 24 +/- 19%. The volume of gas per gram of tissue was less in the gravity-dependent regions due to a pleural pressure gradient of 0.24 +/- 0.08 cmH2O/cm of descent in the thorax. The proportion of tissue to air obtained with CT was similar to that obtained by quantitative histology. We conclude that the CT scan can be used to estimate total and regional lung volumes and that measurements of the proportions of tissue and air within the thorax by CT can be used in conjunction with quantitative histology to evaluate lung structure.

[Left ventricular volume determination by first-pass radionuclide angiocardiography using a semi-geometric count-based method].

PubMed

Kinoshita, S; Suzuki, T; Yamashita, S; Muramatsu, T; Ide, M; Dohi, Y; Nishimura, K; Miyamae, T; Yamamoto, I

1992-01-01

A new radionuclide technique for the calculation of left ventricular (LV) volume by the first-pass (FP) method was developed and examined. Using a semi-geometric count-based method, the LV volume can be measured by the following equation: CV = CM/(L/d). V = (CT/CV) x d3 = (CT/CM) x L x d2. (V = LV volume, CV = voxel count, CM = the maximum LV count, CT = the total LV count, L = LV depth where the maximum count was obtained, and d = pixel size.) This theorem was applied to FP LV images obtained in the 30-degree right anterior oblique position. Frame-mode acquisition was performed and the LV end-diastolic maximum count and total count were obtained. The maximum LV depth was obtained as the maximum width of the LV on the FP end-diastolic image, using the assumption that the LV cross-section is circular. These values were substituted in the above equation and the LV end-diastolic volume (FP-EDV) was calculated. A routine equilibrium (EQ) study was done, and the end-diastolic maximum count and total count were obtained. The LV maximum depth was measured on the FP end-diastolic frame, as the maximum length of the LV image. Using these values, the EQ-EDV was calculated and the FP-EDV was compared to the EQ-EDV. The correlation coefficient for these two values was r = 0.96 (n = 23, p less than 0.001), and the standard error of the estimated volume was 10 ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparing SUV values of images at PET-CT console and the RT planning console using identical dataset of a study phantom.

PubMed

Munshi, Anusheel; Paul, Sayan; Sarkar, Biplab; Bala, Pinkey; Ganesh, Tharmar; Sen, Ishita B; Pant, Vineet; Mohanti, Bidhu K

2016-01-01

The use of positron emission tomography (PET) for radiotherapy planning purposes has become increasingly important in the last few years.In the current study, we compared the SUV values of images at the PET CT console to the SUV values obtained at the RT planning workstation. The PET-CT cylindrical body phantom was filled with a uniform 18F solution of 5.3. ± 0.27 kBq/mL radioactivity concentration. PET-CT scans were performed on a16 slice Time of Flight system. On a single day, the three consecutive scans were done at three time points 15 minutes apart to generate time points image data sets titled T1, T2, and T3. SUV calculations were performed by drawing region of interest. (ROI) encompassing the entire hot spot on each slice on the PET-CT console and the iPlan workstation. Minimum SUV, Maximum SUV and the Mean SUV were recorded. Statistical analysis was done using the SPSS software. (SPSS Inc.) (Version 18). The absolute difference in average max SUV values i.e. Max (PET-CT) - Max (iPlan) for the time points T1, T2 and T3 were -0.168 (SD 0.175), -0.172 (SD 0.172) and -0.178 (SD 0.169). The difference in the minimum SUV values were -0.513 (SD 0.428), -0.311 (SD 0.358) and -0.303 (SD 0.322), respectively. Finally, the difference in the mean SUV values were -0.107 (SD 0.040), -0.096 (SD 0.067) and -0.072 (SD 0.044), respectively. Our study found out that the average difference in the two systems for maximum SUV values was < 0.2 absolute units.Our study suggests good reproducibility of SUV between the two systems. The relevance of these findings would be of seminal importance in current and future SUV-based PET-CT-based contouring in treatment planning systems.

Comparison of skeletal stability after sagittal split ramus osteotomy with and without extraction of the third molar in patients with mandibular prognathism.

PubMed

Moroi, Akinori; Yoshizawa, Kunio; Iguchi, Ran; Hiroumi, Ikawa; Kosaka, Akihiko; Hotta, Asami; Tsutsui, Takamitsu; Saita, Yuriko; Ueki, Koichiro

2015-09-01

The purpose of this study was to evaluate, through cephalometric analysis, the skeletal stability following BSSRO performed with and without extraction of the third molar, and to examine the healing of the extraction sockets through computed tomography (CT). Sixty Japanese patients (male: 14, female: 46) diagnosed with mandibular prognathism were included in this study. While 30 patients underwent BSSRO along with extraction of the third molar (extraction group), the other 30 patients underwent BSSRO alone (non-extraction group). Skeletal stability was assessed using axial, frontal, and lateral cephalograms. CT scans were obtained 1 week after surgery and at the 1-year follow-up for all the patients. CT value was measured at the point of the extraction socket on the horizontal plane parallel to the Frankfurt plane using computer software (SimPlant 2011; Materialise Dental, Leuven, Belgium). The region of interest (ROI) was approximately 4 mm(2) and the mean value was recorded. Healing of the extraction sockets was examined through CT 1 year postoperatively. There were no significant differences between the groups for any of the parameters at any observation interval. In the extraction group, there were significant differences between the values of CT obtained 1 week postoperatively and 1 year postoperatively in the extraction socket (P = 0.0003). The results of this study indicate that there is no significant difference in the skeletal stability between BSSRO performed with and without third molar extraction. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Adapting anatomy teaching to surgical trends: a combination of classical dissection, medical imaging, and 3D-printing technologies.

PubMed

Fasel, Jean H D; Aguiar, Diego; Kiss-Bodolay, Daniel; Montet, Xavier; Kalangos, Afksendiyos; Stimec, Bojan V; Ratib, Osman

2016-04-01

Many regions worldwide report difficulties in recruiting applicants to surgery. One strategy proposed to reverse this trend consists of early exposure of medical students to the field. Against this backdrop, the present study presents an innovative approach for anatomy teaching, integrating a surgically relevant trend: 3D printing. Whole-body computed tomography (CT) was made of two cadavers. Twelve students performed measurements and 3D reconstructions of selected anatomical structures (Osirix, Mimics). 3D printed (3DP) models were obtained (ZPrinter 310 Plus), and the students completed the analogous measurements on these replicas. Finally, classical anatomical dissection was performed and the same parameters were measured. The differences between the values obtained by the three modalities were submitted to standard statistical analysis (Wilcoxon two-tail paired test). Qualitative comparison of the digital 3D reconstructions based on the students' manual CT segmentation and the anatomical reality showed excellent correlation. Quantitatively, the values measured on the CT images and the physical models created by 3D printing differed from those measured on the cadavers by less than 2 mm. Students were highly appreciative of the approach (CT, 3DP, cadaver). Their average satisfaction score was 5.8 on a 1-6 scale. This study shows that the approach proposed can be achieved. The results obtained also show that CT-based 3D printed models are close to the authentic anatomic reality. The program allows early and interactive exposure of medical students to a surgically relevant trend-in this case 3D printing.

Effective doses to patients undergoing thoracic computed tomography examinations.

PubMed

Huda, W; Scalzetti, E M; Roskopf, M

2000-05-01

The purpose of this study was to investigate how x-ray technique factors and effective doses vary with patient size in chest CT examinations. Technique factors (kVp, mAs, section thickness, and number of sections) were recorded for 44 patients who underwent a routine chest CT examination. Patient weights were recorded together with dimensions and mean Hounsfield unit values obtained from representative axial CT images. The total mass of directly irradiated patient was modeled as a cylinder of water to permit the computation of the mean patient dose and total energy imparted for each chest CT examination. Computed values of energy imparted during the chest CT examination were converted into effective doses taking into account the patient weight. Patient weights ranged from 4.5 to 127 kg, and half the patients in this study were children under 18 years of age. All scans were performed at 120 kVp with a 1 s scan time. The selected tube current showed no correlation with patient weight (r2=0.06), indicating that chest CT examination protocols do not take into account for the size of the patient. Energy imparted increased with increasing patient weight, with values of energy imparted for 10 and 70 kg patients being 85 and 310 mJ, respectively. The effective dose showed an inverse correlation with increasing patient weight, however, with values of effective dose for 10 and 70 kg patients being 9.6 and 5.4 mSv, respectively. Current CT technique factors (kVp/mAs) used to perform chest CT examinations result in relatively high patient doses, which could be reduced by adjusting technique factors based on patient size.

Monte Carlo simulations of the dose from imaging with GE eXplore 120 micro-CT using GATE

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

Bretin, Florian; Bahri, Mohamed Ali; Luxen, André

Purpose: Small animals are increasingly used as translational models in preclinical imaging studies involving microCT, during which the subjects can be exposed to large amounts of radiation. While the radiation levels are generally sublethal, studies have shown that low-level radiation can change physiological parameters in mice. In order to rule out any influence of radiation on the outcome of such experiments, or resulting deterministic effects in the subjects, the levels of radiation involved need to be addressed. The aim of this study was to investigate the radiation dose delivered by the GE eXplore 120 microCT non-invasively using Monte Carlo simulationsmore » in GATE and to compare results to previously obtained experimental values. Methods: Tungsten X-ray spectra were simulated at 70, 80, and 97 kVp using an analytical tool and their half-value layers were simulated for spectra validation against experimentally measured values of the physical X-ray tube. A Monte Carlo model of the microCT system was set up and four protocols that are regularly applied to live animal scanning were implemented. The computed tomography dose index (CTDI) inside a PMMA phantom was derived and multiple field of view acquisitions were simulated using the PMMA phantom, a representative mouse and rat. Results: Simulated half-value layers agreed with experimentally obtained results within a 7% error window. The CTDI ranged from 20 to 56 mGy and closely matched experimental values. Derived organ doses in mice reached 459 mGy in bones and up to 200 mGy in soft tissue organs using the highest energy protocol. Dose levels in rats were lower due to the increased mass of the animal compared to mice. The uncertainty of all dose simulations was below 14%. Conclusions: Monte Carlo simulations proved a valuable tool to investigate the 3D dose distribution in animals from microCT. Small animals, especially mice (due to their small volume), receive large amounts of radiation from the GE eXplore 120 microCT, which might alter physiological parameters in a longitudinal study setup.« less

Focal Low and Global High Permeability Predict the Possibility, Risk, and Location of Hemorrhagic Transformation following Intra-Arterial Thrombolysis Therapy in Acute Stroke.

PubMed

Li, Y; Xia, Y; Chen, H; Liu, N; Jackson, A; Wintermark, M; Zhang, Y; Hu, J; Wu, B; Zhang, W; Tu, J; Su, Z; Zhu, G

2017-09-01

The contrast volume transfer coefficient ( K trans ), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation. We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment. K trans maps were obtained with first-pass perfusion CT data. The K trans values at the region level, obtained with the Alberta Stroke Program Early CT Score system, were compared to determine the differences between the hemorrhagic transformation and nonhemorrhagic transformation regions. The K trans values of the whole ischemic region based on baseline perfusion CT were obtained as a variable to hemorrhagic transformation possibility at the global level. Forty-eight (45.3%) patients had hemorrhagic transformation, and 21 (19.8%) had symptomatic intracranial hemorrhage. At the region level, there were 82 ROIs with hemorrhagic transformation and parenchymal hemorrhage with a mean K trans , 0.5 ± 0.5/min, which was significantly lower than that in the nonhemorrhagic transformation regions ( P < .01). The mean K trans value of 615 nonhemorrhagic transformation ROIs was 0.7 ± 0.6/min. At the global level, there was a significant difference ( P = .01) between the mean K trans values of patients with symptomatic intracranial hemorrhage (1.3 ± 0.9) and those without symptomatic intracranial hemorrhage (0.8 ± 0.4). Only a high K trans value at the global level could predict the occurrence of symptomatic intracranial hemorrhage ( P < .01; OR = 5.04; 95% CI, 2.01-12.65). Global high K trans values can predict the likelihood of hemorrhagic transformation or symptomatic intracranial hemorrhage at the patient level, whereas focal low K trans values can predict the spatial distributions of hemorrhagic transformation at the region level. © 2017 by American Journal of Neuroradiology.

Metastases to the Liver from Neuroendocrine Tumors: Effect of Duration of Scan Acquisition on CT Perfusion Values

PubMed Central

Hobbs, Brian P.; Chandler, Adam G.; Anderson, Ella F.; Herron, Delise H.; Charnsangavej, Chusilp; Yao, James

2013-01-01

Purpose To assess the effects of acquisition duration on computed tomographic (CT) perfusion parameter values in neuroendocrine liver metastases and normal liver tissue. Materials and Methods This retrospective study was institutional review board approved, with waiver of informed consent. CT perfusion studies in 16 patients (median age, 57.5 years; range, 42.0–69.7 years), including six men (median, 54.1 years; range, 42.0–69.7), and 10 women (median, 59.3 years; range 43.6–66.3), with neuroendocrine liver metastases were analyzed by means of distributed parametric modeling to determine tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction for tumors and normal liver tissue. Analyses were undertaken with acquisition time of 12–590 seconds. Nonparameteric regression analyses were used to evaluate the functional relationships between CT perfusion parameters and acquisition duration. Evidence for time invariance was evaluated for each parameter at multiple time points by inferring the fitted derivative to assess its proximity to zero as a function of acquisition time by using equivalence tests with three levels of confidence (20%, 70%, and 90%). Results CT perfusion parameter values varied, approaching stable values with increasing acquisition duration. Acquisition duration greater than 160 seconds was required to obtain at least low confidence stability in any of the CT perfusion parameters. At 160 seconds of acquisition, all five CT perfusion parameters stabilized with low confidence in tumor and normal tissues, with the exception of hepatic arterial fraction in tumors. After 220 seconds of acquisition, there was stabilization with moderate confidence for blood flow, blood volume, and hepatic arterial fraction in tumors and normal tissue, and for mean transit time in tumors; however, permeability values did not satisfy the moderate stabilization criteria in both tumors and normal tissue until 360 seconds of acquisition. Blood flow, mean transit time, permeability, and hepatic arterial fraction were significantly different between tumor and normal tissue at 360 seconds (P < .001). Conclusion CT perfusion parameter values are affected by acquisition duration and approach progressively stable values with increasing acquisition times. © RSNA, 2013 Online supplemental material is available for this article. PMID:23824990

Lumber value differences from reduced CT spatial resolution and simulated log sawing

Treesearch

Suraphan Thawornwong; Luis G. Occena; Daniel L. Schmoldt

2003-01-01

In the past few years, computed tomography (CT) scanning technology has been applied to the detection of internal defects in hardwood logs for the purpose of obtaining a priori information that can be used to arrive at better log sawing decisions. Because sawyers currently cannot even see the inside of a log until the log faces are revealed by sawing, there is little...

Pulsed excitation terahertz tomography - multiparametric approach

NASA Astrophysics Data System (ADS)

Lopato, Przemyslaw

2018-04-01

This article deals with pulsed excitation terahertz computed tomography (THz CT). Opposite to x-ray CT, where just a single value (pixel) is obtained, in case of pulsed THz CT the time signal is acquired for each position. Recorded waveform can be parametrized - many features carrying various information about examined structure can be calculated. Based on this, multiparametric reconstruction algorithm was proposed: inverse Radon transform based reconstruction is applied for each parameter and then fusion of results is utilized. Performance of the proposed imaging scheme was experimentally verified using dielectric phantoms.

Comparison of synchrotron radiation and conventional x-ray microcomputed tomography for assessing trabecular bone microarchitecture of human femoral heads

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

Chappard, Christine; Basillais, Armelle; Benhamou, Laurent

Microcomputed tomography ({mu}CT) produces three-dimensional (3D) images of trabecular bone. We compared conventional {mu}CT (C{mu}CT) with a polychromatic x-ray cone beam to synchrotron radiation (SR) {mu}CT with a monochromatic parallel beam for assessing trabecular bone microarchitecture of 14 subchondral femoral head specimens from patients with osteoarthritis (n=10) or osteoporosis (n=4). SR{mu}CT images with a voxel size of 10.13 {mu}m were reconstructed from 900 2D radiographic projections (angular step, 0.2 deg. ). C{mu}CT images with a voxel size of 10.77 {mu}m were reconstructed from 205, 413, and 825 projections obtained using angular steps of 0.9 deg., 0.45 deg., and 0.23 deg.,more » respectively. A single threshold was used to binarize the images. We computed bone volume/tissue volume (BV/TV), bone surface/bone volume (BS/BV), trabecular number (Tb.N), trabecular thickness (Tb.Th and Tb.Th*), trabecular spacing (Tb.Sp), degree of anisotropy (DA), and Euler density. With the 0.9 deg. angular step, all C{mu}CT values were significantly different from SR{mu}CT values. With the 0.23 deg. and 0.45 deg. rotation steps, BV/TV, Tb.Th, and BS/BV by C{mu}CT differed significantly from the values by SR{mu}CT. The error due to slice matching (visual site matching {+-}10 slices) was within 1% for most parameters. Compared to SR{mu}CT, BV/TV, Tb.Sp, and Tb.Th by C{mu}CT were underestimated, whereas Tb.N and Tb.Th* were overestimated. A Bland and Altman plot showed no bias for Tb.N or DA. Bias was -0.8{+-}1.0%, +5.0{+-}1.1 {mu}m, -5.9{+-}6.3 {mu}m, and -5.7{+-}29.1 {mu}m for BV/TV, Tb.Th*, Tb.Th, and Tb.Sp, respectively, and the differences did not vary over the range of values. Although systematic differences were noted between SR{mu}CT and C{mu}CT values, correlations between the techniques were high and the differences would probably not change the discrimination between study groups. C{mu}CT provides a reliable 3D assessment of human defatted bone when working at the 0.23 deg. or 0.45 deg. rotation step; the 0.9 deg. rotation step may be insufficiently accurate for morphological bone analysis.« less

Reproducibility of CT Perfusion Parameters in Liver Tumors and Normal Liver

PubMed Central

Ng, Chaan S.; Chandler, Adam G.; Wei, Wei; Herron, Delise H.; Anderson, Ella F.; Kurzrock, Razelle; Charnsangavej, Chusilp

2011-01-01

Purpose: To assess the reproducibility of computed tomographic (CT) perfusion measurements in liver tumors and normal liver and effects of motion and data acquisition time on parameters. Materials and Methods: Institutional review board approval and written informed consent were obtained for this prospective study. The study complied with HIPAA regulations. Two CT perfusion scans were obtained 2–7 days apart in seven patients with liver tumors with two scanning phases (phase 1: 30-second breath-hold cine; phase 2: six intermittent free-breathing cines) spanning 135 seconds. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability–surface area product (PS) for tumors and normal liver were calculated from phase 1 with and without rigid registration and, for combined phases 1 and 2, with manually and rigid-registered phase 2 images, by using deconvolution modeling. Variability was assessed with within-patient coefficients of variation (CVs) and Bland-Altman analyses. Results: For tumors, BF, BV, MTT, and PS values and reproducibility varied by analytical method, the former by up to 11%, 23%, 21%, and 138%, respectively. Median PS values doubled with the addition of phase 2 data to phase 1 data. The best overall reproducibility was obtained with rigidly registered phase 1 and phase 2 images, with within-patient CVs for BF, BV, MTT, and PS of 11.2%, 14.4%, 5.5% and 12.1%, respectively. Normal liver evaluations were similar, except with marginally lower variability. Conclusion: Absolute values and reproducibility of CT perfusion parameters were markedly influenced by motion and data acquisition time. PS, in particular, probably requires data acquisition beyond a single breath hold, for which motion-correction techniques are likely necessary. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110331/-/DC1 PMID:21788525

An Indirect Method to Measure Abutment Screw Preload: A Pilot Study Based on Micro-CT Scanning.

PubMed

Rezende, Carlos Eduardo E; Griggs, Jason Alan; Duan, Yuanyuan; Mushashe, Amanda M; Nolasco, Gisele Maria Correr; Borges, Ana Flávia Sanches; Rubo, José Henrique

2015-01-01

This study aimed to measure the preload in different implant platform geometries based on micro-CT images. External hexagon (EH) implants and Morse Tapered (MT) implants (n=5) were used for the preload measurement. The abutment screws were scanned in micro-CT to obtain their virtual models, which were used to record their initial length. The abutments were screwed on the implant with a 20 Ncm torque and the set composed by implant, abutment screw and abutment were taken to the micro-CT scanner to obtain virtual slices of the specimens. These slices allowed the measurement of screw lengths after torque application and based on the screw elongation. Preload values were calculated using the Hooke's Law. The preloads of both groups were compared by independent t-test. Removal torque of each specimen was recorded. To evaluate the accuracy of the micro-CT technique, three rods with known lengths were scanned and the length of their virtual model was measured and compared with the original length. One rod was scanned four times to evaluate the measuring method variation. There was no difference between groups for preload (EH = 461.6 N and MT = 477.4 N), but the EH group showed higher removal torque values (13.8 ± 4.7 against 8.2 ± 3.6 N cm for MT group). The micro-CT technique showed a variability of 0.053% and repeatability showed an error of 0.23 to 0.28%. Within the limitations of this study, there was no difference between external hexagon and Morse taper for preload. The method using micro-CT may be considered for preload calculation.

Comparative characteristics of quantitative indexes for 18F-FDG uptake and metabolic volume in sequentially obtained PET/MRI and PET/CT.

PubMed

Lee, Soo Jin; Paeng, Jin Chul; Goo, Jin Mo; Lee, Jeong Min; Cheon, Gi Jeong; Lee, Dong Soo; Chung, June-Key; Kang, Keon Wook

2017-04-01

The purpose of this study was to compare quantitative indexes for fluorine-18 fluorodeoxyglucose uptake and metabolic volume between PET/MRI and PET/CT. Sixty-six patients with solid tumors (32 with lung cancer and 34 with pancreatic cancer) who underwent sequential fluorine-18 fluorodeoxyglucose PET/MRI and PET/CT were retrospectively enrolled. On PET images, maximum and peak standardized uptake values (SUVmax and SUVpeak, respectively), and maximum tumor-to-liver ratio (TLRmax) were measured. Metabolic tumor volume (MTV) and total-lesion glycolysis (TLG) with margin thresholds of 50% SUVmax and SUV 2.5 (MTV50%, MTV2.5; TLG50%, TLG2.5, respectively) were compared between PET/MRI and PET/CT, with patients classified into two groups using imaging protocol (the PET/MRI-first and PET/CT-first groups). There were significant correlations of all tested indexes between PET/MRI and PET/CT (r=0.867-0.987, P<0.001). SUVmax and SUVpeak were lower on PET/MRI regardless of imaging protocol (P<0.001 in the PET/MRI-first group). In contrast, TLRmax exhibited reverse results between the PET/MRI-first and PET/CT-first groups. MTV50% and TLG values varied between PET/MRI and PET/CT, as well as between the PET/MRI-first and PET/CT-first groups. However, MTV2.5 was relatively robust against imaging protocol and modality. There are significant correlations of the quantitative indexes between PET/MRI and PET/CT. However, uptake indexes of SUVmax and SUVpeak are lower on PET/MRI than on PET/CT, and volumetric indexes of MTV50% and TLG values also exhibited significant differences. It may be suggested that TLRmax and MTV2.5 are relatively more appropriate indexes than others when PET/MRI and PET/CT are used interchangeably.

Feasibility of MR-only proton dose calculations for prostate cancer radiotherapy using a commercial pseudo-CT generation method

NASA Astrophysics Data System (ADS)

Maspero, Matteo; van den Berg, Cornelis A. T.; Landry, Guillaume; Belka, Claus; Parodi, Katia; Seevinck, Peter R.; Raaymakers, Bas W.; Kurz, Christopher

2017-12-01

A magnetic resonance (MR)-only radiotherapy workflow can reduce cost, radiation exposure and uncertainties introduced by CT-MRI registration. A crucial prerequisite is generating the so called pseudo-CT (pCT) images for accurate dose calculation and planning. Many pCT generation methods have been proposed in the scope of photon radiotherapy. This work aims at verifying for the first time whether a commercially available photon-oriented pCT generation method can be employed for accurate intensity-modulated proton therapy (IMPT) dose calculation. A retrospective study was conducted on ten prostate cancer patients. For pCT generation from MR images, a commercial solution for creating bulk-assigned pCTs, called MR for Attenuation Correction (MRCAT), was employed. The assigned pseudo-Hounsfield Unit (HU) values were adapted to yield an increased agreement to the reference CT in terms of proton range. Internal air cavities were copied from the CT to minimise inter-scan differences. CT- and MRCAT-based dose calculations for opposing beam IMPT plans were compared by gamma analysis and evaluation of clinically relevant target and organ at risk dose volume histogram (DVH) parameters. The proton range in beam’s eye view (BEV) was compared using single field uniform dose (SFUD) plans. On average, a (2%, 2 mm) gamma pass rate of 98.4% was obtained using a 10% dose threshold after adaptation of the pseudo-HU values. Mean differences between CT- and MRCAT-based dose in the DVH parameters were below 1 Gy (<1.5% ). The median proton range difference was 0.1 mm, with on average 96% of all BEV dose profiles showing a range agreement better than 3 mm. Results suggest that accurate MR-based proton dose calculation using an automatic commercial bulk-assignment pCT generation method, originally designed for photon radiotherapy, is feasible following adaptation of the assigned pseudo-HU values.

Brain tissue segmentation in 4D CT using voxel classification

NASA Astrophysics Data System (ADS)

van den Boom, R.; Oei, M. T. H.; Lafebre, S.; Oostveen, L. J.; Meijer, F. J. A.; Steens, S. C. A.; Prokop, M.; van Ginneken, B.; Manniesing, R.

2012-02-01

A method is proposed to segment anatomical regions of the brain from 4D computer tomography (CT) patient data. The method consists of a three step voxel classification scheme, each step focusing on structures that are increasingly difficult to segment. The first step classifies air and bone, the second step classifies vessels and the third step classifies white matter, gray matter and cerebrospinal fluid. As features the time averaged intensity value and the temporal intensity change value were used. In each step, a k-Nearest-Neighbor classifier was used to classify the voxels. Training data was obtained by placing regions of interest in reconstructed 3D image data. The method has been applied to ten 4D CT cerebral patient data. A leave-one-out experiment showed consistent and accurate segmentation results.

Can pleural adenosine deaminase (ADA) levels in pleural tuberculosis predict the presence of pulmonary tuberculosis? A CT analysis.

PubMed

Koh, Myung Je; Lee, In Jae; Kim, Joo-Hee

2016-06-01

To assess the relationship between imaging features of pulmonary tuberculosis at computed tomography (CT) and adenosine deaminase (ADA) values via pleural fluid analysis in patients with pleural tuberculosis. This retrospective study enrolled 60 patients who underwent fluid analysis for ADA and chest CT and were diagnosed with tuberculosis by culture or polymerase chain reaction of pleural fluid and sputum. The presence of centrilobular nodules, consolidation, cavitation, and mediastinal lymphadenopathy at CT were evaluated. The relationship between ADA values and the pattern of pulmonary involvement of tuberculosis was analysed. Pulmonary involvement was seen in 42 of the 60 patients. A centrilobular nodular pattern was seen in 37 and consolidation in 22. In 17 patients, both findings were identified. A centrilobular nodular pattern was more common than consolidation or cavitary lesions. When ADA values were high, pulmonary involvement was more frequent (p=0.002). Comparing low and high ADA groups using an obtained cut-off value of 80 IU/l, the high group had more frequent pulmonary involvement (p<0.001). Patients with tuberculous pleurisy who had high ADA values had a higher probability of manifesting pulmonary tuberculosis. High ADA values may help predict contagious pleuroparenchymal tuberculosis. The most common pulmonary involvement of tuberculous pleurisy showed a centrilobular nodular pattern. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Convolutional auto-encoder for image denoising of ultra-low-dose CT.

PubMed

Nishio, Mizuho; Nagashima, Chihiro; Hirabayashi, Saori; Ohnishi, Akinori; Sasaki, Kaori; Sagawa, Tomoyuki; Hamada, Masayuki; Yamashita, Tatsuo

2017-08-01

The purpose of this study was to validate a patch-based image denoising method for ultra-low-dose CT images. Neural network with convolutional auto-encoder and pairs of standard-dose CT and ultra-low-dose CT image patches were used for image denoising. The performance of the proposed method was measured by using a chest phantom. Standard-dose and ultra-low-dose CT images of the chest phantom were acquired. The tube currents for standard-dose and ultra-low-dose CT were 300 and 10 mA, respectively. Ultra-low-dose CT images were denoised with our proposed method using neural network, large-scale nonlocal mean, and block-matching and 3D filtering. Five radiologists and three technologists assessed the denoised ultra-low-dose CT images visually and recorded their subjective impressions of streak artifacts, noise other than streak artifacts, visualization of pulmonary vessels, and overall image quality. For the streak artifacts, noise other than streak artifacts, and visualization of pulmonary vessels, the results of our proposed method were statistically better than those of block-matching and 3D filtering (p-values < 0.05). On the other hand, the difference in the overall image quality between our proposed method and block-matching and 3D filtering was not statistically significant (p-value = 0.07272). The p-values obtained between our proposed method and large-scale nonlocal mean were all less than 0.05. Neural network with convolutional auto-encoder could be trained using pairs of standard-dose and ultra-low-dose CT image patches. According to the visual assessment by radiologists and technologists, the performance of our proposed method was superior to that of large-scale nonlocal mean and block-matching and 3D filtering.

Comprehensive CT Evaluation in Acute Ischemic Stroke: Impact on Diagnosis and Treatment Decisions

PubMed Central

Löve, Askell; Siemund, Roger; Andsberg, Gunnar; Cronqvist, Mats; Holtås, Stig; Björkman-Burtscher, Isabella

2011-01-01

Background. With modern CT imaging a comprehensive overview of cerebral macro- and microcirculation can be obtained within minutes in acute ischemic stroke. This opens for patient stratification and individualized treatment. Methods. Four patients with acute ischemic stroke of different aetiologies and/or treatments were chosen for illustration of the comprehensive CT protocol and its value in subsequent treatment decisions. The patients were clinically evaluated according to the NIHSS-scale, examined with the comprehensive CT protocol including both CT angiography and CT perfusion, and followed up by MRI. Results. The comprehensive CT examination protocol increased the examination time but did not delay treatment initiation. In some cases CT angiography revealed the cause of stroke while CT perfusion located and graded the perfusion defect with reasonable accuracy, confirmed by follow-up MR-diffusion. In the presented cases findings of the comprehensive CT examination influenced the treatment strategy. Conclusions. The comprehensive CT examination is a fast and safe method allowing accurate diagnosis and making way for individualized treatment in acute ischemic stroke. PMID:21603175

[Impact of exposure dose reduction of radiation treatment planning CT using low tube voltage technique].

PubMed

Kouno, Takuya; Kuga, Noriyuki; Enzaki, Masahiro; Yamashita, Yuuki; Kitazato, Yumiko; Shimotabira, Haruhiko; Jinnouchi, Takashi; Kusuhara, Kazuo; Kawamura, Shinji

2015-04-01

The aim of this study was to reduce the exposed dose of radiotherapy treatment planning computed tomography (CT) by using low tube voltage technique. We used tube voltages of 80 kV, 100 kV, and 120 kV, respectively. First, we evaluated exposure dose with CT dose index (CTDI) for each voltage. Second, we compared image quality indexes such as modulation transfer function (MTF), noise power spectrum (NPS), and contrast to noise ratio (CNR) of phantom images with each voltage. Third, CT to electron density tables were measured in three voltages and monitor unit value was calculated along with clinical cases. Finally, CT surface exposed dose of chest skin was measured by thermoluminescent dosimeter (TLD). In image evaluation MTF and NPS were approximately equal; CNR slightly decreased, 2.0% for 100 kV. We performed check radiation dose accuracy for each tube voltage with each model phantom. As a result, the difference of MU value was not accepted. Finally, compared with 120 kV, CTDIvol and TLD value showed markedly decreased radiation dose, 60% for 80 kV and 30% for 100 kV. Using a technique with low tube voltages, especially 100 kV, is useful in radiotherapy treatment planning to obtain 20% dose reduction without compromising 120 kV image quality.

SU-D-206-05: A Critical Look at CBCT-Based Dose Calculation Accuracy as It Is Applied to Adaptive Radiotherapy

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

Bejarano Buele, A; Sperling, N; Parsai, E

2016-06-15

Purpose: Cone-beam CTs (CBCT) obtained from On-Board Imaging Devices (OBI) are increasingly being used for dose calculation purposes in adaptive radiotherapy. Patient and target morphology are monitored and the treatment plan is updated using CBCT. Due to the difference in image acquisition parameters, dose calculated in a CBCT can differ from planned dose. We evaluate the difference between dose calculation in kV CBCT and simulation CT, and the effect of HU-density tables in dose discrepancies Methods: HU values for various materials were obtained using a Catphan 504 phantom for a simulator CT (CTSIM) and two different OBI systems using threemore » imaging protocols: Head, Thorax and Pelvis. HU-density tables were created in the TPS for each OBI image protocol. Treatment plans were made on each Catphan 504 dataset and on the head, thorax and pelvis sections of an anthropomorphic phantom, with and without the respective HU-density table. DVH information was compared among OBI systems and planning CT. Results: Dose calculations carried on the Catphan 504 CBCTs, with and without the respective CT-density table, had a maximum difference of −0.65% from the values on the planning CT. The use of the respective HU-density table decreased the percent differences from planned values by half in most of the protocols. For the anthropomorphic phantom datasets, the use of the correct HU-density table reduced differences by 0.89% on OBI1 and 0.59% on OBI2 for the head, 0.49% on OBI1 for the thorax, and 0.25% on OBI2 for the pelvis. Differences from planned values without HU-density correction ranged from 3.13% (OBI1, thorax) to 0.30% (OBI2, thorax). Conclusion: CT-density tables in the TPS yield acceptable differences when used in partly homogeneous medium. Further corrections are needed when the medium contains pronounced density differences for accurate CBCT calculation. Current difference range (1–3%) can be clinically acceptable.« less

Lung texture in serial thoracic CT scans: Assessment of change introduced by image registration1

PubMed Central

Cunliffe, Alexandra R.; Al-Hallaq, Hania A.; Labby, Zacariah E.; Pelizzari, Charles A.; Straus, Christopher; Sensakovic, William F.; Ludwig, Michelle; Armato, Samuel G.

2012-01-01

Purpose: The aim of this study was to quantify the effect of four image registration methods on lung texture features extracted from serial computed tomography (CT) scans obtained from healthy human subjects. Methods: Two chest CT scans acquired at different time points were collected retrospectively for each of 27 patients. Following automated lung segmentation, each follow-up CT scan was registered to the baseline scan using four algorithms: (1) rigid, (2) affine, (3) B-splines deformable, and (4) demons deformable. The registration accuracy for each scan pair was evaluated by measuring the Euclidean distance between 150 identified landmarks. On average, 1432 spatially matched 32 × 32-pixel region-of-interest (ROI) pairs were automatically extracted from each scan pair. First-order, fractal, Fourier, Laws’ filter, and gray-level co-occurrence matrix texture features were calculated in each ROI, for a total of 140 features. Agreement between baseline and follow-up scan ROI feature values was assessed by Bland–Altman analysis for each feature; the range spanned by the 95% limits of agreement of feature value differences was calculated and normalized by the average feature value to obtain the normalized range of agreement (nRoA). Features with small nRoA were considered “registration-stable.” The normalized bias for each feature was calculated from the feature value differences between baseline and follow-up scans averaged across all ROIs in every patient. Because patients had “normal” chest CT scans, minimal change in texture feature values between scan pairs was anticipated, with the expectation of small bias and narrow limits of agreement. Results: Registration with demons reduced the Euclidean distance between landmarks such that only 9% of landmarks were separated by ≥1 mm, compared with rigid (98%), affine (95%), and B-splines (90%). Ninety-nine of the 140 (71%) features analyzed yielded nRoA > 50% for all registration methods, indicating that the majority of feature values were perturbed following registration. Nineteen of the features (14%) had nRoA < 15% following demons registration, indicating relative feature value stability. Student's t-tests showed that the nRoA of these 19 features was significantly larger when rigid, affine, or B-splines registration methods were used compared with demons registration. Demons registration yielded greater normalized bias in feature value change than B-splines registration, though this difference was not significant (p = 0.15). Conclusions: Demons registration provided higher spatial accuracy between matched anatomic landmarks in serial CT scans than rigid, affine, or B-splines algorithms. Texture feature changes calculated in healthy lung tissue from serial CT scans were smaller following demons registration compared with all other algorithms. Though registration altered the values of the majority of texture features, 19 features remained relatively stable after demons registration, indicating their potential for detecting pathologic change in serial CT scans. Combined use of accurate deformable registration using demons and texture analysis may allow for quantitative evaluation of local changes in lung tissue due to disease progression or treatment response. PMID:22894392

SU-F-I-59: Quality Assurance Phantom for PET/CT Alignment and Attenuation Correction

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

Lin, T; Hamacher, K

2016-06-15

Purpose: This study utilizes a commercial PET/CT phantom to investigate two specific properties of a PET/CT system: the alignment accuracy of PET images with those from CT used for attenuation correction and the accuracy of this correction in PET images. Methods: A commercial PET/CT phantom consisting of three aluminum rods, two long central cylinders containing uniform activity, and attenuating materials such as air, water, bone and iodine contrast was scanned using a standard PET/CT protocol. Images reconstructed with 2 mm slice thickness and a 512 by 512 matrix were obtained. The center of each aluminum rod in the PET andmore » CT images was compared to evaluate alignment accuracy. ROIs were drawn on transaxial images of the central rods at each section of attenuating material to determine the corrected activity (in BQML). BQML values were graphed as a function of slice number to provide a visual representation of the attenuation-correction throughout the whole phantom. Results: Alignment accuracy is high between the PET and CT images. The maximum deviation between the two in the axial plane is less than 1.5 mm, which is less than the width of a single pixel. BQML values measured along different sections of the large central rods are similar among the different attenuating materials except iodine contrast. Deviation of BQML values in the air and bone sections from the water section is less than 1%. Conclusion: Accurate alignment of PET and CT images is critical to ensure proper calculation and application of CT-based attenuation correction. This study presents a simple and quick method to evaluate the two with a single acquisition. As the phantom also includes spheres of increasing diameter, this could serve as a straightforward means to annually evaluate the status of a modern PET/CT system.« less

The usefulness of fluorine-18 fluorodeoxyglucose PET in the detection of recurrence in patients with differentiated thyroid cancer with elevated thyroglobulin and negative radioiodine whole-body scan.

PubMed

Stangierski, Adam; Kaznowski, Jaroslaw; Wolinski, Kosma; Jodlowska, Elzbieta; Michaliszyn, Piotr; Kubiak, Katarzyna; Czepczynski, Rafal; Ruchala, Marek

2016-09-01

PET/computed tomography (CT) using fluorine-18 fluorodeoxyglucose (F-FDG) has been used in the diagnosis of recurrence and metastases of differentiated thyroid cancer (DTC) in cases of negative whole-body scan (WBS) despite elevated concentrations of stimulated thyroglobulin (Tg). To assess the utility of PET/CT in the detection of recurrence among patients with DTC with increased Tg levels and negative results of WBS. PET/CT results were retrospectively analyzed in patients with DTC with increased Tg and negative results of WBS as well as negative cervical ultrasonography and chest radiography. PET-CT was performed 1-2 weeks after recent diagnostics under conditions of endogenous or exogenous thyroid-stimulating hormone stimulation. PET/CT was performed using a Discovery ST scanner 1 h after an intravenously F-FDG injection (activity 4-5 MBq/kg). To determine the cutoff value of Tg, receiver operating characteristic curves were analyzed. Sixty-nine patients with DTC (48 women, 21 men) aged 22-83 years (mean 50.9±17.5 years) were qualified. In 44 patients (63.8%), PET/CT indicated lesions of DTC. Thirty (43.5%) patients had F-FDG positive findings. In the remaining 14 patients (20.3%), lesions were found in CT only. Patients with a positive PET/CT scan had significantly higher Tg values than patients with a negative PET/CT (mean 143.8 vs. 26.5 ng/ml, P=0.03). The cutoff value of Tg concentration measured with the receiver operating characteristic analysis was 32.9 ng/ml. PET/CT is a useful tool in the detection of recurrence among thyroid cancer patients in cases of conflicting results of standard procedures, particularly for those with high Tg levels and negative WBS. The probability of obtaining a positive PET-CT result increases with the level of Tg.

Accuracies of the synthesized monochromatic CT numbers and effective atomic numbers obtained with a rapid kVp switching dual energy CT scanner

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

Goodsitt, Mitchell M.; Christodoulou, Emmanuel G.; Larson, Sandra C.

2011-04-15

Purpose: This study was performed to investigate the accuracies of the synthesized monochromatic images and effective atomic number maps obtained with the new GE Discovery CT750 HD CT scanner. Methods: A Gammex-RMI model 467 tissue characterization phantom and the CT number linearity section of a Phantom Laboratory Catphan 600 phantom were scanned using the dual energy (DE) feature on the GE CT750 HD scanner. Synthesized monochromatic images at various energies between 40 and 120 keV and effective atomic number (Z{sub eff}) maps were generated. Regions of interest were placed within these images/maps to measure the average monochromatic CT numbers andmore » average Z{sub eff} of the materials within these phantoms. The true Z{sub eff} values were either supplied by the phantom manufacturer or computed using Mayneord's equation. The linear attenuation coefficients for the true CT numbers were computed using the NIST XCOM program with the input of manufacturer supplied elemental compositions and densities. The effects of small variations in the assumed true densities of the materials were also investigated. Finally, the effect of body size on the accuracies of the synthesized monochromatic CT numbers was investigated using a custom lumbar section phantom with and without an external fat-mimicking ring. Results: Other than the Z{sub eff} of the simulated lung inserts in the tissue characterization phantom, which could not be measured by DECT, the Z{sub eff} values of all of the other materials in the tissue characterization and Catphan phantoms were accurate to 15%. The accuracies of the synthesized monochromatic CT numbers of the materials in both phantoms varied with energy and material. For the 40-120 keV range, RMS errors between the measured and true CT numbers in the Catphan are 8-25 HU when the true CT numbers were computed using the nominal plastic densities. These RMS errors improve to 3-12 HU for assumed true densities within the nominal density {+-}0.02 g/cc range. The RMS errors between the measured and true CT numbers of the tissue mimicking materials in the tissue characterization phantom over the 40-120 keV range varied from about 6 HU-248 HU and did not improve as dramatically with small changes in assumed true density. Conclusions: Initial tests indicate that the Z{sub eff} values computed with DECT on this scanner are reasonably accurate; however, the synthesized monochromatic CT numbers can be very inaccurate, especially for dense tissue mimicking materials at low energies. Furthermore, the synthesized monochromatic CT numbers of materials still depend on the amount of the surrounding tissues especially at low keV, demonstrating that the numbers are not truly monochromatic. Further research is needed to develop DE methods that produce more accurate synthesized monochromatic CT numbers.« less

Computerized method for automatic evaluation of lean body mass from PET/CT: comparison with predictive equations.

PubMed

Chan, Tao

2012-01-01

CT has become an established method for calculating body composition, but it requires data from the whole body, which are not typically obtained in routine PET/CT examinations. A computerized scheme that evaluates whole-body lean body mass (LBM) based on CT data from limited-whole-body coverage was developed. The LBM so obtained was compared with results from conventional predictive equations. LBM can be obtained automatically from limited-whole-body CT data by 3 means: quantification of body composition from CT images in the limited-whole-body scan, based on thresholding of CT attenuation; determination of the range of coverage based on a characteristic trend of changing composition across different levels and pattern recognition of specific features at strategic positions; and estimation of the LBM of the whole body on the basis of a predetermined relationship between proportion of fat mass and extent of coverage. This scheme was validated using 18 whole-body PET/CT examinations truncated at different lengths to emulate limited-whole-body data. LBM was also calculated using predictive equations that had been reported for use in SUV normalization. LBM derived from limited-whole-body data using the proposed method correlated strongly with LBM derived from whole-body CT data, with correlation coefficients ranging from 0.991 (shorter coverage) to 0.998 (longer coverage) and SEMs of LBM ranging from 0.14 to 0.33 kg. These were more accurate than results from different predictive equations, which ranged in correlation coefficient from 0.635 to 0.970 and in SEM from 0.64 to 2.40 kg. LBM of the whole body could be automatically estimated from CT data of limited-whole-body coverage typically acquired in PET/CT examinations. This estimation allows more accurate and consistent quantification of metabolic activity of tumors based on LBM-normalized standardized uptake value.

Development and validation of segmentation and interpolation techniques in sinograms for metal artifact suppression in CT.

PubMed

Veldkamp, Wouter J H; Joemai, Raoul M S; van der Molen, Aart J; Geleijns, Jacob

2010-02-01

Metal prostheses cause artifacts in computed tomography (CT) images. The purpose of this work was to design an efficient and accurate metal segmentation in raw data to achieve artifact suppression and to improve CT image quality for patients with metal hip or shoulder prostheses. The artifact suppression technique incorporates two steps: metal object segmentation in raw data and replacement of the segmented region by new values using an interpolation scheme, followed by addition of the scaled metal signal intensity. Segmentation of metal is performed directly in sinograms, making it efficient and different from current methods that perform segmentation in reconstructed images in combination with Radon transformations. Metal signal segmentation is achieved by using a Markov random field model (MRF). Three interpolation methods are applied and investigated. To provide a proof of concept, CT data of five patients with metal implants were included in the study, as well as CT data of a PMMA phantom with Teflon, PVC, and titanium inserts. Accuracy was determined quantitatively by comparing mean Hounsfield (HU) values and standard deviation (SD) as a measure of distortion in phantom images with titanium (original and suppressed) and without titanium insert. Qualitative improvement was assessed by comparing uncorrected clinical images with artifact suppressed images. Artifacts in CT data of a phantom and five patients were automatically suppressed. The general visibility of structures clearly improved. In phantom images, the technique showed reduced SD close to the SD for the case where titanium was not inserted, indicating improved image quality. HU values in corrected images were different from expected values for all interpolation methods. Subtle differences between interpolation methods were found. The new artifact suppression design is efficient, for instance, in terms of preserving spatial resolution, as it is applied directly to original raw data. It successfully reduced artifacts in CT images of five patients and in phantom images. Sophisticated interpolation methods are needed to obtain reliable HU values close to the prosthesis.

Technical note: estimating absorbed doses to the thyroid in CT.

PubMed

Huda, Walter; Magill, Dennise; Spampinato, Maria V

2011-06-01

To describe a method for estimating absorbed doses to the thyroid in patients undergoing neck CT examinations. Thyroid doses in anthropomorphic phantoms were obtained for all 23 scanner dosimetry data sets in the ImPACT CT patient dosimetry calculator. Values of relative thyroid dose [R(thy)(L)], defined as the thyroid dose for a given scan length (L) divided by the corresponding thyroid dose for a whole body scan, were determined for neck CT scans. Ratios of the maximum thyroid dose to the corresponding CTDI(vol) and [D'(thy)], were obtained for two phantom diameters. The mass-equivalent water cylinder of any patient can be derived from the neck cross-sectional area and the corresponding average Hounsfield Unit, and compared to the 16.5-cm diameter water cylinder that models the ImPACT anthropomorphic phantom neck. Published values of relative doses in water cylinders of varying diameter were used to adjust thyroid doses in the anthropomorphic phantom to those of any sized patient. Relative thyroid doses R(thy)(L) increase to unity with increasing scan length and with very small difference between scanners. A 10-cm scan centered on the thyroid would result in a dose that is, nearly 90% of the thyroid dose from a whole body scan when performed using the constant radiographic techniques. At 120 kV, the average value of D'(thy) for the 16-cm diameter was 1.17 +/- 0.05 and was independent of CT vendor and year of CT scanner, and choice of x-ray tube voltage. The corresponding average value of D'(thy) in the 32-cm diameter phantom was 2.28 +/- 0.22 and showed marked variations depending on vendor, year of introduction into clinical practice as well as x-ray tube voltage. At 120 kV, a neck equivalent to a 10-cm diameter cylinder of water would have thyroid doses 36% higher than those in the ImPACT phantom, whereas a neck equivalent to a 25-cm cylinder diameter would have thyroid doses 35% lower. Patient thyroid doses can be estimated by taking into account the amount of radiation used to perform the CT examination (CTDI(vol)) and accounting for scan length and patient anatomy (i.e., neck diameter) at the thyroid location.

Subjective and objective comparisons of image quality between ultra-high-resolution CT and conventional area detector CT in phantoms and cadaveric human lungs.

PubMed

Yanagawa, Masahiro; Hata, Akinori; Honda, Osamu; Kikuchi, Noriko; Miyata, Tomo; Uranishi, Ayumi; Tsukagoshi, Shinsuke; Tomiyama, Noriyuki

2018-05-29

To compare the image quality of the lungs between ultra-high-resolution CT (U-HRCT) and conventional area detector CT (AD-CT) images. Image data of slit phantoms (0.35, 0.30, and 0.15 mm) and 11 cadaveric human lungs were acquired by both U-HRCT and AD-CT devices. U-HRCT images were obtained with three acquisition modes: normal mode (U-HRCT N : 896 channels, 0.5 mm × 80 rows; 512 matrix), super-high-resolution mode (U-HRCT SHR : 1792 channels, 0.25 mm × 160 rows; 1024 matrix), and volume mode (U-HRCT SHR-VOL : non-helical acquisition with U-HRCT SHR ). AD-CT images were obtained with the same conditions as U-HRCT N . Three independent observers scored normal anatomical structures (vessels and bronchi), abnormal CT findings (faint nodules, solid nodules, ground-glass opacity, consolidation, emphysema, interlobular septal thickening, intralobular reticular opacities, bronchovascular bundle thickening, bronchiectasis, and honeycombing), noise, artifacts, and overall image quality on a 3-point scale (1 = worst, 2 = equal, 3 = best) compared with U-HRCT N . Noise values were calculated quantitatively. U-HRCT could depict a 0.15-mm slit. Both U-HRCT SHR and U-HRCT SHR-VOL significantly improved visualization of normal anatomical structures and abnormal CT findings, except for intralobular reticular opacities and reduced artifacts, compared with AD-CT (p < 0.014). Visually, U-HRCT SHR-VOL has less noise than U-HRCT SHR and AD-CT (p < 0.00001). Quantitative noise values were significantly higher in the following order: U-HRCT SHR (mean, 30.41), U-HRCT SHR-VOL (26.84), AD-CT (16.03), and U-HRCT N (15.14) (p < 0.0001). U-HRCT SHR and U-HRCT SHR-VOL resulted in significantly higher overall image quality than AD-CT and were almost equal to U-HRCT N (p < 0.0001). Both U-HRCT SHR and U-HRCT SHR-VOL can provide higher image quality than AD-CT, while U-HRCT SHR-VOL was less noisy than U-HRCT SHR . • Ultra-high-resolution CT (U-HRCT) can improve spatial resolution. • U-HRCT can reduce streak and dark band artifacts. • U-HRCT can provide higher image quality than conventional area detector CT. • In U-HRCT, the volume mode is less noisy than the super-high-resolution mode. • U-HRCT may provide more detailed information about the lung anatomy and pathology.

Prognosis estimation under the light of metabolic tumor parameters on initial FDG-PET/CT in patients with primary extranodal lymphoma

PubMed Central

Okuyucu, Kursat; Ozaydın, Sukru; Alagoz, Engin; Ozgur, Gokhan; Oysul, Fahrettin Guven; Ozmen, Ozlem; Tuncel, Murat; Ozturk, Mustafa; Arslan, Nuri

2016-01-01

Abstract Background Non-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study. Patients and methods There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival. Results SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively). Conclusions High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis. PMID:27904443

The significance of 99mTc-MAA SPECT/CT liver perfusion imaging in treatment planning for 90Y-microsphere selective internal radiation treatment.

PubMed

Ahmadzadehfar, Hojjat; Sabet, Amir; Biermann, Kim; Muckle, Marianne; Brockmann, Holger; Kuhl, Christiane; Wilhelm, Kai; Biersack, Hans-Jürgen; Ezziddin, Samer

2010-08-01

Selective internal radiation therapy (SIRT), a catheter-based liver-directed modality for treating primary and metastatic liver cancer, requires appropriate planning to maximize its therapeutic response and minimize its side effects. (99m)Tc-macroaggregated albumin (MAA) scanning should precede the therapy to detect any extrahepatic shunting to the lung or gastrointestinal tract. Our aim was to compare the ability of SPECT/CT with that of planar imaging and SPECT in the detection and localization of extrahepatic (99m)Tc-MAA accumulation and to evaluate the impact of SPECT/CT on SIRT treatment planning and its added value to angiography in this setting. Ninety diagnostic hepatic angiograms with (99m)Tc-MAA were obtained for 76 patients with different types of cancer. All images were reviewed retrospectively for extrahepatic MAA deposition in the following order: planar, non-attenuation-corrected SPECT, and SPECT/CT. Review of angiograms and follow-up of patients with abdominal shunting served as reference standards. Extrahepatic accumulation was detected by planar imaging, SPECT, and SPECT/CT in 12%, 17%, and 42% of examinations, respectively. The sensitivity for detecting extrahepatic shunting with planar imaging, SPECT, and SPECT/CT was 32%, 41%, and 100%, respectively; specificity was 98%, 98%, and 93%, respectively. The respective positive predictive values were 92%, 93%, and 89%, and the respective negative predictive values were 71%, 73%, and 100%. The therapy plan was changed according to the results of planar imaging, SPECT, and SPECT/CT in 7.8%, 8.9%, and 29% of patients, respectively. In pre-SIRT planning, (99m)Tc-MAA SPECT/CT is valuable for identifying extrahepatic visceral sites at risk for postradioembolization complications.

Rectosigmoid endometriosis: comparison between CT water enema and video laparoscopy.

PubMed

Stabile Ianora, A A; Moschetta, M; Lorusso, F; Lattarulo, S; Telegrafo, M; Rella, L; Scardapane, A

2013-09-01

To evaluate the accuracy of water enema computed tomography (CT) for predicting the location of endometriosis in patients with contraindications to magnetic resonance imaging (MRI), focusing on rectosigmoid lesions and having laparoscopic and histological data as the reference standard. Thirty-three women (mean age 33.4 ± 3.1 years) suspected of having deep pelvic endometriosis underwent 64-row CT and video laparoscopy within 4 weeks. Two radiologists blinded to the clinical data evaluated the CT images obtained after colonic retrograde distension using water as the contrast medium, and a comparison with laparoscopic and histological findings was performed. CT sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. The radiation dose to patients was estimated. Cohen's weighted kappa (κ) test was used to evaluate the interobserver agreement. In 23 out of 33 patients (69%) intestinal implants were found at surgery and pathological examinations. CT confirmed the diagnosis of rectosigmoid endometriosis in 20 out of 23 implants. Three nodules located on the proximal sigmoid colon (two serosal lesions and one infiltrating the muscularis layer) with a diameter of less than 1 cm were not diagnosed. CT sensitivity, specificity, PPV, NPV, and accuracy values were 87, 100, 100, 77, and 91%, respectively. The mean effective dose estimate was 6.30 ± 1.7 mSv. Almost perfect agreement between the two readers was found (k = 0.84). Water enema CT can play a role in the diagnosis of bowel endometriosis and represents another accurate potential tool for video laparoscopic approaches, especially in patients for whom MRI is contraindicated. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Circulating tumor DNA evaluated by Next-Generation Sequencing is predictive of tumor response and prolonged clinical benefit with nivolumab in advanced non-small cell lung cancer.

PubMed

Giroux Leprieur, Etienne; Herbretau, Guillaume; Dumenil, Coraline; Julie, Catherine; Giraud, Violaine; Labrune, Sylvie; Dumoulin, Jennifer; Tisserand, Julie; Emile, Jean-François; Blons, Hélène; Chinet, Thierry

2018-01-01

Nivolumab is an anti-PD1 antibody, given in second-line or later treatment in advanced non-small cell lung cancer (NSCLC). The objective of this study was to describe the predictive value of circulating tumor DNA (ctDNA) on the efficacy of nivolumab in advanced NSCLC. We prospectively included all consecutive patients with advanced NSCLC treated with nivolumab in our Department between June 2015 and October 2016. Plasma samples were obtained before the first injection of nivolumab and at the first tumor evaluation with nivolumab. ctDNA was analyzed by Next-Generation Sequencing (NGS), and the predominant somatic mutation was followed for each patient and correlated with tumor response, clinical benefit (administration of nivolumab for more than 6 months), and progression-free survival (PFS). Of 23 patients, 15 had evaluable NGS results at both times of analysis. ctDNA concentration at the first tumor evaluation and ctDNA change correlated with tumor response, clinical benefit and PFS. ROC curve analyses showed good diagnostic performances for tumor response and clinical benefit, both for ctDNA concentration at the first tumor evaluation (tumor response: positive predictive value (PPV) at 100.0% and negative predictive value (NPV) at 71.0%; clinical benefit: PPV at 83.3% and NPV 77.8%) and the ctDNA change (tumor response: PPV 100.0% and NPV 62.5%; clinical benefit: PPV 100.0% and NPV 80.0%). Patients without ctDNA concentration increase >9% at 2 months had a long-term benefit of nivolumab. In conclusion, NGS analysis of ctDNA allows the early detection of tumor response and long-term clinical benefit with nivolumab in NSCLC.

Cranial CT with adaptive statistical iterative reconstruction: improved image quality with concomitant radiation dose reduction.

PubMed

Rapalino, O; Kamalian, Shervin; Kamalian, Shahmir; Payabvash, S; Souza, L C S; Zhang, D; Mukta, J; Sahani, D V; Lev, M H; Pomerantz, S R

2012-04-01

To safeguard patient health, there is great interest in CT radiation-dose reduction. The purpose of this study was to evaluate the impact of an iterative-reconstruction algorithm, ASIR, on image-quality measures in reduced-dose head CT scans for adult patients. Using a 64-section scanner, we analyzed 100 reduced-dose adult head CT scans at 6 predefined levels of ASIR blended with FBP reconstruction. These scans were compared with 50 CT scans previously obtained at a higher routine dose without ASIR reconstruction. SNR and CNR were computed from Hounsfield unit measurements of normal GM and WM of brain parenchyma. A blinded qualitative analysis was performed in 10 lower-dose CT datasets compared with higher-dose ones without ASIR. Phantom data analysis was also performed. Lower-dose scans without ASIR had significantly lower mean GM and WM SNR (P = .003) and similar GM-WM CNR values compared with higher routine-dose scans. However, at ASIR levels of 20%-40%, there was no statistically significant difference in SNR, and at ASIR levels of ≥60%, the SNR values of the reduced-dose scans were significantly higher (P < .01). CNR values were also significantly higher at ASIR levels of ≥40% (P < .01). Blinded qualitative review demonstrated significant improvements in perceived image noise, artifacts, and GM-WM differentiation at ASIR levels ≥60% (P < .01). These results demonstrate that the use of ASIR in adult head CT scans reduces image noise and increases low-contrast resolution, while allowing lower radiation doses without affecting spatial resolution.

Preoperative estimation of the liver graft weight in adult right lobe living donor liver transplantation using maximal portal vein diameters.

PubMed

Wang, Frank; Pan, Kuang-Tse; Chu, Sung-Yu; Chan, Kun-Ming; Chou, Hong-Shiue; Wu, Ting-Jung; Lee, Wei-Chen

2011-04-01

An accurate preoperative estimate of the graft weight is vital to avoid small-for-size syndrome in the recipient and ensure donor safety after adult living donor liver transplantation (LDLT). Here we describe a simple method for estimating the graft volume (GV) that uses the maximal right portal vein diameter (RPVD) and the maximal left portal vein diameter (LPVD). Between June 2004 and December 2009, 175 consecutive donors undergoing right hepatectomy for LDLT were retrospectively reviewed. The GV was determined with 3 estimation methods: (1) the radiological graft volume (RGV) estimated by computed tomography (CT) volumetry; (2) the computed tomography-calculated graft volume (CGV-CT), which was obtained by the multiplication of the standard liver volume (SLV) by the RGV percentage with respect to the total liver volume derived from CT; and (3) the portal vein diameter ratio-calculated graft volume (CGV-PVDR), which was obtained by the multiplication of the SLV by the portal vein diameter ratio [PVDR; ie, PVDR = RPVD(2) /(RPVD(2) + LPVD(2) )]. These values were compared to the actual graft weight (AGW), which was measured intraoperatively. The mean AGW was 633.63 ± 107.51 g, whereas the mean RGV, CGV-CT, and CGV-PVDR values were 747.83 ± 138.59, 698.21 ± 94.81, and 685.20 ± 90.88 cm(3) , respectively. All 3 estimation methods tended to overestimate the AGW (P < 0.001). The actual graft-to-recipient body weight ratio (GRWR) was 1.00% ± 0.19%, and the GRWRs calculated on the basis of the RGV, CGV-CT, and CGV-PVDR values were 1.19% ± 0.25%, 1.11% ± 0.22%, and 1.09% ± 0.21%, respectively. Overall, the CGV-PVDR values better correlated with the AGW and GRWR values according to Lin's concordance correlation coefficient and the Landis and Kock benchmark. In conclusion, the PVDR method is a simple estimation method that accurately predicts GVs and GRWRs in adult LDLT. Copyright © 2011 American Association for the Study of Liver Diseases.

Is Preoperative Biochemical Testing for Pheochromocytoma Necessary for All Adrenal Incidentalomas?

PubMed Central

Jun, Joo Hyun; Ahn, Hyun Joo; Lee, Sangmin M.; Kim, Jie Ae; Park, Byung Kwan; Kim, Jee Soo; Kim, Jung Han

2015-01-01

Abstract This study examined whether imaging phenotypes obtained from computed tomography (CT) can replace biochemical tests to exclude pheochromocytoma among adrenal incidentalomas (AIs) in the preoperative setting. We retrospectively reviewed the medical records of all patients (n = 251) who were admitted for operations and underwent adrenal-protocol CT for an incidentally discovered adrenal mass from January 2011 to December 2012. Various imaging phenotypes were assessed for their screening power for pheochromocytoma. Final diagnosis was confirmed by biopsy, biochemical tests, and follow-up CT. Pheochromocytomas showed similar imaging phenotypes as malignancies, but were significantly different from adenomas. Unenhanced attenuation values ≤10 Hounsfield units (HU) showed the highest specificity (97%) for excluding pheochromocytoma as a single phenotype. A combination of size ≤3 cm, unenhanced attenuation values ≤ 10 HU, and absence of suspicious morphology showed 100% specificity for excluding pheochromocytoma. Routine noncontrast CT can be used as a screening tool for pheochromocytoma by combining 3 imaging phenotypes: size ≤3 cm, unenhanced attenuation values ≤10 HU, and absence of suspicious morphology, and may substitute for biochemical testing in the preoperative setting. PMID:26559265

Cross-modality PET/CT and contrast-enhanced CT imaging for pancreatic cancer

PubMed Central

Zhang, Jian; Zuo, Chang-Jing; Jia, Ning-Yang; Wang, Jian-Hua; Hu, Sheng-Ping; Yu, Zhong-Fei; Zheng, Yuan; Zhang, An-Yu; Feng, Xiao-Yuan

2015-01-01

AIM: To explore the diagnostic value of the cross-modality fusion images provided by positron emission tomography/computed tomography (PET/CT) and contrast-enhanced CT (CECT) for pancreatic cancer (PC). METHODS: Data from 70 patients with pancreatic lesions who underwent CECT and PET/CT examinations at our hospital from August 2010 to October 2012 were analyzed. PET/CECT for the cross-modality image fusion was obtained using TureD software. The diagnostic efficiencies of PET/CT, CECT and PET/CECT were calculated and compared with each other using a χ2 test. P < 0.05 was considered to indicate statistical significance. RESULTS: Of the total 70 patients, 50 had PC and 20 had benign lesions. The differences in the sensitivity, negative predictive value (NPV), and accuracy between CECT and PET/CECT in detecting PC were statistically significant (P < 0.05 for each). In 15 of the 31 patients with PC who underwent a surgical operation, peripancreatic vessel invasion was verified. The differences in the sensitivity, positive predictive value, NPV, and accuracy of CECT vs PET/CT and PET/CECT vs PET/CT in diagnosing peripancreatic vessel invasion were statistically significant (P < 0.05 for each). In 19 of the 31 patients with PC who underwent a surgical operation, regional lymph node metastasis was verified by postsurgical histology. There was no statistically significant difference among the three methods in detecting regional lymph node metastasis (P > 0.05 for each). In 17 of the 50 patients with PC confirmed by histology or clinical follow-up, distant metastasis was confirmed. The differences in the sensitivity and NPV between CECT and PET/CECT in detecting distant metastasis were statistically significant (P < 0.05 for each). CONCLUSION: Cross-modality image fusion of PET/CT and CECT is a convenient and effective method that can be used to diagnose and stage PC, compensating for the defects of PET/CT and CECT when they are conducted individually. PMID:25780297

Diagnostic role of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for early and atypical bone metastases.

PubMed

Chen, Xiao-Liang; Li, Qian; Cao, Lin; Jiang, Shi-Xi

2014-01-01

The bone metastasis appeared early before the bone imaging for most of the above patients. (99)Tc(m)-MDP ((99)Tc(m) marked methylene diphosphonate) bone imaging could diagnosis the bone metastasis with highly sensitivity, but with lower specificity. The aim of this study is to explore the diagnostic value of (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging for the early period atypical bone metastases. 15 to 30 mCi (99)Tc(m)-MDP was intravenously injected to the 34 malignant patients diagnosed as doubtful early bone metastases. SPECT, CT and SPECT/CT images were captured and analyzed consequently. For the patients diagnosed as early period atypical bone metastases by SPECT/CT, combining the SPECT/CT and MRI together as the SPECT/MRI integrated image. The obtained SPECT/MRI image was analyzed and compared with the pathogenic results of patients. The results indicated that 34 early period doubtful metastatic focus, including 34 SPECT positive focus, 17 focus without special changes by using CT method, 11 bone metastases focus by using SPECT/CT method, 23 doubtful bone metastases focus, 8 doubtful bone metastases focus, 14 doubtful bone metastases focus and 2 focus without clear image. Totally, SPECT/CT combined with SPECT/MRI method diagnosed 30 bone metastatic focus and 4 doubtfully metastatic focus. In conclusion, (99)Tc(m)-MDP SPECT/CT combined SPECT/MRI Multi modality imaging shows a higher diagnostic value for the early period bone metastases, which also enhances the diagnostic accuracy rate.

Anatomical evaluation and stress distribution of intact canine femur.

PubMed

Verim, Ozgur; Tasgetiren, Suleyman; Er, Mehmet S; Ozdemir, Vural; Yuran, Ahmet F

2013-03-01

In the biomedical field, three-dimensional (3D) modeling and analysis of bones and tissues has steadily gained in importance. The aim of this study was to produce more accurate 3D models of the canine femur derived from computed tomography (CT) data by using several modeling software programs and two different methods. The accuracy of the analysis depends on the modeling process and the right boundary conditions. Solidworks, Rapidform, Inventor, and 3DsMax software programs were used to create 3D models. Data derived from CT were converted into 3D models using two different methods: in the first, 3D models were generated using boundary lines, while in the second, 3D models were generated using point clouds. Stress analyses in the models were made by ANSYS v12, also considering any muscle forces acting on the canine femur. When stress values and statistical values were taken into consideration, more accurate models were obtained with the point cloud method. It was found that the maximum von Mises stress on the canine femur shaft was 34.8 MPa. Stress and accuracy values were obtained from the model formed using the Rapidform software. The values obtained were similar to those in other studies in the literature. Copyright © 2012 John Wiley & Sons, Ltd.

Development of proton CT imaging system using plastic scintillator and CCD camera

NASA Astrophysics Data System (ADS)

Tanaka, Sodai; Nishio, Teiji; Matsushita, Keiichiro; Tsuneda, Masato; Kabuki, Shigeto; Uesaka, Mitsuru

2016-06-01

A proton computed tomography (pCT) imaging system was constructed for evaluation of the error of an x-ray CT (xCT)-to-WEL (water-equivalent length) conversion in treatment planning for proton therapy. In this system, the scintillation light integrated along the beam direction is obtained by photography using the CCD camera, which enables fast and easy data acquisition. The light intensity is converted to the range of the proton beam using a light-to-range conversion table made beforehand, and a pCT image is reconstructed. An experiment for demonstration of the pCT system was performed using a 70 MeV proton beam provided by the AVF930 cyclotron at the National Institute of Radiological Sciences. Three-dimensional pCT images were reconstructed from the experimental data. A thin structure of approximately 1 mm was clearly observed, with spatial resolution of pCT images at the same level as that of xCT images. The pCT images of various substances were reconstructed to evaluate the pixel value of pCT images. The image quality was investigated with regard to deterioration including multiple Coulomb scattering.

Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study

PubMed Central

Cirla, A.; Rondena, M.; Bertolini, G.

2016-01-01

The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single centre. A complete ophthalmic examination was always followed by orbital ultrasound and computed tomography (CT) examination of the head. All masses were sampled with the patient still on the CT table using ultrasound (US) guided automatic tru-cut device. The most suitable sampling approach to the orbit was chosen each time based on the CT image analysis. One of the following different approaches was used: trans-orbital, trans-conjunctival or trans-masseteric. In all cases, the imaging-guided biopsy provided a sufficient amount of tissue for the histopathological diagnosis, which concurred with the biopsies obtained using the excisional technique. CT examination was essential for morphological diagnosis and provided detailed topographic information that allowed us to choose the safest orbital approach for the biopsy. US guided automatic tru-cut biopsy based on CT images, performed with patient still on the CT table, resulted in a minimally invasive, relatively easy, and accurate diagnostic procedure in dogs with orbital masses. PMID:27540512

Elimination of white Gaussian noise in arterial phase CT images to bring adrenal tumours into the forefront.

PubMed

Koyuncu, Hasan; Ceylan, Rahime

2018-04-01

Dynamic Contrast-Enhanced Computed Tomography (DCE-CT) is applied to observe adrenal tumours in detail by utilising from the contrast matter, which generally brings the tumour into the forefront. However, DCE-CT images are generally influenced by noises that occur as the result of the trade-off between radiation doses vs. noise. Herein, this situation constitutes a challenge in the achievement of accurate tumour segmentation. In CT images, most of the noises are similar to Gaussian Noise. In this study, arterial phase CT images containing adrenal tumours are utilised, and elimination of Gaussian Noise is realised by fourteen different techniques reported in literature for the achievement of the best denoising process. In this study, the Block Matching and 3D Filtering (BM3D) algorithm typically achieve reliable Peak Signal-to-Noise Ratios (PSNR) and resolves challenges of similar techniques when addressing different levels of noise. Furthermore, BM3D obtains the best mean PSNR values among the first five techniques. BM3D outperforms to other techniques by obtaining better Total Statistical Success (TSS), CPU time and computation cost. Consequently, it prepares clearer arterial phase CT images for the next step (segmentation of adrenal tumours). Copyright © 2017 Elsevier Ltd. All rights reserved.

Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study.

PubMed

Cirla, A; Rondena, M; Bertolini, G

2016-01-01

The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single centre. A complete ophthalmic examination was always followed by orbital ultrasound and computed tomography (CT) examination of the head. All masses were sampled with the patient still on the CT table using ultrasound (US) guided automatic tru-cut device. The most suitable sampling approach to the orbit was chosen each time based on the CT image analysis. One of the following different approaches was used: trans-orbital, trans-conjunctival or trans-masseteric. In all cases, the imaging-guided biopsy provided a sufficient amount of tissue for the histopathological diagnosis, which concurred with the biopsies obtained using the excisional technique. CT examination was essential for morphological diagnosis and provided detailed topographic information that allowed us to choose the safest orbital approach for the biopsy. US guided automatic tru-cut biopsy based on CT images, performed with patient still on the CT table, resulted in a minimally invasive, relatively easy, and accurate diagnostic procedure in dogs with orbital masses.

Computerized margin and texture analyses for differentiating bacterial pneumonia and invasive mucinous adenocarcinoma presenting as consolidation.

PubMed

Koo, Hyun Jung; Kim, Mi Young; Koo, Ja Hwan; Sung, Yu Sub; Jung, Jiwon; Kim, Sung-Han; Choi, Chang-Min; Kim, Hwa Jung

2017-01-01

Radiologists have used margin characteristics based on routine visual analysis; however, the attenuation changes at the margin of the lesion on CT images have not been quantitatively assessed. We established a CT-based margin analysis method by comparing a target lesion with normal lung attenuation, drawing a slope to represent the attenuation changes. This approach was applied to patients with invasive mucinous adenocarcinoma (n = 40) or bacterial pneumonia (n = 30). Correlations among multiple regions of interest (ROIs) were obtained using intraclass correlation coefficient (ICC) values. CT visual assessment, margin and texture parameters were compared for differentiating the two disease entities. The attenuation and margin parameters in multiple ROIs showed excellent ICC values. Attenuation slopes obtained at the margins revealed a difference between invasive mucinous adenocarcinoma and pneumonia (P<0.001), and mucinous adenocarcinoma produced a sharply declining attenuation slope. On multivariable logistic regression analysis, pneumonia had an ill-defined margin (odds ratio (OR), 4.84; 95% confidence interval (CI), 1.26-18.52; P = 0.02), ground-glass opacity (OR, 8.55; 95% CI, 2.09-34.95; P = 0.003), and gradually declining attenuation at the margin (OR, 12.63; 95% CI, 2.77-57.51, P = 0.001). CT-based margin analysis method has a potential to act as an imaging parameter for differentiating invasive mucinous adenocarcinoma and bacterial pneumonia.

Residual neck disease management in squamous-cell carcinoma of the head and neck treated with radiotherapy plus cetuximab.

PubMed

Montal, R; Oliva, M; Taberna, M; De Avila, L; Rovira, A; Cos, M; Mañós, M; Navarro, V; Nogués, J; Lozano, A; Rodríguez, L; Vilajosana, E; Vázquez, S; Mesia, R

2016-11-01

Management of residual neck disease (RND) is one of the unsolved points after bio-radiotherapy (BRT) in loco-regional advanced squamous-cell carcinoma of the head and neck (SCCHN). The aims of the study were to characterize the radiological pattern of response by computed tomography (CT) and to assess the role of positron-emission tomography (PET)/CT in this setting for a better decision-making in the indication of neck dissection (ND). We retrospectively reviewed 202 patients consecutively diagnosed with node-positive SCCHN (N1: 24; N2: 152; N3: 26) who had been treated with concomitant radiotherapy and cetuximab with or without previous induction chemotherapy between 2006 and 2013. Radiological evaluation after treatment was assessed by standard criteria using CT and in addition by PET/CT when RND was suspected in cases from 2010. There were 42 (21 %) patients who achieved complete response of the primary tumor persisting RND by CT. From this group, 24 patients were managed without PET/CT, leading to the performance of ND in 22 (92 %). On the other hand, 18 patients underwent PET/CT and ND was performed in only 6 (33 %). The overall survival was not different between both groups (p = 0.32). After histological examination and follow-up, PET/CT obtained a positive predictive value of 56 % and a negative predictive value of 89 %. Radiological response after BRT is similar to that after treatment with chemo-radiotherapy, thereby validating in this scenario the accepted CT criteria to define complete response of the neck. However, when RND is suspected by CT, PET/CT is useful to prevent unnecessary ND.

The Value of 18F-FDG PET/CT in Diagnosis and During Follow-up in 273 Patients with Chronic Q Fever.

PubMed

Kouijzer, Ilse J E; Kampschreur, Linda M; Wever, Peter C; Hoekstra, Corneline; van Kasteren, Marjo E E; de Jager-Leclercq, Monique G L; Nabuurs-Franssen, Marrigje H; Wegdam-Blans, Marjolijn C A; Ammerlaan, Heidi S M; Buijs, Jacqueline; Geus-Oei, Lioe-Fee de; Oyen, Wim J G; Bleeker-Rovers, Chantal P

2018-01-01

In 1%-5% of all acute Q fever infections, chronic Q fever develops, mostly manifesting as endocarditis, infected aneurysms, or infected vascular prostheses. In this study, we investigated the diagnostic value of 18 F-FDG PET/CT in chronic Q fever at diagnosis and during follow-up. Methods: All adult Dutch patients suspected of chronic Q fever who were diagnosed since 2007 were retrospectively included until March 2015, when at least one 18 F-FDG PET/CT scan was obtained. Clinical data and results from 18 F-FDG PET/CT at diagnosis and during follow-up were collected. 18 F-FDG PET/CT scans were prospectively reevaluated by 3 nuclear medicine physicians using a structured scoring system. Results: In total, 273 patients with possible, probable, or proven chronic Q fever were included. Of all 18 F-FDG PET/CT scans performed at diagnosis, 13.5% led to a change in diagnosis. Q fever-related mortality rate in patients with and without vascular infection based on 18 F-FDG PET/CT was 23.8% and 2.1%, respectively ( P = 0.001). When 18 F-FDG PET/CT was added as a major criterion to the modified Duke criteria, 17 patients (1.9-fold increase) had definite endocarditis. At diagnosis, 19.6% of 18 F-FDG PET/CT scans led to treatment modification. During follow-up, 57.3% of 18 F-FDG PET/CT scans resulted in treatment modification. Conclusion: 18 F-FDG PET/CT is a valuable technique in diagnosis of chronic Q fever and during follow-up, often leading to a change in diagnosis or treatment modification and providing important prognostic information on patient survival. © 2018 by the Society of Nuclear Medicine and Molecular Imaging.

3-Dimensional quantitative detection of nanoparticle content in biological tissue samples after local cancer treatment

NASA Astrophysics Data System (ADS)

Rahn, Helene; Alexiou, Christoph; Trahms, Lutz; Odenbach, Stefan

2014-06-01

X-ray computed tomography is nowadays used for a wide range of applications in medicine, science and technology. X-ray microcomputed tomography (XμCT) follows the same principles used for conventional medical CT scanners, but improves the spatial resolution to a few micrometers. We present an example of an application of X-ray microtomography, a study of 3-dimensional biodistribution, as along with the quantification of nanoparticle content in tumoral tissue after minimally invasive cancer therapy. One of these minimal invasive cancer treatments is magnetic drug targeting, where the magnetic nanoparticles are used as controllable drug carriers. The quantification is based on a calibration of the XμCT-equipment. The developed calibration procedure of the X-ray-μCT-equipment is based on a phantom system which allows the discrimination between the various gray values of the data set. These phantoms consist of a biological tissue substitute and magnetic nanoparticles. The phantoms have been studied with XμCT and have been examined magnetically. The obtained gray values and nanoparticle concentration lead to a calibration curve. This curve can be applied to tomographic data sets. Accordingly, this calibration enables a voxel-wise assignment of gray values in the digital tomographic data set to nanoparticle content. Thus, the calibration procedure enables a 3-dimensional study of nanoparticle distribution as well as concentration.

Shading correction algorithm for cone-beam CT in radiotherapy: extensive clinical validation of image quality improvement

NASA Astrophysics Data System (ADS)

Joshi, K. D.; Marchant, T. E.; Moore, C. J.

2017-03-01

A shading correction algorithm for the improvement of cone-beam CT (CBCT) images (Phys. Med. Biol. 53 5719{33) has been further developed, optimised and validated extensively using 135 clinical CBCT images of patients undergoing radiotherapy treatment of the pelvis, lungs and head and neck. An automated technique has been developed to efficiently analyse the large number of clinical images. Small regions of similar tissue (for example fat tissue) are automatically identified using CT images. The same regions on the corresponding CBCT image are analysed to ensure that they do not contain pixels representing multiple types of tissue. The mean value of all selected pixels and the non-uniformity, defined as the median absolute deviation of the mean values in each small region, are calculated. Comparisons between CT and raw and corrected CBCT images are then made. Analysis of fat regions in pelvis images shows an average difference in mean pixel value between CT and CBCT of 136:0 HU in raw CBCT images, which is reduced to 2:0 HU after the application of the shading correction algorithm. The average difference in non-uniformity of fat pixels is reduced from 33:7 in raw CBCT to 2:8 in shading-corrected CBCT images. Similar results are obtained in the analysis of lung and head and neck images.

Tumor invasiveness defined by IASLC/ATS/ERS classification of ground-glass nodules can be predicted by quantitative CT parameters.

PubMed

Zhou, Qian-Jun; Zheng, Zhi-Chun; Zhu, Yong-Qiao; Lu, Pei-Ji; Huang, Jia; Ye, Jian-Ding; Zhang, Jie; Lu, Shun; Luo, Qing-Quan

2017-05-01

To investigate the potential value of CT parameters to differentiate ground-glass nodules between noninvasive adenocarcinoma and invasive pulmonary adenocarcinoma (IPA) as defined by IASLC/ATS/ERS classification. We retrospectively reviewed 211 patients with pathologically proved stage 0-IA lung adenocarcinoma which appeared as subsolid nodules, from January 2012 to January 2013 including 137 pure ground glass nodules (pGGNs) and 74 part-solid nodules (PSNs). Pathological data was classified under the 2011 IASLC/ATS/ERS classification. Both quantitative and qualitative CT parameters were used to determine the tumor invasiveness between noninvasive adenocarcinomas and IPAs. There were 154 noninvasive adenocarcinomas and 57 IPAs. In pGGNs, CT size and area, one-dimensional mean CT value and bubble lucency were significantly different between noninvasive adenocarcinomas and IPAs on univariate analysis. Multivariate regression and ROC analysis revealed that CT size and one-dimensional mean CT value were predictive of noninvasive adenocarcinomas compared to IPAs. Optimal cutoff value was 13.60 mm (sensitivity, 75.0%; specificity, 99.6%), and -583.60 HU (sensitivity, 68.8%; specificity, 66.9%). In PSNs, there were significant differences in CT size and area, solid component area, solid proportion, one-dimensional mean and maximum CT value, three-dimensional (3D) mean CT value between noninvasive adenocarcinomas and IPAs on univariate analysis. Multivariate and ROC analysis showed that CT size and 3D mean CT value were significantly differentiators. Optimal cutoff value was 19.64 mm (sensitivity, 53.7%; specificity, 93.9%), -571.63 HU (sensitivity, 85.4%; specificity, 75.8%). For pGGNs, CT size and one-dimensional mean CT value are determinants for tumor invasiveness. For PSNs, tumor invasiveness can be predicted by CT size and 3D mean CT value.

Patient-specific calibration of cone-beam computed tomography data sets for radiotherapy dose calculations and treatment plan assessment.

PubMed

MacFarlane, Michael; Wong, Daniel; Hoover, Douglas A; Wong, Eugene; Johnson, Carol; Battista, Jerry J; Chen, Jeff Z

2018-03-01

In this work, we propose a new method of calibrating cone beam computed tomography (CBCT) data sets for radiotherapy dose calculation and plan assessment. The motivation for this patient-specific calibration (PSC) method is to develop an efficient, robust, and accurate CBCT calibration process that is less susceptible to deformable image registration (DIR) errors. Instead of mapping the CT numbers voxel-by-voxel with traditional DIR calibration methods, the PSC methods generates correlation plots between deformably registered planning CT and CBCT voxel values, for each image slice. A linear calibration curve specific to each slice is then obtained by least-squares fitting, and applied to the CBCT slice's voxel values. This allows each CBCT slice to be corrected using DIR without altering the patient geometry through regional DIR errors. A retrospective study was performed on 15 head-and-neck cancer patients, each having routine CBCTs and a middle-of-treatment re-planning CT (reCT). The original treatment plan was re-calculated on the patient's reCT image set (serving as the gold standard) as well as the image sets produced by voxel-to-voxel DIR, density-overriding, and the new PSC calibration methods. Dose accuracy of each calibration method was compared to the reference reCT data set using common dose-volume metrics and 3D gamma analysis. A phantom study was also performed to assess the accuracy of the DIR and PSC CBCT calibration methods compared with planning CT. Compared with the gold standard using reCT, the average dose metric differences were ≤ 1.1% for all three methods (PSC: -0.3%; DIR: -0.7%; density-override: -1.1%). The average gamma pass rates with thresholds 3%, 3 mm were also similar among the three techniques (PSC: 95.0%; DIR: 96.1%; density-override: 94.4%). An automated patient-specific calibration method was developed which yielded strong dosimetric agreement with the results obtained using a re-planning CT for head-and-neck patients. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

High-kVp Assisted Metal Artifact Reduction for X-ray Computed Tomography

PubMed Central

Xi, Yan; Jin, Yannan; De Man, Bruno; Wang, Ge

2016-01-01

In X-ray computed tomography (CT), the presence of metallic parts in patients causes serious artifacts and degrades image quality. Many algorithms were published for metal artifact reduction (MAR) over the past decades with various degrees of success but without a perfect solution. Some MAR algorithms are based on the assumption that metal artifacts are due only to strong beam hardening and may fail in the case of serious photon starvation. Iterative methods handle photon starvation by discarding or underweighting corrupted data, but the results are not always stable and they come with high computational cost. In this paper, we propose a high-kVp-assisted CT scan mode combining a standard CT scan with a few projection views at a high-kVp value to obtain critical projection information near the metal parts. This method only requires minor hardware modifications on a modern CT scanner. Two MAR algorithms are proposed: dual-energy normalized MAR (DNMAR) and high-energy embedded MAR (HEMAR), aiming at situations without and with photon starvation respectively. Simulation results obtained with the CT simulator CatSim demonstrate that the proposed DNMAR and HEMAR methods can eliminate metal artifacts effectively. PMID:27891293

Development of automatic visceral fat volume calculation software for CT volume data.

PubMed

Nemoto, Mitsutaka; Yeernuer, Tusufuhan; Masutani, Yoshitaka; Nomura, Yukihiro; Hanaoka, Shouhei; Miki, Soichiro; Yoshikawa, Takeharu; Hayashi, Naoto; Ohtomo, Kuni

2014-01-01

To develop automatic visceral fat volume calculation software for computed tomography (CT) volume data and to evaluate its feasibility. A total of 24 sets of whole-body CT volume data and anthropometric measurements were obtained, with three sets for each of four BMI categories (under 20, 20 to 25, 25 to 30, and over 30) in both sexes. True visceral fat volumes were defined on the basis of manual segmentation of the whole-body CT volume data by an experienced radiologist. Software to automatically calculate visceral fat volumes was developed using a region segmentation technique based on morphological analysis with CT value threshold. Automatically calculated visceral fat volumes were evaluated in terms of the correlation coefficient with the true volumes and the error relative to the true volume. Automatic visceral fat volume calculation results of all 24 data sets were obtained successfully and the average calculation time was 252.7 seconds/case. The correlation coefficients between the true visceral fat volume and the automatically calculated visceral fat volume were over 0.999. The newly developed software is feasible for calculating visceral fat volumes in a reasonable time and was proved to have high accuracy.

Assessment of the hepatic microvascular changes in liver cirrhosis by perfusion computed tomography

PubMed Central

Chen, Mai-Lin; Zeng, Qing-Yu; Huo, Jian-Wei; Yin, Xiao-Ming; Li, Bao-Ping; Liu, Jian-Xin

2009-01-01

AIM: To assess the hepatic microvascular parameters in patients with liver cirrhosis by perfusion computed tomography (CT). METHODS: Perfusion CT was performed in 29 patients without liver disease (control subjects) and 39 patients with liver cirrhosis, including 22 patients with compensated cirrhosis and 17 patients with decompensated cirrhosis, proved by clinical and laboratory parameters. CT cine-scans were obtained over 50 s beginning with the injection of 50 mL of contrast agent. Hepatic microvascular parameters, mean transit time (MTT) and permeability surface area product (PS) were obtained with the Perfusion 3 software (General Electric, ADW 4.2). RESULTS: The overall differences of MTT and PS between control subjects, patients with compensated cirrhosis and those with decompensated cirrhosis were statistically significant (P = 0.010 and P = 0.002, respectively). MTT values were 15.613 ± 4.1746 s, 12.592 ± 4.7518 s, and 11.721 ± 4.5681 s for the three groups, respectively, while PS were 18.945 ± 7.2347 mL/min per 100 mL, 22.767 ± 8.3936 mL/min per 100 mL, and 28.735 ± 13.0654 mL/min per 100 mL. MTT in decompensated cirrhotic patients were significantly decreased compared to controls (P = 0.017), whereas PS values were remarkably increased (P = 0.001). CONCLUSION: The hepatic microvascular changes in patients with liver cirrhosis can be quantitatively assessed by perfusion CT. Hepatic microvascular parameters (MTT and PS), as measured by perfusion CT, were significantly altered in decompensated cirrhosis. PMID:19630110

Technical Note: Relation between dual-energy subtraction of CT images for electron density calibration and virtual monochromatic imaging.

PubMed

Saito, Masatoshi

2015-07-01

For accurate tissue inhomogeneity correction in radiotherapy treatment planning, the author previously proposed a simple conversion of the energy-subtracted computed tomography (CT) number to an electron density (ΔHU-ρe conversion), which provides a single linear relationship between ΔHU and ρe over a wide ρe range. The purpose of the present study was to reveal the relation between the ΔHU image for ρe calibration and a virtually monochromatic CT image by performing numerical analyses based on the basis material decomposition in dual-energy CT. The author determined the weighting factor, α0, of the ΔHU-ρe conversion through numerical analyses of the International Commission on Radiation Units and Measurements Report-46 human body tissues using their attenuation coefficients and given ρe values. Another weighting factor, α(E), for synthesizing a virtual monochromatic CT image from high- and low-kV CT images, was also calculated in the energy range of 0.03 < E < 5 MeV, assuming that cortical bone and water were the basis materials. The mass attenuation coefficients for these materials were obtained using the xcom photon cross sections database. The effective x-ray energies used to calculate the attenuation were chosen to imitate a dual-source CT scanner operated at 80-140 and 100-140 kV/Sn. The determined α0 values were 0.455 for 80-140 kV/Sn and 0.743 for 100-140 kV/Sn. These values coincided almost perfectly with the respective maximal points of the calculated α(E) curves located at approximately 1 MeV, in which the photon-matter interaction in human body tissues is exclusively the incoherent (Compton) scattering. The ΔHU image could be regarded substantially as a CT image acquired with monoenergetic 1-MeV photons, which provides a linear relationship between CT numbers and electron densities.

Use of the stereoscopic virtual reality display system for the detection and characterization of intracranial aneurysms: A Icomparison with conventional computed tomography workstation and 3D rotational angiography.

PubMed

Liu, Xiujuan; Tao, Haiquan; Xiao, Xigang; Guo, Binbin; Xu, Shangcai; Sun, Na; Li, Maotong; Xie, Li; Wu, Changjun

2018-07-01

This study aimed to compare the diagnostic performance of the stereoscopic virtual reality display system with the conventional computed tomography (CT) workstation and three-dimensional rotational angiography (3DRA) for intracranial aneurysm detection and characterization, with a focus on small aneurysms and those near the bone. First, 42 patients with suspected intracranial aneurysms underwent both 256-row CT angiography (CTA) and 3DRA. Volume rendering (VR) images were captured using the conventional CT workstation. Next, VR images were transferred to the stereoscopic virtual reality display system. Two radiologists independently assessed the results that were obtained using the conventional CT workstation and stereoscopic virtual reality display system. The 3DRA results were considered as the ultimate reference standard. Based on 3DRA images, 38 aneurysms were confirmed in 42 patients. Two cases were misdiagnosed and 1 was missed when the traditional CT workstation was used. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the conventional CT workstation were 94.7%, 85.7%, 97.3%, 75%, and99.3%, respectively, on a per-aneurysm basis. The stereoscopic virtual reality display system missed a case. The sensitivity, specificity, PPV, NPV, and accuracy of the stereoscopic virtual reality display system were 100%, 85.7%, 97.4%, 100%, and 97.8%, respectively. No difference was observed in the accuracy of the traditional CT workstation, stereoscopic virtual reality display system, and 3DRA in detecting aneurysms. The stereoscopic virtual reality display system has some advantages in detecting small aneurysms and those near the bone. The virtual reality stereoscopic vision obtained through the system was found as a useful tool in intracranial aneurysm diagnosis and pre-operative 3D imaging. Copyright © 2018 Elsevier B.V. All rights reserved.

PET/CT image registration: preliminary tests for its application to clinical dosimetry in radiotherapy.

PubMed

Baños-Capilla, M C; García, M A; Bea, J; Pla, C; Larrea, L; López, E

2007-06-01

The quality of dosimetry in radiotherapy treatment requires the accurate delimitation of the gross tumor volume. This can be achieved by complementing the anatomical detail provided by CT images through fusion with other imaging modalities that provide additional metabolic and physiological information. Therefore, use of multiple imaging modalities for radiotherapy treatment planning requires an accurate image registration method. This work describes tests carried out on a Discovery LS positron emission/computed tomography (PET/CT) system by General Electric Medical Systems (GEMS), for its later use to obtain images to delimit the target in radiotherapy treatment. Several phantoms have been used to verify image correlation, in combination with fiducial markers, which were used as a system of external landmarks. We analyzed the geometrical accuracy of two different fusion methods with the images obtained with these phantoms. We first studied the fusion method used by the PET/CT system by GEMS (hardware fusion) on the basis that there is satisfactory coincidence between the reconstruction centers in CT and PET systems; and secondly the fiducial fusion, a registration method, by means of least-squares fitting algorithm of a landmark points system. The study concluded with the verification of the centroid position of some phantom components in both imaging modalities. Centroids were estimated through a calculation similar to center-of-mass, weighted by the value of the CT number and the uptake intensity in PET. The mean deviations found for the hardware fusion method were: deltax/ +/-sigma = 3.3 mm +/- 1.0 mm and /deltax/ +/-sigma = 3.6 mm +/- 1.0 mm. These values were substantially improved upon applying fiducial fusion based on external landmark points: /deltax/ +/-sigma = 0.7 mm +/- 0.8 mm and /deltax/ +/-sigma = 0.3 mm 1.7 mm. We also noted that differences found for each of the fusion methods were similar for both the axial and helical CT image acquisition protocols.

Multi-national findings on radiation protection of children.

PubMed

Rehani, Madan M

2014-10-01

This article reviews issues of radiation protection in children in 52 low-resource countries. Extensive information was obtained through a survey by the International Atomic Energy Agency (IAEA); wide-ranging information was available from 40 countries and data from the other countries pertained to frequency of pediatric CT examinations. Of note is that multi-detector CT (MDCT) was available in 77% of responses to the survey, typically nodal centers in these countries. Nearly 75% of these scanners were reported to have dose displays. The pediatric CT usage was lower in European facilities as compared to Asian and African facilities, where usage was twice as high. The most frequently scanned body part was the head. Frequent use of 120 kVp was reported in children. The ratio of maximum to minimum CT dose index volume (CTDIvol) values varied between 15 for abdomen CT in the age group 5-10 years and 100 for chest CT in the age group <1 year. In 8% of the CT systems, CTDI values for pediatric patients were higher than those for adults in at least one age group and for one type of examination. Use of adult protocols for children was associated with CTDIw or CTDIvol values in children that were double those of adults for head and chest examination and 50% higher for abdomen examination. Patient dose records were kept in nearly half of the facilities, with the highest frequency in Europe (55% of participating facilities), and in 49% of Asian, 36% of Latin American and 14% of African facilities. The analysis of the first-choice examinations in seven clinical conditions showed that practice was in accordance with guidelines for only three of seven specified clinical conditions.

Whole-remnant and maximum-voxel SPECT/CT dosimetry in {sup 131}I-NaI treatments of differentiated thyroid cancer

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

Mínguez, Pablo, E-mail: pablo.minguezgabina@osakid

Purpose: To investigate the possible differences between SPECT/CT based whole-remnant and maximum-voxel dosimetry in patients receiving radio-iodine ablation treatment of differentiated thyroid cancer (DTC). Methods: Eighteen DTC patients were administered 1.11 GBq of {sup 131}I-NaI after near-total thyroidectomy and rhTSH stimulation. Two patients had two remnants, so in total dosimetry was performed for 20 sites. Three SPECT/CT scans were performed for each patient at 1, 2, and 3–7 days after administration. The activity, the remnant mass, and the maximum-voxel activity were determined from these images and from a recovery-coefficient curve derived from experimental phantom measurements. The cumulated activity was estimatedmore » using trapezoidal-exponential integration. Finally, the absorbed dose was calculated using S-values for unit-density spheres in whole-remnant dosimetry and S-values for voxels in maximum-voxel dosimetry. Results: The mean absorbed dose obtained from whole-remnant dosimetry was 40 Gy (range 2–176 Gy) and from maximum-voxel dosimetry 34 Gy (range 2–145 Gy). For any given patient, the activity concentrations for each of the three time-points were approximately the same for the two methods. The effective half-lives varied (R = 0.865), mainly due to discrepancies in estimation of the longer effective half-lives. On average, absorbed doses obtained from whole-remnant dosimetry were 1.2 ± 0.2 (1 SD) higher than for maximum-voxel dosimetry, mainly due to differences in the S-values. The method-related differences were however small in comparison to the wide range of absorbed doses obtained in patients. Conclusions: Simple and consistent procedures for SPECT/CT based whole-volume and maximum-voxel dosimetry have been described, both based on experimentally determined recovery coefficients. Generally the results from the two approaches are consistent, although there is a small, systematic difference in the absorbed dose due to differences in the S-values, and some variability due to differences in the estimated effective half-lives, especially when the effective half-life is long. Irrespective of the method used, the patient absorbed doses obtained span over two orders of magnitude.« less

Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

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

Alva-Sánchez, Héctor, E-mail: halva@ciencias.unam.mx; Reynoso-Mejía, Alberto; Casares-Cruz, Katiuzka

In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guidemore » provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.« less

Patient dose estimation from CT scans at the Mexican National Neurology and Neurosurgery Institute

NASA Astrophysics Data System (ADS)

Alva-Sánchez, Héctor; Reynoso-Mejía, Alberto; Casares-Cruz, Katiuzka; Taboada-Barajas, Jesús

2014-11-01

In the radiology department of the Mexican National Institute of Neurology and Neurosurgery, a dedicated institute in Mexico City, on average 19.3 computed tomography (CT) examinations are performed daily on hospitalized patients for neurological disease diagnosis, control scans and follow-up imaging. The purpose of this work was to estimate the effective dose received by hospitalized patients who underwent a diagnostic CT scan using typical effective dose values for all CT types and to obtain the estimated effective dose distributions received by surgical and non-surgical patients. Effective patient doses were estimated from values per study type reported in the applications guide provided by the scanner manufacturer. This retrospective study included all hospitalized patients who underwent a diagnostic CT scan between 1 January 2011 and 31 December 2012. A total of 8777 CT scans were performed in this two-year period. Simple brain scan was the CT type performed the most (74.3%) followed by contrasted brain scan (6.1%) and head angiotomography (5.7%). The average number of CT scans per patient was 2.83; the average effective dose per patient was 7.9 mSv; the mean estimated radiation dose was significantly higher for surgical (9.1 mSv) than non-surgical patients (6.0 mSv). Three percent of the patients had 10 or more brain CT scans and exceeded the organ radiation dose threshold set by the International Commission on Radiological Protection for deterministic effects of the eye-lens. Although radiation patient doses from CT scans were in general relatively low, 187 patients received a high effective dose (>20 mSv) and 3% might develop cataract from cumulative doses to the eye lens.

Correlations between quantitative fat–water magnetic resonance imaging and computed tomography in human subcutaneous white adipose tissue

PubMed Central

Gifford, Aliya; Walker, Ronald C.; Towse, Theodore F.; Brian Welch, E.

2015-01-01

Abstract. Beyond estimation of depot volumes, quantitative analysis of adipose tissue properties could improve understanding of how adipose tissue correlates with metabolic risk factors. We investigated whether the fat signal fraction (FSF) derived from quantitative fat–water magnetic resonance imaging (MRI) scans at 3.0 T correlates to CT Hounsfield units (HU) of the same tissue. These measures were acquired in the subcutaneous white adipose tissue (WAT) at the umbilical level of 21 healthy adult subjects. A moderate correlation exists between MRI- and CT-derived WAT values for all subjects, R2=0.54, p<0.0001, with a slope of −2.6, (95% CI [−3.3,−1.8]), indicating that a decrease of 1 HU equals a mean increase of 0.38% FSF. We demonstrate that FSF estimates obtained using quantitative fat–water MRI techniques correlate with CT HU values in subcutaneous WAT, and therefore, MRI-based FSF could be used as an alternative to CT HU for assessing metabolic risk factors. PMID:26702407

Preliminary study on the diagnostic value of single-source dual-energy CT in diagnosing cervical lymph node metastasis of thyroid carcinoma

PubMed Central

Zhao, Yanfeng; Li, Xiaolu; Wang, Xiaoyi; Lin, Meng; Zhao, Xinming; Luo, Dehong; Li, Jianying

2017-01-01

Background To investigate the value of single-source dual-energy spectral CT imaging in improving the accuracy of preoperative diagnosis of lymph node metastasis of thyroid carcinoma. Methods Thirty-four thyroid carcinoma patients were enrolled and received spectral CT scanning before thyroidectomy and cervical lymph node dissection surgery. Iodine-based material decomposition (MD) images and 101 sets of monochromatic images from 40 to 140 keV were reconstructed after CT scans. The iodine concentrations (IC) of lymph nodes were measured on the MD images and was normalized to that of common carotid artery to obtain the normalized iodine concentration (NIC). The CT number of lymph nodes as function of photon energy was measured on the 101 sets of images to generate a spectral HU curve and to calculate its slope λHU. The measurements between the metastatic and non-metastatic lymph nodes were statistically compared and receiver operating characteristic (ROC) curves were used to determine the optimal thresholds of these measurements for diagnosing lymph nodes metastasis. Results There were 136 lymph nodes that were pathologically confirmed. Among them, 102 (75%) were metastatic and 34 (25%) were non-metastatic. The IC, NIC and the slope λHU of the metastatic lymph nodes were 3.93±1.58 mg/mL, 0.70±0.55 and 4.63±1.91, respectively. These values were statistically higher than the respective values of 1.77±0.71 mg/mL, 0.29±0.16 and 2.19±0.91 for the non-metastatic lymph nodes (all P<0.001). ROC analysis determined the optimal diagnostic threshold for IC as 2.56 mg/mL, with the sensitivity, specificity and accuracy of 83.3%, 91.2% and 85.3%, respectively. The optimal threshold for NIC was 0.289, with the sensitivity, specificity and accuracy of 96.1%, 76.5% and 91.2%, respectively. The optimal threshold for the spectral curve slope λHU was 2.692, with the sensitivity, specificity and accuracy of 88.2%, 82.4% and 86.8%, respectively. Conclusions The measurements obtained in dual-energy spectral CT improve the sensitivity and accuracy for preoperatively diagnosing lymph node metastasis in thyroid carcinoma. PMID:29268547

Textural features and SUV-based variables assessed by dual time point 18F-FDG PET/CT in locally advanced breast cancer.

PubMed

Garcia-Vicente, Ana María; Molina, David; Pérez-Beteta, Julián; Amo-Salas, Mariano; Martínez-González, Alicia; Bueno, Gloria; Tello-Galán, María Jesús; Soriano-Castrejón, Ángel

2017-12-01

To study the influence of dual time point 18F-FDG PET/CT in textural features and SUV-based variables and their relation among them. Fifty-six patients with locally advanced breast cancer (LABC) were prospectively included. All of them underwent a standard 18F-FDG PET/CT (PET-1) and a delayed acquisition (PET-2). After segmentation, SUV variables (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained. Eighteen three-dimensional (3D) textural measures were computed including: run-length matrices (RLM) features, co-occurrence matrices (CM) features, and energies. Differences between all PET-derived variables obtained in PET-1 and PET-2 were studied. Significant differences were found between the SUV-based parameters and MTV obtained in the dual time point PET/CT, with higher values of SUV-based variables and lower MTV in the PET-2 with respect to the PET-1. In relation with the textural parameters obtained in dual time point acquisition, significant differences were found for the short run emphasis, low gray-level run emphasis, short run high gray-level emphasis, run percentage, long run emphasis, gray-level non-uniformity, homogeneity, and dissimilarity. Textural variables showed relations with MTV and TLG. Significant differences of textural features were found in dual time point 18F-FDG PET/CT. Thus, a dynamic behavior of metabolic characteristics should be expected, with higher heterogeneity in delayed PET acquisition compared with the standard PET. A greater heterogeneity was found in bigger tumors.

Feasibility of in situ, high-resolution correlation of tracer uptake with histopathology by quantitative autoradiography of biopsy specimens obtained under 18F-FDG PET/CT guidance.

PubMed

Fanchon, Louise M; Dogan, Snjezana; Moreira, Andre L; Carlin, Sean A; Schmidtlein, C Ross; Yorke, Ellen; Apte, Aditya P; Burger, Irene A; Durack, Jeremy C; Erinjeri, Joseph P; Maybody, Majid; Schöder, Heiko; Siegelbaum, Robert H; Sofocleous, Constantinos T; Deasy, Joseph O; Solomon, Stephen B; Humm, John L; Kirov, Assen S

2015-04-01

Core biopsies obtained using PET/CT guidance contain bound radiotracer and therefore provide information about tracer uptake in situ. Our goal was to develop a method for quantitative autoradiography of biopsy specimens (QABS), to use this method to correlate (18)F-FDG tracer uptake in situ with histopathology findings, and to briefly discuss its potential application. Twenty-seven patients referred for a PET/CT-guided biopsy of (18)F-FDG-avid primary or metastatic lesions in different locations consented to participate in this institutional review board-approved study, which complied with the Health Insurance Portability and Accountability Act. Autoradiography of biopsy specimens obtained using 5 types of needles was performed immediately after extraction. The response of autoradiography imaging plates was calibrated using dummy specimens with known activity obtained using 2 core-biopsy needle sizes. The calibration curves were used to quantify the activity along biopsy specimens obtained with these 2 needles and to calculate the standardized uptake value, SUVARG. Autoradiography images were correlated with histopathologic findings and fused with PET/CT images demonstrating the position of the biopsy needle within the lesion. Logistic regression analysis was performed to search for an SUVARG threshold distinguishing benign from malignant tissue in liver biopsy specimens. Pearson correlation between SUVARG of the whole biopsy specimen and average SUVPET over the voxels intersected by the needle in the fused PET/CT image was calculated. Activity concentrations were obtained using autoradiography for 20 specimens extracted with 18- and 20-gauge needles. The probability of finding malignancy in a specimen is greater than 50% (95% confidence) if SUVARG is greater than 7.3. For core specimens with preserved shape and orientation and in the absence of motion, one can achieve autoradiography, CT, and PET image registration with spatial accuracy better than 2 mm. The correlation coefficient between the mean specimen SUVARG and SUVPET was 0.66. Performing QABS on core-biopsy specimens obtained using PET/CT guidance enables in situ correlation of (18)F-FDG tracer uptake and histopathology on a millimeter scale. QABS promises to provide useful information for guiding interventional radiology procedures and localized therapies and for in situ high-spatial-resolution validation of radiopharmaceutical uptake. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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

Luo, P.F.; Wang, J.S.; Chao, Y.J.

The stereo vision is used to study the fracture behavior in the compact tension (CT) specimen made from 304L stainless steel. During crack tip blunting, initiation, and growth in the CT specimen, both in-plane and out-of-plane displacement fields near the crack tip are measured by the stereo vision. Based on the plane stress assumption and the deformation theory of plasticity, the J integral is evaluated along several rectangular paths surrounding the crack tip by using the measured in-plane displacement field. Prior to crack growth, the J integral is path independent. For crack extension up to {Delta}a {approx} 3 mm, themore » near field J integral values are 6% to 10% lower than far field J integral values. For the crack extension of {Delta}a {approx} 4 mm, the J integral lost path independence. The far field J integral values are in good agreement with results obtained from Merkle-Corten`s formula. Both J-{Delta}a and CTOA-{Delta}a are obtained by computing the J integral value and crack tip opening angle (CTOA) at each {Delta}a. Results indicate that CTOA reached a nearly constant value at a crack extension of {Delta}a = 3 mm with a leveled resistance curve thereafter. Also, the J integral value is determined by the maximum transverse diameter of the shadow spots, which are generated by using the out-of-plane displacement field. Results indicate that for crack extension up to 0.25 mm, the J integral values evaluated by using the out-of- plane displacement are close to those obtained by using in-plane displacements and Merkle-Corten`s formula.« less

Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia.

PubMed

Esayag, Yaacov; Nikitin, Irina; Bar-Ziv, Jacob; Cytter, Ruth; Hadas-Halpern, Irith; Zalut, Todd; Yinnon, Amos M

2010-01-01

To assess the diagnostic value of the chest radiograph for the diagnosis of pneumonia in bedridden patients, using non-contrast-enhanced high-resolution chest computed tomography (CT) as the gold standard. We prospectively evaluated bedridden patients hospitalized with moderate to high clinical probability of pneumonia. Chest radiographs were interpreted in a blinded fashion by 3 observers and classified as definite, normal, or uncertain for pneumonia. Chest CT was obtained within 12 hours of chest radiograph. We applied Bayesian analysis to assess the accuracy of chest radiograph in the diagnosis of pneumonia. In a 5-month period, 58 patients were evaluated, 31 (53%) were female. Their chest radiographs were interpreted as negative, uncertain, or positive for pneumonia in 31 (53%), 15 (26%), and 12 (21%) patients, respectively, while CT confirmed pneumonia in 11 (35%), 10 (67%), and in 10 (83%). The sensitivity of the chest radiograph to diagnose pneumonia was 65%, the specificity was 93%, the positive and negative predictive values were, respectively, 83% and 65%, while the overall accuracy was 69% (95% confidence interval, 50%-79%). In bedridden patients with suspected pneumonia, a normal chest radiograph does not rule out the diagnosis, hence, a chest CT scan might provide valuable diagnostic information. Copyright 2010 Elsevier Inc. All rights reserved.

Prognostic value of CtIP/RBBP8 expression in breast cancer

PubMed Central

Soria-Bretones, Isabel; Sáez, Carmen; Ruíz-Borrego, Manuel; Japón, Miguel A; Huertas, Pablo

2013-01-01

CtIP/RBBP8 is a multifunctional protein involved in transcription, DNA replication, DNA repair by homologous recombination and the G1 and G2 checkpoints. Its multiple roles are controlled by its interaction with several specific factors, including the tumor suppressor proteins BRCA1 and retinoblastoma. Both its functions and interactors point to a putative oncogenic potential of CtIP/RBBP8 loss. However, CtIP/RBBP8 relevance in breast tumor appearance, development, and prognosis has yet to be established. We performed a retrospective analysis of CtIP/RBBP8 and RB1 levels by immunohistochemistry using 384 paraffin-embedded breast cancer biopsies obtained during tumor removal surgery. We have observed that low or no expression of CtIP/RBBP8 correlates with high-grade breast cancer and with nodal metastasis. Reduction on CtIP/RBBP8 is most common in hormone receptor (HR)-negative, HER2-positive, and basal-like tumors. We observed lower levels of RB1 on those tumors with reduced CtIP/RBBP8 levels. On luminal tumors, decreased but not absence of CtIP/RBBP8 levels correlate with increased disease-free survival when treated with a combination of hormone, radio, and chemo therapies. PMID:24403251

Validation of Optical Coherence Tomography against Micro-computed Tomography for Evaluation of Remaining Coronal Dentin Thickness.

PubMed

Majkut, Patrycja; Sadr, Alireza; Shimada, Yasushi; Sumi, Yasunori; Tagami, Junji

2015-08-01

Optical coherence tomography (OCT) is a noninvasive modality to obtain in-depth images of biological structures. A dental OCT system has become available for chairside application. This in vitro study hypothesized that swept-source OCT can be used to measure the remaining dentin thickness (RDT) at the roof of the dental pulp chamber during excavation of deep caries. Human molar teeth with deep occlusal caries were investigated. After obtaining 2-dimensional and 3-dimensional OCT scans using a swept-source OCT system at a 1330-nm center wavelength, RDT was evaluated by image analysis software. Microfocus x-ray computed tomographic (micro-CT) images were obtained from the same cross sections to confirm OCT findings. The smallest RDT values at the visible pulp horn were measured on OCT and micro-CT imaging and compared using the Pearson correlation. Pulpal horns and pulp chamber roof observation under OCT and micro-CT imaging resulted in comparable images that allowed the measurement of coronal dentin thickness. RDT measured by OCT showed optical values range between 140 and 2300 μm, which corresponded to the range of 92-1524 μm on micro-CT imaging. A strong correlation was found between the 2 techniques (r = 0.96, P < .001). Further analysis indicated linear regression with a slope of 1.54 and no intercept, closely matching the bulk refractive index of dentin. OCT enables visualization of anatomic structures during deep caries excavation. Exposure of the vital dental pulp because of the removal of very thin remaining coronal dentin can be avoided with this novel noninvasive technique. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Could texture features from preoperative CT image be used for predicting occult peritoneal carcinomatosis in patients with advanced gastric cancer?

PubMed

Kim, Hae Young; Kim, Young Hoon; Yun, Gabin; Chang, Won; Lee, Yoon Jin; Kim, Bohyoung

2018-01-01

To retrospectively investigate whether texture features obtained from preoperative CT images of advanced gastric cancer (AGC) patients could be used for the prediction of occult peritoneal carcinomatosis (PC) detected during operation. 51 AGC patients with occult PC detected during operation from January 2009 to December 2012 were included as occult PC group. For the control group, other 51 AGC patients without evidence of distant metastasis including PC, and whose clinical T and N stage could be matched to those of the patients of the occult PC group, were selected from the period of January 2011 to July 2012. Each group was divided into test (n = 41) and validation cohort (n = 10). Demographic and clinical data of these patients were acquired from the hospital database. Texture features including average, standard deviation, kurtosis, skewness, entropy, correlation, and contrast were obtained from manually drawn region of interest (ROI) over the omentum on the axial CT image showing the omentum at its largest cross sectional area. After using Fisher's exact and Wilcoxon signed-rank test for comparison of the clinical and texture features between the two groups of the test cohort, conditional logistic regression analysis was performed to determine significant independent predictor for occult PC. Using the optimal cut-off value from receiver operating characteristic (ROC) analysis for the significant variables, diagnostic sensitivity and specificity were determined in the test cohort. The cut-off value of the significant variables obtained from the test cohort was then applied to the validation cohort. Bonferroni correction was used to adjust P value for multiple comparisons. Between the two groups, there was no significant difference in the clinical features. Regarding the texture features, the occult PC group showed significantly higher average, entropy, standard deviation, and significantly lower correlation (P value < 0.004 for all). Conditional logistic regression analysis demonstrated that entropy was significant independent predictor for occult PC. When the cut-off value of entropy (> 7.141) was applied to the validation cohort, sensitivity and specificity for the prediction of occult PC were 80% and 90%, respectively. For AGC patients whose PC cannot be detected with routine imaging such as CT, texture analysis may be a useful adjunct for the prediction of occult PC.

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.

Value of Ki-67 and computed tomography in the assessment of peripheral lung adenocarcinoma.

PubMed

Chen, Cheng; Zhu, Wei-Dong; Zhang, Xiao-Hui; Zhu, Ye-Han; Huang, Jian-An

2016-01-01

This study was designed to determine whether proliferation antigen Ki-67 and/or a computed tomography (CT) value could be used to evaluate the clinical-pathological features of peripheral lung adenocarcinoma. A total of 116 eligible lung cancer patients were enrolled. Nodule size, lymph node metastasis, differentiation, Ki-67 expression and CT findings were assessed. The relationship between clinic parameters and the CT feature was analysed statistically. The percentage of lesions that had ground-glass opacity or localised air bronchogram was significantly greater in low CT value group (<30, p < 0.05). No significant association was observed between CT value and size in the subgroup with CT value > 0 (p = 0.66). As a proliferative marker of lung cancer, Ki-67 was present in a total of 115 (99.9%) of the 116 evaluable primary lung cancers. There was a statistically significant correlation between the Ki-67 index and CT value (p < 0.05). Compared to CT value, Ki-67 index possessed higher sensitivity to predict the differentiation and lymph node metastasis of peripheral lung adenocarcinoma, adding of CT value would enhance its specificity. Combination of Ki-67 expression and CT value determination was useful for the classification of differentiation and metastatic or proliferative potential of peripheral lung adenocarcinoma.

[A Retrospective Study of Mean Computed Tomography Value to Predict 
the Tumor Invasiveness in AAH and Clinical Stage Ia Lung Cancer].

PubMed

Wu, Hanran; Liu, Changqing; Xu, Meiqing; Xiong, Ran; Xu, Guangwen; Li, Caiwei; Xie, Mingran

2018-03-20

Recently, the detectable rate of ground-glass opacity (GGO ) was significantly increased, a appropriate diagnosis before clinic treatment tends to be important for patients with GGO lesions. The aim of this study is to validate the ability of the mean computed tomography (m-CT) value to predict tumor invasiveness, and compared with other measurements such as Max CT value, GGO size, solid size of GGO and C/T ratio (consolid/tumor ratio, C/T) to find out the best measurement to predict tumor invasiveness. A retrospective study was conducted of 129 patients who recieved lobectomy and were pathological confirmed as atypical adenomatous pyperplasia (AAH) or clinical stage Ia lung cance in our center between January 2012 and December 2013. Of those 129 patients, the number of patients of AAH, AIS, AIS and invasive adenocarcinoma were 43, 26, 17 and 43, respectively. We defined AAH and AIS as noninvasive cancer (NC), MIA and invasive adenocarcinoma were categorized as invasive cancer(IC). We used receiver operating characteristic (ROC) curve analysis to compare the ability to predict tumor invasiveness between m-CT value, consolidation/tumor ratio, tumor size and solid size of tumor. Multiple logistic regression analyses were performed to determine the independent variables for prediction of pathologic more invasive lung cancer. 129 patients were enrolled in our study (59 male and 70 female), the patients were a median age of (62.0±8.6) years (range, 44 to 82 years). The two groups were similar in terms of age, sex, differentiation (P>0.05). ROC curve analysis was performed to determine the appropriate cutoff value and area under the cure (AUC). The cutoff value of solid tumor size, tumor size, C/T ratio, m-CT value and Max CT value were 9.4 mm, 15.3 mm, 47.5%, -469.0 HU and -35.0 HU, respectively. The AUC of those variate were 0.89, 0.79, 0.82, 0.90, 0.85, respectively. When compared the clinical and radiologic data between two groups, we found the IC group was strongly associated with a high m-CT value, high Max CT value, high C/T ratio and large tumor size. Gender, solid tumor size, tumor size, C/T ratio, m-CT value and MaxCT value were selected factor for multivariate analysis, when using the preoperatively determined variables to predict the tumor invasiveness, revealed that tumor size, C/T ratio, m-CT value and Max CT value were independent predictive factors of IC. The musurements of Max CT value, GGO size, solid size of GGO and C/T ratio were significantly correlated with tumor invasiveness, and the evaluation of m-CT value is most useful musurement in predicting more invasive lung cancer.

Genotyping and chlorine-resistance of Methylobacterium aquaticum isolated from water samples in Japan.

PubMed

Furuhata, Katsunori; Banzai, Azusa U; Kawakami, Yasushi; Ishizaki, Naoto; Yoshida, Yoshihiro; Goto, Keiichi; Fukuyama, Masafumi

2011-09-01

For microbial ecological analysis, 14 strains of Methylobacterium aquaticum isolated from water samples were subjected to clustering analysis on the basis of ribotyping and RAPD-PCR tests. The ribopatterns after digestion with EcoRI obtained from 14 strains of M. aquaticum were used to divide the strains into two groups (Groups I and II) with a similarity of 55%. From the analysis of RAPD patterns using primer 208, the 14 strains were divided into 3 groups (A-C) based on a homology of 45% or greater, and from that using primer 272, there were 4 groups (A-D) based on a homology of 50% or greater. The chlorine resistance (99.9% CT values) of these isolates was also experimentally confirmed, and we attempted to define the connection between chlorine resistance and the geno-cluster. The average CT value of group I was 0.89 mg•min/l and the average of group II was 0.69 mg•min/l. No remarkable differences in the CT values for the groups were found.

Diffuse Large B-Cell Lymphoma: Prospective Multicenter Comparison of Early Interim FLT PET/CT versus FDG PET/CT with IHP, EORTC, Deauville, and PERCIST Criteria for Early Therapeutic Monitoring

PubMed Central

Minamimoto, Ryogo; Fayad, Luis; Advani, Ranjana; Vose, Julie; Macapinlac, Homer; Meza, Jane; Hankins, Jordan; Mottaghy, Felix; Juweid, Malik

2016-01-01

Purpose To compare the performance characteristics of interim fluorine 18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) (after two cycles of chemotherapy) by using the most prominent standardized interpretive criteria (including International Harmonization Project [IHP] criteria, European Organization for Research and Treatment of Cancer [EORTC] criteria, and PET Response Criteria in Solid Tumors (PERCIST) versus those of interim 18F fluorothymidine (FLT) PET/CT and simple visual interpretation. Materials and Methods This HIPAA-compliant prospective study was approved by the institutional review boards, and written informed consent was obtained. Patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) underwent both FLT and FDG PET/CT 18–24 days after two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone or rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. For FDG PET/CT interpretation, IHP criteria, EORTC criteria, PERCIST, Deauville criteria, standardized uptake value, total lesion glycolysis, and metabolic tumor volume were used. FLT PET/CT images were interpreted with visual assessment by two reviewers in consensus. The interim (after cycle 2) FDG and FLT PET/CT studies were then compared with the end-of-treatment FDG PET/CT studies to determine which interim examination and/or criteria best predicted the result after six cycles of chemotherapy. Results From November 2011 to May 2014, there were 60 potential patients for inclusion, of whom 46 patients (24 men [mean age, 60.9 years ± 13.7; range, 28–78 years] and 22 women [mean age, 57.2 years ± 13.4; range, 25–76 years]) fulfilled the criteria. Thirty-four patients had complete response, and 12 had residual disease at the end of treatment. FLT PET/CT had a significantly higher positive predictive value (PPV) (91%) in predicting residual disease than did any FDG PET/CT interpretation method (42%–46%). No difference in negative predictive value (NPV) was found between FLT PET/CT (94%) and FDG PET/CT (82%–95%), regardless of the interpretive criteria used. FLT PET/CT showed statistically higher (P < .001–.008) or similar NPVs than did FDG PET/CT. Conclusion Early interim FLT PET/CT had a significantly higher PPV than standardized FDG PET/CT–based interpretation for therapeutic response assessment in DLBCL. © RSNA, 2016 Online supplemental material is available for this article. PMID:26854705

Reference ranges for LVEF and LV volumes from electrocardiographically gated 82Rb cardiac PET/CT using commercially available software.

PubMed

Bravo, Paco E; Chien, David; Javadi, Mehrbod; Merrill, Jennifer; Bengel, Frank M

2010-06-01

Electrocardiographic gating is increasingly used for (82)Rb cardiac PET/CT, but reference ranges for global functional parameters are not well defined. We sought to establish reference values for left ventricular ejection fraction (LVEF), end systolic volume (ESV), and end diastolic volume (EDV) using 4 different commercial software packages. Additionally, we compared 2 different approaches for the definition of a healthy individual. Sixty-two subjects (mean age +/- SD, 49 +/- 9 y; 85% women; mean body mass index +/- SD, 34 +/- 10 kg/m(2)) who underwent (82)Rb-gated myocardial perfusion PET/CT were evaluated. All subjects had normal myocardial perfusion and no history of coronary artery disease (CAD) or cardiomyopathy. Subgroup 1 consisted of 34 individuals with low pretest probability of CAD (<10%), and subgroup 2 comprised 28 subjects who had no atherosclerosis on a coronary CT angiogram obtained concurrently during the PET/CT session. LVEF, ESV, and EDV were calculated at rest and during dipyridamole-induced stress, using CardIQ Physio (a dedicated PET software) and the 3 major SPECT software packages (Emory Cardiac Toolbox, Quantitative Gated SPECT, and 4DM-SPECT). Mean LVEF was significantly different among all 4 software packages. LVEF was most comparable between CardIQ Physio (62% +/- 6% and 54% +/- 7% at stress and rest, respectively) and 4DM-SPECT (64% +/- 7% and 56% +/- 8%, respectively), whereas Emory Cardiac Toolbox yielded higher values (71% +/- 6% and 65% +/- 6%, respectively, P < 0.001) and Quantitated Gated SPECT lower values (56% +/- 8% and 50% +/- 8%, respectively, P < 0.001). Subgroup 1 (low likelihood) demonstrated higher LVEF values than did subgroup 2 (normal CT angiography findings), using all software packages (P < 0.05). However, mean ESV and EDV at stress and rest were comparable between both subgroups (p = NS). Intra- and interobserver agreement were excellent for all methods. The reference range of LVEF and LV volumes from gated (82)Rb PET/CT varies significantly among available software programs and therefore cannot be used interchangeably. LVEF results were higher when healthy subjects were defined by a low pretest probability of CAD than by normal CT angiography results.

18-Fluorodeoxy-Glucose Positron Emission Tomography- Computed Tomography (18-FDG-PET/CT) for Gross Tumor Volume (GTV) Delineation in Gastric Cancer Radiotherapy

PubMed

Dębiec, Kinga; Wydmański, Jerzy; Gorczewska, Izabela; Leszczyńska, Paulina; Gorczewski, Kamil; Leszczyński, Wojciech; d’Amico, Andrea; Kalemba, Michał

2017-11-26

Purpose: Evaluation of the 18-fluorodeoxy-glucose positron emission tomography-computed tomography (18-FDGPET/ CT) for gross tumor volume (GTV) delineation in gastric cancer patients undergoing radiotherapy. Methods: In this study, 29 gastric cancer patients (17 unresectable and 7 inoperable) were initially enrolled for radical chemoradiotherapy (45Gy/25 fractions + chemotherapy based on 5 fluorouracil) or radiotherapy alone (45Gy/25 fractions) with planning based on the 18-FDG-PET/CT images. Five patients were excluded due to excess blood glucose levels (1), false-negative positron emission tomography (1) and distant metastases revealed by 18-FDG-PET/CT (3). The analysis involved measurement of metabolic tumor volumes (MTVs) performed on PET/CT workstations. Different threshold levels of the standardized uptake value (SUV) and liver uptake were set to obtain MTVs. Secondly, GTVPET values were derived manually using the positron emission tomography (PET) dataset blinded to the computed tomography (CT) data. Subsequently, GTVCT values were delineated using a radiotherapy planning system based on the CT scans blinded to the PET data. The referenced GTVCT values were correlated with the GTVPET and were compared with a conformality index (CI). Results: The mean CI was 0.52 (range, 0.12-0.85). In 13/24 patients (54%), the GTVPET was larger than GTVCT, and in the remainder, GTVPET was smaller. Moreover, the cranio-caudal diameter of GTVPET in 16 cases (64%) was larger than that of GTVCT, smaller in 7 cases (29%), and unchanged in one case. Manual PET delineation (GTVPET) achieved the best correlation with GTVCT (Pearson correlation = 0.76, p <0.0001). Among the analyzed MTVs, a statistically significant correlation with GTVCT was revealed for MTV10%SUVmax (r = 0.63; p = 0.0014), MTVliv (r = 0.60; p = 0.0021), MTVSUV2.5 (r = 0.54; p = 0.0063); MTV20%SUVmax (r = 0.44; p = 0.0344); MTV30%SUVmax (r = 0.44; p = 0.0373). Conclusion: 18-FDG-PET/CT in gastric cancer radiotherapy planning may affect the GTV delineation. https://www.ncbi.nlm.nih.gov/pubmed/management

Determination of Single-Kidney Glomerular Filtration Rate in Human Subjects by Using CT

PubMed Central

Kwon, Soon Hyo; Saad, Ahmed; Herrmann, Sandra M.; Textor, Stephen C.

2015-01-01

Purpose To test the hypothesis that computed tomography (CT)–derived measurements of single-kidney glomerular filtration rate (GFR) obtained in human subjects with 64-section CT agree with those obtained with iothalamate clearance, a rigorous reference standard. Materials and Methods The institutional review board approved this HIPAA-compliant study, and written informed consent was obtained. Ninety-six patients (age range, 51–73 years; 46 men, 50 women) with essential (n = 56) or renovascular (n = 40) hypertension were prospectively studied in controlled conditions (involving sodium intake and renin-angiotensin blockade). Single-kidney perfusion, volume, and GFR were measured by using multidetector CT time-attenuation curves and were compared with GFR measured by using iothalamate clearance, as assigned to the right and left kidney according to relative volumes. The reproducibility of CT GFR over a 3-month period (n = 21) was assessed in patients with renal artery stenosis who were undergoing stable medical treatment. Statistical analysis included the t test, Wilcoxon signed rank test, linear regression, and Bland-Altman analysis. Results CT GFR values were similar to those of iothalamate clearance (mean ± standard deviation, 38.2 mL/min ± 18 vs 41.6 mL/min ± 17; P = .062). Stenotic kidney CT GFR in patients with renal artery stenosis was lower than contralateral kidney GFR or essential hypertension single-kidney GFR (mean, 23.1 mL/min ± 13 vs 36.9 mL/min ± 17 [P = .0008] and 45.2 mL/min ± 16 [P = .019], respectively), as was iothalamate clearance (mean, 26.9 mL/min ± 14 vs 38.5 mL/min ± 15 [P = .0004] and 49.0 mL/min ± 14 [P = .001], respectively). CT GFR correlated well with iothalamate GFR (linear regression, CT GFR = 0.88*iothalamate GFR, r2 = 0.89, P < .0001), and Bland-Altman analysis was used to confirm the agreement. CT GFR was also moderately reproducible in medically treated patients with renal artery stenosis (concordance coefficient correlation, 0.835) but was unaffected by revascularization (mean, 25.3 mL/min ± 15.2 vs 30.3 mL/min ± 18.5; P = .097). Conclusion CT assessments of single-kidney GFR are reproducible and agree well with a reference standard. CT can be useful to obtain minimally invasive estimates of bilateral single-kidney function in human subjects. © RSNA, 2015 PMID:25848903

Treatment of delocalized electron transfer in periodic and embedded cluster DFT calculations: The case of Cu on ZnO (10(1)0).

PubMed

Hellström, Matti; Spångberg, Daniel; Hermansson, Kersti

2015-12-15

We assess the consequences of the interface model-embedded-cluster or periodic-slab model-on the ability of DFT calculations to describe charge transfer (CT) in a particularly challenging case where periodic-slab calculations indicate a delocalized charge-transfer state. Our example is Cu atom adsorption on ZnO(10(1)0), and in fact the periodic slab calculations indicate three types of CT depending on the adsorption site: full CT, partial CT, and no CT. Interestingly, when full CT occurs in the periodic calculations, the calculated Cu atom adsorption energy depends on the underlying ZnO substrate supercell size, since when the electron enters the ZnO it delocalizes over as many atoms as possible. In the embedded-cluster calculations, the electron transferred to the ZnO delocalizes over the entire cluster region, and as a result the calculated Cu atom adsorption energy does not agree with the value obtained using a large periodic supercell, but instead to the adsorption energy obtained for a periodic supercell of roughly the same size as the embedded cluster. Different density functionals (of GGA and hybrid types) and basis sets (local atom-centered and plane-waves) were assessed, and we show that embedded clusters can be used to model Cu adsorption on ZnO(10(1)0), as long as care is taken to account for the effects of CT. © 2015 Wiley Periodicals, Inc.

Very low-dose (0.15 mGy) chest CT protocols using the COPDGene 2 test object and a third-generation dual-source CT scanner with corresponding third-generation iterative reconstruction software.

PubMed

Newell, John D; Fuld, Matthew K; Allmendinger, Thomas; Sieren, Jered P; Chan, Kung-Sik; Guo, Junfeng; Hoffman, Eric A

2015-01-01

The purpose of this study was to evaluate the impact of ultralow radiation dose single-energy computed tomographic (CT) acquisitions with Sn prefiltration and third-generation iterative reconstruction on density-based quantitative measures of growing interest in phenotyping pulmonary disease. The effects of both decreasing dose and different body habitus on the accuracy of the mean CT attenuation measurements and the level of image noise (SD) were evaluated using the COPDGene 2 test object, containing 8 different materials of interest ranging from air to acrylic and including various density foams. A third-generation dual-source multidetector CT scanner (Siemens SOMATOM FORCE; Siemens Healthcare AG, Erlangen, Germany) running advanced modeled iterative reconstruction (ADMIRE) software (Siemens Healthcare AG) was used.We used normal and very large body habitus rings at dose levels varying from 1.5 to 0.15 mGy using a spectral-shaped (0.6-mm Sn) tube output of 100 kV(p). Three CT scans were obtained at each dose level using both rings. Regions of interest for each material in the test object scans were automatically extracted. The Hounsfield unit values of each material using weighted filtered back projection (WFBP) at 1.5 mGy was used as the reference value to evaluate shifts in CT attenuation at lower dose levels using either WFBP or ADMIRE. Statistical analysis included basic statistics, Welch t tests, multivariable covariant model using the F test to assess the significance of the explanatory (independent) variables on the response (dependent) variable, and CT mean attenuation, in the multivariable covariant model including reconstruction method. Multivariable regression analysis of the mean CT attenuation values showed a significant difference with decreasing dose between ADMIRE and WFBP. The ADMIRE has reduced noise and more stable CT attenuation compared with WFBP. There was a strong effect on the mean CT attenuation values of the scanned materials for ring size (P < 0.0001) and dose level (P < 0.0001). The number of voxels in the region of interest for the particular material studied did not demonstrate a significant effect (P > 0.05). The SD was lower with ADMIRE compared with WFBP at all dose levels and ring sizes (P < 0.05). The third-generation dual-source CT scanners using third-generation iterative reconstruction methods can acquire accurate quantitative CT images with acceptable image noise at very low-dose levels (0.15 mGy). This opens up new diagnostic and research opportunities in CT phenotyping of the lung for developing new treatments and increased understanding of pulmonary disease.

Comparison of standard radiography and computed tomography in 21 dogs with maxillary masses.

PubMed

Ghirelli, Carolina O; Villamizar, Lenin A; Pinto, Ana Carolina B C Fonseca

2013-01-01

Imaging of patients with oral cancer is required to determine tumor extension in order to assist in prognosis and surgical planning. Conventional screen-film radiography (SFR) used to be the most common method for oral assessment, but computed tomography (CT) has become more available and is being used for obtaining complementary information. CT examinations eliminate superimposition by acquiring cross-sectional images of the region of interest. The objective of this study was to determine the diagnostic value of SFR compared with CT examinations for evaluation of oral masses in dogs. Twenty-one dogs received head and thorax SFR, and pre- and post-contrast head CT. Bony changes were observed in 80.9% and 95.2% of the cases in SFR and CT studies, respectively. Invasion of adjacent structures (i.e. nasal cavity, frontal and sphenoidal sinuses, orbit, maxillary recess, nasopharynx) was observed in only 30% of cases with SFR while CT showed 90.4% involvement. CT is an important preoperative examination modality and is more effective in identifying bone changes and tumor invasion of adjacent structures compared with SFR.

Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications

PubMed Central

Leng, Shuai; Yu, Lifeng; Fletcher, Joel G.

2015-01-01

In x-ray computed tomography (CT), materials having different elemental compositions can be represented by identical pixel values on a CT image (ie, CT numbers), depending on the mass density of the material. Thus, the differentiation and classification of different tissue types and contrast agents can be extremely challenging. In dual-energy CT, an additional attenuation measurement is obtained with a second x-ray spectrum (ie, a second “energy”), allowing the differentiation of multiple materials. Alternatively, this allows quantification of the mass density of two or three materials in a mixture with known elemental composition. Recent advances in the use of energy-resolving, photon-counting detectors for CT imaging suggest the ability to acquire data in multiple energy bins, which is expected to further improve the signal-to-noise ratio for material-specific imaging. In this review, the underlying motivation and physical principles of dual- or multi-energy CT are reviewed and each of the current technical approaches is described. In addition, current and evolving clinical applications are introduced. © RSNA, 2015 PMID:26302388

Determination of the chemical composition of human renal stones with MDCT: influence of the surrounding media

NASA Astrophysics Data System (ADS)

Grosjean, Romain; Sauer, Benoît; Guerra, Rui; Kermarrec, Isabelle; Ponvianne, Yannick; Winninger, Daniel; Daudon, Michel; Blum, Alain; Felblinger, Jacques; Hubert, Jacques

2007-03-01

The selection of the optimal treatment method for urinary stones diseases depends on the chemical composition of the stone and its corresponding fragility. MDCT has become the most used modality to determine rapidly and accurately the presence of stones when evaluating urinary lithiasis treatment. That is why several studies have tempted to determine the chemical composition of the stones based on the stone X-ray attenuation in-vitro and invivo. However, in-vitro studies did not reproduce the normal abdominal wall and fat, making uncertain the standardization of the obtained values. The aim of this study is to obtain X-ray attenuation values (in Hounsfield Units) of the six more frequent types of human renal stones (n=217) and to analyze the influence of the surrounding media on these values. The stones were first placed in a jelly, which X-ray attenuation is similar to that of the human kidney (30 HU at 120 kV). They were then stuck on a grid, scanned in a water tank and finally scanned in the air. Significant differences in CT-attenuation values were obtained with the three different surrounding media (jelly, water, air). Furthermore there was an influence of the surrounding media and consequently discrepancies in determination of the chemical composition of the renal stones. Consequently, CT-attenuation values found in in-vitro studies cannot really be considered as a reference for the determination of the chemical composition except if the used phantom is an anthropomorphic one.

Lung malignancy: Diagnostic accuracies of bronchoalveolar lavage, bronchial brushing, and fine needle aspiration cytology

PubMed Central

Sareen, Rateesh; Pandey, C L

2016-01-01

Background: Early diagnosis of lung cancer plays a pivotal role in reducing lung cancer death rate. Cytological techniques are safer, economical and provide quick results. Bronchoscopic washing, brushing and fine needle aspirations not only complement tissue biopsies in the diagnosis of lung cancer but also comparable. Objectives: (1) To find out diagnostic yields of bronchioalveolar lavage, bronchial brushings, FNAC in diagnosis of lung malignancy. (2) To compare relative accuracy of these three cytological techniques. (3) To correlate the cytologic diagnosis with clinical, bronchoscopic and CT findings. (4) Cytological and histopathological correlation of lung lesions. Methods: All the patients who came with clinical or radiological suspicion of lung malignancy in two and a half year period were included in study. Bronchoalveolar lavage was the most common type of cytological specimen (82.36%), followed by CT guided FNAC (9.45%) and bronchial brushings (8.19%). Sensitivity, specificity, positive and negative predictive value for all techniques and correlation with histopathology was done using standard formulas. Results: The most sensitive technique was CT FNAC – (87.25%) followed by brushings (77.78%) and BAL (72.69%). CT FNAC had highest diagnostic yield (90.38%), followed by brushings (86.67%) and BAL (83.67%). Specificity and positive predictive value were 100 % each of all techniques. Lowest false negatives were obtained in CT FNAC (12.5%) and highest in BAL (27.3%). Highest negative predictive value was of BAL 76.95 % followed by BB 75.59% and CT FNAC 70.59%. Conclusion: Before administering antitubercular treatment every effort should be made to rule out malignancy. CT FNAC had highest diagnostic yield among three cytological techniques. BAL is an important tool in screening central as well as in accessible lesions. It can be used at places where CT guided FNAC is not available or could not be done due to technical or financial limitations PMID:27890992

Dual energy spectral CT imaging for the evaluation of small hepatocellular carcinoma microvascular invasion.

PubMed

Yang, Chuang-Bo; Zhang, Shuang; Jia, Yong-Jun; Yu, Yong; Duan, Hai-Feng; Zhang, Xi-Rong; Ma, Guang-Ming; Ren, Chenglong; Yu, Nan

2017-10-01

To study the clinical value of dual-energy spectral CT in the quantitative assessment of microvascular invasion of small hepatocellular carcinoma. This study was approved by our ethics committee. 50 patients with small hepatocellular carcinoma who underwent contrast enhanced spectral CT in arterial phase (AP) and portal venous phase (VP) were enrolled. Tumour CT value and iodine concentration (IC) were measured from spectral CT images. The slope of spectral curve, normalized iodine concentration (NIC, to abdominal aorta) and ratio of IC difference between AP and VP (RIC AP-VP : [RIC AP-VP =(IC AP -IC VP )/IC AP ]) were calculated. Tumours were identified as either with or without microvascular invasion based on pathological results. Measurements were statistically compared using independent samples t test. The receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of tumours microvascular invasion assessment. The 70keV images were used to simulate the results of conventional CT scans for comparison. 56 small hepatocellular carcinomas were detected with 37 lesions (Group A) with microvascular invasion and 19 (Group B) without. There were significant differences in IC, NIC and slope in AP and RIC AP-VP between Group A (2.48±0.70mg/ml, 0.23±0.05, 3.39±1.01 and 0.28±0.16) and Group B (1.65±0.47mg/ml, 0.15±0.05, 2.22±0.64 and 0.03±0.24) (all p<0.05). Using 0.188 as the threshold for NIC, one could obtain an area-under-curve (AUC) of 0.87 in ROC to differentiate between tumours with and without microvascular invasion. AUC was 0.71 with CT value at 70keV and improved to 0.81 at 40keV. Dual-energy Spectral CT provides additional quantitative parameters than conventional CT to improve the differentiation between small hepatocellular carcinoma with and without microvascular invasion. Quantitative iodine concentration measurement in spectral CT may be used to provide a new method to improve the evaluation for small hepatocellular carcinoma microvascular invasion. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparing CT perfusion with oxygen partial pressure in a rabbit VX2 soft-tissue tumor model.

PubMed

Sun, Chang-Jin; Li, Chao; Lv, Hai-Bo; Zhao, Cong; Yu, Jin-Ming; Wang, Guang-Hui; Luo, Yun-Xiu; Li, Yan; Xiao, Mingyong; Yin, Jun; Lang, Jin-Yi

2014-01-01

The aim of this study was to evaluate the oxygen partial pressure of the rabbit model of the VX2 tumor using a 64-slice perfusion CT and to compare the results with that obtained using the oxygen microelectrode method. Perfusion CT was performed for 45 successfully constructed rabbit models of a VX2 brain tumor. The perfusion values of the brain tumor region of interest, the blood volume (BV), the time to peak (TTP) and the peak enhancement intensity (PEI) were measured. The results were compared with the partial pressure of oxygen (PO2) of that region of interest obtained using the oxygen microelectrode method. The perfusion values of the brain tumor region of interest in 45 successfully constructed rabbit models of a VX2 brain tumor ranged from 1.3-127.0 (average, 21.1 ± 26.7 ml/min/ml); BV ranged from 1.2-53.5 ml/100g (average, 22.2 ± 13.7 ml/100g); PEI ranged from 8.7-124.6 HU (average, 43.5 ± 28.7 HU); and TTP ranged from 8.2-62.3 s (average, 38.8 ± 14.8 s). The PO2 in the corresponding region ranged from 0.14-47 mmHg (average, 16 ± 14.8 mmHg). The perfusion CT positively correlated with the tumor PO2, which can be used for evaluating the tumor hypoxia in clinical practice.

Oxygen transport properties estimation by DSMC-CT simulations

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

Bruno, Domenico; Frezzotti, Aldo; Ghiroldi, Gian Pietro

Coupling DSMC simulations with classical trajectories calculations is emerging as a powerful tool to improve predictive capabilities of computational rarefied gas dynamics. The considerable increase of computational effort outlined in the early application of the method (Koura,1997) can be compensated by running simulations on massively parallel computers. In particular, GPU acceleration has been found quite effective in reducing computing time (Ferrigni,2012; Norman et al.,2013) of DSMC-CT simulations. The aim of the present work is to study rarefied Oxygen flows by modeling binary collisions through an accurate potential energy surface, obtained by molecular beams scattering (Aquilanti, et al.,1999). The accuracy ofmore » the method is assessed by calculating molecular Oxygen shear viscosity and heat conductivity following three different DSMC-CT simulation methods. In the first one, transport properties are obtained from DSMC-CT simulations of spontaneous fluctuation of an equilibrium state (Bruno et al, Phys. Fluids, 23, 093104, 2011). In the second method, the collision trajectory calculation is incorporated in a Monte Carlo integration procedure to evaluate the Taxman’s expressions for the transport properties of polyatomic gases (Taxman,1959). In the third, non-equilibrium zero and one-dimensional rarefied gas dynamic simulations are adopted and the transport properties are computed from the non-equilibrium fluxes of momentum and energy. The three methods provide close values of the transport properties, their estimated statistical error not exceeding 3%. The experimental values are slightly underestimated, the percentage deviation being, again, few percent.« less

Simultaneous (68)Ga-DOTA-TOC PET/MRI with gadoxetate disodium in patients with neuroendocrine tumor.

PubMed

Hope, Thomas A; Pampaloni, Miguel Hernandez; Nakakura, Eric; VanBrocklin, Henry; Slater, James; Jivan, Salma; Aparici, Carina Mari; Yee, Judy; Bergsland, Emily

2015-08-01

To evaluate a simultaneous PET/MRI approach to imaging patients with neuroendocrine tumor using a combination of (68)Ga-DOTA-TOC as a PET contrast agent and gadoxetate disodium as a hepatobiliary MRI contrast agent. Ten patients with neuroendocrine tumor with known or suspected hepatic disease were imaged using a (68)Ga-DOTA-TOC PET/CT immediately followed by a 3.0T time-of-flight PET/MRI, using a combined whole body and liver specific imaging. The presence of lesions and DOTA-TOC avidity were assessed on CT, PET from PET/CT, diffusion weighted imaging, hepatobiliary phase imaging (HBP), and PET from PET/MRI. Maximum standardized uptake values (SUVmax) in hepatic lesions and nodal metastases were compared between PET/CT and PET/MRI, as were detection rates using each imaging approach. A total of 101 hepatic lesions were identified, 47 of which were DOTA-TOC avid and able to be individually measured on both PET/CT and PET/MRI. HBP imaging had a higher sensitivity for detection of hepatic lesions compared to CT or PET (99% vs. 46% and 64%, respectively; p values <0.001). There was a strong correlation between SUVmax of liver lesions obtained with PET/CT compared to PET/MR imaging (Pearson's correlation = 0.91). For nodal disease, CT had a higher sensitivity compared to whole body MRI (p = 0.015), although PET acquired from PET/MRI detected slightly more lesions compared to PET from PET/CT. A simultaneous PET/MRI using both (68)Ga-DOTA-TOC and gadoxetate disodium was successful in whole body staging of patients with neuroendocrine tumor. HBP imaging had an increased detection rate for hepatic metastases.

Evaluation of a short dynamic 18F-fluoride PET/CT scanning method to assess bone metabolic activity in spinal orthopedics.

PubMed

Peters, Marloes J M; Wierts, Roel; Jutten, Elisabeth M C; Halders, Servé G E A; Willems, Paul C P H; Brans, Boudewijn

2015-11-01

A complication after spinal fusion surgery is pseudarthrosis, but its radiological diagnosis is of limited value. (18)F-fluoride PET with its ability to assess bone metabolism activity could be of value. The goal of this study was to assess the clinical feasibility of calculating the static standardized uptake value (SUV) from a short dynamic scan without the use of blood sampling, thereby obtaining all dynamic and static parameters in a scan of only 30 min. This approach was tested on a retrospective patient population with persisting pain after spinal fusion surgery. In 16 patients, SUVs (SUV max, SUV mean) and kinetic parameters (K 1, k 2, k 3, v b, K i,NLR, K 1/k 2, k 3/(k 2 + k 3), K i,patlak) were derived from static and dynamic PET/CT scans of operated and control regions of the spine, after intravenous administration of 156-214 MBq (18)F-fluoride. Parameter differences between control and operated regions, as well as between pseudarthrosis and fused segments were evaluated. SUVmean at 30 and 60 min was calculated from kinetic parameters obtained from the dynamic data set (SUV mean,2TCM). Agreement between measured and calculated SUVs was evaluated through Bland-Altman plots. Overall, statistically significant differences between control and operated regions were observed for SUV max, SUV mean, K i,NLR, K i,patlak, K 1/k 2 and k 3/(k 2 + k 3). Diagnostic CT showed pseudarthrosis in 6/16 patients, while in 10/16 patients, segments were fused. Of all parameters, only those regarding the incorporation of bone [K i,NLR, K i,patlak, k 3/(k 2 + k 3)] differed statistically significant in the intervertebral disc space between the pseudarthrosis and fused patients group. The mean values of the patient-specific blood clearance rate [Formula: see text] differed statistically significant between the pseudarthrosis and the fusion group, with a p value of 0.011. This may correspond with the lack of statistical significance of the SUV values between pseudarthrosis and fused patients. Bland-Altman plots show that calculated SUV mean,2TCM values corresponded well with the measured SUV mean values. This study shows the feasibility of a 30-min dynamic (18)F-fluoride PET/CT scanning and this may provide dynamic parameters clinically relevant to the diagnosis of pseudarthrosis.

MO-FG-CAMPUS-IeP2-01: Characterization of Beam Shaping Filters and Photon Spectra From HVL Profiles in CT

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

Bujila, R; Royal Institute of Technology, Stockholm; Kull, L

Purpose: Advanced dosimetry in CT (e.g. the Monte Carlo method) requires an accurate characterization of the shaped filter and radiation quality used during a scan. The purpose of this work was to develop a method where half value layer (HVL) profiles along shaped filters could be made. From the HVL profiles the beam shaping properties and effective photon spectrum for a particular scan can be inferred. Methods: A measurement rig was developed to allow determinations of the HVL under a scatter-free narrow-beam geometry and constant focal spot to ionization chamber distance for different fan angles. For each fan angle themore » HVL is obtained by fitting the transmission of radiation through different thicknesses of an Al absorber (type 1100) using an appropriate model. The effective Al thickness of shaped filters and effective photon spectra are estimated using a model of photon emission from a Tungsten anode. This method is used to obtain the effective photon spectra and effective Al thickness of shaped filters for a CT scanner recently introduced to the market. Results: This study resulted in a set of effective photon spectra (central ray) for each kVp along with effective Al thicknesses of the different shaped filters. The effective photon spectra and effective Al thicknesses of shaped filters were used to obtain numerically approximated HVL profiles and compared to measured HVL profiles (mean absolute percentage error = 0.02). The central axis HVL found in the vendor’s technical documentation were compared to approximated HVL values (mean absolute percentage error = 0.03). Conclusion: This work has resulted in a unique method of measuring HVL profiles along shaped filters in CT. Further the effective photon spectra and the effective Al thicknesses of shaped filters that were obtained can be incorporated into Monte Carlo simulations.« less

Development of 1-year-old computational phantom and calculation of organ doses during CT scans using Monte Carlo simulation.

PubMed

Pan, Yuxi; Qiu, Rui; Gao, Linfeng; Ge, Chaoyong; Zheng, Junzheng; Xie, Wenzhang; Li, Junli

2014-09-21

With the rapidly growing number of CT examinations, the consequential radiation risk has aroused more and more attention. The average dose in each organ during CT scans can only be obtained by using Monte Carlo simulation with computational phantoms. Since children tend to have higher radiation sensitivity than adults, the radiation dose of pediatric CT examinations requires special attention and needs to be assessed accurately. So far, studies on organ doses from CT exposures for pediatric patients are still limited. In this work, a 1-year-old computational phantom was constructed. The body contour was obtained from the CT images of a 1-year-old physical phantom and the internal organs were deformed from an existing Chinese reference adult phantom. To ensure the organ locations in the 1-year-old computational phantom were consistent with those of the physical phantom, the organ locations in 1-year-old computational phantom were manually adjusted one by one, and the organ masses were adjusted to the corresponding Chinese reference values. Moreover, a CT scanner model was developed using the Monte Carlo technique and the 1-year-old computational phantom was applied to estimate organ doses derived from simulated CT exposures. As a result, a database including doses to 36 organs and tissues from 47 single axial scans was built. It has been verified by calculation that doses of axial scans are close to those of helical scans; therefore, this database could be applied to helical scans as well. Organ doses were calculated using the database and compared with those obtained from the measurements made in the physical phantom for helical scans. The differences between simulation and measurement were less than 25% for all organs. The result shows that the 1-year-old phantom developed in this work can be used to calculate organ doses in CT exposures, and the dose database provides a method for the estimation of 1-year-old patient doses in a variety of CT examinations.

Development of 1-year-old computational phantom and calculation of organ doses during CT scans using Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Pan, Yuxi; Qiu, Rui; Gao, Linfeng; Ge, Chaoyong; Zheng, Junzheng; Xie, Wenzhang; Li, Junli

2014-09-01

With the rapidly growing number of CT examinations, the consequential radiation risk has aroused more and more attention. The average dose in each organ during CT scans can only be obtained by using Monte Carlo simulation with computational phantoms. Since children tend to have higher radiation sensitivity than adults, the radiation dose of pediatric CT examinations requires special attention and needs to be assessed accurately. So far, studies on organ doses from CT exposures for pediatric patients are still limited. In this work, a 1-year-old computational phantom was constructed. The body contour was obtained from the CT images of a 1-year-old physical phantom and the internal organs were deformed from an existing Chinese reference adult phantom. To ensure the organ locations in the 1-year-old computational phantom were consistent with those of the physical phantom, the organ locations in 1-year-old computational phantom were manually adjusted one by one, and the organ masses were adjusted to the corresponding Chinese reference values. Moreover, a CT scanner model was developed using the Monte Carlo technique and the 1-year-old computational phantom was applied to estimate organ doses derived from simulated CT exposures. As a result, a database including doses to 36 organs and tissues from 47 single axial scans was built. It has been verified by calculation that doses of axial scans are close to those of helical scans; therefore, this database could be applied to helical scans as well. Organ doses were calculated using the database and compared with those obtained from the measurements made in the physical phantom for helical scans. The differences between simulation and measurement were less than 25% for all organs. The result shows that the 1-year-old phantom developed in this work can be used to calculate organ doses in CT exposures, and the dose database provides a method for the estimation of 1-year-old patient doses in a variety of CT examinations.

Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography.

PubMed

Lee, In Sook; Lee, Jung-Hoon; Woo, Chang-Ki; Kim, Hak Jin; Sol, Yu Li; Song, Jong Woon; Cho, Kyu-Sup

2016-02-01

The purpose of this study was to evaluate and compare the diagnostic efficacy of ultrasonography (US) with radiography and multi-detector computed tomography (CT) for the detection of nasal bone fractures. Forty-one patients with a nasal bone fracture who underwent prospective US examinations were included. Plain radiographs and CT images were obtained on the day of trauma. For US examinations, radiologist used a linear array transducer (L17-5 MHz) in 24 patients and hockey-stick probe (L15-7 MHz) in 17. The bony component of the nose was divided into three parts (right and left lateral nasal walls, and midline of nasal bone). Fracture detection by three modalities was subjected to analysis. Furthermore, findings made by each modality were compared with intraoperative findings. Nasal bone fractures were located in the right lateral wall (n = 28), midline of nasal bone (n = 31), or left lateral wall (n = 31). For right and left lateral nasal walls, CT had greater sensitivity and specificity than US or radiography, and better agreed with intraoperative findings. However, for midline fractures of nasal bone, US had higher specificity, positive predictive value, and negative predictive value than CT. Although two US evaluations showed good agreements at all three sites, US findings obtained by the hockey-stick probe showed closer agreement with intraoperative findings for both lateral nasal wall and midline of nasal bone. Although CT showed higher sensitivity and specificity than US or radiography, US found to be helpful for evaluating the midline of nasal bone. Furthermore, for US examinations of the nasal bone, a smaller probe and higher frequency may be required.

Three-phase 18F-fluorocholine PET/CT in the evaluation of prostate cancer recurrence.

PubMed

Steiner, Ch; Vees, H; Zaidi, H; Wissmeyer, M; Berrebi, O; Kossovsky, M P; Khan, H G; Miralbell, R; Ratib, O; Buchegger, F

2009-01-01

Contribution of 3-phase 18F-fluorocholine PET/CT in suspected prostate cancer recurrence at early rise of PSA. Retrospective analysis was performed in 47 patients after initial treatment with radiotherapy (n=30) or surgery (n=17). Following CT, 10 minutes list-mode PET acquisition was done over the prostate bed after injection of 300 MBq of 18F-fluorocholine. Three timeframes of 3 minutes each were reconstructed for analysis. All patients underwent subsequent whole body PET/CT. Delayed pelvic PET/CT was obtained in 36 patients. PET/CT was interpreted visually by two observers and SUVmax determined for suspicious lesions. Biopsies were obtained from 13 patients. Biopsies confirmed the presence of cancer in 11 of 13 patients with positive PET for a total of 15 local recurrences in which average SUVmax increased during 14 minutes post injection and marginally decreased in delayed scanning. Conversely inguinal lymph nodes with mild to moderate metabolic activity on PET showed a clearly different pattern with decreasing SUVmax on dynamic images. Three-phase PET/CT contributed to the diagnostic assessment of 10 of 47 patients with biological evidence of recurrence of cancer. It notably allowed the discrimination of confounding blood pool or urinary activity from suspicious hyperactivities. PET/CT was positive in all patients with PSA>or=2 ng/ml (n=34) and in 4/13 patients presenting PSA values<2 ng/ml. 18F-fluorocholine 3-phase PET/CT showed a progressively increasing SUVmax in biopsy confirmed cancer lesions up to 14 minutes post injection while decreasing in inguinal lymph nodes interpreted as benign. Furthermore, it was very useful in differentiating local recurrences from confounding blood pool and urinary activity.

The value of 99mTc-MAA SPECT/CT for lung shunt estimation in 90Y radioembolization: a phantom and patient study.

PubMed

Allred, Jonathan D; Niedbala, Jeremy; Mikell, Justin K; Owen, Dawn; Frey, Kirk A; Dewaraja, Yuni K

2018-06-15

A major toxicity concern in radioembolization therapy of hepatic malignancies is radiation-induced pneumonitis and sclerosis due to hepatopulmonary shunting of 90 Y microspheres. Currently, 99m Tc macroaggregated albumin ( 99m Tc-MAA) imaging is used to estimate the lung shunt fraction (LSF) prior to treatment. The aim of this study was to evaluate the accuracy/precision of LSF estimated from 99m Tc planar and SPECT/CT phantom imaging, and within this context, to compare the corresponding LSF and lung-absorbed dose values from 99m Tc-MAA patient studies. Additionally, LSFs from pre- and post-therapy imaging were compared. A liver/lung torso phantom filled with 99m Tc to achieve three lung shunt values was scanned by planar and SPECT/CT imaging with repeat acquisitions to assess accuracy and precision. To facilitate processing of patient data, a workflow that relies on SPECT and CT-based auto-contouring to define liver and lung volumes for the LSF calculation was implemented. Planar imaging-based LSF estimates for 40 patients, obtained from their medical records, were retrospectively compared with SPECT/CT imaging-based calculations with attenuation and scatter correction. Additionally, in a subset of 20 patients, the pre-therapy estimates were compared with 90 Y PET/CT-based measurements. In the phantom study, improved accuracy in LSF estimation was achieved using SPECT/CT with attenuation and scatter correction (within 13% of the true value) compared with planar imaging (up to 44% overestimation). The results in patients showed a similar trend with planar imaging significantly overestimating LSF compared to SPECT/CT. There was no correlation between lung shunt estimates and the delay between 99m Tc-MAA administration and scanning, but off-target extra hepatic uptake tended to be more likely in patients with a longer delay. The mean lung absorbed dose predictions for the 28 patients who underwent therapy was 9.3 Gy (range 1.3-29.4) for planar imaging and 3.2 Gy (range 0.4-13.4) for SPECT/CT. For the patients with post-therapy imaging, the mean LSF from 90 Y PET/CT was 1.0%, (range 0.3-2.8). This value was not significantly different from the mean LSF estimate from 99m Tc-MAA SPECT/CT (mean 1.0%, range 0.4-1.6; p = 0.968), but was significantly lower than the mean LSF estimate based on planar imaging (mean 4.1%, range 1.2-15.0; p = 0.0002). The improved accuracy demonstrated by the phantom study, agreement with 90 Y PET/CT in patient studies, and the practicality of using auto-contouring for liver/lung definition suggests that 99m Tc-MAA SPECT/CT with scatter and attenuation corrections should be used for lung shunt estimation prior to radioembolization.

WE-FG-207B-04: Noise Suppression for Energy-Resolved CT Via Variance Weighted Non-Local Filtration

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

Harms, J; Zhu, L

Purpose: The photon starvation problem is exacerbated in energy-resolved CT, since the detected photons are shared by multiple energy channels. Using pixel similarity-based non-local filtration, we aim to produce accurate and high-resolution energy-resolved CT images with significantly reduced noise. Methods: Averaging CT images reconstructed from different energy channels reduces noise at the price of losing spectral information, while conventional denoising techniques inevitably degrade image resolution. Inspired by the fact that CT images of the same object at different energies share the same structures, we aim to reduce noise of energy-resolved CT by averaging only pixels of similar materials - amore » non-local filtration technique. For each CT image, an empirical exponential model is used to calculate the material similarity between two pixels based on their CT values and the similarity values are organized in a matrix form. A final similarity matrix is generated by averaging these similarity matrices, with weights inversely proportional to the estimated total noise variance in the sinogram of different energy channels. Noise suppression is achieved for each energy channel via multiplying the image vector by the similarity matrix. Results: Multiple scans on a tabletop CT system are used to simulate 6-channel energy-resolved CT, with energies ranging from 75 to 125 kVp. On a low-dose acquisition at 15 mA of the Catphan©600 phantom, our method achieves the same image spatial resolution as a high-dose scan at 80 mA with a noise standard deviation (STD) lower by a factor of >2. Compared with another non-local noise suppression algorithm (ndiNLM), the proposed algorithms obtains images with substantially improved resolution at the same level of noise reduction. Conclusion: We propose a noise-suppression method for energy-resolved CT. Our method takes full advantage of the additional structural information provided by energy-resolved CT and preserves image values at each energy level. Research reported in this publication was supported by the National Institute Of Biomedical Imaging And Bioengineering of the National Institutes of Health under Award Number R21EB019597. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.« less

Postoperative PET/CT and target delineation before adjuvant radiotherapy in patients with oral cavity squamous cell carcinoma.

PubMed

Dutta, Pinaki R; Riaz, Nadeem; McBride, Sean; Morris, Luc G; Patel, Snehal; Ganly, Ian; Wong, Richard J; Palmer, Frank; Schöder, Heiko; Lee, Nancy

2016-04-01

The purpose of this study was for us to present our evaluation of the effectiveness of positron emission tomography (PET)/CT imaging in postoperative patients with oral cavity squamous cell carcinoma (SCC) before initiating adjuvant radiation therapy. Treatment planning PET/CT scans were obtained in 44 patients with oral cavity SCC receiving adjuvant radiation. We identified target areas harboring macroscopic disease requiring higher radiation doses or additional surgery. Fourteen PET/CT scans were abnormal. Thirteen patients underwent surgery and/or biopsy, increased radiation dose, and/or addition of chemotherapy. Eleven patients received higher radiation doses. Patients undergoing imaging >8 weeks were more likely to have abnormal results (p = .01). One-year distant metastases-free survival was significantly worse in patients with positive PET/CT scans (61.5% vs 92.7%; p = .01). The estimated positive predictive value (PPV) was 38% for postoperative PET/CT scanning. We demonstrated that 32% of patients have abnormal PET/CT scans resulting in management changes. Patients may benefit from postoperative PET/CT imaging to optimize adjuvant radiation treatment planning. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1285-E1293, 2016. © 2015 Wiley Periodicals, Inc.

Combined Electrocardiography- and Respiratory-Triggered CT of the Lung to Reduce Respiratory Misregistration Artifacts between Imaging Slabs in Free-Breathing Children: Initial Experience.

PubMed

Goo, Hyun Woo; Allmendinger, Thomas

2017-01-01

Cardiac and respiratory motion artifacts degrade the image quality of lung CT in free-breathing children. The aim of this study was to evaluate the effect of combined electrocardiography (ECG) and respiratory triggering on respiratory misregistration artifacts on lung CT in free-breathing children. In total, 15 children (median age 19 months, range 6 months-8 years; 7 boys), who underwent free-breathing ECG-triggered lung CT with and without respiratory-triggering were included. A pressure-sensing belt of a respiratory gating system was used to obtain the respiratory signal. The degree of respiratory misregistration artifacts between imaging slabs was graded on a 4-point scale (1, excellent image quality) on coronal and sagittal images and compared between ECG-triggered lung CT studies with and without respiratory triggering. A p value < 0.05 was considered significant. Lung CT with combined ECG and respiratory triggering showed significantly less respiratory misregistration artifacts than lung CT with ECG triggering only (1.1 ± 0.4 vs. 2.2 ± 1.0, p = 0.003). Additional respiratory-triggering reduces respiratory misregistration artifacts on ECG-triggered lung CT in free-breathing children.

CT differentiation of 1-2-cm gallbladder polyps: benign vs malignant.

PubMed

Song, E Rang; Chung, Woo-Suk; Jang, Hye Young; Yoon, Minjae; Cha, Eun Jung

2014-04-01

To evaluate MDCT findings of 1-2-cm sized gallbladder (GB) polyps for differentiation between benign and malignant polyps. Institutional review board approval was obtained, and informed consent was waived. Portal venous phase CT scans of 1-2-cm sized GB polyps caused by various pathologic conditions were retrospectively reviewed by two blinded observers. Among the 36 patients identified, 21 had benign polyps with the remaining 15 having malignant polyps. Size, margin, and shape of GB polyps were evaluated. Attenuation values of the polyps, including mean attenuation, maximum attenuation, and standard deviation, were recorded. As determined by visual inspection, the degree of polyp enhancement was evaluated. Using these CT findings, each of the two radiologists assessed and recorded individual diagnostic confidence for differentiating benign versus malignant polyps on a 5-point scale. The diagnostic performance of CT was evaluated using a receiver operating characteristic curve analysis. There was no significant difference in size between benign and malignant GB polyps. Ill-defined margin and sessile morphology were significantly associated with malignant polyp. There was a significant difference in mean and maximum attenuation values between benign and malignant GB polyps. Mean standard deviation value of malignant polyps was significantly higher than that of benign polyps. All malignant polyps showed either hyperenhancement or marked hyperenhancement. A z value for the diagnosis of malignant GB polyps was 0.905. Margin, shape, and enhancement degree are helpful in differentiating between benign and malignant polyps of 1-2-cm sizes.

Diagnostic value of combining ¹¹C-choline and ¹⁸F-FDG PET/CT in hepatocellular carcinoma.

PubMed

Castilla-Lièvre, Maria-Angéla; Franco, Dominique; Gervais, Philippe; Kuhnast, Bertrand; Agostini, Hélène; Marthey, Lysiane; Désarnaud, Serge; Helal, Badia-Ourkia

2016-05-01

In this prospective study, our goal was to emphasize the diagnostic value of combining (11)C-choline and (18)F-FDG PET/CT for hepatocellular carcinoma (HCC) in patients with chronic liver disease. Thirty-three consecutive patients were enrolled. All patients were suspected to have HCC based on CT and/or MRI imaging. A final diagnosis was obtained by histopathological examination or by imaging alone according to American Association for the Study of Liver Disease criteria. All patients underwent PET/CT with both tracers within a median of 5 days. All lesions showing higher tracer uptake than normal liver were considered positive for HCC. We examined how tracer uptake was related to biological (serum α-fetoprotein levels) and pathological (differentiation status, peritumoral capsule and vascular invasion) prognostic markers of HCC, as well as clinical observations at 6 months (recurrence and death). Twenty-eight HCC, four cholangiocarcinomas and one adenoma were diagnosed. In the HCC patients, the sensitivity of (11)C-choline, (18)F-FDG and combined (11)C-choline and (18)F-FDG PET/CT for the detection of HCC was 75 %, 36 % and 93 %, respectively. Serum α-fetoprotein levels >200 ng/ml were more frequent among patients with (18)F-FDG-positive lesions than those with (18)F-FDG-negative lesions (p < 0.05). Early recurrence (n=2) or early death (n=5) occurred more frequently in patients with (18)F-FDG-positive lesions than in those with (18)F-FDG-negative lesions (p < 0.05). The combined use of (11)C-choline and (18)F-FDG PET/CT detected HCC with high sensitivity. This approach appears to be of potential prognostic value and may facilitate the selection of patients for surgical resection or liver transplantation.

[Phrenic nerve stimulation protects against mechanical ventilation-induced diaphragmatic dysfunction through myogenic regulatory factors].

PubMed

An, G H; Chen, M; Zhan, W F; Hu, B; Zhang, H X

2018-02-12

Objective: To explore the protective effect of electrical stimulation of phrenic nerve on diaphragmatic function during mechanical ventilation. Methods: Forty healthy adult SD rats were randomly divided into 5 groups: blank control group (BC), spontaneous breathing group (SB), electrical stimulation group (ES), mechanical ventilation group (MV), and electrical stimulation and mechanical ventilation group (MS). The rats in each group were treated for 18 h except for the BC group. After treatment, the diaphragm muscle tissue was obtained and the diaphragm contractility including peak-to-peak value(Vpp) and maximum rate of contraction(+ dT/dt max) were measured. Expression of MyoD and myogenin were detected. Results: Except for the ES and the MS groups, there was a significant difference for peak-to-peak value (Vpp) between each 2 groups ( P <0.05). Expression levels of MyoD in treatment groups were also significantly different ( P <0.05). Expressions of MS(Q-PCR 2(-ΔΔCt) value: 11.66±2.80) and MV(Q-PCR 2(-ΔΔCt) value: 40.89±24.71) in the treatment group were significantly different ( P <0.05). The expression of myogenin in the MS and the MV groups were significantly different from those of the BC group( P <0.05), however there was no significant difference between the MS(Q-PCR 2(-ΔΔCt) value: 2.58±2.75) and the MV group(Q-PCR 2(-ΔΔCt) value: 1.63±0.71). Conclusions: Electrical stimulation of the phrenic nerve can change the expression level of MyoD and myogenin to offset mechanical ventilation induced diaphragmatic function damage, and therefore plays a protective effect on the diaphragm.

Utility of PET-CT in detecting nodal metastasis in cN0 early stage oral cavity squamous cell carcinoma.

PubMed

Zhang, Han; Seikaly, Hadi; Biron, Vincent L; Jeffery, Caroline C

2018-05-01

Management of the clinically node-negative neck (cN0) in patients with early stage oral cavity squamous cell carcinoma (OCSCC) is challenging. Accurate imaging alternatives to elective neck dissections would help reduce surgical morbidity. While pooled studies suggest that imaging modalities have similar accuracy in predicting occult nodal disease, no study has examined the utility of PET-CT in this specific population of low-volume, clinically T1 and T2 OCSCC patients. A retrospective review of patients in the Alberta Cancer Registry who were diagnosed with cT1 or T2N0M0 OCSCC who underwent elective unilateral or bilateral neck dissections was performed. Pre-operative PET-CT and CT necks were reviewed for number of radiographically suspicious lymph nodes. Surgical pathology reports were reviewed to obtain the total number of nodes sampled and number of malignant nodes. Between 2009 and 2013, 148 patients were diagnosed with cT1 or T2N0M0 OCSCC. Of these, 96 patients underwent elective neck dissections. All patients underwent preoperative CT of the neck with 32 patients having undergone additional preoperative PET-CT. Based on finally surgical pathology, the overall rate of occult metastasis was 13.5% (13/96). The overall sensitivity and specificity of PET-CT in this cohort was 21.4% and 98.4%, respectively with a negative predictive value of 99.1%. Although sensitivity improved in patients with tumors ≥2 cm and depth ≥4 mm, specificity remained unchanged. In patients with cT1 and T2N0 OCSCC, PET-CT has high negative predictive value. These patients can be considered for treatment with single modality surgical resection and elective neck dissection. Copyright © 2018 Elsevier Ltd. All rights reserved.

Quantitative CT based radiomics as predictor of resectability of pancreatic adenocarcinoma

NASA Astrophysics Data System (ADS)

van der Putten, Joost; Zinger, Svitlana; van der Sommen, Fons; de With, Peter H. N.; Prokop, Mathias; Hermans, John

2018-02-01

In current clinical practice, the resectability of pancreatic ductal adenocarcinoma (PDA) is determined subjec- tively by a physician, which is an error-prone procedure. In this paper, we present a method for automated determination of resectability of PDA from a routine abdominal CT, to reduce such decision errors. The tumor features are extracted from a group of patients with both hypo- and iso-attenuating tumors, of which 29 were resectable and 21 were not. The tumor contours are supplied by a medical expert. We present an approach that uses intensity, shape, and texture features to determine tumor resectability. The best classification results are obtained with fine Gaussian SVM and the L0 Feature Selection algorithms. Compared to expert predictions made on the same dataset, our method achieves better classification results. We obtain significantly better results on correctly predicting non-resectability (+17%) compared to a expert, which is essential for patient treatment (negative prediction value). Moreover, our predictions of resectability exceed expert predictions by approximately 3% (positive prediction value).

Vertebral and femoral bone mineral density and bone strength in prostate cancer patients assessed in phantomless PET/CT examinations.

PubMed

Schwaiger, Benedikt J; Kopperdahl, David L; Nardo, Lorenzo; Facchetti, Luca; Gersing, Alexandra S; Neumann, Jan; Lee, Kwang J; Keaveny, Tony M; Link, Thomas M

2017-08-01

Bone fracture risk assessed ancillary to positron emission tomography with computed tomography co-registration (PET/CT) could provide substantial clinical value to oncology patients with elevated fracture risk without introducing additional radiation dose. The purpose of our study was to investigate the feasibility of obtaining valid measurements of bone mineral density (BMD) and finite element analysis-derived bone strength of the hip and spine using PET/CT examinations of prostate cancer patients by comparing against values obtained using routine multidetector-row computed tomography (MDCT) scans-as validated in previous studies-as a reference standard. Men with prostate cancer (n=82, 71.6±8.3 years) underwent Fluorine-18 NaF PET/CT and routine MDCT within three months. Femoral neck and total hip areal BMD, vertebral trabecular BMD and femur and vertebral strength based on finite element analysis were assessed in 63 paired PET/CT and MDCT examinations using phantomless calibration and Biomechanical-CT analysis. Men with osteoporosis or fragile bone strength identified at either the hip or spine (vertebral trabecular BMD ≤80mg/cm 3 , femoral neck or total hip T-score ≤-2.5, vertebral strength ≤6500N and femoral strength ≤3500N, respectively) were considered to be at high risk of fracture. PET/CT- versus MDCT-based BMD and strength measurements were compared using paired t-tests, linear regression and by generating Bland-Altman plots. Agreement in fracture-risk classification was assessed in a contingency table. All measurements from PET/CT versus MDCT were strongly correlated (R 2 =0.93-0.97; P<0.0001 for all). Mean differences for total hip areal BMD (0.001g/cm 2 , 1.1%), femoral strength (-60N, 1.3%), vertebral trabecular BMD (2mg/cm 3 , 2.6%) and vertebral strength (150N; 1.7%) measurements were not statistically significant (P>0.05 for all), whereas the mean difference in femoral neck areal BMD measurements was small but significant (-0.018g/cm 2 ; -2.5%; P=0.007). The agreement between PET/CT and MDCT for fracture-risk classification was 97% (0.89 kappa for repeatability). Ancillary analyses of BMD, bone strength, and fracture risk agreed well between PET/CT and MDCT, suggesting that PET/CT can be used opportunistically to comprehensively assess bone integrity. In subjects with high fracture risk such as cancer patients this may serve as an additional clinical tool to guide therapy planning and prevention of fractures. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of ultrasound versus computed tomography for the detection of kidney stones in the pediatric population: a clinical effectiveness study.

PubMed

Roberson, Nathaniel P; Dillman, Jonathan R; O'Hara, Sara M; DeFoor, William R; Reddy, Pramod P; Giordano, Richard M; Trout, Andrew T

2018-07-01

The incidence of pediatric nephrolithiasis in the United States is increasing. There is a paucity of literature comparing the diagnostic performance of computed ultrasound (US) to tomography (CT) in the pediatric population. To determine the diagnostic performance of renal US for nephrolithiasis in children using a clinical effectiveness approach. Institutional review board approval with a waiver of informed consent was obtained for this retrospective, HIPAA-complaint investigation. Billing records and imaging reports were used to identify children (≤18 years old) evaluated for nephrolithiasis by both US and unenhanced CT within 24 h between March 2012 and March 2017. Imaging reports were reviewed for presence, number, size and location of kidney stones. Diagnostic performance of US (reference standard=CT) was calculated per renal unit (left/right kidney) and per renal sector (four sectors per kidney). For sector analysis, US was considered truly positive if a stone was identified at CT in the same or an adjacent sector. There were 68 renal stones identified by CT in 30/69 patients (43%). Mean patient age was 14.7±3.6 years, and 35 were boys. For detecting nephrolithiasis in any kidney, US was 66.7% (48.8-80.8%) sensitive and 97.4% (86.8-99.9%) specific (positive predictive value=95.2% [77.3-99.8%], negative predictive value=79.2% [65.7-88.3%], positive likelihood ratio=26.0). Per renal sector, US was 59.7% (46.7-71.4%) sensitive and 97.4% (95.5-98.5%) specific (positive predictive value=72.3% [58.2-83.1%], negative predictive value=95.4% [93.2-96.9%], positive likelihood ratio=22.5). Of the 30 stones not detected by US, only 3 were >3 mm at CT. In clinical practice, US has high specificity for detecting nephrolithiasis in children but only moderate sensitivity and false negatives are common.

Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach.

PubMed

Ono, Hiroshi; Furuta, Kazuhiko; Fujitani, Ryotaro; Katayama, Takeshi; Akahane, Manabu

2010-07-01

The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopyguided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of > or = 2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after internal fixation.

SU-F-18C-09: Assessment of OSL Dosimeter Technology in the Validation of a Monte Carlo Radiation Transport Code for CT Dosimetry

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

Carver, D; Kost, S; Pickens, D

Purpose: To assess the utility of optically stimulated luminescent (OSL) dosimeter technology in calibrating and validating a Monte Carlo radiation transport code for computed tomography (CT). Methods: Exposure data were taken using both a standard CT 100-mm pencil ionization chamber and a series of 150-mm OSL CT dosimeters. Measurements were made at system isocenter in air as well as in standard 16-cm (head) and 32-cm (body) CTDI phantoms at isocenter and at the 12 o'clock positions. Scans were performed on a Philips Brilliance 64 CT scanner for 100 and 120 kVp at 300 mAs with a nominal beam width ofmore » 40 mm. A radiation transport code to simulate the CT scanner conditions was developed using the GEANT4 physics toolkit. The imaging geometry and associated parameters were simulated for each ionization chamber and phantom combination. Simulated absorbed doses were compared to both CTDI{sub 100} values determined from the ion chamber and to CTDI{sub 100} values reported from the OSLs. The dose profiles from each simulation were also compared to the physical OSL dose profiles. Results: CTDI{sub 100} values reported by the ion chamber and OSLs are generally in good agreement (average percent difference of 9%), and provide a suitable way to calibrate doses obtained from simulation to real absorbed doses. Simulated and real CTDI{sub 100} values agree to within 10% or less, and the simulated dose profiles also predict the physical profiles reported by the OSLs. Conclusion: Ionization chambers are generally considered the standard for absolute dose measurements. However, OSL dosimeters may also serve as a useful tool with the significant benefit of also assessing the radiation dose profile. This may offer an advantage to those developing simulations for assessing radiation dosimetry such as verification of spatial dose distribution and beam width.« less

Automated movement correction for dynamic PET/CT images: evaluation with phantom and patient data.

PubMed

Ye, Hu; Wong, Koon-Pong; Wardak, Mirwais; Dahlbom, Magnus; Kepe, Vladimir; Barrio, Jorge R; Nelson, Linda D; Small, Gary W; Huang, Sung-Cheng

2014-01-01

Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (P<0.05) in the FDDNP DVR and FDG Ki values in the parietal and temporal regions after MC. In conclusion, MC applied to dynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers.

Automated Movement Correction for Dynamic PET/CT Images: Evaluation with Phantom and Patient Data

PubMed Central

Ye, Hu; Wong, Koon-Pong; Wardak, Mirwais; Dahlbom, Magnus; Kepe, Vladimir; Barrio, Jorge R.; Nelson, Linda D.; Small, Gary W.; Huang, Sung-Cheng

2014-01-01

Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (P<0.05) in the FDDNP DVR and FDG Ki values in the parietal and temporal regions after MC. In conclusion, MC applied to dynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers. PMID:25111700

EFFECT ON PERFUSION VALUES OF SAMPLING INTERVAL OF CT PERFUSION ACQUISITIONS IN NEUROENDOCRINE LIVER METASTASES AND NORMAL LIVER

PubMed Central

Ng, Chaan S.; Hobbs, Brian P.; Wei, Wei; Anderson, Ella F.; Herron, Delise H.; Yao, James C.; Chandler, Adam G.

2014-01-01

Objective To assess the effects of sampling interval (SI) of CT perfusion acquisitions on CT perfusion values in normal liver and liver metastases from neuroendocrine tumors. Methods CT perfusion in 16 patients with neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction, for tumor and normal liver. CT perfusion values for the reference sampling interval of 0.5s (SI0.5) were compared with those of SI datasets of 1s, 2s, 3s and 4s, using mixed-effects model analyses. Results Increases in SI beyond 1s were associated with significant and increasing departures of CT perfusion parameters from reference values at SI0.5 (p≤0.0009). CT perfusion values deviated from reference with increasing uncertainty with increasing SIs. Findings for normal liver were concordant. Conclusion Increasing SIs beyond 1s yield significantly different CT perfusion parameter values compared to reference values at SI0.5. PMID:25626401

Prognostic value of CtIP/RBBP8 expression in breast cancer.

PubMed

Soria-Bretones, Isabel; Sáez, Carmen; Ruíz-Borrego, Manuel; Japón, Miguel A; Huertas, Pablo

2013-12-01

CtIP/RBBP8 is a multifunctional protein involved in transcription, DNA replication, DNA repair by homologous recombination and the G1 and G2 checkpoints. Its multiple roles are controlled by its interaction with several specific factors, including the tumor suppressor proteins BRCA1 and retinoblastoma. Both its functions and interactors point to a putative oncogenic potential of CtIP/RBBP8 loss. However, CtIP/RBBP8 relevance in breast tumor appearance, development, and prognosis has yet to be established. We performed a retrospective analysis of CtIP/RBBP8 and RB1 levels by immunohistochemistry using 384 paraffin-embedded breast cancer biopsies obtained during tumor removal surgery. We have observed that low or no expression of CtIP/RBBP8 correlates with high-grade breast cancer and with nodal metastasis. Reduction on CtIP/RBBP8 is most common in hormone receptor (HR)-negative, HER2-positive, and basal-like tumors. We observed lower levels of RB1 on those tumors with reduced CtIP/RBBP8 levels. On luminal tumors, decreased but not absence of CtIP/RBBP8 levels correlate with increased disease-free survival when treated with a combination of hormone, radio, and chemo therapies. © 2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Patient-specific lean body mass can be estimated from limited-coverage computed tomography images.

PubMed

Devriese, Joke; Beels, Laurence; Maes, Alex; van de Wiele, Christophe; Pottel, Hans

2018-06-01

In PET/CT, quantitative evaluation of tumour metabolic activity is possible through standardized uptake values, usually normalized for body weight (BW) or lean body mass (LBM). Patient-specific LBM can be estimated from whole-body (WB) CT images. As most clinical indications only warrant PET/CT examinations covering head to midthigh, the aim of this study was to develop a simple and reliable method to estimate LBM from limited-coverage (LC) CT images and test its validity. Head-to-toe PET/CT examinations were retrospectively retrieved and semiautomatically segmented into tissue types based on thresholding of CT Hounsfield units. LC was obtained by omitting image slices. Image segmentation was validated on the WB CT examinations by comparing CT-estimated BW with actual BW, and LBM estimated from LC images were compared with LBM estimated from WB images. A direct method and an indirect method were developed and validated on an independent data set. Comparing LBM estimated from LC examinations with estimates from WB examinations (LBMWB) showed a significant but limited bias of 1.2 kg (direct method) and nonsignificant bias of 0.05 kg (indirect method). This study demonstrates that LBM can be estimated from LC CT images with no significant difference from LBMWB.

Enhancing 18F-FDG-PET/CT analysis in lung cancer patients. Is CT-CT image fusion helpful in predicting pleural involvement? A pilot study.

PubMed

Kapfhammer, A; Winkens, T; Lesser, T; Reissig, A; Steinert, M; Freesmeyer, M

2015-01-01

To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/CT for lung cancer staging. Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semi-transparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

Prehistological evaluation of benign and malignant pigmented skin lesions with optical computed tomography

NASA Astrophysics Data System (ADS)

Kokolakis, Athanasios; Zacharakis, Giannis; Krasagakis, Konstantin; Lasithiotakis, Konstantinos; Favicchio, Rosy; Spiliopoulos, George; Giannikaki, Elpida; Ripoll, Jorge; Tosca, Androniki

2012-06-01

Discrimination of benign and malignant melanocytic lesions is a major issue in clinical dermatology. Assessment of the thickness of melanoma is critical for prognosis and treatment selection. We aimed to evaluate a novel optical computed tomography (optical-CT) system as a tool for three-dimensional (3-D) imaging of melanocytic lesions and its ability to discriminate benign from malignant melanocytic lesions while simultaneously determining the thickness of invasive melanoma. Seventeen melanocytic lesions, one hemangioma, and normal skin were assessed immediately after their excision by optical-CT and subsequently underwent histopathological examination. Tomographic reconstructions were performed with a back-propagation algorithm calculating a 3-D map of the total attenuation coefficient (AC). There was a statistically significant difference between melanomas, dysplastic nevi, and non-dysplastic nevi, as indicated by Kruskal-Wallis test. Median AC values were higher for melanomas compared with dysplastic and non-dysplastic nevi. No statistically significant difference was observed when thickness values obtained by optical-CT were compared with histological thickness using a Wilcoxon sighed rank test. Our results suggest that optical-CT can be important for the immediate prehistological evaluation of biopsies, assisting the physician for a rapid assessment of malignancy and of the thickness of a melanocytic lesion.

Correlation between tissue metabolism and cellularity assessed by standardized uptake value and apparent diffusion coefficient in peritoneal metastasis.

PubMed

Yu, Xue; Lee, Elaine Yuen Phin; Lai, Vincent; Chan, Queenie

2014-07-01

To evaluate the correlation between standardized uptake value (SUV) (tissue metabolism) and apparent diffusion coefficient (ADC) (water diffusivity) in peritoneal metastases. Patients with peritoneal dissemination detected on (18)F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) were prospectively recruited for MRI examinations with informed consent and the study was approved by the local Institutional Review Board. FDG-PET/CT, diffusion-weighted imaging (DWI), MRI, and DWI/MRI images were independently reviewed by two radiologists based on visual analysis. SUVmax/SUVmean and ADCmin/ADCmean were obtained manually by drawing ROIs over the peritoneal metastases on FDG-PET/CT and DWI, respectively. Diagnostic characteristics of each technique were evaluated. Pearson's coefficient and McNemar and Kappa tests were used for statistical analysis. Eight patients were recruited for this prospective study and 34 peritoneal metastases were evaluated. ADCmean was significantly and negatively correlated with SUVmax (r = -0.528, P = 0.001) and SUVmean (r = -0.548, P = 0.001). ADCmin had similar correlation with SUVmax (r = -0.508, P = 0.002) and SUVmean (r = -0.513, P = 0.002). DWI/MRI had high diagnostic performance (accuracy = 98%) comparable to FDG-PET/CT, in peritoneal metastasis detection. Kappa values were excellent for all techniques. There was a significant inverse correlation between SUV and ADC. © 2013 Wiley Periodicals, Inc.

Monte Carlo simulations in multi-detector CT (MDCT) for two PET/CT scanner models using MASH and FASH adult phantoms

NASA Astrophysics Data System (ADS)

Belinato, W.; Santos, W. S.; Paschoal, C. M. M.; Souza, D. N.

2015-06-01

The combination of positron emission tomography (PET) and computed tomography (CT) has been extensively used in oncology for diagnosis and staging of tumors, radiotherapy planning and follow-up of patients with cancer, as well as in cardiology and neurology. This study determines by the Monte Carlo method the internal organ dose deposition for computational phantoms created by multidetector CT (MDCT) beams of two PET/CT devices operating with different parameters. The different MDCT beam parameters were largely related to the total filtration that provides a beam energetic change inside the gantry. This parameter was determined experimentally with the Accu-Gold Radcal measurement system. The experimental values of the total filtration were included in the simulations of two MCNPX code scenarios. The absorbed organ doses obtained in MASH and FASH phantoms indicate that bowtie filter geometry and the energy of the X-ray beam have significant influence on the results, although this influence can be compensated by adjusting other variables such as the tube current-time product (mAs) and pitch during PET/CT procedures.

Projection matrix acquisition for cone-beam computed tomography iterative reconstruction

NASA Astrophysics Data System (ADS)

Yang, Fuqiang; Zhang, Dinghua; Huang, Kuidong; Shi, Wenlong; Zhang, Caixin; Gao, Zongzhao

2017-02-01

Projection matrix is an essential and time-consuming part in computed tomography (CT) iterative reconstruction. In this article a novel calculation algorithm of three-dimensional (3D) projection matrix is proposed to quickly acquire the matrix for cone-beam CT (CBCT). The CT data needed to be reconstructed is considered as consisting of the three orthogonal sets of equally spaced and parallel planes, rather than the individual voxels. After getting the intersections the rays with the surfaces of the voxels, the coordinate points and vertex is compared to obtain the index value that the ray traversed. Without considering ray-slope to voxel, it just need comparing the position of two points. Finally, the computer simulation is used to verify the effectiveness of the algorithm.

Relationship Between Ebola Virus Real-Time Quantitative Polymerase Chain Reaction-Based Threshold Cycle Value and Virus Isolation From Human Plasma.

PubMed

Spengler, Jessica R; McElroy, Anita K; Harmon, Jessica R; Ströher, Ute; Nichol, Stuart T; Spiropoulou, Christina F

2015-10-01

We performed a longitudinal analysis of plasma samples obtained from 4 patients with Ebola virus (EBOV) disease (EVD) to determine the relationship between the real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR)-based threshold cycle (Ct) value and the presence of infectious EBOV. EBOV was not isolated from plasma samples with a Ct value of >35.5 or >12 days after onset of symptoms. EBOV was not isolated from plasma samples in which anti-EBOV nucleoprotein immunoglobulin G was detected. These data demonstrate the utility of interpreting qRT-PCR results in the context of the course of EBOV infection and associated serological responses for patient-management decisions. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Dosimetric changes with computed tomography automatic tube-current modulation techniques.

PubMed

Spampinato, Sofia; Gueli, Anna Maria; Milone, Pietro; Raffaele, Luigi Angelo

2018-04-06

The study is aimed at a verification of dose changes for a computed tomography automatic tube-current modulation (ATCM) technique. For this purpose, anthropomorphic phantom and Gafchromic ® XR-QA2 films were used. Radiochromic films were cut according to the shape of two thorax regions. The ATCM algorithm is based on noise index (NI) and three exam protocols with different NI were chosen, of which one was a reference. Results were compared with dose values displayed by the console and with Poisson statistics. The information obtained with radiochromic films has been normalized with respect to the NI reference value to compare dose percentage variations. Results showed that, on average, the information reported by the CT console and calculated values coincide with measurements. The study allowed verification of the dose information reported by the CT console for an ATCM technique. Although this evaluation represents an estimate, the method can be a starting point for further studies.

Determination of CT number and density profile of binderless, pre-treated and tannin-based Rhizophora spp. particleboards using computed tomography imaging and electron density phantom

NASA Astrophysics Data System (ADS)

Yusof, Mohd Fahmi Mohd; Hamid, Puteri Nor Khatijah Abdul; Bauk, Sabar; Hashim, Rokiah; Tajuddin, Abdul Aziz

2015-04-01

Plug density phantoms were constructed in accordance to CT density phantom model 062M CIRS using binderless, pre-treated and tannin-based Rhizophora Spp. particleboards. The Rhizophora Spp. plug phantoms were scanned along with the CT density phantom using Siemens Somatom Definition AS CT scanner at three CT energies of 80, 120 and 140 kVp. 15 slices of images with 1.0 mm thickness each were taken from the central axis of CT density phantom for CT number and CT density profile analysis. The values were compared to water substitute plug phantom from the CT density phantom. The tannin-based Rhizophora Spp. gave the nearest value of CT number to water substitute at 80 and 120 kVp CT energies with χ2 value of 0.011 and 0.014 respectively while the binderless Rhizphora Spp. gave the nearest CT number to water substitute at 140 kVp CT energy with χ2 value of 0.023. The tannin-based Rhizophora Spp. gave the nearest CT density profile to water substitute at all CT energies. This study indicated the suitability of Rhizophora Spp. particleboard as phantom material for the use in CT imaging studies.

Correlation Between Resonance Frequency Analysis and Bone Quality Assessments at Dental Implant Recipient Sites.

PubMed

Fu, Min-Wen; Fu, Earl; Lin, Fu-Gong; Chang, Wei-Jeng; Hsieh, Yao-Dung; Shen, E-Chin

To evaluate whether primary implant stability could be used to predict bone quality, the association between the implant stability quotient (ISQ) value and the bone type at the implant site was evaluated. Ninety-five implant sites in 50 patients were included. Bone type (categorized by Lekholm and Zarb) at the implant site was initially assessed using presurgical dental radiography. During the preparation of the implant site, a bone core specimen was carefully obtained. The bone type was assessed by tactile sensation during the drilling operation, according to the Misch criteria. The primary stability of the inserted implant was evaluated by resonance frequency analysis (RFA). The ISQ value was recorded. The bone core specimen was then examined by stereomicroscopy or microcomputed tomography (micro-CT), and the bone type was determined by the surface characteristics of the specimen, based on Lekholm and Zarb classification. Agreement between the bone quality assessed by the four methods (ie, presurgical radiography, tactile sensation, stereomicroscopy, and micro-CT) was tested by Cohen's kappa statistics, whereas the association between the ISQ value and the bone type was evaluated by the generalized linear regression model. The mean ISQ score was 72.6, and the score was significantly influenced by the maxillary or mandibular arch (P = .001). The bone type at the implant sites varied according to the assessment method. However, a significant influence of the arch was repeatedly noted when using radiography or tactile sensation. Among the four bone-quality assessment methods, a weak agreement existed only between stereomicroscopy and micro-CT, especially in the maxilla (κ = 0.469). A negative association between the ISQ value and the bone type assessed by stereomicroscopy or by micro-CT was significant in the maxilla, but not in the mandible, after adjustments for sex, age, and right/left side (P = .013 and P = .027 for stereomicroscopy and micro-CT, respectively). The ISQ value was weakly associated with the bone type when assessed by stereomicroscopy or micro-CT in the maxilla. Caution is necessary if RFA is used as a tool to evaluate bone quality at the implant site, especially in the mandible.

Studies on the weak interactions and CT complex formations between chloranilic acid, 2,3-dichloro-5,6-dicyano-p-benzoquinone, tetracyanoethylene and papaverine in acetonitrile and their thermodynamic properties, theoretically, spectrophotometrically aided by FTIR

NASA Astrophysics Data System (ADS)

Datta, Asim Sagar; (Chattaraj), Seema Bagchi; Chakrabortty, Ashutosh; Lahiri, Sujit Chandra

2015-07-01

Spectrophotometric, FTIR and theoretical studies of the charge-transfer complexes between mild narcotic drug papaverine and the acceptors chloranilic acid (Cl-A), 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ) and tetracyanoethylene (TCNE) in acetonitrile, their association constants, thermodynamic (ΔG0, ΔH0 and ΔS0) and other related properties had been described. Papaverine was found to form colored charge-transfer complexes with Cl-A, DDQ and TCNE in acetonitrile. The absorption maxima of the complexes were 518.5, 584.0 and 464.0 nm for Cl-A complex, DDQ complex, and TCNE complex respectively. The compositions of the papaverine complexes were determined to be 1:1 from Job's method of continuous variation. Solid complexes formed between papaverine and the acceptors were isolated. Comparison of the FTIR spectra of the solid complexes between papaverine and the acceptors and their constituents showed considerable shift in absorption peaks, changes in intensities of the peaks and formation of the new bands on complexation. However, no attempt has been made to purify the complexes and study the detailed spectra both theoretically and experimentally. The energies hνCT of the charge-transfer complexes were compared with the theoretical values of hνCT of the complexes obtained from HOMO and LUMO of the donor and the acceptors. The reasons for the differences in hνCT values were explained. Density function theory was used for calculation. hνCT (experimental) values of the transition energies of the complexes in acetonitrile differed from hνCT (theoretical) values. IDV value of papaverine was calculated. Charge-transfer complexes were assumed to be partial electrovalent compounds with organic dative ions D+ and A- (in the excited state) and attempts had been made to correlate the energy changes for the formation of the complexes with the energy changes for the formation of electrovalent compounds between M+ and X- ions.

Prognostic Value of Negative Coronary CT Angiography in Severely Obese Patients Prior to Bariatric Surgery: a Follow-Up After 6 Years.

PubMed

Messerli, Michael; Maywald, Céline; Wälti, Stephan; Warschkow, René; Wildermuth, Simon; Alkadhi, Hatem; Leschka, Sebastian; Schiesser, Marc

2017-08-01

This study aims to determine the long-term prognostic value of coronary CT angiography (CCTA) prior to bariatric surgery in severely obese patients with a body mass index (BMI) ≥35 kg/m 2 . Seventy consecutive patients undergoing cardiac CT for coronary assessment prior to bariatric surgery were prospectively included. Images were analysed for the presence of coronary calcification and for non-obstructive (<50%) or obstructive (>50% stenosis) coronary artery disease (CAD). A median clinical follow-up of 6.1 years in 54 patients was obtained for major adverse cardiovascular events (MACEs), defined as death, non-fatal myocardial infarction or coronary revascularisation. Weight loss and BMI decrease following bariatric surgery were recorded. The median BMI prior to surgery was 46.9 kg/m 2 . The median percentage of excess BMI loss after surgery was 75%. CT showed coronary calcification in 26 (48%) patients, whereas 28 (52%) patients had no calcification. CCTA revealed normal coronaries in 47 (87%) and non-obstructive CAD in 7 (13%) patients. No obstructive CAD was found. All patients successfully underwent bariatric surgery, and no MACE occurred neither perioperatively nor in the follow-up period. The negative predictive value of CCTA was 100% (95% confidence interval of 90.1-100.0%). In severely obese patients, the absence of obstructive CAD in cardiac CT prior to bariatric surgery with subsequently marked weight reduction has strong long-term prognostic implications for ruling out major adverse cardiac events in the postoperative period.

18F-FDG PET/CT in Detecting Metastatic Infection in Children.

PubMed

Kouijzer, Ilse J E; Blokhuis, Gijsbert J; Draaisma, Jos M T; Oyen, Wim J G; de Geus-Oei, Lioe-Fee; Bleeker-Rovers, Chantal P

2016-04-01

Metastatic infection is a severe complication of bacteremia with high morbidity and mortality. The aim of this study was to investigate the diagnostic value of 18F-FDG PET combined with CT (FDG PET/CT) in children suspected of having metastatic infection. The results of FDG PET/CT scans performed in children because of suspected metastatic infection from September 2003 to June 2013 were analyzed retrospectively. The results were compared with the final clinical diagnosis. FDG PET/CT was performed in 13 children with suspected metastatic infection. Of the total number of FDG PET/CT scans, 38% were clinically helpful. Positive predictive value of FDG PET/CT was 71%, and negative predictive value was 100%. FDG PET/CT appears to be a valuable diagnostic technique in children with suspected metastatic infection. Prospective studies of FDG PET/CT as part of a structured diagnostic protocol are needed to assess the exact additional diagnostic value.

An iterative reconstruction method for high-pitch helical luggage CT

NASA Astrophysics Data System (ADS)

Xue, Hui; Zhang, Li; Chen, Zhiqiang; Jin, Xin

2012-10-01

X-ray luggage CT is widely used in airports and railway stations for the purpose of detecting contrabands and dangerous goods that may be potential threaten to public safety, playing an important role in homeland security. An X-ray luggage CT is usually in a helical trajectory with a high pitch for achieving a high passing speed of the luggage. The disadvantage of high pitch is that conventional filtered back-projection (FBP) requires a very large slice thickness, leading to bad axial resolution and helical artifacts. Especially when severe data inconsistencies are present in the z-direction, like the ends of a scanning object, the partial volume effect leads to inaccuracy value and may cause a wrong identification. In this paper, an iterative reconstruction method is developed to improve the image quality and accuracy for a large-spacing multi-detector high-pitch helical luggage CT system. In this method, the slice thickness is set to be much smaller than the pitch. Each slice involves projection data collected in a rather small angular range, being an ill-conditioned limited-angle problem. Firstly a low-resolution reconstruction is employed to obtain images, which are used as prior images in the following process. Then iterative reconstruction is performed to obtain high-resolution images. This method enables a high volume coverage speed and a thin reconstruction slice for the helical luggage CT. We validate this method with data collected in a commercial X-ray luggage CT.

Clinical Utility of Dual-Energy CT Analysis of Bone Marrow Edema in Acute Wrist Fractures.

PubMed

Ali, Ismail T; Wong, William D; Liang, Teresa; Khosa, Faisal; Mian, Memoona; Jalal, Sabeena; Nicolaou, Savvas

2018-04-01

The purpose of this study is to determine the utility of dual-energy CT (DECT) for assessing carpal fractures and to obtain an attenuation value cutoff (in Hounsfield units) to identify bone marrow edema due to an acute carpal fracture. In this retrospective study, 24 patients who presented with wrist fractures from September 3, 2014, through March 9, 2015, underwent imaging with DECT (80 and 140 kVp). Using the three-material decomposition algorithm specific for virtual noncalcium to construct images, two radiologists identified carpal fractures and associated bone marrow edema. Readers noted the attenuation at areas with and without bone marrow edema. The cutoff value was obtained by ROC analysis and was internally validated on 13 separate patients with suspected wrist fractures. A p < 0.05 was considered statistically significant. CT attenuation was significantly higher in areas of bone marrow edema than in areas without it (p < 0.0001, t test). A cutoff of 5.90 HU allows detection of bone marrow edema associated with acute wrist fractures with 100% sensitivity and 99.5% specificity, compared with visual DECT interpretation. In the 13 validation cases, the cutoff of 5.90 HU identified bone marrow edema with 100% accuracy, compared with visual interpretation. Kappa values were 0.83 between the two readings by reader 1, and 0.73 and 0.96 comparing the two readings of reader 1 with the reading by reader 2. DECT is a useful tool for identifying bone marrow edema in the setting of acute wrist fractures, providing an alternative to MRI. A cutoff value of 5.90 HU can be used for accurate diagnosis and exclusion of carpal fractures.

SU-E-J-252: A Motion Algorithm to Extract Physical and Motion Parameters of a Mobile Target in Cone-Beam Computed Tomographic Imaging Retrospective to Image Reconstruction

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

Ali, I; Ahmad, S; Alsbou, N

Purpose: A motion algorithm was developed to extract actual length, CT-numbers and motion amplitude of a mobile target imaged with cone-beam-CT (CBCT) retrospective to image-reconstruction. Methods: The motion model considered a mobile target moving with a sinusoidal motion and employed three measurable parameters: apparent length, CT number level and gradient of a mobile target obtained from CBCT images to extract information about the actual length and CT number value of the stationary target and motion amplitude. The algorithm was verified experimentally with a mobile phantom setup that has three targets with different sizes manufactured from homogenous tissue-equivalent gel material embeddedmore » into a thorax phantom. The phantom moved sinusoidal in one-direction using eight amplitudes (0–20mm) and a frequency of 15-cycles-per-minute. The model required imaging parameters such as slice thickness, imaging time. Results: This motion algorithm extracted three unknown parameters: length of the target, CT-number-level, motion amplitude for a mobile target retrospective to CBCT image reconstruction. The algorithm relates three unknown parameters to measurable apparent length, CT-number-level and gradient for well-defined mobile targets obtained from CBCT images. The motion model agreed with measured apparent lengths which were dependent on actual length of the target and motion amplitude. The cumulative CT-number for a mobile target was dependent on CT-number-level of the stationary target and motion amplitude. The gradient of the CT-distribution of mobile target is dependent on the stationary CT-number-level, actual target length along the direction of motion, and motion amplitude. Motion frequency and phase did not affect the elongation and CT-number distributions of mobile targets when imaging time included several motion cycles. Conclusion: The motion algorithm developed in this study has potential applications in diagnostic CT imaging and radiotherapy to extract actual length, size and CT-numbers distorted by motion in CBCT imaging. The model provides further information about motion of the target.« less

Comparison of 68Ga-HBED-CC PSMA-PET/CT and multiparametric MRI for gross tumour volume detection in patients with primary prostate cancer based on slice by slice comparison with histopathology

PubMed Central

Zamboglou, Constantinos; Drendel, Vanessa; Jilg, Cordula A.; Rischke, Hans C.; Beck, Teresa I.; Schultze-Seemann, Wolfgang; Krauss, Tobias; Mix, Michael; Schiller, Florian; Wetterauer, Ulrich; Werner, Martin; Langer, Mathias; Bock, Michael; Meyer, Philipp T.; Grosu, Anca L.

2017-01-01

Purpose: The exact detection and delineation of the intraprostatic tumour burden is crucial for treatment planning in primary prostate cancer (PCa). We compared 68Ga-HBED-CC-PSMA PET/CT with multiparametric MRI (mpMRI) for diagnosis and tumour delineation in patients with primary PCa based on slice by slice correlation with histopathological reference material. Methodology: Seven patients with histopathologically proven primary PCa underwent 68Ga-HBED-CC-PSMA PET/CT and MRI followed by radical prostatectomy. Resected prostates were scanned by ex-vivo CT in a special localizer and prepared for histopathology. Invasive PCa was delineated on a HE stained histologic tissue slide and matched to ex-vivo CT to obtain gross tumor volume (GTV-)histo. Ex-vivo CT including GTV-histo and MRI data were matched to in-vivo CT(PET). Consensus contours based on MRI (GTV-MRI), PSMA PET (GTV-PET) or the combination of both (GTV-union/-intersection) were created. In each in-vivo CT slice the prostate was separated into 4 equal segments and sensitivity and specificity for PSMA PET and mpMRI were assessed by comparison with histological reference material. Furthermore, the spatial overlap between GTV-histo and GTV-PET/-MRI and the Sørensen-Dice coefficient (DSC) were calculated. In the case of multifocal PCa (4/7 patients), SUV values (PSMA PET) and ADC-values (diffusion weighted MRI) were obtained for each lesion. Results: PSMA PET and mpMRI detected PCa in all patients. GTV-histo was detected in 225 of 340 segments (66.2%). Sensitivity and specificity for GTV-PET, GTV-MRI, GTV-union and GTV-intersection were 75% and 87%, 70% and 82%, 82% and 67%, 55% and 99%, respectively. GTV-histo had on average the highest overlap with GTV-union (57±22%), which was significantly higher than overlap with GTV-MRI (p=0.016) and GTV-PET (p=0.016), respectively. The mean DSC for GTV-union, GTV-PET and GTV-MRI was 0.51 (±0.18), 0.45 (±0.17) and 0.48 (±0.19), respectively. In every patient with multifocal PCa there was one lesion which had both the highest SUV and the lowest ADC-value (mean and max). Conclusion: In a slice by slice analysis with histopathology, 68Ga-HBED-CC-PSMA PET/CT and mpMRI showed high sensitivity and specificity in detection of primary PCa. A combination of both methods performed even better in terms of sensitivity (GTV-union) and specificity (GTV-intersection). A moderate to good spatial overlap with GTV-histo was observed for PSMA PET/CT and mpMRI alone which was significantly improved by GTV-union. Further studies are warranted to analyse the impact of these preliminary findings for diagnostic (multimodal guided TRUS biopsy) and therapeutic (focal therapy) strategies in primary PCa. PMID:28042330

Adrenocortical tumours: high CT attenuation value correlates with eosinophilia but does not discriminate lipid-poor adenomas from malignancy.

PubMed

Pennanen, Mirkka; Raade, Merja; Louhimo, Johanna; Sane, Timo; Heiskanen, Ilkka; Arola, Johanna; Haglund, Caj

2013-12-01

Characterisation of adrenal tumours is an important clinical problem. Unenhanced CT is the primary imaging modality to assess the nature of these lesions. To study the correlation between unenhanced CT attenuation value and the specific histopathology, as well as the proportion of lipid-poor eosinophilic cells in adrenocortical tumours. We studied retrospectively primary adrenocortical tumours that had been operated on at Helsinki University Central Hospital between 2002 and 2008. Of 171 tumours, 79 had appropriate preoperative CT scans and were included in the study. We evaluated the unenhanced CT attenuation values (Hounsfield units, HU) of these tumours and determined their histopathological diagnosis by the Weiss scoring system. We also assessed the proportion of lipid-poor eosinophilic cells for each tumour. Unenhanced CT attenuation value (HU) in adrenocortical tumours correlated well with the proportion of lipid-poor eosinophilic cells (rs=0.750, p<0.001). HU and Weiss score also had a correlation (rs=0.582, p<0.001). Unenhanced CT attenuation value correlates well with the percentage of lipid-poor eosinophilic cells, but unenhanced CT attenuation value fails to differentiate between benign lipid-poor adenomas and malignant adrenocortical tumours. All adrenocortical tumours with unenhanced CT attenuation value ≤10 HU are histologically benign lipid-rich tumours.

The anterior trochlear line as a reference for femoral component positioning in total knee arthroplasty.

PubMed

Morizane, Kazuki; Takahashi, Toshiaki; Konishi, Fumihiko; Yamamoto, Haruyasu

2011-12-01

A new radiographic method using the anterior and posterior femoral condyles as a landmark to determine the rotational alignment of the femoral component in TKA had been developed. The new radiograph presents an axial view of the distal femur. The patients were asked to lie in the supine position and flex the knee approximately 120° to 130°. Radiographs were applied at an inclination angle of 20° to 30°. The condylar twist angle (CTA), the external rotational angle between the posterior condylar (PC) line and the clinical transepicondylar axis (TEA), and the trochlear line angle (TLA), and the internal rotational angle between the anterior trochlear line and the clinical TEA were measured. Images were taken of 129 knees in 87 patients with osteoarthritis of the knee. The measurement values obtained using our method with those obtained using 3D reconstructed images from a 3-dimensional helical CT system (n = 35) were compared. The average CTA was 5.7° ± 2.8° and the average TLA was -5.6° ± 3.2°. The CTA was negatively correlated with the tibiofemoral angle (TFA). The average TLA was positively correlated with the TFA. The average difference between the TLA values obtained with this view and those obtained using the 3D-CT was 0.5° ± 1.6°. The relationship between the radiograph and 3D-CT in TLA was higher than that in CTA. This radiographic technique allows easy and simultaneous measurement of the CTA and TLA and may provide an alternative method for assessing the TEA of the femur during preoperative planning for TKA.

Molecular Mechanism for Prostate Cancer Resistance to the Anti-tumor Activity of Vitamin D

DTIC Science & Technology

2006-11-01

point where each curve crossed the threshold line (Ct) using the following equation : Rel. value = 2[Ct(control) Ct(test)]test gene / 2[Ct(control...by hypermethylation in human pancreatic cancer. J Hum Genet 2005;50:159–67. 41. Armes JE, Hammet F, de Silva M, et al. Candidate tumor-suppressor...line (Ct) using the equation : Rel. Value = 2 - [Ct(control) – Ct(test)]test gene/ 2 -[Ct(control) – Ct(test)]housekeeping gene [22]. Reactions were

CRYPTOSPORIDIUM LOG-INACTIVATION WITH OZONE USING EFFLUENT CT 10, GEOMETRIC MEAN CT 10 EXTENDED INTEGRATED CT 10 AND EXTENDED-CSTR CALCULATIONS

EPA Science Inventory

The draft Long Term 2 Enhanced Surface Water Treatment Rule ("LT2ESWTR") contains Cryptosporidium log-inactivation CT tables. Depending on the water temperature, the Cryptosporidium CT values that are listed are 15 to 25 times greater than CT values fo...

WE-G-207-05: Relationship Between CT Image Quality, Segmentation Performance, and Quantitative Image Feature Analysis

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

Lee, J; Nishikawa, R; Reiser, I

Purpose: Segmentation quality can affect quantitative image feature analysis. The objective of this study is to examine the relationship between computed tomography (CT) image quality, segmentation performance, and quantitative image feature analysis. Methods: A total of 90 pathology proven breast lesions in 87 dedicated breast CT images were considered. An iterative image reconstruction (IIR) algorithm was used to obtain CT images with different quality. With different combinations of 4 variables in the algorithm, this study obtained a total of 28 different qualities of CT images. Two imaging tasks/objectives were considered: 1) segmentation and 2) classification of the lesion as benignmore » or malignant. Twenty-three image features were extracted after segmentation using a semi-automated algorithm and 5 of them were selected via a feature selection technique. Logistic regression was trained and tested using leave-one-out-cross-validation and its area under the ROC curve (AUC) was recorded. The standard deviation of a homogeneous portion and the gradient of a parenchymal portion of an example breast were used as an estimate of image noise and sharpness. The DICE coefficient was computed using a radiologist’s drawing on the lesion. Mean DICE and AUC were used as performance metrics for each of the 28 reconstructions. The relationship between segmentation and classification performance under different reconstructions were compared. Distributions (median, 95% confidence interval) of DICE and AUC for each reconstruction were also compared. Results: Moderate correlation (Pearson’s rho = 0.43, p-value = 0.02) between DICE and AUC values was found. However, the variation between DICE and AUC values for each reconstruction increased as the image sharpness increased. There was a combination of IIR parameters that resulted in the best segmentation with the worst classification performance. Conclusion: There are certain images that yield better segmentation or classification performance. The best segmentation Result does not necessarily lead to the best classification Result. This work has been supported in part by grants from the NIH R21-EB015053. R Nishikawa is receives royalties form Hologic, Inc.« less

Evaluation of BD MAX Staph SR Assay for Differentiating Between Staphylococcus aureus and Coagulase-Negative Staphylococci and Determining Methicillin Resistance Directly From Positive Blood Cultures.

PubMed

Lee, Jaewoong; Park, Yeon Joon; Park, Dong Jin; Park, Kang Gyun; Lee, Hae Kyung

2017-01-01

We evaluated the performance of the BD MAX StaphSR Assay (SR assay; BD, USA) for direct detection of Staphylococcus aureus and methicillin resistance not only in S. aureus but also in coagulase-negative Staphylococci (CNS) from positive blood cultures. From 228 blood culture bottles, 103 S. aureus [45 methicillin-resistant S. aureus (MRSA), 55 methicillin-susceptible S. aureus (MSSA), 3 mixed infections (1 MRSA+Enterococcus faecalis, 1 MSSA+MRCNS, 1 MSSA+MSCNS)], and 125 CNS (102 MRCNS, 23 MSCNS) were identified by Vitek 2. For further analysis, we obtained the cycle threshold (Ct) values from the BD MAX system software to determine an appropriate cutoff value. For discrepancy analysis, conventional mecA/mecC PCR and oxacillin minimum inhibitory concentrations (MICs) were determined. Compared to Vitek 2, the SR assay identified all 103 S. aureus isolates correctly but failed to detect methicillin resistance in three MRSA isolates. All 55 MSSA isolates were correctly identified by the SR assay. In the concordant cases, the highest Ct values for nuc, mecA, and mec right-extremity junction (MREJ) were 25.6, 22, and 22.2, respectively. Therefore, we selected Ct values from 0-27 as a range of positivity, and applying this cutoff, the sensitivity/specificity of the SR assay were 100%/100% for detecting S. aureus, and 97.9%/98.1% and 99.0%/95.8% for detecting methicillin resistance in S. aureus and CNS, respectively. We propose a Ct cutoff value for nuc/mec assay without considering MREJ because mixed cultures of MSSA and MRCNS were very rare (0.4%) in the positive blood cultures.

Metabolic Tumor Burden Assessed by Dual Time Point [18F]FDG PET/CT in Locally Advanced Breast Cancer: Relation with Tumor Biology.

PubMed

Garcia-Vicente, Ana María; Pérez-Beteta, Julián; Pérez-García, Víctor Manuel; Molina, David; Jiménez-Londoño, German Andrés; Soriano-Castrejón, Angel; Martínez-González, Alicia

2017-08-01

The aim of the study was to investigate the influence of dual time point 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) on the standard uptake value (SUV) and volume-based metabolic variables of breast lesions and their relation with biological characteristics and molecular phenotypes. Retrospective analysis including 67 patients with locally advanced breast cancer (LABC). All patients underwent a dual time point [ 18 F]FDG PET/CT, 1 h (PET-1) and 3 h (PET-2) after [ 18 F]FDG administration. Tumors were segmented following a three-dimensional methodology. Semiquantitative metabolic variables (SUV max , SUV mean , and SUV peak ) and volume-based variables (metabolic tumor volume, MTV, and total lesion glycolysis, TLG) were obtained. Biologic prognostic parameters, such as the hormone receptors status, p53, HER2 expression, proliferation rate (Ki-67), and grading were obtained. Molecular phenotypes and risk-classification [low: luminal A, intermediate: luminal B HER2 (-) or luminal B HER2 (+), and high: HER2 pure or triple negative] were established. Relations between clinical and biological variables with the metabolic parameters were studied. The relevance of each metabolic variable in the prediction of phenotype risk was assessed using a multivariate analysis. SUV-based variables and TLG obtained in the PET-1 and PET-2 showed high and significant correlations between them. MTV and SUV variables (SUV max , SUV mean , and SUV peak ) where only marginally correlated. Significant differences were found between mean SUV variables and TLG obtained in PET-1 and PET-2. High and significant associations were found between metabolic variables obtained in PET-1 and their homonymous in PET-2. Based on that, only relations of PET-1 variables with biological tumor characteristics were explored. SUV variables showed associations with hormone receptors status (p < 0.001 and p = 0.001 for estrogen and progesterone receptor, respectively) and risk-classification according to phenotype (SUV max , p = 0.003; SUV mean , p = 0.004; SUV peak , p = 0.003). As to volume-based variables, only TLG showed association with hormone receptors status (estrogen, p < 0.001; progesterone, p = 0.031), risk-classification (p = 0.007), and grade (p = 0.036). Hormone receptor negative tumors, high-grade tumors, and high-risk phenotypes showed higher TLG values. No association was found between the metabolic variables and Ki-67, HER2, or p53 expression. Statistical differences were found between mean SUV-based variables and TLG obtained in the dual time point PET/CT. Most of PET-derived parameters showed high association with molecular factors of breast cancer. However, dual time point PET/CT did not offer any added value to the single PET acquisition with respect to the relations with biological variables, based on PET-1 SUV, and volume-based variables were predictors of those obtained in PET-2.

Diffuse Reflectance Spectroscopy for Total Carbon Analysis of Hawaiian Soils

NASA Astrophysics Data System (ADS)

McDowell, M. L.; Bruland, G. L.; Deenik, J. L.; Grunwald, S.; Uchida, R.

2010-12-01

Accurate assessment of total carbon (Ct) content is important for fertility and nutrient management of soils, as well as for carbon sequestration studies. The non-destructive analysis of soils by diffuse reflectance spectroscopy (DRS) is a potential supplement or alternative to the traditional time-consuming and costly combustion method of Ct analysis, especially in spatial or temporal studies where sample numbers are large. We investigate the use of the visible to near-infrared (VNIR) and mid-infrared (MIR) spectra of soils coupled with chemometric analysis to determine their Ct content. Our specific focus is on Hawaiian soils of agricultural importance. Though this technique has been introduced to the soil community, it has yet to be fully tested and used in practical applications for all soil types, and this is especially true for Hawaii. In short, DRS characterizes and differentiates materials based on the variation of the light reflected by a material at certain wavelengths. This spectrum is dependent on the material’s composition, structure, and physical state. Multivariate chemometric analysis unravels the information in a set of spectra that can help predict a property such as Ct. This study benefits from the remarkably diverse soils of Hawaii. Our sample set includes 216 soil samples from 145 pedons from the main Hawaiian Islands archived at the National Soil Survey Center in Lincoln, NE, along with more than 50 newly-collected samples from Kauai, Oahu, Molokai, and Maui. In total, over 90 series from 10 of the 12 soil orders are represented. The Ct values of these samples range from < 1% - 55%. We anticipate that the diverse nature of our sample set will ensure a model with applicability to a wide variety of soils, both in Hawaii and globally. We have measured the VNIR and MIR spectra of these samples and obtained their Ct values by dry combustion. Our initial analyses are conducted using only samples obtained from the Lincoln archive. In this preliminary case, we use Partial Least Squares (PLS) regression with cross validation to develop a prediction model for soils of unknown carbon content given only their spectral signature. We find R2 values of greater than 0.93 for the MIR spectra and 0.87 for the VNIR spectra, indicating a strong ability to correlate a soil’s spectrum with its Ct content. We build on these encouraging results by continuing chemometric analyses using the full data set, different data subsets, separate model calibration and validation groups, combined VNIR and MIR spectra, and exploring different data pretreatment options and variations to the PLS parameters.

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%.

Whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) vs choline-positron emission tomography-computed tomography (choline-PET/CT) for selecting treatments in recurrent prostate cancer.

PubMed

Conde-Moreno, A J; Herrando-Parreño, G; Muelas-Soria, R; Ferrer-Rebolleda, J; Broseta-Torres, R; Cozar-Santiago, M P; García-Piñón, F; Ferrer-Albiach, C

2017-05-01

To determine the effectiveness of whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) in detecting metastases by comparing the results with those from choline-positron emission tomography-computed tomography (choline-PET/CT) in patients with biochemical relapse after primary treatment, and no metastases in bone scintigraphy, CT and/or pelvic MRI, or metastatic/oligometastatic prostate cancer (PCa). Patients with this disease profile who could benefit from treatment with stereotactic body radiation therapy (SBRT) were selected and their responses to these techniques were rated. This was a prospective, controlled, unicentric study, involving 46 consecutive patients from our centre who presented biochemical relapse after adjuvant, salvage or radical treatment with external beam radiotherapy, or brachytherapy. After initial tests (bone scintigraphy, CT, pelvic MRI), 35 patients with oligometastases or without them were selected. 11 patients with multiple metastases were excluded from the study. WB-DW-MRI and choline-PET/CT was then performed on each patient within 1 week. The results were interpreted by specialists in nuclear medicine and MRI. If they were candidates for treatment with ablative SBRT (SABR), they were then evaluated every three months with both tests. Choline-PET/CT detected lesions in 16 patients that were not observable using WB-DW-MRI. The results were consistent in seven patients and in three cases, a lesion was observed using WB-DW-MRI that was not detected with choline-PET/CT. The Kappa value obtained was 0.133 (p = 0.089); the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of WB-DW-MRI were estimated at 44.93, 64.29, 86.11, and 19.15%, respectively. For choline-PET/CT patients, the sensitivity, specificity, PPV, and NPV were 97.10, 58.33, 93.06, and 77.78%, respectively. Choline-PET/CT has a high global sensitivity while WB-DW-MRI has a high specificity, and so they are complementary techniques. Future studies with more enrolled patients and a longer follow-up period will be required to confirm these data. The initial data show that the best technique for evaluating response after SBRT is choline-PET/CT. Trial registration number NCT02858128.

Combined Electrocardiography- and Respiratory-Triggered CT of the Lung to Reduce Respiratory Misregistration Artifacts between Imaging Slabs in Free-Breathing Children: Initial Experience

PubMed Central

Allmendinger, Thomas

2017-01-01

Objective Cardiac and respiratory motion artifacts degrade the image quality of lung CT in free-breathing children. The aim of this study was to evaluate the effect of combined electrocardiography (ECG) and respiratory triggering on respiratory misregistration artifacts on lung CT in free-breathing children. Materials and Methods In total, 15 children (median age 19 months, range 6 months–8 years; 7 boys), who underwent free-breathing ECG-triggered lung CT with and without respiratory-triggering were included. A pressure-sensing belt of a respiratory gating system was used to obtain the respiratory signal. The degree of respiratory misregistration artifacts between imaging slabs was graded on a 4-point scale (1, excellent image quality) on coronal and sagittal images and compared between ECG-triggered lung CT studies with and without respiratory triggering. A p value < 0.05 was considered significant. Results Lung CT with combined ECG and respiratory triggering showed significantly less respiratory misregistration artifacts than lung CT with ECG triggering only (1.1 ± 0.4 vs. 2.2 ± 1.0, p = 0.003). Conclusion Additional respiratory-triggering reduces respiratory misregistration artifacts on ECG-triggered lung CT in free-breathing children. PMID:28860904

Spatial resolution measurements by Radia diagnostic software with SEDENTEXCT image quality phantom in cone beam CT for dental use.

PubMed

Watanabe, Hiroshi; Nomura, Yoshikazu; Kuribayashi, Ami; Kurabayashi, Tohru

2018-02-01

We aimed to employ the Radia diagnostic software with the safety and efficacy of a new emerging dental X-ray modality (SEDENTEXCT) image quality (IQ) phantom in CT, and to evaluate its validity. The SEDENTEXCT IQ phantom and Radia diagnostic software were employed. The phantom was scanned using one medical full-body CT and two dentomaxillofacial cone beam CTs. The obtained images were imported to the Radia software, and the spatial resolution outputs were evaluated. The oversampling method was employed using our original wire phantom as a reference. The resultant modulation transfer function (MTF) curves were compared. The null hypothesis was that MTF curves generated using both methods would be in agreement. One-way analysis of variance tests were applied to the f50 and f10 values from the MTF curves. The f10 values were subjectively confirmed by observing the line pair modules. The Radia software reported the MTF curves on the xy-plane of the CT scans, but could not return f50 and f10 values on the z-axis. The null hypothesis concerning the reported MTF curves on the xy-plane was rejected. There were significant differences between the results of the Radia software and our reference method, except for f10 values in CS9300. These findings were consistent with our line pair observations. We evaluated the validity of the Radia software with the SEDENTEXCT IQ phantom. The data provided were semi-automatic, albeit with problems and statistically different from our reference. We hope the manufacturer will overcome these limitations.

SU-E-J-150: Four-Dimensional Cone-Beam CT Algorithm by Extraction of Physical and Motion Parameter of Mobile Targets Retrospective to Image Reconstruction with Motion Modeling

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

Ali, I; Ahmad, S; Alsbou, N

Purpose: To develop 4D-cone-beam CT (CBCT) algorithm by motion modeling that extracts actual length, CT numbers level and motion amplitude of a mobile target retrospective to image reconstruction by motion modeling. Methods: The algorithm used three measurable parameters: apparent length and blurred CT number distribution of a mobile target obtained from CBCT images to determine actual length, CT-number value of the stationary target, and motion amplitude. The predictions of this algorithm were tested with mobile targets that with different well-known sizes made from tissue-equivalent gel which was inserted into a thorax phantom. The phantom moved sinusoidally in one-direction to simulatemore » respiratory motion using eight amplitudes ranging 0–20mm. Results: Using this 4D-CBCT algorithm, three unknown parameters were extracted that include: length of the target, CT number level, speed or motion amplitude for the mobile targets retrospective to image reconstruction. The motion algorithms solved for the three unknown parameters using measurable apparent length, CT number level and gradient for a well-defined mobile target obtained from CBCT images. The motion model agreed with measured apparent lengths which were dependent on the actual target length and motion amplitude. The gradient of the CT number distribution of the mobile target is dependent on the stationary CT number level, actual target length and motion amplitude. Motion frequency and phase did not affect the elongation and CT number distribution of the mobile target and could not be determined. Conclusion: A 4D-CBCT motion algorithm was developed to extract three parameters that include actual length, CT number level and motion amplitude or speed of mobile targets directly from reconstructed CBCT images without prior knowledge of the stationary target parameters. This algorithm provides alternative to 4D-CBCT without requirement to motion tracking and sorting of the images into different breathing phases which has potential applications in diagnostic CT imaging and radiotherapy.« less

Assessing the effects of lumbar posterior stabilization and fusion to vertebral bone density in stabilized and adjacent segments by using Hounsfield unit

PubMed Central

Öksüz, Erol; Deniz, Fatih Ersay; Demir, Osman

2017-01-01

Background Computed tomography (CT) with Hounsfield unit (HU) is being used with increasing frequency for determining bone density. Established correlations between HU and bone density have been shown in the literature. The aim of this retrospective study was to determine the bone density changes of the stabilized and adjacent segment vertebral bodies by comparing HU values before and after lumbar posterior stabilization. Methods Sixteen patients who had similar diagnosis of lumbar spondylosis and stenosis were evaluated in this study. Same surgical procedures were performed to all of the patients with L2-3-4-5 transpedicular screw fixation, fusion and L3-4 total laminectomy. Bone mineral density measurements were obtained with clinical CT. Measurements were obtained from stabilized and adjacent segment vertebral bodies. Densities of vertebral bodies were evaluated with HU before the surgeries and approximately one year after the surgeries. The preoperative HU value of each vertebra was compared with postoperative HU value of the same vertebrae by using statistical analysis. Results The HU values of vertebra in the stabilized and adjacent segments consistently decreased after the operations. There were significant differences between the preoperative HU values and the postoperative HU values of the all evaluated vertebral bodies in the stabilized and adjacent segments. Additionally first sacral vertebra HU values were found to be significantly higher than lumbar vertebra HU values in the preoperative group and postoperative group. Conclusions Decrease in the bone density of the adjacent segment vertebral bodies may be one of the major predisposing factors for adjacent segment disease (ASD). PMID:29354730

Apical Transportation, Centering Ratio, and Volume Increase after Manual, Rotary, and Reciprocating Instrumentation in Curved Root Canals: Analysis by Micro-computed Tomographic and Digital Subtraction Radiography.

PubMed

Zanesco, Caroline; Só, Marcus Vinicius Reis; Schmidt, Sabrina; Fontanella, Vania Regina Camargo; Grazziotin-Soares, Renata; Barletta, Fernando Branco

2017-03-01

This study aimed to evaluate apical transportation (AT), centering ratio (CR), and volume increase (VI) produced after instrumentation of mesiobuccal canals of maxillary molars with hand files, rotary, and reciprocating instruments using micro-computed tomographic (micro-CT) imaging and to demonstrate the ability of digital subtraction radiography (DSR) to evaluate AT. Forty-five canals were randomly assigned to either group K, manual K-files; PTN, ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland); or Rec, Reciproc (n = 15 for each group) for preparation. Master apical files were #25, X2 (#25/06), and R25 (#25/08), respectively. Micro-CT imaging was used to measure AT (mm) and CR (mm) at 3 different locations (1, 4, and 7 mm from the apex). VI (mm 3 ) was measured for each root third and for the whole canal. DSR (mesiodistal and buccolingual projections) was used to measure AT at 1 mm from the apex. AT and CR values were statistically similar across the groups at 1, 4, and 7 mm. AT results obtained for the different locations were similar within each group; CR, in turn, showed statistically lower values at 1 mm. VI was statistically similar in all groups. Both DSR and micro-CT imaging showed that AT always occurred on the outside of canal curvature. The highest mean value obtained for AT was 0.215 mm. AT, CR, and VI were similar for the K, PTN, and Rec groups. AT results were clinically irrelevant. DSR was as effective as micro-CT imaging in AT analysis and could be considered as an alternative method for assessing this outcome. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Noninvasive microwave ablation zone radii estimation using x-ray CT image analysis.

PubMed

Weiss, Noam; Goldberg, S Nahum; Nissenbaum, Yitzhak; Sosna, Jacob; Azhari, Haim

2016-08-01

The aims of this study were to noninvasively and automatically estimate both the radius of the ablated liver tissue and the radius encircling the treated zone, which also defines where the tissue is definitely untreated during a microwave (MW) thermal ablation procedure. Fourteen ex vivo bovine fresh liver specimens were ablated at 40 W using a 14 G microwave antenna, for durations of 3, 6, 8, and 10 min. The tissues were scanned every 5 s during the ablation using an x-ray CT scanner. In order to estimate the radius of the ablation zone, the acquired images were transformed into a polar presentation by displaying the Hounsfield units (HU) as a function of angle and radius. From this polar presentation, the average HU radial profile was analyzed at each time point and the ablation zone radius was estimated. In addition, textural analysis was applied to the original CT images. The proposed algorithm identified high entropy regions and estimated the treated zone radius per time. The estimated ablated zone radii as a function of treatment durations were compared, by means of correlation coefficient and root mean square error (RMSE) to gross pathology measurements taken immediately post-treatment from similarly ablated tissue. Both the estimated ablation radii and the treated zone radii demonstrated strong correlation with the measured gross pathology values (R(2) ≥ 0.89 and R(2) ≥ 0.86, respectively). The automated ablation radii estimation had an average discrepancy of less than 1 mm (RMSE = 0.65 mm) from the gross pathology measured values, while the treated zone radii showed a slight overestimation of approximately 1.5 mm (RMSE = 1.6 mm). Noninvasive monitoring of MW ablation using x-ray CT and image analysis is feasible. Automatic estimations of the ablation zone radius and the radius encompassing the treated zone that highly correlate with actual ablation measured values can be obtained. This technique can therefore potentially be used to obtain real time monitoring and improve the clinical outcome.

Binding and thermodynamics of REV peptide-ctDNA interaction.

PubMed

Upadhyay, Santosh Kumar

2017-03-01

The thermodynamics of DNA-ligand binding is important as it provides useful information to understand the details of binding processes. HIV-1 REV response element (RRE) located in the env coding region of the viral genome is reported to be well conserved across different HIV-1 isolates. In this study, the binding characteristics of Calf thymus DNA (ctDNA) and REV peptide from HIV-1 were investigated using spectroscopic (UV-visible, fluorescence, and circular dichroism (CD)) and isothermal titration calorimetric (ITC) techniques. Thermal stability and ligand binding properties of the ctDNA revealed that native ctDNA had a T m of 75.5 °C, whereas the ctDNA-REV peptide complex exhibited an incremental shift in the T m by 8 °C, indicating thermal stability of the complex. CD data indicated increased ellipticity due to large conformational changes in ctDNA molecule upon binding with REV peptide and two binding stoichiometric modes are apparent. The ctDNA experienced condensation due to large conformational changes in the presence of REV peptide and positive B→Ψ transition was observed at higher molar charge ratios. Fluorescence studies performed at several ligand concentrations revealed a gradual decrease in the fluorescence intensity of EtBr-bound ctDNA in response to increasing ligand concentrations. The fluorescence data further confirmed two stoichiometric modes of binding for ctDNA-REV peptide complex as previously observed with CD studies. The binding enthalpies were determined using ITC in the temperature range of 293 K-308 K. The ITC binding isotherm was exothermic at all temperatures examined, with low ΔH values indicating that the ctDNA-REV peptide interaction is driven largely by entropy. The heat capacity change (ΔC p ) was insignificant, an unusual finding in the area of DNA-peptide interaction studies. The variation in the values obtained for ΔH, ΔS, and ΔG with temperature further suggests that ctDNA-REV peptide interaction is entropically driven. ITC based analysis of salt dependence of binding constant gave a charge value (Z) = +4.01, as determined for the δlnK/δln[Na + ] parameter, suggesting the participation of only 3-4 Arg out of 11 Arg charge from REV peptide. The stoichiometry observed for the complex was three molar charge of REV peptide binding per molar charge of ctDNA. ITC based analysis further confirmed that the binding between ctDNA and REV peptide is governed by electrostatic interaction. Molecular interactions including H-bonding, van der Waals forces, and solvent molecules rearrangement, underlie the binding of REV peptide to ctDNA. © 2016 Wiley Periodicals, Inc.

Lean body mass correction of standardized uptake value in simultaneous whole-body positron emission tomography and magnetic resonance imaging

NASA Astrophysics Data System (ADS)

Jochimsen, Thies H.; Schulz, Jessica; Busse, Harald; Werner, Peter; Schaudinn, Alexander; Zeisig, Vilia; Kurch, Lars; Seese, Anita; Barthel, Henryk; Sattler, Bernhard; Sabri, Osama

2015-06-01

This study explores the possibility of using simultaneous positron emission tomography—magnetic resonance imaging (PET-MRI) to estimate the lean body mass (LBM) in order to obtain a standardized uptake value (SUV) which is less dependent on the patients' adiposity. This approach is compared to (1) the commonly-used method based on a predictive equation for LBM, and (2) to using an LBM derived from PET-CT data. It is hypothesized that an MRI-based correction of SUV provides a robust method due to the high soft-tissue contrast of MRI. A straightforward approach to calculate an MRI-derived LBM is presented. It is based on the fat and water images computed from the two-point Dixon MRI primarily used for attenuation correction in PET-MRI. From these images, a water fraction was obtained for each voxel. Averaging over the whole body yielded the weight-normalized LBM. Performance of the new approach in terms of reducing variations of 18F-Fludeoxyglucose SUVs in brain and liver across 19 subjects was compared with results using predictive methods and PET-CT data to estimate the LBM. The MRI-based method reduced the coefficient of variation of SUVs in the brain by 41  ± 10% which is comparable to the reduction by the PET-CT method (35  ± 10%). The reduction of the predictive LBM method was 29  ± 8%. In the liver, the reduction was less clear, presumably due to other sources of variation. In conclusion, employing the Dixon data in simultaneous PET-MRI for calculation of lean body mass provides a brain SUV which is less dependent on patient adiposity. The reduced dependency is comparable to that obtained by CT and predictive equations. Therefore, it is more comparable across patients. The technique does not impose an overhead in measurement time and is straightforward to implement.

Lean body mass correction of standardized uptake value in simultaneous whole-body positron emission tomography and magnetic resonance imaging.

PubMed

Jochimsen, Thies H; Schulz, Jessica; Busse, Harald; Werner, Peter; Schaudinn, Alexander; Zeisig, Vilia; Kurch, Lars; Seese, Anita; Barthel, Henryk; Sattler, Bernhard; Sabri, Osama

2015-06-21

This study explores the possibility of using simultaneous positron emission tomography--magnetic resonance imaging (PET-MRI) to estimate the lean body mass (LBM) in order to obtain a standardized uptake value (SUV) which is less dependent on the patients' adiposity. This approach is compared to (1) the commonly-used method based on a predictive equation for LBM, and (2) to using an LBM derived from PET-CT data. It is hypothesized that an MRI-based correction of SUV provides a robust method due to the high soft-tissue contrast of MRI. A straightforward approach to calculate an MRI-derived LBM is presented. It is based on the fat and water images computed from the two-point Dixon MRI primarily used for attenuation correction in PET-MRI. From these images, a water fraction was obtained for each voxel. Averaging over the whole body yielded the weight-normalized LBM. Performance of the new approach in terms of reducing variations of (18)F-Fludeoxyglucose SUVs in brain and liver across 19 subjects was compared with results using predictive methods and PET-CT data to estimate the LBM. The MRI-based method reduced the coefficient of variation of SUVs in the brain by 41 ± 10% which is comparable to the reduction by the PET-CT method (35 ± 10%). The reduction of the predictive LBM method was 29 ± 8%. In the liver, the reduction was less clear, presumably due to other sources of variation. In conclusion, employing the Dixon data in simultaneous PET-MRI for calculation of lean body mass provides a brain SUV which is less dependent on patient adiposity. The reduced dependency is comparable to that obtained by CT and predictive equations. Therefore, it is more comparable across patients. The technique does not impose an overhead in measurement time and is straightforward to implement.

Rational mutagenesis by engineering disulphide bonds improves Kluyveromyces lactis beta-galactosidase for high-temperature industrial applications

PubMed Central

Rico-Díaz, Agustín; Álvarez-Cao, María-Efigenia; Escuder-Rodríguez, Juan-José; González-Siso, María-Isabel; Cerdán, M. Esperanza; Becerra, Manuel

2017-01-01

Kluyveromyces lactis β-galactosidase (Kl-β-Gal) is one of the most important enzymes in the dairy industry. The poor stability of this enzyme limits its use in the synthesis of galactooligosaccharides (GOS) and other applications requiring high operational temperature. To obtain thermoresistant variants, a rational mutagenesis strategy by introducing disulphide bonds in the interface between the enzyme subunits was used. Two improved mutants, R116C/T270C and R116C/T270C/G818C, had increased half-lives at 45 °C compared to Kl-β-Gal (2.2 and 6.8 fold increases, respectively). Likewise, Tm values of R116C/T270C and R116C/T270C/G818C were 2.4 and 8.5 °C, respectively, higher than Kl-β-Gal Tm. Enrichment in enzymatically active oligomeric forms in these mutant variants also increased their catalytic efficiency, due to the reinforcement of the interface contacts. In this way, using an artificial substrate (p-nitrophenyl-β-D-galactopyranoside), the Vmax values of the mutants were ~1.4 (R116C/T270C) and 2 (R116C/T270C/G818C) fold higher than that of native Kl-β-Gal. Using the natural substrate (lactose) the Vmax for R116C/T270C/G818C almost doubled the Vmax for Kl-β-Gal. Validation of these mutant variants of the enzyme for their use in applications that depend on prolonged incubations at high temperatures was achieved at the laboratory scale by monitoring their catalytic activity in GOS synthesis. PMID:28361909

Comparison of five segmentation tools for 18F-fluoro-deoxy-glucose-positron emission tomography-based target volume definition in head and neck cancer.

PubMed

Schinagl, Dominic A X; Vogel, Wouter V; Hoffmann, Aswin L; van Dalen, Jorn A; Oyen, Wim J; Kaanders, Johannes H A M

2007-11-15

Target-volume delineation for radiation treatment to the head and neck area traditionally is based on physical examination, computed tomography (CT), and magnetic resonance imaging. Additional molecular imaging with (18)F-fluoro-deoxy-glucose (FDG)-positron emission tomography (PET) may improve definition of the gross tumor volume (GTV). In this study, five methods for tumor delineation on FDG-PET are compared with CT-based delineation. Seventy-eight patients with Stages II-IV squamous cell carcinoma of the head and neck area underwent coregistered CT and FDG-PET. The primary tumor was delineated on CT, and five PET-based GTVs were obtained: visual interpretation, applying an isocontour of a standardized uptake value of 2.5, using a fixed threshold of 40% and 50% of the maximum signal intensity, and applying an adaptive threshold based on the signal-to-background ratio. Absolute GTV volumes were compared, and overlap analyses were performed. The GTV method of applying an isocontour of a standardized uptake value of 2.5 failed to provide successful delineation in 45% of cases. For the other PET delineation methods, volume and shape of the GTV were influenced heavily by the choice of segmentation tool. On average, all threshold-based PET-GTVs were smaller than on CT. Nevertheless, PET frequently detected significant tumor extension outside the GTV delineated on CT (15-34% of PET volume). The choice of segmentation tool for target-volume definition of head and neck cancer based on FDG-PET images is not trivial because it influences both volume and shape of the resulting GTV. With adequate delineation, PET may add significantly to CT- and physical examination-based GTV definition.

Measurement of cardiac output from dynamic pulmonary circulation time CT

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

Yee, Seonghwan, E-mail: Seonghwan.Yee@Beaumont.edu; Scalzetti, Ernest M.

Purpose: To introduce a method of estimating cardiac output from the dynamic pulmonary circulation time CT that is primarily used to determine the optimal time window of CT pulmonary angiography (CTPA). Methods: Dynamic pulmonary circulation time CT series, acquired for eight patients, were retrospectively analyzed. The dynamic CT series was acquired, prior to the main CTPA, in cine mode (1 frame/s) for a single slice at the level of the main pulmonary artery covering the cross sections of ascending aorta (AA) and descending aorta (DA) during the infusion of iodinated contrast. The time series of contrast changes obtained for DA,more » which is the downstream of AA, was assumed to be related to the time series for AA by the convolution with a delay function. The delay time constant in the delay function, representing the average time interval between the cross sections of AA and DA, was determined by least square error fitting between the convoluted AA time series and the DA time series. The cardiac output was then calculated by dividing the volume of the aortic arch between the cross sections of AA and DA (estimated from the single slice CT image) by the average time interval, and multiplying the result by a correction factor. Results: The mean cardiac output value for the six patients was 5.11 (l/min) (with a standard deviation of 1.57 l/min), which is in good agreement with the literature value; the data for the other two patients were too noisy for processing. Conclusions: The dynamic single-slice pulmonary circulation time CT series also can be used to estimate cardiac output.« less

Can Fan-Beam Interactive Computed Tomography Accurately Predict Indirect Decompression in Minimally Invasive Spine Surgery Fusion Procedures?

PubMed

Janssen, Insa; Lang, Gernot; Navarro-Ramirez, Rodrigo; Jada, Ajit; Berlin, Connor; Hilis, Aaron; Zubkov, Micaella; Gandevia, Lena; Härtl, Roger

2017-11-01

Recently, novel mobile intraoperative fan-beam computed tomography (CT) was introduced, allowing for real-time navigation and immediate intraoperative evaluation of neural decompression in spine surgery. This study sought to investigate whether intraoperatively assessed neural decompression during minimally invasive spine surgery (MISS) has a predictive value for clinical and radiographic outcome. A retrospective study of patients undergoing intraoperative CT (iCT)-guided extreme lateral interbody fusion or transforaminal lumbar interbody fusion was conducted. 1) Preoperative, 2) intraoperative (after cage implantation, 3) postoperative, and 4) follow-up radiographic and clinical parameters obtained from radiography or CT were quantified. Thirty-four patients (41 spinal segments) were analyzed. iCT-based navigation was successfully accomplished in all patients. Radiographic parameters showed significant improvement from preoperatively to intraoperatively after cage implantation in both MISS procedures (extreme lateral interbody fusion/transforaminal lumbar interbody fusion) (P ≤ 0.05). Radiologic parameters for both MISS fusion procedures did not show significant differences to the assessed radiographic measures at follow-up (P > 0.05). Radiologic outcome values did not decrease when compared intraoperatively (after cage implantation) to latest follow-up. Intraoperative fan-beam CT is capable of assessing neural decompression intraoperatively with high accuracy, allowing for precise prediction of radiologic outcome and earliest possible feedback during MISS fusion procedures. These findings are highly valuable for routine practice and future investigations toward finding a threshold for neural decompression that translates into clinical improvement. If sufficient neural decompression has been confirmed with iCT imaging studies, additional postoperative and/or follow-up imaging studies might no longer be required if patients remain asymptomatic. Copyright © 2017 Elsevier Inc. All rights reserved.

Rational mutagenesis by engineering disulphide bonds improves Kluyveromyces lactis beta-galactosidase for high-temperature industrial applications.

PubMed

Rico-Díaz, Agustín; Álvarez-Cao, María-Efigenia; Escuder-Rodríguez, Juan-José; González-Siso, María-Isabel; Cerdán, M Esperanza; Becerra, Manuel

2017-03-31

Kluyveromyces lactis β-galactosidase (Kl-β-Gal) is one of the most important enzymes in the dairy industry. The poor stability of this enzyme limits its use in the synthesis of galactooligosaccharides (GOS) and other applications requiring high operational temperature. To obtain thermoresistant variants, a rational mutagenesis strategy by introducing disulphide bonds in the interface between the enzyme subunits was used. Two improved mutants, R116C/T270C and R116C/T270C/G818C, had increased half-lives at 45 °C compared to Kl-β-Gal (2.2 and 6.8 fold increases, respectively). Likewise, Tm values of R116C/T270C and R116C/T270C/G818C were 2.4 and 8.5 °C, respectively, higher than Kl-β-Gal Tm. Enrichment in enzymatically active oligomeric forms in these mutant variants also increased their catalytic efficiency, due to the reinforcement of the interface contacts. In this way, using an artificial substrate (p-nitrophenyl-β-D-galactopyranoside), the Vmax values of the mutants were ~1.4 (R116C/T270C) and 2 (R116C/T270C/G818C) fold higher than that of native Kl-β-Gal. Using the natural substrate (lactose) the Vmax for R116C/T270C/G818C almost doubled the Vmax for Kl-β-Gal. Validation of these mutant variants of the enzyme for their use in applications that depend on prolonged incubations at high temperatures was achieved at the laboratory scale by monitoring their catalytic activity in GOS synthesis.

Use of computed tomography as a non-invasive method for diagnosing cephenemyiosis in roe deer (Capreolus capreolus).

PubMed

Fidalgo, L E; López-Beceiro, A M; Vila-Pastor, M; Martínez-Carrasco, C; Barreiro-Vázquez, J D; Pérez, J M

2015-03-01

This study was conducted to assess the reliability of computed tomography (CT) for diagnosing bot fly infestations by Cephenemyia stimulator (Clark) (Diptera: Oestridae) in roe deer (Capreolus capreolus L.) (Artiodactyla: Cervidae). For this purpose, the heads of 30 animals were analysed, firstly by CT and then by necropsy, which was used as the reference standard method. The prevalence values obtained by both methods were identical; the prevalence of infestation was 40.0% overall, and was higher in males (45.5%) than in females (25.0%). These results highlight the usefulness of CT as an alternative or non-invasive method for diagnosing cephenemyiosis in live-captured roe deer and in hunting trophies or museum collections that cannot be destroyed or damaged. © 2014 The Royal Entomological Society.

PATIENT STUDY OF IN VIVO VERIFICATION OF BEAM DELIVERY AND RANGE, USING POSITRON EMISSION TOMOGRAPHY AND COMPUTED TOMOGRAPHY IMAGING AFTER PROTON THERAPY

PubMed Central

Parodi, Katia; Paganetti, Harald; Shih, Helen A.; Michaud, Susan; Loeffler, Jay S.; Delaney, Thomas F.; Liebsch, Norbert J.; Munzenrider, John E.; Fischman, Alan J.; Knopf, Antje; Bortfeld, Thomas

2007-01-01

Purpose To investigate the feasibility and value of positron emission tomography and computed tomography (PET/CT) for treatment verification after proton radiotherapy. Methods and Materials This study included 9 patients with tumors in the cranial base, spine, orbit, and eye. Total doses of 1.8–3 GyE and 10 GyE (for an ocular melanoma) per fraction were delivered in 1 or 2 fields. Imaging was performed with a commercial PET/CT scanner for 30 min, starting within 20 min after treatment. The same treatment immobilization device was used during imaging for all but 2 patients. Measured PET/CT images were coregistered to the planning CT and compared with the corresponding PET expectation, obtained from CT-based Monte Carlo calculations complemented by functional information. For the ocular case, treatment position was approximately replicated, and spatial correlation was deduced from reference clips visible in both the planning radiographs and imaging CT. Here, the expected PET image was obtained from an analytical model. Results Good spatial correlation and quantitative agreement within 30% were found between the measured and expected activity. For head-and-neck patients, the beam range could be verified with an accuracy of 1–2 mm in well-coregistered bony structures. Low spine and eye sites indicated the need for better fixation and coregistration methods. An analysis of activity decay revealed as tissue-effective half-lives of 800–1,150 s. Conclusions This study demonstrates the feasibility of postradiation PET/CT for in vivo treatment verification. It also indicates some technological and methodological improvements needed for optimal clinical application. PMID:17544003

Value of PET/CT 3D visualization of head and neck squamous cell carcinoma extended to mandible.

PubMed

Lopez, R; Gantet, P; Julian, A; Hitzel, A; Herbault-Barres, B; Alshehri, S; Payoux, P

2018-05-01

To study an original 3D visualization of head and neck squamous cell carcinoma extending to the mandible by using [18F]-NaF PET/CT and [18F]-FDG PET/CT imaging along with a new innovative FDG and NaF image analysis using dedicated software. The main interest of the 3D evaluation is to have a better visualization of bone extension in such cancers and that could also avoid unsatisfying surgical treatment later on. A prospective study was carried out from November 2016 to September 2017. Twenty patients with head and neck squamous cell carcinoma extending to the mandible (stage 4 in the UICC classification) underwent [18F]-NaF and [18F]-FDG PET/CT. We compared the delineation of 3D quantification obtained with [18F]-NaF and [18F]-FDG PET/CT. In order to carry out this comparison, a method of visualisation and quantification of PET images was developed. This new approach was based on a process of quantification of radioactive activity within the mandibular bone that objectively defined the significant limits of this activity on PET images and on a 3D visualization. Furthermore, the spatial limits obtained by analysis of the PET/CT 3D images were compared to those obtained by histopathological examination of mandibular resection which confirmed intraosseous extension to the mandible. The [18F]-NaF PET/CT imaging confirmed the mandibular extension in 85% of cases and was not shown in [18F]-FDG PET/CT imaging. The [18F]-NaF PET/CT was significantly more accurate than [18F]-FDG PET/CT in 3D assessment of intraosseous extension of head and neck squamous cell carcinoma. This new 3D information shows the importance in the imaging approach of cancers. All cases of mandibular extension suspected on [18F]-NaF PET/CT imaging were confirmed based on histopathological results as a reference. The [18F]-NaF PET/CT 3D visualization should be included in the pre-treatment workups of head and neck cancers. With the use of a dedicated software which enables objective delineation of radioactive activity within the bone, it gives a very encouraging results. The [18F]-FDG PET/CT appears insufficient to confirm mandibular extension. This new 3D simulation management is expected to avoid under treatment of patients with intraosseous mandibular extension of head and neck cancers. However, there is also a need for a further study that will compare the interest of PET/CT and PET/MRI in this indication. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference.

PubMed

Suh, Young Joo; Lee, Sak; Im, Dong Jin; Chang, Suyon; Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Chang, Byung-Chul; Shim, Chi Young; Hong, Geu-Ru; Kim, Young Jin

2016-07-01

The added value of cardiac computed tomography (CT) with transesophageal echocardiography (TEE) for evaluating mechanical aortic valve (AV) dysfunction has not yet been investigated. The purposes of this study were to investigate the added value of cardiac CT for evaluation of mechanical AVs and diagnoses of pannus compared to TEE, with surgical findings of redo-aortic valve replacement (AVR) used as a standard reference. 25 patients who underwent redo-AVR due to mechanical AV dysfunction and cardiac CT before redo-AVR were included. The presence of pannus, encroachment ratio by pannus, and limitation of motion (LOM) were evaluated on CT. The diagnostic performance of pannus detection was compared using TEE, CT, and CT+TEE, with surgical findings as a standard reference. The added value of CT for diagnosing the cause of mechanical AV dysfunction was assessed compared to TTE+TEE. In two patients, CT analysis was not feasible due to severe metallic artifacts. On CT, pannus and LOM were found in 100% (23/23) and 60.9% (14/23). TEE identified pannus in 48.0% of patients (12/25). CT, TEE, and CT+TEE correctly identified pannus with sensitivity of 92.0%, 48.0%, and 92.0%, respectively (P=0.002 for CT vs. TEE). In 11 of 13 cases (84.6%) with inconclusive or negative TEE results for pannus, CT detected the pannus. Among 13 inconclusive cases of TTE+TEE for the cause of mechanical AV dysfunction, CT suggested 6 prosthetic valve obstruction (PVO) by pannus, 4 low-flow low-gradient PVO, and one LOM without significant PVO. Cardiac CT showed added diagnostic value with TEE in the detection of pannus as the cause of mechanical AV dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Multimaterial Decomposition Algorithm for the Quantification of Liver Fat Content by Using Fast-Kilovolt-Peak Switching Dual-Energy CT: Experimental Validation.

PubMed

Hyodo, Tomoko; Hori, Masatoshi; Lamb, Peter; Sasaki, Kosuke; Wakayama, Tetsuya; Chiba, Yasutaka; Mochizuki, Teruhito; Murakami, Takamichi

2017-02-01

Purpose To assess the ability of fast-kilovolt-peak switching dual-energy computed tomography (CT) by using the multimaterial decomposition (MMD) algorithm to quantify liver fat. Materials and Methods Fifteen syringes that contained various proportions of swine liver obtained from an abattoir, lard in food products, and iron (saccharated ferric oxide) were prepared. Approval of this study by the animal care and use committee was not required. Solid cylindrical phantoms that consisted of a polyurethane epoxy resin 20 and 30 cm in diameter that held the syringes were scanned with dual- and single-energy 64-section multidetector CT. CT attenuation on single-energy CT images (in Hounsfield units) and MMD-derived fat volume fraction (FVF; dual-energy CT FVF) were obtained for each syringe, as were magnetic resonance (MR) spectroscopy measurements by using a 1.5-T imager (fat fraction [FF] of MR spectroscopy). Reference values of FVF (FVF ref ) were determined by using the Soxhlet method. Iron concentrations were determined by inductively coupled plasma optical emission spectroscopy and divided into three ranges (0 mg per 100 g, 48.1-55.9 mg per 100 g, and 92.6-103.0 mg per 100 g). Statistical analysis included Spearman rank correlation and analysis of covariance. Results Both dual-energy CT FVF (ρ = 0.97; P < .001) and CT attenuation on single-energy CT images (ρ = -0.97; P < .001) correlated significantly with FVF ref for phantoms without iron. Phantom size had a significant effect on dual-energy CT FVF after controlling for FVF ref (P < .001). The regression slopes for CT attenuation on single-energy CT images in 20- and 30-cm-diameter phantoms differed significantly (P = .015). In sections with higher iron concentrations, the linear coefficients of dual-energy CT FVF decreased and those of MR spectroscopy FF increased (P < .001). Conclusion Dual-energy CT FVF allows for direct quantification of fat content in units of volume percent. Dual-energy CT FVF was larger in 30-cm than in 20-cm phantoms, though the effect of object size on fat estimation was less than that of CT attenuation on single-energy CT images. In the presence of iron, dual-energy CT FVF led to underestimateion of FVF ref to a lesser degree than FF of MR spectroscopy led to overestimation of FVF ref . © RSNA, 2016 Online supplemental material is available for this article.

Ultrafast dynamic computed tomography myelography for the precise identification of high-flow cerebrospinal fluid leaks caused by spiculated spinal osteophytes.

PubMed

Thielen, Kent R; Sillery, John C; Morris, Jonathan M; Hoxworth, Joseph M; Diehn, Felix E; Wald, John T; Rosebrock, Richard E; Yu, Lifeng; Luetmer, Patrick H

2015-03-01

Precise localization and understanding of the origin of spontaneous high-flow spinal CSF leaks is required prior to targeted treatment. This study demonstrates the utility of ultrafast dynamic CT myelography for the precise localization of high-flow CSF leaks caused by spiculated spinal osteophytes. This study reports a series of 14 patients with high-flow CSF leaks caused by spiculated spinal osteophytes who underwent ultrafast dynamic CT myelography between March 2009 and December 2010. There were 10 male and 4 female patients, with an average age of 49 years (range 37-74 years). The value of ultrafast dynamic CT myelography in depicting the CSF leak site was qualitatively assessed. In all 14 patients, ultrafast dynamic CT myelography was technically successful at precisely demonstrating the site of the CSF leak, the causative spiculated osteophyte piercing the dura, and the relationship of the implicated osteophyte to adjacent structures. Leak sites included 3 cervical, 11 thoracic, and 0 lumbar levels, with 86% of the leaks occurring from C-5 to T-7. Information obtained from the ultrafast dynamic CT myelogram was considered useful in all treated CSF leaks. Spinal osteophytes piercing the dura are a more frequent cause of high-flow CSF leaks than previously recognized. Ultrafast dynamic CT myelography adds value beyond standard dynamic myelography or digital subtraction myelography in the diagnosis and anatomical characterization of high-flow spinal CSF leaks caused by these osteophytes. This information allows for appropriate planning for percutaneous or surgical treatment.

Effect of rivaroxaban on blood coagulation using the viscoelastic coagulation test ROTEM™.

PubMed

Casutt, M; Konrad, C; Schuepfer, G

2012-11-01

This study investigated the influence of the oral direct inhibitor of factor Xa rivaroxaban on blood coagulation measured by rotation thrombelastometry ROTEM™. Blood was obtained from 11 healthy male volunteers before and 2.5 h after oral administration of 10 mg rivaroxaban. In addition to standard coagulation tests clot formation was measured by ROTEM™ analyzing extrinsic (Extem) and intrinsic thrombelastometry (Intem). Significant differences to the baseline values were found in the Extem clotting time (Extem-CT, 58 ± 9 s and 87 ± 17 s, p < 0.01), Intem-CT (194 ± 26 s and 239 ± 43 s; p = 0.02), prothrombin time (PT, 86 ± 9% and 67 ± 7%; p < 0.01) and activated partial thromboplastin time (aPTT, 28 ± 1 s and 35 ± 2 s; p < 0.01). There was a low correlation between Extem-CT and PT as well as between Intem-CT and aPTT before and after rivaroxaban intake. The receiver operating characteristic curve (ROC) analysis determined aPTT to be the most appropriate parameter for the prediction of rivaroxaban-induced anticoagulation, Intem-CT and Extem-CT proved to be moderate tests and PT had no significance in the prediction of rivaroxaban-induced anticoagulation. Of utmost clinical importance was the fact that rivaroxaban treated patients could still show normal ROTEM™ values. Thus, ROTEM™ cannot be a suitable test method to exclude inhibition of blood coagulation by rivaroxaban.

Ex vivo evaluation of 4 different viscoelastic assays for detecting moderate to severe coagulopathy during liver transplantation.

PubMed

Abuelkasem, Ezeldeen; Mazzeffi, Michael A; Lu, Shu Yang; Planinsic, Raymond M; Sakai, Tetsuro; Tanaka, Kenichi A

2016-04-01

Prolonged prothrombin time (PT) and its ratio are routinely used for the assessment of candidates for liver transplantation (LT), but intraoperative coagulation management of transfusion is hindered by its long turnaround time. Abnormal reaction time (R time) on thromboelastography (TEG) or clotting time (CT) of rotational thromboelastometry (ROTEM) are presumably an alternative, but there is a paucity of clinical data on abnormal R time/CT values compared to PT during LT. After receiving institutional review board approval and informed consent, we obtained blood samples from 36 LT patients for international normalized ratio (INR), factor (F) X level, and viscoelastic tests (EXTEM/INTEM and kaolin/rapid TEG) at baseline and 30 minutes after graft reperfusion. Receiver operating characteristic (ROC) curves were calculated for INR > 1.5 and viscoelastic R time/CT thresholds to assess the ability to diagnose FX deficiency at the moderate (<50%) or severe (<35%) level. The FX deficiency data were calculated using cutoff values of INR (>1.5) and abnormal R time/CT for TEG and ROTEM. Tissue factor (TF)-activated INR and EXTEM-CT performed well in diagnosing FX below 50%, but rapid TEG with combined TF and kaolin activators failed. Improved performance of INTEM-CT in diagnosing FX below 35% underlies multifactorial deficiency involving both intrinsic and common pathways. In conclusion, the differences among different viscoelastic tests and clinical situations should be carefully considered when they are used to guide transfusion during LT. © 2015 American Association for the Study of Liver Diseases.

Usage of density analysis based on micro-CT for studying lung injury associated with burn-blast combined injury.

PubMed

Chang, Yang; Zhang, Dong-Hai; Hu, Quan; Liu, Ling-Ying; Yu, Yong-Hui; Chai, Jia-Ke

2018-02-12

Burn-blast combined injury is a kind of injury caused by heat and blast at the same time. The lung injury after burn-blast combined injuries is of primary importance, and investigation of lung injury is needed in the clinical care of patients. Computed tomography (CT) is one of the standard tools used to observe the anatomical basis and pathophysiology of acute lung injury. We applied a method of fast 3D (three-dimensional) reconstruction to calculate the density value of the lung injury by CT analysis. Blast-injury group (BL group), burn-injury group (B group), burn-blast combined injury group (BBL group), and sham control group (C group) were established. Each group had 16 rats. The three-dimensional images of the lung tissue were obtained at 6h, 24h, and 48h according to the CT value. The average density of the whole lung, left lung, and right lung were measured. The lung tissues were paraffin-embedded and HE stained. Smith scoring was performed according to the pathological findings. In the BBL group, the density of the lung tissue was higher than those of the BL group and B group (P<0.01). The lung tissue density values at 24h after injury were higher than those at 6h and 48h after injury (P<0.01). Pathological results confirmed the changes of density analysis of the lung tissue. The results have indicated that density analysis through a CT scan can be used as a way to evaluate lung injury in a burn-blast injury. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon

PubMed Central

Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

2017-01-01

Abstract Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results. Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon–oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images. Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively (r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC (r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV1) (r = 0.59 and 0.56), weakly with the ratio of FEV1 to FVC (r = 0.46 and 0.42), and moderately with the ratio of FEV1 to its predicted value (r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV1 with bronchodilators. Inhalation of xenon gas caused no adverse effects. Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images reflected pulmonary function. Xenon images obtained with xenon-enhanced CT using a single-breath-hold technique can qualitatively depict pulmonary ventilation. A larger study comprising only COPD patients should be conducted, as xenon-enhanced CT is expected to be a promising technique for the management of COPD. PMID:28099359

Evaluation of pulmonary function using single-breath-hold dual-energy computed tomography with xenon: Results of a preliminary study.

PubMed

Kyoyama, Hiroyuki; Hirata, Yusuke; Kikuchi, Satoshi; Sakai, Kosuke; Saito, Yuriko; Mikami, Shintaro; Moriyama, Gaku; Yanagita, Hisami; Watanabe, Wataru; Otani, Katharina; Honda, Norinari; Uematsu, Kazutsugu

2017-01-01

Xenon-enhanced dual-energy computed tomography (xenon-enhanced CT) can provide lung ventilation maps that may be useful for assessing structural and functional abnormalities of the lung. Xenon-enhanced CT has been performed using a multiple-breath-hold technique during xenon washout. We recently developed xenon-enhanced CT using a single-breath-hold technique to assess ventilation. We sought to evaluate whether xenon-enhanced CT using a single-breath-hold technique correlates with pulmonary function testing (PFT) results.Twenty-six patients, including 11 chronic obstructive pulmonary disease (COPD) patients, underwent xenon-enhanced CT and PFT. Three of the COPD patients underwent xenon-enhanced CT before and after bronchodilator treatment. Images from xenon-CT were obtained by dual-source CT during a breath-hold after a single vital-capacity inspiration of a xenon-oxygen gas mixture. Image postprocessing by 3-material decomposition generated conventional CT and xenon-enhanced images.Low-attenuation areas on xenon images matched low-attenuation areas on conventional CT in 21 cases but matched normal-attenuation areas in 5 cases. Volumes of Hounsfield unit (HU) histograms of xenon images correlated moderately and highly with vital capacity (VC) and total lung capacity (TLC), respectively (r = 0.68 and 0.85). Means and modes of histograms weakly correlated with VC (r = 0.39 and 0.38), moderately with forced expiratory volume in 1 second (FEV1) (r = 0.59 and 0.56), weakly with the ratio of FEV1 to FVC (r = 0.46 and 0.42), and moderately with the ratio of FEV1 to its predicted value (r = 0.64 and 0.60). Mode and volume of histograms increased in 2 COPD patients after the improvement of FEV1 with bronchodilators. Inhalation of xenon gas caused no adverse effects.Xenon-enhanced CT using a single-breath-hold technique depicted functional abnormalities not detectable on thin-slice CT. Mode, mean, and volume of HU histograms of xenon images reflected pulmonary function. Xenon images obtained with xenon-enhanced CT using a single-breath-hold technique can qualitatively depict pulmonary ventilation. A larger study comprising only COPD patients should be conducted, as xenon-enhanced CT is expected to be a promising technique for the management of COPD.

Assessment of real-time PCR cycle threshold values in Microsporum canis culture-positive and culture-negative cats in an animal shelter: a field study.

PubMed

Jacobson, Linda S; McIntyre, Lauren; Mykusz, Jenny

2018-02-01

Objectives Real-time PCR provides quantitative information, recorded as the cycle threshold (Ct) value, about the number of organisms detected in a diagnostic sample. The Ct value correlates with the number of copies of the target organism in an inversely proportional and exponential relationship. The aim of the study was to determine whether Ct values could be used to distinguish between culture-positive and culture-negative samples. Methods This was a retrospective analysis of Ct values from dermatophyte PCR results in cats with suspicious skin lesions or suspected exposure to dermatophytosis. Results One hundred and thirty-two samples were included. Using culture as the gold standard, 28 were true positives, 12 were false positives and 92 were true negatives. The area under the curve for the pretreatment time point was 96.8% (95% confidence interval [CI] 94.2-99.5) compared with 74.3% (95% CI 52.6-96.0) for pooled data during treatment. Before treatment, a Ct cut-off of <35.7 (approximate DNA count 300) provided a sensitivity of 92.3% and specificity of 95.2%. There was no reliable cut-off Ct value between culture-positive and culture-negative samples during treatment. Ct values prior to treatment differed significantly between the true-positive and false-positive groups ( P = 0.0056). There was a significant difference between the pretreatment and first and second negative culture time points ( P = 0.0002 and P <0.0001, respectively). However, there was substantial overlap between Ct values for true positives and true negatives, and for pre- and intra-treatment time points. Conclusions and relevance Ct values had limited usefulness for distinguishing between culture-positive and culture-negative cases when field study samples were analyzed. In addition, Ct values were less reliable than fungal culture for determining mycological cure.

Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC).

PubMed

Mazzei, Maria Antonietta; Khader, Leila; Cirigliano, Alfredo; Cioffi Squitieri, Nevada; Guerrini, Susanna; Forzoni, Beatrice; Marrelli, Daniele; Roviello, Franco; Mazzei, Francesco Giuseppe; Volterrani, Luca

2013-12-01

To evaluate the accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent a peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) after neoadjuvant chemotherapy to obtain a pre-surgery prognostic evaluation and a prediction of optimal cytoreduction surgery. Pre-HIPEC CT examinations of 43 patients with advanced ovarian cancer after neoadjuvant chemotherapy were analyzed by two radiologists. The PCI was scored according to the Sugarbaker classification, based on lesion size and distribution. The results were compared with macroscopic and histologic data after peritonectomy and HIPEC. To evaluate the accuracy of MDCT to detect and localize peritoneal carcinomatosis, both patient-level and regional-level analyses were conducted. A correlation between PCI CT and histologic values for each patient was searched according to the PCI grading. Considering the patient-level analysis, CT shows a sensitivity, specificity, PPV, NPV, and an accuracy in detecting the peritoneal carcinomatosis of 100 %, 40 %, 93 % 100 %, and 93 %, respectively. Considering the regional level analysis, a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 72 %, 80 %, 66 %, 84 %, and 77 %, respectively were obtained for the correlation between CT and histology. Our results encourage the use of MDCT as the only technique sufficient to select patients with peritoneal carcinomatosis for cytoreductive surgery and HIPEC on the condition that a CT examination will be performed using a dedicated protocol optimized to detect minimal peritoneal disease and CT images will be analyzed by an experienced reader.

Extension of the International Atomic Energy Agency phantom study in image quantification: results of multicentre evaluation in Croatia.

PubMed

Grošev, Darko; Gregov, Marin; Wolfl, Miroslava Radić; Krstonošić, Branislav; Debeljuh, Dea Dundara

2018-06-07

To make quantitative methods of nuclear medicine more available, four centres in Croatia participated in the national intercomparison study, following the materials and methods used in the previous international study organized by the International Atomic Energy Agency (IAEA). The study task was to calculate the activities of four Ba sources (T1/2=10.54 years; Eγ=356 keV) using planar and single-photon emission computed tomography (SPECT) or SPECT/CT acquisitions of the sources inside a water-filled cylindrical phantom. The sources were previously calibrated by the US National Institute of Standards and Technology. Triple-energy window was utilized for scatter correction. Planar studies were corrected for attenuation correction (AC) using the conjugate-view method. For SPECT/CT studies, data from X-ray computed tomography were used for attenuation correction (CT-AC), whereas for SPECT-only acquisition, the Chang-AC method was applied. Using the lessons learned from the IAEA study, data were acquired according to the harmonized data acquisition protocol, and the acquired images were then processed using centralized data analysis. The accuracy of the activity quantification was evaluated as the ratio R between the calculated activity and the value obtained from National Institute of Standards and Technology. For planar studies, R=1.06±0.08; for SPECT/CT study using CT-AC, R=1.00±0.08; and for Chang-AC, R=0.89±0.12. The results are in accordance with those obtained within the larger IAEA study and confirm that SPECT/CT method is the most appropriate for accurate activity quantification.

A motion algorithm to extract physical and motion parameters of mobile targets from cone-beam computed tomographic images.

PubMed

Alsbou, Nesreen; Ahmad, Salahuddin; Ali, Imad

2016-05-17

A motion algorithm has been developed to extract length, CT number level and motion amplitude of a mobile target from cone-beam CT (CBCT) images. The algorithm uses three measurable parameters: Apparent length and blurred CT number distribution of a mobile target obtained from CBCT images to determine length, CT-number value of the stationary target, and motion amplitude. The predictions of this algorithm are tested with mobile targets having different well-known sizes that are made from tissue-equivalent gel which is inserted into a thorax phantom. The phantom moves sinusoidally in one-direction to simulate respiratory motion using eight amplitudes ranging 0-20 mm. Using this motion algorithm, three unknown parameters are extracted that include: Length of the target, CT number level, speed or motion amplitude for the mobile targets from CBCT images. The motion algorithm solves for the three unknown parameters using measured length, CT number level and gradient for a well-defined mobile target obtained from CBCT images. The motion model agrees with the measured lengths which are dependent on the target length and motion amplitude. The gradient of the CT number distribution of the mobile target is dependent on the stationary CT number level, the target length and motion amplitude. Motion frequency and phase do not affect the elongation and CT number distribution of the mobile target and could not be determined. A motion algorithm has been developed to extract three parameters that include length, CT number level and motion amplitude or speed of mobile targets directly from reconstructed CBCT images without prior knowledge of the stationary target parameters. This algorithm provides alternative to 4D-CBCT without requirement of motion tracking and sorting of the images into different breathing phases. The motion model developed here works well for tumors that have simple shapes, high contrast relative to surrounding tissues and move nearly in regular motion pattern that can be approximated with a simple sinusoidal function. This algorithm has potential applications in diagnostic CT imaging and radiotherapy in terms of motion management.

A Method for Application of Classification Tree Models to Map Aquatic Vegetation Using Remotely Sensed Images from Different Sensors and Dates

PubMed Central

Jiang, Hao; Zhao, Dehua; Cai, Ying; An, Shuqing

2012-01-01

In previous attempts to identify aquatic vegetation from remotely-sensed images using classification trees (CT), the images used to apply CT models to different times or locations necessarily originated from the same satellite sensor as that from which the original images used in model development came, greatly limiting the application of CT. We have developed an effective normalization method to improve the robustness of CT models when applied to images originating from different sensors and dates. A total of 965 ground-truth samples of aquatic vegetation types were obtained in 2009 and 2010 in Taihu Lake, China. Using relevant spectral indices (SI) as classifiers, we manually developed a stable CT model structure and then applied a standard CT algorithm to obtain quantitative (optimal) thresholds from 2009 ground-truth data and images from Landsat7-ETM+, HJ-1B-CCD, Landsat5-TM and ALOS-AVNIR-2 sensors. Optimal CT thresholds produced average classification accuracies of 78.1%, 84.7% and 74.0% for emergent vegetation, floating-leaf vegetation and submerged vegetation, respectively. However, the optimal CT thresholds for different sensor images differed from each other, with an average relative variation (RV) of 6.40%. We developed and evaluated three new approaches to normalizing the images. The best-performing method (Method of 0.1% index scaling) normalized the SI images using tailored percentages of extreme pixel values. Using the images normalized by Method of 0.1% index scaling, CT models for a particular sensor in which thresholds were replaced by those from the models developed for images originating from other sensors provided average classification accuracies of 76.0%, 82.8% and 68.9% for emergent vegetation, floating-leaf vegetation and submerged vegetation, respectively. Applying the CT models developed for normalized 2009 images to 2010 images resulted in high classification (78.0%–93.3%) and overall (92.0%–93.1%) accuracies. Our results suggest that Method of 0.1% index scaling provides a feasible way to apply CT models directly to images from sensors or time periods that differ from those of the images used to develop the original models.

The utility of dual-energy CT for metal artifact reduction from intracranial clipping and coiling.

PubMed

Mera Fernández, D; Santos Armentia, E; Bustos Fiore, A; Villanueva Campos, A M; Utrera Pérez, E; Souto Bayarri, M

2018-04-23

To assess the ability of dual-energy CT (DECT) to reduce metal-related artifacts in patients with clips and coils in head CT angiography, and to analyze the differences in this reduction between both type of devices. Thirteen patients (6 clips, 7 coils) were selected and retrospectively analized. Virtual monoenergetic images (MEI) with photon energies from 40 to 150 keV were obtained. Noise was measured at the area of maximum artifact. Subjective evaluation of streak artifact was performed by two radiologists independently. Differences between noise values in all groups were tested by using the ANOVA test. Mann-Whitney U test was used to compare the differences between clips and coils. Coheńs κ statistic was used to determine interobserver agreement. The lowest noise value was observed at high energy levels (p<0,05). Noise was higher in the coil group than in the clip group (p<0.001). Interobserver agreement was good (κ=0.72). TCED with MEI helps to minimize the artifact from clips ands coils in patients who undergo head CT angiography. The reduction of the artifact is greater in patients with surgical clipping than in patients with endovascular coiling. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

The effect of anesthetic eye drop instillation on the distribution of corneal thickness.

PubMed

Sanchis-Gimeno, Juan A; Palanca-Sanfrancisco, José M; García-Lázaro, Santiago; Madrid-Costa, David; Cerviño, Alejandro

2013-05-01

To address the effect of topical instillation of oxybuprocaine on the relative distribution of corneal thickness (CT) in young healthy subjects. Prospective study involving 30 eyes of 30 emmetropic subjects (24 ± 3 years). Corneal thickness measurements were carried out before and 3 minutes after the instillation of oxybuprocaine 4% using slit-scanning corneal topography (Orbscan topography system II). No acoustic correction factor was applied. The mean of 5 consecutive Orbscan measurements was obtained at the center and 3 mm from the visual axis in the temporal, superior, nasal, and inferior hemimeridians. No significant mean differences were found at any corneal location after anesthesia (P > 0.05). The difference between the baseline values obtained of the central, superior, inferior, nasal, and temporal cornea and those obtained after anesthesia ranged from -15 to 16 μm, from -19 to 32 μm, from -14 to 24 μm, from -20 to 33 μm, and from -31 to 18 μm, respectively. The maximum paracentral CT was never found at the temporal location before anesthesia, whereas it was never found at the inferior location after anesthesia. The minimum paracentral CT was never found in the superior location after anesthesia. Topical anesthetic eye drops induce CT increases and decreases at each corneal location; however, the differences are not significant. Nevertheless, a change in the location of the minimum and maximum paracentral thickness occurs in some individuals after corneal anesthesia.

Sources of funding for adult and paediatric CT procedures at a metropolitan tertiary hospital: How much do Medicare statistics really cover?

PubMed

Hayton, Anna; Wallace, Anthony; Johnston, Peter

2015-12-01

The radiation dose to the Australian paediatric population as a result of medical imaging is of growing concern, in particular the dose from CT. Estimates of the Australian population dose have largely relied on Medicare Australia statistics, which capture only a fraction of those imaging procedures actually performed. The fraction not captured has been estimated using a value obtained for a survey of the adult population in the mid-1990s. To better quantify the fraction of procedures that are not captured by Medicare Australia, procedure frequency and funding data for adult and paediatric patients were obtained from a metropolitan tertiary teaching and research hospital. Five calendar years of data were obtained with a financial class specified for each individual procedure. The financial classes were grouped to give the percentage of Medicare Australia billable procedures for both adult and paediatric patients. The data were also grouped to align with the Medicare Australia age cohorts. The percentage of CT procedures billable to Medicare Australia increased from 16% to 28% between 2008 and 2012. In 2012, the percentage billable for adult and paediatric patients was 28% and 33%, respectively; however, many adult CT procedures are performed at stand-alone clinics, which bulk bill. Using Medicare Australia statistics alone, the frequency of paediatric CT procedures performed on the Australian paediatric population will be grossly under estimated. A correction factor of 4.5 is suggested for paediatric procedures and 1.5 for adult procedures. The fraction of actual procedures performed that are captured by Medicare Australia will vary with time. © 2015 The Royal Australian and New Zealand College of Radiologists.

Prediction of calcium level in melamine-related urinary calculi with helical CT: diagnostic performance evaluation and clinical significance.

PubMed

Yuan, Li; Xiaorui, Ru; Gang, Huang; Xinsheng, Xi; Xiaogang, Huang; Li, Dong; Yirong, Chen

2012-06-01

The aim of the study was to investigate the relationship between CT-attenuation and stone calcium level in melamine-related urinary calculi (MRUC). A total of 25 MRUC with known composition and calcium level were included (11 uric acid stones, 2 calcium oxalate stones and 12 mixture stones of uric acid and calcium oxalate). Of all, 18 renal stones accepted alkalization therapy except for 5 lower urinary tract stones and 2 stones of unknown position. With well-matched composition, 61 adult urinary stones were included as controls. Every stone was scanned by helical CT (80 kV/120 kV, 300 mA, pitch 0.625 mm) and the highest CT-attenuation value measured. CT-attenuation values of MRUC increased gradually from uric acid stones, mixture stones to calcium oxalate stones, but were always lower than the values of controls. Furthermore, a strong positive correlation was found between stone CT-attenuation value and stone calcium level (n = 25, r (80kV) = 0.883, p = 0.000; r (120kV) = 0.855, p = 0.000). Compared with alkalization-therapy-alone group, stone CT-attenuation values and stone calcium level in the comprehensive-therapy group were significantly greater (CT(80kV) 1,057 ± 639 vs. 172 ± 61 HU, p = 0.001; CT(120kV) 783 ± 476 vs. 162 ± 60 HU, p = 0.001; Ca 19.83 ± 7.48% vs. 1.30 ± 1.51%, p = 0.000). Fisher's exact test suggested that the stones with higher CT-attenuation values tended to resist alkalization when 400 HU served as the cutoff value (P (80kV) = 0.002, P (120kV) = 0.000). In conclusion, the study was the first to illustrate that the CT-attenuation value could reflect calcium level in MRUC and found that stones with higher CT-attenuation value were not amenable to alkalization because they probably contained greater calcium. For those patients, we believe that comprehensive therapy will be the best choice.

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-aided implant placement. Part II: reliability of mucosa-supported stereolithographic guides.

PubMed

Arisan, Volkan; Karabuda, Zihni Cüneyt; Pişkin, Bülent; Özdemir, Tayfun

2013-12-01

Deviations of implants that were placed by conventional computed tomography (CT)- or cone beam CT (CBCT)-derived mucosa-supported stereolithographic (SLA) surgical guides were analyzed in this study. Eleven patients were randomly scanned by a multi-slice CT (CT group) or a CBCT scanner (CBCT group). A total of 108 implants were planned on the software and placed using SLA guides. A new CT or CBCT scan was obtained and merged with the planning data to identify the deviations between the planned and placed implants. Results were analyzed by Mann-Whitney U test and multiple regressions (p < .05). Mean angular and linear deviations in the CT group were 3.30° (SD 0.36), and 0.75 (SD 0.32) and 0.80 mm (SD 0.35) at the implant shoulder and tip, respectively. In the CBCT group, mean angular and linear deviations were 3.47° (SD 0.37), and 0.81 (SD 0.32) and 0.87 mm (SD 0.32) at the implant shoulder and tip, respectively. No statistically significant differences were detected between the CT and CBCT groups (p = .169 and p = .551, p = .113 for angular and linear deviations, respectively). Implant placement via CT- or CBCT-derived mucosa-supported SLA guides yielded similar deviation values. Results should be confirmed on alternative CBCT scanners. © 2012 Wiley Periodicals, Inc.

Assessment of medial coronoid disease in 180 canine lame elbow joints: a sensitivity and specificity comparison of radiographic, computed tomographic and arthroscopic findings.

PubMed

Villamonte-Chevalier, A; van Bree, H; Broeckx, Bjg; Dingemanse, W; Soler, M; Van Ryssen, B; Gielen, I

2015-09-25

Diagnostic imaging is essential to assess the lame patient; lesions of the elbow joint have traditionally been evaluated radiographically, however computed tomography (CT) has been suggested as a useful technique to diagnose various elbow pathologies. The primary objective of this study was to determine the sensitivity and specificity of CT to assess medial coronoid disease (MCD), using arthroscopy as gold standard. The secondary objective was to ascertain the radiographic sensitivity and specificity for MCD compared with CT. For this study 180 elbow joints were assessed, of which 141 had been examined with radiography, CT and arthroscopy; and 39 joints, had radiographic and CT assessment. Sensitivity and specificity were calculated for CT and radiographic findings using available statistical software. Sensitivity and specificity of CT using arthroscopy as gold standard resulted in high values for sensitivity (100 %) and specificity (93 %) for the assessment of MCD. For the radiographic evaluation, a sensitivity of 98 % and specificity of 64 - 69 % using CT as the technique of reference, were found. These results suggest that in case of doubt during radiographic assessment, CT could be used as a non-invasive technique to assess the presence of MCD. Based on the high sensitivity and specificity obtained in this study it has been considered that CT, rather than arthroscopy, is the preferred noninvasive technique to assess MCD lesions of the canine elbow joint.

Development of numerical phantoms by MRI for RF electromagnetic dosimetry: a female model.

PubMed

Mazzurana, M; Sandrini, L; Vaccari, A; Malacarne, C; Cristoforetti, L; Pontalti, R

2004-01-01

Numerical human models for electromagnetic dosimetry are commonly obtained by segmentation of CT or MRI images and complex permittivity values are ascribed to each issue according to literature values. The aim of this study is to provide an alternative semi-automatic method by which non-segmented images, obtained by a MRI tomographer, can be automatically related to the complex permittivity values through two frequency dependent transfer functions. In this way permittivity and conductivity vary with continuity--even in the same tissue--reflecting the intrinsic realistic spatial dispersion of such parameters. A female human model impinged by a plane wave is tested using finite-difference time-domain algorithm and the results of the total body and layer-averaged specific absorption rate are reported.

Effect of cluster thinning and prohexadione calcium applications on phenolic composition and sensory properties of red wines.

PubMed

Avizcuri-Inac, José-Miguel; Gonzalo-Diago, Ana; Sanz-Asensio, Jesús; Martínez-Soria, María-Teresa; López-Alonso, Miguel; Dizy-Soto, Marta; Echávarri-Granado, José-Federico; Vaquero-Fernández, Luis; Fernández-Zurbano, Purificación

2013-02-06

The overall objective of this study was to investigate the effect of manual cluster thinning (CT) and the application of the growth regulator Prohexadione calcium (ProCa) on the phenolic composition and the sensory profile of Tempranillo and Grenache wines produced from treated vines in La Rioja (Spain). ProCa was applied at preblooming and CT was carried out at veraison in two consecutive years. Different physicochemical parameters and analyses of phenolic compounds were carried out in control, CT and ProCa grapes and wines and wine sensory was performed. Thinning treatments decreased crop yield, besides ProCa application reduced berry size, and berry weight. Color and phenolic composition of Grenache and Tempranillo wines in general were affected by thinning treatments, with an increase in anthocyanin, flavanol and flavonol concentrations. In sensory analysis, wines obtained from thinned vines presented higher values for several aromatic (e.g., white and yellow fruits, fresh flowers) and taste attributes (i.e., astringency, bitternes, persistence). CT and ProCa treatments resulted in an improvement in wine quality. In general, similar results in phenolic composition, sensory properties and quality of wines were obtained by manual and chemical cluster thinning. ProCa as a growth regulator may be an option for a quality vitiviniculture.

Hybrid imaging worldwide-challenges and opportunities for the developing world: a report of a Technical Meeting organized by IAEA.

PubMed

Kashyap, Ravi; Dondi, Maurizio; Paez, Diana; Mariani, Guliano

2013-05-01

The growth in nuclear medicine, in the past decade, is largely due to hybrid imaging, specifically single-photon emission tomography-computed tomography (SPECT-CT) and positron emission tomography-computed tomography (PET-CT). Introduction and use of hybrid imaging has been growing at a fast pace. This has led to many challenges and opportunities to the personnel dealing with it. The International Atomic Energy Agency (IAEA) keeps a close watch on the trends in applications of nuclear techniques in health by many ways, including obtaining inputs from member states and professional societies. In 2012, a Technical Meeting on trends in hybrid imaging was organized by IAEA to understand the current status and trends of hybrid imaging using nuclear techniques, its role in clinical practice, and associated educational needs and challenges. Perspective of scientific societies and professionals from all the regions of the world was obtained. Heterogeneity in value, educational needs, and access was noted and the drivers of this heterogeneity were discussed. This article presents the key points shared during the technical meeting, focusing primarily on SPECT-CT and PET-CT, and shares the action plan for IAEA to deal with heterogeneity as suggested by the participants. Copyright © 2013 Elsevier Inc. All rights reserved.

CT-guided brachytherapy of prostate cancer: reduction of effective dose from X-ray examination

NASA Astrophysics Data System (ADS)

Sanin, Dmitriy B.; Biryukov, Vitaliy A.; Rusetskiy, Sergey S.; Sviridov, Pavel V.; Volodina, Tatiana V.

2014-03-01

Computed tomography (CT) is one of the most effective and informative diagnostic method. Though the number of CT scans among all radiographic procedures in the USA and European countries is 11% and 4% respectively, CT makes the highest contribution to the collective effective dose from all radiographic procedures, it is 67% in the USA and 40% in European countries [1-5]. Therefore it is necessary to understand the significance of dose value from CT imaging to a patient . Though CT dose from multiple scans and potential risk is of great concern in pediatric patients, this applies to adults as well. In this connection it is very important to develop optimal approaches to dose reduction and optimization of CT examination. International Commission on Radiological Protection (ICRP) in its publications recommends radiologists to be aware that often CT image quality is higher than it is necessary for diagnostic confidence[6], and there is a potential to reduce the dose which patient gets from CT examination [7]. In recent years many procedures, such as minimally invasive surgery, biopsy, brachytherapy and different types of ablation are carried out under guidance of computed tomography [6;7], and during a procedures multiple CT scans focusing on a specific anatomic region are performed. At the Clinics of MRRC different types of treatment for patients with prostate cancer are used, incuding conformal CT-guided brachytherapy, implantation of microsources of I into the gland under guidance of spiral CT [8]. So, the purpose of the study is to choose optimal method to reduce radiation dose from CT during CT-guided prostate brachytherapy and to obtain the image of desired quality.

3D temporal subtraction on multislice CT images using nonlinear warping technique

NASA Astrophysics Data System (ADS)

Ishida, Takayuki; Katsuragawa, Shigehiko; Kawashita, Ikuo; Kim, Hyounseop; Itai, Yoshinori; Awai, Kazuo; Li, Qiang; Doi, Kunio

2007-03-01

The detection of very subtle lesions and/or lesions overlapped with vessels on CT images is a time consuming and difficult task for radiologists. In this study, we have developed a 3D temporal subtraction method to enhance interval changes between previous and current multislice CT images based on a nonlinear image warping technique. Our method provides a subtraction CT image which is obtained by subtraction of a previous CT image from a current CT image. Reduction of misregistration artifacts is important in the temporal subtraction method. Therefore, our computerized method includes global and local image matching techniques for accurate registration of current and previous CT images. For global image matching, we selected the corresponding previous section image for each current section image by using 2D cross-correlation between a blurred low-resolution current CT image and a blurred previous CT image. For local image matching, we applied the 3D template matching technique with translation and rotation of volumes of interests (VOIs) which were selected in the current and the previous CT images. The local shift vector for each VOI pair was determined when the cross-correlation value became the maximum in the 3D template matching. The local shift vectors at all voxels were determined by interpolation of shift vectors of VOIs, and then the previous CT image was nonlinearly warped according to the shift vector for each voxel. Finally, the warped previous CT image was subtracted from the current CT image. The 3D temporal subtraction method was applied to 19 clinical cases. The normal background structures such as vessels, ribs, and heart were removed without large misregistration artifacts. Thus, interval changes due to lung diseases were clearly enhanced as white shadows on subtraction CT images.

Semi-Quantitative Analysis of Post-Transarterial Radioembolization (90)Y Microsphere Positron Emission Tomography Combined with Computed Tomography (PET/CT) Images in Advanced Liver Malignancy: Comparison With (99m)Tc Macroaggregated Albumin (MAA) Single Photon Emission Computed Tomography (SPECT).

PubMed

Rhee, Seunghong; Kim, Sungeun; Cho, Jaehyuk; Park, Jukyung; Eo, Jae Seon; Park, Soyeon; Lee, Eunsub; Kim, Yun Hwan; Choe, Jae-Gol

2016-03-01

The purpose of this study is to evaluate the correlation between pretreatment planning technetium-99m ((99m)Tc) macroaggregated albumin (MAA) SPECT images and posttreatment transarterial radioembolization (TARE) yttirum-90 ((90)Y) PET/CT images by comparing the ratios of tumor-to-normal liver counts. Fifty-two patients with advanced hepatic malignancy who underwent (90)Y microsphere radioembolization from January 2010 to December 2012 were retrospectively reviewed. Patients had undergone (99m)Tc MAA intraarterial injection SPECT for a pretreatment evaluation of microsphere distribution and therapy planning. After the administration of (90)Y microspheres, the patients underwent posttreatment (90)Y PET/CT within 24 h. For semiquantitative analysis, the tumor-to-normal uptake ratios in (90)Y PET/CT (TNR-yp) and (99m)Tc MAA SPECT (TNR-ms) as well as the tumor volumes measured in angiographic CT were obtained and analyzed. The relationship of TNR-yp and TNR-ms was evaluated by Spearman's rank correlation and Wilcoxon's matched pairs test. In a total of 79 lesions of 52 patients, the distribution of microspheres was well demonstrated in both the SPECT and PET/CT images. A good correlation was observed of between TNR-ms and TNR-yp (rho value = 0.648, p < 0.001). The TNR-yp (median 2.78, interquartile range 2.43) tend to show significantly higher values than TNR-ms (median 2.49, interquartile range of 1.55) (p = 0.012). The TNR-yp showed weak correlation with tumor volume (rho = 0.230, p = 0.041). The (99m)Tc MAA SPECT showed a good correlation with (90)Y PET/CT in TNR values, suggesting that (99m)Tc MAA can be used as an adequate pretreatment evaluation method. However, the (99m)Tc MAA SPECT image consistently shows lower TNR values compared to (90)Y PET/CT, which means the possibility of underestimation of tumorous uptake in the partition dosimetry model using (99m)Tc MAA SPECT. Considering that (99m)Tc MAA is the only clinically available surrogate marker for distribution of microsphere, we recommend measurement of tumorous uptake using (90)Y PET/CT should be included routinely in the posttherapeutic evaluation.

Visualization of x-ray computer tomography using computer-generated holography

NASA Astrophysics Data System (ADS)

Daibo, Masahiro; Tayama, Norio

1998-09-01

The theory converted from x-ray projection data to the hologram directly by combining the computer tomography (CT) with the computer generated hologram (CGH), is proposed. The purpose of this study is to offer the theory for realizing the all- electronic and high-speed seeing through 3D visualization system, which is for the application to medical diagnosis and non- destructive testing. First, the CT is expressed using the pseudo- inverse matrix which is obtained by the singular value decomposition. CGH is expressed in the matrix style. Next, `projection to hologram conversion' (PTHC) matrix is calculated by the multiplication of phase matrix of CGH with pseudo-inverse matrix of the CT. Finally, the projection vector is converted to the hologram vector directly, by multiplication of the PTHC matrix with the projection vector. Incorporating holographic analog computation into CT reconstruction, it becomes possible that the calculation amount is drastically reduced. We demonstrate the CT cross section which is reconstituted by He-Ne laser in the 3D space from the real x-ray projection data acquired by x-ray television equipment, using our direct conversion technique.

Patient and surgeon radiation exposure during spinal instrumentation using intraoperative computed tomography-based navigation.

PubMed

Mendelsohn, Daniel; Strelzow, Jason; Dea, Nicolas; Ford, Nancy L; Batke, Juliet; Pennington, Andrew; Yang, Kaiyun; Ailon, Tamir; Boyd, Michael; Dvorak, Marcel; Kwon, Brian; Paquette, Scott; Fisher, Charles; Street, John

2016-03-01

Imaging modalities used to visualize spinal anatomy intraoperatively include X-ray studies, fluoroscopy, and computed tomography (CT). All of these emit ionizing radiation. Radiation emitted to the patient and the surgical team when performing surgeries using intraoperative CT-based spine navigation was compared. This is a retrospective cohort case-control study. Seventy-three patients underwent CT-navigated spinal instrumentation and 73 matched controls underwent spinal instrumentation with conventional fluoroscopy. Effective doses of radiation to the patient when the surgical team was inside and outside of the room were analyzed. The number of postoperative imaging investigations between navigated and non-navigated cases was compared. Intraoperative X-ray imaging, fluoroscopy, and CT dosages were recorded and standardized to effective doses. The number of postoperative imaging investigations was compared with the matched cohort of surgical cases. A literature review identified historical radiation exposure values for fluoroscopic-guided spinal instrumentation. The 73 navigated operations involved an average of 5.44 levels of instrumentation. Thoracic and lumbar instrumentations had higher radiation emission from all modalities (CT, X-ray imaging, and fluoroscopy) compared with cervical cases (6.93 millisievert [mSv] vs. 2.34 mSv). Major deformity and degenerative cases involved more radiation emission than trauma or oncology cases (7.05 mSv vs. 4.20 mSv). On average, the total radiation dose to the patient was 8.7 times more than the radiation emitted when the surgical team was inside the operating room. Total radiation exposure to the patient was 2.77 times the values reported in the literature for thoracolumbar instrumentations performed without navigation. In comparison, the radiation emitted to the patient when the surgical team was inside the operating room was 2.50 lower than non-navigated thoracolumbar instrumentations. The average total radiation exposure to the patient was 5.69 mSv, a value less than a single routine lumbar CT scan (7.5 mSv). The average radiation exposure to the patient in the present study was approximately one quarter the recommended annual occupational radiation exposure. Navigation did not reduce the number of postoperative X-rays or CT scans obtained. Intraoperative CT navigation increases the radiation exposure to the patient and reduces the radiation exposure to the surgeon when compared with values reported in the literature. Intraoperative CT navigation improves the accuracy of spine instrumentation with acceptable patient radiation exposure and reduced surgical team exposure. Surgeons should be aware of the implications of radiation exposure to both the patient and the surgical team when using intraoperative CT navigation. Copyright © 2016 Elsevier Inc. All rights reserved.

Single-phase Whole-body 64-MDCT Split-bolus Protocol for Pediatric Oncology: Diagnostic Efficacy and Dose Radiation.

PubMed

Scialpi, Michele; Schiavone, Raffaele; D'Andrea, Alfredo; Palumbo, Isabella; Magli, Michelle; Gravante, Sabrina; Falcone, Giuseppe; De Filippi, Claudio; Manganaro, Lucia; Palumbo, Barbara

2015-05-01

To evaluate the image quality and the diagnostic efficacy by single-phase whole-body 64-slice multidetector CT (MDCT) for pediatric oncology. Chest-abdomen-pelvis CT examinations with single-phase split-bolus technique were evaluated for T: detection and delineation of primary tumor (assessment of the extent of the lesion to neighboring tissues), N: regional lymph nodes and M: distant metastasis. Quality scores (5-point scale) were assessed by two radiologists on parenchymal and vascular enhancement. Accurate TNM staging in term of detection and delineation of primary tumor, regional lymph nodes and distant metastasis was obtained in all cases. On the image quality and severity artifact, the Kappa value for the interobserver agreement measure obtained from the analysis was 0.754, (p<0.001), characterizing a very good agreement between observers. Single-pass total body CT split-bolus technique reached the highest overall image quality and an accurate TNM staging in pediatric patients with cancer. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

CT volumetry of the skeletal tissues

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

Brindle, James M.; Alexandre Trindade, A.; Pichardo, Jose C.

2006-10-15

Computed tomography (CT) is an important and widely used modality in the diagnosis and treatment of various cancers. In the field of molecular radiotherapy, the use of spongiosa volume (combined tissues of the bone marrow and bone trabeculae) has been suggested as a means to improve the patient-specificity of bone marrow dose estimates. The noninvasive estimation of an organ volume comes with some degree of error or variation from the true organ volume. The present study explores the ability to obtain estimates of spongiosa volume or its surrogate via manual image segmentation. The variation among different segmentation raters was exploredmore » and found not to be statistically significant (p value >0.05). Accuracy was assessed by having several raters manually segment a polyvinyl chloride (PVC) pipe with known volumes. Segmentation of the outer region of the PVC pipe resulted in mean percent errors as great as 15% while segmentation of the pipe's inner region resulted in mean percent errors within {approx}5%. Differences between volumes estimated with the high-resolution CT data set (typical of ex vivo skeletal scans) and the low-resolution CT data set (typical of in vivo skeletal scans) were also explored using both patient CT images and a PVC pipe phantom. While a statistically significant difference (p value <0.002) between the high-resolution and low-resolution data sets was observed with excised femoral heads obtained following total hip arthroplasty, the mean difference between high-resolution and low-resolution data sets was found to be only 1.24 and 2.18 cm{sup 3} for spongiosa and cortical bone, respectively. With respect to differences observed with the PVC pipe, the variation between the high-resolution and low-resolution mean percent errors was a high as {approx}20% for the outer region volume estimates and only as high as {approx}6% for the inner region volume estimates. The findings from this study suggest that manual segmentation is a reasonably accurate and reliable means for the in vivo estimation of spongiosa volume. This work also provides a foundation for future studies where spongiosa volumes are estimated by various raters in more comprehensive CT data sets.« less

TU-H-CAMPUS-JeP2-03: Machine-Learning-Based Delineation Framework of GTV Regions of Solid and Ground Glass Opacity Lung Tumors at Datasets of Planning CT and PET/CT Images

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

Ikushima, K; Arimura, H; Jin, Z

Purpose: In radiation treatment planning, delineation of gross tumor volume (GTV) is very important, because the GTVs affect the accuracies of radiation therapy procedure. To assist radiation oncologists in the delineation of GTV regions while treatment planning for lung cancer, we have proposed a machine-learning-based delineation framework of GTV regions of solid and ground glass opacity (GGO) lung tumors following by optimum contour selection (OCS) method. Methods: Our basic idea was to feed voxel-based image features around GTV contours determined by radiation oncologists into a machine learning classifier in the training step, after which the classifier produced the degree ofmore » GTV for each voxel in the testing step. Ten data sets of planning CT and PET/CT images were selected for this study. The support vector machine (SVM), which learned voxel-based features which include voxel value and magnitudes of image gradient vector that obtained from each voxel in the planning CT and PET/CT images, extracted initial GTV regions. The final GTV regions were determined using the OCS method that was able to select a global optimum object contour based on multiple active delineations with a level set method around the GTV. To evaluate the results of proposed framework for ten cases (solid:6, GGO:4), we used the three-dimensional Dice similarity coefficient (DSC), which denoted the degree of region similarity between the GTVs delineated by radiation oncologists and the proposed framework. Results: The proposed method achieved an average three-dimensional DSC of 0.81 for ten lung cancer patients, while a standardized uptake value-based method segmented GTV regions with the DSC of 0.43. The average DSCs for solid and GGO were 0.84 and 0.76, respectively, obtained by the proposed framework. Conclusion: The proposed framework with the support vector machine may be useful for assisting radiation oncologists in delineating solid and GGO lung tumors.« less

Immunoscore encompassing CD3+ and CD8+ T cell densities in distant metastasis is a robust prognostic marker for advanced colorectal cancer

PubMed Central

Kwak, Yoonjin; Koh, Jiwon; Kim, Duck-Woo; Kang, Sung-Bum; Kim, Woo Ho; Lee, Hye Seung

2016-01-01

Background The immunoscore (IS), an index based on the density of CD3+ and CD8+ tumor-infiltrating lymphocytes (TILs) in the tumor center (CT) and invasive margin (IM), has gained considerable attention as a prognostic marker. Tumor-associated macrophages (TAMs) have also been reported to have prognostic value. However, its clinical significance has not been fully clarified in patients with advanced CRC who present with distant metastases. Methods The density of CD3+, CD4+, CD8+, FOXP3+, CD68+, and CD163+ immune cells within CRC tissue procured from three sites–the primary CT, IM, and distant metastasis (DM)–was determined using immunohistochemistry and digital image analyzer (n=196). The IS was obtained by quantifying the densities of CD3+ and CD8+ TILs in the CT and IM. IS-metastatic and IS-macrophage–additional IS models designed in this study–were obtained by adding the score of CD3 and CD8 in DM and the score of CD163 in primary tumors (CT and IM), respectively, to the IS. Result Higher IS, IS-metastatic, and IS-macrophage values were significantly correlated with better prognosis (p=0.020, p≤0.001, and p=0.005, respectively). Multivariate analysis revealed that only IS-metastatic was an independent prognostic marker (p=0.012). No significant correlation was observed between KRAS mutation and three IS models. However, in the subgroup analysis, IS-metastatic showed a prognostic association regardless of the KRAS mutational status. Conclusion IS is a reproducible method for predicting the survival of patients with advanced CRC. Additionally, an IS including the CD3+ and CD8+ TIL densities at DM could be a strong prognostic marker for advanced CRC. PMID:27835889

Quantifying regional cerebral blood flow by N-isopropyl-P-[I-123]iodoamphetamine (IMP) using a ring type single-photon emission computed tomography system

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

Takahashi, N.; Odano, I.; Ohkubo, M.

1994-05-01

We developed a more accurate quantitative measurement of regional cerebral blood flow (rCBF) with the microsphere model using N-isopropyl-p-[I-123] iodoamphetamine (IMP) and a ring type single photon emission computed tomography (SPECT) system. SPECT studies were performed in 17 patients with brain diseases. A dose of 222 MBq (6 mCi) of [I-123]IMP was injected i.v., at the same time a 5 min period of arterial blood withdrawal was begun. SPECT data were acquired from 25 min to 60 min after tracer injection. For obtaining the brain activity concentration at 5 min after IMP injection, total brain counts collections and one minutemore » period short time SPECT studies were performed at 5, 20, and 60 min. Measurement of the values of rCBF was calculated using short time SPECT images at 5 min (rCBF), static SPECT images corrected with total cerebral counts (rCBF{sub Ct}.) and those corrected with reconstructed counts on short time SPECT images (rCBF{sub Cb}). There was a good relationship (r=0.69) between rCBF and rCBF{sub Ct}, however, rCBF{sub Ct} tends to be underestimated in high flow areas and overestimated in low flow areas. There was better relationship between rCBF and rCBF{sub Cb}(r=0.92). The overestimation and underestimation shown in rCBF{sub Ct} was considered to be due to the correction of reconstructed counts using a total cerebral time activity curve, because of the kinetic behavior of [I-123]IMP was different in each region. We concluded that more accurate rCBF values could be obtained using the regional time activity curves.« less

CT-Guided Transthoracic Core Biopsy for Pulmonary Tuberculosis: Diagnostic Value of the Histopathological Findings in the Specimen

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

Fukuda, Hozumi, E-mail: fkdhzmrad@mitsuihosp.or.jp; Ibukuro, Kenji; Tsukiyama, Toshitaka

We evaluated the value of CT-guided transthoracic core biopsy for the diagnosis of mycobacterial pulmonary nodules. The 30 subjects in this study had pulmonary nodules that had been either diagnosed histopathologically as tuberculosis or were suspected as tuberculosis based on a specimen obtained by CT-guided transthoracic core biopsy. The histopathological findings, the existence of acid-fast bacilli in the biopsy specimens, and the clinical course of the patients after the biopsy were reviewed retrospectively. Two of the three histological findings for tuberculosis that included epithelioid cells, multinucleated giant cells and caseous necrosis were observed in 21 of the nodules which weremore » therefore diagnosed as histological tuberculosis. Six of these 21 nodules were positive for acid-fast bacilli, confirming the diagnosis of tuberculosis. Thirteen of the 21 nodules did not contain acid-fast bacilli but decreased in size in response to antituberculous treatment and were therefore diagnosed as clinical tuberculosis. Seven nodules with only caseous necrosis were diagnosed as suspected tuberculosis, with a final diagnosis of tuberculosis being made in 4 of the nodules and a diagnosis of old tuberculosis in 2 nodules. Two nodules with only multinucleated giant cells were diagnosed as suspected tuberculosis with 1 of these nodules being diagnosed finally as tuberculosis and the other nodule as a nonspecific granuloma. When any two of the three following histopathological findings - epithelioid cells, multinucleated giant cells or caseous necrosis - are observed in a specimen obtained by CT-guided transthoracic core biopsy, the diagnosis of tuberculosis can be established without the detection of acid-fast bacilli or Mycobacterium tuberculosis.« less

Advanced quantitative methods in correlating sarcopenic muscle degeneration with lower extremity function biometrics and comorbidities

PubMed Central

Gíslason, Magnús; Sigurðsson, Sigurður; Guðnason, Vilmundur; Harris, Tamara; Carraro, Ugo; Gargiulo, Paolo

2018-01-01

Sarcopenic muscular degeneration has been consistently identified as an independent risk factor for mortality in aging populations. Recent investigations have realized the quantitative potential of computed tomography (CT) image analysis to describe skeletal muscle volume and composition; however, the optimum approach to assessing these data remains debated. Current literature reports average Hounsfield unit (HU) values and/or segmented soft tissue cross-sectional areas to investigate muscle quality. However, standardized methods for CT analyses and their utility as a comorbidity index remain undefined, and no existing studies compare these methods to the assessment of entire radiodensitometric distributions. The primary aim of this study was to present a comparison of nonlinear trimodal regression analysis (NTRA) parameters of entire radiodensitometric muscle distributions against extant CT metrics and their correlation with lower extremity function (LEF) biometrics (normal/fast gait speed, timed up-and-go, and isometric leg strength) and biochemical and nutritional parameters, such as total solubilized cholesterol (SCHOL) and body mass index (BMI). Data were obtained from 3,162 subjects, aged 66–96 years, from the population-based AGES-Reykjavik Study. 1-D k-means clustering was employed to discretize each biometric and comorbidity dataset into twelve subpopulations, in accordance with Sturges’ Formula for Class Selection. Dataset linear regressions were performed against eleven NTRA distribution parameters and standard CT analyses (fat/muscle cross-sectional area and average HU value). Parameters from NTRA and CT standards were analogously assembled by age and sex. Analysis of specific NTRA parameters with standard CT results showed linear correlation coefficients greater than 0.85, but multiple regression analysis of correlative NTRA parameters yielded a correlation coefficient of 0.99 (P<0.005). These results highlight the specificities of each muscle quality metric to LEF biometrics, SCHOL, and BMI, and particularly highlight the value of the connective tissue regime in this regard. PMID:29513690

Advanced quantitative methods in correlating sarcopenic muscle degeneration with lower extremity function biometrics and comorbidities.

PubMed

Edmunds, Kyle; Gíslason, Magnús; Sigurðsson, Sigurður; Guðnason, Vilmundur; Harris, Tamara; Carraro, Ugo; Gargiulo, Paolo

2018-01-01

Sarcopenic muscular degeneration has been consistently identified as an independent risk factor for mortality in aging populations. Recent investigations have realized the quantitative potential of computed tomography (CT) image analysis to describe skeletal muscle volume and composition; however, the optimum approach to assessing these data remains debated. Current literature reports average Hounsfield unit (HU) values and/or segmented soft tissue cross-sectional areas to investigate muscle quality. However, standardized methods for CT analyses and their utility as a comorbidity index remain undefined, and no existing studies compare these methods to the assessment of entire radiodensitometric distributions. The primary aim of this study was to present a comparison of nonlinear trimodal regression analysis (NTRA) parameters of entire radiodensitometric muscle distributions against extant CT metrics and their correlation with lower extremity function (LEF) biometrics (normal/fast gait speed, timed up-and-go, and isometric leg strength) and biochemical and nutritional parameters, such as total solubilized cholesterol (SCHOL) and body mass index (BMI). Data were obtained from 3,162 subjects, aged 66-96 years, from the population-based AGES-Reykjavik Study. 1-D k-means clustering was employed to discretize each biometric and comorbidity dataset into twelve subpopulations, in accordance with Sturges' Formula for Class Selection. Dataset linear regressions were performed against eleven NTRA distribution parameters and standard CT analyses (fat/muscle cross-sectional area and average HU value). Parameters from NTRA and CT standards were analogously assembled by age and sex. Analysis of specific NTRA parameters with standard CT results showed linear correlation coefficients greater than 0.85, but multiple regression analysis of correlative NTRA parameters yielded a correlation coefficient of 0.99 (P<0.005). These results highlight the specificities of each muscle quality metric to LEF biometrics, SCHOL, and BMI, and particularly highlight the value of the connective tissue regime in this regard.

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

Thomas, S; Yuen, C; Huang, V

Purpose: In this abstract we implement and validate a 4D VMAT Acuros XB dose calculation using Gafchromic film. Special attention is paid to the physical material assignment in the CT dataset and to reported dose to water and dose to medium. Methods: A QUASAR phantom with a 3 cm sinusoidal tumor motion and 5 second period was scanned using 4D computed tomography. A CT was also obtained of the static QUASAR phantom with the tumor at the central position. A VMAT plan was created on the average CT dataset and was delivered on a Varian TrueBeam linear accelerator. The trajectorymore » log file from this treatment was acquired and used to create 10 VMAT subplans (one for each portion of the breathing cycle). Motion for each subplan was simulated by moving the beam isocentre in the superior/inferior direction in the Treatment Planning System on the static CT scan. The 10 plans were calculated (both dose to medium and dose to water) and summed for 1) the original HU values from the static CT scan and 2) the correct physical material assignment in the CT dataset. To acquire a breathing phase synchronized film measurements the trajectory log was used to create a VMAT delivery plan which includes dynamic couch motion using the Developer Mode. Three different treatment start phases were investigated (mid inhalation, full inhalation and full exhalation). Results: For each scenario the coronal dose distributions were measured using Gafchromic film and compared to the corresponding calculation with Film QA Pro Software using a Gamma test with a 3%/3mm distance to agreement criteria. Good agreement was found between calculation and measurement. No statistically significant difference in agreement was found between calculations to original HU values vs calculations to over-written (material-assigned) HU values. Conclusion: The investigated 4D dose calculation method agrees well with measurement.« less

Diagnostic value of contrast-enhanced CT combined with 18-FDG PET in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

PubMed

Sommariva, Antonio; Evangelista, Laura; Pintacuda, Giovanna; Cervino, Anna Rita; Ramondo, Gaetano; Rossi, Carlo Riccardo

2018-05-01

Aim of the study is to assess the reliability and correlation with surgical peritoneal cancer index (PCI) of combined PET/CT and ceCT scans (PET/ceCT) performed in a session in patients with peritoneal carcinomatosis candidates for cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC). We retrospectively analyzed data collected from 27 patients with different types of peritoneal carcinomatosis candidates to CS + HIPEC who underwent FDG PET/ceCT in a single session. Two nuclear medicine physicians and two radiologists independently and blindly evaluated PET/CT and ceCT imaging, respectively. In the case of discordance, the consensus was reached by a discussion between the specialists. Moreover, the combined images were evaluated by all the specialists in consensus. The PCIs obtained from surgical look, PET/CT, ceCT, and PET/ceCT were compared with each other. The coefficients of correlation (r) were calculated. The study was conducted after approval of local ethics committee. Surgical PCI was available in 21 patients. The coefficient of correlation between PCI of PET/CT and surgery was 0.528, while it resulted higher between PET/ceCT and surgery (r = 0.878), very similar to ceCT and surgery (r = 0.876). The r coefficient between surgical PCI and PET/CT was higher in patients with a non-mucinous cancer (n = 12) than the counterpart (0.601 vs. 0.303) and the addition of ceCT significantly increases the correlation (r = 0.863), which is anyway similar to ceCT alone (r = 0.856). PET/ceCT as single examination is more accurate than PET/CT but not than ceCT alone for the definition of PCI in a selected group of patients candidates to CS + HIPEC.

The appearance and effects of metallic implants in CT images.

PubMed

Kairn, T; Crowe, S B; Fogg, P; Trapp, J V

2013-06-01

The computed tomography (CT) imaging artefacts that metallic medical implants produce in surrounding tissues are usually contoured and over-ridden during radiotherapy treatment planning. In cases where radiotherapy treatment beams unavoidably pass though implants, it is especially important to understand the imaging artefacts that may occur within the implants themselves. This study examines CT images of a set of simple metallic objects, immersed in water, in order to evaluate reliability and variability of CT numbers (Hounsfield units, HUs) within medical implants. Model implants with a range of sizes (heights from 2.2 to 49.6 mm), electron densities (from 2.3 to 7.7 times the electron density of water) and effective atomic numbers (from 3.9 to 9.0 times the effective atomic number of water in a CT X-ray beam) were created by stacking metal coins from several currencies. These 'implants' were CT scanned within a large (31.0 cm across) and a small (12.8 cm across) water phantom. Resulting HU values are as much as 50 % lower than the result of extrapolating standard electron density calibration data (obtained for tissue and bone densities) up to the metal densities and there is a 6 % difference between the results obtained by scanning with 120 and 140 kVp tube potentials. Profiles through the implants show localised cupping artefacts, within the implants, as well as a gradual decline in HU outside the implants that can cause the implants' sizes to be over estimated by 1.3-9.0 mm. These effects are exacerbated when the implants are scanned in the small phantom or at the side of the large phantom, due to reduced pre-hardening of the X-ray beam in these configurations. These results demonstrate the necessity of over-riding the densities of metallic implants, as well as their artefacts in tissue, in order to obtain accurate radiotherapy dose calculations.

Sensitivity and daily quality control of a mobile PET/CT scanner operating in 3-dimensional mode.

PubMed

Belakhlef, Abdelfatihe; Church, Clifford; Fraser, Ron; Lakhanpal, Suresh

2007-12-01

This study investigated the stability of the sensitivity of a mobile PET/CT scanner and tested a phantom experiment to improve on the daily quality control recommendations of the manufacturer. Unlike in-house scanners, mobile PET/CT devices are subjected to a harsher, continuously changing environment that can alter their performance. The parameter of sensitivity was investigated because it reflects directly on standardized uptake value, a key factor in cancer evaluation. A (68)Ge phantom of known activity concentration was scanned 6 times a month for 11 consecutive months using a mobile PET/CT scanner that operates in 3-dimensional mode only. The scans were acquired as 2 contiguous bed positions, with raw data obtained and reconstructed using parameters identical to those used for oncology patients, including CT-extracted attenuation coefficients and decay, scatter, geometry, and randoms corrections. After visual inspection of all reconstructed images, identical regions of interest were drawn on each image to obtain the activity concentration of individual slices. The original activity concentration was then decay-corrected to the scanning day, and the percentage sensitivity of the slice was calculated and graphed. The daily average sensitivity of the scanner, over 11 consecutive months, was also obtained and used to evaluate the stability of sensitivity. Our particular scanner showed a daily average sensitivity ranging from -8.6% to 6.5% except for one instance, when the sensitivity dropped by an unacceptable degree, 34.8%. Our 11-mo follow-up of a mobile PET/CT scanner demonstrated that its sensitivity remained within acceptable clinical limits except for one instance, when the scanner had to be serviced before patients could be imaged. To enhance our confidence in the uniformity of sensitivity across slices, we added a phantom scan to the daily quality control recommendations of the manufacturer.

The possibility of application of spiral brain computed tomography to traumatic brain injury.

PubMed

Lim, Daesung; Lee, Soo Hoon; Kim, Dong Hoon; Choi, Dae Seub; Hong, Hoon Pyo; Kang, Changwoo; Jeong, Jin Hee; Kim, Seong Chun; Kang, Tae-Sin

2014-09-01

The spiral computed tomography (CT) with the advantage of low radiation dose, shorter test time required, and its multidimensional reconstruction is accepted as an essential diagnostic method for evaluating the degree of injury in severe trauma patients and establishment of therapeutic plans. However, conventional sequential CT is preferred for the evaluation of traumatic brain injury (TBI) over spiral CT due to image noise and artifact. We aimed to compare the diagnostic power of spiral facial CT for TBI to that of conventional sequential brain CT. We evaluated retrospectively the images of 315 traumatized patients who underwent both brain CT and facial CT simultaneously. The hemorrhagic traumatic brain injuries such as epidural hemorrhage, subdural hemorrhage, subarachnoid hemorrhage, and contusional hemorrhage were evaluated in both images. Statistics were performed using Cohen's κ to compare the agreement between 2 imaging modalities and sensitivity, specificity, positive predictive value, and negative predictive value of spiral facial CT to conventional sequential brain CT. Almost perfect agreement was noted regarding hemorrhagic traumatic brain injuries between spiral facial CT and conventional sequential brain CT (Cohen's κ coefficient, 0.912). To conventional sequential brain CT, sensitivity, specificity, positive predictive value, and negative predictive value of spiral facial CT were 92.2%, 98.1%, 95.9%, and 96.3%, respectively. In TBI, the diagnostic power of spiral facial CT was equal to that of conventional sequential brain CT. Therefore, expanded spiral facial CT covering whole frontal lobe can be applied to evaluate TBI in the future. Copyright © 2014 Elsevier Inc. All rights reserved.

Analysis of uncertainties in Monte Carlo simulated organ dose for chest CT

NASA Astrophysics Data System (ADS)

Muryn, John S.; Morgan, Ashraf G.; Segars, W. P.; Liptak, Chris L.; Dong, Frank F.; Primak, Andrew N.; Li, Xiang

2015-03-01

In Monte Carlo simulation of organ dose for a chest CT scan, many input parameters are required (e.g., half-value layer of the x-ray energy spectrum, effective beam width, and anatomical coverage of the scan). The input parameter values are provided by the manufacturer, measured experimentally, or determined based on typical clinical practices. The goal of this study was to assess the uncertainties in Monte Carlo simulated organ dose as a result of using input parameter values that deviate from the truth (clinical reality). Organ dose from a chest CT scan was simulated for a standard-size female phantom using a set of reference input parameter values (treated as the truth). To emulate the situation in which the input parameter values used by the researcher may deviate from the truth, additional simulations were performed in which errors were purposefully introduced into the input parameter values, the effects of which on organ dose per CTDIvol were analyzed. Our study showed that when errors in half value layer were within ± 0.5 mm Al, the errors in organ dose per CTDIvol were less than 6%. Errors in effective beam width of up to 3 mm had negligible effect (< 2.5%) on organ dose. In contrast, when the assumed anatomical center of the patient deviated from the true anatomical center by 5 cm, organ dose errors of up to 20% were introduced. Lastly, when the assumed extra scan length was longer by 4 cm than the true value, dose errors of up to 160% were found. The results answer the important question: to what level of accuracy each input parameter needs to be determined in order to obtain accurate organ dose results.

An EMG-CT method using multiple surface electrodes in the forearm.

PubMed

Nakajima, Yasuhiro; Keeratihattayakorn, Saran; Yoshinari, Satoshi; Tadano, Shigeru

2014-12-01

Electromyography computed tomography (EMG-CT) method is proposed for visualizing the individual muscle activities in the human forearm. An EMG conduction model was formulated for reverse-estimation of muscle activities using EMG signals obtained with multi surface electrodes. The optimization process was calculated using sequential quadratic programming by comparing the estimated EMG values from the model with the measured values. The individual muscle activities in the deep region were estimated and used to produce an EMG tomographic image. For validation of the method, isometric contractions of finger muscles were examined for three subjects, applying a flexion load (4.9, 7.4 and 9.8 N) to the proximal interphalangeal joint of the middle finger. EMG signals in the forearm were recorded during the tasks using multiple surface electrodes, which were bound around the subject's forearm. The EMG-CT method illustrates the distribution of muscle activities within the forearm. The change in amplitude and area of activated muscles can be observed. The normalized muscle activities of all three subjects appear to increase monotonically with increases in the load. Kinesiologically, this method was able to estimate individual muscle activation values and could provide a novel tool for studying hand function and development of an examination for evaluating rehabilitation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Early Head CT Findings Are Associated With Outcomes After Pediatric Out-of-Hospital Cardiac Arrest.

PubMed

Starling, Rebecca M; Shekdar, Karuna; Licht, Dan; Nadkarni, Vinay M; Berg, Robert A; Topjian, Alexis A

2015-07-01

Head CT after out-of-hospital cardiac arrest is often obtained to evaluate intracranial pathology. Among children admitted to the PICU following pediatric out-of-hospital cardiac arrest, we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. Retrospective, cohort study. Single, tertiary-care center PICU. Seventy-eight patients less than 18 years old who survived out-of-hospital cardiac arrest to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. None. Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median patient age was 2.3 years (0.4, 9.5). Thirty-nine patients (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p < 0.001), 2) basilar cistern effacement (93% vs 7%; p = 0.001; positive predictive value, 94%; negative predictive value, 59%), and 3) sulcal effacement (100% vs 0%; p ≤ 0.001; positive predictive value, 100%; negative predictive value, 68%). All patients with poor gray-white matter differentiation or sulcal effacement had unfavorable neurologic outcomes. Only one patient with basilar cistern effacement had favorable outcome. Loss of gray-white matter differentiation and basilar cistern effacement and sulcal effacement are associated with poor outcome after pediatric out-of-hospital cardiac arrest. Select patients may have favorable outcomes despite these findings.

Early Head CT Findings Are Associated With Outcomes After Pediatric Out-of-Hospital Cardiac Arrest

PubMed Central

Starling, Rebecca M.; Shekdar, Karuna; Licht, Dan; Nadkarni, Vinay M.; Berg, Robert A.; Topjian, Alexis A.

2015-01-01

Objectives Head CT after out-of-hospital cardiac arrest is often obtained to evaluate intracranial pathology. Among children admitted to the PICU following pediatric out-of-hospital cardiac arrest, we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. Design Retrospective, cohort study. Setting Single, tertiary-care center PICU. Patients Seventy-eight patients less than 18 years old who survived out-of-hospital cardiac arrest to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. Interventions None. Measurements and Main Results Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median patient age was 2.3 years (0.4, 9.5). Thirty-nine patients (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p < 0.001), 2) basilar cistern effacement (93% vs 7%; p = 0.001; positive predictive value, 94%; negative predictive value, 59%), and 3) sulcal effacement (100% vs 0%; p ≤ 0.001; positive predictive value, 100%; negative predictive value, 68%). All patients with poor gray-white matter differentiation or sulcal effacement had unfavorable neurologic outcomes. Only one patient with basilar cistern effacement had favorable outcome. Conclusions Loss of gray-white matter differentiation and basilar cistern effacement and sulcal effacement are associated with poor outcome after pediatric out-of-hospital cardiac arrest. Select patients may have favorable outcomes despite these findings. PMID:25844694

Effect of object location on the density measurement in cone-beam computed tomography versus multislice computed tomography

PubMed Central

Eskandarloo, Amir; Abdinian, Mehrdad; Salemi, Fatemeh; Hashemzadeh, Zahra; Safaei, Mehran

2012-01-01

Background: Bone density measurement in a radiographic view is a valuable method for evaluating the density of bone quality before performing some dental procedures such as, dental implant placements. It seems that Cone-Beam Computed Tomography (CBCT) can be used as a diagnostic tool for evaluating the density of the bone, prior to any treatment, as the reported radiation dose in this method is minimal. The aim of this study is to investigate the effect of object location on the density measurement in CBCT versus Multislice computed tomography (CT). Materials and Methods: In an experimental study, three samples with similar dimensions, but different compositions, different densities (Polyethylene, Polyamide, Polyvinyl Chloride), and three bone pieces of different parts of the mandibular bone were imaged in three different positions by CBCT and Multislice CT sets. The average density value was computed for each sample in each position. Then the data obtained from each CBCT was converted to a Hounsfield unit and evaluated using a single variable T analysis. A P value <0.05 was considered to be significant. Results: The density in a Multislice CT is stable in the form of a Hounsfield Number, but this density is variable in the images acquired through CBCT, and the change in the position results in significant changes in the density. In this study, a statistically significant difference (P value = 0.000) has been observed for the position of the sample and its density in CBCT in comparison to Multislice CT. Conclusions: Density values in CBCT are not real because they are affected by the position of the object in the machine. PMID:23814567

Diagnostic value of quantitative assessment of cardiac 18F-fluoro-2-deoxyglucose uptake in suspected cardiac sarcoidosis.

PubMed

Lebasnier, Adrien; Legallois, Damien; Bienvenu, Boris; Bergot, Emmanuel; Desmonts, Cédric; Zalcman, Gérard; Agostini, Denis; Manrique, Alain

2018-06-01

The identification of cardiac sarcoidosis is challenging as there is no gold standard consensually admitted for its diagnosis. The aim of this study was to evaluate the diagnostic value of the assessment of cardiac dynamic 18 F-fluoro-2-deoxyglucose positron emission tomography ( 18 F-FDG PET/CT) and net influx constant (Ki) in patients suspected of cardiac sarcoidosis. Data obtained from 30 biopsy-proven sarcoidosis patients suspected of cardiac sarcoidosis who underwent a 50-min list-mode cardiac dynamic 18 F-FDG PET/CT after a 24 h high-fat and low-carbohydrate diet were analyzed. A normalized coefficient of variation of quantitative glucose influx constant, calculated as the ratio: standard deviation of the segmental Ki (min -1 )/global Ki (min -1 ) was determined using a validated software (Carimas ® 2.4, Turku PET Centre). Cardiac sarcoidosis was diagnosed according to the Japanese Ministry of Health and Welfare criteria. Receiving operating curve analysis was performed to determine sensitivity and specificity of cardiac dynamic 18 F-FDG PET/CT analysis to diagnose cardiac sarcoidosis. Six out of 30 patients (20%) were diagnosed as having cardiac sarcoidosis. Myocardial glucose metabolism was significantly heterogeneous in patients with cardiac sarcoidosis who showed significantly higher normalized coefficient of variation values compared to patients without cardiac sarcoidosis (0.513 ± 0.175 vs. 0.205 ± 0.081; p = 0.0007). Using ROC curve analysis, we found a cut-off value of 0.38 for the diagnosis of cardiac sarcoidosis with a sensitivity of 100% and a specificity of 91%. Our results suggest that quantitative analysis of cardiac dynamic 18 F-FDG PET/CT could be a useful tool for the diagnosis of cardiac sarcoidosis.

Determination of CT number and density profile of binderless, pre-treated and tannin-based Rhizophora spp. particleboards using computed tomography imaging and electron density phantom

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

Yusof, Mohd Fahmi Mohd, E-mail: mfahmi@usm.my; Hamid, Puteri Nor Khatijah Abdul; Tajuddin, Abdul Aziz

2015-04-29

Plug density phantoms were constructed in accordance to CT density phantom model 062M CIRS using binderless, pre-treated and tannin-based Rhizophora Spp. particleboards. The Rhizophora Spp. plug phantoms were scanned along with the CT density phantom using Siemens Somatom Definition AS CT scanner at three CT energies of 80, 120 and 140 kVp. 15 slices of images with 1.0 mm thickness each were taken from the central axis of CT density phantom for CT number and CT density profile analysis. The values were compared to water substitute plug phantom from the CT density phantom. The tannin-based Rhizophora Spp. gave the nearest valuemore » of CT number to water substitute at 80 and 120 kVp CT energies with χ{sup 2} value of 0.011 and 0.014 respectively while the binderless Rhizphora Spp. gave the nearest CT number to water substitute at 140 kVp CT energy with χ{sup 2} value of 0.023. The tannin-based Rhizophora Spp. gave the nearest CT density profile to water substitute at all CT energies. This study indicated the suitability of Rhizophora Spp. particleboard as phantom material for the use in CT imaging studies.« less

The role of FDG PET/CT in patients with locoregional breast cancer recurrence: a comparison to conventional imaging techniques.

PubMed

Aukema, T S; Rutgers, E J Th; Vogel, W V; Teertstra, H J; Oldenburg, H S; Vrancken Peeters, M T F D; Wesseling, J; Russell, N S; Valdés Olmos, R A

2010-04-01

The aim of this study was to evaluate the impact of (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) on clinical management in patients with locoregional breast cancer recurrence amenable for locoregional treatment and to compare the PET/CT results with the conventional imaging data. From January 2006 to August 2008, all patients with locoregional breast cancer recurrence underwent whole-body PET/CT. PET/CT findings were compared with results of the conventional imaging techniques and final pathology. The impact of PET/CT results on clinical management was evaluated based on clinical decisions obtained from patient files. 56 patients were included. In 32 patients (57%) PET/CT revealed additional tumour localisations. Distant metastases were detected in 11 patients on conventional imaging and in 23 patients on PET/CT images (p < 0.01). In 25 patients (45%), PET/CT detected additional lesions not visible on conventional imaging. PET/CT had an impact on clinical management in 27 patients (48%) by detecting more extensive locoregional disease or distant metastases. In 20 patients (36%) extensive surgery was prevented and treatment was changed to palliative treatment. The sensitivity, specificity, accuracy, positive and negative predictive values of FDG PET/CT were respectively 97%, 92%, 95%, 94% and 96%. PET/CT, in addition to conventional imaging techniques, plays an important role in staging patients with locoregional breast cancer recurrence since its result changed the clinical management in almost half of the patients. PET/CT could potentially replace conventional staging imaging in patients with a locoregional breast cancer recurrence. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Determination of single-kidney glomerular filtration rate (GFR) with CT urography versus renal dynamic imaging Gates method.

PubMed

You, Shan; Ma, XianWu; Zhang, ChangZhu; Li, Qiang; Shi, WenWei; Zhang, Jing; Yuan, XiaoDong

2018-03-01

To present a single-kidney CT-GFR measurement and compare it with the renal dynamic imaging Gates-GFR. Thirty-six patients with hydronephrosis referred for CT urography and 99mTc-DTPA renal dynamic imaging were prospectively included. Informed consent was obtained from all patients. The CT urography protocol included non-contrast, nephrographic, and excretory phase imaging. The total CT-GFR was calculated by dividing the CT number increments of the total urinary system between the nephrographic and excretory phase by the products of iodine concentration in the aorta and the elapsed time, then multiplied by (1- Haematocrit). The total CT-GFR was then split into single-kidney CT-GFR by a left and right kidney proportionality factor. The results were compared with single-kidney Gates-GFR by using paired t-test, correlation analysis, and Bland-Altman plots. Paired difference between single-kidney CT-GFR (45.02 ± 13.91) and single-kidney Gates-GFR (51.21 ± 14.76) was 6.19 ± 5.63 ml/min, p<0.001, demonstrating 12.1% systematic underestimation with ±11.03 ml/min (±21.5%) measurement deviation. A good correlation was revealed between both measurements (r=0.87, p<0.001). The proposed single-kidney CT-GFR correlates and agrees well with the reference standard despite a systematic underestimation, therefore it could be a one-stop-shop for evaluating urinary tract morphology and split renal function. • A new CT method can assess split renal function • Only using images from CT urography and the value of haematocrit • A one-stop-shop CT technique without additional radiation dose.

Assessment of regional adipose tissue depots: a DXA and CT comparison in cadavers of elderly persons.

PubMed

Scafoglieri, Aldo; Deklerck, Rudi; Tresignie, Jonathan; De Mey, Johan; Clarys, Jan Pieter; Bautmans, Ivan

2013-09-01

Since dual energy X-ray absorptiometry (DXA) cannot distinguish between different adipose tissue (AT) deposits, it remains unclear how DXA-derived body composition variables relate to anatomical tissue (sub)compartments. The aim of the present study was to compare and relate regional DXA variables with absolute tissue masses obtained by computer tomography (CT) scanning of the lower limbs in elderly persons. Eleven well-preserved white Caucasian adults (seven male and four female cadavers) with a median age of 79.0 years (ranging from 68 to 96 years) were fully scanned with DXA and CT. Separate densities of skin tissue, AT, muscle tissue and bone were obtained by hydrostatic weighing. The leg DXA-variables were significantly related (rho-values between 0.60 and 0.98, P < 0.01) to CT-derived tissue counterparts, but showed significant systematic differences except for subcutaneous AT mass (P = 0.773). After controlling for other AT depots, fat as measured by DXA (fat(DXA)) related only to intermuscular AT (rho = 0.82, P < 0.01) in males and to subcutaneous AT (rho = 0.84, P < 0.05) in females. Although significantly interrelated, DXA and CT variables should not be used interchangeably since they have different quantitative and physiological significance. Our results suggest that fat(DXA) represents different parts of AT depots in elderly men and women. Since DXA is not appropriate for assessing tissue variability cautious clinical interpretation is warranted. © 2013.

The value of preoperative computed tomography combined with ultrasound in the investigation of small indeterminate liver lesions in patients with colorectal cancer.

PubMed

Abraham-Nordling, Mirna; Öistämö, Emma; Josephson, Thomas; Hjern, Fredrik; Blomqvist, Lennart

2017-11-01

Background Computed tomography (CT) is used routinely for the preoperative detection of colorectal cancer (CRC) metastases. When small indeterminate focal liver lesions are detected that are too small to characterize (TSTC) on CT, additional imaging is usually needed, resulting in a potential delay in obtaining a complete diagnostic work-up. Purpose To determine the diagnostic accuracy of ultrasound (US) of the liver performed in direct conjunction to CT in the preoperative investigation among patients with newly diagnosed CRC when indeterminate liver lesions were found on CT. Material and Methods Preoperative investigations with CT and consecutive US where CT had shown at least one focal liver lesion in 74 patients diagnosed with CRC between June 2009 and February 2012 were retrospectively reviewed. Either histopathological findings or a combination of imaging and clinical follow-up one to three years after surgery was used as the reference. Results Liver metastases were diagnosed with CT/US in 13 out of 74 patients (17.6%). In one patient, a liver cyst was preoperatively regarded as liver metastasis by a combined CT/US. The sensitivity and specificity for the CT with consecutive US procedure was 100% (13/13) and 98.4% (60/61). Conclusion US performed in conjunction with CT in patients with indeterminate focal liver lesions on CT is an accurate work-up for detection of liver metastases in patients with newly diagnosed CRC. Although our results are promising, they cannot be considered safely generalizable to all hospitals.

MRI-based IMRT planning for MR-linac: comparison between CT- and MRI-based plans for pancreatic and prostate cancers

NASA Astrophysics Data System (ADS)

Prior, Phil; Chen, Xinfeng; Botros, Maikel; Paulson, Eric S.; Lawton, Colleen; Erickson, Beth; Li, X. Allen

2016-05-01

The treatment planning in radiation therapy (RT) can be arranged to combine benefits of computed tomography (CT) and magnetic resonance imaging (MRI) together to maintain dose calculation accuracy and improved target delineation. Our aim is study the dosimetric impact of uniform relative electron density assignment on IMRT treatment planning with additional consideration given to the effect of a 1.5 T transverse magnetic field (TMF) in MR-Linac. A series of intensity modulated RT (IMRT) plans were generated for two representative tumor sites, pancreas and prostate, using CT and MRI datasets. Representative CT-based IMRT plans were generated to assess the impact of different electron density (ED) assignment on plan quality using CT without the presence of a 1.5 T TMF. The relative ED (rED) values used were taken from the ICRU report 46. Four types of rED assignment in the organs at risk (OARs), the planning target volumes (PTV) and in the non-specified tissue (NST) were considered. Dose was recalculated (no optimization) using a Monaco 5.09.07a research planning system employing Monte Carlo calculations with an option to include TMF. To investigate the dosimetric effect of different rED assignment, the dose-volume parameters (DVPs) obtained from these specific rED plans were compared to those obtained from the original plans based on CT. Overall, we found that uniform rED assignment results in differences in DVPs within 3% for the PTV and 5% for OAR. The presence of 1.5 T TMF on IMRT DVPs resulted in differences that were generally within 3% of the Gold St for both the pancreas and prostate. The combination of uniform rED assignment and TMF produced differences in DVPs that were within 4-5% of the Gold St. Larger differences in DVPs were observed for OARs on T2-based plans. The effects of using different rED assignments and the presence of 1.5 T TMF for pancreas and prostate IMRT plans are generally within 3% and 5% of PTV and OAR Gold St values. There are noticeable dosimetric differences between the CT- and MRI-based IMRT plans caused by a combination of anatomical changes between the two image acquisition times, uniform rED assignment and 1.5 T TMF. This work was present in part at the 2014 ASTRO annual meeting.

TU-A-12A-12: Improved Airway Measurement Accuracy for Low Dose Quantitative CT (qCT) Using Statistical (ASIR), at Reduced DFOV, and High Resolution Kernels in a Phantom and Swine Model

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

Yadava, G; Imai, Y; Hsieh, J

2014-06-15

Purpose: Quantitative accuracy of Iodine Hounsfield Unit (HU) in conventional single-kVp scanning is susceptible to beam-hardening effect. Dual-energy CT has unique capabilities of quantification using monochromatic CT images, but this scanning mode requires the availability of the state-of-the-art CT scanner and, therefore, is limited in routine clinical practice. Purpose of this work was to develop a beam-hardening-correction (BHC) for single-kVp CT that can linearize Iodine projections at any nominal energy, apply this approach to study Iodine response with respect to keV, and compare with dual-energy based monochromatic images obtained from material-decomposition using 80kVp and 140kVp. Methods: Tissue characterization phantoms (Gammexmore » Inc.), containing solid-Iodine inserts of different concentrations, were scanned using GE multi-slice CT scanner at 80, 100, 120, and 140 kVp. A model-based BHC algorithm was developed where Iodine was estimated using re-projection of image volume and corrected through an iterative process. In the correction, the re-projected Iodine was linearized using a polynomial mapping between monochromatic path-lengths at various nominal energies (40 to 140 keV) and physically modeled polychromatic path-lengths. The beam-hardening-corrected 80kVp and 140kVp images (linearized approximately at effective energy of the beam) were used for dual-energy material-decomposition in Water-Iodine basis-pair followed by generation of monochromatic images. Characterization of Iodine HU and noise in the images obtained from singlekVp with BHC at various nominal keV, and corresponding dual-energy monochromatic images, was carried out. Results: Iodine HU vs. keV response from single-kVp with BHC and dual-energy monochromatic images were found to be very similar, indicating that single-kVp data may be used to create material specific monochromatic equivalent using modelbased projection linearization. Conclusion: This approach may enable quantification of Iodine contrast enhancement and potential reduction in injected contrast without using dual-energy scanning. However, in general, dual-energy scanning has unique value in material characterization and quantification, and its value cannot be discounted. GE Healthcare Employee.« less

Application of multislice spiral CT for guidance of insertion of thoracic spine pedicle screws: an in vitro study.

PubMed

Wang, Juan; Zhou, Yicheng; Hu, Ning; Wang, Renfa

2006-01-01

To investigate the value of the guidance of three dimensional (3-D) reconstruction of multi-slice spiral CT (MSCT) for the placement of pedicle screws, the 3-D anatomical data of the thoracic pedicles were measured by MSCT in two embalmed human cadaveric thoracic pedicles spines (T1-T10) to guide the insertion of pedicle screws. After pulling the screws out, the pathways were filled with contrast media. The PW, PH, TSA and SSA of developed pathways were measured on the CT images and they were also measured on the real objects by caliper and goniometer. Analysis of variance demonstrated that the difference between the CT scans and real objects had no statistical significance (P > 0.05). Moreover, the difference between pedicle axis and developed pathway also had no statistical significance (P > 0.05). The data obtained from 3-D reconstruction of MSCT demonstrated that individualized standards, are not only accurate but also helpful for the successful placement of pedicle screws.

Improved proton CT imaging using a bismuth germanium oxide scintillator.

PubMed

Tanaka, Sodai; Nishio, Teiji; Tsuneda, Masato; Matsushita, Keiichiro; Kabuki, Shigeto; Uesaka, Mitsuru

2018-02-02

Range uncertainty is among the most formidable challenges associated with the treatment planning of proton therapy. Proton imaging, which includes proton radiography and proton computed tomography (pCT), is a useful verification tool. We have developed a pCT detection system that uses a thick bismuth germanium oxide (BGO) scintillator and a CCD camera. The current method is based on a previous detection system that used a plastic scintillator, and implements improved image processing techniques. In the new system, the scintillation light intensity is integrated along the proton beam path by the BGO scintillator, and acquired as a two-dimensional distribution with the CCD camera. The range of a penetrating proton is derived from the integrated light intensity using a light-to-range conversion table, and a pCT image can be reconstructed. The proton range in the BGO scintillator is shorter than in the plastic scintillator, so errors due to extended proton ranges can be reduced. To demonstrate the feasibility of the pCT system, an experiment was performed using a 70 MeV proton beam created by the AVF930 cyclotron at the National Institute of Radiological Sciences. The accuracy of the light-to-range conversion table, which is susceptible to errors due to its spatial dependence, was investigated, and the errors in the acquired pixel values were less than 0.5 mm. Images of various materials were acquired, and the pixel-value errors were within 3.1%, which represents an improvement over previous results. We also obtained a pCT image of an edible chicken piece, the first of its kind for a biological material, and internal structures approximately one millimeter in size were clearly observed. This pCT imaging system is fast and simple, and based on these findings, we anticipate that we can acquire 200 MeV pCT images using the BGO scintillator system.

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

Zhang, J; Zhang, W; Lu, J

Purpose: To investigate the accuracy and feasibility of dose calculations using kilovoltage cone beam computed tomography in cervical cancer radiotherapy using a correction algorithm. Methods: The Hounsfield units (HU) and electron density (HU-density) curve was obtained for both planning CT (pCT) and kilovoltage cone beam CT (CBCT) using a CIRS-062 calibration phantom. The pCT and kV-CBCT images have different HU values, and if the HU-density curve of CBCT was directly used to calculate dose in CBCT images may have a deviation on dose distribution. It is necessary to normalize the different HU values between pCT and CBCT. A HU correctionmore » algorithm was used for CBCT images (cCBCT). Fifteen intensity-modulated radiation therapy (IMRT) plans of cervical cancer were chosen, and the plans were transferred to the pCT and cCBCT data sets without any changes for dose calculations. Phantom and patient studies were carried out. The dose differences and dose distributions were compared between cCBCT plan and pCT plan. Results: The HU number of CBCT was measured by several times, and the maximum change was less than 2%. To compare with pCT, the CBCT and cCBCT has a discrepancy, the dose differences in CBCT and cCBCT images were 2.48%±0.65% (range: 1.3%∼3.8%) and 0.48%±0.21% (range: 0.1%∼0.82%) for phantom study, respectively. For dose calculation in patient images, the dose differences were 2.25%±0.43% (range: 1.4%∼3.4%) and 0.63%±0.35% (range: 0.13%∼0.97%), respectively. And for the dose distributions, the passing rate of cCBCT was higher than the CBCTs. Conclusion: The CBCT image for dose calculation is feasible in cervical cancer radiotherapy, and the correction algorithm offers acceptable accuracy. It will become a useful tool for adaptive radiation therapy.« less

Clinical Application of Dual-Energy Spectral Computed Tomography in Detecting Cholesterol Gallstones From Surrounding Bile.

PubMed

Yang, Chuang-Bo; Zhang, Shuang; Jia, Yong-Jun; Duan, Hai-Feng; Ma, Guang-Ming; Zhang, Xi-Rong; Yu, Yong; He, Tai-Ping

2017-04-01

This study aimed to investigate the clinical value of spectral computed tomography (CT) in the detection of cholesterol gallstones from surrounding bile. This study was approved by the institutional review board. The unenhanced spectral CT data of 24 patients who had surgically confirmed cholesterol gallstones were analyzed. Lipid concentrations and CT numbers were measured from fat-based material decomposition image and virtual monochromatic image sets (40-140 keV), respectively. The difference in lipid concentration and CT number between cholesterol gallstones and the surrounding bile were statistically analyzed. Receiver operating characteristic analysis was applied to determine the diagnostic accuracy of using lipid concentration to differentiate cholesterol gallstones from bile. Cholesterol gallstones were bright on fat-based material decomposition images yielding a 92% detection rate (22 of 24). The lipid concentrations (552.65 ± 262.36 mg/mL), CT number at 40 keV (-31.57 ± 16.88 HU) and 140 keV (24.30 ± 5.85 HU) for the cholesterol gallstones were significantly different from those of bile (-13.94 ± 105.12 mg/mL, 12.99 ± 9.39 HU and 6.19 ± 4.97 HU, respectively). Using 182.59 mg/mL as the threshold value for lipid concentration, one could obtain sensitivity of 95.5% and specificity of 100% with accuracy of 0.994 for differentiating cholesterol gallstones from bile. Virtual monochromatic spectral CT images at 40 keV and 140 keV provide significant CT number differences between cholesterol gallstones and the surrounding bile. Spectral CT provides an excellent detection rate for cholesterol gallstones. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Improved proton CT imaging using a bismuth germanium oxide scintillator

NASA Astrophysics Data System (ADS)

Tanaka, Sodai; Nishio, Teiji; Tsuneda, Masato; Matsushita, Keiichiro; Kabuki, Shigeto; Uesaka, Mitsuru

2018-02-01

Range uncertainty is among the most formidable challenges associated with the treatment planning of proton therapy. Proton imaging, which includes proton radiography and proton computed tomography (pCT), is a useful verification tool. We have developed a pCT detection system that uses a thick bismuth germanium oxide (BGO) scintillator and a CCD camera. The current method is based on a previous detection system that used a plastic scintillator, and implements improved image processing techniques. In the new system, the scintillation light intensity is integrated along the proton beam path by the BGO scintillator, and acquired as a two-dimensional distribution with the CCD camera. The range of a penetrating proton is derived from the integrated light intensity using a light-to-range conversion table, and a pCT image can be reconstructed. The proton range in the BGO scintillator is shorter than in the plastic scintillator, so errors due to extended proton ranges can be reduced. To demonstrate the feasibility of the pCT system, an experiment was performed using a 70 MeV proton beam created by the AVF930 cyclotron at the National Institute of Radiological Sciences. The accuracy of the light-to-range conversion table, which is susceptible to errors due to its spatial dependence, was investigated, and the errors in the acquired pixel values were less than 0.5 mm. Images of various materials were acquired, and the pixel-value errors were within 3.1%, which represents an improvement over previous results. We also obtained a pCT image of an edible chicken piece, the first of its kind for a biological material, and internal structures approximately one millimeter in size were clearly observed. This pCT imaging system is fast and simple, and based on these findings, we anticipate that we can acquire 200 MeV pCT images using the BGO scintillator system.

Virtual non-contrast dual-energy CT compared to single-energy CT of the urinary tract: a prospective study.

PubMed

Lundin, Margareta; Lidén, Mats; Magnuson, Anders; Mohammed, Ahmed Abdulilah; Geijer, Håkan; Andersson, Torbjörn; Persson, Anders

2012-07-01

Dual-energy computed tomography (DECT) has been shown to be useful for subtracting bone or calcium in CT angiography and gives an opportunity to produce a virtual non-contrast-enhanced (VNC) image from a series where contrast agents have been given intravenously. High noise levels and low resolution have previously limited the diagnostic value of the VNC images created with the first generation of DECT. With the recent introduction of a second generation of DECT, there is a possibility of obtaining VNC images with better image quality at hopefully lower radiation dose compared to the previous generation. To compare the image quality of the single-energy series to a VNC series obtained with a two generations of DECT scanners. CT of the urinary tract was used as a model. Thirty patients referred for evaluation of hematuria were examined with an older system (Somatom Definition) and another 30 patients with a new generation (Somatom Definition Flash). One single-energy series was obtained before and one dual-energy series after administration of intravenous contrast media. We created a VNC series from the contrast-enhanced images. Images were assessed concerning image quality with a visual grading scale evaluation of the VNC series with the single-energy series as gold standard. The image quality of the VNC images was rated inferior to the single-energy variant for both scanners, OR 11.5-67.3 for the Definition and OR 2.1-2.8 for the Definition Flash. Visual noise and overall quality were regarded as better with Flash than Definition. Image quality of VNC images obtained with the new generation of DECT is still slightly inferior compared to native images. However, the difference is smaller with the new compared to the older system.

SU-E-I-31: Differences Observed in Radiation Doses Across 2 Similar CT Scanners From Adult Brain-Neck CT Angiography

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

Fujii, K; UCLA School of Medicine, Los Angeles, CA; McMillan, K

2015-06-15

Purpose: The aim of this study is to evaluate the difference in radiation doses from adult Brain-Neck CT angiography (CTA) between two CT scanners. Methods: We collected CT dose index data (CTDIvol, DLP) from adult Brain-Neck CTA performed with two CT scanners (Sensation 64 (S64) and Definition AS (AS), Siemens Healthcare) performed at two of our facilities from Jan 1st to Dec 31th, 2014. X-ray dose management software (Radmetrics, Bayer Healthcare) was used to mine these data. All exams were performed with Tube Current Modulation (Care Dose 4D), tube voltage of 120 kVp, quality reference mAs of 300, beam collimationmore » of 64*0.6 mm. The rotation time was set to 0.5 sec for S64 and 1.0 sec for AS. We also scanned an anthropomorphic skull and chest phantom under routine Brain-Neck CTA protocol with the two scanners and extracted the tube current values from the raw projection data. Results: The mean CTDIvol and DLP in Brain-Neck CTA was 72 mGy and 2554 mGy*cm for AS, which was substantially larger than the mean values of 46 mGy and 1699 mGy*cm for S64. The maximum tube current was 583 mA for most cases on the S64 while the maximum was 666 mA for AS even though the rotation time set for AS was 1.0 sec. Measurements obtained with the anthropomorphic phantom showed that the tube current reached 583 mA at the shoulder region for S64 while it reached to 666 mA for AS. Conclusion: The results of this study showed that substantially different CT doses can Result from Brain-Neck CTA protocols even when similar scanners and similar settings are used. Though both scanners have a similar maximum mA rating, differences in mA were observed through the shoulders, resulting in substantially different CTDIvol values.« less

Spatial correspondence of 4D CT ventilation and SPECT pulmonary perfusion defects in patients with malignant airway stenosis

NASA Astrophysics Data System (ADS)

Castillo, Richard; Castillo, Edward; McCurdy, Matthew; Gomez, Daniel R.; Block, Alec M.; Bergsma, Derek; Joy, Sarah; Guerrero, Thomas

2012-04-01

To determine the spatial overlap agreement between four-dimensional computed tomography (4D CT) ventilation and single photon emission computed tomography (SPECT) perfusion hypo-functioning pulmonary defect regions in a patient population with malignant airway stenosis. Treatment planning 4D CT images were obtained retrospectively for ten lung cancer patients with radiographically demonstrated airway obstruction due to gross tumor volume. Each patient also received a SPECT perfusion study within one week of the planning 4D CT, and prior to the initiation of treatment. Deformable image registration was used to map corresponding lung tissue elements between the extreme component phase images, from which quantitative three-dimensional (3D) images representing the local pulmonary specific ventilation were constructed. Semi-automated segmentation of the percentile perfusion distribution was performed to identify regional defects distal to the known obstructing lesion. Semi-automated segmentation was similarly performed by multiple observers to delineate corresponding defect regions depicted on 4D CT ventilation. Normalized Dice similarity coefficient (NDSC) indices were determined for each observer between SPECT perfusion and 4D CT ventilation defect regions to assess spatial overlap agreement. Tidal volumes determined from 4D CT ventilation were evaluated versus measurements obtained from lung parenchyma segmentation. Linear regression resulted in a linear fit with slope = 1.01 (R2 = 0.99). Respective values for the average DSC, NDSC1 mm and NDSC2 mm for all cases and multiple observers were 0.78, 0.88 and 0.99, indicating that, on average, spatial overlap agreement between ventilation and perfusion defect regions was comparable to the threshold for agreement within 1-2 mm uncertainty. Corresponding coefficients of variation for all metrics were similarly in the range: 0.10%-19%. This study is the first to quantitatively assess 3D spatial overlap agreement between clinically acquired SPECT perfusion and specific ventilation from 4D CT. Results suggest high correlation between methods within the sub-population of lung cancer patients with malignant airway stenosis.

Variation in the human ribs geometrical properties and mechanical response based on X-ray computed tomography images resolution.

PubMed

Perz, Rafał; Toczyski, Jacek; Subit, Damien

2015-01-01

Computational models of the human body are commonly used for injury prediction in automobile safety research. To create these models, the geometry of the human body is typically obtained from segmentation of medical images such as computed tomography (CT) images that have a resolution between 0.2 and 1mm/pixel. While the accuracy of the geometrical and structural information obtained from these images depend greatly on their resolution, the effect of image resolution on the estimation of the ribs geometrical properties has yet to be established. To do so, each of the thirty-four sections of ribs obtained from a Post Mortem Human Surrogate (PMHS) was imaged using three different CT modalities: standard clinical CT (clinCT), high resolution clinical CT (HRclinCT), and microCT. The images were processed to estimate the rib cross-section geometry and mechanical properties, and the results were compared to those obtained from the microCT images by computing the 'deviation factor', a metric that quantifies the relative difference between results obtained from clinCT and HRclinCT to those obtained from microCT. Overall, clinCT images gave a deviation greater than 100%, and were therefore deemed inadequate for the purpose of this study. HRclinCT overestimated the rib cross-sectional area by 7.6%, the moments of inertia by about 50%, and the cortical shell area by 40.2%, while underestimating the trabecular area by 14.7%. Next, a parametric analysis was performed to quantify how the variations in the estimate of the geometrical properties affected the rib predicted mechanical response under antero-posterior loading. A variation of up to 45% for the predicted peak force and up to 50% for the predicted stiffness was observed. These results provide a quantitative estimate of the sensitivity of the response of the FE model to the resolution of the images used to generate it. They also suggest that a correction factor could be derived from the comparison between microCT and HRclinCT images to improve the response of the model developed based on HRclinCT images. Copyright © 2014 Elsevier Ltd. All rights reserved.

Is There an Additional Value of {sup 11}C-Choline PET-CT to T2-weighted MRI Images in the Localization of Intraprostatic Tumor Nodules?

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

Van den Bergh, Laura, E-mail: laura.vandenbergh@uzleuven.be; Koole, Michel; Isebaert, Sofie

2012-08-01

Purpose: To investigate the additional value of {sup 11}C-choline positron emission tomography (PET)-computed tomography (CT) to T2-weighted (T2w) magnetic resonance imaging (MRI) for localization of intraprostatic tumor nodules. Methods and Materials: Forty-nine prostate cancer patients underwent T2w MRI and {sup 11}C-choline PET-CT before radical prostatectomy and extended lymphadenectomy. Tumor regions were outlined on the whole-mount histopathology sections and on the T2w MR images. Tumor localization was recorded in the basal, middle, and apical part of the prostate by means of an octant grid. To analyze {sup 11}C-choline PET-CT images, the same grid was used to calculate the standardized uptake valuesmore » (SUV) per octant, after rigid registration with the T2w MR images for anatomic reference. Results: In total, 1,176 octants were analyzed. Sensitivity, specificity, and accuracy of T2w MRI were 33.5%, 94.6%, and 70.2%, respectively. For {sup 11}C-choline PET-CT, the mean SUV{sub max} of malignant octants was significantly higher than the mean SUV{sub max} of benign octants (3.69 {+-} 1.29 vs. 3.06 {+-} 0.97, p < 0.0001) which was also true for mean SUV{sub mean} values (2.39 {+-} 0.77 vs. 1.94 {+-} 0.61, p < 0.0001). A positive correlation was observed between SUV{sub mean} and absolute tumor volume (Spearman r = 0.3003, p = 0.0362). No correlation was found between SUVs and prostate-specific antigen, T-stage or Gleason score. The highest accuracy (61.1%) was obtained with a SUV{sub max} cutoff of 2.70, resulting in a sensitivity of 77.4% and a specificity of 44.9%. When both modalities were combined (PET-CT or MRI positive), sensitivity levels increased as a function of SUV{sub max} but at the cost of specificity. When only considering suspect octants on {sup 11}C-choline PET-CT (SUV{sub max} {>=} 2.70) and T2w MRI, 84.7% of these segments were in agreement with the gold standard, compared with 80.5% for T2w MRI alone. Conclusions: The additional value of {sup 11}C-choline PET-CT next to T2w MRI in detecting tumor nodules within the prostate is limited.« less

X-ray CT core imaging of Oman Drilling Project on D/V CHIKYU

NASA Astrophysics Data System (ADS)

Michibayashi, K.; Okazaki, K.; Leong, J. A. M.; Kelemen, P. B.; Johnson, K. T. M.; Greenberger, R. N.; Manning, C. E.; Harris, M.; de Obeso, J. C.; Abe, N.; Hatakeyama, K.; Ildefonse, B.; Takazawa, E.; Teagle, D. A. H.; Coggon, J. A.

2017-12-01

We obtained X-ray computed tomography (X-ray CT) images for all cores (GT1A, GT2A, GT3A and BT1A) in Oman Drilling Project Phase 1 (OmanDP cores), since X-ray CT scanning is a routine measurement of the IODP measurement plan onboard Chikyu, which enables the non-destructive observation of the internal structure of core samples. X-ray CT images provide information about chemical compositions and densities of the cores and is useful for assessing sample locations and the quality of the whole-round samples. The X-ray CT scanner (Discovery CT 750HD, GE Medical Systems) on Chikyu scans and reconstructs the image of a 1.4 m section in 10 minutes and produces a series of scan images, each 0.625 mm thick. The X-ray tube (as an X-ray source) and the X-ray detector are installed inside of the gantry at an opposing position to each other. The core sample is scanned in the gantry with the scanning rate of 20 mm/sec. The distribution of attenuation values mapped to an individual slice comprises the raw data that are used for subsequent image processing. Successive two-dimensional (2-D) slices of 512 x 512 pixels yield a representation of attenuation values in three-dimensional (3-D) voxels of 512 x 512 by 1600 in length. Data generated for each core consist of core-axis-normal planes (XY planes) of X-ray attenuation values with dimensions of 512 × 512 pixels in 9 cm × 9 cm cross-section, meaning at the dimensions of a core section, the resolution is 0.176 mm/pixel. X-ray intensity varies as a function of X-ray path length and the linear attenuation coefficient (LAC) of the target material is a function of the chemical composition and density of the target material. The basic measure of attenuation, or radiodensity, is the CT number given in Hounsfield units (HU). CT numbers of air and water are -1000 and 0, respectively. Our preliminary results show that CT numbers of OmanDP cores are well correlated to gamma ray attenuation density (GRA density) as a function of chemical composition and mineral density, so that their profiles with respect to the core depth provide quick lithological information such as mineral identification and phase boundary etc. Moreover, X-ray CT images can be used for 3-D fabric analyses of the whole core even after core cutting into halves for individual analyses.

CAD - CAM Procedures Used for Rapid Prototyping of Prosthetic Hip Joint Bone

NASA Astrophysics Data System (ADS)

Popa, Luminita I.; Popa, Vasile N.

2016-11-01

The article addresses the issue of rapid prototyping CAD/ CAM procedures, based on CT imaging, for custom implants dedicated to hip arthroplasty and the correlation study to be achieved between femoral canal shape, valued by modern imaging methods, and the prosthesis form. A set of CT images is transformed into a digital model using one of several software packages available for conversion. The purpose of research is to obtain prosthesis with compatible characteristics as close to the physiological, with an optimal adjustment of the prosthesis to the bone in which it is implanted, allowing the recovery of the patient physically, mentally and socially.

WE-H-207A-07: Image-Based Versus Atlas-Based Internal Dosimetry

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

Fallahpoor, M; Abbasi, M; Parach, A

Purpose: Monte Carlo (MC) simulation is known as the gold standard method for internal dosimetry. It requires radionuclide distribution from PET or SPECT and body structure from CT for accurate dose calculation. The manual or semi-automatic segmentation of organs from CT images is a major obstacle. The aim of this study is to compare the dosimetry results based on patient’s own CT and a digital humanoid phantom as an atlas with pre-specified organs. Methods: SPECT-CT images of a 50 year old woman who underwent bone pain palliation with Samarium-153 EDTMP for osseous metastases from breast cancer were used. The anatomicalmore » date and attenuation map were extracted from SPECT/CT and three XCAT digital phantoms with different BMIs (i.e. matched (38.8) and unmatched (35.5 and 36.7) with patient’s BMI that was 38.3). Segmentation of patient’s organs in CT image was performed using itk-SNAP software. GATE MC Simulator was used for dose calculation. Specific absorbed fractions (SAFs) and S-values were calculated for the segmented organs. Results: The differences between SAFs and S-values are high using different anatomical data and range from −13% to 39% for SAF values and −109% to 79% for S-values in different organs. In the spine, the clinically important target organ for Samarium Therapy, the differences in the S-values and SAF values are higher between XCAT phantom and CT when the phantom with identical BMI is employed (53.8% relative difference in S-value and 26.8% difference in SAF). However, the whole body dose values were the same between the calculations based on the CT and XCAT with different BMIs. Conclusion: The results indicated that atlas-based dosimetry using XCAT phantom even with matched BMI for patient leads to considerable errors as compared to image-based dosimetry that uses the patient’s own CT Patient-specific dosimetry using CT image is essential for accurate results.« less

The effect of metal artefact reduction on CT-based attenuation correction for PET imaging in the vicinity of metallic hip implants: a phantom study.

PubMed

Harnish, Roy; Prevrhal, Sven; Alavi, Abass; Zaidi, Habib; Lang, Thomas F

2014-07-01

To determine if metal artefact reduction (MAR) combined with a priori knowledge of prosthesis material composition can be applied to obtain CT-based attenuation maps with sufficient accuracy for quantitative assessment of (18)F-fluorodeoxyglucose uptake in lesions near metallic prostheses. A custom hip prosthesis phantom with a lesion-sized cavity filled with 0.2 ml (18)F-FDG solution having an activity of 3.367 MBq adjacent to a prosthesis bore was imaged twice with a chrome-cobalt steel hip prosthesis and a plastic replica, respectively. Scanning was performed on a clinical hybrid PET/CT system equipped with an additional external (137)Cs transmission source. PET emission images were reconstructed from both phantom configurations with CT-based attenuation correction (CTAC) and with CT-based attenuation correction using MAR (MARCTAC). To compare results with the attenuation-correction method extant prior to the advent of PET/CT, we also carried out attenuation correction with (137)Cs transmission-based attenuation correction (TXAC). CTAC and MARCTAC images were scaled to attenuation coefficients at 511 keV using a trilinear function that mapped the highest CT values to the prosthesis alloy attenuation coefficient. Accuracy and spatial distribution of the lesion activity was compared between the three reconstruction schemes. Compared to the reference activity of 3.37 MBq, the estimated activity quantified from the PET image corrected by TXAC was 3.41 MBq. The activity estimated from PET images corrected by MARCTAC was similar in accuracy at 3.32 MBq. CTAC corrected PET images resulted in nearly 40 % overestimation of lesion activity at 4.70 MBq. Comparison of PET images obtained with the plastic and metal prostheses in place showed that CTAC resulted in a marked distortion of the (18)F-FDG distribution within the lesion, whereas application of MARCTAC and TXAC resulted in lesion distributions similar to those observed with the plastic replica. MAR combined with a trilinear CT number mapping for PET attenuation correction resulted in estimates of lesion activity comparable in accuracy to that obtained with (137)Cs transmission-based attenuation correction, and far superior to estimates made without attenuation correction or with a standard CT attenuation map. The ability to use CT images for attenuation correction is a potentially important development because it obviates the need for a (137)Cs transmission source, which entails extra scan time, logistical complexity and expense.

Determination of dosimetric quantities in pediatric abdominal computed tomography scans*

PubMed Central

Jornada, Tiago da Silva; da Silva, Teógenes Augusto

2014-01-01

Objective Aiming at contributing to the knowledge on doses in computed tomography (CT), this study has the objective of determining dosimetric quantities associated with pediatric abdominal CT scans, comparing the data with diagnostic reference levels (DRL). Materials and methods The study was developed with a Toshiba Asteion single-slice CT scanner and a GE BrightSpeed multi-slice CT unit in two hospitals. Measurements were performed with a pencil-type ionization chamber and a 16 cm-diameter polymethylmethacrylate trunk phantom. Results No significant difference was observed in the values for weighted air kerma index (CW), but the differences were relevant in values for volumetric air kerma index (CVOL), air kerma-length product (PKL,CT) and effective dose. Conclusion Only the CW values were lower than the DRL, suggesting that dose optimization might not be necessary. However, PKL,CT and effective dose values stressed that there still is room for reducing pediatric radiation doses. The present study emphasizes the importance of determining all dosimetric quantities associated with CT scans. PMID:25741103

Cumulative effective dose associated with computed tomography examinations in adolescent trauma patients.

PubMed

Choi, Seung Joon; Kim, Eun Young; Kim, Hyung Sik; Choi, Hye-Young; Cho, Jinseong; Yang, Hyuk Jun; Chung, Yong Eun

2014-07-01

The aims of this study were to analyze cumulative effective dose (cED) and to assess lifetime attributable risk (LAR) of cancer due to radiation exposure during computed tomography (CT) examinations in adolescent trauma patients. Between January 2010 and May 2011, the adolescent patients with trauma were enrolled in this study. Numbers of CT examinations and body regions examined were collated, and cEDs were calculated using dose-length product values and conversion factors. Lifetime attributable risk for cancer incidence and cancer-associated mortality were quantified based on the studies of survivors of the atomic bombs on Japan. Data were stratified according to severity of trauma: minor trauma, injury severity score of less than 16; and major trauma, injury severity score of 16 or greater. A total of 698 CT scans were obtained on the following regions of 484 adolescent patients: head CT, n = 647; rest of the body, n = 41; and thorax, n = 10. Mean cED per patient was 3.4 mSv, and mean LARs for cancer incidence and mortality were 0.05% and 0.02%, respectively. The majority of patients (98.4%) experienced minor trauma, and their mean cED and LARs for cancer incidence and mortality (3.0 mSv and 0.04% and 0.02%, respectively) were significantly lower than those of patients with major trauma (24.3 mSv and 0.31% and 0.15%, respectively, all P values < 0.001). The overall radiation-induced cancer risk due to CT examinations performed for the initial assessment of minor trauma was found to be relatively low in adolescent patients. However, adolescent patients with major trauma were exposed to a substantial amount of radiation during multiple CT examinations.

Measurement of focal ground-glass opacity diameters on CT images: interobserver agreement in regard to identifying increases in the size of ground-glass opacities.

PubMed

Kakinuma, Ryutaro; Ashizawa, Kazuto; Kuriyama, Keiko; Fukushima, Aya; Ishikawa, Hiroyuki; Kamiya, Hisashi; Koizumi, Naoya; Maruyama, Yuichiro; Minami, Kazunori; Nitta, Norihisa; Oda, Seitaro; Oshiro, Yasuji; Kusumoto, Masahiko; Murayama, Sadayuki; Murata, Kiyoshi; Muramatsu, Yukio; Moriyama, Noriyuki

2012-04-01

To evaluate interobserver agreement in regard to measurements of focal ground-glass opacities (GGO) diameters on computed tomography (CT) images to identify increases in the size of GGOs. Approval by the institutional review board and informed consent by the patients were obtained. Ten GGOs (mean size, 10.4 mm; range, 6.5-15 mm), one each in 10 patients (mean age, 65.9 years; range, 58-78 years), were used to make the diameter measurements. Eleven radiologists independently measured the diameters of the GGOs on a total of 40 thin-section CT images (the first [n = 10], the second [n = 10], and the third [n = 10] follow-up CT examinations and remeasurement of the first [n = 10] follow-up CT examinations) without comparing time-lapse CT images. Interobserver agreement was assessed by means of Bland-Altman plots. The smallest range of the 95% limits of interobserver agreement between the members of the 55 pairs of the 11 radiologists in regard to maximal diameter was -1.14 to 1.72 mm, and the largest range was -7.7 to 1.7 mm. The mean value of the lower limit of the 95% limits of agreement was -3.1 ± 1.4 mm, and the mean value of their upper limit was 2.5 ± 1.1 mm. When measurements are made by any two radiologists, an increase in the length of the maximal diameter of more than 1.72 mm would be necessary in order to be able to state that the maximal diameter of a particular GGO had actually increased. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Automated extraction method for the center line of spinal canal and its application to the spinal curvature quantification in torso X-ray CT images

NASA Astrophysics Data System (ADS)

Hayashi, Tatsuro; Zhou, Xiangrong; Chen, Huayue; Hara, Takeshi; Miyamoto, Kei; Kobayashi, Tatsunori; Yokoyama, Ryujiro; Kanematsu, Masayuki; Hoshi, Hiroaki; Fujita, Hiroshi

2010-03-01

X-ray CT images have been widely used in clinical routine in recent years. CT images scanned by a modern CT scanner can show the details of various organs and tissues. This means various organs and tissues can be simultaneously interpreted on CT images. However, CT image interpretation requires a lot of time and energy. Therefore, support for interpreting CT images based on image-processing techniques is expected. The interpretation of the spinal curvature is important for clinicians because spinal curvature is associated with various spinal disorders. We propose a quantification scheme of the spinal curvature based on the center line of spinal canal on CT images. The proposed scheme consists of four steps: (1) Automated extraction of the skeletal region based on CT number thresholding. (2) Automated extraction of the center line of spinal canal. (3) Generation of the median plane image of spine, which is reformatted based on the spinal canal. (4) Quantification of the spinal curvature. The proposed scheme was applied to 10 cases, and compared with the Cobb angle that is commonly used by clinicians. We found that a high-correlation (for the 95% confidence interval, lumbar lordosis: 0.81-0.99) between values obtained by the proposed (vector) method and Cobb angle. Also, the proposed method can provide the reproducible result (inter- and intra-observer variability: within 2°). These experimental results suggested a possibility that the proposed method was efficient for quantifying the spinal curvature on CT images.

A procedure to estimate the origins and the insertions of the knee ligaments from computed tomography images.

PubMed

Ascani, Daniele; Mazzà, Claudia; De Lollis, Angelo; Bernardoni, Massimiliano; Viceconti, Marco

2015-01-21

The estimation of the origin and insertion of the four knee ligaments is crucial for individualised dynamic modelling of the knee. Commonly this information is obtained ex vivo or from high resolution MRI, which is not always available. Aim of this work is to devise a method to estimate the origins and insertions from computed tomography (CT) images. A reference registration atlas was created using a set of 16 bone landmarks visible in CT and eight origins and insertions estimated from MRI and in vitro data available in the literature for three knees. This atlas can be registered to the set of bone landmarks palpated on any given CT using an affine transformation. The resulting orientation and translation matrices and scaling factors can be used to find also the ligament origin and insertions. This procedure was validated on seven pathological knees for which both CT and MRI of the knee region were available, using a proprietary software tool (NMSBuilder, SCS srl, Italy). To assess the procedure reproducibility and repeatability, four different operators performed the landmarks palpation on all seven patients. The average difference between the values predicted by registration on the CT scan and those estimated on the MRI was 2.1±1.2 mm for the femur and 2.7±1.0 mm for the tibia, respectively. The procedure is highly repeatable, with no significant differences observed within or between the operators (p>0.1) and allows to estimate origins and insertions of the knee ligaments from a CT scan with the same level of accuracy obtainable with MRI. Copyright © 2014 Elsevier Ltd. All rights reserved.

Electromotive force analysis of current transformer during lightning surge inflow using Fourier series expansion

NASA Astrophysics Data System (ADS)

Kim, Youngsun

2017-05-01

The most common structure used for current transformers (CTs) consists of secondary windings around a ferromagnetic core past the primary current being measured. A CT used as a surge protection device (SPD) may experience large inrushes of current, like surges. However, when a large current flows into the primary winding, measuring the magnitude of the current is difficult because the ferromagnetic core becomes magnetically saturated. Several approaches to reduce the saturation effect are described in the literature. A Rogowski coil is representative of several devices that measure large currents. It is an electrical device that measures alternating current (AC) or high-frequency current. However, such devices are very expensive in application. In addition, the volume of a CT must be increased to measure sufficiently large currents, but for installation spaces that are too small, other methods must be used. To solve this problem, it is necessary to analyze the magnetic field and electromotive force (EMF) characteristics when designing a CT. Thus, we proposed an analysis method for the CT under an inrush current using the time-domain finite element method (TDFEM). The input source current of a surge waveform is expanded by a Fourier series to obtain an instantaneous value. An FEM model of the device is derived in a two-dimensional system and coupled with EMF circuits. The time-derivative term in the differential equation is solved in each time step by the finite difference method. It is concluded that the proposed algorithm is useful for analyzing CT characteristics, including the field distribution. Consequently, the proposed algorithm yields a reference for obtaining the effects of design parameters and magnetic materials for special shapes and sizes before the CT is designed and manufactured.

PET/MRI in the Presence of Metal Implants: Completion of the Attenuation Map from PET Emission Data.

PubMed

Fuin, Niccolo; Pedemonte, Stefano; Catalano, Onofrio A; Izquierdo-Garcia, David; Soricelli, Andrea; Salvatore, Marco; Heberlein, Keith; Hooker, Jacob M; Van Leemput, Koen; Catana, Ciprian

2017-05-01

We present a novel technique for accurate whole-body attenuation correction in the presence of metallic endoprosthesis, on integrated non-time-of-flight (non-TOF) PET/MRI scanners. The proposed implant PET-based attenuation map completion (IPAC) method performs a joint reconstruction of radioactivity and attenuation from the emission data to determine the position, shape, and linear attenuation coefficient (LAC) of metallic implants. Methods: The initial estimate of the attenuation map was obtained using the MR Dixon method currently available on the Siemens Biograph mMR scanner. The attenuation coefficients in the area of the MR image subjected to metal susceptibility artifacts are then reconstructed from the PET emission data using the IPAC algorithm. The method was tested on 11 subjects presenting 13 different metallic implants, who underwent CT and PET/MR scans. Relative mean LACs and Dice similarity coefficients were calculated to determine the accuracy of the reconstructed attenuation values and the shape of the metal implant, respectively. The reconstructed PET images were compared with those obtained using the reference CT-based approach and the Dixon-based method. Absolute relative change (aRC) images were generated in each case, and voxel-based analyses were performed. Results: The error in implant LAC estimation, using the proposed IPAC algorithm, was 15.7% ± 7.8%, which was significantly smaller than the Dixon- (100%) and CT- (39%) derived values. A mean Dice similarity coefficient of 73% ± 9% was obtained when comparing the IPAC- with the CT-derived implant shape. The voxel-based analysis of the reconstructed PET images revealed quantification errors (aRC) of 13.2% ± 22.1% for the IPAC- with respect to CT-corrected images. The Dixon-based method performed substantially worse, with a mean aRC of 23.1% ± 38.4%. Conclusion: We have presented a non-TOF emission-based approach for estimating the attenuation map in the presence of metallic implants, to be used for whole-body attenuation correction in integrated PET/MR scanners. The Graphics Processing Unit implementation of the algorithm will be included in the open-source reconstruction toolbox Occiput.io. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-assisted implant placement. Part I: relationship of radiographic gray density and implant stability.

PubMed

Arisan, Volkan; Karabuda, Zihni Cüneyt; Avsever, Hakan; Özdemir, Tayfun

2013-12-01

The relationship of conventional multi-slice computed tomography (CT)- and cone beam CT (CBCT)-based gray density values and the primary stability parameters of implants that were placed by stereolithographic surgical guides were analyzed in this study. Eighteen edentulous jaws were randomly scanned by a CT (CT group) or a CBCT scanner (CBCT group) and radiographic gray density was measured from the planned implants. A total of 108 implants were placed, and primary stability parameters were measured by insertion torque value (ITV) and resonance frequency analysis (RFA). Radiographic and subjective bone quality classification (BQC) was also classified. Results were analyzed by correlation tests and multiple regressions (p < .05). CBCT-based gray density values (765 ± 97.32 voxel value) outside the implants were significantly higher than those of CT-based values (668.4 ± 110 Hounsfield unit, p < .001). Significant relations were found among the gray density values outside the implants, ITV (adjusted r(2)  = 0.6142, p = .001 and adjusted r(2)  = 0.5166, p = .0021), and RFA (adjusted r(2)  = 0.5642, p = .0017 and adjusted r(2)  = 0.5423, p = .0031 for CT and CBCT groups, respectively). Data from radiographic and subjective BQC were also in agreement. Similar to the gray density values of CT, that of CBCT could also be predictive for the subjective BQC and primary implant stability. Results should be confirmed on different CBCT scanners. © 2012 Wiley Periodicals, Inc.

The predictive value of single-photon emission computed tomography/computed tomography for sentinel lymph node localization in head and neck cutaneous malignancy.

PubMed

Remenschneider, Aaron K; Dilger, Amanda E; Wang, Yingbing; Palmer, Edwin L; Scott, James A; Emerick, Kevin S

2015-04-01

Preoperative localization of sentinel lymph nodes in head and neck cutaneous malignancies can be aided by single-photon emission computed tomography/computed tomography (SPECT/CT); however, its true predictive value for identifying lymph nodes intraoperatively remains unquantified. This study aims to understand the sensitivity, specificity, and positive and negative predictive values of SPECT/CT in sentinel lymph node biopsy for cutaneous malignancies of the head and neck. Blinded retrospective imaging review with comparison to intraoperative gamma probe confirmed sentinel lymph nodes. A consecutive series of patients with a head and neck cutaneous malignancy underwent preoperative SPECT/CT followed by sentinel lymph node biopsy with a gamma probe. Two nuclear medicine physicians, blinded to clinical data, independently reviewed each SPECT/CT. Activity within radiographically defined nodal basins was recorded and compared to intraoperative gamma probe findings. Sensitivity, specificity, and negative and positive predictive values were calculated with subgroup stratification by primary tumor site. Ninety-two imaging reads were performed on 47 patients with cutaneous malignancy who underwent SPECT/CT followed by sentinel lymph node biopsy. Overall sensitivity was 73%, specificity 92%, positive predictive value 54%, and negative predictive value 96%. The predictive ability of SPECT/CT to identify the basin or an adjacent basin containing the single hottest node was 92%. SPECT/CT overestimated uptake by an average of one nodal basin. In the head and neck, SPECT/CT has higher reliability for primary lesions of the eyelid, scalp, and cheek. SPECT/CT has high sensitivity, specificity, and negative predictive value, but may overestimate relevant nodal basins in sentinel lymph node biopsy. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

The Value of Lung Cancer CT Screening: It Is All about Implementation.

PubMed

Goulart, Bernardo H L

2015-01-01

Hospitals have been gradually implementing new lung cancer CT screening programs following the release of the U.S. Preventive Services Task Force grade B recommendation to screen individuals at high risk for lung cancer. Policy makers have legitimately questioned whether adoption of CT screening in the community will reproduce the mortality benefits seen in the National Lung Screening Trial (NLST) and whether the benefits of screening will justify the potentially high costs. Although three annual CT screening exams proved cost-effective for the patient population enrolled in the NLST, uncertainty still exists about whether CT screening will be cost-effective in practice. The value of CT screening will depend largely on the strategies used to implement it. This manuscript reviews the current reimbursement policies for CT screening and explains the relationship between implementation strategies and screening value on the basis of the NLST cost-effectiveness analysis and other published data. A subsequent discussion ensues about the potential implementation inefficiencies that can negatively affect the value of CT screening (e.g., selection of low-risk individuals for screening, inappropriate follow-up visits for screening-detected lung nodules, failure to offer smoking cessation interventions, and overuse of medical resources for clinically irrelevant incidental findings) and the actions that can be taken to mitigate these inefficiencies and increase the value of screening.

Micro X-ray CT imaging of pore-scale changes in unconsolidated sediment under confining pressure

NASA Astrophysics Data System (ADS)

Schindler, M.; Prasad, M.

2017-12-01

Micro X-ray computed tomography was used to image confining-pressure induced changes in a dry, unconsolidated quartz sand pack while simultaneously recording ultrasonic P-wave velocities. The experiments were performed under in-situ pressure of up to 4000 psi. The majority of digital rock physics studies rely on micro CT images obtained under ambient pressure and temperature conditions although effective rock properties strongly depend on in situ conditions. Goal of this work is to be able to obtain micro CT images of rock samples while pore and confining pressure is applied. Simultaneously we recorded ultrasonic P-wave velocities. The combination of imaging and velocity measurements provides insight in pore-scale changes in the rock and their influence on elastic properties. We visually observed a reduction in porosity by more than a third of the initial value as well as extensive grain damage, changes in pore and grain size distribution and an increase in contact number and contact radius with increasing confining pressure. An increase in measured ultrasonic P-wave velocities with increasing pressure was observed. We used porosity, contact number and contact radius obtained from micro CT images to model P-wave velocity with the contact-radius model by Bachrach et al. (1998). Our observations showed that the frame of unconsolidated sediments is significantly altered starting at pressures of only 1000 psi. This finding indicates that common assumptions in rock physics models (the solid frame remains unchanged) are violated for unconsolidated sediments. The effects on the solid frame should be taken into account when modeling the pressure dependence of elastic rock properties.

A study of photon interaction in some hormones

NASA Astrophysics Data System (ADS)

Manjunatha, H. C.

2013-05-01

The effective atomic numbers (Z eff) and electron density (N el) of some hormones such as testosterone, methandienone, estradiol and rogesterone for total and partial photon interactions have been computed in the wide energy region 1 keV-100 GeV using an accurate database of photon-interaction cross sections and the WinXCom program. The computed Z eff and N el are compared with the values generated by XMuDat program. The computer tomography (CT) numbers and kerma values relative to air are also calculated and the computed data of CT numbers in the low-energy region help in visualizing the image of the biological samples and to obtain precise accuracy in treating the inhomogenity of them in medical radiology. In view of dosimetric interest, the photon absorbed dose rates of some commonly used gamma sources (Na-21, Cs-137, Mn-52, Co-60 and Na-22) are also estimated.

Can a toxin gene NAAT be used to predict toxin EIA and the severity of Clostridium difficile infection?

PubMed

Garvey, Mark I; Bradley, Craig W; Wilkinson, Martyn A C; Holden, Elisabeth

2017-01-01

Diagnosis of C. difficile infection (CDI) is controversial because of the many laboratory methods available and their lack of ability to distinguish between carriage, mild or severe disease. Here we describe whether a low C. difficile toxin B nucleic acid amplification test (NAAT) cycle threshold (CT) can predict toxin EIA, CDI severity and mortality. A three-stage algorithm was employed for CDI testing, comprising a screening test for glutamate dehydrogenase (GDH), followed by a NAAT, then a toxin enzyme immunoassay (EIA). All diarrhoeal samples positive for GDH and NAAT between 2012 and 2016 were analysed. The performance of the NAAT CT value as a classifier of toxin EIA outcome was analysed using a ROC curve; patient mortality was compared to CTs and toxin EIA via linear regression models. A CT value ≤26 was associated with ≥72% toxin EIA positivity; applying a logistic regression model we demonstrated an association between low CT values and toxin EIA positivity. A CT value of ≤26 was significantly associated ( p  = 0.0262) with increased one month mortality, severe cases of CDI or failure of first line treatment. The ROC curve probabilities demonstrated a CT cut off value of 26.6. Here we demonstrate that a CT ≤26 indicates more severe CDI and is associated with higher mortality. Samples with a low CT value are often toxin EIA positive, questioning the need for this additional EIA test. A CT ≤26 could be used to assess the potential for severity of CDI and guide patient treatment.

Radiotherapy volume delineation using dynamic [18F]-FDG PET/CT imaging in patients with oropharyngeal cancer: a pilot study.

PubMed

Silvoniemi, Antti; Din, Mueez U; Suilamo, Sami; Shepherd, Tony; Minn, Heikki

2016-11-01

Delineation of gross tumour volume in 3D is a critical step in the radiotherapy (RT) treatment planning for oropharyngeal cancer (OPC). Static [ 18 F]-FDG PET/CT imaging has been suggested as a method to improve the reproducibility of tumour delineation, but it suffers from low specificity. We undertook this pilot study in which dynamic features in time-activity curves (TACs) of [ 18 F]-FDG PET/CT images were applied to help the discrimination of tumour from inflammation and adjacent normal tissue. Five patients with OPC underwent dynamic [ 18 F]-FDG PET/CT imaging in treatment position. Voxel-by-voxel analysis was performed to evaluate seven dynamic features developed with the knowledge of differences in glucose metabolism in different tissue types and visual inspection of TACs. The Gaussian mixture model and K-means algorithms were used to evaluate the performance of the dynamic features in discriminating tumour voxels compared to the performance of standardized uptake values obtained from static imaging. Some dynamic features showed a trend towards discrimination of different metabolic areas but lack of consistency means that clinical application is not recommended based on these results alone. Impact of inflammatory tissue remains a problem for volume delineation in RT of OPC, but a simple dynamic imaging protocol proved practicable and enabled simple data analysis techniques that show promise for complementing the information in static uptake values.

Implementation of material decomposition using an EMCCD and CMOS-based micro-CT system.

PubMed

Podgorsak, Alexander R; Nagesh, Sv Setlur; Bednarek, Daniel R; Rudin, Stephen; Ionita, Ciprian N

2017-02-11

This project assessed the effectiveness of using two different detectors to obtain dual-energy (DE) micro-CT data for the carrying out of material decomposition. A micro-CT coupled to either a complementary metal-oxide semiconductor (CMOS) or an electron multiplying CCD (EMCCD) detector was used to acquire image data of a 3D-printed phantom with channels filled with different materials. At any instance, materials such as iohexol contrast agent, water, and platinum were selected to make up the scanned object. DE micro-CT data was acquired, and slices of the scanned object were differentiated by material makeup. The success of the decomposition was assessed quantitatively through the computation of percentage normalized root-mean-square error (%NRMSE). Our results indicate a successful decomposition of iohexol for both detectors (%NRMSE values of 1.8 for EMCCD, 2.4 for CMOS), as well as platinum (%NRMSE value of 4.7). The CMOS detector performed material decomposition on air and water on average with 7 times more %NRMSE, possibly due to the decreased sensitivity of the CMOS system. Material decomposition showed the potential to differentiate between materials such as the iohexol and platinum, perhaps opening the door for its use in the neurovascular anatomical region. Work supported by Toshiba America Medical Systems, and partially supported by NIH grant 2R01EB002873.

Implementation of material decomposition using an EMCCD and CMOS-based micro-CT system

NASA Astrophysics Data System (ADS)

Podgorsak, Alexander R.; Nagesh, S. V. Setlur; Bednarek, Daniel R.; Rudin, Stephen; Ionita, Ciprian N.

2017-03-01

This project assessed the effectiveness of using two different detectors to obtain dual-energy (DE) micro-CT data for the carrying out of material decomposition. A micro-CT coupled to either a complementary metal-oxide semiconductor (CMOS) or an electron multiplying CCD (EMCCD) detector was used to acquire image data of a 3D-printed phantom with channels filled with different materials. At any instance, materials such as iohexol contrast agent, water, and platinum were selected to make up the scanned object. DE micro-CT data was acquired, and slices of the scanned object were differentiated by material makeup. The success of the decomposition was assessed quantitatively through the computation of percentage normalized root-mean-square error (%NRMSE). Our results indicate a successful decomposition of iohexol for both detectors (%NRMSE values of 1.8 for EMCCD, 2.4 for CMOS), as well as platinum (%NRMSE value of 4.7). The CMOS detector performed material decomposition on air and water on average with 7 times more %NRMSE, possibly due to the decreased sensitivity of the CMOS system. Material decomposition showed the potential to differentiate between materials such as the iohexol and platinum, perhaps opening the door for its use in the neurovascular anatomical region. Work supported by Toshiba America Medical Systems, and partially supported by NIH grant 2R01EB002873.

The utility of focused assessment with sonography for trauma as a triage tool in multiple-casualty incidents during the second Lebanon war.

PubMed

Beck-Razi, Nira; Fischer, Doron; Michaelson, Moshe; Engel, Ahuva; Gaitini, Diana

2007-09-01

The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict. The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate. Two-hundred eighty-one physically injured patients, 215 soldiers (76.5%) and 66 civilians (23.5%), were admitted. Focused assessment with sonography for trauma was performed in 102 casualties suspected to have an abdominal injury. Sixty-eight underwent computed tomography (CT); 12 underwent laparotomy; and 28 were kept under clinical observation alone. We compared FAST results against CT, laparotomy, and clinical observation records. Focused assessment with sonography for trauma results were positive in 17 casualties and negative in 85. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FAST were 75%, 97.6%, 88.2%, 94.1%, and 93.1%, respectively. A strong correlation between FAST and CT results, laparotomy, and clinical observation was obtained (P < .05). In a setting of a war conflict-related MCI, FAST enabled immediate triage of casualties to laparotomy, CT, or clinical observation. Because of its moderate sensitivity, a negative FAST result with strong clinical suspicion demands further evaluation, especially in an MCI.

Development of a patient-specific dosimetry estimation system in nuclear medicine examination

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

Lin, H. H.; Dong, S. L.; Yang, H. J.

2011-07-01

The purpose of this study is to develop a patient-specific dosimetry estimation system in nuclear medicine examination using a SimSET-based Monte Carlo code. We added a dose deposition routine to store the deposited energy of the photons during their flights in SimSET and developed a user-friendly interface for reading PET and CT images. Dose calculated on ORNL phantom was used to validate the accuracy of this system. The S values for {sup 99m}Tc, {sup 18}F and {sup 131}I obtained by the system were compared to those from the MCNP4C code and OLINDA. The ratios of S values computed by thismore » system to those obtained with OLINDA for various organs were ranged from 0.93 to 1.18, which are comparable to that obtained from MCNP4C code (0.94 to 1.20). The average ratios of S value were 0.99{+-}0.04, 1.03{+-}0.05, and 1.00{+-}0.07 for isotopes {sup 131}I, {sup 18}F, and {sup 99m}Tc, respectively. The simulation time of SimSET was two times faster than MCNP4C's for various isotopes. A 3D dose calculation was also performed on a patient data set with PET/CT examination using this system. Results from the patient data showed that the estimated S values using this system differed slightly from those of OLINDA for ORNL phantom. In conclusion, this system can generate patient-specific dose distribution and display the isodose curves on top of the anatomic structure through a friendly graphic user interface. It may also provide a useful tool to establish an appropriate dose-reduction strategy to patients in nuclear medicine environments. (authors)« less

Cupping artifact correction and automated classification for high-resolution dedicated breast CT images.

PubMed

Yang, Xiaofeng; Wu, Shengyong; Sechopoulos, Ioannis; Fei, Baowei

2012-10-01

To develop and test an automated algorithm to classify the different tissues present in dedicated breast CT images. The original CT images are first corrected to overcome cupping artifacts, and then a multiscale bilateral filter is used to reduce noise while keeping edge information on the images. As skin and glandular tissues have similar CT values on breast CT images, morphologic processing is used to identify the skin mask based on its position information. A modified fuzzy C-means (FCM) classification method is then used to classify breast tissue as fat and glandular tissue. By combining the results of the skin mask with the FCM, the breast tissue is classified as skin, fat, and glandular tissue. To evaluate the authors' classification method, the authors use Dice overlap ratios to compare the results of the automated classification to those obtained by manual segmentation on eight patient images. The correction method was able to correct the cupping artifacts and improve the quality of the breast CT images. For glandular tissue, the overlap ratios between the authors' automatic classification and manual segmentation were 91.6% ± 2.0%. A cupping artifact correction method and an automatic classification method were applied and evaluated for high-resolution dedicated breast CT images. Breast tissue classification can provide quantitative measurements regarding breast composition, density, and tissue distribution.

Cupping artifact correction and automated classification for high-resolution dedicated breast CT images

PubMed Central

Yang, Xiaofeng; Wu, Shengyong; Sechopoulos, Ioannis; Fei, Baowei

2012-01-01

Purpose: To develop and test an automated algorithm to classify the different tissues present in dedicated breast CT images. Methods: The original CT images are first corrected to overcome cupping artifacts, and then a multiscale bilateral filter is used to reduce noise while keeping edge information on the images. As skin and glandular tissues have similar CT values on breast CT images, morphologic processing is used to identify the skin mask based on its position information. A modified fuzzy C-means (FCM) classification method is then used to classify breast tissue as fat and glandular tissue. By combining the results of the skin mask with the FCM, the breast tissue is classified as skin, fat, and glandular tissue. To evaluate the authors’ classification method, the authors use Dice overlap ratios to compare the results of the automated classification to those obtained by manual segmentation on eight patient images. Results: The correction method was able to correct the cupping artifacts and improve the quality of the breast CT images. For glandular tissue, the overlap ratios between the authors’ automatic classification and manual segmentation were 91.6% ± 2.0%. Conclusions: A cupping artifact correction method and an automatic classification method were applied and evaluated for high-resolution dedicated breast CT images. Breast tissue classification can provide quantitative measurements regarding breast composition, density, and tissue distribution. PMID:23039675

CHOROIDAL THICKNESS IN DIABETIC RETINOPATHY ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY.

PubMed

Laíns, Inês; Talcott, Katherine E; Santos, Ana R; Marques, João H; Gil, Pedro; Gil, João; Figueira, João; Husain, Deeba; Kim, Ivana K; Miller, Joan W; Silva, Rufino; Miller, John B

2018-01-01

To compare the choroidal thickness (CT) of diabetic eyes (different stages of disease) with controls, using swept-source optical coherence tomography. A multicenter, prospective, cross-sectional study of diabetic and nondiabetic subjects using swept-source optical coherence tomography imaging. Choroidal thickness maps, according to the nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields, were obtained using automated software. Mean CT was calculated as the mean value within the ETDRS grid, and central CT as the mean in the central 1 mm. Diabetic eyes were divided into four groups: no diabetic retinopathy (No DR), nonproliferative DR (NPDR), NPDR with diabetic macular edema (NPDR + DME), and proliferative DR (PDR). Multilevel mixed linear models were performed for analyses. The authors included 50 control and 160 diabetic eyes (n = 27 No DR, n = 51 NPDR, n = 61 NPDR + DME, and n = 21 PDR). Mean CT (ß = -42.9, P = 0.022) and central CT (ß = -50.2, P = 0.013) were statistically significantly thinner in PDR eyes compared with controls, even after adjusting for confounding factors. Controlling for age, DR eyes presented a significantly decreased central CT than diabetic eyes without retinopathy (β = -36.2, P = 0.009). Swept-source optical coherence tomography demonstrates a significant reduction of CT in PDR compared with controls. In the foveal region, the choroid appears to be thinner in DR eyes than in diabetic eyes without retinopathy.

Preliminary study on the differentiation between parapelvic cyst and hydronephrosis with non-calculous using only pre-contrast dual-energy spectral CT scans

PubMed Central

Han, Dong; Ma, Guangming; Wei, Lequn; Ren, Chenglong; Zhou, Jieli; Shen, Chen

2017-01-01

Objective: To investigate the value of using the quantitative parameters from only the pre-contrast dual-energy spectral CT imaging for distinguishing between parapelvic cyst and hydronephrosis with non-calculous (HNC). Methods: This retrospective study was approved by the institutional review board. 28 patients with parapelvic cyst and 24 patients with HNC who underwent standard pre-contrast and multiphase contrast-enhanced dual-energy spectral CT imaging were retrospectively identified. The parapelvic cyst and HNC were identified using the contrast-enhanced scans, and their CT number in the 70-keV monochromatic images, effective atomic number (Zeff), iodine concentration (IC) and water concentration in the pre-contrast images were measured. The slope of the spectral curve (λ) was calculated. The difference in the measurements between parapelvic cyst and HNC was statistically analyzed using SPSS® v. 19.0 (IBM Corp., New York, NY; formerly SPSS Inc., Chicago, IL) statistical software. Receiver-operating characteristic analysis was performed to assess the diagnostic performance. Results: The CT numbers in the 70-keV images, Zeff and IC values were statistically different between parapelvic cyst and HNC (all p < 0.05). The sensitivity, specificity and accuracy of these parameters for distinguishing between parapelvic cyst and HNC were 89.2%, 73.3% and 82.1%; 86.5%, 43.3% and 67.2%; 91.9%, 40.0% and 68.7%; and 64.9%, 73.3% and 83.6%, respectively, and the combined specificity was 92.9%. There was no statistical difference in λ between the two groups (p > 0.05). Conclusion: The quantitative parameters obtained in the pre-contrast dual-energy spectral CT imaging may be used to differentiate between parapelvic cyst and HNC. Advances in knowledge: The pre-contrast dual-energy spectral CT scans may be used to screen parapelvic cysts for patients who are asymptomatic, thereby avoiding contrast-enhanced CT or CT urography examination for these patients to reduce ionizing radiation dose and contrast dose. PMID:28281789

Low-dose head computed tomography in children: a single institutional experience in pediatric radiation risk reduction: clinical article.

PubMed

Morton, Ryan P; Reynolds, Renee M; Ramakrishna, Rohan; Levitt, Michael R; Hopper, Richard A; Lee, Amy; Browd, Samuel R

2013-10-01

In this study, the authors describe their experience with a low-dose head CT protocol for a preselected neurosurgical population at a dedicated pediatric hospital (Seattle Children's Hospital), the largest number of patients with this protocol reported to date. All low-dose head CT scans between October 2011 and November 2012 were reviewed. Two different low-dose radiation dosages were used, at one-half or one-quarter the dose of a standard head CT scan, based on patient characteristics agreed upon by the neurosurgery and radiology departments. Patient information was also recorded, including diagnosis and indication for CT scan. Six hundred twenty-four low-dose head CT procedures were performed within the 12-month study period. Although indications for the CT scans varied, the most common reason was to evaluate the ventricles and catheter placement in hydrocephalic patients with shunts (70%), followed by postoperative craniosynostosis imaging (12%). These scans provided adequate diagnostic imaging, and no patient required a follow-up full-dose CT scan as a result of poor image quality on a low-dose CT scan. Overall physician comfort and satisfaction with interpretation of the images was high. An additional 2150 full-dose head CT scans were performed during the same 12-month time period, making the total number of CT scans 2774. This value compares to 3730 full-dose head CT scans obtained during the year prior to the study when low-dose CT and rapid-sequence MRI was not a reliable option at Seattle Children's Hospital. Thus, over a 1-year period, 22% of the total CT scans were able to be converted to low-dose scans, and full-dose CT scans were able to be reduced by 42%. The implementation of a low-dose head CT protocol substantially reduced the amount of ionizing radiation exposure in a preselected population of pediatric neurosurgical patients. Image quality and diagnostic utility were not significantly compromised.

Imaging the Parasinus Region with a Third-Generation Dual-Source CT and the Effect of Tin Filtration on Image Quality and Radiation Dose.

PubMed

Lell, M M; May, M S; Brand, M; Eller, A; Buder, T; Hofmann, E; Uder, M; Wuest, W

2015-07-01

CT is the imaging technique of choice in the evaluation of midface trauma or inflammatory disease. We performed a systematic evaluation of scan protocols to optimize image quality and radiation exposure on third-generation dual-source CT. CT protocols with different tube voltage (70-150 kV), current (25-300 reference mAs), prefiltration, pitch value, and rotation time were systematically evaluated. All images were reconstructed with iterative reconstruction (Advanced Modeled Iterative Reconstruction, level 2). To individually compare results with otherwise identical factors, we obtained all scans on a frozen human head. Conebeam CT was performed for image quality and dose comparison with multidetector row CT. Delineation of important anatomic structures and incidental pathologic conditions in the cadaver head was evaluated. One hundred kilovolts with tin prefiltration demonstrated the best compromise between dose and image quality. The most dose-effective combination for trauma imaging was Sn100 kV/250 mAs (volume CT dose index, 2.02 mGy), and for preoperative sinus surgery planning, Sn100 kV/150 mAs (volume CT dose index, 1.22 mGy). "Sn" indicates an additional prefiltration of the x-ray beam with a tin filter to constrict the energy spectrum. Exclusion of sinonasal disease was possible with even a lower dose by using Sn100 kV/25 mAs (volume CT dose index, 0.2 mGy). High image quality at very low dose levels can be achieved by using a Sn100-kV protocol with iterative reconstruction. The effective dose is comparable with that of conventional radiography, and the high image quality at even lower radiation exposure favors multidetector row CT over conebeam CT. © 2015 by American Journal of Neuroradiology.

Probabilistic Air Segmentation and Sparse Regression Estimated Pseudo CT for PET/MR Attenuation Correction

PubMed Central

Chen, Yasheng; Juttukonda, Meher; Su, Yi; Benzinger, Tammie; Rubin, Brian G.; Lee, Yueh Z.; Lin, Weili; Shen, Dinggang; Lalush, David

2015-01-01

Purpose To develop a positron emission tomography (PET) attenuation correction method for brain PET/magnetic resonance (MR) imaging by estimating pseudo computed tomographic (CT) images from T1-weighted MR and atlas CT images. Materials and Methods In this institutional review board–approved and HIPAA-compliant study, PET/MR/CT images were acquired in 20 subjects after obtaining written consent. A probabilistic air segmentation and sparse regression (PASSR) method was developed for pseudo CT estimation. Air segmentation was performed with assistance from a probabilistic air map. For nonair regions, the pseudo CT numbers were estimated via sparse regression by using atlas MR patches. The mean absolute percentage error (MAPE) on PET images was computed as the normalized mean absolute difference in PET signal intensity between a method and the reference standard continuous CT attenuation correction method. Friedman analysis of variance and Wilcoxon matched-pairs tests were performed for statistical comparison of MAPE between the PASSR method and Dixon segmentation, CT segmentation, and population averaged CT atlas (mean atlas) methods. Results The PASSR method yielded a mean MAPE ± standard deviation of 2.42% ± 1.0, 3.28% ± 0.93, and 2.16% ± 1.75, respectively, in the whole brain, gray matter, and white matter, which were significantly lower than the Dixon, CT segmentation, and mean atlas values (P < .01). Moreover, 68.0% ± 16.5, 85.8% ± 12.9, and 96.0% ± 2.5 of whole-brain volume had within ±2%, ±5%, and ±10% percentage error by using PASSR, respectively, which was significantly higher than other methods (P < .01). Conclusion PASSR outperformed the Dixon, CT segmentation, and mean atlas methods by reducing PET error owing to attenuation correction. © RSNA, 2014 PMID:25521778

Is radiography justified for the evaluation of patients presenting with cervical spine trauma?

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

Theocharopoulos, Nicholas; Chatzakis, Georgios; Damilakis, John

2009-10-15

Conventional radiography has been for decades the standard method of evaluation for cervical spine trauma patients. However, currently available helical multidetector CT scanners allow multiplanar reconstruction of images, leading to increased diagnostic accuracy. The purpose of this study was to determine the relative benefit/risk ratio between cervical spine CT and cervical spine radiography and between cervical spine CT and cervical spine radiography, followed by CT as an adjunct for positive findings. A decision analysis model for the determination of the optimum imaging technique was developed. The sensitivity and specificity of CT and radiography were obtained by dedicated meta-analysis. Lifetime attributablemore » risk of mortal cancer from CT and radiography was calculated using updated organ-specific risk coefficients and organ-absorbed doses. Patient organ doses from radiography were calculated using Monte Carlo techniques, simulated exposures performed on an anthropomorphic phantom, and thermoluminescence dosimetry. A prospective patient study was performed regarding helical CT scans of the cervical spine. Patient doses were calculated based on the dose-length-product values and Monte Carlo-based CT dosimetry software program. Three groups of patient risk for cervical spine fracture were incorporated in the decision model on the basis of hypothetical trauma mechanism and clinical findings. Radiation effects were assessed separately for males and females for four age groups (20, 40, 60, and 80 yr old). Effective dose from radiography amounts to 0.050 mSv and from a typical CT scan to 3.8 mSv. The use of CT in a hypothetical cohort of 10{sup 6} patients prevents approximately 130 incidents of paralysis in the low risk group (a priori fracture probability of 0.5%), 500 in the moderate risk group (a priori fracture probability of 2%), and 5100 in the high risk group (a priori fracture probability of 20%). The expense of this CT-based prevention is 15-32 additional radiogenic lethal cancer incidents. According to the decision model calculations, the use of CT is more favorable over the use of radiography alone or radiography with CT by a factor of 13, for low risk 20 yr old patients, to a factor of 23, for high risk patients younger than 80 yr old. The radiography/CT imaging strategy slightly outperforms plain radiography for high and moderate risk patients. Regardless of the patient age, sex, and fracture risk, the higher diagnostic accuracy obtained by the CT examination counterbalances the increase in dose compared to plain radiography or radiography followed by CT only for positive radiographs and renders CT utilization justified and the radiographic screening redundant.« less

Multiple supervised residual network for osteosarcoma segmentation in CT images.

PubMed

Zhang, Rui; Huang, Lin; Xia, Wei; Zhang, Bo; Qiu, Bensheng; Gao, Xin

2018-01-01

Automatic and accurate segmentation of osteosarcoma region in CT images can help doctor make a reasonable treatment plan, thus improving cure rate. In this paper, a multiple supervised residual network (MSRN) was proposed for osteosarcoma image segmentation. Three supervised side output modules were added to the residual network. The shallow side output module could extract image shape features, such as edge features and texture features. The deep side output module could extract semantic features. The side output module could compute the loss value between output probability map and ground truth and back-propagate the loss information. Then, the parameters of residual network could be modified by gradient descent method. This could guide the multi-scale feature learning of the network. The final segmentation results were obtained by fusing the results output by the three side output modules. A total of 1900 CT images from 15 osteosarcoma patients were used to train the network and a total of 405 CT images from another 8 osteosarcoma patients were used to test the network. Results indicated that MSRN enabled a dice similarity coefficient (DSC) of 89.22%, a sensitivity of 88.74% and a F1-measure of 0.9305, which were larger than those obtained by fully convolutional network (FCN) and U-net. Thus, MSRN for osteosarcoma segmentation could give more accurate results than FCN and U-Net. Copyright © 2018 Elsevier Ltd. All rights reserved.

Identifying and classifying hyperostosis frontalis interna via computerized tomography.

PubMed

May, Hila; Peled, Nathan; Dar, Gali; Hay, Ori; Abbas, Janan; Masharawi, Youssef; Hershkovitz, Israel

2010-12-01

The aim of this study was to recognize the radiological characteristics of hyperostosis frontalis interna (HFI) and to establish a valid and reliable method for its identification and classification. A reliability test was carried out on 27 individuals who had undergone a head computerized tomography (CT) scan. Intra-observer reliability was obtained by examining the images three times, by the same researcher, with a 2-week interval between each sample ranking. The inter-observer test was performed by three independent researchers. A validity test was carried out using two methods for identifying and classifying HFI: 46 cadaver skullcaps were ranked twice via computerized tomography scans and then by direct observation. Reliability and validity were calculated using Kappa test (SPSS 15.0). Reliability tests of ranking HFI via CT scans demonstrated good results (K > 0.7). As for validity, a very good consensus was obtained between the CT and direct observation, when moderate and advanced types of HFI were present (K = 0.82). The suggested classification method for HFI, using CT, demonstrated a sensitivity of 84%, specificity of 90.5%, and positive predictive value of 91.3%. In conclusion, volume rendering is a reliable and valid tool for identifying HFI. The suggested three-scale classification is most suitable for radiological diagnosis of the phenomena. Considering the increasing awareness of HFI as an early indicator of a developing malady, this study may assist radiologists in identifying and classifying the phenomena.

Comparison of quantitative myocardial perfusion imaging CT to fluorescent microsphere-based flow from high-resolution cryo-images

NASA Astrophysics Data System (ADS)

Eck, Brendan L.; Fahmi, Rachid; Levi, Jacob; Fares, Anas; Wu, Hao; Li, Yuemeng; Vembar, Mani; Dhanantwari, Amar; Bezerra, Hiram G.; Wilson, David L.

2016-03-01

Myocardial perfusion imaging using CT (MPI-CT) has the potential to provide quantitative measures of myocardial blood flow (MBF) which can aid the diagnosis of coronary artery disease. We evaluated the quantitative accuracy of MPI-CT in a porcine model of balloon-induced LAD coronary artery ischemia guided by fractional flow reserve (FFR). We quantified MBF at baseline (FFR=1.0) and under moderate ischemia (FFR=0.7) using MPI-CT and compared to fluorescent microsphere-based MBF from high-resolution cryo-images. Dynamic, contrast-enhanced CT images were obtained using a spectral detector CT (Philips Healthcare). Projection-based mono-energetic images were reconstructed and processed to obtain MBF. Three MBF quantification approaches were evaluated: singular value decomposition (SVD) with fixed Tikhonov regularization (ThSVD), SVD with regularization determined by the L-Curve criterion (LSVD), and Johnson-Wilson parameter estimation (JW). The three approaches over-estimated MBF compared to cryo-images. JW produced the most accurate MBF, with average error 33.3+/-19.2mL/min/100g, whereas LSVD and ThSVD had greater over-estimation, 59.5+/-28.3mL/min/100g and 78.3+/-25.6 mL/min/100g, respectively. Relative blood flow as assessed by a flow ratio of LAD-to-remote myocardium was strongly correlated between JW and cryo-imaging, with R2=0.97, compared to R2=0.88 and 0.78 for LSVD and ThSVD, respectively. We assessed tissue impulse response functions (IRFs) from each approach for sources of error. While JW was constrained to physiologic solutions, both LSVD and ThSVD produced IRFs with non-physiologic properties due to noise. The L-curve provided noise-adaptive regularization but did not eliminate non-physiologic IRF properties or optimize for MBF accuracy. These findings suggest that model-based MPI-CT approaches may be more appropriate for quantitative MBF estimation and that cryo-imaging can support the development of MPI-CT by providing spatial distributions of MBF.

Estimating the effective radiation dose imparted to patients by intraoperative cone-beam computed tomography in thoracolumbar spinal surgery.

PubMed

Lange, Jeffrey; Karellas, Andrew; Street, John; Eck, Jason C; Lapinsky, Anthony; Connolly, Patrick J; Dipaola, Christian P

2013-03-01

Observational. To estimate the radiation dose imparted to patients during typical thoracolumbar spinal surgical scenarios. Minimally invasive techniques continue to become more common in spine surgery. Computer-assisted navigation systems coupled with intraoperative cone-beam computed tomography (CT) represent one such method used to aid in instrumented spinal procedures. Some studies indicate that cone-beam CT technology delivers a relatively low dose of radiation to patients compared with other x-ray-based imaging modalities. The goal of this study was to estimate the radiation exposure to the patient imparted during typical posterior thoracolumbar instrumented spinal procedures, using intraoperative cone-beam CT and to place these values in the context of standard CT doses. Cone-beam CT scans were obtained using Medtronic O-arm (Medtronic, Minneapolis, MN). Thermoluminescence dosimeters were placed in a linear array on a foam-plastic thoracolumbar spine model centered above the radiation source for O-arm presets of lumbar scans for small or large patients. In-air dosimeter measurements were converted to skin surface measurements, using published conversion factors. Dose-length product was calculated from these values. Effective dose was estimated using published effective dose to dose-length product conversion factors. Calculated dosages for many full-length procedures using the small-patient setting fell within the range of published effective doses of abdominal CT scans (1-31 mSv). Calculated dosages for many full-length procedures using the large-patient setting fell within the range of published effective doses of abdominal CT scans when the number of scans did not exceed 3. We have demonstrated that single cone-beam CT scans and most full-length posterior instrumented spinal procedures using O-arm in standard mode would likely impart a radiation dose within the range of those imparted by a single standard CT scan of the abdomen. Radiation dose increases with patient size, and the radiation dose received by larger patients as a result of more than 3 O-arm scans in standard mode may exceed the dose received during standard CT of the abdomen. Understanding radiation imparted to patients by cone-beam CT is important for assessing risks and benefits of this technology, especially when spinal surgical procedures require multiple intraoperative scans.

SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

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

Wang, H; Barbee, D; Wang, W

Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CTmore » for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.« less

Prognostic implications of 62Cu-diacetyl-bis (N4-methylthiosemicarbazone) PET/CT in patients with glioma.

PubMed

Toriihara, Akira; Ohtake, Makoto; Tateishi, Kensuke; Hino-Shishikura, Ayako; Yoneyama, Tomohiro; Kitazume, Yoshio; Inoue, Tomio; Kawahara, Nobutaka; Tateishi, Ukihide

2018-05-01

The potential of positron emission tomography/computed tomography using 62 Cu-diacetyl-bis (N 4 -methylthiosemicarbazone) ( 62 Cu-ATSM PET/CT), which was originally developed as a hypoxic tracer, to predict therapeutic resistance and prognosis has been reported in various cancers. Our purpose was to investigate prognostic value of 62 Cu-ATSM PET/CT in patients with glioma, compared to PET/CT using 2-deoxy-2-[ 18 F]fluoro-D-glucose ( 18 F-FDG). 56 patients with glioma of World Health Organization grade 2-4 were enrolled. All participants had undergone both 62 Cu-ATSM PET/CT and 18 F-FDG PET/CT within mean 33.5 days prior to treatment. Maximum standardized uptake value and tumor/background ratio were calculated within areas of increased radiotracer uptake. The prognostic significance for progression-free survival and overall survival were assessed by log-rank test and Cox's proportional hazards model. Disease progression and death were confirmed in 37 and 27 patients in follow-up periods, respectively. In univariate analysis, there was significant difference of both progression-free survival and overall survival in age, tumor grade, history of chemoradiotherapy, maximum standardized uptake value and tumor/background ratio calculated using 62 Cu-ATSM PET/CT. Multivariate analysis revealed that maximum standardized uptake value calculated using 62 Cu-ATSM PET/CT was an independent predictor of both progression-free survival and overall survival (p < 0.05). In a subgroup analysis including patients of grade 4 glioma, only the maximum standardized uptake values calculated using 62 Cu-ATSM PET/CT showed significant difference of progression-free survival (p < 0.05). 62 Cu-ATSM PET/CT is a more promising imaging method to predict prognosis of patients with glioma compared to 18 F-FDG PET/CT.

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis

PubMed Central

Vensby, Philip H; Schmidt, Grethe; Kjær, Andreas; Fischer, Barbara M

2017-01-01

The incidence of melanoma (MM) is among the fastest rising cancers in the western countries. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. However, research on the value of PET/CT in follow-up of melanoma patients is limited. This study assesses the diagnostic value of PET/CT for follow-up after melanoma surgery. This retrospective study includes patients with MM who performed at least one PET/CT scan after initial surgery and staging. PET/CT findings were compared to histology, MRI or fine needle aspiration (FNA) to estimate the diagnostic accuracy. The diagnostic performance of PET/CT performed in patients with and without a clinical suspicion of relapse was compared. 238 patients (526 scans) were included. Of the 526 scans 130 (25%) scans were PET-positive, 365 (69%) PET-negative, and 28 (5%) had equivocal findings. Sensitivity was 89% [0.82-0.94], specificity 92% [0.89-0.95], positive and negative predictive values of 78% [0.70-0.84] and 97% [0.94-0.98] respectively. When stratified for reason of referral there was no statistical significant difference in the diagnostic accuracy of PET/CT between patients referred with or without a clinical suspicion of relapse. This study demonstrates that PET/CT despite a moderate sensitivity has a high negative predictive value in the follow-up of melanoma patients. Thus, a negative PET/CT-scan essentially rules out relapse. However, the frequency of false positive findings is relatively high, especially among patients undergoing a “routine” PET/CT with no clinical suspicion of relapse, potentially causing anxiety and leading to further diagnostic procedures. PMID:29348980

The value of FDG PET/CT for follow-up of patients with melanoma: a retrospective analysis.

PubMed

Vensby, Philip H; Schmidt, Grethe; Kjær, Andreas; Fischer, Barbara M

2017-01-01

The incidence of melanoma (MM) is among the fastest rising cancers in the western countries. Positron Emission Tomography with Computed Tomography (PET/CT) is a valuable non-invasive tool for the diagnosis and staging of patients with MM. However, research on the value of PET/CT in follow-up of melanoma patients is limited. This study assesses the diagnostic value of PET/CT for follow-up after melanoma surgery. This retrospective study includes patients with MM who performed at least one PET/CT scan after initial surgery and staging. PET/CT findings were compared to histology, MRI or fine needle aspiration (FNA) to estimate the diagnostic accuracy. The diagnostic performance of PET/CT performed in patients with and without a clinical suspicion of relapse was compared. 238 patients (526 scans) were included. Of the 526 scans 130 (25%) scans were PET-positive, 365 (69%) PET-negative, and 28 (5%) had equivocal findings. Sensitivity was 89% [0.82-0.94], specificity 92% [0.89-0.95], positive and negative predictive values of 78% [0.70-0.84] and 97% [0.94-0.98] respectively. When stratified for reason of referral there was no statistical significant difference in the diagnostic accuracy of PET/CT between patients referred with or without a clinical suspicion of relapse. This study demonstrates that PET/CT despite a moderate sensitivity has a high negative predictive value in the follow-up of melanoma patients. Thus, a negative PET/CT-scan essentially rules out relapse. However, the frequency of false positive findings is relatively high, especially among patients undergoing a "routine" PET/CT with no clinical suspicion of relapse, potentially causing anxiety and leading to further diagnostic procedures.

Absorption spectrometric and thermodynamic study of charge transfer complexes of menadione (Vitamin K 3) with a series of phenols

NASA Astrophysics Data System (ADS)

Pal, Purnendu; Bhattacharya, Sumanta; Mukherjee, Asok K.; Mukherjee, Dulal C.

2005-03-01

The electron donor-acceptor (EDA) interactions between menadione (i.e., 2-methyl-1,4-naphthoquinone, which is also called 'Vitamin K 3') and a series of phenols (viz., phenol, resorcinol and p-quinol) have been studied in CCl 4 medium. In all the cases, charge transfer (CT) bands have been located. The CT transition energies ( hνCT) of the complexes are found to change systematically with change in the number and position of the -OH groups in the aromatic ring of the phenol moiety. From the trends in the hνCT values, the Hückel parameters ( hÖ and kC-Ö) for the -OH group have been obtained. The CT transition energies are well correlated with the ionisation potentials of the phenols. From an analysis of this variation the electron affinity of Vitamin K 3 has been found to be 2.28 eV. The stoichiometry of the complexes in each case has been found to be 1(menadione):2 (phenol). Formation constants of the complexes have been determined at four different temperatures from which the enthalpies and entropies of formation of the complexes have been estimated.

Absorption spectrometric and thermodynamic study of charge transfer complexes of menadione (Vitamin K3) with a series of phenols.

PubMed

Pal, Purnendu; Bhattacharya, Sumanta; Mukherjee, Asok K; Mukherjee, Dulal C

2005-03-01

The electron donor-acceptor (EDA) interactions between menadione (i.e., 2-methyl-1,4-naphthoquinone, which is also called 'Vitamin K3') and a series of phenols (viz., phenol, resorcinol and p-quinol) have been studied in CCl4 medium. In all the cases, charge transfer (CT) bands have been located. The CT transition energies (h nu(CT)) of the complexes are found to change systematically with change in the number and position of the -OH groups in the aromatic ring of the phenol moiety. From the trends in the h nu(CT) values, the Hückel parameters (h(O) and k(C-O)) for the -OH group have been obtained. The CT transition energies are well correlated with the ionisation potentials of the phenols. From an analysis of this variation the electron affinity of Vitamin K3 has been found to be 2.28 eV. The stoichiometry of the complexes in each case has been found to be 1(menadione):2 (phenol). Formation constants of the complexes have been determined at four different temperatures from which the enthalpies and entropies of formation of the complexes have been estimated.

Quantitative assessment of scatter correction techniques incorporated in next generation dual-source computed tomography

NASA Astrophysics Data System (ADS)

Mobberley, Sean David

Accurate, cross-scanner assessment of in-vivo air density used to quantitatively assess amount and distribution of emphysema in COPD subjects has remained elusive. Hounsfield units (HU) within tracheal air can be considerably more positive than -1000 HU. With the advent of new dual-source scanners which employ dedicated scatter correction techniques, it is of interest to evaluate how the quantitative measures of lung density compare between dual-source and single-source scan modes. This study has sought to characterize in-vivo and phantom-based air metrics using dual-energy computed tomography technology where the nature of the technology has required adjustments to scatter correction. Anesthetized ovine (N=6), swine (N=13: more human-like rib cage shape), lung phantom and a thoracic phantom were studied using a dual-source MDCT scanner (Siemens Definition Flash. Multiple dual-source dual-energy (DSDE) and single-source (SS) scans taken at different energy levels and scan settings were acquired for direct quantitative comparison. Density histograms were evaluated for the lung, tracheal, water and blood segments. Image data were obtained at 80, 100, 120, and 140 kVp in the SS mode (B35f kernel) and at 80, 100, 140, and 140-Sn (tin filtered) kVp in the DSDE mode (B35f and D30f kernels), in addition to variations in dose, rotation time, and pitch. To minimize the effect of cross-scatter, the phantom scans in the DSDE mode was obtained by reducing the tube current of one of the tubes to its minimum (near zero) value. When using image data obtained in the DSDE mode, the median HU values in the tracheal regions of all animals and the phantom were consistently closer to -1000 HU regardless of reconstruction kernel (chapters 3 and 4). Similarly, HU values of water and blood were consistently closer to their nominal values of 0 HU and 55 HU respectively. When using image data obtained in the SS mode the air CT numbers demonstrated a consistent positive shift of up to 35 HU with respect to the nominal -1000 HU value. In vivo data demonstrated considerable variability in tracheal, influenced by local anatomy with SS mode scanning while tracheal air was more consistent with DSDE imaging. Scatter effects in the lung parenchyma differed from adjacent tracheal measures. In summary, data suggest that enhanced scatter correction serves to provide more accurate CT lung density measures sought to quantitatively assess the presence and distribution of emphysema in COPD subjects. Data further suggest that CT images, acquired without adequate scatter correction, cannot be corrected by linear algorithms given the variability in tracheal air HU values and the independent scatter effects on lung parenchyma.

Diagnostic value of 18F-FDG-PET/CT for the follow-up and restaging of soft tissue sarcomas in adults.

PubMed

Kassem, T W; Abdelaziz, O; Emad-Eldin, S

2017-10-01

The purpose of this study was to evaluate the clinical utility of 2-[ 18 F] fluoro-2-deoxy-D-glucose ( 18 FDG) positron emission tomography (PET)/computed tomography (CT) ( 18 F-FDG-PET/CT) in the follow-up of adult patients with soft tissue sarcomas. We prospectively evaluated 37 consecutive patients with known soft tissue sarcoma with 18 F-FDG-PET/CT examination for suspected recurrence of disease. They were 21 men and 16 women with a mean age of 49.6±10.6 (SD) years (range, 34-75years). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 18 F-FDG-PET/CT examination were calculated on a per patient basis. 18 F-FDG-PET/CT showed an overall diagnostic accuracy of 91.8%, sensitivity of 90% and a specificity of 100%. The positive predictive value and negative predictive value were 100 and 70%, respectively. The 18 F-FDG-PET/CT interpretations were correct in 34/37 patients (91.8%). Incorrect interpretations occurred in three patients (8.1%). Reasons for false negative findings were low 18 F-FDG uptake of local recurrence in one patient and low 18 F-FDG uptake of subcentimetric inguinal lymph node metastases. 18 F-FDG-PET/CT has a high diagnostic value in the follow-up of patients with soft tissue sarcoma. Copyright © 2017 Editions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Fracture network created by 3D printer and its validation using CT images

NASA Astrophysics Data System (ADS)

Suzuki, A.; Watanabe, N.; Li, K.; Horne, R. N.

2017-12-01

Understanding flow mechanisms in fractured media is essential for geoscientific research and geological development industries. This study used 3D printed fracture networks in order to control the properties of fracture distributions inside the sample. The accuracy and appropriateness of creating samples by the 3D printer was investigated by using a X-ray CT scanner. The CT scan images suggest that the 3D printer is able to reproduce complex three-dimensional spatial distributions of fracture networks. Use of hexane after printing was found to be an effective way to remove wax for the post-treatment. Local permeability was obtained by the cubic law and used to calculate the global mean. The experimental value of the permeability was between the arithmetic and geometric means of the numerical results, which is consistent with conventional studies. This methodology based on 3D printed fracture networks can help validate existing flow modeling and numerical methods.

Our transthoracic biopsy practices accompanied by the imaging process: The contribution of positron emission tomography usage to accurate diagnosis.

PubMed

İntepe, Yavuz Selim; Metin, Bayram; Şahin, Sevinç; Kaya, Buğra; Okur, Aylin

2016-08-01

The objective of this study was to compare the results of transthoracic biopsies performed through the use of FDG PET/CT imaging with the results of transthoracic needle biopsy performed without using the FDG PET/CT imaging. The medical files of a total of 58 patients with pulmonary and mediastinal masses. A total of 20 patients, who were suspected of malignancy with the SUVmax value of over 2.5 in FDG PET/CT, underwent a biopsy process. Twelve patients with no suspicion of malignancy in accordance with CT images and with the SUVmax value below 2.5 underwent no biopsy procedure, and hence, they were excluded from the study. On the other hand, 26 patients directly went through a biopsy process with the suspicion of malignancy according to CT imaging, regardless of performing any FDG PET/CT imaging. According to the biopsy results, the number of the patients diagnosed with cancer was 20 (43.5%), while the number of non-cancerous patients was 26 (56.5%). When these findings were considered, it was determined that the sensitivity of the whole TTNB (transthoracic needle biopsy) was 80.8%, and the specificity was found as 100%. The positive predictive value of the whole TTNB was 100%, while its negative predictive value was found to be 80%. The sensitivity in TTNB performed together with FDG PET/CT was 90.9%, whereas the specificity was 100%. The positive predictive value of TTNB with FDG PET/CT was 100%, while its negative predictive value was found to be 81.8%. The sensitivity in TTNB performed without the use of FDG PET/CT was 73.3%, whereas the specificity was determined as 100%. Performing FDG PET/CT imaging process prior to a transthoracic biopsy as well as preferring FDG PET/CT for the spot on which the biopsy will be performed during the transthoracic biopsy procedure increases the rate of receiving accurate diagnosis.

The effects of variations in parameters and algorithm choices on calculated radiomics feature values: initial investigations and comparisons to feature variability across CT image acquisition conditions

NASA Astrophysics Data System (ADS)

Emaminejad, Nastaran; Wahi-Anwar, Muhammad; Hoffman, John; Kim, Grace H.; Brown, Matthew S.; McNitt-Gray, Michael

2018-02-01

Translation of radiomics into clinical practice requires confidence in its interpretations. This may be obtained via understanding and overcoming the limitations in current radiomic approaches. Currently there is a lack of standardization in radiomic feature extraction. In this study we examined a few factors that are potential sources of inconsistency in characterizing lung nodules, such as 1)different choices of parameters and algorithms in feature calculation, 2)two CT image dose levels, 3)different CT reconstruction algorithms (WFBP, denoised WFBP, and Iterative). We investigated the effect of variation of these factors on entropy textural feature of lung nodules. CT images of 19 lung nodules identified from our lung cancer screening program were identified by a CAD tool and contours provided. The radiomics features were extracted by calculating 36 GLCM based and 4 histogram based entropy features in addition to 2 intensity based features. A robustness index was calculated across different image acquisition parameters to illustrate the reproducibility of features. Most GLCM based and all histogram based entropy features were robust across two CT image dose levels. Denoising of images slightly improved robustness of some entropy features at WFBP. Iterative reconstruction resulted in improvement of robustness in a fewer times and caused more variation in entropy feature values and their robustness. Within different choices of parameters and algorithms texture features showed a wide range of variation, as much as 75% for individual nodules. Results indicate the need for harmonization of feature calculations and identification of optimum parameters and algorithms in a radiomics study.

Quantification of osteoblastic activity in epiphyseal growth plates by quantitative bone SPECT/CT.

PubMed

Yamane, Tomohiko; Kuji, Ichiei; Seto, Akira; Matsunari, Ichiro

2018-06-01

Quantifying the function of the epiphyseal plate is worthwhile for the management of children with growth disorders. The aim of this retrospective study was to quantify the osteoblastic activity at the epiphyseal plate using the quantitative bone SPECT/CT. We enrolled patients under the age of 20 years who received Tc-99m hydroxymethylene diphosphonate bone scintigraphy acquired by a quantitative SPECT/CT scanner. The images were reconstructed by ordered subset conjugate-gradient minimizer, and the uptake on the distal margin of the femur was quantified by peak standardized uptake value (SUVpeak). A public database of standard body height was used to calculate growth velocities (cm/year). Fifteen patients (6.9-19.7 years, 9 female, 6 male) were enrolled and a total of 25 legs were analyzed. SUVpeak in the epiphyseal plate was 18.9 ± 2.4 (average ± standard deviation) in the subjects under 15 years and decreased gradually by aging. The SUVpeak correlated significantly with the age- and sex-matched growth velocity obtained from the database (R 2  = 0.83, p < 0.0001). The SUV measured by quantitative bone SPECT/CT was increased at the epiphyseal plates of children under the age of 15 years in comparison with the older group, corresponding to higher osteoblastic activity. Moreover, this study suggested a correlation between growth velocity and the SUV. Although this is a small retrospective pilot study, the objective and quantitative values measured by the quantitative bone SPECT/CT has the potential to improve the management of children with growth disorder.

Triphenylamine-based fluorescent NLO phores with ICT characteristics: Solvatochromic and theoretical study

NASA Astrophysics Data System (ADS)

Katariya, Santosh B.; Patil, Dinesh; Rhyman, Lydia; Alswaidan, Ibrahim A.; Ramasami, Ponnadurai; Sekar, Nagaiyan

2017-12-01

The static first and second hyperpolarizability and their related properties were calculated for triphenylamine-based "push-pull" dyes using the B3LYP, CAM-B3LYP and BHHLYP functionals in conjunction with the 6-311+G(d,p) basis set. The electronic coupling for the electron transfer reaction of the dyes were calculated with the generalized Mulliken-Hush method. The results obtained were correlated with the polarizability parameter αCT , first hyperpolarizability parameter βCT, and the solvatochromic descriptor of 〈 γ〉 SD obtained by the solvatochromic method. The dyes studied show a high total first order hyperpolarizability (70-238 times) and second order hyperpolarizability (412-778 times) compared to urea. Among the three functionals, the CAM-B3LYP and BHHLYP functionals show hyperpolarizability values closer to experimental values. Experimental absorption and emission wavelengths measured for all the synthesized dyes are in good agreement with those predicted using the time-dependent density functional theory. The theoretical examination on non-linear optical properties was performed on the key parameters of polarizability and hyperpolarizability. A remarkable increase in non-linear optical response is observed on insertion of benzothiazole unit compared to benzimidazole unit.

Optical differentiation between malignant and benign lymphadenopathy by grey scale texture analysis of endobronchial ultrasound convex probe images.

PubMed

Nguyen, Phan; Bashirzadeh, Farzad; Hundloe, Justin; Salvado, Olivier; Dowson, Nicholas; Ware, Robert; Masters, Ian Brent; Bhatt, Manoj; Kumar, Aravind Ravi; Fielding, David

2012-03-01

Morphologic and sonographic features of endobronchial ultrasound (EBUS) convex probe images are helpful in predicting metastatic lymph nodes. Grey scale texture analysis is a well-established methodology that has been applied to ultrasound images in other fields of medicine. The aim of this study was to determine if this methodology could differentiate between benign and malignant lymphadenopathy of EBUS images. Lymph nodes from digital images of EBUS procedures were manually mapped to obtain a region of interest and were analyzed in a prediction set. The regions of interest were analyzed for the following grey scale texture features in MATLAB (version 7.8.0.347 [R2009a]): mean pixel value, difference between maximal and minimal pixel value, SEM pixel value, entropy, correlation, energy, and homogeneity. Significant grey scale texture features were used to assess a validation set compared with fluoro-D-glucose (FDG)-PET-CT scan findings where available. Fifty-two malignant nodes and 48 benign nodes were in the prediction set. Malignant nodes had a greater difference in the maximal and minimal pixel values, SEM pixel value, entropy, and correlation, and a lower energy (P < .0001 for all values). Fifty-one lymph nodes were in the validation set; 44 of 51 (86.3%) were classified correctly. Eighteen of these lymph nodes also had FDG-PET-CT scan assessment, which correctly classified 14 of 18 nodes (77.8%), compared with grey scale texture analysis, which correctly classified 16 of 18 nodes (88.9%). Grey scale texture analysis of EBUS convex probe images can be used to differentiate malignant and benign lymphadenopathy. Preliminary results are comparable to FDG-PET-CT scan.

Quantitative computed tomography of lung parenchyma in patients with emphysema: analysis of higher-density lung regions

NASA Astrophysics Data System (ADS)

Lederman, Dror; Leader, Joseph K.; Zheng, Bin; Sciurba, Frank C.; Tan, Jun; Gur, David

2011-03-01

Quantitative computed tomography (CT) has been widely used to detect and evaluate the presence (or absence) of emphysema applying the density masks at specific thresholds, e.g., -910 or -950 Hounsfield Unit (HU). However, it has also been observed that subjects with similar density-mask based emphysema scores could have varying lung function, possibly indicating differences of disease severity. To assess this possible discrepancy, we investigated whether density distribution of "viable" lung parenchyma regions with pixel values > -910 HU correlates with lung function. A dataset of 38 subjects, who underwent both pulmonary function testing and CT examinations in a COPD SCCOR study, was assembled. After the lung regions depicted on CT images were automatically segmented by a computerized scheme, we systematically divided the lung parenchyma into different density groups (bins) and computed a number of statistical features (i.e., mean, standard deviation (STD), skewness of the pixel value distributions) in these density bins. We then analyzed the correlations between each feature and lung function. The correlation between diffusion lung capacity (DLCO) and STD of pixel values in the bin of -910HU <= PV < -750HU was -0.43, as compared with a correlation of -0.49 obtained between the post-bronchodilator ratio (FEV1/FVC) measured by the forced expiratory volume in 1 second (FEV1) dividing the forced vital capacity (FVC) and the STD of pixel values in the bin of -1024HU <= PV < -910HU. The results showed an association between the distribution of pixel values in "viable" lung parenchyma and lung function, which indicates that similar to the conventional density mask method, the pixel value distribution features in "viable" lung parenchyma areas may also provide clinically useful information to improve assessments of lung disease severity as measured by lung functional tests.

Corneal thickness differences between sexes after oxybuprocaine eye drops.

PubMed

Fernandez-Garcia, Pablo; Cerviño, Alejandro; Quiles-Guiñau, Laura; Albarran-Diego, Cesar; Garcia-Lazaro, Santiago; Sanchis-Gimeno, Juan A

2015-01-01

We aimed to analyze the corneal thickness (CT) values of female and male subjects before and after instillation of oxybuprocaine 0.4% anesthetic eye drops. The CT of 30 female subjects and 28 male subjects was measured using scanning-slit corneal topography (Orbscan Topography System II, Orbscan, Inc, Salt Lake City, UT). Measurements were carried out before and 3 minutes after the instillation of oxybuprocaine 0.4% eye drops. The difference between the baseline values and those obtained after anesthesia ranged as follows: male subjects: central, -26 to +24 μm; superior, -24 to +23 μm; inferior, -19 to +20 μm; nasal, -25 to +30 μm; and temporal, -21 to +20 μm; female subjects: central, -16 to +24 μm; superior, -19 to +32 μm; inferior, -14 to +34 μm; nasal, -19 to +33 μm; and temporal, -36 to +16 μm. No significant differences were found in any corneal location in male subjects. The differences were significant at inferior (p = 0.001) and nasal (p = 0.011) corneal sites in female subjects. Oxybuprocaine anesthetic eye drops induce significant CT increases in female subjects but not in male subjects.

SU-E-J-100: The Combination of Deformable Image Registration and Regions-Of-Interest Mapping Technique to Accomplish Accurate Dose Calculation On Cone Beam Computed Tomography for Esophageal Cancer

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

Huang, B-T; Lu, J-Y

Purpose: We introduce a new method combined with the deformable image registration (DIR) and regions-of-interest mapping (ROIM) technique to accurately calculate dose on daily CBCT for esophageal cancer. Methods: Patients suffered from esophageal cancer were enrolled in the study. Prescription was set to 66 Gy/30 F and 54 Gy/30 F to the primary tumor (PTV66) and subclinical disease (PTV54) . Planning CT (pCT) were segmented into 8 substructures in terms of their differences in physical density, such as gross target volume (GTV), venae cava superior (SVC), aorta, heart, spinal cord, lung, muscle and bones. The pCT and its substructures weremore » transferred to the MIM software to readout their mean HU values. Afterwards, a deformable planning CT to daily KV-CBCT image registration method was then utilized to acquire a new structure set on CBCT. The newly generated structures on CBCT were then transferred back to the treatment planning system (TPS) and its HU information were overridden manually with mean HU values obtained from pCT. Finally, the treatment plan was projected onto the CBCT images with the same beam arrangements and monitor units (MUs) to accomplish dose calculation. Planning target volume (PTV) and organs at risk (OARs) from both of the pCT and CBCT were compared to evaluate the dose calculation accuracy. Results: It was found that the dose distribution in the CBCT showed little differences compared to the pCT, regardless of whether PTV or OARs were concerned. Specifically, dose variation in GTV, PTV54, PTV66, SVC, lung and heart were within 0.1%. The maximum dose variation was presented in the spinal cord, which was up to 2.7% dose difference. Conclusion: The proposed method combined with DIR and ROIM technique to accurately calculate dose distribution on CBCT for esophageal cancer is feasible.« less

Simultaneous whole-body time-of-flight 18F-FDG PET/MRI: a pilot study comparing SUVmax with PET/CT and assessment of MR image quality.

PubMed

Iagaru, Andrei; Mittra, Erik; Minamimoto, Ryogo; Jamali, Mehran; Levin, Craig; Quon, Andrew; Gold, Garry; Herfkens, Robert; Vasanawala, Shreyas; Gambhir, Sanjiv Sam; Zaharchuk, Greg

2015-01-01

The recent introduction of hybrid PET/MRI scanners in clinical practice has shown promising initial results for several clinical scenarios. However, the first generation of combined PET/MRI lacks time-of-flight (TOF) technology. Here we report the results of the first patients to be scanned on a completely novel fully integrated PET/MRI scanner with TOF. We analyzed data from patients who underwent a clinically indicated F FDG PET/CT, followed by PET/MRI. Maximum standardized uptake values (SUVmax) were measured from F FDG PET/MRI and F FDG PET/CT for lesions, cerebellum, salivary glands, lungs, aortic arch, liver, spleen, skeletal muscle, and fat. Two experienced radiologists independently reviewed the MR data for image quality. Thirty-six patients (19 men, 17 women, mean [±standard deviation] age of 61 ± 14 years [range: 27-86 years]) with a total of 69 discrete lesions met the inclusion criteria. PET/CT images were acquired at a mean (±standard deviation) of 74 ± 14 minutes (range: 49-100 minutes) after injection of 10 ± 1 mCi (range: 8-12 mCi) of F FDG. PET/MRI scans started at 161 ± 29 minutes (range: 117 - 286 minutes) after the F FDG injection. All lesions identified on PET from PET/CT were also seen on PET from PET/MRI. The mean SUVmax values were higher from PET/MRI than PET/CT for all lesions. No degradation of MR image quality was observed. The data obtained so far using this investigational PET/MR system have shown that the TOF PET system is capable of excellent performance during simultaneous PET/MR with routine pulse sequences. MR imaging was not compromised. Comparison of the PET images from PET/CT and PET/MRI show no loss of image quality for the latter. These results support further investigation of this novel fully integrated TOF PET/MRI instrument.

Stereological assessment of mouse lung parenchyma via nondestructive, multiscale micro-CT imaging validated by light microscopic histology

PubMed Central

Vasilescu, Dragoş M.; Klinge, Christine; Knudsen, Lars; Yin, Leilei; Wang, Ge; Weibel, Ewald R.; Ochs, Matthias

2013-01-01

Quantitative assessment of the lung microstructure using standard stereological methods such as volume fractions of tissue, alveolar surface area, or number of alveoli, are essential for understanding the state of normal and diseased lung. These measures are traditionally obtained from histological sections of the lung tissue, a process that ultimately destroys the three-dimensional (3-D) anatomy of the tissue. In comparison, a novel X-ray-based imaging method that allows nondestructive sectioning and imaging of fixed lungs at multiple resolutions can overcome this limitation. Scanning of the whole lung at high resolution and subsequent regional sampling at ultrahigh resolution without physically dissecting the organ allows the application of design-based stereology for assessment of the whole lung structure. Here we validate multiple stereological estimates performed on micro–computed tomography (μCT) images by comparing them with those obtained via conventional histology on the same mouse lungs. We explore and discuss the potentials and limitations of the two approaches. Histological examination offers higher resolution and the qualitative differentiation of tissues by staining, but ultimately loses 3-D tissue relationships, whereas μCT allows for the integration of morphometric data with the spatial complexity of lung structure. However, μCT has limited resolution satisfactory for the sterological estimates presented in this study but not for differentiation of tissues. We conclude that introducing stereological methods in μCT studies adds value by providing quantitative information on internal structures while not curtailing more complex approaches to the study of lung architecture in the context of physiological or pathological studies. PMID:23264542

SU-E-J-124: FDG PET Metrics Analysis in the Context of An Adaptive PET Protocol for Node Positive Gynecologic Cancer Patients

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

Nawrocki, J; Chino, J; Light, K

2014-06-01

Purpose: To compare PET extracted metrics and investigate the role of a gradient-based PET segmentation tool, PET Edge (MIM Software Inc., Cleveland, OH), in the context of an adaptive PET protocol for node positive gynecologic cancer patients. Methods: An IRB approved protocol enrolled women with gynecological, PET visible malignancies. A PET-CT was obtained for treatment planning prescribed to 45–50.4Gy with a 55– 70Gy boost to the PET positive nodes. An intra-treatment PET-CT was obtained between 30–36Gy, and all volumes re-contoured. Standard uptake values (SUVmax, SUVmean, SUVmedian) and GTV volumes were extracted from the clinician contoured GTVs on the pre- andmore » intra-treament PET-CT for primaries and nodes and compared with a two tailed Wilcoxon signed-rank test. The differences between primary and node GTV volumes contoured in the treatment planning system and those volumes generated using PET Edge were also investigated. Bland-Altman plots were used to describe significant differences between the two contouring methods. Results: Thirteen women were enrolled in this study. The median baseline/intra-treatment primary (SUVmax, mean, median) were (30.5, 9.09, 7.83)/( 16.6, 4.35, 3.74), and nodes were (20.1, 4.64, 3.93)/( 6.78, 3.13, 3.26). The p values were all < 0.001. The clinical contours were all larger than the PET Edge generated ones, with mean difference of +20.6 ml for primary, and +23.5 ml for nodes. The Bland-Altman revealed changes between clinician/PET Edge contours to be mostly within the margins of the coefficient of variability. However, there was a proportional trend, i.e. the larger the GTV, the larger the clinical contours as compared to PET Edge contours. Conclusion: Primary and node SUV values taken from the intratreament PET-CT can be used to assess the disease response and to design an adaptive plan. The PET Edge tool can streamline the contouring process and lead to smaller, less user-dependent contours.« less

LED-CT Scan for pH Distribution on a Cross-Section of Cell Culture Medium.

PubMed

Higashino, Nobuya; Takayama, Toshio; Ito, Hiroaki; Horade, Mitsuhiro; Yamaguchi, Yasutaka; Dylan Tsai, Chia-Hung; Kaneko, Makoto

2018-01-11

In cell culture, the pH of the culture medium is one of the most important conditions. However, the culture medium may have non-uniform pH distribution due to activities of cells and changes in the environment. Although it is possible to measure the pH distribution with an existing pH meter using distributed electrodes, the method involves direct contact with the medium and would greatly increase the risk of contamination. Here in this paper, we propose a computed tomography (CT) scan for measuring pH distribution using the color change of phenol red with a light-emitting diode (LED) light source. Using the principle of CT scan, we can measure pH distribution without contacting culture medium, and thus, decrease the risk of contamination. We have developed the device with a LED, an array of photo receivers and a rotation mechanism. The system is firstly calibrated with different shapes of wooden objects that do not pass light, we succeeded in obtaining their 3D topographies. The system was also used for measuring a culture medium with two different pH values, it was possible to obtain a pH distribution that clearly shows the boundary.

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.

Evaluation of CT Perfusion Biomarkers of Tumor Hypoxia

PubMed Central

Qi, Qi; Yeung, Timothy Pok Chi; Lee, Ting-Yim; Bauman, Glenn; Crukley, Cathie; Morrison, Laura; Hoffman, Lisa; Yartsev, Slav

2016-01-01

Background Tumor hypoxia is associated with treatment resistance to cancer therapies. Hypoxia can be investigated by immunohistopathologic methods but such procedure is invasive. A non-invasive method to interrogate tumor hypoxia is an attractive option as such method can provide information before, during, and after treatment for personalized therapies. Our study evaluated the correlations between computed tomography (CT) perfusion parameters and immunohistopathologic measurement of tumor hypoxia. Methods Wistar rats, 18 controls and 19 treated with stereotactic radiosurgery (SRS), implanted with the C6 glioma tumor were imaged using CT perfusion on average every five days to monitor tumor growth. A final CT perfusion scan and the brain were obtained on average 14 days (8–22 days) after tumor implantation. Tumor hypoxia was detected immunohistopathologically with pimonidazole. The tumor, necrotic, and pimonidazole-positive areas on histology samples were measured. Percent necrotic area and percent hypoxic areas were calculated. Tumor volume (TV), blood flow (BF), blood volume (BV), and permeability-surface area product (PS) were obtained from the CT perfusion studies. Correlations between CT perfusion parameters and histological parameters were assessed by Spearman’s ρ correlation. A Bonferroni-corrected P value < 0.05 was considered significant. Results BF and BV showed significant correlations with percent hypoxic area ρ = -0.88, P < 0.001 and ρ = -0.81, P < 0.001, respectively, for control animals and ρ = -0.7, P < 0.001 and ρ = -0.6, P = 0.003, respectively, for all animals, while TV and BV were correlated (ρ = -0.64, P = 0.01 and ρ = -0.43, P = 0.043, respectively) with percent necrotic area. PS was not correlated with either percent necrotic or percent hypoxic areas. Conclusions Percent hypoxic area provided significant correlations with BF and BV, suggesting that CT perfusion parameters are potential non-invasive imaging biomarkers of tumor hypoxia. PMID:27078858

Computed tomography synthesis from magnetic resonance images in the pelvis using multiple random forests and auto-context features

NASA Astrophysics Data System (ADS)

Andreasen, Daniel; Edmund, Jens M.; Zografos, Vasileios; Menze, Bjoern H.; Van Leemput, Koen

2016-03-01

In radiotherapy treatment planning that is only based on magnetic resonance imaging (MRI), the electron density information usually obtained from computed tomography (CT) must be derived from the MRI by synthesizing a so-called pseudo CT (pCT). This is a non-trivial task since MRI intensities are neither uniquely nor quantitatively related to electron density. Typical approaches involve either a classification or regression model requiring specialized MRI sequences to solve intensity ambiguities, or an atlas-based model necessitating multiple registrations between atlases and subject scans. In this work, we explore a machine learning approach for creating a pCT of the pelvic region from conventional MRI sequences without using atlases. We use a random forest provided with information about local texture, edges and spatial features derived from the MRI. This helps to solve intensity ambiguities. Furthermore, we use the concept of auto-context by sequentially training a number of classification forests to create and improve context features, which are finally used to train a regression forest for pCT prediction. We evaluate the pCT quality in terms of the voxel-wise error and the radiologic accuracy as measured by water-equivalent path lengths. We compare the performance of our method against two baseline pCT strategies, which either set all MRI voxels in the subject equal to the CT value of water, or in addition transfer the bone volume from the real CT. We show an improved performance compared to both baseline pCTs suggesting that our method may be useful for MRI-only radiotherapy.

Utility of CT after sonography for suspected appendicitis in children: integration of a clinical scoring system with a staged imaging protocol.

PubMed

Srinivasan, Abhay; Servaes, Sabah; Peña, Andrès; Darge, Kassa

2015-02-01

To improve diagnosis of pediatric appendicitis, many institutions have implemented a staged imaging protocol utilizing ultrasonography (US) first and then computed tomography (CT). A substantial number of children with suspected appendicitis undergo CT after US, and the efficient and accurate diagnosis of pediatric appendicitis continues to be challenging. The objective of the study is to characterize the utility of CT following US for diagnosis of pediatric appendicitis, in conjunction with a clinical appendicitis score (AS). Imaging studies of children with suspected appendicitis who underwent CT after US in an imaging protocol were retrospectively reviewed by three radiologists in consensus. Chart review derived the AS (range 0-10) and obtained the patient diagnosis and disposition, and an AS was applied to each patient. Clinical and radiologic data were analyzed to assess the yield of CT after US. Studies of 211 children (mean age 11.3 years) were included. The positive threshold for AS was determined to be 6 out of 10. When AS and US were concordant (N = 140), the sensitivity and specificity of US were similar to CT. When AS and US were discordant (N = 71) and also when AS ≥ 6 (N = 84), subsequent CT showed superior sensitivity and specificity to US alone. In the subset where US showed neither the appendix nor inflammatory change in the right lower quadrant (126/211, 60 % of scans), when AS < 6 (N = 83), the negative predictive value (NPV) of US was 0.98. However, when AS ≥ 6 (N = 43), NPV of US was 0.58, and the positive predictive value of subsequent CT was 1. There was a significant decrease in depiction of the appendix on US with patient weight-to-age ratio of >6 (kg/year, P < 0.001) and after-hours (1700 -0730 hours) performance of US (P < 0.001). Results suggest that the appendicitis score has utility in guiding an imaging protocol and support the contention that non-visualization of the appendix on US is not intrinsically non-diagnostic. There was little benefit to additional CT when AS < 6 and US did not show the appendix or evidence of inflammation; this would have avoided CT in 140/211 (66 %) patients. CT demonstrated benefit when AS ≥ 6, suggesting that cases with AS ≥ 6 and features that limit depiction of the appendix on US may be triaged to CT.

TU-H-207A-03: CT Hounsfield Unit Accuracy: Effect of Beam Hardening On Phantom and Clinical Whole-Body CT Images

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

Ai, H; Wendt, R

2016-06-15

Purpose: To assess the effect of beam hardening on measured CT HU values. Methods: An anthropomorphic knee phantom was scanned with the CT component of a GE Discovery 690 PET/CT scanner (120kVp, 300mAs, 40?0.625mm collimation, pitch=0.984, FOV=500mm, matrix=512?512) with four different scan setups, each of which induces different degrees of beam hardening by introducing additional attenuation media into the field of view. Homogeneous voxels representing “soft tissue” and “bone” were segmented by HU thresholding followed by a 3D morphological erosion operation which removes the non-homogenous voxels located on the interface of thresholded tissue mask. HU values of segmented “soft tissue”more » and “bone” were compared.Additionally, whole-body CT data with coverage from the skull apex to the end of toes were retrospectively retrieved from seven PET/CT exams to evaluate the effect of beam hardening in vivo. Homogeneous bone voxels were segmented with the same method previously described. Total In-Slice Attenuation (TISA) for each CT slice, defined as the summation of HU values over all voxels within a CT slice, was calculated for all slices of the seven whole-body CT datasets and evaluated against the mean HU values of homogeneous bone voxels within that slice. Results: HU values measured from the phantom showed that while “soft tissue” HU values were unaffected, added attenuation within the FOV caused noticeable decreases in the measured HU values of “bone” voxels. A linear relationship was observed between bone HU and TISA for slices of the torso and legs, but not of the skull. Conclusion: Beam hardening effect is not an issue of concern for voxels with HU in the soft tissue range, but should not be neglected for bone voxels. A linear relationship exists between bone HU and the associated TISA in non-skull CT slices, which can be exploited to develop a correction strategy.« less

Component extraction on CT volumes of assembled products using geometric template matching

NASA Astrophysics Data System (ADS)

Muramatsu, Katsutoshi; Ohtake, Yutaka; Suzuki, Hiromasa; Nagai, Yukie

2017-03-01

As a method of non-destructive internal inspection, X-ray computed tomography (CT) is used not only in medical applications but also for product inspection. Some assembled products can be divided into separate components based on density, which is known to be approximately proportional to CT values. However, components whose densities are similar cannot be distinguished using the CT value driven approach. In this study, we proposed a new component extraction algorithm from the CT volume, using a set of voxels with an assigned CT value with the surface mesh as the template rather than the density. The method has two main stages: rough matching and fine matching. At the rough matching stage, the position of candidate targets is identified roughly from the CT volume, using the template of the target component. At the fine matching stage, these candidates are precisely matched with the templates, allowing the correct position of the components to be detected from the CT volume. The results of two computational experiments showed that the proposed algorithm is able to extract components with similar density within the assembled products on CT volumes.

Ab initio characterization of electron transfer coupling in photoinduced systems: generalized Mulliken-Hush with configuration-interaction singles.

PubMed

Chen, Hung-Cheng; Hsu, Chao-Ping

2005-12-29

To calculate electronic couplings for photoinduced electron transfer (ET) reactions, we propose and test the use of ab initio quantum chemistry calculation for excited states with the generalized Mulliken-Hush (GMH) method. Configuration-interaction singles (CIS) is proposed to model the locally excited (LE) and charge-transfer (CT) states. When the CT state couples with other high lying LE states, affecting coupling values, the image charge approximation (ICA), as a simple solvent model, can lower the energy of the CT state and decouple the undesired high-lying local excitations. We found that coupling strength is weakly dependent on many details of the solvent model, indicating the validity of the Condon approximation. Therefore, a trustworthy value can be obtained via this CIS-GMH scheme, with ICA used as a tool to improve and monitor the quality of the results. Systems we tested included a series of rigid, sigma-linked donor-bridge-acceptor compounds where "through-bond" coupling has been previously investigated, and a pair of molecules where "through-space" coupling was experimentally demonstrated. The calculated results agree well with experimentally inferred values in the coupling magnitudes (for both systems studied) and in the exponential distance dependence (for the through-bond series). Our results indicate that this new scheme can properly account for ET coupling arising from both through-bond and through-space mechanisms.

Value of apparent diffusion coefficient (ADC) in assessing radiotherapy and chemotherapy success in cervical cancer.

PubMed

Fu, Zhan-Zhao; Peng, Yong; Cao, Li-Yan; Chen, Yan-Sheng; Li, Kun; Fu, Bao-Hong

2015-06-01

We investigated the clinical significance of apparent diffusion coefficient (ADC) values in diffusion-weighted magnetic resonance imaging (DWI) in monitoring the efficacy of radiotherapy (RT) and chemotherapy (CT) treatments in cervical cancer. In order to identify relevant high quality clinical cohort studies reporting the use of DWI in cervical cancers, the following electronic databases in English and Chinese languages were comprehensively searched: MEDLINE, Science Citation Index database, Cochrane Library Database, PubMed, Embase, CINAHL, and Current Contents Index; Chinese Biomedical Database, Chinese Journal Full-Text Database. All selected studies were published prior to March 2014, and data extracted from these studies were analyzed using STATA 12.0 statistical software. We initially retrieved 196 articles (79 Chinese articles and 117 English articles) through database searches and finally selected sixteen cohort studies for this meta-analysis. The 16 studies contained a combined total of 517 subjects, and all selected studies reported the mean ADC value (10(-3) mm(2)/s) in DWI in cervical cancer patients treated with RT and CT. Combined standardized mean difference (SMD) suggested that the mean post-RT and mean post-CT ADC values were significantly higher than the mean pre-RT and mean pre-CT ADC values, respectively, in cervical cancer patients (SMD=2.95, 95% CI=2.19-3.72, P<0.001). Ethnicity-stratified analysis revealed that increased ADC values were observed post-RT and post-CT in both Caucasian (SMD=1.44, 95% CI=0.93-1.95, P<0.001) and Asian populations (SMD=3.32, 95% CI=2.42-4.22, P<0.001), compared with the mean ADC values before RT and CT, respectively, in the two subgroups. Further, subgroup analysis based on b-value revealed that higher ADC values were found in cervical cancer patients after RT and CT, compared to before RT and CT treatment, with both b value≤900 (SMD=3.71, 95% CI=2.35-5.07, P<0.001) and >900 (SMD=2.55, 95% CI=1.78-3.32, P<0.001). The mean ADC value in patients without residual tumor post-RT and post-CT treatment was significantly higher than seen in patients with residual tumors (SMD=0.80, 95% CI=0.49-1.12, P<0.001). Our meta-analysis revealed a significant correlation between mean ADC values and the clinical response to RT and CT treatment. Thus, ADC values in DWI may be effective in evaluating the clinical outcome of treatments in cervical cancer patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Measuring coronary calcium on CT images adjusted for attenuation differences.

PubMed

Nelson, Jennifer Clark; Kronmal, Richard A; Carr, J Jeffrey; McNitt-Gray, Michael F; Wong, Nathan D; Loria, Catherine M; Goldin, Jonathan G; Williams, O Dale; Detrano, Robert

2005-05-01

To quantify scanner and participant variability in attenuation values for computed tomographic (CT) images assessed for coronary calcium and define a method for standardizing attenuation values and calibrating calcium measurements. Institutional review board approval and participant informed consent were obtained at all study sites. An image attenuation adjustment method involving the use of available calibration phantom data to define standard attenuation values was developed. The method was applied to images from two population-based multicenter studies: the Coronary Artery Risk Development in Young Adults study (3041 participants) and the Multi-Ethnic Study of Atherosclerosis (6814 participants). To quantify the variability in attenuation, analysis of variance techniques were used to compare the CT numbers of standardized torso phantom regions across study sites, and multivariate linear regression models of participant-specific calibration phantom attenuation values that included participant age, race, sex, body mass index (BMI), smoking status, and site as covariates were developed. To assess the effect of the calibration method on calcium measurements, Pearson correlation coefficients between unadjusted and attenuation-adjusted calcium measurements were computed. Multivariate models were used to examine the effect of sex, race, BMI, smoking status, unadjusted score, and site on Agatston score adjustments. Mean attenuation values (CT numbers) of a standard calibration phantom scanned beneath participants varied significantly according to scanner and participant BMI (P < .001 for both). Values were lowest for Siemens multi-detector row CT scanners (110.0 HU), followed by GE-Imatron electron-beam (116.0 HU) and GE LightSpeed multi-detector row scanners (121.5 HU). Values were also lower for morbidly obese (BMI, > or =40.0 kg/m(2)) participants (108.9 HU), followed by obese (BMI, 30.0-39.9 kg/m(2)) (114.8 HU), overweight (BMI, 25.0-29.9 kg/m(2)) (118.5 HU), and normal-weight or underweight (BMI, <25.0 kg/m(2)) (120.1 HU) participants. Agatston score calibration adjustments ranged from -650 to 1071 (mean, -8 +/- 50 [standard deviation]) and increased with Agatston score (P < .001). The direction and magnitude of adjustment varied significantly according to scanner and BMI (P < .001 for both) and were consistent with phantom attenuation results in that calibration resulted in score decreases for images with higher phantom attenuation values. Image attenuation values vary by scanner and participant body size, producing calcium score differences that are not due to true calcium burden disparities. Use of calibration phantoms to adjust attenuation values and calibrate calcium measurements in research studies and clinical practice may improve the comparability of such measurements between persons scanned with different scanners and within persons over time.

Assessment of fluid distribution and flow properties in two phase fluid flow using X-ray CT technology

NASA Astrophysics Data System (ADS)

Jiang, Lanlan; Wu, Bohao; Li, Xingbo; Wang, Sijia; Wang, Dayong; Zhou, Xinhuan; Zhang, Yi

2018-04-01

To study on microscale distribution of CO2 and brine during two-phase flow is crucial for understanding the trapping mechanisms of CO2 storage. In this study, CO2-brine flow experiments in porous media were conducted using X-ray computed tomography. The porous media were packed with glass beads. The pore structure (porosity/tortuosity) and flow properties at different flow rates and flow fractions were investigated. The results showed that porosity of the packed beads differed at different position as a result of heterogeneity. The CO2 saturation is higher at low injection flow rates and high CO2 fractions. CO2 distribution at the pore scale was also visualized. ∅ Porosity of porous media CT brine_ sat grey value of sample saturated with brine CT dry grey value of sample saturated with air CT brine grey value of pure brine CT air grey value of pure air CT flow grey values of sample with two fluids occupying the pore space {CT}_{CO_2_ sat} grey value of sample saturated with CO2 {f}_{CO_2}({S}_{CO_2}) CO2 fraction {q}_{CO_2} the volume flow rate for CO2 q brine the volume flow rate for brine L Thickness of the porous media, mm L e a bundle of capillaries of equal length, mm τ Tortuosity, calculated from L e / L.

Contouring Variability of the Penile Bulb on CT Images: Quantitative Assessment Using a Generalized Concordance Index

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

Carillo, Viviana; Cozzarini, Cesare; Perna, Lucia

2012-11-01

Purpose: Within a multicenter study (DUE-01) focused on the search of predictors of erectile dysfunction and urinary toxicity after radiotherapy for prostate cancer, a dummy run exercise on penile bulb (PB) contouring on computed tomography (CT) images was carried out. The aim of this study was to quantitatively assess interobserver contouring variability by the application of the generalized DICE index. Methods and Materials: Fifteen physicians from different Institutes drew the PB on CT images of 10 patients. The spread of DICE values was used to objectively select those observers who significantly disagreed with the others. The analyses were performed withmore » a dedicated module in the VODCA software package. Results: DICE values were found to significantly change among observers and patients. The mean DICE value was 0.67, ranging between 0.43 and 0.80. The statistics of DICE coefficients identified 4 of 15 observers who systematically showed a value below the average (p value range, 0.013 - 0.059): Mean DICE values were 0.62 for the 4 'bad' observers compared to 0.69 of the 11 'good' observers. For all bad observers, the main cause of the disagreement was identified. Average DICE values were significantly worse from the average in 2 of 10 patients (0.60 vs. 0.70, p < 0.05) because of the limited visibility of the PB. Excluding the bad observers and the 'bad' patients,' the mean DICE value increased from 0.67 to 0.70; interobserver variability, expressed in terms of standard deviation of DICE spread, was also reduced. Conclusions: The obtained values of DICE around 0.7 shows an acceptable agreement, considered the small dimension of the PB. Additional strategies to improve this agreement are under consideration and include an additional tutorial of the so-called bad observers with a recontouring procedure, or the recontouring by a single observer of the PB for all patients included in the DUE-01 study.« less

Factors influencing the robustness of P-value measurements in CT texture prognosis studies

NASA Astrophysics Data System (ADS)

McQuaid, Sarah; Scuffham, James; Alobaidli, Sheaka; Prakash, Vineet; Ezhil, Veni; Nisbet, Andrew; South, Christopher; Evans, Philip

2017-07-01

Several studies have recently reported on the value of CT texture analysis in predicting survival, although the topic remains controversial, with further validation needed in order to consolidate the evidence base. The aim of this study was to investigate the effect of varying the input parameters in the Kaplan-Meier analysis, to determine whether the resulting P-value can be considered to be a robust indicator of the parameter’s prognostic potential. A retrospective analysis of the CT-based normalised entropy of 51 patients with lung cancer was performed and overall survival data for these patients were collected. A normalised entropy cut-off was chosen to split the patient cohort into two groups and log-rank testing was performed to assess the survival difference of the two groups. This was repeated for varying normalised entropy cut-offs and varying follow-up periods. Our findings were also compared with previously published results to assess robustness of this parameter in a multi-centre patient cohort. The P-value was found to be highly sensitive to the choice of cut-off value, with small changes in cut-off producing substantial changes in P. The P-value was also sensitive to follow-up period, with particularly noisy results at short follow-up periods. Using matched conditions to previously published results, a P-value of 0.162 was obtained. Survival analysis results can be highly sensitive to the choice in texture cut-off value in dichotomising patients, which should be taken into account when performing such studies to avoid reporting false positive results. Short follow-up periods also produce unstable results and should therefore be avoided to ensure the results produced are reproducible. Previously published findings that indicated the prognostic value of normalised entropy were not replicated here, but further studies with larger patient numbers would be required to determine the cause of the different outcomes.

Diagnostic value of CT, PET and combined PET/CT performed with low-dose unenhanced CT and full-dose enhanced CT in the initial staging of lymphoma.

PubMed

Pinilla, I; Gómez-León, N; Del Campo-Del Val, L; Hernandez-Maraver, D; Rodríguez-Vigil, B; Jover-Díaz, R; Coya, J

2011-10-01

The aim of this paper was to compare the accuracy of contrast-enhanced computed tomography (CT), positron emission tomography (PET), unenhanced low-dose PET/CT (LD-PET/CT) and full-dose enhanced PET/CT (FD-PET/CT) for the initial staging of lymphoma. One hundred and one lymphoma patients were examined by [18F]FDG-PET/CT including unenhanced low-dose CT and enhanced full-dose CT. Each modality of PET/CT was evaluated by a nuclear medicine physician and a radiologist unaware of the other modality, while the CT and PET images were interpreted separately by another independent radiologist and nuclear medicine physician respectively. The nodal and extranodal lesions detected by each technique were compared with a reference standard. For nodal assessment, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative LR (LR-) of LD-PET/CT were 97%, 96%, 98%, 95%, 26 and 0.02 respectively, and those of FD-PET/CT were 97%, 97%, 98%, 95%, 36 and 0.02. These results were significantly better than those of PET (sensitivity 82%, specificity 81%, PPV 88%, NPV 72%, LR+ 4.3, LR- 0.21). Likewise, both PET/CT displayed a higher sensitivity, NPV and LR- than CT (91%, 84%, 0.1 respectively). For organ evaluation, both modalities of PET/CT also had significantly better sensitivity and NPV than that of PET (LD-PET/CT: sensitivity 92%, NPV 90%; FD-PET/CT sensitivity 94%, NPV 92%; PET: sensitivity 70%, NPV 69%). The sensitivity, specificity, PPV and NPV for bone marrow involvement were 29%, 84%, 45% and 72% respectively for PET, and 29%, 90%, 56%, and 74% for both, LD-PET/CT, and FD-PET/CT. No significant differences were found between LD-PET/CT and FD-PET/CT, but FD-PET/CT detected important incidental findings in 5.9% of patients. PET/CT is an accurate technique for the initial staging of lymphomas without significant differences between LD-PET/CT and FD-PET/CT. FD-PET/CT detects relevant incidental findings that are missed on LD-PET/CT.

Summary Statistics for Homemade ?Play Dough? -- Data Acquired at LLNL

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

Kallman, J S; Morales, K E; Whipple, R E

Using x-ray computerized tomography (CT), we have characterized the x-ray linear attenuation coefficients (LAC) of a homemade Play Dough{trademark}-like material, designated as PDA. Table 1 gives the first-order statistics for each of four CT measurements, estimated with a Gaussian kernel density estimator (KDE) analysis. The mean values of the LAC range from a high of about 2700 LMHU{sub D} 100kVp to a low of about 1200 LMHUD at 300kVp. The standard deviation of each measurement is around 10% to 15% of the mean. The entropy covers the range from 6.0 to 7.4. Ordinarily, we would model the LAC of themore » material and compare the modeled values to the measured values. In this case, however, we did not have the detailed chemical composition of the material and therefore did not model the LAC. Using a method recently proposed by Lawrence Livermore National Laboratory (LLNL), we estimate the value of the effective atomic number, Z{sub eff}, to be near 10. LLNL prepared about 50mL of the homemade 'Play Dough' in a polypropylene vial and firmly compressed it immediately prior to the x-ray measurements. We used the computer program IMGREC to reconstruct the CT images. The values of the key parameters used in the data capture and image reconstruction are given in this report. Additional details may be found in the experimental SOP and a separate document. To characterize the statistical distribution of LAC values in each CT image, we first isolated an 80% central-core segment of volume elements ('voxels') lying completely within the specimen, away from the walls of the polypropylene vial. All of the voxels within this central core, including those comprised of voids and inclusions, are included in the statistics. We then calculated the mean value, standard deviation and entropy for (a) the four image segments and for (b) their digital gradient images. (A digital gradient image of a given image was obtained by taking the absolute value of the difference between the initial image and that same image offset by one voxel horizontally, parallel to the rows of the x-ray detector array.) The statistics of the initial image of LAC values are called 'first order statistics;' those of the gradient image, 'second order statistics.'« less

SU-D-202-03: Statistical Segmentation On Quantitative CT for Assessing Spatial Tumor Response During Radiation Therapy Delivery

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

Schott, D; Chen, X; Klawikowski, S

2016-06-15

Purpose: Develop a method to segment regions of interest (ROIs) in tumor with statistically similar Hounsfield unit (HU) values and/or HU changes during chemoradiation therapy (CRT) delivery, to assess spatial tumor treatment response based on daily CTs during CRT delivery. Methods: Generate a three region map of ROIs with differential HUs, by sampling neighboring voxels around a selected voxel and comparing to the mean of the entire ROI using a t-test. The cumulative distribution function, P, is calculated from the t-test. The P value is assigned to be the value at the selected voxel, and this is repeated over allmore » voxels in the initial ROI. Three regions are defined as: (1-P) < 0.00001 (mid region), and 0.00001 < (1-P) (mean greater than baseline and mean lower than baseline). The test is then expanded to compare daily CT sets acquired during routine CT-guided RT delivery using a CT-on-rails. The first fraction CT is used as the baseline for comparison. We tested 15 pancreatic head tumor cases undergoing CRT, to identify the ROIs and changes corresponding to normal, fibrotic, and tumor tissue. The obtained ROIs were compared with MRI-ADC maps acquired pre- and post-CRT. Results: The ROIs in 13 out of 15 patients’ first fraction CTs and pre-CRT MRIs matched the general region and slices covered, as well as in 6 out of the 9 patients with post-CRT MRIs. The high HU region designated by the t-test was seen to correlate with the tumor region in MR, and these ROIs are positioned within the same region over the course of treatment. In patients with poorly delineated tumors in MR, the t-test was inconclusive. Conclusion: The proposed statistical segmentation technique shows the potential to identify regions in tumor with differential HUs and HU changes during CRT delivery for patients with pancreas head cancer.« less

Diagnostic accuracy of 256-row multidetector CT coronary angiography with prospective ECG-gating combined with fourth-generation iterative reconstruction algorithm in the assessment of coronary artery bypass: evaluation of dose reduction and image quality.

PubMed

Ippolito, Davide; Fior, Davide; Franzesi, Cammillo Talei; Riva, Luca; Casiraghi, Alessandra; Sironi, Sandro

2017-12-01

Effective radiation dose in coronary CT angiography (CTCA) for coronary artery bypass graft (CABG) evaluation is remarkably high because of long scan lengths. Prospective electrocardiographic gating with iterative reconstruction can reduce effective radiation dose. To evaluate the diagnostic performance of low-kV CT angiography protocol with prospective ecg-gating technique and iterative reconstruction (IR) algorithm in follow-up of CABG patients compared with standard retrospective protocol. Seventy-four non-obese patients with known coronary disease treated with artery bypass grafting were prospectively enrolled. All the patients underwent 256 MDCT (Brilliance iCT, Philips) CTCA using low-dose protocol (100 kV; 800 mAs; rotation time: 0.275 s) combined with prospective ECG-triggering acquisition and fourth-generation IR technique (iDose 4 ; Philips); all the lengths of the bypass graft were included in the evaluation. A control group of 42 similar patients was evaluated with a standard retrospective ECG-gated CTCA (100 kV; 800 mAs).On both CT examinations, ROIs were placed to calculate standard deviation of pixel values and intra-vessel density. Diagnostic quality was also evaluated using a 4-point quality scale. Despite the statistically significant reduction of radiation dose evaluated with DLP (study group mean DLP: 274 mGy cm; control group mean DLP: 1224 mGy cm; P value < 0.001). No statistical differences were found between PGA group and RGH group regarding intra-vessel density absolute values and SNR. Qualitative analysis, evaluated by two radiologists in "double blind", did not reveal any significant difference in diagnostic quality of the two groups. The development of high-speed MDCT scans combined with modern IR allows an accurate evaluation of CABG with prospective ECG-gating protocols in a single breath hold, obtaining a significant reduction in radiation dose.

SU-G-IeP1-06: Estimating Relative Tissue Density From Quantitative MR Images: A Novel Perspective for MRI-Only Heterogeneity Corrected Dose Calculation

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

Soliman, A; Hashemi, M; Safigholi, H

Purpose: To explore the feasibility of extracting the relative density from quantitative MRI measurements as well as estimate a correlation between the extracted measures and CT Hounsfield units. Methods: MRI has the ability to separate water and fat signals, producing two separate images for each component. By performing appropriate corrections on the separated images, quantitative measurement of water and fat mass density can be estimated. This work aims to test this hypothesis on 1.5T.Peanut oil was used as fat-representative, while agar as water-representative. Gadolinium Chloride III and Sodium Chloride were added to the agar solution to adjust the relaxation timesmore » and the medium conductivity, respectively. Peanut oil was added to the agar solution with different percentages: 0%, 3%, 5%, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90% and 100%. The phantom was scanned on 1.5T GE Optima 450W with the body coil using a multigradient echo sequences. Water/fat separation were performed while correcting for main field (B0) inhomogeneity and T{sub 2}* relaxation time. B1+ inhomogeneities were ignored. The phantom was subsequently scanned on a Philips Brilliance CT Big Bore. MR-corrected fat signal from all vials were normalized to 100% fat signal. CT Hounsfield values were then compared to those obtained from the normalized MR-corrected fat values as well as to the phantom for validation. Results: Good agreement were found between CT HU and the MR-extracted fat values (R{sup 2} = 0.98). CT HU also showed excellent agreement with the prepared fat fractions (R{sup 2}=0.99). Vials with 70%, 80%, and 90% fat percentages showed inhomogeneous distributions, however their results were included for completion. Conclusion: Quantitative MRI water/fat imaging can be potentially used to extract the relative tissue density. Further in-vivo validation are required.« less

Differentiating the grades of thymic epithelial tumor malignancy using textural features of intratumoral heterogeneity via (18)F-FDG PET/CT.

PubMed

Lee, Hyo Sang; Oh, Jungsu S; Park, Young Soo; Jang, Se Jin; Choi, Ik Soo; Ryu, Jin-Sook

2016-05-01

We aimed to explore the ability of textural heterogeneity indices determined by (18)F-FDG PET/CT for grading the malignancy of thymic epithelial tumors (TETs). We retrospectively enrolled 47 patients with pathologically proven TETs who underwent pre-treatment (18)F-FDG PET/CT. TETs were classified by pathological results into three subgroups with increasing grades of malignancy: low-risk thymoma (LRT; WHO classification A, AB and B1), high-risk thymoma (B2 and B3), and thymic carcinoma (TC). Using (18)F-FDG PET/CT, we obtained conventional imaging indices including SUVmax and 20 intratumoral heterogeneity indices: i.e., four local-scale indices derived from the neighborhood gray-tone difference matrix (NGTDM), eight regional-scale indices from the gray-level run-length matrix (GLRLM), and eight regional-scale indices from the gray-level size zone matrix (GLSZM). Area under the receiver operating characteristic curve (AUC) was used to demonstrate the abilities of the imaging indices for differentiating subgroups. Multivariable logistic regression analysis was performed to show the independent significance of the textural indices. Combined criteria using optimal cutoff values of the SUVmax and a best-performing heterogeneity index were applied to investigate whether they improved differentiation between the subgroups. Most of the GLRLM and GLSZM indices and the SUVmax showed good or fair discrimination (AUC >0.7) with best performance for some of the GLRLM indices and the SUVmax, whereas the NGTDM indices showed relatively inferior performance. The discriminative ability of some of the GLSZM indices was independent from that of SUVmax in multivariate analysis. Combined use of the SUVmax and a GLSZM index improved positive predictive values for LRT and TC. Texture analysis of (18)F-FDG PET/CT scans has the potential to differentiate between TET tumor grades; regional-scale indices from GLRLM and GLSZM perform better than local-scale indices from the NGTDM. The SUVmax and heterogeneity indices may have complementary value in differentiating TET subgroups.

Determination of enoxaparin with rotational thrombelastometry using the prothrombinase-induced clotting time reagent.

PubMed

Schaden, Eva; Schober, Andreas; Hacker, Stefan; Spiss, Christian; Chiari, Astrid; Kozek-Langenecker, Sibylle

2010-04-01

Drug monitoring of low molecular weight heparin is generally not recommended, but could be reasonable in critically ill patients, whose risk for bleeding or thrombosis shows a high interpatient variability. Anti-Xa assays are not available around the clock even in central hospitals, whereas rotational thrombelastometry (ROTEM) becomes increasingly used at the bedside. Prothrombinase-induced clotting time (PiCT) reagent allows determination of factor Xa-inhibition in plasma. The aim of our study was to evaluate enoxaparin determination in whole blood with the ROTEM using specific test modifications, including PiCT. After ethics committee's approval, citrated whole blood obtained from overall 16 healthy volunteers was incubated with enoxaparin at 16 different anti-Xa concentrations. Main endpoint was the clotting time (CT) in ROTEM representing initial activation of clot formation. CT was determined in the new PiCT-ROTEM test, in a low-tissue factor-activated modification (LowTF-ROTEM) as well as in the commercially available heparin-sensitive ROTEM assays (HEPTEM and INTEM). In the absence of enoxaparin, CT values were 168.6 +/- 6.1 s (PiCT-ROTEM), 247.3 +/- 18.6 s (LowTF-ROTEM), and -6.2 +/- 7.9 s (INTEM-HEPTEM). A linear dependency (P < 0.01) between anti-Xa concentration and CT was found for PiCT-ROTEM, LowTF-ROTEM, and for INTEM-HEPTEM with correlation coefficients of 0.93 for PiCT-ROTEM, 0.94 for LowTF-ROTEM, and 0.81 for INTEM-HEPTEM. This in-vitro experiment demonstrates a strong correlation between enoxaparin anti-Xa concentrations and specific ROTEM tests. These promising assays should be further evaluated for monitoring anticoagulation in high-risk patients in clinical studies.

The use of multiple time point dynamic positron emission tomography/computed tomography in patients with oral/head and neck cancer does not predictably identify metastatic cervical lymph nodes.

PubMed

Carlson, Eric R; Schaefferkoetter, Josh; Townsend, David; McCoy, J Michael; Campbell, Paul D; Long, Misty

2013-01-01

To determine whether the time course of 18-fluorine fluorodeoxyglucose (18F-FDG) activity in multiple consecutively obtained 18F-FDG positron emission tomography (PET)/computed tomography (CT) scans predictably identifies metastatic cervical adenopathy in patients with oral/head and neck cancer. It is hypothesized that the activity will increase significantly over time only in those lymph nodes harboring metastatic cancer. A prospective cohort study was performed whereby patients with oral/head and neck cancer underwent consecutive imaging at 9 time points with PET/CT from 60 to 115 minutes after injection with (18)F-FDG. The primary predictor variable was the status of the lymph nodes based on dynamic PET/CT imaging. Metastatic lymph nodes were defined as those that showed an increase greater than or equal to 10% over the baseline standard uptake values. The primary outcome variable was the pathologic status of the lymph node. A total of 2,237 lymph nodes were evaluated histopathologically in the 83 neck dissections that were performed in 74 patients. A total of 119 lymph nodes were noted to have hypermetabolic activity on the 90-minute (static) portion of the study and were able to be assessed by time points. When we compared the PET/CT time point (dynamic) data with the histopathologic analysis of the lymph nodes, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 60.3%, 70.5%, 66.0%, 65.2%, and 65.5%, respectively. The use of dynamic PET/CT imaging does not permit the ablative surgeon to depend only on the results of the PET/CT study to determine which patients will benefit from neck dissection. As such, we maintain that surgeons should continue to rely on clinical judgment and maintain a low threshold for executing neck dissection in patients with oral/head and neck cancer, including those patients with N0 neck designations. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Usefulness of CA125 and their kinetic parameters and positron emission tomography/computed tomography (PET/CT) with fluorodeoxyglucose ([18F] FDG) in the detection of recurrent ovarian cancer levels.

PubMed

Palomar Muñoz, Azahara; Cordero García, José Manuel; Talavera Rubio, Prado; García Vicente, Ana M; González García, Beatriz; Bellón Guardia, María Emiliana; Soriano Castrejón, Ángel; Aranda Aguilar, Enrique

2017-12-21

To assess the usefulness of cancer antigen 125 (CA125) serum levels and kinetic values, velocity (CA125vel) and doubling time (CA125dt), as well as fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT), in the detection of ovarian cancer recurrence. To assess the optimal cut-off for CA125, CA125vel and CA125dt to detect relapse with [ 18 F]FDG-PET/CT. A retrospective analysis was performed of 59 [ 18 F]FDG-PET/CT (48 patients) for suspected recurrence of ovarian cancer. Receiver operating characteristic (ROC) curves were plotted and area-under-the curve (AUC) statistics were computed for CA125, CA125vel and CA125dt. The results obtained in the group with normal and high (>35U/ml) CA125 levels were compared. Forty-four cases of recurrence were diagnosed (7 had CA125 ≤35U/ml), whereas 15 showed no disease. All of them were correctly catalogued by PET/CT. In ROC analysis, the discriminatory power of CA125 was relatively high (AUC 0.835) and the optimal cut-off point to reflect active disease was 23.9U/ml. The ROC analyses for the CA125vel and CA125dt showed an AUC of 0.849 and 0.728, respectively, with an optimal cut-off point of 1.96U/ml/month and 0.76 months, respectively. In patients with normal CA125 and recurrence of ovarian cancer, the CA125vel was significantly higher than in patients without recurrence (p=0.029). [ 18 F]FDG-PET/CT is more accurate than CA125 parameters in the detection of ovarian cancer recurrence. CA125 serum levels are essential; nevertheless, CA125 kinetic values must be considered to detect relapse. Particularly in patients with CA125 within normal values, in which a higher CA125vel is indicative of recurrence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Use of computed tomography to predict the outcome of a noninvasive intranasal infusion in dogs with nasal aspergillosis

PubMed Central

Saunders, Jimmy H.; Duchateau, Luc; Störk, Christophe; van Bree, Henri

2003-01-01

Computed tomography (CT) was performed on 36 dogs with nasal aspergillosis to assess whether this imaging technique can be used to predict the success of a noninvasive intranasal infusion of enilconazole. A CT score based on the severity of the disease was given to each dog, prior to treatment, by dividing the nasal cavities and frontal sinuses into 8 anatomical regions. After therapy, the dogs were classified into 2 response groups (success group: dogs cured after 1 treatment; failure group: dogs needing more than 1 treatment or with treatment failure). No significant relationship on the logistic scale was found between the CT score and the response to treatment. High sensitivity (treatment failures correctly predicted) and specificity (treatment successes correctly predicted) could not be obtained at the same time, whatever the cut-off value chosen. The results of this study suggest that CT cannot predict the therapeutic success of nasal aspergillosis in dogs treated with a 1-hour infusion of enilconazole. However, dogs with a low score seem to be good candidates to respond after 1 treatment. PMID:12715982

Analyzing radiation absorption difference of dental substance by using Dual CT

NASA Astrophysics Data System (ADS)

Yu, H.; Lee, H. K.; Cho, J. H.; Yang, H. J.; Ju, Y. S.

2015-07-01

The purpose of this study was to evaluate the changes of noise and computer tomography (CT) number in each dental substance, by using the metal artefact reduction algorithm; we used dual CT for this study. For the study, we produced resin, titanium, gypsum, and wax that are widely used by dentists. In addition, we made nickel to increase the artefact. While making the study materials, we made sure that there is no difficulty when inserting the substances inside phantom. In order to study, we scanned before and after using the metal artefact reduction algorithm. We conducted an average analysis of CT number and noise, before and after using the metal artefact reduction algorithm. As a result, there was no difference in CT number and noise before and after using the metal artefact reduction algorithm. However, when it comes to the noise value in each substance, wax's noise value was the lowest whereas titanium's noise value was the highest, after applying the metal artefact reduction algorithm. In nickel, CT number and noise value from artefact area showed a decreased noise value when applying the metal artefact reduction algorithm. In conclusion, we assumed that we could increase the effectiveness of CT examination by applying dual energy's metal artefact reduction algorithm.

[The Clinical Application of Video Mediastinoscopy and CT in the N Staging of Preoperative Lung Cancer.].

PubMed

Wang, Zhiheng; Qi, Weibo; Zhu, Yong; Lin, Ruobai

2009-10-20

Preoperative lung cancer with mediastinal lymph nodes metastasis can be diagnosed by vedio mediastinoscopy (VM) and CT. This study was to explore the value of VM and CT in the diagnosis of N staging of preoperative lung cancer, and to discuss the difference between the two methods. Forty-eight cases diagnosed of lung cancer by CT or PET-CT were examined by VM. The sensitivity, specificity, validity, positive predictive value and negative predictive value of VM and CT were speculated according to the postoperative pathological reports, and the difference between VM and CT in the diagnosis of lung cancer with mediastinal lymph nodes metastasis was discussed. (1)Under the examination of VM, 31 patients with the negative outcome received the direct operation; 14 patients with N2 received 2 courses of neoadjuvant chemotherapy before operation; 3 patients with N3 received chemotherapy and/or radiotherapy. (2)Forty-one cases with final diagnosis of lung cancer were used as samples to speculate the sensitivity, specificity, validity, positive predictive value and negative predictive value of VM. They were 93.3%, 100%, 97.6%, 100%, 96.3%, which of CT were 66.7%, 53.8%, 58.5%, 45.5%, 73.7% (Chi-square=4.083, P=0.039), the difference between VM and CT was statistically significant. (3)In this group, the complications of VM incidence rate was 2.08% (1/48), and the case was pneumothorax. VM is superior to CT in the diagnosis of N staging of preoperative lung cancer; Due to its safety and effectiveness, VM will be wildly used in the field of thoracic surgery.

Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers.

PubMed

Ohno, Yoshiharu; Yoshikawa, Takeshi; Takenaka, Daisuke; Fujisawa, Yasuko; Sugihara, Naoki; Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Sugimura, Kazuro

2017-01-01

To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT) MATERIALS AND METHODS: Twenty-three consecutive smokers (15 men and 8 women, mean age: 69.7±8.7years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV 1 . Each inter-observer agreement was rated as substantial (Sub-CT: κ=0.69, p<0.0001; DE-CT: κ=0.64, p<0.0001; SPECT/CT: κ=0.64, p<0.0001). Functional lung volume for each method showed significant to good correlation with%FEV 1 (Sub-CT: r=0.72, p=0.0001; DE-CT: r=0.74, p<0.0001; SPECT/CT: r=0.66, p=0.0006). Xenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

New insights in non-small-cell lung cancer: circulating tumor cells and cell-free DNA

PubMed Central

Duréndez-Sáez, Elena; Azkárate, Aitor; Meri, Marina; Calabuig-Fariñas, Silvia; Aguilar-Gallardo, Cristóbal; Blasco, Ana

2017-01-01

Lung cancer is the second most frequent tumor and the leading cause of death by cancer in both men and women. Increasing knowledge about the cancer genome and tumor environment has led to a new setting in which morphological and molecular characterization is needed to treat patients in the most personalized way in order to achieve better outcomes. Since tumor products can be detected in body fluids, the liquid biopsy, particularly, peripheral blood, has emerged as a new source for lung cancer biomarker’s analysis. A variety of tumor components can be used for this purpose. Among them, circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) should be especially considered. Different detection methods for both CTCs and ctDNA have been and are being developed to improve the sensitivity and specificity of these tests. This would lead to better characterization and would solve some clinical doubts at different disease evolution times, e.g., intratumoral or temporal heterogeneity, difficulty in the obtaining a tumor sample, etc., and would also avoid the side effects of very expensive and complicated tumor obtaining interventions. CTCs and ctDNA are useful in different lung cancer settings. Their value has been shown for the early diagnosis, prognosis, prediction of treatment efficacy, monitoring responses and early detection of lung cancer relapse. CTCs have still not been validated for use in clinical settings in non-small-cell lung cancer (NSCLC), while ctDNA has been approved by the Food and Drug Administration (FDA) and European Medical Association (EMA), and the main clinical guidelines used for detect different epidermal growth factor receptor (EGFR) mutations and the monitoring and treatment choice of mutated patients with tyrosine kinase inhibitors (TKIs). This review, describes how ctDNA seem to be winning the race against CTCs from the laboratory bench to clinical practice due to easier obtaining methods, manipulation and its implementation into clinical practice. PMID:29184672

Effect of Localizer Radiography Projection on Organ Dose at Chest CT with Automatic Tube Current Modulation.

PubMed

Saltybaeva, Natalia; Krauss, Andreas; Alkadhi, Hatem

2017-03-01

Purpose To calculate the effect of localizer radiography projections to the total radiation dose, including both the dose from localizer radiography and that from subsequent chest computed tomography (CT) with tube current modulation (TCM). Materials and Methods An anthropomorphic phantom was scanned with 192-section CT without and with differently sized breast attachments. Chest CT with TCM was performed after one localizer radiographic examination with anteroposterior (AP) or posteroanterior (PA) projections. Dose distributions were obtained by means of Monte Carlo simulations based on acquired CT data. For Monte Carlo simulations of localizer radiography, the tube position was fixed at 0° and 180°; for chest CT, a spiral trajectory with TCM was used. The effect of tube start angles on dose distribution was investigated with Monte Carlo simulations by using TCM curves with fixed start angles (0°, 90°, and 180°). Total doses for lungs, heart, and breast were calculated as the sum of the dose from localizer radiography and CT. Image noise was defined as the standard deviation of attenuation measured in 14 circular regions of interest. The Wilcoxon signed rank test, paired t test, and Friedman analysis of variance were conducted to evaluate differences in noise, TCM curves, and organ doses, respectively. Results Organ doses from localizer radiography were lower when using a PA instead of an AP projection (P = .005). The use of a PA projection resulted in higher TCM values for chest CT (P < .001) owing to the higher attenuation (P < .001) and thus resulted in higher total organ doses for all investigated phantoms and protocols (P < .001). Noise in CT images was lower with PA localizer radiography than with AP localizer radiography (P = .03). The use of an AP projection allowed for total dose reductions of 16%, 15%, and 12% for lungs, breast, and heart, respectively. Differences in organ doses were not related to tube start angles (P = .17). Conclusion The total organ doses are higher when using PA projection localizer radiography owing to higher TCM values, whereas the organ doses from PA localizer radiography alone are lower. Thus, PA localizer radiography should be used in combination with reduced reference tube current at subsequent chest CT. © RSNA, 2016 Online supplemental material is available for this article.

Differentiation of Central Lung Cancer from Atelectasis: Comparison of Diffusion-Weighted MRI with PET/CT

PubMed Central

Yang, Rui-Meng; Li, Long; Wei, Xin-Hua; Guo, Yong-Mei; Huang, Yun-Hai; Lai, Li-Sha; Chen, A-Mei; Liu, Guo-Shun; Xiong, Wei-Feng; Luo, Liang-Ping; Jiang, Xin-Qing

2013-01-01

Objective Prospectively assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis. Materials and Methods 38 consecutive lung cancer patients (26 males, 12 females; age range: 28–71 years; mean age: 49 years) who were referred for thoracic MR imaging examinations were enrolled. MR examinations were performed using a 1.5-T clinical scanner and scanning sequences of T1WI, T2WI, and DWI. Cancers and atelectasis were measured by mapping of the apparent diffusion coefficients (ADCs) obtained with a b-value of 500 s/mm2. Results PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm2/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both). Conclusions DW-MR imaging provides valuable information not obtained by conventional MR and may be useful for differentiation of central lung carcinoma from atelectasis. Future developments may allow DW-MR imaging to be used as an alternative to PET-CT in imaging of patients with lung cancer. PMID:23593186

Multi-energy spectral CT: adding value in emergency body imaging.

PubMed

Punjabi, Gopal V

2018-04-01

Most vendors offer scanners capable of dual- or multi-energy computed tomography (CT) imaging. Advantages of multi-energy CT scanning include superior tissue characterization, detection of subtle iodine uptake differences, and opportunities to reduce contrast dose. However, utilization of this technology in the emergency department (ED) remains low. The purpose of this pictorial essay is to illustrate the value of multi-energy CT scanning in emergency body imaging.

4D-CT Lung registration using anatomy-based multi-level multi-resolution optical flow analysis and thin-plate splines.

PubMed

Min, Yugang; Neylon, John; Shah, Amish; Meeks, Sanford; Lee, Percy; Kupelian, Patrick; Santhanam, Anand P

2014-09-01

The accuracy of 4D-CT registration is limited by inconsistent Hounsfield unit (HU) values in the 4D-CT data from one respiratory phase to another and lower image contrast for lung substructures. This paper presents an optical flow and thin-plate spline (TPS)-based 4D-CT registration method to account for these limitations. The use of unified HU values on multiple anatomy levels (e.g., the lung contour, blood vessels, and parenchyma) accounts for registration errors by inconsistent landmark HU value. While 3D multi-resolution optical flow analysis registers each anatomical level, TPS is employed for propagating the results from one anatomical level to another ultimately leading to the 4D-CT registration. 4D-CT registration was validated using target registration error (TRE), inverse consistency error (ICE) metrics, and a statistical image comparison using Gamma criteria of 1 % intensity difference in 2 mm(3) window range. Validation results showed that the proposed method was able to register CT lung datasets with TRE and ICE values <3 mm. In addition, the average number of voxel that failed the Gamma criteria was <3 %, which supports the clinical applicability of the propose registration mechanism. The proposed 4D-CT registration computes the volumetric lung deformations within clinically viable accuracy.

The diagnostic performance and added value of (18)F-FDG PET/CT in the detection of liver metastases in recurrent colorectal carcinoma patients.

PubMed

Odalovic, Strahinja; Artiko, Vera; Sobic-Saranovic, Dragana; Stojiljkovic, Milica; Petrovic, Milorad; Petrovic, Nebojsa; Kozarevic, Nebojsa; Grozdic-Milojevic, Isidora; Obradovic, Vladimir

2015-01-01

The aim of this study was to assess the value of (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT in detection of liver metastases in patients with suspected recurrent colorectal carcinoma, as well as to compare diagnostic performance of (18)F-FDG PET/CT with conventional imaging methods (MDCT). This study included 73 patients with resected primary colorectal adenocarcinoma referred for (18)F-FDG PET/CT to the National PET Center, at the Clinical Center of Serbia, Belgrade, from January 2010 to May 2013, with suspicion of recurrence. The patients underwent (18)F-FDG PET/CT examination on a 64-slice hybrid PET/CT scanner (Biograph, TruePoint64, Siemens Medical Solutions, Inc. USA). Prior to (18)F-FDG PET/CT all patients underwent contrast-enhanced MDCT. Findings of (18)F-FDG PET/CT and MDCT were compared to findings of subsequent histopathological examinations or with results of clinical and imaging follow-up over at least six months. Final diagnosis of liver metastases of colorectal cancer was made either by histopathological examination of specimen after biopsy or surgery, or based on clinical, laboratory and imaging evaluation during first six months after PET/CT scan. In detection of liver metastases (18)F-FDG PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 83.3%, 95.3%, 92.6%, 89.1% and 90.4%, respectively. In addition, MDCT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detection of liver metastases of 60%, 88.4%, 78.3%, 76% and 76.7%, respectively. There was significant difference in sensitivity (83.3% vs 60%; P=0.045) between these two methods. In addition, significant difference was observed in accuracy between PET/CT and MDCT (90.4% vs 76.7%; P=0.016). The higher specificity in visualization of liver metastases was also achieved by (18)F-FDG PET/CT compared to MDCT (95.3% vs 88.4%), but this difference was not significant (P=0.37). (18)F-FDG PET/CT was highly sensitive, specific and accurate method in detection of liver metastases in patients with suspected recurrent colorectal carcinoma in our study. This hybrid imaging showed superior diagnostic performance in evaluation of suspected colorectal cancer liver metastases compared to conventional imaging.

Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial): A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea.

PubMed

Sissoko, Daouda; Laouenan, Cedric; Folkesson, Elin; M'Lebing, Abdoul-Bing; Beavogui, Abdoul-Habib; Baize, Sylvain; Camara, Alseny-Modet; Maes, Piet; Shepherd, Susan; Danel, Christine; Carazo, Sara; Conde, Mamoudou N; Gala, Jean-Luc; Colin, Géraldine; Savini, Hélène; Bore, Joseph Akoi; Le Marcis, Frederic; Koundouno, Fara Raymond; Petitjean, Frédéric; Lamah, Marie-Claire; Diederich, Sandra; Tounkara, Alexis; Poelart, Geertrui; Berbain, Emmanuel; Dindart, Jean-Michel; Duraffour, Sophie; Lefevre, Annabelle; Leno, Tamba; Peyrouset, Olivier; Irenge, Léonid; Bangoura, N'Famara; Palich, Romain; Hinzmann, Julia; Kraus, Annette; Barry, Thierno Sadou; Berette, Sakoba; Bongono, André; Camara, Mohamed Seto; Chanfreau Munoz, Valérie; Doumbouya, Lanciné; Souley Harouna; Kighoma, Patient Mumbere; Koundouno, Fara Roger; Réné Lolamou; Loua, Cécé Moriba; Massala, Vincent; Moumouni, Kinda; Provost, Célia; Samake, Nenefing; Sekou, Conde; Soumah, Abdoulaye; Arnould, Isabelle; Komano, Michel Saa; Gustin, Lina; Berutto, Carlotta; Camara, Diarra; Camara, Fodé Saydou; Colpaert, Joliene; Delamou, Léontine; Jansson, Lena; Kourouma, Etienne; Loua, Maurice; Malme, Kristian; Manfrin, Emma; Maomou, André; Milinouno, Adele; Ombelet, Sien; Sidiboun, Aboubacar Youla; Verreckt, Isabelle; Yombouno, Pauline; Bocquin, Anne; Carbonnelle, Caroline; Carmoi, Thierry; Frange, Pierre; Mely, Stéphane; Nguyen, Vinh-Kim; Pannetier, Delphine; Taburet, Anne-Marie; Treluyer, Jean-Marc; Kolie, Jacques; Moh, Raoul; Gonzalez, Minerva Cervantes; Kuisma, Eeva; Liedigk, Britta; Ngabo, Didier; Rudolf, Martin; Thom, Ruth; Kerber, Romy; Gabriel, Martin; Di Caro, Antonino; Wölfel, Roman; Badir, Jamal; Bentahir, Mostafa; Deccache, Yann; Dumont, Catherine; Durant, Jean-François; El Bakkouri, Karim; Gasasira Uwamahoro, Marie; Smits, Benjamin; Toufik, Nora; Van Cauwenberghe, Stéphane; Ezzedine, Khaled; D'Ortenzio, Eric; Dortenzio, Eric; Pizarro, Louis; Etienne, Aurélie; Guedj, Jérémie; Fizet, Alexandra; Barte de Sainte Fare, Eric; Murgue, Bernadette; Tran-Minh, Tuan; Rapp, Christophe; Piguet, Pascal; Poncin, Marc; Draguez, Bertrand; Allaford Duverger, Thierry; Barbe, Solenne; Baret, Guillaume; Defourny, Isabelle; Carroll, Miles; Raoul, Hervé; Augier, Augustin; Eholie, Serge P; Yazdanpanah, Yazdan; Levy-Marchal, Claire; Antierrens, Annick; Van Herp, Michel; Günther, Stephan; de Lamballerie, Xavier; Keïta, Sakoba; Mentre, France; Anglaret, Xavier; Malvy, Denis

2016-03-01

Ebola virus disease (EVD) is a highly lethal condition for which no specific treatment has proven efficacy. In September 2014, while the Ebola outbreak was at its peak, the World Health Organization released a short list of drugs suitable for EVD research. Favipiravir, an antiviral developed for the treatment of severe influenza, was one of these. In late 2014, the conditions for starting a randomized Ebola trial were not fulfilled for two reasons. One was the perception that, given the high number of patients presenting simultaneously and the very high mortality rate of the disease, it was ethically unacceptable to allocate patients from within the same family or village to receive or not receive an experimental drug, using a randomization process impossible to understand by very sick patients. The other was that, in the context of rumors and distrust of Ebola treatment centers, using a randomized design at the outset might lead even more patients to refuse to seek care. Therefore, we chose to conduct a multicenter non-randomized trial, in which all patients would receive favipiravir along with standardized care. The objectives of the trial were to test the feasibility and acceptability of an emergency trial in the context of a large Ebola outbreak, and to collect data on the safety and effectiveness of favipiravir in reducing mortality and viral load in patients with EVD. The trial was not aimed at directly informing future guidelines on Ebola treatment but at quickly gathering standardized preliminary data to optimize the design of future studies. Inclusion criteria were positive Ebola virus reverse transcription PCR (RT-PCR) test, age ≥ 1 y, weight ≥ 10 kg, ability to take oral drugs, and informed consent. All participants received oral favipiravir (day 0: 6,000 mg; day 1 to day 9: 2,400 mg/d). Semi-quantitative Ebola virus RT-PCR (results expressed in "cycle threshold" [Ct]) and biochemistry tests were performed at day 0, day 2, day 4, end of symptoms, day 14, and day 30. Frozen samples were shipped to a reference biosafety level 4 laboratory for RNA viral load measurement using a quantitative reference technique (genome copies/milliliter). Outcomes were mortality, viral load evolution, and adverse events. The analysis was stratified by age and Ct value. A "target value" of mortality was defined a priori for each stratum, to guide the interpretation of interim and final analysis. Between 17 December 2014 and 8 April 2015, 126 patients were included, of whom 111 were analyzed (adults and adolescents, ≥13 y, n = 99; young children, ≤6 y, n = 12). Here we present the results obtained in the 99 adults and adolescents. Of these, 55 had a baseline Ct value ≥ 20 (Group A Ct ≥ 20), and 44 had a baseline Ct value < 20 (Group A Ct < 20). Ct values and RNA viral loads were well correlated, with Ct = 20 corresponding to RNA viral load = 7.7 log10 genome copies/ml. Mortality was 20% (95% CI 11.6%-32.4%) in Group A Ct ≥ 20 and 91% (95% CI 78.8%-91.1%) in Group A Ct < 20. Both mortality 95% CIs included the predefined target value (30% and 85%, respectively). Baseline serum creatinine was ≥110 μmol/l in 48% of patients in Group A Ct ≥ 20 (≥300 μmol/l in 14%) and in 90% of patients in Group A Ct < 20 (≥300 μmol/l in 44%). In Group A Ct ≥ 20, 17% of patients with baseline creatinine ≥110 μmol/l died, versus 97% in Group A Ct < 20. In patients who survived, the mean decrease in viral load was 0.33 log10 copies/ml per day of follow-up. RNA viral load values and mortality were not significantly different between adults starting favipiravir within <72 h of symptoms compared to others. Favipiravir was well tolerated. In the context of an outbreak at its peak, with crowded care centers, randomizing patients to receive either standard care or standard care plus an experimental drug was not felt to be appropriate. We did a non-randomized trial. This trial reaches nuanced conclusions. On the one hand, we do not conclude on the efficacy of the drug, and our conclusions on tolerance, although encouraging, are not as firm as they could have been if we had used randomization. On the other hand, we learned about how to quickly set up and run an Ebola trial, in close relationship with the community and non-governmental organizations; we integrated research into care so that it improved care; and we generated knowledge on EVD that is useful to further research. Our data illustrate the frequency of renal dysfunction and the powerful prognostic value of low Ct values. They suggest that drug trials in EVD should systematically stratify analyses by baseline Ct value, as a surrogate of viral load. They also suggest that favipiravir monotherapy merits further study in patients with medium to high viremia, but not in those with very high viremia. ClinicalTrials.gov NCT02329054.

Remote sensing of aquatic vegetation distribution in Taihu Lake using an improved classification tree with modified thresholds.

PubMed

Zhao, Dehua; Jiang, Hao; Yang, Tangwu; Cai, Ying; Xu, Delin; An, Shuqing

2012-03-01

Classification trees (CT) have been used successfully in the past to classify aquatic vegetation from spectral indices (SI) obtained from remotely-sensed images. However, applying CT models developed for certain image dates to other time periods within the same year or among different years can reduce the classification accuracy. In this study, we developed CT models with modified thresholds using extreme SI values (CT(m)) to improve the stability of the models when applying them to different time periods. A total of 903 ground-truth samples were obtained in September of 2009 and 2010 and classified as emergent, floating-leaf, or submerged vegetation or other cover types. Classification trees were developed for 2009 (Model-09) and 2010 (Model-10) using field samples and a combination of two images from winter and summer. Overall accuracies of these models were 92.8% and 94.9%, respectively, which confirmed the ability of CT analysis to map aquatic vegetation in Taihu Lake. However, Model-10 had only 58.9-71.6% classification accuracy and 31.1-58.3% agreement (i.e., pixels classified the same in the two maps) for aquatic vegetation when it was applied to image pairs from both a different time period in 2010 and a similar time period in 2009. We developed a method to estimate the effects of extrinsic (EF) and intrinsic (IF) factors on model uncertainty using Modis images. Results indicated that 71.1% of the instability in classification between time periods was due to EF, which might include changes in atmospheric conditions, sun-view angle and water quality. The remainder was due to IF, such as phenological and growth status differences between time periods. The modified version of Model-10 (i.e. CT(m)) performed better than traditional CT with different image dates. When applied to 2009 images, the CT(m) version of Model-10 had very similar thresholds and performance as Model-09, with overall accuracies of 92.8% and 90.5% for Model-09 and the CT(m) version of Model-10, respectively. CT(m) decreased the variability related to EF and IF and thereby improved the applicability of the models to different time periods. In both practice and theory, our results suggested that CT(m) was more stable than traditional CT models and could be used to map aquatic vegetation in time periods other than the one for which the model was developed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Optimal Monochromatic Energy Levels in Spectral CT Pulmonary Angiography for the Evaluation of Pulmonary Embolism

PubMed Central

Wu, Huawei; Zhang, Qing; Hua, Jia; Hua, Xiaolan; Xu, Jianrong

2013-01-01

Background The aim of this study was to determine the optimal monochromatic spectral CT pulmonary angiography (sCTPA) levels to obtain the highest image quality and diagnostic confidence for pulmonary embolism detection. Methods The Institutional Review Board of the Shanghai Jiao Tong University School of Medicine approved this study, and written informed consent was obtained from all participating patients. Seventy-two patients with pulmonary embolism were scanned with spectral CT mode in the arterial phase. One hundred and one sets of virtual monochromatic spectral (VMS) images were generated ranging from 40 keV to 140 keV. Image noise, clot diameter and clot to artery contrast-to-noise ratio (CNR) from seven sets of VMS images at selected monochromatic levels in sCTPA were measured and compared. Subjective image quality and diagnostic confidence for these images were also assessed and compared. Data were analyzed by paired t test and Wilcoxon rank sum test. Results The lowest noise and the highest image quality score for the VMS images were obtained at 65 keV. The VMS images at 65 keV also had the second highest CNR value behind that of 50 keV VMS images. There was no difference in the mean noise and CNR between the 65 keV and 70 keV VMS images. The apparent clot diameter correlated with the keV levels. Conclusions The optimal energy level for detecting pulmonary embolism using dual-energy spectral CT pulmonary angiography was 65–70 keV. Virtual monochromatic spectral images at approximately 65–70 keV yielded the lowest image noise, high CNR and highest diagnostic confidence for the detection of pulmonary embolism. PMID:23667583

Microtomography evaluation of dental tissue wear surface induced by in vitro simulated chewing cycles on human and composite teeth.

PubMed

Bedini, Rossella; Pecci, Raffaella; Notarangelo, Gianluca; Zuppante, Francesca; Persico, Salvatore; Di Carlo, Fabio

2012-01-01

In this study a 3D microtomography display of tooth surfaces after in vitro dental wear tests has been obtained. Natural teeth have been compared with prosthetic teeth, manufactured by three different polyceramic composite materials. The prosthetic dental element samples, similar to molars, have been placed in opposition to human teeth extracted by paradontology diseases. After microtomography analysis, samples have been subjected to in vitro fatigue test cycles by servo-hydraulic mechanical testing machine. After the fatigue test, each sample has been subjected again to microtomography analysis to obtain volumetric value changes and dental wear surface images. Wear surface images were obtained by 3D reconstruction software and volumetric value changes were measured by CT analyser software. The aim of this work has been to show the potential of microtomography technique to display very clear and reliable wear surface images. Microtomography analysis methods to evaluate volumetric value changes have been used to quantify dental tissue and composite material wear.

Advances in the Quantitative Characterization of the Shape of Ash-Sized Pyroclast Populations: Fractal Analyses Coupled to Micro- and Nano-Computed Tomography Techniques

NASA Astrophysics Data System (ADS)

Rausch, J.; Vonlanthen, P.; Grobety, B. H.

2014-12-01

The quantification of shape parameters in pyroclasts is fundamental to infer the dominant type of magma fragmentation (magmatic vs. phreatomagmatic), as well as the behavior of volcanic plumes and clouds in the atmosphere. In a case study aiming at reconstructing the fragmentation mechanisms triggering maar eruptions in two geologically and compositionally distinctive volcanic fields (West and East Eifel, Germany), the shapes of a large number of ash particle contours obtained from SEM images were analyzed by a dilation-based fractal method. Volcanic particle contours are pseudo-fractals showing mostly two distinct slopes in Richardson plots related to the fractal dimensions D1 (small-scale "textural" dimension) and D2 (large-scale "morphological" dimension). The validity of the data obtained from 2D sections was tested by analysing SEM micro-CT slices of one particle cut in different orientations and positions. Results for West Eifel maar particles yield large D1 values (> 1.023), resembling typical values of magmatic particles, which are characterized by a complex shape, especially at small scales. In contrast, the D1 values of ash particles from one East Eifel maar deposit are much smaller, coinciding with the fractal dimensions obtained from phreatomagmatic end-member particles. These quantitative morphological analyses suggest that the studied maar eruptions were triggered by two different fragmentation processes: phreatomagmatic in the East Eifel and magmatic in the West Eifel. The application of fractal analysis to quantitatively characterize the shape of pyroclasts and the linking of fractal dimensions to specific fragmentation processes has turned out to be a very promising tool for studying the fragmentation history of any volcanic eruption. The next step is to extend morphological analysis of volcanic particles to 3 dimensions. SEM micro-CT, already applied in this study, offers the required resolution, but is not suitable for the analysis of a large number of particles. Newly released nano CT-scanners, however, allows the simultaneous analysis of a statistically relevant number of particles (in the hundreds range). Preliminary results of a first trial will be presented.

SU-E-CAMPUS-I-06: Y90 PET/CT for the Instantaneous Determination of Both Target and Non-Target Absorbed Doses Following Hepatic Radioembolization

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

Pasciak, A; Kao, J

2014-06-15

Purpose The process of converting Yttrium-90 (Y90) PET/CT images into 3D absorbed dose maps will be explained. The simple methods presented will allow the medical physicst to analyze Y90 PET images following radioembolization and determine the absorbed dose to tumor, normal liver parenchyma and other areas of interest, without application of Monte-Carlo radiation transport or dose-point-kernel (DPK) convolution. Methods Absorbed dose can be computed from Y90 PET/CT images based on the premise that radioembolization is a permanent implant with a constant relative activity distribution after infusion. Many Y90 PET/CT publications have used DPK convolution to obtain 3D absorbed dose maps.more » However, this method requires specialized software limiting clinical utility. The Local Deposition method, an alternative to DPK convolution, can be used to obtain absorbed dose and requires no additional computer processing. Pixel values from regions of interest drawn on Y90 PET/CT images can be converted to absorbed dose (Gy) by multiplication with a scalar constant. Results There is evidence that suggests the Local Deposition method may actually be more accurate than DPK convolution and it has been successfully used in a recent Y90 PET/CT publication. We have analytically compared dose-volume-histograms (DVH) for phantom hot-spheres to determine the difference between the DPK and Local Deposition methods, as a function of PET scanner point-spread-function for Y90. We have found that for PET/CT systems with a FWHM greater than 3.0 mm when imaging Y90, the Local Deposition Method provides a more accurate representation of DVH, regardless of target size than DPK convolution. Conclusion Using the Local Deposition Method, post-radioembolization Y90 PET/CT images can be transformed into 3D absorbed dose maps of the liver. An interventional radiologist or a Medical Physicist can perform this transformation in a clinical setting, allowing for rapid prediction of treatment efficacy by comparison to published tumoricidal thresholds.« less

Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established predictors for the outcome of shock wave lithotripsy.

PubMed

Langenauer, J; Betschart, P; Hechelhammer, L; Güsewell, S; Schmid, H P; Engeler, D S; Abt, D; Zumstein, V

2018-05-29

To evaluate the predictive value of advanced non-contrasted computed tomography (NCCT) post-processing using novel CT-calculometry (CT-CM) parameters compared to established predictors of success of shock wave lithotripsy (SWL) for urinary calculi. NCCT post-processing was retrospectively performed in 312 patients suffering from upper tract urinary calculi who were treated by SWL. Established predictors such as skin to stone distance, body mass index, stone diameter or mean stone attenuation values were assessed. Precise stone size and shape metrics, 3-D greyscale measurements and homogeneity parameters such as skewness and kurtosis, were analysed using CT-CM. Predictive values for SWL outcome were analysed using logistic regression and receiver operating characteristics (ROC) statistics. Overall success rate (stone disintegration and no re-intervention needed) of SWL was 59% (184 patients). CT-CM metrics mainly outperformed established predictors. According to ROC analyses, stone volume and surface area performed better than established stone diameter, mean 3D attenuation value was a stronger predictor than established mean attenuation value, and parameters skewness and kurtosis performed better than recently emerged variation coefficient of stone density. Moreover, prediction of SWL outcome with 80% probability to be correct would be possible in a clearly higher number of patients (up to fivefold) using CT-CM-derived parameters. Advanced NCCT post-processing by CT-CM provides novel parameters that seem to outperform established predictors of SWL response. Implementation of these parameters into clinical routine might reduce SWL failure rates.

Quantitative evaluation for accumulative calibration error and video-CT registration errors in electromagnetic-tracked endoscopy.

PubMed

Liu, Sheena Xin; Gutiérrez, Luis F; Stanton, Doug

2011-05-01

Electromagnetic (EM)-guided endoscopy has demonstrated its value in minimally invasive interventions. Accuracy evaluation of the system is of paramount importance to clinical applications. Previously, a number of researchers have reported the results of calibrating the EM-guided endoscope; however, the accumulated errors of an integrated system, which ultimately reflect intra-operative performance, have not been characterized. To fill this vacancy, we propose a novel system to perform this evaluation and use a 3D metric to reflect the intra-operative procedural accuracy. This paper first presents a portable design and a method for calibration of an electromagnetic (EM)-tracked endoscopy system. An evaluation scheme is then described that uses the calibration results and EM-CT registration to enable real-time data fusion between CT and endoscopic video images. We present quantitative evaluation results for estimating the accuracy of this system using eight internal fiducials as the targets on an anatomical phantom: the error is obtained by comparing the positions of these targets in the CT space, EM space and endoscopy image space. To obtain 3D error estimation, the 3D locations of the targets in the endoscopy image space are reconstructed from stereo views of the EM-tracked monocular endoscope. Thus, the accumulated errors are evaluated in a controlled environment, where the ground truth information is present and systematic performance (including the calibration error) can be assessed. We obtain the mean in-plane error to be on the order of 2 pixels. To evaluate the data integration performance for virtual navigation, target video-CT registration error (TRE) is measured as the 3D Euclidean distance between the 3D-reconstructed targets of endoscopy video images and the targets identified in CT. The 3D error (TRE) encapsulates EM-CT registration error, EM-tracking error, fiducial localization error, and optical-EM calibration error. We present in this paper our calibration method and a virtual navigation evaluation system for quantifying the overall errors of the intra-operative data integration. We believe this phantom not only offers us good insights to understand the systematic errors encountered in all phases of an EM-tracked endoscopy procedure but also can provide quality control of laboratory experiments for endoscopic procedures before the experiments are transferred from the laboratory to human subjects.

Predictive value of PET-CT for pathological response in stages II and III breast cancer patients following neoadjuvant chemotherapy with docetaxel.

PubMed

García García-Esquinas, Marta A; Arrazola García, Juan; García-Sáenz, José A; Furió-Bacete, V; Fuentes Ferrer, Manuel E; Ortega Candil, Aída; Cabrera Martín, María N; Carreras Delgado, José L

2014-01-01

To prospectively study the value of PET-CT with fluorine-18 fluorodeoxyglucose (FDG) to predict neoadjuvant chemotherapy (NAC) response of locoregional disease of stages II and III breast cancer patients. A written informed consent and approval were obtained from the Ethics Committee. PET-CT accuracy in the prediction of pathologic complete response (pCR) after NAC was studied in primary tumors and lymph node metastasis in 43 women (mean age: 50 years: range: 27-71 years) with histologically proven breast cancer between December 2009 and January 2011. PET-CT was performed at baseline and after NAC. SUV(max) percentage changes (ΔSUV(max)) were compared with pathology findings at surgery. Receiver-operator characteristic (ROC) analysis was used to discriminate between locoregional pCR and non-pCR. In patients not achieving pCR, it was investigated if ΔSUV(max) could accurately identify the residual cancer burden (RCB) classes: RCB-I (minimal residual disease (MRD)), RCB-II (moderate RD), and RCB-III (extensive RD). pCR was obtained in 11 patients (25.6%). Residual disease was found in 32 patients (74.4%): 16 (37.2%) RCB-I, 15 (35.6%) RCB-II and 2 (4.7%) RCB-III. Sensitivity, specificity, and accuracy to predict pCR were 90.9%, 90.6%, and 90.7%, respectively. Specificity was 94.1% in the identification of a subset of patients who had either pCR or MRD. Accuracy of ΔSUV(max) in the locoregional disease of stages II and III breast cancer patients after NAC is high for the identification of pCR cases. Its specificity is potentially sufficient to identify a subgroup of patients who could be managed with conservative surgery. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

Clinical impact of 18 F-FDG positron emission tomography/CT on adenoid cystic carcinoma of the head and neck.

PubMed

Jung, Ji-Hoon; Lee, Sang-Woo; Son, Seung Hyun; Kim, Choon-Young; Lee, Chang-Hee; Jeong, Ju Hye; Jeong, Shin Young; Ahn, Byeong-Cheol; Lee, Jaetae

2017-03-01

The purpose of this retrospective study was to assess the diagnostic value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and the prognostic value of metabolic PET parameters in patients with adenoid cystic carcinoma of the head and neck (ACCHN). Forty patients with newly diagnosed ACCHN were enrolled in this study. We investigated the diagnostic value of 18 F-FDG PET/CT for detecting and staging compared to conventional CT. Kaplan-Meier survival analysis for progression-free survival (PFS) was performed with clinicopathological factors and metabolic PET parameters. The 18 F-FDG PET/CT showed comparable sensitivity (92.3%) to conventional CT for lesion detection, and changed staging and management plan in 6 patients (15.0%). Lower PFS rates were associated with advanced T classification, advanced TNM classification, high maximum standardized uptake value (SUVmax; >5.1), and high total lesion glycolysis (>40.1) of the primary tumor. The 18 F-FDG PET/CT can provide additional information for initial staging, and metabolic PET parameters may serve as prognostic factors of ACCHN. © 2016 Wiley Periodicals, Inc. Head Neck 39: 447-455, 2017. © 2016 Wiley Periodicals, Inc.

A Monte Carlo study of the energy spectra and transmission characteristics of scattered radiation from x-ray computed tomography.

PubMed

Platten, David John

2014-06-01

Existing data used to calculate the barrier transmission of scattered radiation from computed tomography (CT) are based on primary beam CT energy spectra. This study uses the EGSnrc Monte Carlo system and Epp user code to determine the energy spectra of CT scatter from four different primary CT beams passing through an ICRP 110 male reference phantom. Each scatter spectrum was used as a broad-beam x-ray source in transmission simulations through seventeen thicknesses of lead (0.00-3.50 mm). A fit of transmission data to lead thickness was performed to obtain α, β and γ parameters for each spectrum. The mean energy of the scatter spectra were up to 12.3 keV lower than that of the primary spectrum. For 120 kVp scatter beams the transmission through lead was at least 50% less than predicted by existing data for thicknesses of 1.5 mm and greater; at least 30% less transmission was seen for 140 kVp scatter beams. This work has shown that the mean energy and half-value layer of CT scatter spectra are lower than those of the corresponding primary beam. The transmission of CT scatter radiation through lead is lower than that calculated with currently available data. Using the data from this work will result in less lead shielding being required for CT scanner installations.

Collateral Ventilation to Congenital Hyperlucent Lung Lesions Assessed on Xenon-Enhanced Dynamic Dual-Energy CT: an Initial Experience

PubMed Central

Yang, Dong Hyun; Kim, Namkug; Park, Seung Il; Kim, Dong Kwan; Kim, Ellen Ai-Rhan

2011-01-01

Objective We wanted to evaluate the resistance to collateral ventilation in congenital hyperlucent lung lesions and to correlate that with the anatomic findings on xenon-enhanced dynamic dual-energy CT. Materials and Methods Xenon-enhanced dynamic dual-energy CT was successfully and safely performed in eight children (median age: 5.5 years, 4 boys and 4 girls) with congenital hyperlucent lung lesions. Functional assessment of the lung lesions on the xenon map was done, including performing a time-xenon value curve analysis and assessing the amplitude of xenon enhancement (A) value, the rate of xenon enhancement (K) value and the time of arrival value. Based on the A value, the lung lesions were categorized into high or low (A value > 10 Hounsfield unit [HU]) resistance to collateral ventilation. In addition, the morphologic CT findings of the lung lesions, including cyst, mucocele and an accessory or incomplete fissure, were assessed on the weighted-average CT images. The xenon-enhanced CT radiation dose was estimated. Results Five of the eight lung lesions were categorized into the high resistance group and three lesions were categorized into the low resistance group. The A and K values in the normal lung were higher than those in the low resistance group. The time of arrival values were delayed in the low resistance group. Cysts were identified in five lesions, mucocele in four, accessory fissure in three and incomplete fissure in two. Either cyst or an accessory fissure was seen in four of the five lesions showing high resistance to collateral ventilation. The xenon-enhanced CT radiation dose was 2.3 ± 0.6 mSv. Conclusion Xenon-enhanced dynamic dual-energy CT can help visualize and quantitate various degrees of collateral ventilation to congenital hyperlucent lung lesions in addition to assessing the anatomic details of the lung. PMID:21228937

Collateral ventilation to congenital hyperlucent lung lesions assessed on xenon-enhanced dynamic dual-energy CT: an initial experience.

PubMed

Goo, Hyun Woo; Yang, Dong Hyun; Kim, Namkug; Park, Seung Il; Kim, Dong Kwan; Kim, Ellen Ai-Rhan

2011-01-01

We wanted to evaluate the resistance to collateral ventilation in congenital hyperlucent lung lesions and to correlate that with the anatomic findings on xenon-enhanced dynamic dual-energy CT. Xenon-enhanced dynamic dual-energy CT was successfully and safely performed in eight children (median age: 5.5 years, 4 boys and 4 girls) with congenital hyperlucent lung lesions. Functional assessment of the lung lesions on the xenon map was done, including performing a time-xenon value curve analysis and assessing the amplitude of xenon enhancement (A) value, the rate of xenon enhancement (K) value and the time of arrival value. Based on the A value, the lung lesions were categorized into high or low (A value > 10 Hounsfield unit [HU]) resistance to collateral ventilation. In addition, the morphologic CT findings of the lung lesions, including cyst, mucocele and an accessory or incomplete fissure, were assessed on the weighted-average CT images. The xenon-enhanced CT radiation dose was estimated. Five of the eight lung lesions were categorized into the high resistance group and three lesions were categorized into the low resistance group. The A and K values in the normal lung were higher than those in the low resistance group. The time of arrival values were delayed in the low resistance group. Cysts were identified in five lesions, mucocele in four, accessory fissure in three and incomplete fissure in two. Either cyst or an accessory fissure was seen in four of the five lesions showing high resistance to collateral ventilation. The xenon-enhanced CT radiation dose was 2.3 ± 0.6 mSv. Xenon-enhanced dynamic dual-energy CT can help visualize and quantitate various degrees of collateral ventilation to congenital hyperlucent lung lesions in addition to assessing the anatomic details of the lung.

Prediction of Hip Failure Load: In Vitro Study of 80 Femurs Using Three Imaging Methods and Finite Element Models-The European Fracture Study (EFFECT).

PubMed

Pottecher, Pierre; Engelke, Klaus; Duchemin, Laure; Museyko, Oleg; Moser, Thomas; Mitton, David; Vicaut, Eric; Adams, Judith; Skalli, Wafa; Laredo, Jean Denis; Bousson, Valérie

2016-09-01

Purpose To evaluate the performance of three imaging methods (radiography, dual-energy x-ray absorptiometry [DXA], and quantitative computed tomography [CT]) and that of a numerical analysis with finite element modeling (FEM) in the prediction of failure load of the proximal femur and to identify the best densitometric or geometric predictors of hip failure load. Materials and Methods Institutional review board approval was obtained. A total of 40 pairs of excised cadaver femurs (mean patient age at time of death, 82 years ± 12 [standard deviation]) were examined with (a) radiography to measure geometric parameters (lengths, angles, and cortical thicknesses), (b) DXA (reference standard) to determine areal bone mineral densities (BMDs), and (c) quantitative CT with dedicated three-dimensional analysis software to determine volumetric BMDs and geometric parameters (neck axis length, cortical thicknesses, volumes, and moments of inertia), and (d) quantitative CT-based FEM to calculate a numerical value of failure load. The 80 femurs were fractured via mechanical testing, with random assignment of one femur from each pair to the single-limb stance configuration (hereafter, stance configuration) and assignment of the paired femur to the sideways fall configuration (hereafter, side configuration). Descriptive statistics, univariate correlations, and stepwise regression models were obtained for each imaging method and for FEM to enable us to predict failure load in both configurations. Results Statistics reported are for stance and side configurations, respectively. For radiography, the strongest correlation with mechanical failure load was obtained by using a geometric parameter combined with a cortical thickness (r(2) = 0.66, P < .001; r(2) = 0.65, P < .001). For DXA, the strongest correlation with mechanical failure load was obtained by using total BMD (r(2) = 0.73, P < .001) and trochanteric BMD (r(2) = 0.80, P < .001). For quantitative CT, in both configurations, the best model combined volumetric BMD and a moment of inertia (r(2) = 0.78, P < .001; r(2) = 0.85, P < .001). FEM explained 87% (P < .001) and 83% (P < .001) of bone strength, respectively. By combining (a) radiography and DXA and (b) quantitative CT and DXA, correlations with mechanical failure load increased to 0.82 (P < .001) and 0.84 (P < .001), respectively, for radiography and DXA and to 0.80 (P < .001) and 0.86 (P < .001) , respectively, for quantitative CT and DXA. Conclusion Quantitative CT-based FEM was the best method with which to predict the experimental failure load; however, combining quantitative CT and DXA yielded a performance as good as that attained with FEM. The quantitative CT DXA combination may be easier to use in fracture prediction, provided standardized software is developed. These findings also highlight the major influence on femoral failure load, particularly in the trochanteric region, of a densitometric parameter combined with a geometric parameter. (©) RSNA, 2016 Online supplemental material is available for this article.

Investigation of statistical iterative reconstruction for dedicated breast CT

PubMed Central

Makeev, Andrey; Glick, Stephen J.

2013-01-01

Purpose: Dedicated breast CT has great potential for improving the detection and diagnosis of breast cancer. Statistical iterative reconstruction (SIR) in dedicated breast CT is a promising alternative to traditional filtered backprojection (FBP). One of the difficulties in using SIR is the presence of free parameters in the algorithm that control the appearance of the resulting image. These parameters require tuning in order to achieve high quality reconstructions. In this study, the authors investigated the penalized maximum likelihood (PML) method with two commonly used types of roughness penalty functions: hyperbolic potential and anisotropic total variation (TV) norm. Reconstructed images were compared with images obtained using standard FBP. Optimal parameters for PML with the hyperbolic prior are reported for the task of detecting microcalcifications embedded in breast tissue. Methods: Computer simulations were used to acquire projections in a half-cone beam geometry. The modeled setup describes a realistic breast CT benchtop system, with an x-ray spectra produced by a point source and an a-Si, CsI:Tl flat-panel detector. A voxelized anthropomorphic breast phantom with 280 μm microcalcification spheres embedded in it was used to model attenuation properties of the uncompressed woman's breast in a pendant position. The reconstruction of 3D images was performed using the separable paraboloidal surrogates algorithm with ordered subsets. Task performance was assessed with the ideal observer detectability index to determine optimal PML parameters. Results: The authors' findings suggest that there is a preferred range of values of the roughness penalty weight and the edge preservation threshold in the penalized objective function with the hyperbolic potential, which resulted in low noise images with high contrast microcalcifications preserved. In terms of numerical observer detectability index, the PML method with optimal parameters yielded substantially improved performance (by a factor of greater than 10) compared to FBP. The hyperbolic prior was also observed to be superior to the TV norm. A few of the best-performing parameter pairs for the PML method also demonstrated superior performance for various radiation doses. In fact, using PML with certain parameter values results in better images, acquired using 2 mGy dose, than FBP-reconstructed images acquired using 6 mGy dose. Conclusions: A range of optimal free parameters for the PML algorithm with hyperbolic and TV norm-based potentials is presented for the microcalcification detection task, in dedicated breast CT. The reported values can be used as starting values of the free parameters, when SIR techniques are used for image reconstruction. Significant improvement in image quality can be achieved by using PML with optimal combination of parameters, as compared to FBP. Importantly, these results suggest improved detection of microcalcifications can be obtained by using PML with lower radiation dose to the patient, than using FBP with higher dose. PMID:23927318

Technical Note: FreeCT_wFBP: A robust, efficient, open-source implementation of weighted filtered backprojection for helical, fan-beam CT.

PubMed

Hoffman, John; Young, Stefano; Noo, Frédéric; McNitt-Gray, Michael

2016-03-01

With growing interest in quantitative imaging, radiomics, and CAD using CT imaging, the need to explore the impacts of acquisition and reconstruction parameters has grown. This usually requires extensive access to the scanner on which the data were acquired and its workflow is not designed for large-scale reconstruction projects. Therefore, the authors have developed a freely available, open-source software package implementing a common reconstruction method, weighted filtered backprojection (wFBP), for helical fan-beam CT applications. FreeCT_wFBP is a low-dependency, GPU-based reconstruction program utilizing c for the host code and Nvidia CUDA C for GPU code. The software is capable of reconstructing helical scans acquired with arbitrary pitch-values, and sampling techniques such as flying focal spots and a quarter-detector offset. In this work, the software has been described and evaluated for reconstruction speed, image quality, and accuracy. Speed was evaluated based on acquisitions of the ACR CT accreditation phantom under four different flying focal spot configurations. Image quality was assessed using the same phantom by evaluating CT number accuracy, uniformity, and contrast to noise ratio (CNR). Finally, reconstructed mass-attenuation coefficient accuracy was evaluated using a simulated scan of a FORBILD thorax phantom and comparing reconstructed values to the known phantom values. The average reconstruction time evaluated under all flying focal spot configurations was found to be 17.4 ± 1.0 s for a 512 row × 512 column × 32 slice volume. Reconstructions of the ACR phantom were found to meet all CT Accreditation Program criteria including CT number, CNR, and uniformity tests. Finally, reconstructed mass-attenuation coefficient values of water within the FORBILD thorax phantom agreed with original phantom values to within 0.0001 mm(2)/g (0.01%). FreeCT_wFBP is a fast, highly configurable reconstruction package for third-generation CT available under the GNU GPL. It shows good performance with both clinical and simulated data.

Latent class analysis of the diagnostic characteristics of PCR and conventional bacteriological culture in diagnosing intramammary infections caused by Staphylococcus aureus in dairy cows at dry off

PubMed Central

2012-01-01

Background Staphylococcus aureus is one of the most common causes of intramammary infections in dairy cows at dry off. Reliable identification is important for disease management on herd level and for antimicrobial treatment of infected animals. Our objective was to evaluate the test characteristics of PathoProof ™ Mastitis PCR Assay and bacteriological culture (BC) in diagnosing bovine intramammary infections caused by S. aureus at dry off at different PCR cycle threshold (Ct)-value cut-offs. Methods Sterile quarter samples and non-sterile composite samples from 140 animals in seven herds were collected in connection with the dairy herd improvement (DHI) milk recording. All quarter samples were analyzed using BC whereas all composite samples were analyzed with PathoProof ™ Mastitis PCR Assay. Latent class analysis was used to estimate test properties for PCR and BC in the absence of a perfect reference test. The population was divided into two geographically divided subpopulations and the Hui-Walter 2-test 2-populations model applied to estimate Se, Sp for the two tests, and prevalence for the two subpopulations. Results The Se for PCR increased with increasing Ct-value cut-off, accompanied by a small decrease in Sp. For BC the Se decreased and Sp increased with increasing Ct-value cut-off. Most optimal test estimates for the real-time PCR assay were at a Ct-value cut-off of 37; 0.93 [95% posterior probability interval (PPI) 0.60-0.99] for Se and 0.95 [95% PPI 0.95-0.99] for Sp. At the same Ct-value cut-off, Se and Sp for BC were 0.83 [95% PPI 0.66-0.99] and 0.97 [95% PPI 0.91-0.99] respectively. Depending on the chosen PCR Ct-value cut-off, the prevalence in the subpopulations varied; the prevalence increased with increasing PCR Ct-value cut-offs. Conclusion Neither BC nor real-time PCR is a perfect test in detecting IMI in dairy cows at dry off. The changes in sensitivity and prevalence at different Ct-value cut-offs for both PCR and BC may indicate a change in the underlying disease definition. At low PCR Ct-value cut-offs the underlying disease definition may be a truly/heavily infected cow, whereas at higher PCR Ct-value cut-offs the disease definition may be a S. aureus positive cow. PMID:23164432

Value of a Lower-Limb Immobilization Device for Optimization of SPECT/CT Image Fusion.

PubMed

Machado, Joana do Mar F; Monteiro, Marina S; Vieira, Victor Fernandes; Collinot, Jean-Aybert; Prior, John O; Vieira, Lina; Pires-Jorge, José A

2015-06-01

The foot and the ankle are small structures commonly affected by disorders, and their complex anatomy represents a significant diagnostic challenge. By providing information on anatomic and bone structure that cannot be obtained from functional imaging, SPECT/CT image fusion can be particularly useful in increasing diagnostic certainty about bone pathology. However, because of the lengthy duration of a SPECT acquisition, a patient's involuntary movements may lead to misalignment between SPECT and CT images. Patient motion can be reduced using a dedicated patient support. We designed an ankle- and foot-immobilizing device and measured its efficacy at improving image fusion. We enrolled 20 patients who underwent SPECT/CT of the ankle and foot with and without a foot support. The misalignment between SPECT and CT images was computed by manually measuring 14 fiducial markers chosen among anatomic landmarks also visible on bone scintigraphy. ANOVA was performed for statistical analysis. The absolute average difference without and with support was 5.1 ± 5.2 mm (mean ± SD) and 3.1 ± 2.7 mm, respectively, which is significant (P < 0.001). The introduction of the foot support significantly decreased misalignment between SPECT and CT images, which may have a positive clinical influence in the precise localization of foot and ankle pathology. © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Evaluation of variations in absorbed dose and image noise according to patient forms in X-ray computed tomography.

PubMed

Matsubara, Kosuke; Koshida, Kichiro; Suzuki, Masayuki; Hayakawa, Mayumi; Tsujii, Hideo; Yamamoto, Tomoyuki

2005-12-20

Excessive radiation exposure in pediatric computed tomography (CT) scanning has become a serious problem, and it is difficult to select scan parameters for the scanning of small patients such as children. We investigated differences in absorbed dose and standard deviation (SD) in Hounsfield unit (HU) caused by differences in the form of the subject using a body-type phantom with removable body parts. Using four X-ray CT scanners, measurements were made with values from 50 mAs to 300 mAs, with slices of 50 mAs, using scan protocols that were assumed to perform thorough examinations. The results showed that the mAs values and absorbed doses were almost proportional, and the absorbed doses in the phantom without body parts were about 1.1-2.2-fold higher than those of the phantom with body parts at the same points. The SD values obtained indicated that the absorbed doses in the phantom with body parts were 0.3-0.6 times those of the phantom without body parts when the mAs values used were adjusted so that both SD values were the same. The absorbed doses in various patient forms can be estimated from these results, and they will become critical data for the selection of appropriate scan protocols.

INVESTIGATION OF PARTIAL VOLUME EFFECT IN DIFFERENT PET/CT SYSTEMS: A COMPARISON OF RESULTS USING THE MADEIRA PHANTOM AND THE NEMA NU-2 2001 PHANTOM.

PubMed

Chipiga, L; Sydoff, M; Zvonova, I; Bernhardsson, C

2016-06-01

Positron emission tomography combined with computed tomography (PET/CT) is a quantitative technique used for diagnosing various diseases and for monitoring treatment response for different types of tumours. However, the accuracy of the data is limited by the spatial resolution of the system. In addition, the so-called partial volume effect (PVE) causes a blurring of image structures, which in turn may cause an underestimation of activity of a structure with high-activity content. In this study, a new phantom, MADEIRA (Minimising Activity and Dose with Enhanced Image quality by Radiopharmaceutical Administrations) for activity quantification in PET and single photon emission computed tomography (SPECT) was used to investigate the influence on the PVE by lesion size and tumour-to-background activity concentration ratio (TBR) in four different PET/CT systems. These measurements were compared with data from measurements with the NEMA NU-2 2001 phantom. The results with the MADEIRA phantom showed that the activity concentration (AC) values were closest to the true values at low ratios of TBR (<10) and reduced to 50 % of the actual AC values at high TBR (30-35). For all scanners, recovery of true values became closer to 1 with an increasing diameter of the lesion. The MADEIRA phantom showed good agreement with the results obtained from measurements with the NEMA NU-2 2001 phantom but allows for a wider range of possibilities in measuring image quality parameters. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pulmonary MR imaging with ultra-short TEs: utility for disease severity assessment of connective tissue disease patients.

PubMed

Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Takenaka, Daisuke; Takahashi, Masaya; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Obara, Makoto; van Cauteren, Marc; Sugimura, Kazuro

2013-08-01

To evaluate the utility of pulmonary magnetic resonance (MR) imaging with ultra-short echo times (UTEs) at a 3.0 T MR system for pulmonary functional loss and disease severity assessments of connective tissue disease (CTD) patients with interstitial lung disease (ILD). This prospective study was approved by the institutional review board, and written informed consent was obtained from 18 CTD patients (eight men and ten women) and eight normal subjects with suspected chest disease (three men and five women). All subjects underwent thin-section MDCT, pulmonary MR imaging with UTEs, pulmonary function test and serum KL-6. Regional T2 maps were generated from each MR data set, and mean T2 values were determined from ROI measurements. From each thin-section MDCT data set, CT-based disease severity was evaluated with a visual scoring system. Mean T2 values for normal and CTD subjects were statistically compared by using Student's t-test. To assess capability for pulmonary functional loss and disease severity assessments, mean T2 values were statistically correlated with pulmonary functional parameters, serum KL-6 and CT-based disease severity. Mean T2 values for normal and CTD subjects were significantly different (p=0.0019) and showed significant correlations with %VC, %DLCO, serum KL-6 and CT-based disease severity of CTD patients (p<0.05). Pulmonary MR imaging with UTEs is useful for pulmonary functional loss and disease severity assessments of CTD patients with ILD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Physical analysis of breast cancer using dual-source computed tomography

NASA Astrophysics Data System (ADS)

Kim, H. J.; Lee, H. K.; Cho, J. H.

2014-12-01

This study was aimed to analyze various physical characteristics of breast cancer using dual-source computed tomography (CT). A phantom study and a clinical trial were performed in order and a 64-multidetector CT device was used for the examinations. In the phantom study, single-source (SS) CT was set up with a conventional scanning condition that is usually applied for breast CT examination and implementation was done at tube voltage of 120 kVp. Dual-source CT acquired images by irradiating X-ray sources with fast switching between two kilovoltage settings (80 and 140 kVp). After scanning, Hounsfield Unit (HU) values and radiation doses in a region of interest were measured and analyzed. In the clinical trial, the HU values were measured and analyzed after single-source computed tomography (SSCT) and dual-source CT in patients diagnosed with breast cancer. Also, the tumor size measured by dual-source CT was compared with the actual tumor size. The phantom study determined that the tumor region was especially measured by dual-source CT, while nylon fiber and specks region were especially measured by SSCT. The radiation dose was high with dual-source CT. The clinical trial showed a higher HU value of cancerous regions when scanned by dual-source CT compared with SSCT.

68Ga-PSMA PET/CT in the evaluation of bone metastases in prostate cancer.

PubMed

Sachpekidis, Christos; Bäumer, P; Kopka, K; Hadaschik, B A; Hohenfellner, M; Kopp-Schneider, A; Haberkorn, U; Dimitrakopoulou-Strauss, A

2018-06-01

The aims of this retrospective analysis were to compare 68 Ga-PSMA PET findings and low-dose CT findings (120 kV, 30 mA), and to obtain semiquantitative and quantitative 68 Ga-PSMA PET data in patients with prostate cancer (PC) bone metastases. In total, 152 PET/CT scans from 140 patients were evaluated. Of these patients, 30 had previously untreated primary PC, and 110 had biochemical relapse after treatment of primary PC. All patients underwent dynamic PET/CT scanning of the pelvis and lower abdomen as well as whole-body PET/CT with 68 Ga-PSMA-11. The PET/CT scans were analysed qualitatively (visually), semiquantitatively (SUV), and quantitatively based on a two-tissue compartment model and a noncompartmental approach leading to the extraction of the fractal dimension. Differences were considered significant for p values <0.05. In total, 168 68 Ga-PSMA-positive and 113 CT-positive skeletal lesions were detected in 37 patients (8 with primary PC, 29 with biochemical recurrence). Of these 168 lesions, 103 were both 68 Ga-PSMA PET-positive and CT-positive, 65 were only 68 Ga-PSMA-positive, and 10 were only CT-positive. The Yang test showed that there were significantly more 68 Ga-PSMA PET-positive lesions than CT-positive lesions. Association analysis showed that PSA plasma levels were significantly correlated with several 68 Ga-PSMA-11-associated parameters in bone metastases, including the degree of tracer uptake (SUV average and SUV max ), its transport rate from plasma to the interstitial/intracellular compartment (K 1 ), its rate of binding to the PSMA receptor and its internalization (k 3 ), its influx rate (K i ), and its distribution heterogeneity. 68 Ga-PSMA PET/CT is a useful diagnostic tool in the detection of bone metastases in PC. 68 Ga-PSMA PET visualizes more bone metastases than low-dose CT. PSA plasma levels are significantly correlated with several 68 Ga-PSMA PET parameters.

PET-PANC: multicentre prospective diagnostic accuracy and health economic analysis study of the impact of combined modality 18fluorine-2-fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography scanning in the diagnosis and management of pancreatic cancer.

PubMed

Ghaneh, Paula; Hanson, Robert; Titman, Andrew; Lancaster, Gill; Plumpton, Catrin; Lloyd-Williams, Huw; Yeo, Seow Tien; Edwards, Rhiannon Tudor; Johnson, Colin; Abu Hilal, Mohammed; Higginson, Antony P; Armstrong, Tom; Smith, Andrew; Scarsbrook, Andrew; McKay, Colin; Carter, Ross; Sutcliffe, Robert P; Bramhall, Simon; Kocher, Hemant M; Cunningham, David; Pereira, Stephen P; Davidson, Brian; Chang, David; Khan, Saboor; Zealley, Ian; Sarker, Debashis; Al Sarireh, Bilal; Charnley, Richard; Lobo, Dileep; Nicolson, Marianne; Halloran, Christopher; Raraty, Michael; Sutton, Robert; Vinjamuri, Sobhan; Evans, Jonathan; Campbell, Fiona; Deeks, Jon; Sanghera, Bal; Wong, Wai-Lup; Neoptolemos, John P

2018-02-01

Pancreatic cancer diagnosis and staging can be difficult in 10-20% of patients. Positron emission tomography (PET)/computed tomography (CT) adds precise anatomical localisation to functional data. The use of PET/CT may add further value to the diagnosis and staging of pancreatic cancer. To determine the incremental diagnostic accuracy and impact of PET/CT in addition to standard diagnostic work-up in patients with suspected pancreatic cancer. A multicentre prospective diagnostic accuracy and clinical value study of PET/CT in suspected pancreatic malignancy. Patients with suspected pancreatic malignancy. All patients to undergo PET/CT following standard diagnostic work-up. The primary outcome was the incremental diagnostic value of PET/CT in addition to standard diagnostic work-up with multidetector computed tomography (MDCT). Secondary outcomes were (1) changes in patients' diagnosis, staging and management as a result of PET/CT; (2) changes in the costs and effectiveness of patient management as a result of PET/CT; (3) the incremental diagnostic value of PET/CT in chronic pancreatitis; (4) the identification of groups of patients who would benefit most from PET/CT; and (5) the incremental diagnostic value of PET/CT in other pancreatic tumours. Between 2011 and 2013, 589 patients with suspected pancreatic cancer underwent MDCT and PET/CT, with 550 patients having complete data and in-range PET/CT. Sensitivity and specificity for the diagnosis of pancreatic cancer were 88.5% and 70.6%, respectively, for MDCT and 92.7% and 75.8%, respectively, for PET/CT. The maximum standardised uptake value (SUV max. ) for a pancreatic cancer diagnosis was 7.5. PET/CT demonstrated a significant improvement in relative sensitivity ( p  = 0.01) and specificity ( p  = 0.023) compared with MDCT. Incremental likelihood ratios demonstrated that PET/CT significantly improved diagnostic accuracy in all scenarios ( p  < 0.0002). PET/CT correctly changed the staging of pancreatic cancer in 56 patients ( p  = 0.001). PET/CT influenced management in 250 (45%) patients. PET/CT stopped resection in 58 (20%) patients who were due to have surgery. The benefit of PET/CT was limited in patients with chronic pancreatitis or other pancreatic tumours. PET/CT was associated with a gain in quality-adjusted life-years of 0.0157 (95% confidence interval -0.0101 to 0.0430). In the base-case model PET/CT was seen to dominate MDCT alone and is thus highly likely to be cost-effective for the UK NHS. PET/CT was seen to be most cost-effective for the subgroup of patients with suspected pancreatic cancer who were thought to be resectable. PET/CT provided a significant incremental diagnostic benefit in the diagnosis of pancreatic cancer and significantly influenced the staging and management of patients. PET/CT had limited utility in chronic pancreatitis and other pancreatic tumours. PET/CT is likely to be cost-effective at current reimbursement rates for PET/CT to the UK NHS. This was not a randomised controlled trial and therefore we do not have any information from patients who would have undergone MDCT only for comparison. In addition, there were issues in estimating costs for PET/CT. Future work should evaluate the role of PET/CT in intraductal papillary mucinous neoplasm and prognosis and response to therapy in patients with pancreatic cancer. Current Controlled Trials ISRCTN73852054 and UKCRN 8166. The National Institute for Health Research Health Technology Assessment programme.

Facial asymmetry quantitative evaluation in oculoauriculovertebral spectrum.

PubMed

Manara, Renzo; Schifano, Giovanni; Brotto, Davide; Mardari, Rodica; Ghiselli, Sara; Gerunda, Antonio; Ghirotto, Cristina; Fusetti, Stefano; Piacentile, Katherine; Scienza, Renato; Ermani, Mario; Martini, Alessandro

2016-03-01

Facial asymmetries in oculoauriculovertebral spectrum (OAVS) patients might require surgical corrections that are mostly based on qualitative approach and surgeon's experience. The present study aimed to develop a quantitative 3D CT imaging-based procedure suitable for maxillo-facial surgery planning in OAVS patients. Thirteen OAVS patients (mean age 3.5 ± 4.0 years; range 0.2-14.2, 6 females) and 13 controls (mean age 7.1 ± 5.3 years; range 0.6-15.7, 5 females) who underwent head CT examination were retrospectively enrolled. Eight bilateral anatomical facial landmarks were defined on 3D CT images (porion, orbitale, most anterior point of frontozygomatic suture, most superior point of temporozygomatic suture, most posterior-lateral point of the maxilla, gonion, condylion, mental foramen) and distance from orthogonal planes (in millimeters) was used to evaluate the asymmetry on each axis and to calculate a global asymmetry index of each anatomical landmark. Mean asymmetry values and relative confidence intervals were obtained from the control group. OAVS patients showed 2.5 ± 1.8 landmarks above the confidence interval while considering the global asymmetry values; 12 patients (92%) showed at least one pathologically asymmetric landmark. Considering each axis, the mean number of pathologically asymmetric landmarks increased to 5.5 ± 2.6 (p = 0.002) and all patients presented at least one significant landmark asymmetry. Modern CT-based 3D reconstructions allow accurate assessment of facial bone asymmetries in patients affected by OAVS. The evaluation as a global score and in different orthogonal axes provides precise quantitative data suitable for maxillo-facial surgical planning. CT-based 3D reconstruction might allow a quantitative approach for planning and following-up maxillo-facial surgery in OAVS patients.

Pilot study utilizing Fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography for glycolytic phenotyping of canine mast cell tumors.

PubMed

Griffin, Lynn R; Thamm, Doug H; Selmic, Laura E; Ehrhart, E J; Randall, Elissa

2018-03-23

The goal of this prospective pilot study was to use naturally occurring canine mast cell tumors of various grades and stages as a model for attempting to determine how glucose uptake and markers of biologic behavior are correlated. It was hypothesized that enhanced glucose uptake, as measured by 2-[fluorine-18]fluoro-d-glucose-positron emission tomography/computed tomography (F18 FDG PET-CT), would correlate with histologic grade. Dogs were recruited for this study from a population referred for treatment of cytologically or histologically confirmed mast cell tumors. Patients were staged utilizing standard of care methods (abdominal ultrasound and three view thoracic radiographs), followed by a whole body F18 FDG PET-CT. Results of the F18 FDG PET-CT were analyzed for possible metastasis and standard uptake value maximum (SUV max ) of identified lesions. Incisional or excisional biopsies of the accessible mast cell tumors were obtained and histology performed. Results were then analyzed to look for a possible correlation between the grade of mast cell tumors and SUV max . A total of nine animals were included in the sample. Findings indicated that there was a correlation between grade of mast cell tumors and SUV max as determined by F18 FDG PET-CT (p-value = 0.073, significance ≤ 0.1). Based on the limited power of this study, it is felt that further research to examine the relationship between glucose utilization and biologic aggressiveness in canine mast cell tumors is warranted. This study was unable to show that F18 FDG PET-CT was a better staging tool than standard of care methods. © 2018 American College of Veterinary Radiology.

Are flexion extension films necessary for cervical spine clearance in patients with neck pain after negative cervical CT scan?

PubMed

Tran, Baotram; Saxe, Jonathan M; Ekeh, Akpofure Peter

2013-09-01

There are variations in cervical spine (CS) clearance protocols in neurologically intact blunt trauma patients with negative radiological imaging but persistent neck pain. Current guidelines from the current Eastern Association for the Surgery of Trauma include options of maintaining the cervical collar or obtaining either magnetic resonance imaging (MRI) or flexion-extension films (FEF). We evaluated the utility of FEF in the current era of routine computerized tomography (CT) for imaging the CS in trauma. All neurologically intact, awake, nonintoxicated patients who underwent FEF for persistent neck pain after negative CT scan of the CS at our level I trauma center over a 13-mo period were identified. Their charts were reviewed and demographic data obtained. There were 354 patients (58.5% male) with negative cervical CS CT scans who had FEF for residual neck pain. Incidental degenerative changes were seen in 37%--which did not affect their acute management. FEF were positive for possible ligamentous injury in 5 patients (1.4%). Two of these patients had negative magnetic resonance images and the other three had collars removed within 3 wk as the findings were ultimately determined to be degenerative. In the current era, where cervical CT has universally supplanted initial plain films, FEF appear to be of little value in the evaluation of persistent neck pain. Their use should be excluded from cervical spine clearance protocols in neurologically intact, awake patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Evaluation of the radiation doses in newborn patients submitted to CT examinations

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

De Souza Santos, William; Caldas, Linda V.E.; Belinato, Walmir

The number of computed tomography (CT) scans available to the population is increasing, as well as the complexity of such exams. As a result, the radiation doses are increasing as well. Considering the population exposed to CT exams, pediatric patients are considerably more sensitive to radiation than adults. They have a longer life expectancy than adults, and may receive a higher radiation dose than necessary if the CT scan settings are not adjusted for their smaller body size. As a result of these considerations, the risk of developing cancer is of great concern when newborn patients are involved. The objectivemore » of this work was to study the radiation doses on radiosensitive organs of newborn patients undergoing a whole body CT examination, utilizing Monte Carlo simulations. The novelty of this work is the use of pediatric virtual anthropomorphic phantoms, developed at the Department of Nuclear Energy at the Federal University of Pernambuco (DEN/UFPE). The CT equipment utilized during the simulations was a Discovery VCT GE PET/CT system, with a tube voltage of 140 kVp. The X-ray spectrum of this CT scanner was generated by the SRS-78 software, which takes into account the X-ray beam energy used in PET/CT procedures. The absorbed organ doses were computed employing the F6 tally (MeV/g). The results were converted to dose coefficients (mGy/100 mA) for all the structures, considering all employed beams. The highest dose coefficients values were obtained for the brain and the thyroid. This work provides useful information regarding the risks involving ionizing radiation in newborn patients, employing a new and reliable technique. (authors)« less

Deterioration of Cortical Bone Microarchitecture: Critical Component of Renal Osteodystrophy Evaluation.

PubMed

Sharma, Ashish K; Toussaint, Nigel D; Masterson, Rosemary; Holt, Stephen G; Rajapakse, Chamith S; Ebeling, Peter R; Mohanty, Sindhu T; Baldock, Paul; Elder, Grahame J

2018-05-23

Cortical bone is a significant determinant of bone strength and its deterioration contributes to bone fragility. Thin cortices and increased cortical porosity have been noted in patients with chronic kidney disease (CKD), but the "Turnover Mineralization Volume" classification of renal osteodystrophy does not emphasize cortical bone as a key parameter. We aimed to assess trabecular and cortical bone microarchitecture by histomorphometry and micro-CT in patients with CKD G5 and 5D (dialysis). Transiliac bone biopsies were performed in 14 patients undergoing kidney transplantation (n = 12) and parathyroidectomy (n = 2). Structural parameters were analysed by histomorphometry and micro-CT including trabecular bone volume, thickness (TbTh), number (TbN) and separation and cortical thickness (CtTh) and porosity (CtPo). Indices of bone remodelling and mineralisation were obtained and relationships to bone biomarkers examined. Associations were determined by Spearman's or Pearson's rank correlation coefficients. By micro-CT, trabecular parameters were within normal ranges in most patients, but all patients showed very low CtTh (127 ± 44 µm) and high CtPo (60.3 ± 22.5%). CtPo was inversely related to TbN (r = -0.56; p = 0.03) by micro-CT and to TbTh (r = -0.60; p = 0.024) by histomorphometry and correlated to parathyroid hormone values (r = 0.62; p = 0.021). By histomorphometry, bone turnover was high in 50%, low in 21% and normal in 29%, while 36% showed abnormal patterns of mineralization. Significant positive associations were observed between osteoblast surface, osteoclast surface, mineralization surface and bone turnover markers. Deterioration of cortical -microarchitecture despite predominantly normal trabecular parameters reinforces the importance of comprehensive cortical evaluation in patients with CKD. © 2018 S. Karger AG, Basel.

Evaluation of a semiautomated lung mass calculation technique for internal dosimetry applications

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

Busse, Nathan; Erwin, William; Pan, Tinsu

2013-12-15

Purpose: The authors sought to evaluate a simple, semiautomated lung mass estimation method using computed tomography (CT) scans obtained using a variety of acquisition techniques and reconstruction parameters for mass correction of medical internal radiation dose-based internal radionuclide radiation absorbed dose estimates.Methods: CT scans of 27 patients with lung cancer undergoing stereotactic body radiation therapy treatment planning with PET/CT were analyzed retrospectively. For each patient, free-breathing (FB) and respiratory-gated 4DCT scans were acquired. The 4DCT scans were sorted into ten respiratory phases, representing one complete respiratory cycle. An average CT reconstruction was derived from the ten-phase reconstructions. Mid expiration breath-holdmore » CT scans were acquired in the same session for many patients. Deep inspiration breath-hold diagnostic CT scans of many of the patients were obtained from different scanning sessions at similar time points to evaluate the effect of contrast administration and maximum inspiration breath-hold. Lung mass estimates were obtained using all CT scan types, and intercomparisons made to assess lung mass variation according to scan type. Lung mass estimates using the FB CT scans from PET/CT examinations of another group of ten male and ten female patients who were 21–30 years old and did not have lung disease were calculated and compared with reference lung mass values. To evaluate the effect of varying CT acquisition and reconstruction parameters on lung mass estimation, an anthropomorphic chest phantom was scanned and reconstructed with different CT parameters. CT images of the lungs were segmented using the OsiriX MD software program with a seed point of about −850 HU and an interval of 1000. Lung volume, and mean lung, tissue, and air HUs were recorded for each scan. Lung mass was calculated by assuming each voxel was a linear combination of only air and tissue. The specific gravity of lung volume was calculated using the formula (lung HU − air HU)/(tissue HU − air HU), and mass = specific gravity × total volume × 1.04 g/cm{sup 3}.Results: The range of calculated lung masses was 0.51–1.29 kg. The average male and female lung masses during FB CT were 0.80 and 0.71 kg, respectively. The calculated lung mass varied across the respiratory cycle but changed to a lesser degree than did lung volume measurements (7.3% versus 15.4%). Lung masses calculated using deep inspiration breath-hold and average CT were significantly larger (p < 0.05) than were some masses calculated using respiratory-phase and FB CT. Increased voxel size and smooth reconstruction kernels led to high lung mass estimates owing to partial volume effects.Conclusions: Organ mass correction is an important component of patient-specific internal radionuclide dosimetry. Lung mass calculation necessitates scan-based density correction to account for volume changes owing to respiration. The range of lung masses in the authors’ patient population represents lung doses for the same absorbed energy differing from 25% below to 64% above the dose found using reference phantom organ masses. With proper management of acquisition parameters and selection of FB or midexpiration breath hold scans, lung mass estimates with about 10% population precision may be achieved.« less

Thoracic computed tomography is an effective screening modality in patients with penetrating injuries to the chest.

PubMed

Strumwasser, Aaron; Chong, Vincent; Chu, Eveline; Victorino, Gregory P

2016-09-01

The precise role of thoracic CT in penetrating chest trauma remains to be defined. We hypothesized that thoracic CT effectively screens hemodynamically normal patients with penetrating thoracic trauma to surgery vs. expectant management (NOM). A ten-year review of all penetrating torso cases was retrospectively analyzed from our urban University-based trauma center. We included hemodynamically normal patients (systolic blood pressure ≥90) with penetrating chest injuries that underwent screening thoracic CT. Hemodynamically unstable patients and diaphragmatic injuries were excluded. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. A total of 212 patients (mean injury severity score=24, Abbreviated Injury Score for Chest=3.9) met inclusion criteria. Of these, 84.3% underwent NOM, 9.1% necessitated abdominal exploration, 6.6% underwent exploration for retained hemothorax/empyema, 6.6% underwent immediate thoracic exploration for significant injuries on chest CT, and 1.0% underwent delayed thoracic exploration for missed injuries. Thoracic CT had a sensitivity of 82%, specificity of 99%, positive predictive value of 90%, a negative predictive value of 99%, and an accuracy of 99% in predicting surgery vs. NOM. Thoracic CT has a negative predictive value of 99% in triaging hemodynamically normal patients with penetrating chest trauma. Screening thoracic CT successfully excludes surgery in patients with non-significant radiologic findings. Copyright © 2016. Published by Elsevier Ltd.

TH-C-BRD-06: A Novel MRI Based CT Artifact Correction Method for Improving Proton Range Calculation in the Presence of Severe CT Artifacts

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

Park, P; Schreibmann, E; Fox, T

2014-06-15

Purpose: Severe CT artifacts can impair our ability to accurately calculate proton range thereby resulting in a clinically unacceptable treatment plan. In this work, we investigated a novel CT artifact correction method based on a coregistered MRI and investigated its ability to estimate CT HU and proton range in the presence of severe CT artifacts. Methods: The proposed method corrects corrupted CT data using a coregistered MRI to guide the mapping of CT values from a nearby artifact-free region. First patient MRI and CT images were registered using 3D deformable image registration software based on B-spline and mutual information. Themore » CT slice with severe artifacts was selected as well as a nearby slice free of artifacts (e.g. 1cm away from the artifact). The two sets of paired MRI and CT images at different slice locations were further registered by applying 2D deformable image registration. Based on the artifact free paired MRI and CT images, a comprehensive geospatial analysis was performed to predict the correct CT HU of the CT image with severe artifact. For a proof of concept, a known artifact was introduced that changed the ground truth CT HU value up to 30% and up to 5cm error in proton range. The ability of the proposed method to recover the ground truth was quantified using a selected head and neck case. Results: A significant improvement in image quality was observed visually. Our proof of concept study showed that 90% of area that had 30% errors in CT HU was corrected to 3% of its ground truth value. Furthermore, the maximum proton range error up to 5cm was reduced to 4mm error. Conclusion: MRI based CT artifact correction method can improve CT image quality and proton range calculation for patients with severe CT artifacts.« less

Influence of cone beam CT enhancement filters on diagnosis ability of longitudinal root fractures

PubMed Central

Nascimento, M C C; Nejaim, Y; de Almeida, S M; Bóscolo, F N; Haiter-Neto, F; Sobrinho, L C

2014-01-01

Objectives: To determine whether cone beam CT (CBCT) enhancement filters influence the diagnosis of longitudinal root fractures. Methods: 40 extracted human posterior teeth were endodontically prepared, and fractures with no separation of fragments were made in 20 teeth of this sample. The teeth were placed in a dry mandible and scanned using a Classic i-CAT® CBCT device (Imaging Sciences International, Inc., Hatfield, PA). Evaluations were performed with and without CBCT filters (Sharpen Mild, Sharpen Super Mild, S9, Sharpen, Sharpen 3 × 3, Angio Sharpen Medium 5 × 5, Angio Sharpen High 5 × 5 and Shadow 3 × 3) by three oral radiologists. Inter- and intraobserver agreement was calculated by the kappa test. Accuracy, sensitivity, specificity and positive and negative predictive values were determined. McNemar test was applied for agreement between all images vs the gold standard and original images vs images with filters (p < 0.05). Results: Means of intraobserver agreement ranged from good to excellent. Angio Sharpen Medium 5 × 5 filter obtained the highest positive predictive value (80.0%) and specificity value (76.5%). Angio Sharpen High 5 × 5 filter obtained the highest sensitivity (78.9%) and accuracy (77.5%) value. Negative predictive value was the highest (82.9%) for S9 filter. The McNemar test showed no statistically significant differences between images with and without CBCT filters (p > 0.05). Conclusions: Although no statistical differences was observed in the diagnosis of root fractures when using filters, these filters seem to improve diagnostic capacity for longitudinal root fractures. Further in vitro studies with endodontic-treated teeth and research in vivo should be considered. PMID:24408819

Skeletal Muscle Metrics on Clinical 18F-FDG PET/CT Predict Health Outcomes in Patients with Sarcoma

PubMed Central

Foster, Brent; Boutin, Robert D.; Lenchik, Leon; Gedeon, David; Liu, Yu; Nittur, Vinay; Badawi, Ramsey D.; Li, Chin-Shang; Canter, Robert J.; Chaudhari, Abhijit J.

2018-01-01

The aim of this study was to determine the association of measures of skeletal muscle determined from 18F-FDG PET/CT with health outcomes in patients with soft-tissue sarcoma. 14 patients (8 women and 6 men; mean age 66.5 years) with sarcoma had PET/CT examinations. On CTs of the abdomen and pelvis, skeletal muscle was segmented, and cross-sectional muscle area, muscle volume, and muscle attenuation were determined. Within the segmented muscle, intramuscular fat area, volume, and density were derived. On PET images, the standardized uptake value (SUV) of muscle was determined. Regression analyses were conducted to determine the association between the imaging measures and health outcomes including overall survival (OS), local recurrence-free survival (LRFS), distant cancer recurrence (DCR), and major surgical complications (MSC). The association between imaging metrics and pre-therapy levels of serum C-reactive protein (CRP), creatinine, hemoglobin, and albumin was determined. Decreased volumetric muscle CT attenuation was associated with increased DCR. Increased PET SUV of muscle was associated with decreased OS and LRFS. Lower muscle SUV was associated with lower serum hemoglobin and albumin. Muscle measurements obtained on routine 18F-FDG PET/CT are associated with outcomes and serum hemoglobin and albumin in patients with sarcoma. PMID:29756042

Skeletal Muscle Metrics on Clinical 18F-FDG PET/CT Predict Health Outcomes in Patients with Sarcoma.

PubMed

Foster, Brent; Boutin, Robert D; Lenchik, Leon; Gedeon, David; Liu, Yu; Nittur, Vinay; Badawi, Ramsey D; Li, Chin-Shang; Canter, Robert J; Chaudhari, Abhijit J

2018-01-01

The aim of this study was to determine the association of measures of skeletal muscle determined from 18 F-FDG PET/CT with health outcomes in patients with soft-tissue sarcoma. 14 patients (8 women and 6 men; mean age 66.5 years) with sarcoma had PET/CT examinations. On CTs of the abdomen and pelvis, skeletal muscle was segmented, and cross-sectional muscle area, muscle volume, and muscle attenuation were determined. Within the segmented muscle, intramuscular fat area, volume, and density were derived. On PET images, the standardized uptake value (SUV) of muscle was determined. Regression analyses were conducted to determine the association between the imaging measures and health outcomes including overall survival (OS), local recurrence-free survival (LRFS), distant cancer recurrence (DCR), and major surgical complications (MSC). The association between imaging metrics and pre-therapy levels of serum C-reactive protein (CRP), creatinine, hemoglobin, and albumin was determined. Decreased volumetric muscle CT attenuation was associated with increased DCR. Increased PET SUV of muscle was associated with decreased OS and LRFS. Lower muscle SUV was associated with lower serum hemoglobin and albumin. Muscle measurements obtained on routine 18 F-FDG PET/CT are associated with outcomes and serum hemoglobin and albumin in patients with sarcoma.

Application of CT-PSF-based computer-simulated lung nodules for evaluating the accuracy of computer-aided volumetry.

PubMed

Funaki, Ayumu; Ohkubo, Masaki; Wada, Shinichi; Murao, Kohei; Matsumoto, Toru; Niizuma, Shinji

2012-07-01

With the wide dissemination of computed tomography (CT) screening for lung cancer, measuring the nodule volume accurately with computer-aided volumetry software is increasingly important. Many studies for determining the accuracy of volumetry software have been performed using a phantom with artificial nodules. These phantom studies are limited, however, in their ability to reproduce the nodules both accurately and in the variety of sizes and densities required. Therefore, we propose a new approach of using computer-simulated nodules based on the point spread function measured in a CT system. The validity of the proposed method was confirmed by the excellent agreement obtained between computer-simulated nodules and phantom nodules regarding the volume measurements. A practical clinical evaluation of the accuracy of volumetry software was achieved by adding simulated nodules onto clinical lung images, including noise and artifacts. The tested volumetry software was revealed to be accurate within an error of 20 % for nodules >5 mm and with the difference between nodule density and background (lung) (CT value) being 400-600 HU. Such a detailed analysis can provide clinically useful information on the use of volumetry software in CT screening for lung cancer. We concluded that the proposed method is effective for evaluating the performance of computer-aided volumetry software.

First report of charge-transfer induced heat-set hydrogel. Structural insights and remarkable properties

NASA Astrophysics Data System (ADS)

Bhattacharjee, Subham; Maiti, Bappa; Bhattacharya, Santanu

2016-05-01

The remarkable ability of a charge-transfer (CT) complex prepared from a pyrene-based donor (Py-D) and a naphthalenediimide-based acceptor (NDI-A) led to the formation of a deep-violet in color, transparent hydrogel at room temperature (RT-gel). Simultaneously, the RT-gel was diluted beyond its critical gelator concentration (CGC) to obtain a transparent sol. Very interestingly, the resultant sol, on heating above 70 °C, transformed into a heat-set gel instantaneously with a hitherto unknown CGC value. Detailed studies revealed the smaller globular aggregates of the RT-gels fuse to form giant globules upon heating, which, in turn, resulted in heat-set gelation through further aggregation. The thermoresponsive property of Py-D alone and 1 : 1 Py-D : NDI-A CT complex was investigated in detail which revealed the hydrophobic collapse of the oxyethylene chains of the CT complex upon heating was mainly responsible for heat-set gelation. Thixotropy, injectability, as well as stimuli responsiveness of the RT-gels were also addressed. In contrast, heat-set gel did not show thixotropic behavior. The X-ray diffraction (XRD) patterns of the xerogel depicted lamellar packing of the CT stacks in the gel phase. Single crystal XRD studies further evidenced the 1 : 1 mixed CT stack formation in the lamellae and also ruled out orthogonal hydrogen bonding possibilities among the hydrazide unit in the CT gel although such interaction was observed in a single crystal of NDI-A alone. In addition, a Ag+-ion triggered metallogelation of NDI-A and nematic liquid-crystalline property of Py-D were also observed.The remarkable ability of a charge-transfer (CT) complex prepared from a pyrene-based donor (Py-D) and a naphthalenediimide-based acceptor (NDI-A) led to the formation of a deep-violet in color, transparent hydrogel at room temperature (RT-gel). Simultaneously, the RT-gel was diluted beyond its critical gelator concentration (CGC) to obtain a transparent sol. Very interestingly, the resultant sol, on heating above 70 °C, transformed into a heat-set gel instantaneously with a hitherto unknown CGC value. Detailed studies revealed the smaller globular aggregates of the RT-gels fuse to form giant globules upon heating, which, in turn, resulted in heat-set gelation through further aggregation. The thermoresponsive property of Py-D alone and 1 : 1 Py-D : NDI-A CT complex was investigated in detail which revealed the hydrophobic collapse of the oxyethylene chains of the CT complex upon heating was mainly responsible for heat-set gelation. Thixotropy, injectability, as well as stimuli responsiveness of the RT-gels were also addressed. In contrast, heat-set gel did not show thixotropic behavior. The X-ray diffraction (XRD) patterns of the xerogel depicted lamellar packing of the CT stacks in the gel phase. Single crystal XRD studies further evidenced the 1 : 1 mixed CT stack formation in the lamellae and also ruled out orthogonal hydrogen bonding possibilities among the hydrazide unit in the CT gel although such interaction was observed in a single crystal of NDI-A alone. In addition, a Ag+-ion triggered metallogelation of NDI-A and nematic liquid-crystalline property of Py-D were also observed. Electronic supplementary information (ESI) available: General experimental section, synthesis and characterization, single crystal X-ray data including CIF files and additional experimental results. See DOI: 10.1039/c6nr01128d

Proton range shift analysis on brain pseudo-CT generated from T1 and T2 MR.

PubMed

Pileggi, Giampaolo; Speier, Christoph; Sharp, Gregory C; Izquierdo Garcia, David; Catana, Ciprian; Pursley, Jennifer; Amato, Francesco; Seco, Joao; Spadea, Maria Francesca

2018-05-29

In radiotherapy, MR imaging is only used because it has significantly better soft tissue contrast than CT, but it lacks electron density information needed for dose calculation. This work assesses the feasibility of using pseudo-CT (pCT) generated from T1w/T2w MR for proton treatment planning, where proton range comparisons are performed between standard CT and pCT. MR and CT data from 14 glioblastoma patients were used in this study. The pCT was generated by using conversion libraries obtained from tissue segmentation and anatomical regioning of the T1w/T2w MR. For each patient, a plan consisting of three 18 Gy beams was designed on the pCT, for a total of 42 analyzed beams. The plan was then transferred onto the CT that represented the ground truth. Range shift (RS) between pCT and CT was computed at R 80 over 10 slices. The acceptance threshold for RS was according to clinical guidelines of two institutions. A γ-index test was also performed on the total dose for each patient. Mean absolute error and bias for the pCT were 124 ± 10 and -16 ± 26 Hounsfield Units (HU), respectively. The median and interquartile range of RS was 0.5 and 1.4 mm, with highest absolute value being 4.4 mm. Of the 42 beams, 40 showed RS less than the clinical range margin. The two beams with larger RS were both in the cranio-caudal direction and had segmentation errors due to the partial volume effect, leading to misassignment of the HU. This study showed the feasibility of using T1w and T2w MRI to generate a pCT for proton therapy treatment, thus avoiding the use of a planning CT and allowing better target definition and possibilities for online adaptive therapies. Further improvements of the methodology are still required to improve the conversion from MRI intensities to HUs.

New diagnostic pathways urgently needed. Protocol of PET Guidance I pilot study: positron emission tomography in suspected cardiac implantable electronic device-related infection.

PubMed

Marciniak-Emmons, Marta Barbara; Sterliński, Maciej; Syska, Paweł; Maciąg, Aleksander; Farkowski, Michał Mirosław; Firek, Bohdan; Dziuk, Mirosław; Zając, Dariusz; Pytkowski, Mariusz; Szwed, Hanna

2016-01-01

Cardiovascular implantable electronic device (CIED) infection is a complication of increasing incidence. We present a protocol of an observational case control clinical trial "Positron Emission Tomography Combined With Computed Tomography (PET CT) in Suspected Cardiac Implantable Electronic Device Infection, a Pilot Study - PET Guidance I" (NCT02196753). The aim of this observational clinical trial is to assess and standardise diagnostic algorithms for CIED infections (lead-dependent infective endocarditis, generator pocket infection, fever of unknown origin) with PET CT in Poland. Study group will consist of 20 patients with initial diagnosis of CIED-related infection paired with a control group of 20 patients with implanted CIEDs, who underwent PET CT due to other non-infectious indications and have no data for infectious process in follow-up. All patients included in the study will undergo standard diagnostic pro-cess. Conventional/standard diagnostic and therapeutic process will consist of: medical interview, physical examination, laboratory tests, blood cultures; imaging studies: echocardiography: transthoracic (TTE), and, if there are no contraindications transoesophageal, computed tomography scan for pulmonary embolism if indicated; if there are abnormalities in other systems, decisions concerning further diagnostics will be made at the physician's discretion. As well as standard diagnostic procedures, patients will undergo whole body PET CT scan to localise infection or inflammation. Diagnosis and therapeutic decision will be obtained from the Study Committee. Follow-up will be held within six months with control visits at three and six months. During each follow-up visit, all patients will undergo laboratory tests, two blood cultures collected 1 h apart, and TTE. In case of actual clinical suspicion of infective endocarditis or local generator pocket infection, patients will be referred for further diagnostics. Endpoints for the results assessment - primary endpoints are to standardise PET CT in the diagnostic process: sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis made by PET CT; secondary endpoints are: assessment of usefulness of PET CT for detection of remote infective complications (metastatic abscesses, infected pulmonary emboli), incidence of particular localisations of infection, influence of PET CT on therapeutic decision: confirmation or change of decision based on PET CT, safety and complications of diagnostic process of CIED-related infections with PET CT. Evaluation of PET CT use for device-related infections in a case control study may be conclusive and improve diagnostic pathway.

Radiotherapy treatment planning: benefits of CT-MR image registration and fusion in tumor volume delineation.

PubMed

Djan, Igor; Petrović, Borislava; Erak, Marko; Nikolić, Ivan; Lucić, Silvija

2013-08-01

Development of imaging techniques, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), made great impact on radiotherapy treatment planning by improving the localization of target volumes. Improved localization allows better local control of tumor volumes, but also minimizes geographical misses. Mutual information is obtained by registration and fusion of images achieved manually or automatically. The aim of this study was to validate the CT-MRI image fusion method and compare delineation obtained by CT versus CT-MRI image fusion. The image fusion software (XIO CMS 4.50.0) was applied to delineate 16 patients. The patients were scanned on CT and MRI in the treatment position within an immobilization device before the initial treatment. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated on CT alone and on CT+MRI images consecutively and image fusion was obtained. Image fusion showed that CTV delineated on a CT image study set is mainly inadequate for treatment planning, in comparison with CTV delineated on CT-MRI fused image study set. Fusion of different modalities enables the most accurate target volume delineation. This study shows that registration and image fusion allows precise target localization in terms of GTV and CTV and local disease control.

A single institution study of radiation dose received from CT imaging: A comparison to Malaysian NDRL

NASA Astrophysics Data System (ADS)

Osman, N. D.; Shamsuri, S. B. M.; Tan, Y. W.; Razali, M. A. S. M.; Isa, S. M.

2017-05-01

Advancement of CT technology has led to an increase in CT scanning as it improves the diagnosis. However, it is important to assess health risk of patients associated with ionising radiation received from CT. This study evaluated current dose distributions at Advanced Medical and Dental Institute (AMDI), Malaysia and was used to establish Local Diagnostic Reference Level (LDRL). Dose indicators such as CT Dose Index (CTDIvol and CTDIw) and Dose-Length Product (DLP) were gathered for all routine CT examinations performed at the Imaging Unit, AMDI from January 2015 to June 2016. The first and third quartile values for each dose indicator were determined. A total of 364 CT studies were performed during that period with the highest number of cases being Thorax-Abdomen-Pelvis (TAP) study (57% of total study). The CTDIw ranged between 2.0 mGy to 23.4 mGy per procedure. DLP values were ranged between 94 mGy.cm to 1687 mGy.cm. The local dose data was compared with the national DRL to monitor the current CT practice at AMDI and LDRL will be established from the calculated third quartile values of dose distribution. From the results, some of the local dose values exceeded the Malaysian and further evaluation is important to ensure the dose optimisation for patients.

Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial): A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea

PubMed Central

Sissoko, Daouda; Laouenan, Cedric; Folkesson, Elin; M’Lebing, Abdoul-Bing; Beavogui, Abdoul-Habib; Baize, Sylvain; Camara, Alseny-Modet; Maes, Piet; Shepherd, Susan; Danel, Christine; Carazo, Sara; Conde, Mamoudou N.; Gala, Jean-Luc; Colin, Géraldine; Savini, Hélène; Bore, Joseph Akoi; Le Marcis, Frederic; Koundouno, Fara Raymond; Petitjean, Frédéric; Lamah, Marie-Claire; Diederich, Sandra; Tounkara, Alexis; Poelart, Geertrui; Berbain, Emmanuel; Dindart, Jean-Michel; Duraffour, Sophie; Lefevre, Annabelle; Leno, Tamba; Peyrouset, Olivier; Irenge, Léonid; Bangoura, N’Famara; Palich, Romain; Hinzmann, Julia; Kraus, Annette; Barry, Thierno Sadou; Berette, Sakoba; Bongono, André; Camara, Mohamed Seto; Chanfreau Munoz, Valérie; Doumbouya, Lanciné; Souley Harouna; Kighoma, Patient Mumbere; Koundouno, Fara Roger; Réné Lolamou; Loua, Cécé Moriba; Massala, Vincent; Moumouni, Kinda; Provost, Célia; Samake, Nenefing; Sekou, Conde; Soumah, Abdoulaye; Arnould, Isabelle; Komano, Michel Saa; Gustin, Lina; Berutto, Carlotta; Camara, Diarra; Camara, Fodé Saydou; Colpaert, Joliene; Delamou, Léontine; Jansson, Lena; Kourouma, Etienne; Loua, Maurice; Malme, Kristian; Manfrin, Emma; Maomou, André; Milinouno, Adele; Ombelet, Sien; Sidiboun, Aboubacar Youla; Verreckt, Isabelle; Yombouno, Pauline; Bocquin, Anne; Carbonnelle, Caroline; Carmoi, Thierry; Frange, Pierre; Mely, Stéphane; Nguyen, Vinh-Kim; Pannetier, Delphine; Taburet, Anne-Marie; Treluyer, Jean-Marc; Kolie, Jacques; Moh, Raoul; Gonzalez, Minerva Cervantes; Kuisma, Eeva; Liedigk, Britta; Ngabo, Didier; Rudolf, Martin; Thom, Ruth; Kerber, Romy; Gabriel, Martin; Di Caro, Antonino; Wölfel, Roman; Badir, Jamal; Bentahir, Mostafa; Deccache, Yann; Dumont, Catherine; Durant, Jean-François; El Bakkouri, Karim; Gasasira Uwamahoro, Marie; Smits, Benjamin; Toufik, Nora; Van Cauwenberghe, Stéphane; Ezzedine, Khaled; Dortenzio, Eric; Pizarro, Louis; Etienne, Aurélie; Guedj, Jérémie; Fizet, Alexandra; Barte de Sainte Fare, Eric; Murgue, Bernadette; Tran-Minh, Tuan; Rapp, Christophe; Piguet, Pascal; Poncin, Marc; Draguez, Bertrand; Allaford Duverger, Thierry; Barbe, Solenne; Baret, Guillaume; Defourny, Isabelle; Carroll, Miles; Raoul, Hervé; Augier, Augustin; Eholie, Serge P.; Yazdanpanah, Yazdan; Levy-Marchal, Claire; Antierrens, Annick; Van Herp, Michel; Günther, Stephan; de Lamballerie, Xavier; Keïta, Sakoba; Mentre, France

2016-01-01

Background Ebola virus disease (EVD) is a highly lethal condition for which no specific treatment has proven efficacy. In September 2014, while the Ebola outbreak was at its peak, the World Health Organization released a short list of drugs suitable for EVD research. Favipiravir, an antiviral developed for the treatment of severe influenza, was one of these. In late 2014, the conditions for starting a randomized Ebola trial were not fulfilled for two reasons. One was the perception that, given the high number of patients presenting simultaneously and the very high mortality rate of the disease, it was ethically unacceptable to allocate patients from within the same family or village to receive or not receive an experimental drug, using a randomization process impossible to understand by very sick patients. The other was that, in the context of rumors and distrust of Ebola treatment centers, using a randomized design at the outset might lead even more patients to refuse to seek care. Therefore, we chose to conduct a multicenter non-randomized trial, in which all patients would receive favipiravir along with standardized care. The objectives of the trial were to test the feasibility and acceptability of an emergency trial in the context of a large Ebola outbreak, and to collect data on the safety and effectiveness of favipiravir in reducing mortality and viral load in patients with EVD. The trial was not aimed at directly informing future guidelines on Ebola treatment but at quickly gathering standardized preliminary data to optimize the design of future studies. Methods and Findings Inclusion criteria were positive Ebola virus reverse transcription PCR (RT-PCR) test, age ≥ 1 y, weight ≥ 10 kg, ability to take oral drugs, and informed consent. All participants received oral favipiravir (day 0: 6,000 mg; day 1 to day 9: 2,400 mg/d). Semi-quantitative Ebola virus RT-PCR (results expressed in “cycle threshold” [Ct]) and biochemistry tests were performed at day 0, day 2, day 4, end of symptoms, day 14, and day 30. Frozen samples were shipped to a reference biosafety level 4 laboratory for RNA viral load measurement using a quantitative reference technique (genome copies/milliliter). Outcomes were mortality, viral load evolution, and adverse events. The analysis was stratified by age and Ct value. A “target value” of mortality was defined a priori for each stratum, to guide the interpretation of interim and final analysis. Between 17 December 2014 and 8 April 2015, 126 patients were included, of whom 111 were analyzed (adults and adolescents, ≥13 y, n = 99; young children, ≤6 y, n = 12). Here we present the results obtained in the 99 adults and adolescents. Of these, 55 had a baseline Ct value ≥ 20 (Group A Ct ≥ 20), and 44 had a baseline Ct value < 20 (Group A Ct < 20). Ct values and RNA viral loads were well correlated, with Ct = 20 corresponding to RNA viral load = 7.7 log10 genome copies/ml. Mortality was 20% (95% CI 11.6%–32.4%) in Group A Ct ≥ 20 and 91% (95% CI 78.8%–91.1%) in Group A Ct < 20. Both mortality 95% CIs included the predefined target value (30% and 85%, respectively). Baseline serum creatinine was ≥110 μmol/l in 48% of patients in Group A Ct ≥ 20 (≥300 μmol/l in 14%) and in 90% of patients in Group A Ct < 20 (≥300 μmol/l in 44%). In Group A Ct ≥ 20, 17% of patients with baseline creatinine ≥110 μmol/l died, versus 97% in Group A Ct < 20. In patients who survived, the mean decrease in viral load was 0.33 log10 copies/ml per day of follow-up. RNA viral load values and mortality were not significantly different between adults starting favipiravir within <72 h of symptoms compared to others. Favipiravir was well tolerated. Conclusions In the context of an outbreak at its peak, with crowded care centers, randomizing patients to receive either standard care or standard care plus an experimental drug was not felt to be appropriate. We did a non-randomized trial. This trial reaches nuanced conclusions. On the one hand, we do not conclude on the efficacy of the drug, and our conclusions on tolerance, although encouraging, are not as firm as they could have been if we had used randomization. On the other hand, we learned about how to quickly set up and run an Ebola trial, in close relationship with the community and non-governmental organizations; we integrated research into care so that it improved care; and we generated knowledge on EVD that is useful to further research. Our data illustrate the frequency of renal dysfunction and the powerful prognostic value of low Ct values. They suggest that drug trials in EVD should systematically stratify analyses by baseline Ct value, as a surrogate of viral load. They also suggest that favipiravir monotherapy merits further study in patients with medium to high viremia, but not in those with very high viremia. Trial registration ClinicalTrials.gov NCT02329054 PMID:26930627

[Diagnostic value of ¹⁸F-fluorodexyglucose positron emission tomography combined with contrast enhanced computed tomography in colorectal cancer liver metastasis].

PubMed

Zhang, Zhanwen; Lyu, Qinghu; Chen, Feini; Liao, Siqin; Zhang, Jie; Hu, Rui; Hu, Ping

2015-03-01

To explore the preoperative diagnostic value of ¹⁸F-fluorodexyglucose positron emission tomography combined with contrast enhanced computed tomography (¹⁸F-FDG PET-ceCT) in patients with colorectal cancer liver metastasis. Clinical and imaging data of 58 patients with suspicious colorectal cancer liver metastasis between April 2010 and March 2013 were retrospectively evaluated. All the patients underwent ¹⁸F-FDG PET-ceCT. On the basis of definitive diagnosis, the sensitivity, specificity, accuracy and consistency of routine PET-CT, ceCT and ¹⁸F-FDG PET-ceCT were calculated. A total of 147 suspicious lesions of colorectal cancer liver metastasis were found in 58 patients. Finally, 125 lesions were confinmed as malignant, of which 58 (46.4%) lesions were less than 1.0 cm. The other 22 lesions were confinmed as benign, of which 17 (77.3%) lesions were less than 1.0 cm. The diagnostic accuracy of routine PET-CT, ceCT and ¹⁸F-FDG PET-ceCT in colorectal cancer liver metastasis for the lesions more than 1.0 cm was 100%, 93.1%, 100% respectively, and the consistency with final diagnosis was perfect, moderate, and perfect respectively (Kappa value 01.00, 0.408, 1.00). For the lesions less than 1.0 cm, the accuracy was 42.7%, 78.7%, 94.7% respectively, and the consistency with definitive diagnosis was insignificance, fair, and almost perfect respectively (Kappa value -0.005, 0.305, 0.848). The area under curve(AUC) was 0.525 (95% CI: 0.407-0.462) for routine PET-CT, 0.651(95% CI:0.532-0.757) for ceCT, and 0.924 (95% CI:0.839-0.972) for ¹⁸F-FDG PET-ceCT respectively. The AUC of ¹⁸F-FDG PET-ceCT was significantly larger than that of routine PET-CT (Z=5.559, P<0.05) or ceCT (Z=4.183, P<0.05). (18)F-FDG PET-ceCT can improve the diagnostic accuracy for smaller lesions of colorectal cancer liver metastasis.

SU-F-J-224: Impact of 4D PET/CT On PERCIST Classification of Lung and Liver Metastases in NSLC and Colorectal Cancer

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

Meier, J; Lopez, B; Mawlawi, O

2016-06-15

Purpose: To quantify the impact of 4D PET/CT on PERCIST metrics in lung and liver tumors in NSCLC and colorectal cancer patients. Methods: 32 patients presenting lung or liver tumors of 1–3 cm size affected by respiratory motion were scanned on a GE Discovery 690 PET/CT. The bed position with lesion(s) affected by motion was acquired in a 12 minute PET LIST mode and unlisted into 8 bins with respiratory gating. Three different CT maps were used for attenuation correction: a clinical helical CT (CT-clin), an average CT (CT-ave), and an 8-phase 4D CINE CT (CT-cine). All reconstructions were 3Dmore » OSEM, 2 iterations, 24 subsets, 6.4 Gaussian filtration, 192×192 matrix, non-TOF, and non-PSF. Reconstructions using CT-clin and CT-ave used only 3 out of the 12 minutes of the data (clinical protocol); all 12 minutes were used for the CT-cine reconstruction. The percent change of SUVbw-peak and SUVbw-max was calculated between PET-CTclin and PET-CTave. The same percent change was also calculated between PET-CTclin and PET-CTcine in each of the 8 bins and in the average of all bins. A 30% difference from PET-CTclin classified lesions as progressive metabolic disease (PMD) using maximum bin value and the average of eight bin values. Results: 30 lesions in 25 patients were evaluated. Using the bin with maximum SUVbw-peak and SUVbw-max difference, 4 and 13 lesions were classified as PMD, respectively. Using the average bin values for SUVbw-peak and SUVbw-max, 3 and 6 lesions were classified as PMD, respectively. Using PET-CTave values for SUVbw-peak and SUVbw-max, 4 and 3 lesions were classified as PMD, respectively. Conclusion: These results suggest that response evaluation in 4D PET/CT is dependent on SUV measurement (SUVpeak vs. SUVmax), number of bins (single or average), and the CT map used for attenuation correction.« less

[Quantitative Evaluation of Metal Artifacts on CT Images on the Basis of Statistics of Extremes].

PubMed

Kitaguchi, Shigetoshi; Imai, Kuniharu; Ueda, Suguru; Hashimoto, Naomi; Hattori, Shouta; Saika, Takahiro; Ono, Yoshifumi

2016-05-01

It is well-known that metal artifacts have a harmful effect on the image quality of computed tomography (CT) images. However, the physical property remains still unknown. In this study, we investigated the relationship between metal artifacts and tube currents using statistics of extremes. A commercially available phantom for measuring CT dose index 160 mm in diameter was prepared and a brass rod 13 mm in diameter was placed at the centerline of the phantom. This phantom was used as a target object to evaluate metal artifacts and was scanned using an area detector CT scanner with various tube currents under a constant tube voltage of 120 kV. Sixty parallel line segments with a length of 100 pixels were placed to cross metal artifacts on CT images and the largest difference between two adjacent CT values in each of 60 CT value profiles of these line segments was employed as a feature variable for measuring metal artifacts; these feature variables were analyzed on the basis of extreme value theory. The CT value variation induced by metal artifacts was statistically characterized by Gumbel distribution, which was one of the extreme value distributions; namely, metal artifacts have the same statistical characteristic as streak artifacts. Therefore, Gumbel evaluation method makes it possible to analyze not only streak artifacts but also metal artifacts. Furthermore, the location parameter in Gumbel distribution was shown to be in inverse proportion to the square root of a tube current. This result suggested that metal artifacts have the same dose dependence as image noises.

SU-E-T-02: 90Y Microspheres Dosimetry Calculation with Voxel-S-Value Method: A Simple Use in the Clinic

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

Maneru, F; Gracia, M; Gallardo, N

2015-06-15

Purpose: To present a simple and feasible method of voxel-S-value (VSV) dosimetry calculation for daily clinical use in radioembolization (RE) with {sup 90}Y microspheres. Dose distributions are obtained and visualized over CT images. Methods: Spatial dose distributions and dose in liver and tumor are calculated for RE patients treated with Sirtex Medical miscrospheres at our center. Data obtained from the previous simulation of treatment were the basis for calculations: Tc-99m maggregated albumin SPECT-CT study in a gammacamera (Infinia, General Electric Healthcare.). Attenuation correction and ordered-subsets expectation maximization (OSEM) algorithm were applied.For VSV calculations, both SPECT and CT were exported frommore » the gammacamera workstation and registered with the radiotherapy treatment planning system (Eclipse, Varian Medical systems). Convolution of activity matrix and local dose deposition kernel (S values) was implemented with an in-house developed software based on Python code. The kernel was downloaded from www.medphys.it. Final dose distribution was evaluated with the free software Dicompyler. Results: Liver mean dose is consistent with Partition method calculations (accepted as a good standard). Tumor dose has not been evaluated due to the high dependence on its contouring. Small lesion size, hot spots in health tissue and blurred limits can affect a lot the dose distribution in tumors. Extra work includes: export and import of images and other dicom files, create and calculate a dummy plan of external radiotherapy, convolution calculation and evaluation of the dose distribution with dicompyler. Total time spent is less than 2 hours. Conclusion: VSV calculations do not require any extra appointment or any uncomfortable process for patient. The total process is short enough to carry it out the same day of simulation and to contribute to prescription decisions prior to treatment. Three-dimensional dose knowledge provides much more information than other methods of dose calculation usually applied in the clinic.« less

Fusion positron emission/computed tomography underestimates the presence of hilar nodal metastases in patients with resected non-small cell lung cancer.

PubMed

Carrillo, Sergio A; Daniel, Vincent C; Hall, Nathan; Hitchcock, Charles L; Ross, Patrick; Kassis, Edmund S

2012-05-01

The 5-year survival for patients with resected stage II (N1) non-small cell lung cancer ranges from 40% to 55%. No data exist addressing the benefit of neoadjuvant therapy for patients with stage II disease. This is largely in part due to the lack of a reliable, minimally invasive method to assess hilar nodes. This study is aimed at determining the ability of fusion positron emission/computed tomography (PET/CT) to identify hilar metastases in patients with resected non-small cell lung cancer. A retrospective review of surgically resected patients with fusion PET/CT within 30 days of resection was performed. The sensitivity, specificity, positive predictive value, and negative predictive value for PET/CT in detecting hilar nodal metastases was calculated for a range of maximum standardized uptake values (SUVmax). Hilar nodes from patients with falsely positive PET/CT scans were analyzed for the presence of histoplasmosis. Additionally, the impact of hilar node size greater than 1 centimeter on the calculated values was assessed. There were 119 patients evaluated. The number of lymph nodes resected ranged from 1 to 12 (X=2.98). There was decreased sensitivity and increased specificity with higher SUVmax cutoff values. At the standard SUVmax value of 2.5, the sensitivity and specificity were only 48.5% and 80.2%. The addition of size of hilar node by CT led to a modest improvement in sensitivity at all SUVmax cutoff values. Fusion PET/CT lacks sensitivity and specificity in identifying hilar nodal metastasis in patients with resected non-small cell lung cancer. Further prospective studies assessing the utility of PET/CT versus alternative sampling techniques are warranted. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

[A computer tomography assisted method for the automatic detection of region of interest in dynamic kidney images].

PubMed

Jing, Xueping; Zheng, Xiujuan; Song, Shaoli; Liu, Kai

2017-12-01

Glomerular filtration rate (GFR), which can be estimated by Gates method with dynamic kidney single photon emission computed tomography (SPECT) imaging, is a key indicator of renal function. In this paper, an automatic computer tomography (CT)-assisted detection method of kidney region of interest (ROI) is proposed to achieve the objective and accurate GFR calculation. In this method, the CT coronal projection image and the enhanced SPECT synthetic image are firstly generated and registered together. Then, the kidney ROIs are delineated using a modified level set algorithm. Meanwhile, the background ROIs are also obtained based on the kidney ROIs. Finally, the value of GFR is calculated via Gates method. Comparing with the clinical data, the GFR values estimated by the proposed method were consistent with the clinical reports. This automatic method can improve the accuracy and stability of kidney ROI detection for GFR calculation, especially when the kidney function has been severely damaged.

Nonlinear optical properties of curcumin: solvatochromism-based approach and computational study

NASA Astrophysics Data System (ADS)

Margar, Sachin N.; Sekar, Nagaiyan

2016-06-01

Nonlinear optical (NLO) properties of curcumin were studied using solvatochromic method and density functional theory (DFT). DFT calculations were performed to determine the static first hyperpolarisability (βο) and its related properties (μ, α0,Δα, β, ?) for curcumin, using B3LYP functional with 6-31G (d), 6-311+G (d) and 6-311+G (d,p) basis sets at the ground-state and excited-state geometries and with CAM-B3LYP using 6-311+G (d,p) basis sets at the ground-state geometry in different solvent environments. In polar solvent environment, the values are slightly lower as compared to the non-polar solvent environments. The results obtained are correlated with the polarisability parameter αCT, first hyperpolarisability parameter βCT and the solvatochromic descriptor of γSDobtained by the solvatochromic method. The static first hyperpolarisability (βο) and its related properties were compared with urea and dibenzoylmethane (β-diketonate) and it is observed that curcumin shows very large values for first hyperpolarisability and its components.

Comparison Between 64Cu-PSMA-617 PET/CT and 18F-Choline PET/CT Imaging in Early Diagnosis of Prostate Cancer Biochemical Recurrence.

PubMed

Cantiello, Francesco; Crocerossa, Fabio; Russo, Giorgio Ivan; Gangemi, Vincenzo; Ferro, Matteo; Vartolomei, Mihai Dorin; Lucarelli, Giuseppe; Mirabelli, Maria; Scafuro, Chiara; Ucciero, Giuseppe; De Cobelli, Ottavio; Morgia, Giuseppe; Damiano, Rocco; Cascini, Giuseppe Lucio

2018-06-04

To evaluate the diagnostic performance of 64 Cu-PSMA-617 positron emission tomography (PET) with computed tomography (CT) for restaging prostate cancer after biochemical recurrence (BCR) and to compare it with 18 F-choline PET/CT in a per-patient analysis. An observational study was performed of 43 patients with BCR after laparoscopic radical prostatectomy who underwent 64 Cu-PSMA-617 PET/CT and subsequently 18 F-choline PET/CT for restaging. The detection rates (DR) of 64 Cu-PSMA-617 PET/CT and of 18 F-choline PET/CT were calculated by standardized maximum uptake value (SUV max ) at 4 hours and SUV max at 1 hour as reference, respectively. Furthermore, univariate logistic regression analysis was carried out to identify independent predictive factors of positivity with 64 Cu-PSMA-617 PET/CT. An overall positivity with 64 Cu-PSMA-617 PET/CT was found in 32 patients (74.4%) versus 19 (44.2%) with 18 F-choline PET/CT. Specifically, after stratifying for prostate-specific antigen (PSA) values, we found a good performance of 64 Cu-PSMA-617 PET/CT at low PSA levels compared to 18 F-choline PET/CT, with a DR of 57.1% versus 14.3% for PSA 0.2-0.5 ng/mL (P = .031), and of 60% versus 30% with PSA 0.5-1 ng/mL. At univariate binary logistic regression analysis, PSA level was the only independent predictor of 64 Cu-PSMA-617 PET/CT positivity. No significant difference in terms of DR for both 64 Cu-PSMA-617 PET/CT and 18 F-choline PET/CT was found according to different Gleason score subgroups. In our study cohort, a better performance was observed for 64 Cu-PSMA-617 PET/CT compared to 18 F-choline PET/CT in restaging after BCR, especially in patients with low PSA values. Copyright © 2018 Elsevier Inc. All rights reserved.

Early Dynamic 68Ga-DOTA-D-Phe1-Tyr3-Octreotide PET/CT in Patients With Hepatic Metastases of Neuroendocrine Tumors.

PubMed

Sänger, Philipp Wilhelm; Freesmeyer, Martin

2016-06-01

Whole-body PET with Ga-DOTA-D-Phe-Tyr-octreotide (Ga-DOTATOC) and contrast-enhanced CT (ceCT) are considered a standard for the staging of neuroendocrine tumors (NETs). This study sought to verify whether early dynamic (ed) Ga-DOTATOC PET/CT can reliably detect liver metastases of NETs (hypervascular, nonhypervascular; positive or negative for somatostatin receptors) and to verify if the receptor positivity has a significant impact on the detection of tumor hypervascularization. Twenty-seven patients with NET were studied by ceCT and standard whole-body PET according to established Ga-DOTATOC protocols. In addition, edPET data were obtained by continuous scanning during the first 300 seconds after bolus injections of the radiotracer. Early dynamic PET required an additional low-dose, native CT image of the liver for the purpose of attenuation correction. Time-activity and time-contrast curves were obtained, the latter being calculated by the difference between tumor and reference regions. Early dynamic PET/CT proved comparable with ceCT in readily identifying hypervascular lesions, irrespective of the receptor status, with activities rising within 16 to 40 seconds. Early dynamic PET/CT also readily identified nonhypervascular, receptor-positive lesions. Positive image contrasts were obtained for hypervascular, receptor-positive lesions, whereas early negative contrasts were obtained for nonhypervascular, receptor-negative lesions. The high image contrast of hypervascular NET metastases in early arterial phases suggests that edPET/CT can become a useful alternative in patients with contraindications to ceCT. The high density of somatostatin receptors did not seem to interfere with the detection of the lesion's hypervascularization.

Development of quantitative real-time PCR for detection and enumeration of Enterobacteriaceae.

PubMed

Takahashi, Hajime; Saito, Rumi; Miya, Satoko; Tanaka, Yuichiro; Miyamura, Natsumi; Kuda, Takashi; Kimura, Bon

2017-04-04

The family Enterobacteriaceae, members of which are widely distributed in the environment, includes many important human pathogens. In this study, a rapid real-time PCR method targeting rplP, coding for L16 protein, a component of the ribosome large subunit, was developed for enumerating Enterobacteriaceae strains, and its efficiency was evaluated using naturally contaminated food products. The rplP-targeted real-time PCR amplified Enterobacteriaceae species with Ct values of 14.0-22.8, whereas the Ct values for non-Enterobacteriaceae species were >30, indicating the specificity of this method for the Enterobacteriaceae. Using a calibration curve of Ct=-3.025 (log CFU/g)+37.35, which was calculated from individual plots of the cell numbers in different concentrations of 5 Enterobacteriaceae species, the rplP-targeted real-time PCR was applied to 51 food samples. A <1log difference between the real-time PCR and culture methods was obtained in a majority of the food samples (81.8%), with good correlation (r 2 =0.8285). This study demonstrated that the rplP-targeted real-time PCR method could detect and enumerate Enterobacteriaceae species in foods rapidly and accurately, and therefore, it can be used for the microbiological risk analysis of foods. Copyright © 2017 Elsevier B.V. All rights reserved.

Midline Shift Threshold Value for Hemiparesis in Chronic Subdural Hematoma.

PubMed

Juković, Mirela F; Stojanović, Dejan B

2015-01-01

Chronic subdural hematoma (CSDH) has a variety of clinical presentations, with numerous neurological symptoms and signs. Hemiparesis is one of the leading signs that potentially indicates CSDH. Purpose of this study was to determine the threshold (cut-off) value of midsagittal line (MSL) shift after which hemiparesis is likely to appear. The study evaluated 83 patients with 53 unilateral and 30 bilateral CSDHs in period of three years. Evaluated computed tomography (CT) findings in patients with CSDH were diameter of the hematoma and midsagittal line shift, measured on non-contrast CT scan in relation with occurrence of hemiparesis. Threshold values of MSL shift for both types of CSDHs were obtained as maximal (equal) sensitivity and specificity (intersection of the curves). MSL is a good predictor for hemiparesis occurrence (total sample, AUROC 0.75, p=0.0001). Unilateral and bilateral CSDHs had different threshold values of the MSL for hemiparesis development. Results suggested that in unilateral CSDH the threshold values of MSL could be at 10 mm (AUROC=0.65; p=0.07). For bilateral CSDH the threshold level of MSL shift was 4.5 mm (AUROC=0.77; p=0.01). Our study pointed on the phenomenon that midsagittal line shift can predict hemiparesis occurrence. Hemiparesis in patients with bilateral CSDH was more related to midsagittal line shift compared with unilateral CSDH. When value of midsagittal line shift exceed the threshold level, hemiparesis occurs with certain probability.

Organ doses for reference pediatric and adolescent patients undergoing computed tomography estimated by Monte Carlo simulation

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

Lee, Choonsik; Kim, Kwang Pyo; Long, Daniel J.

Purpose: To establish an organ dose database for pediatric and adolescent reference individuals undergoing computed tomography (CT) examinations by using Monte Carlo simulation. The data will permit rapid estimates of organ and effective doses for patients of different age, gender, examination type, and CT scanner model. Methods: The Monte Carlo simulation model of a Siemens Sensation 16 CT scanner previously published was employed as a base CT scanner model. A set of absorbed doses for 33 organs/tissues normalized to the product of 100 mAs and CTDI{sub vol} (mGy/100 mAs mGy) was established by coupling the CT scanner model with age-dependentmore » reference pediatric hybrid phantoms. A series of single axial scans from the top of head to the feet of the phantoms was performed at a slice thickness of 10 mm, and at tube potentials of 80, 100, and 120 kVp. Using the established CTDI{sub vol}- and 100 mAs-normalized dose matrix, organ doses for different pediatric phantoms undergoing head, chest, abdomen-pelvis, and chest-abdomen-pelvis (CAP) scans with the Siemens Sensation 16 scanner were estimated and analyzed. The results were then compared with the values obtained from three independent published methods: CT-Expo software, organ dose for abdominal CT scan derived empirically from patient abdominal circumference, and effective dose per dose-length product (DLP). Results: Organ and effective doses were calculated and normalized to 100 mAs and CTDI{sub vol} for different CT examinations. At the same technical setting, dose to the organs, which were entirely included in the CT beam coverage, were higher by from 40 to 80% for newborn phantoms compared to those of 15-year phantoms. An increase of tube potential from 80 to 120 kVp resulted in 2.5-2.9-fold greater brain dose for head scans. The results from this study were compared with three different published studies and/or techniques. First, organ doses were compared to those given by CT-Expo which revealed dose differences up to several-fold when organs were partially included in the scan coverage. Second, selected organ doses from our calculations agreed to within 20% of values derived from empirical formulae based upon measured patient abdominal circumference. Third, the existing DLP-to-effective dose conversion coefficients tended to be smaller than values given in the present study for all examinations except head scans. Conclusions: A comprehensive organ/effective dose database was established to readily calculate doses for given patients undergoing different CT examinations. The comparisons of our results with the existing studies highlight that use of hybrid phantoms with realistic anatomy is important to improve the accuracy of CT organ dosimetry. The comprehensive pediatric dose data developed here are the first organ-specific pediatric CT scan database based on the realistic pediatric hybrid phantoms which are compliant with the reference data from the International Commission on Radiological Protection (ICRP). The organ dose database is being coupled with an adult organ dose database recently published as part of the development of a user-friendly computer program enabling rapid estimates of organ and effective dose doses for patients of any age, gender, examination types, and CT scanner model.« less

Atopic dermatitis patients carrying G allele in -1082 G/A IL-10 polymorphism are predisposed to higher serum concentration of IL-10.

PubMed

Lesiak, Aleksandra; Zakrzewski, Marcin; Przybyłowska, Karolina; Rogowski-Tylman, Michał; Wozniacka, Anna; Narbutt, Joanna

2014-12-22

Atopic dermatitis (AD) is a chronic skin inflammatory disease in which Th2-derived cytokines play an essential role. Aim of the study was to assess interleukin 4, 10 and 13 (IL-4, IL-10 and IL-13) serum concentrations in AD patients and to correlate the values with the occurrence of genotypes of selected polymorphisms in genes encoding these cytokines. Seventy-six AD patients (mean age 11.4 years) and 60 healthy controls were enrolled in the study. Blood samples were analyzed for IL-4, IL-10 and IL-13 concentrations with ELISA assay and genotyping for -590C/T IL-4, -1082A/G IL-10 and -1055C/T IL-13 polymorphisms with PCR-RFLP. The obtained results revealed statistically higher serum concentration of IL-10 and IL-13 in AD patients when compared to healthy controls (10.30 pg/ml vs. 8.51 pg/ml for IL-10 and 5.67 pg/ml vs. 4.98 pg/ml for IL-13). There were no significant differences between AD patients and controls in regard to IL-4 serum level (5.10 pg/ml vs. 7.1 pg/ml). Analyzing the association between level of the examined cytokines and genotype polymorphisms -590 C/T for the IL-4 gene, -1082 A/G for the IL-10 gene and -1055 C/T for the IL-13 gene, we found a statistically higher IL-10 serum level among carriers of the G allele in the -1082 G/A IL-10 polymorphism both in AD and control groups. We did not find any significant differences between serum level of IL-4 and IL-13 in regard to genotype occurrence in examined polymorphisms: -590 C/T for the IL-4 gene and -1055 C/T for the IL-13 gene. The obtained results confirm the genetic background of IL-10 synthesis in the Polish population.

Comparison of extended field-of-view reconstructions in C-arm flat-detector CT using patient size, shape or attenuation information.

PubMed

Kolditz, Daniel; Meyer, Michael; Kyriakou, Yiannis; Kalender, Willi A

2011-01-07

In C-arm-based flat-detector computed tomography (FDCT) it frequently happens that the patient exceeds the scan field of view (SFOV) in the transaxial direction because of the limited detector size. This results in data truncation and CT image artefacts. In this work three truncation correction approaches for extended field-of-view (EFOV) reconstructions have been implemented and evaluated. An FDCT-based method estimates the patient size and shape from the truncated projections by fitting an elliptical model to the raw data in order to apply an extrapolation. In a camera-based approach the patient is sampled with an optical tracking system and this information is used to apply an extrapolation. In a CT-based method the projections are completed by artificial projection data obtained from the CT data acquired in an earlier exam. For all methods the extended projections are filtered and backprojected with a standard Feldkamp-type algorithm. Quantitative evaluations have been performed by simulations of voxelized phantoms on the basis of the root mean square deviation and a quality factor Q (Q = 1 represents the ideal correction). Measurements with a C-arm FDCT system have been used to validate the simulations and to investigate the practical applicability using anthropomorphic phantoms which caused truncation in all projections. The proposed approaches enlarged the FOV to cover wider patient cross-sections. Thus, image quality inside and outside the SFOV has been improved. Best results have been obtained using the CT-based method, followed by the camera-based and the FDCT-based truncation correction. For simulations, quality factors up to 0.98 have been achieved. Truncation-induced cupping artefacts have been reduced, e.g., from 218% to less than 1% for the measurements. The proposed truncation correction approaches for EFOV reconstructions are an effective way to ensure accurate CT values inside the SFOV and to recover peripheral information outside the SFOV.

Image quality characteristics for virtual monoenergetic images using dual-layer spectral detector CT: Comparison with conventional tube-voltage images.

PubMed

Sakabe, Daisuke; Funama, Yoshinori; Taguchi, Katsuyuki; Nakaura, Takeshi; Utsunomiya, Daisuke; Oda, Seitaro; Kidoh, Masafumi; Nagayama, Yasunori; Yamashita, Yasuyuki

2018-05-01

To investigate the image quality characteristics for virtual monoenergetic images compared with conventional tube-voltage image with dual-layer spectral CT (DLCT). Helical scans were performed using a first-generation DLCT scanner, two different sizes of acrylic cylindrical phantoms, and a Catphan phantom. Three different iodine concentrations were inserted into the phantom center. The single-tube voltage for obtaining virtual monoenergetic images was set to 120 or 140 kVp. Conventional 120- and 140-kVp images and virtual monoenergetic images (40-200-keV images) were reconstructed from slice thicknesses of 1.0 mm. The CT number and image noise were measured for each iodine concentration and water on the 120-kVp images and virtual monoenergetic images. The noise power spectrum (NPS) was also calculated. The iodine CT numbers for the iodinated enhancing materials were similar regardless of phantom size and acquisition method. Compared with the iodine CT numbers of the conventional 120-kVp images, those for the monoenergetic 40-, 50-, and 60-keV images increased by approximately 3.0-, 1.9-, and 1.3-fold, respectively. The image noise values for each virtual monoenergetic image were similar (for example, 24.6 HU at 40 keV and 23.3 HU at 200 keV obtained at 120 kVp and 30-cm phantom size). The NPS curves of the 70-keV and 120-kVp images for a 1.0-mm slice thickness over the entire frequency range were similar. Virtual monoenergetic images represent stable image noise over the entire energy spectrum and improved the contrast-to-noise ratio than conventional tube voltage using the dual-layer spectral detector CT. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Effects of the 3D bone-to-implant contact and bone stiffness on the initial stability of a dental implant: micro-CT and resonance frequency analyses.

PubMed

Hsu, J T; Huang, H L; Tsai, M T; Wu, A Y J; Tu, M G; Fuh, L J

2013-02-01

This study investigated the effects of bone stiffness (elastic modulus) and three-dimensional (3D) bone-to-implant contact ratio (BIC%) on the primary stabilities of dental implants using micro-computed tomography (micro-CT) and resonance frequency analyses. Artificial sawbone models with five values of elastic modulus (137, 123, 47.5, 22, and 12.4 MPa) comprising two types of trabecular structure (solid-rigid and cellular-rigid) were investigated for initial implant stability quotient (ISQ), measured using the wireless Osstell resonance frequency analyzer. Bone specimens were attached to 2 mm fibre-filled epoxy sheets mimicking the cortical shell. ISQ was measured after placing a dental implant into the bone specimen. Each bone specimen with an implant was subjected to micro-CT scanning to calculate the 3D BIC% values. The similarity of the cellular type of artificial bone to the trabecular structure might make it more appropriate for obtaining accurate values of primary implant stability than solid-bone blocks. For the cellular-rigid bone models, the ISQ increased with the elastic modulus of cancellous bone. The regression correlation coefficient was 0.96 for correlations of the ISQ with the elasticity of cancellous bone and with the 3D BIC%. The initial implant stability was moderately positively correlated with the elasticity of cancellous bone and with the 3D BIC%. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Is the corticomedullary index valid to distinguish human from nonhuman bones: a multislice computed tomography study.

PubMed

Rérolle, Camille; Saint-Martin, Pauline; Dedouit, Fabrice; Rousseau, Hervé; Telmon, Norbert

2013-09-10

The first step in the identification process of bone remains is to determine whether they are of human or nonhuman origin. This issue may arise when only a fragment of bone is available, as the species of origin is usually easily determined on a complete bone. The present study aims to assess the validity of a morphometric method used by French forensic anthropologists to determine the species of origin: the corticomedullary index (CMI), defined by the ratio of the diameter of the medullary cavity to the total diameter of the bone. We studied the constancy of the CMI from measurements made on computed tomography images (CT scans) of different human bones, and compared our measurements with reference values selected in the literature. The measurements obtained on CT scans at three different sites of 30 human femurs, 24 tibias, and 24 fibulas were compared between themselves and with the CMI reference values for humans, pigs, dogs and sheep. Our results differed significantly from these reference values, with three exceptions: the proximal quarter of the femur and mid-fibular measurements for the human CMI, and the proximal quarter of the tibia for the sheep CMI. Mid-tibial, mid-femoral, and mid-fibular measurements also differed significantly between themselves. Only 22.6% of CT scans of human bones were correctly identified as human. We concluded that the CMI is not an effective method for determining the human origin of bone remains. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Hyaline cartilage thickness in radiographically normal cadaveric hips: comparison of spiral CT arthrographic and macroscopic measurements.

PubMed

Wyler, Annabelle; Bousson, Valérie; Bergot, Catherine; Polivka, Marc; Leveque, Eric; Vicaut, Eric; Laredo, Jean-Denis

2007-02-01

To assess spiral multidetector computed tomographic (CT) arthrography for the depiction of cartilage thickness in hips without cartilage loss, with evaluation of anatomic slices as the reference standard. Permission to perform imaging studies in cadaveric specimens of individuals who had willed their bodies to science was obtained from the institutional review board. Two independent observers measured the femoral and acetabular hyaline cartilage thickness of 12 radiographically normal cadaveric hips (from six women and five men; age range at death, 52-98 years; mean, 76.5 years) on spiral multidetector CT arthrographic reformations and on coronal anatomic slices. Regions of cartilage loss at gross or histologic examination were excluded. CT arthrographic and anatomic measurements in the coronal plane were compared by using Bland-Altman representation and a paired t test. Differences between mean cartilage thicknesses at the points of measurement were tested by means of analysis of variance. Interobserver and intraobserver reproducibilities were determined. At CT arthrography, mean cartilage thickness ranged from 0.32 to 2.53 mm on the femoral head and from 0.95 to 3.13 mm on the acetabulum. Observers underestimated cartilage thickness in the coronal plane by 0.30 mm +/- 0.52 (mean +/- standard error) at CT arthrography (P < .001) compared with the anatomic reference standard. Ninety-five percent of the differences between CT arthrography and anatomic values ranged from -1.34 to 0.74 mm. The difference between mean cartilage thicknesses at the different measurement points was significant for coronal spiral multidetector CT arthrography and anatomic measurement of the femoral head and acetabulum and for sagittal and transverse CT arthrography of the femoral head (P < .001). Changes in cartilage thickness from the periphery to the center of the joint ("gradients") were found by means of spiral multidetector CT arthrography and anatomic measurement. Spiral multidetector CT arthrography depicts cartilage thickness gradients in radiographically normal cadaveric hips. (c) RSNA, 2007.

Diagnostic Performance of Ultrafast Brain MRI for Evaluation of Abusive Head Trauma.

PubMed

Kralik, S F; Yasrebi, M; Supakul, N; Lin, C; Netter, L G; Hicks, R A; Hibbard, R A; Ackerman, L L; Harris, M L; Ho, C Y

2017-04-01

MR imaging with sedation is commonly used to detect intracranial traumatic pathology in the pediatric population. Our purpose was to compare nonsedated ultrafast MR imaging, noncontrast head CT, and standard MR imaging for the detection of intracranial trauma in patients with potential abusive head trauma. A prospective study was performed in 24 pediatric patients who were evaluated for potential abusive head trauma. All patients received noncontrast head CT, ultrafast brain MR imaging without sedation, and standard MR imaging with general anesthesia or an immobilizer, sequentially. Two pediatric neuroradiologists independently reviewed each technique blinded to other modalities for intracranial trauma. We performed interreader agreement and consensus interpretation for standard MR imaging as the criterion standard. Diagnostic accuracy was calculated for ultrafast MR imaging, noncontrast head CT, and combined ultrafast MR imaging and noncontrast head CT. Interreader agreement was moderate for ultrafast MR imaging (κ = 0.42), substantial for noncontrast head CT (κ = 0.63), and nearly perfect for standard MR imaging (κ = 0.86). Forty-two percent of patients had discrepancies between ultrafast MR imaging and standard MR imaging, which included detection of subarachnoid hemorrhage and subdural hemorrhage. Sensitivity, specificity, and positive and negative predictive values were obtained for any traumatic pathology for each examination: ultrafast MR imaging (50%, 100%, 100%, 31%), noncontrast head CT (25%, 100%, 100%, 21%), and a combination of ultrafast MR imaging and noncontrast head CT (60%, 100%, 100%, 33%). Ultrafast MR imaging was more sensitive than noncontrast head CT for the detection of intraparenchymal hemorrhage ( P = .03), and the combination of ultrafast MR imaging and noncontrast head CT was more sensitive than noncontrast head CT alone for intracranial trauma ( P = .02). In abusive head trauma, ultrafast MR imaging, even combined with noncontrast head CT, demonstrated low sensitivity compared with standard MR imaging for intracranial traumatic pathology, which may limit its utility in this patient population. © 2017 by American Journal of Neuroradiology.

Solitary pulmonary nodules: Comparison of dynamic first-pass contrast-enhanced perfusion area-detector CT, dynamic first-pass contrast-enhanced MR imaging, and FDG PET/CT.

PubMed

Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Seki, Shinichiro; Tsubakimoto, Maho; Fujisawa, Yasuko; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Sugimura, Kazuro

2015-02-01

To prospectively compare the capabilities of dynamic perfusion area-detector computed tomography (CT), dynamic magnetic resonance (MR) imaging, and positron emission tomography (PET) combined with CT (PET/CT) with use of fluorine 18 fluorodeoxyglucose (FDG) for the diagnosis of solitary pulmonary nodules. The institutional review board approved this study, and written informed consent was obtained from each subject. A total of 198 consecutive patients with 218 nodules prospectively underwent dynamic perfusion area-detector CT, dynamic MR imaging, FDG PET/CT, and microbacterial and/or pathologic examinations. Nodules were classified into three groups: malignant nodules (n = 133) and benign nodules with low (n = 53) or high (n = 32) biologic activity. Total perfusion was determined with dual-input maximum slope models at area-detector CT, maximum and slope of enhancement ratio at MR imaging, and maximum standardized uptake value (SUVmax) at PET/CT. Next, all indexes for malignant and benign nodules were compared with the Tukey honest significant difference test. Then, receiver operating characteristic analysis was performed for each index. Finally, sensitivity, specificity, and accuracy were compared with the McNemar test. All indexes showed significant differences between malignant nodules and benign nodules with low biologic activity (P < .0001). The area under the receiver operating characteristic curve for total perfusion was significantly larger than that for other indexes (.0006 ≤ P ≤ .04). The specificity and accuracy of total perfusion were significantly higher than those of maximum relative enhancement ratio (specificity, P < .0001; accuracy, P < .0001), slope of enhancement ratio (specificity, P < .0001; accuracy, P < .0001), and SUVmax (specificity, P < .0001; accuracy, P < .0001). Dynamic perfusion area-detector CT is more specific and accurate than dynamic MR imaging and FDG PET/CT in the diagnosis of solitary pulmonary nodules in routine clinical practice. © RSNA, 2014.

Determination of calibration parameters of a VRX CT system using an “Amoeba” algorithm

PubMed Central

Jordan, Lawrence M.; DiBianca, Frank A.; Melnyk, Roman; Choudhary, Apoorva; Shukla, Hemant; Laughter, Joseph; Gaber, M. Waleed

2008-01-01

Efforts to improve the spatial resolution of CT scanners have focused mainly on reducing the source and detector element sizes, ignoring losses from the size of the secondary-ionization charge “clouds” created by the detected x-ray photons, i.e., the “physics limit.” This paper focuses on implementing a technique called “projective compression.” which allows further reduction in effective cell size while overcoming the physics limit as well. Projective compression signifies detector geometries in which the apparent cell size is smaller than the physical cell size, allowing large resolution boosts. A realization of this technique has been developed with a dual-arm “variable-resolution x-ray” (VRX) detector. Accurate values of the geometrical parameters are needed to convert VRX outputs to formats ready for optimal image reconstruction by standard CT techniques. The required calibrating data are obtained by scanning a rotating pin and fitting a theoretical parametric curve (using a multi-parameter minimization algorithm) to the resulting pin sinogram. Excellent fits are obtained for both detector-arm sections with an average (maximum) fit deviation of ~0.05 (0.1) detector cell width. Fit convergence and sensitivity to starting conditions are considered. Pre- and post-optimization reconstructions of the alignment pin and a biological subject reconstruction after calibration are shown. PMID:19430581

Determination of calibration parameters of a VRX CT system using an "Amoeba" algorithm.

PubMed

Jordan, Lawrence M; Dibianca, Frank A; Melnyk, Roman; Choudhary, Apoorva; Shukla, Hemant; Laughter, Joseph; Gaber, M Waleed

2004-01-01

Efforts to improve the spatial resolution of CT scanners have focused mainly on reducing the source and detector element sizes, ignoring losses from the size of the secondary-ionization charge "clouds" created by the detected x-ray photons, i.e., the "physics limit." This paper focuses on implementing a technique called "projective compression." which allows further reduction in effective cell size while overcoming the physics limit as well. Projective compression signifies detector geometries in which the apparent cell size is smaller than the physical cell size, allowing large resolution boosts. A realization of this technique has been developed with a dual-arm "variable-resolution x-ray" (VRX) detector. Accurate values of the geometrical parameters are needed to convert VRX outputs to formats ready for optimal image reconstruction by standard CT techniques. The required calibrating data are obtained by scanning a rotating pin and fitting a theoretical parametric curve (using a multi-parameter minimization algorithm) to the resulting pin sinogram. Excellent fits are obtained for both detector-arm sections with an average (maximum) fit deviation of ~0.05 (0.1) detector cell width. Fit convergence and sensitivity to starting conditions are considered. Pre- and post-optimization reconstructions of the alignment pin and a biological subject reconstruction after calibration are shown.

[Risk behaviours and Chlamydia trachomatis prevalence in prisoners by length of stay in prison].

PubMed

Lopez-Corbeto, Evelin; Humet, Victoria; Leal, M Jesús; Teixidó, Nuria; Quiroga, Teresa; Casabona, Jordi

2014-11-18

Young prisoners have high-risk behaviors and socio-economic insecurity that increases vulnerability for Chlamydia trachomatis (CT) acquisition. Monitoring its prevalence will help to reduce infection rates. Cross-sectional study from a convenience sample of prisoners aged 18-25 years. Urine samples were obtained to determine CT. A standardized and anonymous questionnaire was used to collect the study variables. The overall CT prevalence was 11%, significantly higher in those with less than one year in prison, who also presented higher frequencies in risk behaviors, while these were reduced in those who had been imprisoned for more than a year. The prevalence values obtained give an idea of the concentration of the population vulnerable to this disease in prisons and underscore the need to continue programs for the prevention and control of sexual transmitted infections (STIs). Being imprisoned longer decreased risk behaviors; therefore, it is important to screen for STIs upon admission because they are more likely to be infected and it would be thus possible to influence at that time in sex education because, at that time, risk behaviors occur more commonly, which are most likely done when they were free. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Cutaneous lesions in pet rabbits following subcutaneous administration of a novel bivalent vaccine against myxomatosis and rabbit haemorrhagic disease.

PubMed

Selleri, Paolo; Di Girolamo, Nicola; Vögtlin, Andrea; Fileccia, Ivan; Hoop, Richard; Bongiovanni, Laura

2014-12-01

A novel bivalent vaccine to protect against myxomatosis and rabbit haemorrhagic disease is commercially available for pet rabbits. To describe the appearance of cutaneous lesions arising in pet rabbits positive for myxoma virus (MV) by RT-PCR evaluation shortly after vaccination. Four pet rabbits presenting with papular, crusting skin lesions ~10 days after vaccination. Histological evaluation of formalin-fixed skin biopsies obtained from lesional skin (case 1). Real-time polymerase chain reaction (RT-PCR) evaluation of paraffin-embedded tissue from skin biopsies (case 1) and crusts obtained from the lesion surface (cases 2-4) for myxoma virus are reported as cycle threshold (Ct ) values. Lesions affecting the ear pinna, dorsal aspect of the nose, vulva and/or conjunctiva are reported. Histopathological findings included severe ulcerative, necrotizing dermatitis and intralesional cytoplasmic inclusion bodies in myxoma cells. DNA was amplified from all the paraffin-embedded skin biopsies (Ct  = 34-35) and crusts (Ct  = 20-24). Although a wild virus challenge cannot be definitively excluded, veterinarians and pet-owners should be aware that cutaneous lesions have been observed after vaccination with this novel vaccine in low numbers of rabbits. © 2014 ESVD and ACVD.

CBF measured by Xe-CT: Approach to analysis and normal values

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

Yonas, H.; Darby, J.M.; Marks, E.C.

1991-09-01

Normal reference values and a practical approach to CBF analysis are needed for routine clinical analysis and interpretation of xenon-enhanced computed tomography (CT) CBF studies. The authors measured CBF in 67 normal individuals with the GE 9800 CT scanner adapted for CBF imaging with stable Xe. CBF values for vascular territories were systematically analyzed using the clustering of contiguous 2-cm circular regions of interest (ROIs) placed within the cortical mantle and basal ganglia. Mixed cortical flows averaged 51 {plus minus} 10ml.100g-1.min-1. High and low flow compartments, sampled by placing 5-mm circular ROIs in regions containing the highest and lowest flowmore » values in each hemisphere, averaged 84 {plus minus} 14 and 20 {plus minus} 5 ml.100 g-1.min-1, respectively. Mixed cortical flow values as well as values within the high flow compartment demonstrated significant decline with age; however, there were no significant age-related changes in the low flow compartment. The clustering of systematically placed cortical and subcortical ROIs has provided a normative data base for Xe-CT CBF and a flexible and uncomplicated method for the analysis of CBF maps generated by Xe-enhanced CT.« less

Energy dependence of radiation interaction parameters of some organic compounds

NASA Astrophysics Data System (ADS)

Singh, Mohinder; Tondon, Akash; Sandhu, B. S.; Singh, Bhajan

2018-04-01

Gamma rays interact with a material through photoelectric absorption, Compton scattering, Rayleigh scattering and Pair production in the intermediate energy range. The probability of occurrence of a particular type of process depends on the energy of incident gamma rays, atomic number of the material, scattering angle and geometrical conditions. Various radiological parameters for organic compounds, namely ethylene glycol (C2H6O2), propylene glycol (C3H8O2), glycerin (C3H8O3), isoamyl alcohol (C5H12O), butanone (C4H8O), acetophenone (C8H8O2), cyclohexanone (C6H10O), furfural (C5H4O2), benzaldehyde (C7H6O), cinnamaldehyde (C9H8O), glutaraldehyde (C5H8O2), aniline (C6H7N), benzyl amine (C6H7N), nitrobenzene (C6H5NO2), ethyl benzene (C8H10), ethyl formate (C3H6O2) and water (H2O) are presented at 81, 122, 356 and 511 keV energies employing NaI(Tl) scintillation detector in narrow-beam transmission geometry. The radiation interaction parameters such as mass attenuation, molar extinction and mass energy absorption coefficients, half value layer, total atomic and effective electronic cross-sections and CT number have been evaluated for these organic compounds. The general trend of values of mass attenuation coefficients, half value layer, molar extinction coefficients, total atomic and effective electronic cross-sections and mass energy absorption coefficients shows a decrease with increase in incident gamma photon energy. The values of CT number are found to increases linearly with increase of effective atomic number (Zeff). The variation in CT number around Zeff ≈ 3.3 shows the peak like structure with respect to water and the correlation between CT number and linear attenuation coefficient is about 0.99. Appropriate equations are fitted to these experimentally determined parameters for the organic compounds at incident photon energy ranging from 81 keV to 511 keV used in the present study. Experimental values are compared with the theoretical data obtained using WinXcom software package, and are found in good agreement.

SU-E-J-89: Comparative Analysis of MIM and Velocity’s Image Deformation Algorithm Using Simulated KV-CBCT Images for Quality Assurance

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

Cline, K; Narayanasamy, G; Obediat, M

Purpose: Deformable image registration (DIR) is used routinely in the clinic without a formalized quality assurance (QA) process. Using simulated deformations to digitally deform images in a known way and comparing to DIR algorithm predictions is a powerful technique for DIR QA. This technique must also simulate realistic image noise and artifacts, especially between modalities. This study developed an algorithm to create simulated daily kV cone-beam computed-tomography (CBCT) images from CT images for DIR QA between these modalities. Methods: A Catphan and physical head-and-neck phantom, with known deformations, were used. CT and kV-CBCT images of the Catphan were utilized tomore » characterize the changes in Hounsfield units, noise, and image cupping that occur between these imaging modalities. The algorithm then imprinted these changes onto a CT image of the deformed head-and-neck phantom, thereby creating a simulated-CBCT image. CT and kV-CBCT images of the undeformed and deformed head-and-neck phantom were also acquired. The Velocity and MIM DIR algorithms were applied between the undeformed CT image and each of the deformed CT, CBCT, and simulated-CBCT images to obtain predicted deformations. The error between the known and predicted deformations was used as a metric to evaluate the quality of the simulated-CBCT image. Ideally, the simulated-CBCT image registration would produce the same accuracy as the deformed CBCT image registration. Results: For Velocity, the mean error was 1.4 mm for the CT-CT registration, 1.7 mm for the CT-CBCT registration, and 1.4 mm for the CT-simulated-CBCT registration. These same numbers were 1.5, 4.5, and 5.9 mm, respectively, for MIM. Conclusion: All cases produced similar accuracy for Velocity. MIM produced similar values of accuracy for CT-CT registration, but was not as accurate for CT-CBCT registrations. The MIM simulated-CBCT registration followed this same trend, but overestimated MIM DIR errors relative to the CT-CBCT registration.« less

Systematic review on the value of CT scanning in the diagnosis of anastomotic leakage after colorectal surgery.

PubMed

Kornmann, Verena N N; Treskes, Nikki; Hoonhout, Lilian H F; Bollen, Thomas L; van Ramshorst, Bert; Boerma, Djamila

2013-04-01

Timely diagnosis of anastomotic leakage after colorectal surgery and adequate treatment is important to reduce morbidity and mortality. Abdominal computed tomography (CT) scanning is the diagnostic tool of preference, but its value may be questionable in the early postoperative period. The accuracy of CT scanning for the detection of anastomotic leakage and its role in timing of intervention was evaluated. A systematic literature search was performed. Relevant publications were identified from four electronic databases between 1990 and 2011. Inclusion criteria were human studies, studies published in English or Dutch, colorectal surgery with primary anastomosis, and abdominal CT scan with reported outcome for the detection of anastomotic leakage. Exclusion criteria were cohort of fewer than five patients, other gastrointestinal surgery, no anastomosis, and radiological imaging other than CT. Eight studies, including 221 abdominal CT scans, fulfilled the inclusion criteria. Overall, the methodological quality of the studies was poor. The overall sensitivity of CT scanning to diagnose leakage was 0.68 (95 % confidence interval 0.59-0.75) for colonic resection. Data on the sequelae of false-negative CT scanning was not available. There is limited good-quality evidence to determine the value of CT scans in the detection of anastomotic leakage. To prevent delay in diagnosis and appropriate treatment of anastomotic leakage, the relatively low sensitivity of CT scanning must be taken into account.

Clinical values of (18) F-FDG PET/CT in oral cavity cancer with dental artifacts on CT or MRI.

PubMed

Hong, Hye Ran; Jin, Soyoung; Koo, Hyun Jung; Roh, Jong-Lyel; Kim, Jae Seung; Cho, Kyung-Ja; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

2014-11-01

2a To investigate the role of (18) F-FDG PET/CT in tumor staging, extent, and volume measurements in oral cavity squamous cell carcinoma (OSCC) patients with/without dental artifacts on CT or MRI. This study was conducted in 63 consecutive patients with OSCC who received initial workups including (18) F-FDG PET/CT and MRI. The results of the imaging modalities were compared to those of pathology, using McNemar's test and the paired t-test. Thirty-seven patients (59%) had dental or metallic artifacts obscuring primary tumors. (18) F-FDG PET/CT scanning was superior to MRI in tumor staging (weighted κ = 0.870 vs. 0.518, P = 0.004) in patients with dental artifacts. In addition, (18) F-FDG PET/CT scans were more specific than MRI in detecting sublingual gland (P = 0.014) and mouth floor (P = 0.011) involvement. In patients with dental artifacts, there was a significant discrepancy between primary tumor volume (PTV) measured by pathology and MRI (P = 0.018), but not between PTV measured from pathology and (18) F-FDG PET/CT at SUV2.5 (P = 0.245), which showed the highest intraclass correlation coefficient value (0.860). (18) F-FDG PET/CT scans provide accurate tumor staging and volume measurements in OSCC patients with CR/MRI dental artifacts, leading to improved preoperative planning. 2b CONDENSED ABSTRACT This study evaluated the clinical value of (18) F-FDG PET/CT in 63 patients with oral cavity cancers. In 37 (59%) patients with dental artifacts on CT/MRI, (18) F-FDG PET/CT showed superior results compared to MRI in tumor staging and represented the highest intraclass correlation coefficient value to tumor volume determined by pathology. © 2014 Wiley Periodicals, Inc.

Computed Tomography to Estimate the Representative Elementary Area for Soil Porosity Measurements

PubMed Central

Borges, Jaqueline Aparecida Ribaski; Pires, Luiz Fernando; Belmont Pereira, André

2012-01-01

Computed tomography (CT) is a technique that provides images of different solid and porous materials. CT could be an ideal tool to study representative sizes of soil samples because of the noninvasive characteristic of this technique. The scrutiny of such representative elementary sizes (RESs) has been the target of attention of many researchers related to soil physics field owing to the strong relationship between physical properties and size of the soil sample. In the current work, data from gamma-ray CT were used to assess RES in measurements of soil porosity (ϕ). For statistical analysis, a study on the full width at a half maximum (FWHM) of the adjustment of distribution of ϕ at different areas (1.2 to 1162.8 mm2) selected inside of tomographic images was proposed herein. The results obtained point out that samples with a section area corresponding to at least 882.1 mm2 were the ones that provided representative values of ϕ for the studied Brazilian tropical soil. PMID:22666133

Acoustic property reconstruction of a neonate Yangtze finless porpoise's (Neophocaena asiaeorientalis) head based on CT imaging.

PubMed

Wei, Chong; Wang, Zhitao; Song, Zhongchang; Wang, Kexiong; Wang, Ding; Au, Whitlow W L; Zhang, Yu

2015-01-01

The reconstruction of the acoustic properties of a neonate finless porpoise's head was performed using X-ray computed tomography (CT). The head of the deceased neonate porpoise was also segmented across the body axis and cut into slices. The averaged sound velocity and density were measured, and the Hounsfield units (HU) of the corresponding slices were obtained from computed tomography scanning. A regression analysis was employed to show the linear relationships between the Hounsfield unit and both sound velocity and density of samples. Furthermore, the CT imaging data were used to compare the HU value, sound velocity, density and acoustic characteristic impedance of the main tissues in the porpoise's head. The results showed that the linear relationships between HU and both sound velocity and density were qualitatively consistent with previous studies on Indo-pacific humpback dolphins and Cuvier's beaked whales. However, there was no significant increase of the sound velocity and acoustic impedance from the inner core to the outer layer in this neonate finless porpoise's melon.

Optimization of SPECT-CT Hybrid Imaging Using Iterative Image Reconstruction for Low-Dose CT: A Phantom Study

PubMed Central

Grosser, Oliver S.; Kupitz, Dennis; Ruf, Juri; Czuczwara, Damian; Steffen, Ingo G.; Furth, Christian; Thormann, Markus; Loewenthal, David; Ricke, Jens; Amthauer, Holger

2015-01-01

Background Hybrid imaging combines nuclear medicine imaging such as single photon emission computed tomography (SPECT) or positron emission tomography (PET) with computed tomography (CT). Through this hybrid design, scanned patients accumulate radiation exposure from both applications. Imaging modalities have been the subject of long-term optimization efforts, focusing on diagnostic applications. It was the aim of this study to investigate the influence of an iterative CT image reconstruction algorithm (ASIR) on the image quality of the low-dose CT images. Methodology/Principal Findings Examinations were performed with a SPECT-CT scanner with standardized CT and SPECT-phantom geometries and CT protocols with systematically reduced X-ray tube currents. Analyses included image quality with respect to photon flux. Results were compared to the standard FBP reconstructed images. The general impact of the CT-based attenuation maps used during SPECT reconstruction was examined for two SPECT phantoms. Using ASIR for image reconstructions, image noise was reduced compared to FBP reconstructions for the same X-ray tube current. The Hounsfield unit (HU) values reconstructed by ASIR were correlated to the FBP HU values(R2 ≥ 0.88) and the contrast-to-noise ratio (CNR) was improved by ASIR. However, for a phantom with increased attenuation, the HU values shifted for low X-ray tube currents I ≤ 60 mA (p ≤ 0.04). In addition, the shift of the HU values was observed within the attenuation corrected SPECT images for very low X-ray tube currents (I ≤ 20 mA, p ≤ 0.001). Conclusion/Significance In general, the decrease in X-ray tube current up to 30 mA in combination with ASIR led to a reduction of CT-related radiation exposure without a significant decrease in image quality. PMID:26390216

Prediction value of the Canadian CT head rule and the New Orleans criteria for positive head CT scan and acute neurosurgical procedures in minor head trauma: a multicenter external validation study.

PubMed

Bouida, Wahid; Marghli, Soudani; Souissi, Sami; Ksibi, Hichem; Methammem, Mehdi; Haguiga, Habib; Khedher, Sonia; Boubaker, Hamdi; Beltaief, Kaouthar; Grissa, Mohamed Habib; Trimech, Mohamed Naceur; Kerkeni, Wiem; Chebili, Nawfel; Halila, Imen; Rejeb, Imen; Boukef, Riadh; Rekik, Noureddine; Bouhaja, Bechir; Letaief, Mondher; Nouira, Semir

2013-05-01

The New Orleans Criteria and the Canadian CT Head Rule have been developed to decrease the number of normal computed tomography (CT) results in mild head injury. We compare the performance of both decision rules for identifying patients with intracranial traumatic lesions and those who require an urgent neurosurgical intervention after mild head injury. This was an observational cohort study performed between 2008 and 2011 on patients with mild head injury who were aged 10 years or older. We collected prospectively clinical head CT scan findings and outcome. Primary outcome was need for neurosurgical intervention, defined as either death or craniotomy, or the need of intubation within 15 days of the traumatic event. Secondary outcome was the presence of traumatic lesions on head CT scan. New Orleans Criteria and Canadian CT Head Rule decision rules were compared by using sensitivity specifications and positive and negative predictive value. We enrolled 1,582 patients. Neurosurgical intervention was performed in 34 patients (2.1%) and positive CT findings were demonstrated in 218 patients (13.8%). Sensitivity and specificity for need for neurosurgical intervention were 100% (95% confidence interval [CI] 90% to 100%) and 60% (95% CI 44% to 76%) for the Canadian CT Head Rule and 82% (95% CI 69% to 95%) and 26% (95% CI 24% to 28%) for the New Orleans Criteria. Negative predictive values for the above-mentioned clinical decision rules were 100% and 99% and positive values were 5% and 2%, respectively, for the Canadian CT Head Rule and New Orleans Criteria. Sensitivity and specificity for clinical significant head CT findings were 95% (95% CI 92% to 98%) and 65% (95% CI 62% to 68%) for the Canadian CT Head Rule and 86% (95% CI 81% to 91%) and 28% (95% CI 26% to 30%) for the New Orleans Criteria. A similar trend of results was found in the subgroup of patients with a Glasgow Coma Scale score of 15. For patients with mild head injury, the Canadian CT Head Rule had higher sensitivity than the New Orleans Criteria, with higher negative predictive value. The question of whether the use of the Canadian CT Head Rule would have a greater influence on head CT scan reduction requires confirmation in real clinical practice. Copyright © 2012 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Dose and detectability for a cone-beam C-arm CT system revisited

PubMed Central

Ganguly, Arundhuti; Yoon, Sungwon; Fahrig, Rebecca

2010-01-01

Purpose: The authors had previously published measurements of the detectability of disk-shaped contrast objects in images obtained from a C-arm CT system. A simple approach based on Rose’s criterion was used to scale the date, assuming the threshold for the smallest diameter detected should be inversely proportional to (dose)1∕2. A more detailed analysis based on recent theoretical modeling of C-arm CT images is presented in this work. Methods: The signal and noise propagations in a C-arm based CT system have been formulated by other authors using cascaded systems analysis. They established a relationship between detectability and the noise equivalent quanta. Based on this model, the authors obtained a relation between x-ray dose and the diameter of the smallest disks detected. A closed form solution was established by assuming no rebinning and no resampling of data, with low additive noise and using a ramp filter. For the case when no such assumptions were made, a numerically calculated solution using previously reported imaging and reconstruction parameters was obtained. The detection probabilities for a range of dose and kVp values had been measured previously. These probabilities were normalized to a single dose of 56.6 mGy using the Rose-criteria-based relation to obtain a universal curve. Normalizations based on the new numerically calculated relationship were compared to the measured results. Results: The theoretical and numerical calculations have similar results and predict the detected diameter size to be inversely proportional to (dose)1∕3 and (dose)1∕2.8, respectively. The normalized experimental curves and the associated universal plot using the new relation were not significantly different from those obtained using the Rose-criterion-based normalization. Conclusions: From numerical simulations, the authors found that the diameter of detected disks depends inversely on the cube root of the dose. For observer studies for disks larger than 4 mm, the cube root as well as square root relations appear to give similar results when used for normalization. PMID:20527560

The feasibility of a regional CTDI{sub vol} to estimate organ dose from tube current modulated CT exams

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

Khatonabadi, Maryam; Kim, Hyun J.; Lu, Peiyun

Purpose: In AAPM Task Group 204, the size-specific dose estimate (SSDE) was developed by providing size adjustment factors which are applied to the Computed Tomography (CT) standardized dose metric, CTDI{sub vol}. However, that work focused on fixed tube current scans and did not specifically address tube current modulation (TCM) scans, which are currently the majority of clinical scans performed. The purpose of this study was to extend the SSDE concept to account for TCM by investigating the feasibility of using anatomic and organ specific regions of scanner output to improve accuracy of dose estimates. Methods: Thirty-nine adult abdomen/pelvis and 32more » chest scans from clinically indicated CT exams acquired on a multidetector CT using TCM were obtained with Institutional Review Board approval for generating voxelized models. Along with image data, raw projection data were obtained to extract TCM functions for use in Monte Carlo simulations. Patient size was calculated using the effective diameter described in TG 204. In addition, the scanner-reported CTDI{sub vol} (CTDI{sub vol,global}) was obtained for each patient, which is based on the average tube current across the entire scan. For the abdomen/pelvis scans, liver, spleen, and kidneys were manually segmented from the patient datasets; for the chest scans, lungs and for female models only, glandular breast tissue were segmented. For each patient organ doses were estimated using Monte Carlo Methods. To investigate the utility of regional measures of scanner output, regional and organ anatomic boundaries were identified from image data and used to calculate regional and organ-specific average tube current values. From these regional and organ-specific averages, CTDI{sub vol} values, referred to as regional and organ-specific CTDI{sub vol}, were calculated for each patient. Using an approach similar to TG 204, all CTDI{sub vol} values were used to normalize simulated organ doses; and the ability of each normalized dose to correlate with patient size was investigated. Results: For all five organs, the correlations with patient size increased when organ doses were normalized by regional and organ-specific CTDI{sub vol} values. For example, when estimating dose to the liver, CTDI{sub vol,global} yielded a R{sup 2} value of 0.26, which improved to 0.77 and 0.86, when using the regional and organ-specific CTDI{sub vol} for abdomen and liver, respectively. For breast dose, the global CTDI{sub vol} yielded a R{sup 2} value of 0.08, which improved to 0.58 and 0.83, when using the regional and organ-specific CTDI{sub vol} for chest and breasts, respectively. The R{sup 2} values also increased once the thoracic models were separated for the analysis into females and males, indicating differences between genders in this region not explained by a simple measure of effective diameter. Conclusions: This work demonstrated the utility of regional and organ-specific CTDI{sub vol} as normalization factors when using TCM. It was demonstrated that CTDI{sub vol,global} is not an effective normalization factor in TCM exams where attenuation (and therefore tube current) varies considerably throughout the scan, such as abdomen/pelvis and even thorax. These exams can be more accurately assessed for dose using regional CTDI{sub vol} descriptors that account for local variations in scanner output present when TCM is employed.« less

On the accuracy and reproducibility of a novel probabilistic atlas-based generation for calculation of head attenuation maps on integrated PET/MR scanners.

PubMed

Chen, Kevin T; Izquierdo-Garcia, David; Poynton, Clare B; Chonde, Daniel B; Catana, Ciprian

2017-03-01

To propose an MR-based method for generating continuous-valued head attenuation maps and to assess its accuracy and reproducibility. Demonstrating that novel MR-based photon attenuation correction methods are both accurate and reproducible is essential prior to using them routinely in research and clinical studies on integrated PET/MR scanners. Continuous-valued linear attenuation coefficient maps ("μ-maps") were generated by combining atlases that provided the prior probability of voxel positions belonging to a certain tissue class (air, soft tissue, or bone) and an MR intensity-based likelihood classifier to produce posterior probability maps of tissue classes. These probabilities were used as weights to generate the μ-maps. The accuracy of this probabilistic atlas-based continuous-valued μ-map ("PAC-map") generation method was assessed by calculating the voxel-wise absolute relative change (RC) between the MR-based and scaled CT-based attenuation-corrected PET images. To assess reproducibility, we performed pair-wise comparisons of the RC values obtained from the PET images reconstructed using the μ-maps generated from the data acquired at three time points. The proposed method produced continuous-valued μ-maps that qualitatively reflected the variable anatomy in patients with brain tumor and agreed well with the scaled CT-based μ-maps. The absolute RC comparing the resulting PET volumes was 1.76 ± 2.33 %, quantitatively demonstrating that the method is accurate. Additionally, we also showed that the method is highly reproducible, the mean RC value for the PET images reconstructed using the μ-maps obtained at the three visits being 0.65 ± 0.95 %. Accurate and highly reproducible continuous-valued head μ-maps can be generated from MR data using a probabilistic atlas-based approach.

SU-E-J-123: Assessing Segmentation Accuracy of Internal Volumes and Sub-Volumes in 4D PET/CT of Lung Tumors Using a Novel 3D Printed Phantom

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

Soultan, D; Murphy, J; James, C

2015-06-15

Purpose: To assess the accuracy of internal target volume (ITV) segmentation of lung tumors for treatment planning of simultaneous integrated boost (SIB) radiotherapy as seen in 4D PET/CT images, using a novel 3D-printed phantom. Methods: The insert mimics high PET tracer uptake in the core and 50% uptake in the periphery, by using a porous design at the periphery. A lung phantom with the insert was placed on a programmable moving platform. Seven breathing waveforms of ideal and patient-specific respiratory motion patterns were fed to the platform, and 4D PET/CT scans were acquired of each of them. CT images weremore » binned into 10 phases, and PET images were binned into 5 phases following the clinical protocol. Two scenarios were investigated for segmentation: a gate 30–70 window, and no gating. The radiation oncologist contoured the outer ITV of the porous insert with on CT images, while the internal void volume with 100% uptake was contoured on PET images for being indistinguishable from the outer volume in CT images. Segmented ITVs were compared to the expected volumes based on known target size and motion. Results: 3 ideal breathing patterns, 2 regular-breathing patient waveforms, and 2 irregular-breathing patient waveforms were used for this study. 18F-FDG was used as the PET tracer. The segmented ITVs from CT closely matched the expected motion for both no gating and gate 30–70 window, with disagreement of contoured ITV with respect to the expected volume not exceeding 13%. PET contours were seen to overestimate volumes in all the cases, up to more than 40%. Conclusion: 4DPET images of a novel 3D printed phantom designed to mimic different uptake values were obtained. 4DPET contours overestimated ITV volumes in all cases, while 4DCT contours matched expected ITV volume values. Investigation of the cause and effects of the discrepancies is undergoing.« less

The Neuroimaging Studies in Children with Ventriculoperitoneal Shunt Complications: A 10 Years Descriptive Sudy in Tehran.

PubMed

Shahi, Mohammad Vafaee; Noorbakhsh, Samileh; Zarrabi, Vida; Nourozi, Banafsheh; Tahernia, Leila

2018-01-01

Any mismatch between the production and absorption of CSF results in hydrocephalus. In most cases, the selected choice of treatment is the ventriculoperitoneal shunt insertion. Although, the surgery could have complications such as infection, shunt malfunction, subdural hematoma, seizure and Shunt immigration; so, the early and proper detection of these complications could result in better prognosis. The aim of this study was to evaluate and compare the efficacy of CT scan, CSF analysis and X-ray radiography in detection of shunt complications and problems in shunt placement and further follow-up in hospitalized children. The medical records of children in Rasul Akram hospital in Tehran were reviewed retrospectively in the last 10 years, from 2006 to 2016. All data were recorded in the prepared form including the age, sex, shunt complication, CT scan and CSF characteristics. The total number of 95 patients were interfered in this study including 56 males (58.9%) and 39 females (41.1%). The mean age at the onset of complications were 2.8±2.2 years-old. The shunt obstruction (60%) and infection (25.3%) were the most common complications. The CT scan was able to detect 36.5% of shunt complications. The CT scan had the sensitivity and specificity of 50 and 87%, respectively in detection of shunt obstruction. The all cases of brain hematoma and hemorrhage were revealed by CT scan. On the other hand, the CT scan had 20% of sensitivity and 60% of specificity in the detection of shunt infection. The CSF evaluation in shunt infection revealed 92% hypoglycemia, 87.5% pleocytosis, and 62.5% positive CSF culture. CSF had the sensitivity, specificity, positive predictive value and negative predictive value of 92, 82, 63 and 97%, respectively. The patient's symptoms and signs were helpful in obtaining higher test accuracy. The CT scan was not a good sensitive and specific study in the detection of shunt obstruction and infection, but it was very accurate in detection of hemorrhage and hematoma. On the other hand, CSF evaluation was a reliable test in shunt infection disclosure.

Temporal Subtraction of Serial CT Images with Large Deformation Diffeomorphic Metric Mapping in the Identification of Bone Metastases.

PubMed

Sakamoto, Ryo; Yakami, Masahiro; Fujimoto, Koji; Nakagomi, Keita; Kubo, Takeshi; Emoto, Yutaka; Akasaka, Thai; Aoyama, Gakuto; Yamamoto, Hiroyuki; Miller, Michael I; Mori, Susumu; Togashi, Kaori

2017-11-01

Purpose To determine the improvement of radiologist efficiency and performance in the detection of bone metastases at serial follow-up computed tomography (CT) by using a temporal subtraction (TS) technique based on an advanced nonrigid image registration algorithm. Materials and Methods This retrospective study was approved by the institutional review board, and informed consent was waived. CT image pairs (previous and current scans of the torso) in 60 patients with cancer (primary lesion location: prostate, n = 14; breast, n = 16; lung, n = 20; liver, n = 10) were included. These consisted of 30 positive cases with a total of 65 bone metastases depicted only on current images and confirmed by two radiologists who had access to additional imaging examinations and clinical courses and 30 matched negative control cases (no bone metastases). Previous CT images were semiautomatically registered to current CT images by the algorithm, and TS images were created. Seven radiologists independently interpreted CT image pairs to identify newly developed bone metastases without and with TS images with an interval of at least 30 days. Jackknife free-response receiver operating characteristics (JAFROC) analysis was conducted to assess observer performance. Reading time was recorded, and usefulness was evaluated with subjective scores of 1-5, with 5 being extremely useful and 1 being useless. Significance of these values was tested with the Wilcoxon signed-rank test. Results The subtraction images depicted various types of bone metastases (osteolytic, n = 28; osteoblastic, n = 26; mixed osteolytic and blastic, n = 11) as temporal changes. The average reading time was significantly reduced (384.3 vs 286.8 seconds; Wilcoxon signed rank test, P = .028). The average figure-of-merit value increased from 0.758 to 0.835; however, this difference was not significant (JAFROC analysis, P = .092). The subjective usefulness survey response showed a median score of 5 for use of the technique (range, 3-5). Conclusion TS images obtained from serial CT scans using nonrigid registration successfully depicted newly developed bone metastases and showed promise for their efficient detection. © RSNA, 2017 Online supplemental material is available for this article.

Algorithm of pulmonary emphysema extraction using thoracic 3-D CT images

NASA Astrophysics Data System (ADS)

Saita, Shinsuke; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Ohmatsu, Hironobu; Tominaga, Keigo; Eguchi, Kenji; Moriyama, Noriyuki

2008-03-01

Emphysema patients have the tendency to increase due to aging and smoking. Emphysematous disease destroys alveolus and to repair is impossible, thus early detection is essential. CT value of lung tissue decreases due to the destruction of lung structure. This CT value becomes lower than the normal lung- low density absorption region or referred to as Low Attenuation Area (LAA). So far, the conventional way of extracting LAA by simple thresholding has been proposed. However, the CT value of CT image fluctuates due to the measurement conditions, with various bias components such as inspiration, expiration and congestion. It is therefore necessary to consider these bias components in the extraction of LAA. We removed these bias components and we proposed LAA extraction algorithm. This algorithm has been applied to the phantom image. Then, by using the low dose CT(normal: 30 cases, obstructive lung disease: 26 cases), we extracted early stage LAA and quantitatively analyzed lung lobes using lung structure.

Immunohistochemical analysis of tenascin expression in different grades of oral submucous fibrosis.

PubMed

Tak, Jalaj; Rao, Nirmala N; Chandra, Akhilesh; Gupta, Neha

2015-01-01

Tenascin, a glycoprotein, is one of the major constituents of extracellular matrix, which may function in organizing the stroma in normal and pathological conditions. The study aimed to correlate the structural organization of tenascin with the pathological progression of disease from early, moderate and advanced changes in oral submucous fibrosis (OSMF). A retrospective cross-sectional immunohistochemical (IHC) analysis of OSMF cases was performed. Total 70 slide samples were prepared for the study from 35 formalin-fixed paraffin-embedded tissue blocks with 10 each from histologically proven and graded as early, moderate and advanced OSMF and 5 of normal oral mucosa. The IHC sections were analyzed for the intensity and pattern of tenascin expression at the junction of epithelium and connective tissue (ECJ) and deeper connective tissue (CT), as well as presence or absence of staining around inflammatory cells, fibroblast and endothelial cells using anti-human tenascin. Most of the OSMF cases showed retention of antigen at ECJ and in deeper CT. Its expression varied in different grades as well as around inflammatory cells, fibroblast and endothelial cells in same tissue section. Highly significant P values of 0.001 and 0.003 were obtained for tenascin intensity and pattern, respectively, at ECJ in different OSMF grades. In addition, for the expression of tenascin pattern in deeper CT among different OSMF grades, a significant P value of 0.018 was obtained. A differential expression of tenascin was observed with the progression of disease. The expression of tenascin as bright and continuous deposition at ECJ in early and moderate stages of OSMF signifies either proliferative organization within the overlying epithelium or an epithelial-mesenchymal interaction. However, a weak immunoreactivity of tenascin at ECJ was observed in advanced stage of OSMF.

Observation of glassy state relaxation during annealing of frozen sugar solutions by X-ray computed tomography.

PubMed

Nakagawa, Kyuya; Tamiya, Shinri; Do, Gabsoo; Kono, Shinji; Ochiai, Takaaki

2018-06-01

Glassy phase formation in a frozen product determines various properties of the freeze-dried products. When an aqueous solution is subjected to freezing, a glassy phase forms as a consequence of freeze-concentration. During post-freezing annealing, the relaxation of the glassy phase and the ripening of ice crystals (i.e. Ostwald ripening) spontaneously occur, where the kinetics are controlled by the annealing and glass transition temperatures. This study was motivated to observe the progress of glassy state relaxation separate from ice coarsening during annealing. X-ray computed tomography (CT) was used to observe a frozen and post-freezing annealed solutions by using monochromatized X-ray from the synchrotron radiation. CT images were successfully obtained, and the frozen matrix were analyzed based on the gray level values that were equivalent to the linear X-ray attenuation coefficients of the observed matters. The CT images obtained from rapidly frozen sucrose and dextrin solutions with different concentrations gave clear linear relationships between the linear X-ray attenuation coefficients values and the solute concentrations. It was confirmed that the glassy state relaxation progressed as increasing annealing time, and this trend was larger in the order of the glass transition temperature of the maximally freeze-concentrated phase. The sucrose-water system required nearly 20 h of annealing time at -5 °C for the completion of the glassy phase relaxation, whereas dextrin-water systems required much longer periods because of their higher glass transition temperatures. The trends of ice coarsening, however, did not perfectly correspond to the trends of the relaxation, suggesting that the glassy phase relaxation and Ostwald ripening would jointly control the ice crystal growth/ripening kinetics, and the dominant mechanism differed by the annealing stage. Copyright © 2018 Elsevier B.V. All rights reserved.

Drought-induced embolism in stems of sunflower: A comparison of in vivo micro-CT observations and destructive hydraulic measurements.

PubMed

Savi, Tadeja; Miotto, Andrea; Petruzzellis, Francesco; Losso, Adriano; Pacilè, Serena; Tromba, Giuliana; Mayr, Stefan; Nardini, Andrea

2017-11-01

Vulnerability curves (VCs) are a useful tool to investigate the susceptibility of plants to drought-induced hydraulic failure, and several experimental techniques have been used for their measurement. The validity of the bench dehydration method coupled to hydraulic measurements, considered as a 'golden standard', has been recently questioned calling for its validation with non-destructive methods. We compared the VCs of a herbaceous crop plant (Helianthus annuus) obtained during whole-plant dehydration followed by i) hydraulic flow measurements in stem segments (classical destructive method) or by ii) in vivo micro-CT observations of stem xylem conduits in intact plants. The interpolated P 50 values (xylem water potential inducing 50% loss of hydraulic conductance) were -1.74 MPa and -0.87 MPa for the hydraulic and the micro-CT VC, respectively. Interpolated P 20 values were similar, while P 50 and P 80 were significantly different, as evidenced by non-overlapping 95% confidence intervals. Our results did not support the tension-cutting artefact, as no overestimation of vulnerability was observed when comparing the hydraulic VC to that obtained with in vivo imaging. After one scan, 25% of plants showed signs of x-ray induced damage, while three successive scans caused the formation of a circular brownish scar in all tested plants. Our results support the validity of hydraulic measurements of samples excised under tension provided standard sampling and handling protocols are followed, but also show that caution is needed when investigating vital plant processes with x-ray imaging. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Transport of Carbon Tetrachloride in a Fractured Vadose Zone due to Atmospheric Pressure Fluctuations, Diffusion, and Vapor Density

NASA Astrophysics Data System (ADS)

McCray, J. E.; Downs, W.; Falta, R. W.; Housley, T.

2005-12-01

DNAPL sources of carbon tetrachloride (CT) vapors are of interest at the Radioactive Waste Management Complex (RWMC) at the Idaho National Engineering and Environmental Laboratory (INEEL). The site is underlain by thick fractured basalt that includes sedimentary interbeds, each are a few meters thick. Daily atmospheric pressure fluctuations serve as driving forces for CT vapor transport in the subsurface. Other important transport processes for vapor movement include gas-phase diffusion and density-driven transport. The objective of this research is to investigate the influence and relative importance of these processes on gaseous transport of CT. Gas pressure and vapor concentration measurements were conducted at various depths in two wells. A numerical multiphase flow model (TOUGH2), calibrated to field pressure data, is used to conduct sensitivity analyses to elucidate the importance of the different transport mechanisms. Results show that the basalt is highly permeable to vertical air flow. The pressure dampening occurs mainly in the sedimentary interbeds. Model-calibrated permeability values for the interbeds are similar to those obtained in a study by the U.S. Geological Survey for shallow sediments, and an order of magnitude higher than column-scale values obtained by previous studies conducted by INEEL scientists. The transport simulations indicate that considering the effect of barometric pressure changes is critical to simulating transport of pollutants in the vadose zone above the DNAPL source. Predicted concentrations can be orders of magnitude smaller than actual concentrations if the effect is not considered. Below the DNAPL vapor source, accounting for density and diffusion alone would yield acceptable results provided that a 20% error in concentrations are acceptable, and that simulating concentrations trends (and not actual concentrations) is the primary goal.

Comparative Evaluation of Three Homogenization Methods for Isolating Middle East Respiratory Syndrome Coronavirus Nucleic Acids From Sputum Samples for Real-Time Reverse Transcription PCR.

PubMed

Sung, Heungsup; Yong, Dongeun; Ki, Chang Seok; Kim, Jae Seok; Seong, Moon Woo; Lee, Hyukmin; Kim, Mi Na

2016-09-01

Real-time reverse transcription PCR (rRT-PCR) of sputum samples is commonly used to diagnose Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Owing to the difficulty of extracting RNA from sputum containing mucus, sputum homogenization is desirable prior to nucleic acid isolation. We determined optimal homogenization methods for isolating viral nucleic acids from sputum. We evaluated the following three sputum-homogenization methods: proteinase K and DNase I (PK-DNase) treatment, phosphate-buffered saline (PBS) treatment, and N-acetyl-L-cysteine and sodium citrate (NALC) treatment. Sputum samples were spiked with inactivated MERS-CoV culture isolates. RNA was extracted from pretreated, spiked samples using the easyMAG system (bioMérieux, France). Extracted RNAs were then subjected to rRT-PCR for MERS-CoV diagnosis (DiaPlex Q MERS-coronavirus, SolGent, Korea). While analyzing 15 spiked sputum samples prepared in technical duplicate, false-negative results were obtained with five (16.7%) and four samples (13.3%), respectively, by using the PBS and NALC methods. The range of threshold cycle (Ct) values observed when detecting upE in sputum samples was 31.1-35.4 with the PK-DNase method, 34.7-39.0 with the PBS method, and 33.9-38.6 with the NALC method. Compared with the control, which were prepared by adding a one-tenth volume of 1:1,000 diluted viral culture to PBS solution, the ranges of Ct values obtained by the PBS and NALC methods differed significantly from the mean control Ct of 33.2 (both P<0.0001). The PK-DNase method is suitable for homogenizing sputum samples prior to RNA extraction.

Comparative Evaluation of Three Homogenization Methods for Isolating Middle East Respiratory Syndrome Coronavirus Nucleic Acids From Sputum Samples for Real-Time Reverse Transcription PCR

PubMed Central

Yong, Dongeun; Ki, Chang-Seok; Kim, Jae-Seok; Seong, Moon-Woo; Lee, Hyukmin

2016-01-01

Background Real-time reverse transcription PCR (rRT-PCR) of sputum samples is commonly used to diagnose Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Owing to the difficulty of extracting RNA from sputum containing mucus, sputum homogenization is desirable prior to nucleic acid isolation. We determined optimal homogenization methods for isolating viral nucleic acids from sputum. Methods We evaluated the following three sputum-homogenization methods: proteinase K and DNase I (PK-DNase) treatment, phosphate-buffered saline (PBS) treatment, and N-acetyl-L-cysteine and sodium citrate (NALC) treatment. Sputum samples were spiked with inactivated MERS-CoV culture isolates. RNA was extracted from pretreated, spiked samples using the easyMAG system (bioMérieux, France). Extracted RNAs were then subjected to rRT-PCR for MERS-CoV diagnosis (DiaPlex Q MERS-coronavirus, SolGent, Korea). Results While analyzing 15 spiked sputum samples prepared in technical duplicate, false-negative results were obtained with five (16.7%) and four samples (13.3%), respectively, by using the PBS and NALC methods. The range of threshold cycle (Ct) values observed when detecting upE in sputum samples was 31.1–35.4 with the PK-DNase method, 34.7–39.0 with the PBS method, and 33.9–38.6 with the NALC method. Compared with the control, which were prepared by adding a one-tenth volume of 1:1,000 diluted viral culture to PBS solution, the ranges of Ct values obtained by the PBS and NALC methods differed significantly from the mean control Ct of 33.2 (both P<0.0001). Conclusions The PK-DNase method is suitable for homogenizing sputum samples prior to RNA extraction. PMID:27374711

Immunohistochemical analysis of tenascin expression in different grades of oral submucous fibrosis

PubMed Central

Tak, Jalaj; Rao, Nirmala N; Chandra, Akhilesh; Gupta, Neha

2015-01-01

Aim: Tenascin, a glycoprotein, is one of the major constituents of extracellular matrix, which may function in organizing the stroma in normal and pathological conditions. The study aimed to correlate the structural organization of tenascin with the pathological progression of disease from early, moderate and advanced changes in oral submucous fibrosis (OSMF). Study Design: A retrospective cross-sectional immunohistochemical (IHC) analysis of OSMF cases was performed. Total 70 slide samples were prepared for the study from 35 formalin-fixed paraffin-embedded tissue blocks with 10 each from histologically proven and graded as early, moderate and advanced OSMF and 5 of normal oral mucosa. The IHC sections were analyzed for the intensity and pattern of tenascin expression at the junction of epithelium and connective tissue (ECJ) and deeper connective tissue (CT), as well as presence or absence of staining around inflammatory cells, fibroblast and endothelial cells using anti-human tenascin. Result: Most of the OSMF cases showed retention of antigen at ECJ and in deeper CT. Its expression varied in different grades as well as around inflammatory cells, fibroblast and endothelial cells in same tissue section. Highly significant P values of 0.001 and 0.003 were obtained for tenascin intensity and pattern, respectively, at ECJ in different OSMF grades. In addition, for the expression of tenascin pattern in deeper CT among different OSMF grades, a significant P value of 0.018 was obtained. Conclusion: A differential expression of tenascin was observed with the progression of disease. The expression of tenascin as bright and continuous deposition at ECJ in early and moderate stages of OSMF signifies either proliferative organization within the overlying epithelium or an epithelial-mesenchymal interaction. However, a weak immunoreactivity of tenascin at ECJ was observed in advanced stage of OSMF. PMID:26980955

Quantitative assessment of atherosclerotic plaques on (18)F-FDG PET/MRI: comparison with a PET/CT hybrid system.

PubMed

Li, Xiang; Heber, Daniel; Rausch, Ivo; Beitzke, Dietrich; Mayerhoefer, Marius E; Rasul, Sazan; Kreissl, Michael; Mitthauser, Markus; Wadsak, Wolfgang; Hartenbach, Markus; Haug, Alexander; Zhang, Xiaoli; Loewe, Christian; Beyer, Thomas; Hacker, Marcus

2016-07-01

PET with (18)F-FDG has the potential to assess vascular macrophage metabolism. (18)F-FDG is most often used in combination with contrast-enhanced CT to localize increased metabolism to specific arterial lesions. Novel (18)F-FDG PET/MRI hybrid imaging shows high potential for the combined evaluation of atherosclerotic plaques, due to the superior morphological conspicuity of plaque lesions. The purpose of this study was to evaluate the reliability and accuracy of (18)F-FDG PET/MRI uptake quantification compared to PET/CT as a reference standard in patients with carotid atherosclerotic plaques. The study group comprised 34 consecutive oncological patients with carotid plaques who underwent both PET/CT and PET/MRI with (18)F-FDG on the same day. The presence of atherosclerotic plaques was confirmed by 3 T MRI scans. Maximum standardized uptake values (SUVmax) for carotid plaque lesions and the average SUV of the blood pool within the adjacent internal jugular vein were determined and target-to-blood ratios (TBRs, plaque to blood pool) were calculated. Atherosclerotic lesions with maximum colocalized focal FDG uptake were assessed in each patient. SUVmax values of carotid plaque lesions were significantly lower on PET/MRI than on PET/CT (2.3 ± 0.6 vs. 3.1 ± 0.6; P < 0.01), but were significantly correlated between PET/CT and PET/MRI (Spearman's r = 0.67, P < 0.01). In contrast, TBRmax values of plaque lesions were similar on PET/MRI and on PET/CT (2.2 ± 0.3 vs. 2.2 ± 0.3; P = 0.4), and again were significantly correlated between PET/MRI and PET/CT (Spearman's r = 0.73, P < 0.01). Considering the increasing trend in SUVmax and TBRmax values from early to delayed imaging time-points on PET/CT and PET/MRI, respectively, with continuous clearance of radioactivity from the blood, a slight underestimation of TBRmax values may also be expected with PET/MRI compared with PET/CT. SUVmax and TBRmax values are widely accepted reference parameters for estimation of the radioactivity of atherosclerotic plaques on PET/CT. However, due to a systematic underestimation of SUVmax and TBRmax with PET/MRI, the optimal cut-off values indicating the presence of inflamed plaque tissue need to be newly defined for PET/MRI.

MO-DE-207B-10: Impact of Morphologic Characteristics On Radiomics Features From Contast-Enhanced CT for Primary Lung Tumors

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

Fried, D; Zhang, L; Fave, X

Purpose: Determine the impact of morphologic characteristics (e.g. necrosis, vascular enhancement, and cavitation) on radiomic features from contrast enhanced CT (CE-CT) in primary lung tumors. Methods: We developed an auto-segmentation algorithm to separate lung tumors on contrast-enhanced CT into cavitation (air), necrosis, tissue, and enhancing vessels using a combination of thresholding and region-growing. An auto-segmentation algorithm was also designed to identify necrosis on FDG-PET scans. Wilcoxon rank-sum tests were used to determine if significant differences existed in radiomics features (histogram-uniformity and Laplacian-of-Gaussian average) from 249 patients, found to prognostic in previous work, based on the presence/absence of morphologic features. Featuremore » values were also compared between the original tumor contours and contours excluding a specific morphologic feature. Comparison of necrosis segmentation on CE-CT versus FDG-PET was performed in 78 patients to assess for agreement using the concordance correlation coefficient (CCC). Results: Tumors with cavitation and enhancing vasculature had lower uniformity values (p = 0.001 and p = 0.03, respectively). Tumors with enhancing vasculature and necrosis had higher Laplacian-of-Gaussian average values (measure of “edges” within the tumor) (p < 0.001). Removing these tissue types from regions-of-interest did not drastically alter either radiomic feature value (all scenarios had R{sup 2} > 0.8). This suggests there may be interactions between morphologic characteristics and the radiomic feature value of tumor tissue. Comparison of necrosis volume and percent necrosis volume of tumor were found to have CCC values of 0.85 and 0.76, respectively between CE-CT and FDG-PET segmentation methods. Conclusions: Tumors with enhancing vasculature, necrosis, and cavitation have higher radiomic feature values that are associated with poor prognosis than tumors without these features. Removing these tissue types from quantitative assessment did not drastically impact radiomic feature values. High reproducibility of CE-CT segmented necrosis compared to FDG-PET segmented necrosis provides a reasonable validation of segmentation accuracy on CE-CT.« less

Experimental Evaluation of a Deformable Registration Algorithm for Motion Correction in PET-CT Guided Biopsy.

PubMed

Khare, Rahul; Sala, Guillaume; Kinahan, Paul; Esposito, Giuseppe; Banovac, Filip; Cleary, Kevin; Enquobahrie, Andinet

2013-01-01

Positron emission tomography computed tomography (PET-CT) images are increasingly being used for guidance during percutaneous biopsy. However, due to the physics of image acquisition, PET-CT images are susceptible to problems due to respiratory and cardiac motion, leading to inaccurate tumor localization, shape distortion, and attenuation correction. To address these problems, we present a method for motion correction that relies on respiratory gated CT images aligned using a deformable registration algorithm. In this work, we use two deformable registration algorithms and two optimization approaches for registering the CT images obtained over the respiratory cycle. The two algorithms are the BSpline and the symmetric forces Demons registration. In the first optmization approach, CT images at each time point are registered to a single reference time point. In the second approach, deformation maps are obtained to align each CT time point with its adjacent time point. These deformations are then composed to find the deformation with respect to a reference time point. We evaluate these two algorithms and optimization approaches using respiratory gated CT images obtained from 7 patients. Our results show that overall the BSpline registration algorithm with the reference optimization approach gives the best results.

Achieving high time-resolution with a new flow-through type analyzer for total inorganic carbon in seawater.

PubMed

Kimoto, Hideshi; Nozaki, Ken; Kudo, Setsuko; Kato, Ken; Negishi, Akira; Kayanne, Hajime

2002-03-01

A fully automated, continuous-flow-through type analyzer was developed to observe rapid changes in the concentration of total inorganic carbon (CT) in coastal zones. Seawater and an H3PO4 solution were fed into the analyzer's mixing coil by two high-precision valveless piston pumps. The CO2 was stripped from the seawater and moved into a carrier gas, using a newly developed continuous-flow-through CO2 extractor. A mass flow controller was used to assure a precise flow rate of the carrier gas. The CO2 concentration was then determined with a nondispersive infrared gas analyzer. This analyzer achieved a time-resolution of as good as 1 min. In field experiments on a shallow reef flat of Shiraho (Ishigaki Island, Southwest Japan), the analyzer detected short-term, yet extreme, variations in CT which manual sampling missed. Analytical values obtained by the analyzer on the boat were compared with those determined by potentiometric titration with a closed cell in a laboratory: CT(flow-through) = 0.980 x CT(titration) + 38.8 with r2 = 0.995 (n = 34; September 1998).

Comparison of hand and semiautomatic tracing methods for creating maxillofacial artificial organs using sequences of computed tomography (CT) and cone beam computed tomography (CBCT) images.

PubMed

Szabo, Bence T; Aksoy, Seçil; Repassy, Gabor; Csomo, Krisztian; Dobo-Nagy, Csaba; Orhan, Kaan

2017-06-09

The aim of this study was to compare the paranasal sinus volumes obtained by manual and semiautomatic imaging software programs using both CT and CBCT imaging. 121 computed tomography (CT) and 119 cone beam computed tomography (CBCT) examinations were selected from the databases of the authors' institutes. The Digital Imaging and Communications in Medicine (DICOM) images were imported into 3-dimensonal imaging software, in which hand mode and semiautomatic tracing methods were used to measure the volumes of both maxillary sinuses and the sphenoid sinus. The determined volumetric means were compared to previously published averages. Isometric CBCT-based volume determination results were closer to the real volume conditions, whereas the non-isometric CT-based volume measurements defined coherently lower volumes. By comparing the 2 volume measurement modes, the values gained from hand mode were closer to the literature data. Furthermore, CBCT-based image measurement results corresponded to the known averages. Our results suggest that CBCT images provide reliable volumetric information that can be depended on for artificial organ construction, and which may aid the guidance of the operator prior to or during the intervention.

CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical Planning.

PubMed

Shpilberg, Katya A; Daniel, Simon C; Doshi, Amish H; Lawson, William; Som, Peter M

2015-06-01

The purpose of this study was to determine the incidence of sinonasal anatomic variants and to assess their relation to sinonasal mucosal disease. A retrospective evaluation of 192 sinus CT examinations of patients with a clinical history of rhinosinusitis was conducted. The CT scans were evaluated for the presence of several anatomic variants of the sinonasal cavities, and the prevalence of each variant was calculated. Prevalences of all sinonasal anatomic variants were compared between patients who had minimal to no apparent imaging evidence of rhinosinusitis and those who had radiologic evidence of clinically significant rhinosinusitis. The most common normal variants were nasal septal deviation, Agger nasi cells, and extension of the sphenoid sinuses into the posterior nasal septum. We found no statistically significant difference in the prevalence of any of the studied anatomic variants between patients with minimal and those with clinically significant paranasal sinus or nasal cavity disease. Analysis of every routine CT scan of the paranasal sinuses obtained for sinusitis or rhinitis for the presence of different anatomic variants is of questionable value unless surgery is planned.

Validation of CBCT for the computation of textural biomarkers

NASA Astrophysics Data System (ADS)

Paniagua, Beatriz; Ruellas, Antonio C.; Benavides, Erika; Marron, Steve; Wolford, Larry; Cevidanes, Lucia

2015-03-01

Osteoarthritis (OA) is associated with significant pain and 42.6% of patients with TMJ disorders present with evidence of TMJ OA. However, OA diagnosis and treatment remain controversial, since there are no clear symptoms of the disease. The subchondral bone in the TMJ is believed to play a major role in the progression of OA. We hypothesize that the textural imaging biomarkers computed in high resolution Conebeam CT (hr- CBCT) and μCT scans are comparable. The purpose of this study is to test the feasibility of computing textural imaging biomarkers in-vivo using hr-CBCT, compared to those computed in μCT scans as our Gold Standard. Specimens of condylar bones obtained from condylectomies were scanned using μCT and hr- CBCT. Nine different textural imaging biomarkers (four co-occurrence features and five run-length features) from each pair of μCT and hr-CBCT were computed and compared. Pearson correlation coefficients were computed to compare textural biomarkers values of μCT and hr-CBCT. Four of the nine computed textural biomarkers showed a strong positive correlation between biomarkers computed in μCT and hr-CBCT. Higher correlations in Energy and Contrast, and in GLN (grey-level non-uniformity) and RLN (run length non-uniformity) indicate quantitative texture features can be computed reliably in hr-CBCT, when compared with μCT. The textural imaging biomarkers computed in-vivo hr-CBCT have captured the structure, patterns, contrast between neighboring regions and uniformity of healthy and/or pathologic subchondral bone. The ability to quantify bone texture non-invasively now makes it possible to evaluate the progression of subchondral bone alterations, in TMJ OA.

Improved correlation between CT emphysema quantification and pulmonary function test by density correction of volumetric CT data based on air and aortic density.

PubMed

Kim, Song Soo; Seo, Joon Beom; Kim, Namkug; Chae, Eun Jin; Lee, Young Kyung; Oh, Yeon Mok; Lee, Sang Do

2014-01-01

To determine the improvement of emphysema quantification with density correction and to determine the optimal site to use for air density correction on volumetric computed tomography (CT). Seventy-eight CT scans of COPD patients (GOLD II-IV, smoking history 39.2±25.3 pack-years) were obtained from several single-vendor 16-MDCT scanners. After density measurement of aorta, tracheal- and external air, volumetric CT density correction was conducted (two reference values: air, -1,000 HU/blood, +50 HU). Using in-house software, emphysema index (EI) and mean lung density (MLD) were calculated. Differences in air densities, MLD and EI prior to and after density correction were evaluated (paired t-test). Correlation between those parameters and FEV1 and FEV1/FVC were compared (age- and sex adjusted partial correlation analysis). Measured densities (HU) of tracheal- and external air differed significantly (-990 ± 14, -1016 ± 9, P<0.001). MLD and EI on original CT data, after density correction using tracheal- and external air also differed significantly (MLD: -874.9 ± 27.6 vs. -882.3 ± 24.9 vs. -860.5 ± 26.6; EI: 16.8 ± 13.4 vs. 21.1 ± 14.5 vs. 9.7 ± 10.5, respectively, P<0.001). The correlation coefficients between CT quantification indices and FEV1, and FEV1/FVC increased after density correction. The tracheal air correction showed better results than the external air correction. Density correction of volumetric CT data can improve correlations of emphysema quantification and PFT. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A minimum spanning forest based classification method for dedicated breast CT images

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

Pike, Robert; Sechopoulos, Ioannis; Fei, Baowei, E-mail: bfei@emory.edu

Purpose: To develop and test an automated algorithm to classify different types of tissue in dedicated breast CT images. Methods: Images of a single breast of five different patients were acquired with a dedicated breast CT clinical prototype. The breast CT images were processed by a multiscale bilateral filter to reduce noise while keeping edge information and were corrected to overcome cupping artifacts. As skin and glandular tissue have similar CT values on breast CT images, morphologic processing is used to identify the skin based on its position information. A support vector machine (SVM) is trained and the resulting modelmore » used to create a pixelwise classification map of fat and glandular tissue. By combining the results of the skin mask with the SVM results, the breast tissue is classified as skin, fat, and glandular tissue. This map is then used to identify markers for a minimum spanning forest that is grown to segment the image using spatial and intensity information. To evaluate the authors’ classification method, they use DICE overlap ratios to compare the results of the automated classification to those obtained by manual segmentation on five patient images. Results: Comparison between the automatic and the manual segmentation shows that the minimum spanning forest based classification method was able to successfully classify dedicated breast CT image with average DICE ratios of 96.9%, 89.8%, and 89.5% for fat, glandular, and skin tissue, respectively. Conclusions: A 2D minimum spanning forest based classification method was proposed and evaluated for classifying the fat, skin, and glandular tissue in dedicated breast CT images. The classification method can be used for dense breast tissue quantification, radiation dose assessment, and other applications in breast imaging.« less

Validation of CBCT for the computation of textural biomarkers

PubMed Central

Paniagua, Beatriz; Ruellas, Antonio Carlos; Benavides, Erika; Marron, Steve; Woldford, Larry; Cevidanes, Lucia

2015-01-01

Osteoarthritis (OA) is associated with significant pain and 42.6% of patients with TMJ disorders present with evidence of TMJ OA. However, OA diagnosis and treatment remain controversial, since there are no clear symptoms of the disease. The subchondral bone in the TMJ is believed to play a major role in the progression of OA. We hypothesize that the textural imaging biomarkers computed in high resolution Conebeam CT (hr-CBCT) and μCT scans are comparable. The purpose of this study is to test the feasibility of computing textural imaging biomarkers in-vivo using hr-CBCT, compared to those computed in μCT scans as our Gold Standard. Specimens of condylar bones obtained from condylectomies were scanned using μCT and hr-CBCT. Nine different textural imaging biomarkers (four co-occurrence features and five run-length features) from each pair of μCT and hr-CBCT were computed and compared. Pearson correlation coefficients were computed to compare textural biomarkers values of μCT and hr-CBCT. Four of the nine computed textural biomarkers showed a strong positive correlation between biomarkers computed in μCT and hr-CBCT. Higher correlations in Energy and Contrast, and in GLN (grey-level non-uniformity) and RLN (run length non-uniformity) indicate quantitative texture features can be computed reliably in hr-CBCT, when compared with μCT. The textural imaging biomarkers computed in-vivo hr-CBCT have captured the structure, patterns, contrast between neighboring regions and uniformity of healthy and/or pathologic subchondral bone. The ability to quantify bone texture non-invasively now makes it possible to evaluate the progression of subchondral bone alterations, in TMJ OA. PMID:26085710

Validation of CBCT for the computation of textural biomarkers.

PubMed

Paniagua, Beatriz; Ruellas, Antonio Carlos; Benavides, Erika; Marron, Steve; Woldford, Larry; Cevidanes, Lucia

2015-03-17

Osteoarthritis (OA) is associated with significant pain and 42.6% of patients with TMJ disorders present with evidence of TMJ OA. However, OA diagnosis and treatment remain controversial, since there are no clear symptoms of the disease. The subchondral bone in the TMJ is believed to play a major role in the progression of OA. We hypothesize that the textural imaging biomarkers computed in high resolution Conebeam CT (hr-CBCT) and μCT scans are comparable. The purpose of this study is to test the feasibility of computing textural imaging biomarkers in-vivo using hr-CBCT, compared to those computed in μCT scans as our Gold Standard. Specimens of condylar bones obtained from condylectomies were scanned using μCT and hr-CBCT. Nine different textural imaging biomarkers (four co-occurrence features and five run-length features) from each pair of μCT and hr-CBCT were computed and compared. Pearson correlation coefficients were computed to compare textural biomarkers values of μCT and hr-CBCT. Four of the nine computed textural biomarkers showed a strong positive correlation between biomarkers computed in μCT and hr-CBCT. Higher correlations in Energy and Contrast, and in GLN (grey-level non-uniformity) and RLN (run length non-uniformity) indicate quantitative texture features can be computed reliably in hr-CBCT, when compared with μCT. The textural imaging biomarkers computed in-vivo hr-CBCT have captured the structure, patterns, contrast between neighboring regions and uniformity of healthy and/or pathologic subchondral bone. The ability to quantify bone texture non-invasively now makes it possible to evaluate the progression of subchondral bone alterations, in TMJ OA.

Prostate Postbrachytherapy Seed Distribution: Comparison of High-Resolution, Contrast-Enhanced, T1- and T2-Weighted Endorectal Magnetic Resonance Imaging Versus Computed Tomography: Initial Experience

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

Bloch, B. Nicolas; Department of Radiology, General Hospital Vienna, Medical University Vienna, Vienna; Lenkinski, Robert E.

2007-09-01

Purpose: To compare contrast-enhanced, T1-weighted, three-dimensional magnetic resonance imaging (CEMR) and T2-weighted magnetic resonance imaging (T2MR) with computed tomography (CT) for prostate brachytherapy seed location for dosimetric calculations. Methods and Materials: Postbrachytherapy prostate MRI was performed on a 1.5 Tesla unit with combined surface and endorectal coils in 13 patients. Both CEMR and T2MR used a section thickness of 3 mm. Spiral CT used a section thickness of 5 mm with a pitch factor of 1.5. All images were obtained in the transverse plane. Two readers using CT and MR imaging assessed brachytherapy seed distribution independently. The dependency of datamore » read by both readers for a specific subject was assessed with a linear mixed effects model. Results: The mean percentage ({+-} standard deviation) values of the readers for seed detection and location are presented. Of 1205 implanted seeds, CEMR, T2MR, and CT detected 91.5% {+-} 4.8%, 78.5% {+-} 8.5%, and 96.1% {+-} 2.3%, respectively, with 11.8% {+-} 4.5%, 8.5% {+-} 3.5%, 1.9% {+-} 1.0% extracapsular, respectively. Assignment to periprostatic structures was not possible with CT. Periprostatic seed assignments for CEMR and T2MR, respectively, were as follows: neurovascular bundle, 3.5% {+-} 1.6% and 2.1% {+-} 0.9%; seminal vesicles, 0.9% {+-} 1.8% and 0.3% {+-} 0.7%; periurethral, 7.1% {+-} 3.3% and 5.8% {+-} 2.9%; penile bulb, 0.6% {+-} 0.8% and 0.3% {+-} 0.6%; Denonvillier's Fascia/rectal wall, 0.5% {+-} 0.6% and 0%; and urinary bladder, 0.1% {+-} 0.3% and 0%. Data dependency analysis showed statistical significance for the type of imaging but not for reader identification. Conclusion: Both enumeration and localization of implanted seeds are readily accomplished with CEMR. Calculations with MRI dosimetry do not require CT data. Dose determinations to specific extracapsular sites can be obtained with MRI but not with CT.« less

Summary Statistics for Fun Dough Data Acquired at LLNL

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

Kallman, J S; Morales, K E; Whipple, R E

Using x-ray computerized tomography (CT), we have characterized the x-ray linear attenuation coefficients (LAC) of a Play Dough{trademark}-like product, Fun Dough{trademark}, designated as PD. Table 1 gives the first-order statistics for each of four CT measurements, estimated with a Gaussian kernel density estimator (KDE) analysis. The mean values of the LAC range from a high of about 2100 LMHU{sub D} at 100kVp to a low of about 1100 LMHU{sub D} at 300kVp. The standard deviation of each measurement is around 1% of the mean. The entropy covers the range from 3.9 to 4.6. Ordinarily, we would model the LAC ofmore » the material and compare the modeled values to the measured values. In this case, however, we did not have the composition of the material and therefore did not model the LAC. Using a method recently proposed by Lawrence Livermore National Laboratory (LLNL), we estimate the value of the effective atomic number, Z{sub eff}, to be near 8.5. LLNL prepared about 50mL of the Fun Dough{trademark} in a polypropylene vial and firmly compressed it immediately prior to the x-ray measurements. Still, layers can plainly be seen in the reconstructed images, indicating that the bulk density of the material in the container is affected by voids and bubbles. We used the computer program IMGREC to reconstruct the CT images. The values of the key parameters used in the data capture and image reconstruction are given in this report. Additional details may be found in the experimental SOP and a separate document. To characterize the statistical distribution of LAC values in each CT image, we first isolated an 80% central-core segment of volume elements ('voxels') lying completely within the specimen, away from the walls of the polypropylene vial. All of the voxels within this central core, including those comprised of voids and inclusions, are included in the statistics. We then calculated the mean value, standard deviation and entropy for (a) the four image segments and for (b) their digital gradient images. (A digital gradient image of a given image was obtained by taking the absolute value of the difference between the initial image and that same image offset by one voxel horizontally, parallel to the rows of the x-ray detector array.) The statistics of the initial image of LAC values are called 'first order statistics;' those of the gradient image, 'second order statistics.'« less

A prospective evaluation of conventional cystography for detection of urine leakage at the vesicourethral anastomosis site after radical prostatectomy based on computed tomography.

PubMed

Han, K S; Choi, H J; Jung, D C; Park, S; Cho, K S; Joung, J Y; Seo, H K; Chung, J; Lee, K H

2011-03-01

To evaluate the diagnostic accuracy of conventional cystography for the detection of urine leakage at the vesicourethral anastomosis (VUA) site after radical prostatectomy based on computed tomography (CT) cystography. Patients who underwent radical prostatectomies at a single tertiary cancer centre were prospectively enrolled. Conventional cystography was routinely performed on postoperative day 7. Non-enhanced pelvic CT images were obtained after retrograde instillation of the same contrast material for a reference standard of urine leakage at the VUA site. Urine leakage was classified as follows: none; a plication abnormality; mild; moderate; and excessive. One hundred and twenty consecutive patients were enrolled. Conventional cystography detected 14 urine leakages, but CT cystography detected 40 urine leakages, which consisted of 28 mild and 12 moderate urine leakages. When using CT cystography as the standard measurement, conventional cystography showed a diagnostic accuracy of 17.8% (5/28) for mild urine leakage and 75% (9/12) for moderate leakage. Of nine patients diagnosed with mild leakage on conventional cystography, four (44.4%) had complicated moderate urine leakages based on CT cystography, requiring prolonged catheterization. The sensitivity, specificity, positive and negative predictive values, and accuracy of conventional cystography were 35, 100, 100, 75.4, and 78.3%, respectively. Conventional cystography is less accurate than CT cystography for diagnosing urine leakage at the VUA site after a radical prostatectomy. The present results suggest that CT cystography is a good choice for diagnostic imaging of urine leakage after radical prostatectomy. Copyright © 2010 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Direct Imaging of Cerebral Thromboemboli Using Computed Tomography and Fibrin-targeted Gold Nanoparticles

PubMed Central

Kim, Jeong-Yeon; Ryu, Ju Hee; Schellingerhout, Dawid; Sun, In-Cheol; Lee, Su-Kyoung; Jeon, Sangmin; Kim, Jiwon; Kwon, Ick Chan; Nahrendorf, Matthias; Ahn, Cheol-Hee; Kim, Kwangmeyung; Kim, Dong-Eog

2015-01-01

Computed tomography (CT) is the current standard for time-critical decision-making in stroke patients, informing decisions on thrombolytic therapy with tissue plasminogen activator (tPA), which has a narrow therapeutic index. We aimed to develop a CT-based method to directly visualize cerebrovascular thrombi and guide thrombolytic therapy. Glycol-chitosan-coated gold nanoparticles (GC-AuNPs) were synthesized and conjugated to fibrin-targeting peptides, forming fib-GC-AuNP. This targeted imaging agent and non-targeted control agent were characterized in vitro and in vivo in C57Bl/6 mice (n = 107) with FeCl3-induced carotid thrombosis and/or embolic ischemic stroke. Fibrin-binding capacity was superior with fib-GC-AuNPs compared to GC-AuNPs, with thrombi visualized as high density on microCT (mCT). mCT imaging using fib-GC-AuNP allowed the prompt detection and quantification of cerebral thrombi, and monitoring of tPA-mediated thrombolytic effect, which reflected histological stroke outcome. Furthermore, recurrent thrombosis could be diagnosed by mCT without further nanoparticle administration for up to 3 weeks. fib-GC-AuNP-based direct cerebral thrombus imaging greatly enhance the value and information obtainable by regular CT, has multiple uses in basic / translational vascular research, and will likely allow personalized thrombolytic therapy in clinic by a) optimizing tPA-dosing to match thrombus burden, b) enabling the rational triage of patients to more radical therapies such as endovascular clot-retrieval, and c) potentially serving as a theranostic platform for targeted delivery of concurrent thrombolysis. PMID:26199648

The effective dose result of 18F-FDG PET-CT paediatric patients

NASA Astrophysics Data System (ADS)

Hussin, D.; Said, M. A.; Ali, N. S.; Tajuddin, A. A.; Zainon, R.

2017-05-01

Paediatric patient received high exposure from both CT and PET examination. Automatic Exposure Control (AEC) is important in CT dose reduction. This study aimed to compare the effective dose obtained from PET-CT scanner with and without the use of AEC function. In this study, 68 patients underwent PET-CT examination without the use of AEC function, while 25 patients used the AEC function during the examination. Patients involved in this study were between 2 to 15 years old with varies of malignancies and epilepsy diseases. The effective dose obtained from PET and CT examinations was calculated based on recommendation from International Commission on Radiological Protection (ICRP) Publication 106 and ICRP publication 102. The outcome of this study shows that the radiation dose was reduced up to 20% with the use of AEC function. The mean average of effective dose result obtained from PET and CT examinations without the use of AEC and AEC function were found to be as 6.67 mSv, 6.77 mSv, 6.03mSv and 4.96 mSv respectively. Where total effective dose result of PET-CT with non-AEC and AEC were found to be 13.44 mSv and 10.99 mSv respectively. Conclusion of this study is, the installation of AEC function in PET-CT machine does play important role in CT dose reduction especially for paediatric patient.

[Radiation exposure during spiral-CT of the paranasal sinuses].

PubMed

Dammann, F; Momino-Traserra, E; Remy, C; Pereira, P L; Baumann, I; Koitschev, A; Claussen, C D

2000-03-01

Determination of the radiation doses in spiral CT of the paranasal sinuses using a variety of mAs values and scan protocols. CT examinations of the paranasal sinuses were performed using an Alderson-Rando phantom. Radiation dose was determined by LiF-TLD at the level of high risk organs in the head and neck region for combinations of different scan parameters (2/3, 3/3, 3/4 mm) and decreasing charges (200, 150, 100, 50, 25 mAs) on a spiral CT. Additional measurements were performed on three other CT scanners using the 2/3 mm protocol at 50 mAs, and a single slice technique (5/5 mm) on one scanner. The lowest dose values found were 1.88 mGy for the eye lenses, 1.35 mGy for the parotid gland, 0.03 mGy for the thyroid gland and 0.1 mGy for the medulla oblongata using 2 mm collimation and 3 mm table feed at 25 mAs. Maximal dose values resulted using the 3/3 mm protocol at 200 mAs (31.00 mGy for the eye lense, 0.65 mGy for the thyroid gland). There were no significant differences found between the different CT scanners. Using up-to-date CT scanners, radiation exposure may be reduced by a factor of 15-20 compared to that of conventional CT technique. Thus, the exposure of the eye lens comes to only a thousandth of the value supposedly inducing a cataract, as published by the ICRP.

Benign and malignant skull-involved lesions: discriminative value of conventional CT and MRI combined with diffusion-weighted MRI.

PubMed

Tu, Zhanhai; Xiao, Zebin; Zheng, Yingyan; Huang, Hongjie; Yang, Libin; Cao, Dairong

2018-01-01

Background Little is known about the value of computed tomography (CT) and magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) in distinguishing malignant from benign skull-involved lesions. Purpose To evaluate the discriminative value of DWI combined with conventional CT and MRI for differentiating between benign and malignant skull-involved lesions. Material and Methods CT and MRI findings of 58 patients with pathologically proven skull-involved lesions (43 benign and 15 malignant) were retrospectively reviewed. Conventional CT and MRI characteristics and apparent diffusion coefficient (ADC) value of the two groups were evaluated and compared. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter separately and together. Results The presence of cortical defects or break-through and ill-defined margins were associated with malignant skull-involved lesions (both P < 0.05). Malignant skull-involved lesions demonstrated a significantly lower ADC ( P = 0.016) than benign lesions. ROC curve analyses indicated that a combination of CT, MRI, and DWI with an ADC ≤ 0.703 × 10 -3 mm 2 /s showed optimal sensitivity, while DWI along showed optimal specificity of 88.4% in differentiating between benign and malignant skull-involved lesions. Conclusion The combination of CT, MRI, and DWI can help to differentiate malignant from benign skull-involved lesions. CT + MRI + DWI offers optimal sensitivity, while DWI offers optimal specificity.

A study on quantitative analysis of field size and dose by using gating system in 4D conformal radiation treatment

NASA Astrophysics Data System (ADS)

Ji, Youn-Sang; Dong, Kyung-Rae; Kim, Chang-Bok; Chung, Woon-Kwan; Cho, Jae-Hwan; Lee, Hae-Kag

2012-10-01

This study evaluated the gating-based 4-D conformal radiation therapy (4D-CT) treatment planning by a comparison with the common 3-D conformal radiation therapy (3D-CT) treatment planning and examined the change in treatment field size and dose to the tumors and adjacent normal tissues because an unnecessary dose is also included in the 3-D treatment planning for the radiation treatment of tumors in the chest and abdomen. The 3D-CT and gating-based 4D-CT images were obtained from patients who had undergone radiation treatment for chest and abdomen tumors in the oncology department. After establishing a treatment plan, the CT treatment and planning system were used to measure the change in field size for analysis. A dose volume histogram (DVH) was used to calculate the appropriate dose to planning target volume (PTV) tumors and adjacent normal tissue. The difference in the treatment volume of the chest was 0.6 and 0.83 cm on the X- and Y-axis, respectively, for the gross tumor volume (GTV). Accordingly, the values in the 4D-CT treatment planning were smaller and the dose was more concentrated by 2.7% and 0.9% on the GTV and clinical target volume (CTV), respectively. The normal tissues in the surrounding normal tissues were reduced by 3.0%, 7.2%, 0.4%, 1.7%, 2.6% and 0.2% in the bronchus, chest wall, esophagus, heart, lung and spinal cord, respectively. The difference in the treatment volume of the abdomen was 0.72 cm on the X-axis and 0.51 cm on the Y-axis for the GTV; and 1.06 cm on the X-axis and 1.85 cm on the Y-axis for the PTV. Therefore, the values in the 4D-CT treatment planning were smaller. The dose was concentrated by 6.8% and 4.3% on the GTV and PTV, respectively, whereas the adjacent normal tissues in the cord, Lt. kidney, Rt. kidney, small bowels and whole liver were reduced by 3.2%, 4.2%, 1.5%, 6.2% and 12.7%, respectively. The treatment field size was smaller in volume in the case of the 4D-CT treatment planning. In the DVH, the 4D-CT treatment planning showed a higher dose concentration on the part to be treated than the 3D-CT treatment planning with a lower dose to the adjacent normal tissues. Overall, the gating-based 4D-CT treatment planning is believed to be more helpful than the 3D-CT treatment planning.

The Necessity of Follow-Up Brain Computed-Tomography Scans: Is It the Pathology Itself Or Our Fear that We Should Overcome?

PubMed Central

Öğrenci, Ahmet; Koban, Orkun; Ekşi, Murat; Yaman, Onur; Dalbayrak, Sedat

2017-01-01

AIM: This study aimed to make a retrospective analysis of pediatric patients with head traumas that were admitted to one hospital setting and to make an analysis of the patients for whom follow-up CT scans were obtained. METHODS: Pediatric head trauma cases were retrospectively retrieved from the hospital’s electronic database. Patients’ charts, CT scans and surgical notes were evaluated by one of the authors. Repeat CT scans for operated patients were excluded from the total number of repeat CT scans. RESULTS: One thousand one hundred and thirty-eight pediatric patients were admitted to the clinic due to head traumas. Brain CT scan was requested in 863 patients (76%) in the cohort. Follow-up brain CT scans were obtained in 102 patients. Additional abnormal finding requiring surgical intervention was observed in only one patient (isolated 4th ventricle hematoma) on the control CTs (1% of repeat CT scans), who developed obstructive hydrocephalus. None of the patients with no more than 1 cm epidural hematoma in its widest dimension and repeat CT scans obtained 1.5 hours after the trauma necessitated surgery. CONCLUSION: Follow-up CT scans changed clinical approach in only one patient in the present series. When ordering CT scan in the follow-up of pediatric traumas, benefits and harms should be weighted based upon time interval from trauma onset to initial CT scan and underlying pathology. PMID:29104682

Quantification of the Effect of Shuttling on Computed Tomography Perfusion Parameters by Investigation of Aortic Inputs on Different Table Positions From Shuttle-Mode Scans of Lung and Liver Tumors.

PubMed

Ghosh, Payel; Chandler, Adam G; Hobbs, Brian P; Sun, Jia; Rong, John; Hong, David; Subbiah, Vivek; Janku, Filip; Naing, Aung; Hwu, Wen-Jen; Ng, Chaan S

The aim of this study was to quantify the effect of shuttling on computed tomography perfusion (CTp) parameters derived from shuttle-mode body CT images using aortic inputs from different table positions. Axial shuttle-mode CT scans were acquired from 6 patients (10 phases, 2 nonoverlapping table positions 1.4 seconds apart) after contrast agent administration. Artifacts resulting from the shuttling motion were corrected with nonrigid registration before computing CTp maps from 4 aortic levels chosen from the most superior and inferior slices of each table position scan. The effect of shuttling on CTp parameters was estimated by mean differences in mappings obtained from aortic inputs in different table positions. Shuttling effect was also quantified using 95% limits of agreement of CTp parameter differences within-table and between-table aortic positions from the interaortic mean CTp values. Blood flow, permeability surface, and hepatic arterial fraction differences were insignificant (P > 0.05) for both within-table and between-table comparisons. The 95% limits of agreement for within-table blood volume (BV) value deviations obtained from lung tumor regions were less than 4.7% (P = 0.18) compared with less than 12.2% (P = 0.003) for between-table BV value deviations. The 95% limits of agreement of within-table deviations for liver tumor regions were less than 1.9% (P = 0.55) for BV and less than 3.2% (P = 0.23) for mean transit time, whereas between-table BV and mean transit time deviations were less than 11.7% (P < 0.01) and less than 14.6% (P < 0.01), respectively. Values for normal liver tissue regions were concordant. Computed tomography perfusion parameters acquired from aortic levels within-table positions generally yielded higher agreement than mappings obtained from aortic levels between-table positions indicating differences due to shuttling effect.

Dynamic contrast-enhanced CT of head and neck tumors: perfusion measurements using a distributed-parameter tracer kinetic model. Initial results and comparison with deconvolution-based analysis

NASA Astrophysics Data System (ADS)

Bisdas, Sotirios; Konstantinou, George N.; Sherng Lee, Puor; Thng, Choon Hua; Wagenblast, Jens; Baghi, Mehran; San Koh, Tong

2007-10-01

The objective of this work was to evaluate the feasibility of a two-compartment distributed-parameter (DP) tracer kinetic model to generate functional images of several physiologic parameters from dynamic contrast-enhanced CT data obtained of patients with extracranial head and neck tumors and to compare the DP functional images to those obtained by deconvolution-based DCE-CT data analysis. We performed post-processing of DCE-CT studies, obtained from 15 patients with benign and malignant head and neck cancer. We introduced a DP model of the impulse residue function for a capillary-tissue exchange unit, which accounts for the processes of convective transport and capillary-tissue exchange. The calculated parametric maps represented blood flow (F), intravascular blood volume (v1), extravascular extracellular blood volume (v2), vascular transit time (t1), permeability-surface area product (PS), transfer ratios k12 and k21, and the fraction of extracted tracer (E). Based on the same regions of interest (ROI) analysis, we calculated the tumor blood flow (BF), blood volume (BV) and mean transit time (MTT) by using a modified deconvolution-based analysis taking into account the extravasation of the contrast agent for PS imaging. We compared the corresponding values by using Bland-Altman plot analysis. We outlined 73 ROIs including tumor sites, lymph nodes and normal tissue. The Bland-Altman plot analysis revealed that the two methods showed an accepted degree of agreement for blood flow, and, thus, can be used interchangeably for measuring this parameter. Slightly worse agreement was observed between v1 in the DP model and BV but even here the two tracer kinetic analyses can be used interchangeably. Under consideration of whether both techniques may be used interchangeably was the case of t1 and MTT, as well as for measurements of the PS values. The application of the proposed DP model is feasible in the clinical routine and it can be used interchangeably for measuring blood flow and vascular volume with the commercially available reference standard of the deconvolution-based approach. The lack of substantial agreement between the measurements of vascular transit time and permeability-surface area product may be attributed to the different tracer kinetic principles employed by both models and the detailed capillary tissue exchange physiological modeling of the DP technique.

A Simplified Whole-Organ CT Perfusion Technique with Biphasic Acquisition: Preliminary Investigation of Accuracy and Protocol Feasibility in Kidneys.

PubMed

Yuan, XiaoDong; Zhang, Jing; Quan, ChangBin; Tian, Yuan; Li, Hong; Ao, GuoKun

2016-04-01

To determine the feasibility and accuracy of a protocol for calculating whole-organ renal perfusion (renal blood flow [RBF]) and regional perfusion on the basis of biphasic computed tomography (CT), with concurrent dynamic contrast material-enhanced (DCE) CT perfusion serving as the reference standard. This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Biphasic CT of the kidneys, including precontrast and arterial phase imaging, was integrated with a first-pass dynamic volume CT protocol and performed and analyzed in 23 patients suspected of having renal artery stenosis. The perfusion value derived from biphasic CT was calculated as CT number enhancement divided by the area under the arterial input function and compared with the DCE CT perfusion data by using the paired t test, correlation analysis, and Bland-Altman plots. Correlation analysis was made between the RBF and the extent of renal artery stenosis. All postprocessing was independently performed by two observers and then averaged as the final result. Mean ± standard deviation biphasic and DCE CT perfusion data for RBF were 425.62 mL/min ± 124.74 and 419.81 mL/min ± 121.13, respectively (P = .53), and for regional perfusion they were 271.15 mL/min per 100 mL ± 82.21 and 266.33 mL/min per 100 mL ± 74.40, respectively (P = .31). Good correlation and agreement were shown between biphasic and DCE CT perfusion for RBF (r = 0.93; ±10% variation from mean perfusion data [P < .001]) and for regional perfusion (r = 0.90; ±13% variation from mean perfusion data [P < .001]). The extent of renal artery stenosis was negatively correlated with RBF with biphasic CT perfusion (r = -0.81, P = .012). Biphasic CT perfusion is clinically feasible and provides perfusion data comparable to DCE CT perfusion data at both global and regional levels in the kidney. Online supplemental material is available for this article.

Communication Technology: Pros and Cons of Constant Connection to Work

ERIC Educational Resources Information Center

Diaz, Ismael; Chiaburu, Dan S.; Zimmerman, Ryan D.; Boswell, Wendy R.

2012-01-01

We examined the relationship between employees' attitudes related to communication technology (CT) flexibility, communication technology (CT) use, work-to-life conflict and work satisfaction. Based on data obtained from 193 employees, CT flexibility predicted more CT use. Further, CT use was associated not only with increased work satisfaction,…

Advances in Pancreatic CT Imaging.

PubMed

Almeida, Renata R; Lo, Grace C; Patino, Manuel; Bizzo, Bernardo; Canellas, Rodrigo; Sahani, Dushyant V

2018-07-01

The purpose of this article is to discuss the advances in CT acquisition and image postprocessing as they apply to imaging the pancreas and to conceptualize the role of radiogenomics and machine learning in pancreatic imaging. CT is the preferred imaging modality for assessment of pancreatic diseases. Recent advances in CT (dual-energy CT, CT perfusion, CT volumetry, and radiogenomics) and emerging computational algorithms (machine learning) have the potential to further increase the value of CT in pancreatic imaging.

Using computed tomography to assist with diagnosis of avascular necrosis complicating chronic scaphoid nonunion.

PubMed

Smith, Michael L; Bain, Gregory I; Chabrel, Nick; Turner, Perry; Carter, Chris; Field, John

2009-01-01

The primary aim of our study was to investigate use of long axis computed tomography (CT) in predicting avascular necrosis of the proximal pole of the scaphoid and subsequent fracture nonunion after internal fixation. In addition, we describe a new technique of measuring the position of a scaphoid fracture and provide data on its reproducibility. Thirty-one patients operated on by the senior author for delayed union or nonunion of scaphoid fracture were included. Preoperative CT scans were independently assessed for increased radiodensity of the proximal pole, converging trabeculae, degree of deformity, comminution, and fracture position. Intraoperative biopsies of the proximal pole were obtained and histologically assessed for evidence of avascular necrosis. The radiologic variables were statistically compared with the histologic findings. The presence of avascular necrosis was also compared with postoperative union status, identified on longitudinal CT scans. Preoperative CT features that statistically correlated with histologic evidence of avascular necrosis were increased radiodensity of the proximal pole and the absence of any converging trabeculae between the fracture fragments. The radiologic changes of avascular necrosis and the histologic confirmation of avascular necrosis were associated with persistent nonunion. Preoperative longitudinal CT of scaphoid nonunion is of great value in identifying avascular necrosis and predicting subsequent fracture union. If avascular necrosis is suspected based on preoperative CT, management options include vascularized bone grafts and bone morphogenic protein for younger patients and limited wrist arthrodesis for older patients. Diagnostic II.

Automatic lesion tracking for a PET/CT based computer aided cancer therapy monitoring system

NASA Astrophysics Data System (ADS)

Opfer, Roland; Brenner, Winfried; Carlsen, Ingwer; Renisch, Steffen; Sabczynski, Jörg; Wiemker, Rafael

2008-03-01

Response assessment of cancer therapy is a crucial component towards a more effective and patient individualized cancer therapy. Integrated PET/CT systems provide the opportunity to combine morphologic with functional information. However, dealing simultaneously with several PET/CT scans poses a serious workflow problem. It can be a difficult and tedious task to extract response criteria based upon an integrated analysis of PET and CT images and to track these criteria over time. In order to improve the workflow for serial analysis of PET/CT scans we introduce in this paper a fast lesion tracking algorithm. We combine a global multi-resolution rigid registration algorithm with a local block matching and a local region growing algorithm. Whenever the user clicks on a lesion in the base-line PET scan the course of standardized uptake values (SUV) is automatically identified and shown to the user as a graph plot. We have validated our method by a data collection from 7 patients. Each patient underwent two or three PET/CT scans during the course of a cancer therapy. An experienced nuclear medicine physician manually measured the courses of the maximum SUVs for altogether 18 lesions. As a result we obtained that the automatic detection of the corresponding lesions resulted in SUV measurements which are nearly identical to the manually measured SUVs. Between 38 measured maximum SUVs derived from manual and automatic detected lesions we observed a correlation of 0.9994 and a average error of 0.4 SUV units.

Patient-specific dose calculations for pediatric CT of the chest, abdomen and pelvis

PubMed Central

Fraser, Nicholas D.; Carver, Diana E.; Pickens, David R.; Price, Ronald R.; Hernanz-Schulman, Marta; Stabin, Michael G.

2015-01-01

Background Organ dose is essential for accurate estimates of patient dose from CT. Objective To determine organ doses from a broad range of pediatric patients undergoing diagnostic chest–abdomen–pelvis CT and investigate how these relate to patient size. Materials and methods We used a previously validated Monte Carlo simulation model of a Philips Brilliance 64 multi-detector CT scanner (Philips Healthcare, Best, The Netherlands) to calculate organ doses for 40 pediatric patients (M:F=21:19; range 0.6–17 years). Organ volumes and positions were determined from the images using standard segmentation techniques. Non-linear regression was performed to determine the relationship between volume CT dose index (CTDIvol)-normalized organ doses and abdominopelvic diameter. We then compared results with values obtained from independent studies. Results We found that CTDIvol-normalized organ dose correlated strongly with exponentially decreasing abdominopelvic diameter (R2>0.8 for most organs). A similar relationship was determined for effective dose when normalized by dose-length product (R2=0.95). Our results agreed with previous studies within 12% using similar scan parameters (i.e. bowtie filter size, beam collimation); however results varied up to 25% when compared to studies using different bowtie filters. Conclusion Our study determined that organ doses can be estimated from measurements of patient size, namely body diameter, and CTDIvol prior to CT examination. This information provides an improved method for patient dose estimation. PMID:26142256

Renal Cyst Pseudoenhancement: Intraindividual Comparison Between Virtual Monochromatic Spectral Images and Conventional Polychromatic 120-kVp Images Obtained During the Same CT Examination and Comparisons Among Images Reconstructed Using Filtered Back Projection, Adaptive Statistical Iterative Reconstruction, and Model-Based Iterative Reconstruction

PubMed Central

Yamada, Yoshitake; Yamada, Minoru; Sugisawa, Koichi; Akita, Hirotaka; Shiomi, Eisuke; Abe, Takayuki; Okuda, Shigeo; Jinzaki, Masahiro

2015-01-01

Abstract The purpose of this study was to compare renal cyst pseudoenhancement between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp images obtained during the same abdominal computed tomography (CT) examination and among images reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR). Our institutional review board approved this prospective study; each participant provided written informed consent. Thirty-one patients (19 men, 12 women; age range, 59–85 years; mean age, 73.2 ± 5.5 years) with renal cysts underwent unenhanced 120-kVp CT followed by sequential fast kVp-switching dual-energy (80/140 kVp) and 120-kVp abdominal enhanced CT in the nephrographic phase over a 10-cm scan length with a random acquisition order and 4.5-second intervals. Fifty-one renal cysts (maximal diameter, 18.0 ± 14.7 mm [range, 4–61 mm]) were identified. The CT attenuation values of the cysts as well as of the kidneys were measured on the unenhanced images, enhanced VMS images (at 70 keV) reconstructed using FBP and ASIR from dual-energy data, and enhanced 120-kVp images reconstructed using FBP, ASIR, and MBIR. The results were analyzed using the mixed-effects model and paired t test with Bonferroni correction. The attenuation increases (pseudoenhancement) of the renal cysts on the VMS images reconstructed using FBP/ASIR (least square mean, 5.0/6.0 Hounsfield units [HU]; 95% confidence interval, 2.6–7.4/3.6–8.4 HU) were significantly lower than those on the conventional 120-kVp images reconstructed using FBP/ASIR/MBIR (least square mean, 12.1/12.8/11.8 HU; 95% confidence interval, 9.8–14.5/10.4–15.1/9.4–14.2 HU) (all P < .001); on the other hand, the CT attenuation values of the kidneys on the VMS images were comparable to those on the 120-kVp images. Regardless of the reconstruction algorithm, 70-keV VMS images showed a lower degree of pseudoenhancement of renal cysts than 120-kVp images, while maintaining kidney contrast enhancement comparable to that on 120-kVp images. PMID:25881852

Biopsy of CT-Occult Bone Lesions Using Anatomic Landmarks for CT Guidance.

PubMed

Hillen, Travis J; Talbert, Robert J; Friedman, Michael V; Long, Jeremiah R; Jennings, Jack W; Wessell, Daniel E; Baker, Jonathan C

2017-07-01

The purpose of this study is to evaluate the histopathologic diagnostic yield, sample size, procedural time, and dose-length product (DLP) for the biopsy of CT-occult lesions found at MRI or PET or both. A retrospective review of our radiology information system for biopsies of CT-occult lesions using CT guidance from January 1, 2010, through December 31, 2014, was performed and compared with a selection of CT-guided biopsies of CT-evident bone lesions during the same period. The data were then evaluated for diagnostic yield of histopathologic diagnosis, procedural time, use of sedation medication, DLP, and size of specimens obtained. A total of 30 CT-occult biopsies met the inclusion criteria. Twenty-seven of those biopsies had results that were concordant with the patient's primary histopathologic diagnosis, imaging findings, and clinical course. In the CT-evident lesion group, concordant histopathologic abnormalities were identified in 27 of 30 patients. There was a statistically significant increase in number of samples obtained for the CT-evident lesions compared with CT-occult lesions. There was no statistically significant difference in total specimen length, DLP, number of CT scans, procedural time, or use of sedation medication between the CT-occult and CT-evident biopsy groups. Biopsy of CT-occult lesions using anatomic landmarks achieves diagnostic yields similar to those for CT-guided biopsy of CT-evident lesions.

An automated A-value measurement tool for accurate cochlear duct length estimation.

PubMed

Iyaniwura, John E; Elfarnawany, Mai; Ladak, Hanif M; Agrawal, Sumit K

2018-01-22

There has been renewed interest in the cochlear duct length (CDL) for preoperative cochlear implant electrode selection and postoperative generation of patient-specific frequency maps. The CDL can be estimated by measuring the A-value, which is defined as the length between the round window and the furthest point on the basal turn. Unfortunately, there is significant intra- and inter-observer variability when these measurements are made clinically. The objective of this study was to develop an automated A-value measurement algorithm to improve accuracy and eliminate observer variability. Clinical and micro-CT images of 20 cadaveric cochleae specimens were acquired. The micro-CT of one sample was chosen as the atlas, and A-value fiducials were placed onto that image. Image registration (rigid affine and non-rigid B-spline) was applied between the atlas and the 19 remaining clinical CT images. The registration transform was applied to the A-value fiducials, and the A-value was then automatically calculated for each specimen. High resolution micro-CT images of the same 19 specimens were used to measure the gold standard A-values for comparison against the manual and automated methods. The registration algorithm had excellent qualitative overlap between the atlas and target images. The automated method eliminated the observer variability and the systematic underestimation by experts. Manual measurement of the A-value on clinical CT had a mean error of 9.5 ± 4.3% compared to micro-CT, and this improved to an error of 2.7 ± 2.1% using the automated algorithm. Both the automated and manual methods correlated significantly with the gold standard micro-CT A-values (r = 0.70, p < 0.01 and r = 0.69, p < 0.01, respectively). An automated A-value measurement tool using atlas-based registration methods was successfully developed and validated. The automated method eliminated the observer variability and improved accuracy as compared to manual measurements by experts. This open-source tool has the potential to benefit cochlear implant recipients in the future.

Ventricular Geometry From Non-contrast Non-ECG-gated CT Scans: An Imaging Marker of Cardiopulmonary Disease in Smokers.

PubMed

Rahaghi, Farbod N; Vegas-Sanchez-Ferrero, Gonzalo; Minhas, Jasleen K; Come, Carolyn E; De La Bruere, Isaac; Wells, James M; González, Germán; Bhatt, Surya P; Fenster, Brett E; Diaz, Alejandro A; Kohli, Puja; Ross, James C; Lynch, David A; Dransfield, Mark T; Bowler, Russel P; Ledesma-Carbayo, Maria J; San José Estépar, Raúl; Washko, George R

2017-05-01

Imaging-based assessment of cardiovascular structure and function provides clinically relevant information in smokers. Non-cardiac-gated thoracic computed tomographic (CT) scanning is increasingly leveraged for clinical care and lung cancer screening. We sought to determine if more comprehensive measures of ventricular geometry could be obtained from CT using an atlas-based surface model of the heart. Subcohorts of 24 subjects with cardiac magnetic resonance imaging (MRI) and 262 subjects with echocardiography were identified from COPDGene, a longitudinal observational study of smokers. A surface model of the heart was manually initialized, and then automatically optimized to fit the epicardium for each CT. Estimates of right and left ventricular (RV and LV) volume and free-wall curvature were then calculated and compared to structural and functional metrics obtained from MRI and echocardiograms. CT measures of RV dimension and curvature correlated with similar measures obtained using MRI. RV and LV volume obtained from CT inversely correlated with echocardiogram-based estimates of RV systolic pressure using tricuspid regurgitation jet velocity and LV ejection fraction respectively. Patients with evidence of RV or LV dysfunction on echocardiogram had larger RV and LV dimensions on CT. Logistic regression models based on demographics and ventricular measures from CT had an area under the curve of >0.7 for the prediction of elevated right ventricular systolic pressure and ventricular failure. These data suggest that non-cardiac-gated, non-contrast-enhanced thoracic CT scanning may provide insight into cardiac structure and function in smokers. Copyright © 2017. Published by Elsevier Inc.

Differentiation and diagnosis of benign and malignant testicular lesions using 18F-FDG PET/CT.

PubMed

Shao, Dan; Gao, Qiang; Tian, Xu-Wei; Wang, Si-Yun; Liang, Chang-Hong; Wang, Shu-Xia

2017-08-01

The purpose of this study was to evaluate the differential diagnostic value of 18 F-fluorodeoxy glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for benign and malignant testicular lesions. The PET/CT scans of 53 patients with testicular lesions confirmed by biopsy or surgical pathology were retrospectively analyzed. There were 32 cases of malignant tumors and 21 cases of benign lesions. Differences in the maximum standardized uptake value (SUVmax) measurements and the SUVmax lesion/background ratios between benign and malignant lesions were analyzed. The diagnostic value of this PET/CT modality for the differential diagnosis of benign versus malignant testicular lesions was calculated. The differences in the SUVmax measurements and the SUVmax lesion/background ratios between benign and malignant lesions were statistically significant (SUVmax: Z=-4.295, p=0.000; SUVmax lesion/background ratio: Z=-5.219, p=0.000); specifically, both of these indicators were higher in malignant lesions compared to benign lesions. An SUVmax of 3.75 was the optimal cutoff value to differentiate between benign and malignant testicular lesions. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this PET/CT modality in the differential diagnosis of benign versus malignant testicular lesions were 90.6%, 80.9%, 86.8%, 87.9%, and 85.0%, respectively. 18 F-FDG PET/CT can accurately identify benign and malignant testicular lesions. Copyright © 2017 Elsevier B.V. All rights reserved.

Spectral CT imaging in patients with Budd-Chiari syndrome: investigation of image quality.

PubMed

Su, Lei; Dong, Junqiang; Sun, Qiang; Liu, Jie; Lv, Peijie; Hu, Lili; Yan, Liangliang; Gao, Jianbo

2014-11-01

To assess the image quality of monochromatic imaging from spectral CT in patients with Budd-Chiari syndrome (BCS), fifty patients with BCS underwent spectral CT to generate conventional 140 kVp polychromatic images (group A) and monochromatic images, with energy levels from 40 to 80, 40 + 70, and 50 + 70 keV fusion images (group B) during the portal venous phase (PVP) and the hepatic venous phase (HVP). Two-sample t tests compared vessel-to-liver contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) for the portal vein (PV), hepatic vein (HV), inferior vena cava. Readers' subjective evaluations of the image quality were recorded. The highest SNR values in group B were distributed at 50 keV; the highest CNR values in group B were distributed at 40 keV. The higher CNR values and SNR values were obtained though PVP of PV (SNR 18.39 ± 6.13 vs. 10.56 ± 3.31, CNR 7.81 ± 3.40 vs. 3.58 ± 1.31) and HVP of HV (3.89 ± 2.08 vs. 1.27 ± 1.55) in the group B; the lower image noise for group B was at 70 keV and 50 + 70 keV (15.54 ± 8.39 vs. 18.40 ± 4.97, P = 0.0004 and 18.97 ± 7.61 vs. 18.40 ± 4.97, P = 0.0691); the results show that the 50 + 70 keV fusion image quality was better than that in group A. Monochromatic energy levels of 40-70, 40 + 70, and 50 + 70 keV fusion image can increase vascular contrast and that will be helpful for the diagnosis of BCS, we select the 50 + 70 keV fusion image to acquire the best BCS images.

Dynamic-thresholding level set: a novel computer-aided volumetry method for liver tumors in hepatic CT images

NASA Astrophysics Data System (ADS)

Cai, Wenli; Yoshida, Hiroyuki; Harris, Gordon J.

2007-03-01

Measurement of the volume of focal liver tumors, called liver tumor volumetry, is indispensable for assessing the growth of tumors and for monitoring the response of tumors to oncology treatments. Traditional edge models, such as the maximum gradient and zero-crossing methods, often fail to detect the accurate boundary of a fuzzy object such as a liver tumor. As a result, the computerized volumetry based on these edge models tends to differ from manual segmentation results performed by physicians. In this study, we developed a novel computerized volumetry method for fuzzy objects, called dynamic-thresholding level set (DT level set). An optimal threshold value computed from a histogram tends to shift, relative to the theoretical threshold value obtained from a normal distribution model, toward a smaller region in the histogram. We thus designed a mobile shell structure, called a propagating shell, which is a thick region encompassing the level set front. The optimal threshold calculated from the histogram of the shell drives the level set front toward the boundary of a liver tumor. When the volume ratio between the object and the background in the shell approaches one, the optimal threshold value best fits the theoretical threshold value and the shell stops propagating. Application of the DT level set to 26 hepatic CT cases with 63 biopsy-confirmed hepatocellular carcinomas (HCCs) and metastases showed that the computer measured volumes were highly correlated with those of tumors measured manually by physicians. Our preliminary results showed that DT level set was effective and accurate in estimating the volumes of liver tumors detected in hepatic CT images.

NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans.

PubMed

Lee, Choonsik; Kim, Kwang Pyo; Bolch, Wesley E; Moroz, Brian E; Folio, Les

2015-12-01

We developed computational methods and tools to assess organ doses for pediatric and adult patients undergoing computed tomography (CT) examinations. We used the International Commission on Radiological Protection (ICRP) reference pediatric and adult phantoms combined with the Monte Carlo simulation of a reference CT scanner to establish comprehensive organ dose coefficients (DC), organ absorbed dose per unit volumetric CT Dose Index (CTDIvol) (mGy/mGy). We also developed methods to estimate organ doses with tube current modulation techniques and size specific dose estimates. A graphical user interface was designed to obtain user input of patient- and scan-specific parameters, and to calculate and display organ doses. A batch calculation routine was also integrated into the program to automatically calculate organ doses for a large number of patients. We entitled the computer program, National Cancer Institute dosimetry system for CT(NCICT). We compared our dose coefficients with those from CT-Expo, and evaluated the performance of our program using CT patient data. Our pediatric DCs show good agreements of organ dose estimation with those from CT-Expo except for thyroid. Our results support that the adult phantom in CT-Expo seems to represent a pediatric individual between 10 and 15 years rather than an adult. The comparison of CTDIvol values between NCICT and dose pages from 10 selected CT scans shows good agreements less than 12% except for two cases (up to 20%). The organ dose comparison between mean and modulated mAs shows that mean mAs-based calculation significantly overestimates dose (up to 2.4-fold) to the organs in close proximity to lungs in chest and chest-abdomen-pelvis scans. Our program provides more realistic anatomy based on the ICRP reference phantoms, higher age resolution, the most up-to-date bone marrow dosimetry, and several convenient features compared to previous tools. The NCICT will be available for research purpose in the near future.

[Application of Low Dose Spiral CT in Diagnosing Impacted Teeth in Children and Adolescents].

PubMed

Wang, Meng-tian; Li, Xue-sheng; Li, Kai-ming; Bao, Li; Ning, Gang

2015-09-01

[ABSTRACT] To determine the value of low dose spiral CT scanning in diagnosing impacted teeth of children and adolescents. A total of 153 children and adolescents with confirmed impacted teeth in West China Second University Hospital, Sichuan University were enrolled in this study. They were divided into 5 groups according to the different spiral CT scan parameters (tube current time product, scanning thickness and collimation value): Group A (n=30, 330 mAs, 6 X 0. 75 mm and 3. 0 mm), Group B (n=30, 140 mAs, 6 X 0. 75 mm and 3. 0 mm), Group C (n=30, 80 mAs, 6 X 0. 75 mm and 3. 0 mm), Group D (n=31, 80 mAs, 6 X 1. 50 mm and 5. 0 mm), and Group E (n=32, 50 mAs, 6 X 1. 50 mm and 5. 0 mm). There were no significant differences in general clinical features (P>0. 05) among the participants of the five groups. The phantoms were used to measure spatial resolution and contrast resolution of the scan images. Dose length product (DLP) was recorded during CT scanning for calculating effective dose (ED) of exposure. The quality of images was evaluated using a list of quality scoring criteria. (1) Under 330, 140, 80, 80 and 50 mAs, the images had a spatial resolution of 1.0 mm, with contrast resolution of 2. 0, 3. 0, 4. 5, 4. 5 and 6. 0 mm, respectively. (2) Significant differences in ED values were found among the five groups (F=1 064. 119, P=0. 000) and between every two of those groups (P<0. 05). Group E had the lowest ED (0. 19 mSv), 86. 52%, 67. 24%, 45. 71%, and 38. 71% lower than that in Group A, B, C and D, respectively (P<0. 05). (3) All of the five groups obtained an image quality score above 3, and no statistical differences appeared among the 5 groupl (F=1. 978, P>0. 05). The diagnostic results of the spiral CT were consistent with those of orthodontic surgery. Low dose spiral CT scanning can meet the image quality requirements for diagnosing impacted teeth, minimizing radiation exposure effectively.

18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice.

PubMed

Wang, Shao-Bo; Wu, Hu-Bing; Wang, Quan-Shi; Zhou, Wen-Lan; Tian, Ying; Ji, Yun-Hai; Lv, Liang

2015-10-01

The various origins of obstructive jaundice make the diagnosis of the disease difficult. This study was undertaken to evaluate the role of 18F-FDG PET/CT in differentiating malignant from benign origins of obstructive jaundice and to quantify the added value of 18F-FDG PET/CT over conventional imaging (enhanced CT and/or MRI). Eighty-five patients with obstructive jaundice who underwent 18F-FDG PET/CT within 2 weeks after enhanced CT and/or MRI were reviewed retrospectively. All 18F-FDG PET/CT images were independently evaluated by 2 nuclear medicine physicians who were unaware of other imaging data; differences were resolved by consensus of the physicians. All conventional imaging interpretations, according to the medical records, were reviewed by 2 radiologists to determine the potential value. Final diagnoses were based on histological or surgical findings. Sixty-six patients were diagnosed with malignancies, and 19 patients with benign lesions. The maximum standardized uptake values for malignant and benign lesions causing biliary obstruction were 8.2+/-4.4 and 4.0+/-5.0, respectively (P<0.05). The sensitivity, specificity, and overall accuracy for differentiating malignant from benign origins with 18F-FDG PET/CT were 86.4% (57/66), 73.7% (14/19), and 83.5% (71/85), respectively. 18F-FDG PET/CT in conjunction with conventional imaging changed the sensitivity, specificity, and overall accuracy of conventional imaging alone from 75.8% (50/66) to 95.5% (63/66) (P<0.05), 68.4% (13/19) to 57.9% (11/19) (P>0.05), and 74.1% (63/85) to 87.1% (74/85) (P<0.05), respectively. 18F-FDG PET/CT is of great value in differentiating malignant from benign origins of obstructive jaundice and is a useful adjuvant to conventional imaging. 18F-FDG PET/CT should be recommended for further etiological clarification.

Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint.

PubMed

Moche, Jason A; Cohen, Justin C; Pearlman, Steven J

2013-07-01

The objective of this work was to explore the utility of axial computed tomography (CT) imaging to objectively define a narrow internal nasal valve, and compare those findings with clinical examination and patient complaint. Retrospective review from a single facial plastic surgery center. We reviewed 40 consecutive patients evaluated for either sinusitis or nasal airway obstruction for which a CT scan was obtained at a single radiology institution. Thirty-six complete office records were examined for the presence of clinical internal valve narrowing and complaints of nasal obstruction. In total, 72 internal nasal valves were analyzed using axial plane CT and measurements were compared to clinical findings and presence of airway obstruction. Measured valve areas for clinically normal internal nasal valves averaged 0.47 cm(2) vs 0.28 cm(2) for clinically narrow valves, a decrease of 40.4%. In unobstructed nasal airways the valve area averaged 0.51 cm(2) vs 0.38 cm(2) in obstructed airways, a difference of 25.5%. A radiographically measured valve area of <0.30 cm(2) suggests clinical narrowing with a sensitivity of 71.4%, specificity of 88.9%, positive predictive value of 62.5%, and negative predictive value of 92.3%. Using standard axial CT imaging we describe an objective method of radiographically evaluating the nasal valve, demonstrating strong correlation with physical examination and patient complaint. Additionally, radiographic valve areas can be used to screen for clinically narrow nasal valves with good sensitivity and specificity, providing a novel straightforward method for nasal valve assessment. © 2012 ARS-AAOA, LLC.

Pediatric Emergency CT Scans at a Children's Hospital and at Community Hospitals: Radiation Technical Factors Are an Important Source of Radiation Exposure.

PubMed

Agarwal, Saurabh; Jokerst, Clinton; Siegel, Marilyn J; Hildebolt, Charles

2015-08-01

This article compares the technical factors-in particular, tube current and voltage-and the resultant exposure to radiation associated with CT examinations performed at a children's hospital and at more general community hospital emergency departments (EDs). CT scans obtained at community hospital EDs were retrospectively reviewed and compared with CT scans obtained at a children's hospital, to assess differences in kilovoltage, tube current, and volume CT dose index (CTDIvol) used. The number of scans obtained during the contrast-enhanced phase was also assessed. Parametric and nonparametric statistical analyses were used to test differences. A total of 233 body CT examinations were performed at community hospitals, and 287 were performed at a children's hospital. At both types of hospital, the median patient age was 12 years (p = 0.66). Of the body CT scans obtained at community hospitals that focused on the care of adult patients, 194 of 233 (83%) used a tube voltage of 120 kVp, 29 of 233 (12%) used 100 kVp, and two of 233 (< 1%) used 80 kVp. Of the body CT scans obtained at the children's hospital, 121 of 287 (42%) used a tube voltage of 120 kVp, 129 of 287 (45%) used 100 kVp, and 36 of 287 (13%) used 80 kVp. The median tube current was also lower at the children's hospital (110 vs 125 mA) (p < 0.001). At the community hospitals, 11 of 233 studies were multiphasic, whereas at the children's hospital, there were no multiphasic studies. For all CT types, the median CTDIvol was 4.9 mGy (range, 2.5-8.2 mGy) at the children's hospital and 8.6 mGy (range, 6.0-14.4 mGy) at the community hospitals (p < 0.001). The results of this study suggest that a large proportion of children who undergo CT at community hospitals receive relatively higher radiation doses than children who undergo CT at children's hospitals. This finding is related to the higher tube settings (in particular, kilovoltage) used at community hospitals.

Adaptive Control Techniques for Large Space Structures

DTIC Science & Technology

1987-12-23

articles : 41Y’ 4 C - . L) , /V., .**~ V .- ~ ~ __5 -. . ,- . /- . # \\J . . _ I- / ’ ~ - L r,:0- ,*~ ~ . 20 OISTRIBUTION/AVAILABILITY OF AUSTt CT 21...up by the strong theoretical foundations in Ljung(1987) and in Anderson et al.(1986), that results can be obtained which will be of scientific value...has, of course, a long his- tory, and we will not attempt to document that here. There are many excellent survey articles and textbooks that can be

Clinical Significance of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography/computed Tomography in the Follow-up of Colorectal Cancer: Searching off Approaches Increasing Specificity for Detection of Recurrence

PubMed Central

Okuyucu, Kursat; Hancerliogulları, Oguz; Alagoz, Engin; San, Huseyin; Arslan, Nuri

2017-01-01

Abstract Background Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (l8F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC. Patients and methods We examined the SUVmax value of lesions on control or restaging 18F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]). Results Mean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively. 18F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and 18F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease. Conclusions Although SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of 18F-FDG-PET/CT. PMID:29333115

Clinical Significance of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography/computed Tomography in the Follow-up of Colorectal Cancer: Searching off Approaches Increasing Specificity for Detection of Recurrence.

PubMed

Ince, Semra; Okuyucu, Kursat; Hancerliogulları, Oguz; Alagoz, Engin; San, Huseyin; Arslan, Nuri

2017-12-01

Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose ( l8 F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18 F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC. We examined the SUVmax value of lesions on control or restaging 18 F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]). Mean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively. 18 F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and 18 F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease. Although SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of 18 F-FDG-PET/CT.