Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid (Gd-EOB-DTPA)-Enhanced Magnetic Resonance Imaging and Multidetector-Row Computed Tomography for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis.

PubMed

Ye, Feng; Liu, Jun; Ouyang, Han

2015-08-01

The purpose of this meta-analysis was to compare the diagnostic accuracy of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and multidetector-row computed tomography (MDCT) for hepatocellular carcinoma (HCC).Medline, Cochrane, EMBASE, and Google Scholar databases were searched until July 4, 2014, using combinations of the following terms: gadoxetic acid disodium, Gd-EOB-DTPA, multidetector CT, contrast-enhanced computed tomography, and magnetic resonance imaging. Inclusion criteria were as follows: confirmed diagnosis of primary HCC by histopathological examination of a biopsy specimen; comparative study of MRI using Gd-EOB-DTPA and MDCT for diagnosis of HCC; and studies that provided quantitative outcome data. The pooled sensitivity and specificity of the 2 methods were compared, and diagnostic accuracy was assessed with alternative-free response receiver-operating characteristic analysis.Nine studies were included in the meta-analysis, and a total of 1439 lesions were examined. The pooled sensitivity and specificity for 1.5T MRI were 0.95 and 0.96, respectively, for 3.0T MRI were 0.91 and 0.96, respectively, and for MDCT were 0.74 and 0.93, respectively. The pooled diagnostic odds ratio for 1.5T and 3.0T MRI was 242.96, respectively, and that of MDCT was 33.47. To summarize, Gd-EOB-DTPA-enhanced MRI (1.5T and 3.0T) has better diagnostic accuracy for HCC than MDCT.

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.

Radiation dose in 320-slice multidetector cardiac CT: a single center experience of evolving dose minimization.

PubMed

Tung, Matthew K; Cameron, James D; Casan, Joshua M; Crossett, Marcus; Troupis, John M; Meredith, Ian T; Seneviratne, Sujith K

2013-01-01

Minimization of radiation exposure remains an important subject that occurs in parallel with advances in scanner technology. We report our experience of evolving radiation dose and its determinants after the introduction of 320-multidetector row cardiac CT within a single tertiary cardiology referral service. Four cohorts of consecutive patients (total 525 scans), who underwent cardiac CT at defined time points as early as 2008, are described. These include a cohort just after scanner installation, after 2 upgrades of the operating system, and after introduction of an adaptive iterative image reconstruction algorithm. The proportions of nondiagnostic coronary artery segments and studies with nondiagnostic segments were compared between cohorts. Significant reductions were observed in median radiation doses in all cohorts compared with the initial cohort (P < .001). Median dose-length product fell from 944 mGy · cm (interquartile range [IQR], 567.3-1426.5 mGy · cm) to 156 mGy · cm (IQR, 99.2-265.0 mGy · cm). Although the proportion of prospectively triggered scans has increased, reductions in radiation dose have occurred independently of distribution of scan formats. In multiple regression that combined all groups, determinants of dose-length product were tube output, the number of cardiac cycles scanned, tube voltage, scan length, scan format, body mass index, phase width, and heart rate (adjusted R(2) = 0.85, P < .001). The proportion of nondiagnostic coronary artery segments was slightly increased in group 4 (2.9%; P < .01). While maintaining diagnostic quality in 320-multidetector row cardiac CT, the radiation dose has decreased substantially because of a combination of dose-reduction protocols and technical improvements. Continued minimization of radiation dose will increase the potential for cardiac CT to expand as a cardiac imaging modality. Copyright © 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Multi-Detector Row Computed Tomography Findings of Pelvic Congestion Syndrome Caused by Dilated Ovarian Veins

PubMed Central

Eren, Suat

2010-01-01

Objective: To evaluate the efficacy of multi-detector row CT (MDCT) on pelvic congestion syndrome (PCS), which is often overlooked or poorly visualized with routine imaging examination. Materials and Methods: We evaluated the MDCT features of 40 patients with PCS (mean age, 45 years; range, 29–60 years) using axial, coronal, sagittal, 3D volume-rendered, and Maximum Intensity Projection MIP images. Results: MDCT revealed pelvic varices and ovarian vein dilatations in all patients. Bilateral ovarian vein dilatation was present in 25 patients, and 15 patients had unilateral dilatation. While 12 cases of secondary pelvic varices occurred simultaneously with a retroaortic left renal vein, 10 cases were due solely to a mass obstruction or stenosis of venous structures. Conclusion: MDCT is an effective tool in the evaluation of PCS, and it has more advantages than other imaging modalities. PMID:25610142

An anatomical review of spinal cord blood supply.

PubMed

Melissano, G; Bertoglio, L; Rinaldi, E; Leopardi, M; Chiesa, R

2015-10-01

Knowledge of the spinal cord (SC) vascular supply is important in patients undergoing procedures that involve the thoracic and thoracoabdominal aorta. However, the SC vasculature has a complex anatomy, and teaching is often based only on anatomical sketches with highly variable accuracy; historically, this has required a "leap of faith" on the part of aortic surgeons. Fortunately, this "leap of faith" is no longer necessary given recent breakthroughs in imaging technologies and postprocessing software. Imaging methods have expanded the non-invasive diagnostic ability to determine a patient's SC vascular pattern, particularly in detecting the presence and location of the artery of Adamkiewicz. CT is the imaging modality of choice for most patients with thoracic and thoracoabdominal aortic disease, proving especially useful in the determination of feasibility and planning of endovascular treatment. Thus the data set required for analysis of SC vascular anatomy is usually already available. We have concentrated our efforts on CT angiography, which offers particularly good imaging capabilities with state-of-the-art multidetector scanners. Multidetector row helical CT provides examinations of an extensive range in the craniocaudal direction with thin collimation in a short time interval, giving excellent temporal and spatial resolution. This paper provides examples of the SC vasculature imaging quality that can be obtained with 64 row scanners and appropriate postprocessing. Knowledge of the principal anatomical features of the SC blood supply of individual patients undergoing open or endovascular thoracoabdominal procedures has several potential benefits. For open surgery, analysis of the SC vasculature could tell us the aortic region that feeds the Adamkiewicz artery and thus needs to be reimplanted. For endovascular procedures, we can determine whether the stent-graft will cover the Adamkiewicz artery, thus avoiding unnecessary coverage. CT data can also be used to stratify risk of SC ischemia and guide the selective use of spinal cord injury prevention strategies.

Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

PubMed Central

Yi, Ji Sook; Han, Jong Kyu; Kim, Hyun-Joo

2015-01-01

Objective To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Materials and Methods Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. Results The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Conclusion Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI. PMID:26175589

Electrocardiographically gated 16-section CT of the thorax: cardiac motion suppression.

PubMed

Hofmann, Lars K; Zou, Kelly H; Costello, Philip; Schoepf, U Joseph

2004-12-01

Thirty patients underwent 16-section multi-detector row computed tomographic (CT) angiography of the thorax with retrospective electrocardiographic gating. Institutional review board approval was obtained for retrospective analysis of CT scan data and records; patient informed consent was not required. Images reconstructed at six different time points (0%, 20%, 40%, 50%, 60%, 80%) within the R-R interval on the electrocardiogram were analyzed by two radiologists for diagnostic quality, to identify suitable reconstruction intervals for optimal suppression of cardiac motion. Five regions of interest (left coronary artery, aortic root, ascending and descending aorta, pulmonary arteries) were evaluated. Best image quality was achieved by referencing image reconstruction to middiastole (50%-60%) for the left coronary artery, aortic root, and ascending aorta. The pulmonary arteries are best displayed during mid- to late diastole (80%). (c) RSNA, 2004

Diagnosing Early Ischemic Changes with the Latest-Generation Flat Detector CT: A Comparative Study with Multidetector CT.

PubMed

Maier, I L; Leyhe, J R; Tsogkas, I; Behme, D; Schregel, K; Knauth, M; Schnieder, M; Liman, J; Psychogios, M-N

2018-05-01

One-stop management of mechanical thrombectomy-eligible patients with large-vessel occlusion represents an innovative approach in acute stroke treatment. This approach reduces door-to-reperfusion times by omitting multidetector CT, using flat detector CT as pre-mechanical thrombectomy imaging. The purpose of this study was to compare the diagnostic performance of the latest-generation flat detector CT with multidetector CT. Prospectively derived data from patients with ischemic stroke with large-vessel occlusion and mechanical thrombectomy were analyzed in this monocentric study. All included patients underwent multidetector CT before referral to our comprehensive stroke center and flat detector CT in the angiography suite before mechanical thrombectomy. Diagnosis of early ischemic signs, quantified by the ASPECTS, was compared between modalities using cross tables, the Pearson correlation, and Bland-Altman plots. The predictive value of multidetector CT- and flat detector CT-derived ASPECTS for functional outcome was investigated using area under the receiver operating characteristic curve analysis. Of 25 patients, 24 (96%) had flat detector CT with sufficient diagnostic quality. Median multidetector CT and flat detector CT ASPECTSs were 7 (interquartile range, 5.5-9 and 4.25-8, respectively) with a mean period of 143.6 ± 49.5 minutes between both modalities. The overall sensitivity was 85.1% and specificity was 83.1% for flat detector CT ASPECTS compared with multidetector CT ASPECTS as the reference technique. Multidetector CT and flat detector CT ASPECTS were strongly correlated ( r = 0.849, P < .001) and moderately predicted functional outcome (area under the receiver operating characteristic curve, 0.738; P = .007 and .715; P = .069, respectively). Determination of ASPECTS on flat detector CT is feasible, showing no significant difference compared with multidetector CT ASPECTS and a similar predictive value for functional outcome. Our findings support the use of flat detector CT for emergency stroke imaging before mechanical thrombectomy to reduce door-to-groin time. © 2018 by American Journal of Neuroradiology.

Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography.

PubMed

Dreizin, David; Boscak, Alexis R; Anstadt, Michael J; Tirada, Nikki; Chiu, William C; Munera, Felipe; Bodanapally, Uttam K; Hornick, Michael; Stein, Deborah M

2016-12-01

Purpose To determine the diagnostic performance of multidetector computed tomography (CT) with trajectography for penetrating colorectal injuries. Materials and Methods This institutional review board-approved and HIPAA-compliant study was a 6-year blinded retrospective review by two independent readers of 182 consecutive patients who preoperatively underwent 40- or 64-row multidetector CT for penetrating torso trauma below the diaphragm and had surgically confirmed findings. Colorectal perforation was present in 42 patients. Trajectory analysis with postprocessing software was used for all studies. Additional signs evaluated were rectal contrast agent leak, collections of extruded fecal material, mural defect, wall thickening, abnormal enhancement, free fluid or stranding, and free air. The quality of the colorectal contrast agent administration was recorded. Sensitivity, specificity, predictive values, areas under the receiver operating characteristic curves (AUCs), and Cohen κ were determined. Results In patients with rectal contrast agent administration (n = 151), AUCs were 0.90-0.91, which indicated excellent accuracy. Trajectory was sensitive (88%-91%). For single wounds (n = 104), sensitivity of trajectory was 96% for both readers, but was only 80% for multiple wounds (n = 47). Contrast agent leak was highly specific (96%-98%), but insensitive (42%-46%). Improved diagnostic performance was observed in patients with poor colonic distension or opacification. Accuracy remained high (AUC, 0.86-0.99) in the group without rectal contrast agent administration (n = 31). Conclusion Trajectory had excellent sensitivity, while rectal contrast agent leak was specific but insensitive. Sensitivity of trajectory was lower for multiple wounds. Accuracy remained high in patients without rectal contrast agent administration. © RSNA, 2016.

Feasibility of tissue characterization of coronary plaques using 320-detector row computed tomography: comparison with integrated backscatter intravascular ultrasound.

PubMed

Takahashi, Shigekiyo; Kawasaki, Masanori; Miyata, Shusaku; Suzuki, Keita; Yamaura, Makoto; Ido, Takahisa; Aoyama, Takuma; Fujiwara, Hisayoshi; Minatoguchi, Shinya

2016-01-01

Recently, a new generation of multi-detector row computed tomography (CT) with 320-detector rows (DR) has become available in the clinical settings. The purpose of the present study was to determine the cutoff values of Hounsfield unit (HU) for discrimination of plaque components by comparing HU of coronary plaques with integrated backscatter intravascular ultrasound (IB-IVUS) serving as a gold standard. Seventy-seven coronary atherosclerotic lesions in 77 patients with angina were visualized by both 320-DR CT (Aquilion One, Toshiba, Japan) and IB-IVUS at the same site. To determine the thresholds for discrimination of plaque components, we compared HU with IB values as a gold standard. Optimal thresholds were determined from receiver operating characteristic (ROC) curves analysis. The HU values of lipid pool (n = 115), fibrosis (n = 93), vessel lumen and calcification (n = 73) were 28 ± 19 HU (range -18 to 69 HU), 98 ± 31 HU (44 to 195 HU), 357 ± 65 HU (227 to 534 HU) and 998 ± 236 HU (366 to 1,489 HU), respectively. The thresholds of 56 HU, 210 HU and 490 HU were the most reliable predictors of lipid pool, fibrosis, vessel lumen and calcification, respectively. Lipid volume measured by 320-DR CT was correlated with that measured by IB-IVUS (r = 0.63, p < 0.05), whereas fibrous volume measured by 320-DR CT was not. Lipid volume measured by 320-DR CT was correlated with that measured by IB-IVUS, whereas fibrous volume was not correlated with that measured by IB-IVUS because manual exclusion of the outside of vessel hindered rigorous discrimination between fibrosis and extravascular components.

Quantification of myocardial blood flow using dynamic 320-row multi-detector CT as compared with ¹⁵O-H₂O PET.

PubMed

Kikuchi, Yasuka; Oyama-Manabe, Noriko; Naya, Masanao; Manabe, Osamu; Tomiyama, Yuuki; Sasaki, Tsukasa; Katoh, Chietsugu; Kudo, Kohsuke; Tamaki, Nagara; Shirato, Hiroki

2014-07-01

This study introduces a method to calculate myocardium blood flow (MBF) and coronary flow reserve (CFR) using the relatively low-dose dynamic 320-row multi-detector computed tomography (MDCT), validates the method against (15)O-H₂O positron-emission tomography (PET) and assesses the CFRs of coronary artery disease (CAD) patients. Thirty-two subjects underwent both dynamic CT perfusion (CTP) and PET perfusion imaging at rest and during pharmacological stress. In 12 normal subjects (pilot group), the calculation method for MBF and CFR was established. In the other 13 normal subjects (validation group), MBF and CFR obtained by dynamic CTP and PET were compared. Finally, the CFRs obtained by dynamic CTP and PET were compared between the validation group and CAD patients (n = 7). Correlation between MBF of MDCT and PET was strong (r = 0.95, P < 0.0001). CFR showed good correlation between dynamic CTP and PET (r = 0.67, P = 0.0126). CFRCT in the CAD group (2.3 ± 0.8) was significantly lower than that in the validation group (5.2 ± 1.8) (P = 0.0011). We established a method for measuring MBF and CFR with the relatively low-dose dynamic MDCT. Lower CFR was well demonstrated in CAD patients by dynamic CTP. • MBF and CFR can be calculated using dynamic CTP with 320-row MDCT. • MBF and CFR showed good correlation between dynamic CTP and PET. • Lower CFR was well demonstrated in CAD patients by dynamic CTP.

Evaluation of organ doses in CT examinations with an infant anthropomorphic phantom.

PubMed

Fujii, K; Akahane, K; Miyazaki, O; Horiuchi, T; Shimada, A; Nagmatsu, H; Yamauchi, M; Yamauchi-Kawaura, C; Kawasaki, T

2011-09-01

The aim of this study is to evaluate organ doses in infant CT examinations with multi-detector row CT scanners. Radiation doses were measured with radiophotoluminescence glass dosemeters set in various organ positions within a 1-y-old child anthropomorphic phantom and organ doses were evaluated from the measurement values. Doses for tissues or organs within the scan range were 28-36 mGy in an infant head CT, 3-11 mGy in a chest CT, 5-11 mGy in an abdominal-pelvic CT and 2-14 mGy in a cardiac CT. The doses varied by the differences in the types of CT scanners and scan parameters used at each medical facility. Compared with those for children of various ages, the doses in an infant CT protocol were found to be similar to or slightly smaller than those in a paediatric CT for 5- or 6-y-old children.

Safety of Landiolol Hydrochloride as a Premedication for Producing an Appropriate Heart Rate for Multidetector-Row Computed Tomography Coronary Angiography.

PubMed

Koyoshi, Rie; Shiga, Yuhei; Idemoto, Yoshiaki; Ueda, Yoko; Tashiro, Kohei; Kuwano, Takashi; Kitajima, Ken; Fujimi, Kanta; Kawamura, Akira; Ogawa, Masahiro; Miura, Shin-Ichiro

2018-01-01

We evaluated the safety of a bolus injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as a premedication prior to multidetector-row computed tomography coronary angiography (CTA). The subjects consisted of 176 patients (M/F = 64:112, 67 ± 11 years) who had heart rate (HR) at rest ≥ 70 beats/min (bpm) and underwent CTA. Systolic/diastolic blood pressure (SBP/DBP) and HR were measured before and after the administration of landiolol. SBP/DBP and HR upon entry to the CT room were 136 ± 17/80 ± 11 mm Hg and 83 ± 10 bpm, respectively. HR was significantly reduced at the time of CTA scan (62 ± 7 bpm). Next, we divided the patients into three groups according to HR upon entry to the CT room: 70 - 79 bpm (n = 76), 80 - 89 bpm (n = 60) and ≥ 90 bpm (n = 40). HR at the time of CTA scan was significantly lower than that upon entry to the CT room in all three groups: 70 - 79 bpm (74 ± 3 bpm upon entry to the CT room to 61 ± 6 bpm at the time of CAT scan), 80 - 89 bpm (84 ± 3 to 63 ± 7 bpm) and ≥ 90 bpm (98 ± 6 to 65 ± 7 bpm). Although SBP/DBP was significantly decreased after the CTA scan (123 ± 18/72 ± 12 mm Hg), landiolol had no severe adverse events throughout CTA. In conclusion, a bolus injection of landiolol reduced HR by about 20 bpm without any severe adverse effects. Thus, a bolus injection of landiolol hydrochloride may be a suitable pretreatment for controlling HR in CTA.

Interrupted Aortic Arch Associated with Absence of Left Common Carotid Artery: Imaging with MDCT

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

Onbas, Omer; Olgun, Hasim; Ceviz, Naci

2006-06-15

Interrupted aortic arch (IAA) is a rare severe congenital heart defect defined as complete luminal and anatomic discontinuity between ascending and descending aorta. Although its association with various congenital heart defects has been reported, absence of left common carotid artery (CCA) in patients with IAA has not been reported previously. We report a case of IAA associated with the absence of left CCA which was clearly shown on multidetector-row spiral CT.

64-Slice multidetector row CT angiography of the abdomen: comparison of low versus high concentration iodinated contrast media in a porcine model

PubMed Central

Holalkere, N-S; Matthes, K; Kalva, S P; Brugge, W R; Sahani, D V

2011-01-01

Objective In this study we aimed to assess the image quality and degree of vascular enhancement using low-concentration contrast media (LCCM) (300 mg I ml–1) and high-concentration contrast media (HCCM) (370 mg I ml–1) on 64-slice multidetector row CT (MDCT) abdominal CT angiography (CTA). In addition, we aimed to study the feasibility of using HCCM with a reduced total iodine dose. Methods CTA of the abdomen on a 64-slice MDCT was performed on 15 anaesthetised pigs. Study pigs were divided into three groups of five each based on the iodine concentration and dose received: Group A (LCCM; 300 mg I ml–1), Group B (HCCM; 370 mg I ml–1) and Group C HCCM with 20% less iodine dose. The total iodine injected was kept constant (600 mg kg–1) in Groups A and B. Qualitative and quantitative analyses were performed to study and compare each group for image quality, visibility of the branch order of the superior mesenteric artery (SMA), artefacts, degree of enhancement in the aorta and main stem arteries and uniformity of enhancement in the aorta. Groups were compared using the analysis of variance test. Results The image quality of 64-slice MDCT angiography was excellent with a mean score of 4.63 and confident visualisation of the third to fifth order branches of the SMA in all groups. Group B demonstrated superior vascular enhancement, as compared with Groups A and C (p≤0.05). Uniform aortic enhancement was achieved with the use of LCCM and HCCM with 20% less iodine dose. Conclusion 64-slice MDCT angiography of the abdomen was of excellent quality. HCCM improves contrast enhancement and overall CTA image quality and allows the iodine dose to be reduced. PMID:21081582

Prevalence of Temporal Bone Fractures in Patients with Mandibular Fractures Using Multidetector-Row CT.

PubMed

Ogura, I; Kaneda, T; Sasaki, Y; Buch, K; Sakai, O

2015-06-01

Temporal bone fracture after mandibular trauma is thought to be rare, and its prevalence has not been reported in the literature. The purpose of this study was to investigate the prevalence of temporal bone fractures in patients with mandibular fractures and the relationship between temporal bone fractures and the mandibular fracture location using multidetector-row computed tomography (MDCT). A prospective study was performed in 201 patients with mandibular fractures who underwent 64-MDCT scans. The mandibular fracture locations were classified as median, paramedian, angle, and condylar types. Statistical analysis for the relationship between prevalence of temporal bone fractures and mandibular fracture locations was performed using χ(2) test with Fisher's exact test. A P-value < 0.05 was considered statistically significant. The percentage of cases with temporal bone fracture was 3.0 % of all patients with mandibular fractures and 19.0 % of those with multiple mandibular fractures of paramedian and condylar type. There was a significant relationship between the incidence of temporal bone fracture and the paramedian- and condylar-type mandibular fracture (P = 0.001). Multiple mandibular fractures of paramedian and condylar type may be a stronger indicator for temporal bone fractures. This study suggests that patients with mandibular fracture, especially the paramedian and condylar type, should be examined for coexisting temporal bone fracture using MDCT.

Usefulness of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI): assessment of morphology and diameter of the superior mesenteric artery (SMA) on multi-planar reconstructed (MPR) images.

PubMed

Woodhams, Reiko; Nishimaki, Hiroshi; Fujii, Kaoru; Kakita, Satoko; Hayakawa, Kazushige

2010-10-01

The purpose of this study was to assess the efficacy of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI) by analyzing morphology and diameter of superior mesenteric artery (SMA). We assessed whether MDCT was as useful as angiography for the diagnosis of NOMI. Four patients who were diagnosed with NOMI were retrospectively analyzed. All patients had 8-row MDCT followed by laparotomy. Two of them underwent angiography after MDCT. The morphology and diameter of SMA of these cases was analyzed on multi-planar reconstructed (MPR) images. The mean diameter of SMA of NOMI cases was compared to that of 13 control cases. MPR images of all NOMI cases showed irregular narrowing of the SMA, spasm of the arcades of SMA, and poor demonstration of intramural vessels. MPR images of two patients who had angiography were concordant with their angiograms. The mean diameter of SMA of NOMI patients was 3.4±1.1mm, which was statistically smaller than that of 13 control patients, 6.0±1.5mm (P<0.05, Wilcoxon rank sum tests). Angiography has been recognized essential for the diagnosis of NOMI. This study shows the possibility of MDCT to be an equivalently useful modality compared to angiography for the diagnosis of NOMI by interpreting morphologic appearance and diameter of SMA. Introduction of MDCT in the decision tree of NOMI treatment may bring the benefit of prompt diagnosis and subsequent early and efficient initiation of therapy, which may improve the mortality. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

[Comparison of radiation dose reduction of prospective ECG-gated one beat scan using 320 area detector CT coronary angiography and prospective ECG-gated helical scan with high helical pitch (FlashScan) using 64 multidetector-row CT coronary angiography].

PubMed

Matsutani, Hideyuki; Sano, Tomonari; Kondo, Takeshi; Fujimoto, Shinichiro; Sekine, Takako; Arai, Takehiro; Morita, Hitomi; Takase, Shinichi

2010-12-20

A high radiation dose associated with 64 multidetector-row computed tomography (64-MDCT) is a major concern for physicians and patients alike. A new 320 row area detector computed tomography (ADCT) can obtain a view of the entire heart with one rotation (0.35 s) without requiring the helical method. As such, ADCT is expected to reduce the radiation dose. We studied image quality and radiation dose of ADCT compared to that of 64-MDCT in patients with a low heart rate (HR≤60). Three hundred eighty-five consecutive patients underwent 64-MDCT and 379 patients, ADCT. Patients with an arrhythmia were excluded. Prospective ECG-gated helical scan with high HP (FlashScan) in 64 was used for MDCT and prospective ECG-gated conventional one beat scan, for 320-ADCT. Image quality was visually evaluated by an image quality score. Radiation dose was estimated by DLP (mGy･cm) for 64-MDCT and DLP.e (mGy･cm) for 320-ADCT. Radiation dose of 320-ADCT (208±48 mGy･cm) was significantly (P<0.0001) lower than that of 64-MDCT (484±112 mGy･cm), and image quality score of 320-ADCT (3.0±0.2) was significantly (P=0.0011) higher than that of 64-MDCT (2.9±0.4). Scan time of 320-ADCT (1.4±0.1 s) was also significantly (P<0.0001) shorter than that of 64-MDCT (6.8±0.6 s). 320-ADCT can achieve not only a reduction in radiation dose but also a superior image quality and shortening of scan time compared to 64-MDCT.

Low-contrast detectability in volume rendering: a phantom study on multidetector-row spiral CT data.

PubMed

Shin, Hoen-Oh; Falck, Christian V; Galanski, Michael

2004-02-01

To cope with the increasing amount of CT data, there is growing interest in direct volume-rendering techniques (VRT) as a diagnostic tool. The aim of this phantom study was to analyze the low-contrast detectability (LCD) of VRT compared with multi-planar reformations (MPR). Soft tissue lesions were simulated by spheres of different diameters (3-8 mm). The average lesion density was 15 HU compared with a background density of 35 HU. Two different CT protocols with 40 and 150 mAs were performed on a multi-detector row CT. The scanning parameters were as following: 140 kV; 2x0.5-mm slice collimation; pitch 2 (table movement per rotation/single slice collimation), and reconstruction with 0.5-mm slice thickness at 0.5-mm interval. A B30 kernel was used for reconstruction. The VRT was performed by mapping Hounsfield values to gray levels equal to a CT window (center: 60 HU; window: 370 HU ). A linear ramp was applied for the opacity transfer function varying the maximum opacity between 0.1 and 1.0. A statistical method based on the Rose model was used to calculate the detection threshold depending on lesion size and image noise. Additionally, clinical data of 2 patients with three liver lesions of different sizes and density were evaluated. In VRT, LCD was most dependent on object size. Regarding lesions larger than 5 mm, VRT is significantly superior to MPR (p<0.05) for all opacity settings. In lesions sized 3-5 mm a maximum opacity level approximately 40-50% showed a near equivalent detectability in VRT and MPR. For higher opacity levels VRT was superior to MPR. Only for 3-mm lesions MPR performed slightly better in low-contrast detectability (p<0.05). Compared with MPR, VRT shows similar performance in LCD. Due to noise suppression effects, it is suited for visualization of data with high noise content.

Rectal cancer staging: Multidetector-row computed tomography diagnostic accuracy in assessment of mesorectal fascia invasion

PubMed Central

Ippolito, Davide; Drago, Silvia Girolama; Franzesi, Cammillo Talei; Fior, Davide; Sironi, Sandro

2016-01-01

AIM: To assess the diagnostic accuracy of multidetector-row computed tomography (MDCT) as compared with conventional magnetic resonance imaging (MRI), in identifying mesorectal fascia (MRF) invasion in rectal cancer patients. METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner (ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 mAs. Imaging data were reviewed as axial and as multiplanar reconstructions (MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images (DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed. RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91 (41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged (45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value (PPV) 80.4%, negative predictive value (NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the reference magnetic resonance images. The difference in accuracy was statistically significant (P = 0.02). CONCLUSION: New generation CT scanner, using high resolution MPR images, represents a reliable diagnostic tool in assessment of loco-regional and whole body staging of advanced rectal cancer, especially in patients with MRI contraindications. PMID:27239115

Inter- and intrascanner variability of pulmonary nodule volumetry on low-dose 64-row CT: an anthropomorphic phantom study

PubMed Central

Xie, X; Willemink, M J; Zhao, Y; de Jong, P A; van Ooijen, P M A; Oudkerk, M; Greuter, M J W

2013-01-01

Objective: To assess inter- and intrascanner variability in volumetry of solid pulmonary nodules in an anthropomorphic thoracic phantom using low-dose CT. Methods: Five spherical solid artificial nodules [diameters 3, 5, 8, 10 and 12 mm; CT density +100 Hounsfield units (HU)] were randomly placed inside an anthropomorphic thoracic phantom in different combinations. The phantom was examined on two 64-row multidetector CT (64-MDCT) systems (CT-A and CT-B) from different vendors with a low-dose protocol. Each CT examination was performed three times. The CT examinations were evaluated twice by independent blinded observers. Nodule volume was semi-automatically measured by dedicated software. Interscanner variability was evaluated by Bland–Altman analysis and expressed as 95% confidence interval (CI) of relative differences. Intrascanner variability was expressed as 95% CI of relative variation from the mean. Results: No significant difference in CT-derived volume was found between CT-A and CT-B, except for the 3-mm nodules (p<0.05). The 95% CI of interscanner variability was within ±41.6%, ±18.2% and ±4.9% for 3, 5 and ≥8 mm nodules, respectively. The 95% CI of intrascanner variability was within ±28.6%, ±13.4% and ±2.6% for 3, 5 and ≥8 mm nodules, respectively. Conclusion: Different 64-MDCT scanners in low-dose settings yield good agreement in volumetry of artificial pulmonary nodules between 5 mm and 12 mm in diameter. Inter- and intrascanner variability decreases at a larger nodule size to a maximum of 4.9% for ≥8 mm nodules. Advances in knowledge: The commonly accepted cut-off of 25% to determine nodule growth has the potential to be reduced for ≥8 mm nodules. This offers the possibility of reducing the interval for repeated CT scans in lung cancer screenings. PMID:23884758

Quantitative colorectal cancer perfusion measurement using dynamic contrast-enhanced multidetector-row computed tomography: effect of acquisition time and implications for protocols.

PubMed

Goh, Vicky; Halligan, Steve; Hugill, Jo-Ann; Gartner, Louise; Bartram, Clive I

2005-01-01

To determine the effect of acquisition time on quantitative colorectal cancer perfusion measurement. Dynamic contrast-enhanced computed tomography (CT) was performed prospectively in 10 patients with histologically proven colorectal cancer using 4-detector row CT (Lightspeed Plus; GE Healthcare Technologies, Waukesha, WI). Tumor blood flow, blood volume, mean transit time, and permeability were assessed for 3 acquisition times (45, 65, and 130 seconds). Mean values for all 4 perfusion parameters for each acquisition time were compared using the paired t test. Significant differences in permeability values were noted between acquisitions of 45 seconds and 65 and 130 seconds, respectively (P=0.02, P=0.007). There was no significant difference for values of blood volume, blood flow, and mean transit time between any of the acquisition times. Scan acquisitions of 45 seconds are too short for reliable permeability measurement in the abdomen. Longer acquisition times are required.

Prognostic significance of contrast-enhanced CT attenuation value in extrahepatic cholangiocarcinoma.

PubMed

Asayama, Yoshiki; Nishie, Akihiro; Ishigami, Kousei; Ushijima, Yasuhiro; Takayama, Yukihisa; Okamoto, Daisuke; Fujita, Nobuhiro; Ohtsuka, Takao; Yoshizumi, Tomoharu; Aishima, Shinichi; Oda, Yoshinao; Honda, Hiroshi

2017-06-01

To determine whether washout characteristics of dynamic contrast-enhanced computed tomography (CT) could predict survival in patients with extrahepatic cholangiocarcinoma (EHC). This study collected 46 resected cases. All cases were examined by dynamic contrast study on multidetector-row CT. Region-of-interest measurements were obtained at the non-enhanced, portal venous phase and delayed phase in the tumour and were used to calculate the washout ratio as follows: [(attenuation value at portal venous phase CT - attenuation value at delayed enhanced CT)/(attenuation value at portal venous phase CT - attenuation value at unenhanced CT)] × 100. On the basis of the median washout ratio, we classified the cases into two groups, a high-washout group and low-washout group. Associations between overall survival and various factors including washout rates were analysed. The median washout ratio was 29.4 %. Univariate analysis revealed that a lower washout ratio, venous invasion, lymphatic permeation and lymph node metastasis were associated with shorter survival. Multivariate analysis identified the lower washout ratio as an independent prognostic factor (hazard ratio, 3.768; p value, 0.027). The washout ratio obtained from the contrast-enhanced CT may be a useful imaging biomarker for the prediction of survival of patients with EHC. • Dynamic contrast study can evaluate the aggressiveness of extrahepatic cholangiocarcinoma. • A lower washout ratio was an independent prognostic factor for overall survival. • CT can predict survival and inform decisions on surgical options or chemotherapy.

Patent foramen ovale: detection with nongated multidetector CT.

PubMed

Revel, Marie-Pierre; Faivre, Jean-Baptiste; Letourneau, Thierry; Henon, Hilde; Leys, Didier; Delannoy-Deken, Valérie; Remy-Jardin, Martine; Remy, Jacques

2008-10-01

To evaluate nongated multidetector computed tomography (CT) in the detection of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) in comparison with transesophageal echocardiography (TEE). The study was approved by the institutional review board, and informed consent was obtained from all patients. One hundred five patients (57 men, 48 women; mean age, 53 years) with a recent stroke underwent TEE and multidetector CT on the same day. After injection of a diluted iodinated contrast material, a series of 2.4-mm-thick transverse images centered on the fossa ovalis were acquired in conjunction with release of the Valsalva maneuver. Two independent radiologists considered PFO present if left atrial enhancement was detected visually before enhancement of the pulmonary veins or if an early peak of left atrial enhancement was found at time-attenuation curve analysis. PFO was detected with 98% specificity (95% confidence interval [CI]: 0.91, 0.99). Overall sensitivity was 55% (95% CI: 0.38, 0.70), ranging from 28% for shunts classified as grade 1 at TEE to 91% for those classified as grade 4 at TEE. Interreader agreement was good (kappa = 0.81). Visual assessment was better than time-attenuation curve analysis, which enabled detection of only 15 of the 40 cases of PFO. Multidetector CT depicted only 22% of cases of ASA. The mean effective radiation dose was 2.3 mSv. Nongated multidetector CT can be used to diagnose high-grade shunts through a PFO, with 91% sensitivity and 98% specificity. Thus, PFO detection, in addition to routine CT evaluation of the lungs, could be indicated in patients with unexplained hypoxemia. (c) RSNA, 2008.

Imaging in chronic obstructive pulmonary disease.

PubMed

Shaker, Saher B; Dirksen, Asger; Bach, Karen S; Mortensen, Jann

2007-06-01

Chronic obstructive pulmonary disease (COPD) is divided into pulmonary emphysema and chronic bronchitis (CB). Emphysema is defined patho-anatomically as "permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by the destruction of their walls, and without obvious fibrosis" (1). These lesions are readily identified and quantitated using computed tomography (CT), whereas the accompanying hyperinflation is best detected on plain chest X-ray, especially in advanced disease. The diagnosis of CB is clinical and relies on the presence of productive cough for 3 months in 2 or more successive years. The pathological changes of mucosal inflammation and bronchial wall thickening have been more difficult to identify with available imaging techniques. However, recent studies using Multi-detector row CT (MDCT) reported more reproducible assessment of air wall thickening.

Estimation of regional lung expansion via 3D image registration

NASA Astrophysics Data System (ADS)

Pan, Yan; Kumar, Dinesh; Hoffman, Eric A.; Christensen, Gary E.; McLennan, Geoffrey; Song, Joo Hyun; Ross, Alan; Simon, Brett A.; Reinhardt, Joseph M.

2005-04-01

A method is described to estimate regional lung expansion and related biomechanical parameters using multiple CT images of the lungs, acquired at different inflation levels. In this study, the lungs of two sheep were imaged utilizing a multi-detector row CT at different lung inflations in the prone and supine positions. Using the lung surfaces and the airway branch points for guidance, a 3D inverse consistent image registration procedure was used to match different lung volumes at each orientation. The registration was validated using a set of implanted metal markers. After registration, the Jacobian of the deformation field was computed to express regional expansion or contraction. The regional lung expansion at different pressures and different orientations are compared.

Computer-aided detection of acute pulmonary embolism with 64-slice multi-detector row computed tomography: impact of the scanning conditions and overall image quality in the detection of peripheral clots.

PubMed

Dewailly, Marion; Rémy-Jardin, Martine; Duhamel, Alain; Faivre, Jean-Baptiste; Pontana, François; Deken, Valérie; Bakai, Anne-Marie; Remy, Jacques

2010-01-01

To evaluate the performance of a computer-aided detection (CAD) system for diagnosing peripheral acute pulmonary embolism (PE) with a 64-slice multi-detector row computed tomography (CT). Two radiologists investigated the accuracy of a software aimed at detecting peripheral clots (PECAD prototype, version 7; Siemens Medical Systems, Forchheim, Germany) by applying this tool for the analysis of the pulmonary arterial bed of 74 CT angiograms obtained with 64-slice dual-source CT (Definition; Siemens Medical Systems). These cases were retrospectively selected from a database of CT studies performed on the same CT unit, with a similar collimation (64 x 0.6 mm) and similar injection protocols. Patient selection was based on a variety of (1) scanning conditions, namely, nongated (n = 30), electrocardiography-gated (n = 30), and dual-energy CT angiograms (n = 14), and (2) image quality (IQ), namely, scans of excellent IQ (n = 53) and lower IQ due to lower levels of arterial enhancement and/or presence of noise (n = 21). The standard of truth was based on the 2 radiologists' consensus reading and the results of CAD. The software detected 80 of 93 peripheral clots present in the 21 patients (42 segmental and 38 subsegmental clots). The overall sensitivity (95% confidence interval) of the CAD tool was 86% (77%-92%) for detecting peripheral clots, 78% (64.5%-88%) at the segmental level and 97% (85.5%-99.9%) at the subsegmental level. Assuming normal vascular anatomy with 20 segmental and 40 subsegmental arteries, overall specificity and positive and negative predictive values (95% confidence interval) of the software were 91.8% (91%-92.6%), 18.4% (15%-22.4%), and 99.7% (99.5%-99.8%), respectively. A mean of 5.4 false positives was found per patient (total, 354 false positives), mainly linked to the presence of perivascular connective tissue (n = 119; 34%) and perivascular airspace consolidation (n = 97; 27%). The sensitivities (95% confidence interval) for the CAD tool were 91% (69.8%-99.3%) for dual-energy, 87% (59.3%-93.2%) for electrocardiography-gated, and 87% (73.5%-95.3%) for nongated scans (P > 0.05). No significant difference was found in the sensitivity of the CAD software when comparing the scans according to the scanning conditions and image quality. The evaluated CAD software has a good sensitivity in detecting peripheral PE, which is not influenced by the scanning conditions or the overall image quality.

How many CT detector rows are necessary to perform adequate three dimensional visualization?

PubMed

Fischer, Lars; Tetzlaff, Ralf; Schöbinger, Max; Radeleff, Boris; Bruckner, Thomas; Meinzer, H P; Büchler, M W; Schemmer, Peter

2010-06-01

The technical development of computer tomography (CT) imaging has experienced great progress. As consequence, CT data to be used for 3D visualization is not only based on 4 row CTs and 16 row CTs but also on 64 row CTs, respectively. The main goal of this study was to examine whether the increased amount of CT detector rows is correlated with improved quality of the 3D images. All CTs were acquired during routinely performed preoperative evaluation. Overall, there were 12 data sets based on 4 detector row CT, 12 data sets based on 16 detector row CT, and 10 data sets based on 64 detector row CT. Imaging data sets were transferred to the DKFZ Heidelberg using the CHILI teleradiology system. For the analysis all CT scans were examined in a blinded fashion, i.e. both the name of the patient as well as the name of the CT brand were erased. For analysis, the time for segmentation of liver, both portal and hepatic veins as well as the branching depth of portal veins and hepatic veins was recorded automatically. In addition, all results were validated in a blinded fashion based on given quality index. Segmentation of the liver was performed in significantly shorter time (p<0.01, Kruskal-Wallis test) in the 16 row CT (median 479 s) compared to 4 row CT (median 611 s), and 64 row CT (median 670 s), respectively. The branching depth of the portal vein did not differ significantly among the 3 different data sets (p=0.37, Kruskal-Wallis test). However, the branching depth of the hepatic veins was significantly better (p=0.028, Kruskal-Wallis test) in the 4 row CT and 16 row CT compared to 64 row CT. The grading of the quality index was not statistically different for portal veins and hepatic veins (p=0.80, Kruskal-Wallis test). Even though the total quality index was better for the vessel tree based on 64 row CT data sets (mean scale 2.6) compared to 4 CT row data (mean scale 3.25) and 16 row CT data (mean scale 3.0), these differences did not reach statistical difference (p=0.53, Kruskal-Wallis test). Even though 3D visualization is useful in operation planning, the quality of the 3D images appears to be not dependent of the number of CT detector rows. Copyright (c) 2009. Published by Elsevier Ireland Ltd.

Use of multidetector-row computed tomography scan to detect pannus formation in prosthetic mechanical aortic valves.

PubMed

Aladmawi, Mohamed A; Pragliola, Claudio; Vriz, Olga; Galzerano, Domenico

2017-04-01

Obstruction of a mechanical aortic valve by pannus formation at the subvalvular level is a major long-term complication of aortic valve replacement (AVR). In fact, pannus is sometime difficult to differentiate from patient-prosthesis mismatch or valve thrombosis. In most cases cine-angiography and echocardiography, either transthoracic or transesophageal, cannot correctly visualize the complication when the leaflets show a normal mobility. Recent technological refinements made this difficult diagnosis possible by ECG-gated computed tomography (CT) scan which shows adequate images in 90% of the cases and can differentiate pannus from fresh and organized thrombus.

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.

[Chronic pancreatitis: which is the role of 320-row CT for the staging?].

PubMed

Stabile Ianora, Amato Antonio; Rubini, Giuseppe; Lorusso, Filomenamila; Ambriola, Angela; Rella, Leonarda; Di Crescenzo, Vincenzo; Moschetta, Marco

2013-01-01

The purpose of this study was to evaluate the diagnostic potential of multi-planar and volumetric reconstructions obtained from isotropic data by using 16-slice computed tomography (CT) in the diagnosis and staging of chronic pancreatitis. In a group of 42 patients CT images were evaluated searching for alterations in morphology and structure of the pancreas, alterations of the Wirsung duct, dilatation of the bile ducts, fluid collections, and vascular involvement of the digestive tract. The disease was then staged in mild, moderate and severe and correlated with the clinical staging. CT allowed the recognition of chronic pancreatitis in all cases. The staging was correct in 25/42 patients, with an accuracy rate of 59.5%. In the staging of moderate and severe forms, CT correlation with clinical and laboratory data was valid, but in mild forms it appeared less significant. Multi-detector CT is accurate in the recognition of moderate, advanced forms of chronic pancreatitis and in the identification of its complications, while it is poorly correlated with the clinical staging in mild forms of the disease.

Paleoradiology: advanced CT in the evaluation of nine Egyptian mummies.

PubMed

Hoffman, Heidi; Torres, William E; Ernst, Randy D

2002-01-01

Axial thin-collimation state-of-the-art spiral computed tomography (CT) was combined with sagittal and coronal reformatting, three-dimensional (3D) reconstruction, and virtual "fly-through" techniques to nondestructively study nine Egyptian mummies. These techniques provided important paleopathologic and historical information about mummification techniques, depicted anatomy in the most informative imaging plane, illustrated the soft-tissue preservation and physical appearance of mummies in superb detail, and generated an intriguing virtual tour through hollow mummified remains without harming the specimens themselves. Images generated with these methods can help archaeologists and Egyptologists understand these fascinating members of mankind and can serve as adjunct visual aids for laypersons who are interested in mummies. CT has emerged as the imaging modality of choice for the examination of Egyptian mummies due to its noninvasive cross-sectional nature and inherently superior contrast and spatial resolution. As multi-detector row CT and postprocessing tools evolve, the capabilities and applications of CT will continue to proliferate, attesting to the expanded versatility and utility of CT as a noninvasive research tool in the multidisciplinary study of Egyptian mummies. Copyright RSNA, 2002

Volume-rendered hemorrhage-responsible arteriogram created by 64 multidetector-row CT during aortography: utility for catheterization in transcatheter arterial embolization for acute arterial bleeding.

PubMed

Minamiguchi, Hiroki; Kawai, Nobuyuki; Sato, Morio; Ikoma, Akira; Sanda, Hiroki; Nakata, Kouhei; Tanaka, Fumihiro; Nakai, Motoki; Sonomura, Tetsuo; Murotani, Kazuhiro; Hosokawa, Seiki; Nishioku, Tadayoshi

2014-01-01

Aortography for detecting hemorrhage is limited when determining the catheter treatment strategy because the artery responsible for hemorrhage commonly overlaps organs and non-responsible arteries. Selective catheterization of untargeted arteries would result in repeated arteriography, large volumes of contrast medium, and extended time. A volume-rendered hemorrhage-responsible arteriogram created with 64 multidetector-row CT (64MDCT) during aortography (MDCTAo) can be used both for hemorrhage mapping and catheter navigation. The MDCTAo depicted hemorrhage in 61 of 71 cases of suspected acute arterial bleeding treated at our institute in the last 3 years. Complete hemostasis by embolization was achieved in all cases. The hemorrhage-responsible arteriogram was used for navigation during catheterization, thus assisting successful embolization. Hemorrhage was not visualized in the remaining 10 patients, of whom 6 had a pseudoaneurysm in a visceral artery; 1 with urinary bladder bleeding and 1 with chest wall hemorrhage had gaze tamponade; and 1 with urinary bladder hemorrhage and 1 with uterine hemorrhage had spastic arteries. Six patients with pseudoaneurysm underwent preventive embolization and the other 4 patients were managed by watchful observation. MDCTAo has the advantage of depicting the arteries responsible for hemoptysis, whether from the bronchial arteries or other systemic arteries, in a single scan. MDCTAo is particularly useful for identifying the source of acute arterial bleeding in the pancreatic arcade area, which is supplied by both the celiac and superior mesenteric arteries. In a case of pelvic hemorrhage, MDCTAo identified the responsible artery from among numerous overlapping visceral arteries that branched from the internal iliac arteries. In conclusion, a hemorrhage-responsible arteriogram created by 64MDCT immediately before catheterization is useful for deciding the catheter treatment strategy for acute arterial bleeding.

Assessment of temporal resolution of multi-detector row computed tomography in helical acquisition mode using the impulse method.

PubMed

Ichikawa, Katsuhiro; Hara, Takanori; Urikura, Atsushi; Takata, Tadanori; Ohashi, Kazuya

2015-06-01

The purpose of this study was to propose a method for assessing the temporal resolution (TR) of multi-detector row computed tomography (CT) (MDCT) in the helical acquisition mode using temporal impulse signals generated by a metal ball passing through the acquisition plane. An 11-mm diameter metal ball was shot along the central axis at approximately 5 m/s during a helical acquisition, and the temporal sensitivity profile (TSP) was measured from the streak image intensities in the reconstructed helical CT images. To assess the validity, we compared the measured and theoretical TSPs for the 4-channel modes of two MDCT systems. A 64-channel MDCT system was used to compare TSPs and image quality of a motion phantom for the pitch factors P of 0.6, 0.8, 1.0 and 1.2 with a rotation time R of 0.5 s, and for two R/P combinations of 0.5/1.2 and 0.33/0.8. Moreover, the temporal transfer functions (TFs) were calculated from the obtained TSPs. The measured and theoretical TSPs showed perfect agreement. The TSP narrowed with an increase in the pitch factor. The image sharpness of the 0.33/0.8 combination was inferior to that of the 0.5/1.2 combination, despite their almost identical full width at tenth maximum values. The temporal TFs quantitatively confirmed these differences. The TSP results demonstrated that the TR in the helical acquisition mode significantly depended on the pitch factor as well as the rotation time, and the pitch factor and reconstruction algorithm affected the TSP shape. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Scenes from the past: initial investigation of early jurassic vertebrate fossils with multidetector CT.

PubMed

Bolliger, Stephan A; Ross, Steffen; Thali, Michael J; Hostettler, Bernhard; Menkveld-Gfeller, Ursula

2012-01-01

The study of fossils permits the reconstruction of past life on our planet and enhances our understanding of evolutionary processes. However, many fossils are difficult to recognize, being encased in a lithified matrix whose tedious removal is required before examination is possible. The authors describe the use of multidetector computed tomography (CT) in locating, identifying, and examining fossil remains of crocodilians (Mesosuchia) embedded in hard shale, all without removing the matrix. In addition, they describe how three-dimensional (3D) reformatted CT images provided details that were helpful for extraction and preparation. Multidetector CT can help experienced paleontologists localize and characterize fossils in the matrix of a promising rock specimen in a nondestructive manner. Moreover, with its capacity to generate highly accurate 3D images, multidetector CT can help determine whether the fossils warrant extraction and can assist in planning the extraction process. Thus, multidetector CT may well become an invaluable tool in the field of paleoradiology.

High resolution multidetector CT aided tissue analysis and quantification of lung fibrosis

NASA Astrophysics Data System (ADS)

Zavaletta, Vanessa A.; Karwoski, Ronald A.; Bartholmai, Brian; Robb, Richard A.

2006-03-01

Idiopathic pulmonary fibrosis (IPF, also known as Idiopathic Usual Interstitial Pneumontis, pathologically) is a progressive diffuse lung disease which has a median survival rate of less than four years with a prevalence of 15-20/100,000 in the United States. Global function changes are measured by pulmonary function tests and the diagnosis and extent of pulmonary structural changes are typically assessed by acquiring two-dimensional high resolution CT (HRCT) images. The acquisition and analysis of volumetric high resolution Multi-Detector CT (MDCT) images with nearly isotropic pixels offers the potential to measure both lung function and structure. This paper presents a new approach to three dimensional lung image analysis and classification of normal and abnormal structures in lungs with IPF.

Use of multidetector-row computed tomography scan to detect pannus formation in prosthetic mechanical aortic valves

PubMed Central

Aladmawi, Mohamed A.; Vriz, Olga; Galzerano, Domenico

2017-01-01

Obstruction of a mechanical aortic valve by pannus formation at the subvalvular level is a major long-term complication of aortic valve replacement (AVR). In fact, pannus is sometime difficult to differentiate from patient-prosthesis mismatch or valve thrombosis. In most cases cine-angiography and echocardiography, either transthoracic or transesophageal, cannot correctly visualize the complication when the leaflets show a normal mobility. Recent technological refinements made this difficult diagnosis possible by ECG-gated computed tomography (CT) scan which shows adequate images in 90% of the cases and can differentiate pannus from fresh and organized thrombus. PMID:28540078

Features of cranio-maxillofacial trauma in the massive Sichuan earthquake: analysis of 221 cases with multi-detector row CT.

PubMed

Chu, Zhi-gang; Yang, Zhi-gang; Dong, Zhi-hui; Chen, Tian-wu; Zhu, Zhi-yu; Deng, Wen; Xiao, Jia-he

2011-10-01

In a massive earthquake, cranio-maxillofacial trauma was common. The present study was to determine the features of cranio-maxillofacial trauma sustained in the massive Sichuan earthquake by multi-detector row computed tomography (MDCT). The study included 221 consecutive patients (123 males and 98 females; age range, 1-83 years; median age, 35 years) with cranio-maxillofacial trauma in the Sichuan earthquake, who underwent cranio-maxillofacial MDCT scans. The image data were retrospectively reviewed focusing on the injuries of the cranio-maxillofacial soft tissue, facial bones and cranium. All patients had soft tissue injuries frequently with foreign bodies. Ninety-seven (43.9%) patients had fractures (1.5 involved sites per patient, range from 1 to 8) including single cranial fractures in 36 (37.1%) cases, single maxillofacial fractures were seen in 48 (49.5%) and cranio-maxillofacial fractures in 13 (13.4%). Single bone fracture was more common than multiple bone fractures (p<0.05). Nasal, ethmoid bones and the orbits were the most commonly involved sites of the craniofacial region. Thirty-eight (17.2%) patients had intracranial injuries, the commonest being subarachnoid haemorrhage and the commonest sites were the temporal and frontal regions. Coexisting intracranial injuries were more common in patients with cranial fractures than in patients with maxillofacial fractures (p<0.05). Our results indicate that the cranio-maxillofacial trauma arising from the massive Sichuan earthquake had some characteristic features, and a significant number of individuals had the potential for combined cranial and maxillofacial injuries, successful management of which required a multidisciplinary approach. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Quantity and location of aortic valve complex calcification predicts severity and location of paravalvular regurgitation and frequency of post-dilation after balloon-expandable transcatheter aortic valve replacement.

PubMed

Khalique, Omar K; Hahn, Rebecca T; Gada, Hemal; Nazif, Tamim M; Vahl, Torsten P; George, Isaac; Kalesan, Bindu; Forster, Molly; Williams, Mathew B; Leon, Martin B; Einstein, Andrew J; Pulerwitz, Todd C; Pearson, Gregory D N; Kodali, Susheel K

2014-08-01

This study sought to determine the impact of quantity and location of aortic valve calcification (AVC) on paravalvular regurgitation (PVR) and rates of post-dilation (PD) immediately after transcatheter aortic valve replacement (TAVR). The impact of AVC in different locations within the aortic valve complex is incompletely understood. This study analyzed 150 patients with severe, symptomatic aortic stenosis who underwent TAVR. Total AVC volume scores were calculated from contrast-enhanced multidetector row computed tomography imaging. AVC was divided by leaflet sector and region (Leaflet, Annulus, left ventricular outflow tract [LVOT]), and a combination of LVOT and Annulus (AnnulusLVOT). Asymmetry was assessed. Receiver-operating characteristic analysis was performed with greater than or equal to mild PVR and PD as classification variables. Logistic regression was performed. Quantity of and asymmetry of AVC for all regions of the aortic valve complex predicted greater than or equal to mild PVR by receiver-operating characteristic analysis (area under the curve = 0.635 to 0.689), except Leaflet asymmetry. Receiver-operating characteristic analysis for PD was significant for quantity and asymmetry of AVC in all regions, with higher area under the curve values than for PVR (area under the curve = 0.648 to 0.741). On multivariable analysis, Leaflet and AnnulusLVOT calcification were independent predictors of both PVR and PD regardless of multidetector row computed tomography area cover index. Quantity and asymmetry of AVC in all regions of the aortic valve complex predict greater than or equal to mild PVR and performance of PD, with the exception of Leaflet asymmetry. Quantity of AnnulusLVOT and Leaflet calcification independently predict PVR and PD when taking into account multidetector row computed tomography area cover index. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology.

PubMed

Linsenmaier, Ulrich; Wirth, Stefan; Reiser, Maximilian; Körner, Markus

2008-10-01

Pancreatic and duodenal injuries after blunt abdominal trauma are rare; however, delays in diagnosis and treatment can significantly increase morbidity and mortality. Multidetector computed tomography (CT) has a major role in early diagnosis of pancreatic and duodenal injuries. Detecting the often subtle signs of injury with whole-body CT can be difficult because this technique usually does not include a dedicated protocol for scanning the pancreas. Specific injury patterns in the pancreas and duodenum often have variable expression at early posttraumatic multidetector CT: They may be hardly visible, or there may be considerable exudate, hematomas, organ ruptures, or active bleeding. An accurate multidetector CT technique allows optimized detection of subtle abnormalities. In duodenal injuries, differentiation between a contusion of the duodenal wall or mural hematoma and a duodenal perforation is vital. In pancreatic injuries, determination of involvement of the pancreatic duct is essential. The latter conditions require immediate surgical intervention. Use of organ injury scales and a surgical classification adapted for multidetector CT enables classification of organ injuries for trauma scoring, treatment planning, and outcome control. In addition, multidetector CT reliably demonstrates potential complications of duodenal and pancreatic injuries, such as posttraumatic pancreatitis, pseudocysts, fistulas, exudates, and abscesses. (c) RSNA, 2008.

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.

The utility of 64 channel multidetector CT angiography for evaluating the renal vascular anatomy and possible variations: a pictorial essay.

PubMed

Kumar, Sheo; Neyaz, Zafar; Gupta, Archna

2010-01-01

The increased use of laparoscopic nephrectomy and nephron-sparing surgery has prompted the need for a more detailed radiological evaluation of the renal vascular anatomy. Multidetector CT angiography is a fast and accurate modality for assessing the precise anatomy of the renal vessels. In this pictorial review, we present the multidetector CT angiography appearances of the normal renal vascular anatomy and a spectrum of various anomalies that require accurate vascular depiction before undergoing surgical treatment.

Diagnostic Performance of Gadoxetic Acid-enhanced Liver MR Imaging versus Multidetector CT in the Detection of Dysplastic Nodules and Early Hepatocellular Carcinoma.

PubMed

Kim, Bo Ram; Lee, Jeong Min; Lee, Dong Ho; Yoon, Jeong Hee; Hur, Bo Yun; Suh, Kyung Suk; Yi, Nam-Joon; Lee, Kyung Boon; Han, Joon Koo

2017-10-01

Purpose To compare the diagnostic performance of gadoxetic acid-enhanced liver magnetic resonance (MR) imaging with that of contrast material-enhanced multidetector computed tomography (CT) in the detection of borderline hepatocellular nodules in patients with liver cirrhosis and to determine the Liver Imaging Reporting and Data System (LI-RADS) categories of these detected nodules. Materials and Methods The institutional review board approved this retrospective study and waived the informed consent requirement. Sixty-eight patients with pathologically proven dysplastic nodules (DNs) (low-grade DNs, n = 20; high-grade DNs, n = 17), early hepatocellular carcinomas (HCCs) (n = 42), or progressed HCCs (n = 33) underwent gadoxetic acid-enhanced MR imaging and multidetector CT. An additional 57 patients without any DNs or HCCs in the explanted livers were included as control subjects. Three radiologists independently graded the presence of liver nodules on a five-point confidence scale and assigned LI-RADS categories by using imaging findings. Jackknife alternative free-response receiver operating characteristics (JAFROC) software was used to compare the diagnostic accuracy of each modality in lesion detection. Results Reader-averaged figures of merit estimated with JAFROC software to detect hepatocellular nodules were 0.774 for multidetector CT and 0.842 for MR imaging (P = .002). Readers had significantly higher detection sensitivity for early HCCs with MR imaging than with multidetector CT (78.6% vs 52.4% [P = .001], 71.4% vs 50.0% [P = .011], and 73.8% vs 50.0% [P = .001], respectively). A high proportion of overall detected early HCCs at multidetector CT (59.4%) and MR imaging (72.3%) were categorized as LI-RADS category 4. Most early HCCs (76.2%) and high-grade DNs (82.4%) demonstrated hypointensity on hepatobiliary phase images. In total, 30 more LI-RADS category 4 early HCCs were identified with MR imaging than with multidetector CT across all readers. Conclusion Gadoxetic acid-enhanced MR imaging performed significantly better in the detection of high-risk borderline nodules, especially early HCCs, than did multidetector CT. © RSNA, 2017 Online supplemental material is available for this article.

Comparison of the Multidetector-row Computed Tomographic Angiography Axial and Coronal Planes' Usefulness for Detecting Thoracodorsal Artery Perforators

PubMed Central

Kim, Jong Gyu

2012-01-01

Background During the planning of a thoracodorsal artery perforator (TDAP) free flap, preoperative multidetector-row computed tomographic (MDCT) angiography is valuable for predicting the locations of perforators. However, CT-based perforator mapping of the thoracodorsal artery is not easy because of its small diameter. Thus, we evaluated 1-mm-thick MDCT images in multiple planes to search for reliable perforators accurately. Methods Between July 2010 and October 2011, 19 consecutive patients (13 males, 6 females) who underwent MDCT prior to TDAP free flap operations were enrolled in this study. Patients ranged in age from 10 to 75 years (mean, 39.3 years). MDCT images were acquired at a thickness of 1 mm in the axial, coronal, and sagittal planes. Results The thoracodorsal artery perforators were detected in all 19 cases. The reliable perforators originating from the descending branch were found in 14 cases, of which 6 had transverse branches. The former were well identified in the coronal view, and the latter in the axial view. The location of the most reliable perforators on MDCT images corresponded well with the surgical findings. Conclusions Though MDCT has been widely used in performing the abdominal perforator free flap for detecting reliable perforating vessels, it is not popular in the TDAP free flap. The results of this study suggest that multiple planes of MDCT may increase the probability of detecting the most reliable perforators, along with decreasing the probability of missing available vessels. PMID:22872839

Multidetector CT radiation dose optimisation in adults: short- and long-term effects of a clinical audit.

PubMed

Tack, Denis; Jahnen, Andreas; Kohler, Sarah; Harpes, Nico; De Maertelaer, Viviane; Back, Carlo; Gevenois, Pierre Alain

2014-01-01

To report short- and long-term effects of an audit process intended to optimise the radiation dose from multidetector row computed tomography (MDCT). A survey of radiation dose from all eight MDCT departments in the state of Luxembourg performed in 2007 served as baseline, and involved the most frequently imaged regions (head, sinus, cervical spine, thorax, abdomen, and lumbar spine). CT dose index volume (CTDIvol), dose-length product per acquisition (DLP/acq), and DLP per examination (DLP/exa) were recorded, and their mean, median, 25th and 75th percentiles compared. In 2008, an audit conducted in each department helped to optimise doses. In 2009 and 2010, two further surveys evaluated the audit's impact on the dose delivered. Between 2007 and 2009, DLP/exa significantly decreased by 32-69 % for all regions (P < 0.001) except the lumbar spine (5 %, P = 0.455). Between 2009 and 2010, DLP/exa significantly decreased by 13-18 % for sinus, cervical and lumbar spine (P ranging from 0.016 to less than 0.001). Between 2007 and 2010, DLP/exa significantly decreased for all regions (18-75 %, P < 0.001). Collective dose decreased by 30 % and the 75th percentile (diagnostic reference level, DRL) by 20-78 %. The audit process resulted in long-lasting dose reduction, with DRLs reduced by 20-78 %, mean DLP/examination by 18-75 %, and collective dose by 30 %. • External support through clinical audit may optimise default parameters of routine CT. • Reduction of 75th percentiles used as reference diagnostic levels is 18-75 %. • The effect of this audit is sustainable over time. • Dose savings through optimisation can be added to those achievable through CT.

The effects of once-weekly teriparatide on hip structure and biomechanical properties assessed by CT.

PubMed

Ito, M; Oishi, R; Fukunaga, M; Sone, T; Sugimoto, T; Shiraki, M; Nishizawa, Y; Nakamura, T

2014-03-01

Once-weekly administration of 56.5 μg teriparatide improved cortical bone parameters and biomechanical parameters at the proximal femur by CT geometry analysis. The aim of this study was to evaluate the effects of weekly administration of teriparatide [human PTH (1-34)] on bone geometry, volumetric bone mineral density (vBMD), and parameters of bone strength at the proximal femur which were longitudinally investigated using computed tomography (CT). The subjects were a subgroup of a recent, randomly assigned, double-blind study (578 subjects) comparing the anti-fracture efficacy of a once-weekly subcutaneous injection of 56.5 μg teriparatide with placebo (TOWER trial). Sixty-six ambulatory postmenopausal women with osteoporosis were enrolled at 15 study sites having multi-detector row CT, and included women injected with teriparatide (n = 29, 74.2 ± 5.1 years) or with placebo (n = 37, 74.8 ± 5.3 years). CT data were obtained at baseline and follow-up scans were performed at 48 and 72 weeks. The data were analyzed to obtain cross-sectional densitometric, geometric, and biomechanical parameters including the section modulus (SM) and buckling ratio (BR) of the femoral neck, inter-trochanter, and femoral shaft. We found that once-weekly teriparatide increased cortical thickness/cross-sectional area (CSA) and total area, and improved biomechanical properties (i.e., decreasing BR) at the femoral neck and shaft. Teriparatide did not change the cortical perimeter. Our longitudinal analysis of proximal femur geometry by CT revealed that once-weekly administration of 56.5 μg teriparatide improved cortical bone parameters at the femoral neck and shaft and also improved biomechanical parameters.

Computed tomography imaging and angiography - principles.

PubMed

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

2016-01-01

The evaluation of patients with diverse neurologic disorders was forever changed in the summer of 1973, when the first commercial computed tomography (CT) scanners were introduced. Until then, the detection and characterization of intracranial or spinal lesions could only be inferred by limited spatial resolution radioisotope scans, or by the patterns of tissue and vascular displacement on invasive pneumoencaphalography and direct carotid puncture catheter arteriography. Even the earliest-generation CT scanners - which required tens of minutes for the acquisition and reconstruction of low-resolution images (128×128 matrix) - could, based on density, noninvasively distinguish infarct, hemorrhage, and other mass lesions with unprecedented accuracy. Iodinated, intravenous contrast added further sensitivity and specificity in regions of blood-brain barrier breakdown. The advent of rapid multidetector row CT scanning in the early 1990s created renewed enthusiasm for CT, with CT angiography largely replacing direct catheter angiography. More recently, iterative reconstruction postprocessing techniques have made possible high spatial resolution, reduced noise, very low radiation dose CT scanning. The speed, spatial resolution, contrast resolution, and low radiation dose capability of present-day scanners have also facilitated dual-energy imaging which, like magnetic resonance imaging, for the first time, has allowed tissue-specific CT imaging characterization of intracranial pathology. © 2016 Elsevier B.V. All rights reserved.

An ancient Roman bowl embedded in a soil sample: surface shaded three dimensional display using data from a multi-detector CT.

PubMed

De Maeseneer, M; Buls, N; Cleeren, N; Lenchik, L; De Mey, J

2006-01-01

We present an unusual application of multidetector CT and shaded surface rendering in the investigation of a soil sample, containing an ancient Roman bronze bowl. The CT findings were of fundamental importance in helping the archaeologists study the bronze bowl from the soil sample.

Dose reduction in 64-row whole-body CT in multiple trauma: an optimized CT protocol with iterative image reconstruction on a gemstone-based scintillator.

PubMed

Geyer, Lucas L; Körner, Markus; Harrieder, Andreas; Mueck, Fabian G; Deak, Zsuzsanna; Wirth, Stefan; Linsenmaier, Ulrich

2016-01-01

Evaluation of potential dose savings by implementing adaptive statistical iterative reconstruction (ASiR) on a gemstone-based scintillator in a clinical 64-row whole-body CT (WBCT) protocol after multiple trauma. Dose reports of 152 WBCT scans were analysed for two 64-row multidetector CT scanners (Scanners A and B); the main scanning parameters were kept constant. ASiR and a gemstone-based scintillator were used in Scanner B, and the noise index was adjusted (head: 5.2 vs 6.0; thorax/abdomen: 29.0 vs 46.0). The scan length, CT dose index (CTDI) and dose-length product (DLP) were analysed. The estimated mean effective dose was calculated using normalized conversion factors. Student's t-test was used for statistics. Both the mean CTDI (mGy) (Scanner A: 53.8 ± 2.0, 10.3 ± 2.5, 14.4 ± 3.7; Scanner B: 48.7 ± 2.2, 7.1 ± 2.3, 9.1 ± 3.6; p < 0.001, respectively) and the mean DLP (mGy cm) (Scanner A: 1318.9 ± 167.8, 509.3 ± 134.7, 848.8 ± 254.0; Scanner B: 1190.6 ± 172.6, 354.6 ± 128.3, 561.0 ± 246.7; p < 0.001, respectively) for the head, thorax and abdomen were significantly reduced with Scanner B. There was no relevant difference in scan length. The total mean effective dose (mSv) was significantly decreased with Scanner B (24.4 ± 6.0, 17.2 ± 5.8; p < 0.001). The implementation of ASiR and a gemstone-based scintillator allows for significant dose savings in a clinical WBCT protocol. Recent technical developments can significantly reduce radiation dose of WBCT in multiple trauma. Dose reductions of 10-34% can be achieved.

Determining contrast medium dose and rate on basis of lean body weight: does this strategy improve patient-to-patient uniformity of hepatic enhancement during multi-detector row CT?

PubMed

Ho, Lisa M; Nelson, Rendon C; Delong, David M

2007-05-01

To prospectively evaluate the use of lean body weight (LBW) as the main determinant of the volume and rate of contrast material administration during multi-detector row computed tomography of the liver. This HIPAA-compliant study had institutional review board approval. All patients gave written informed consent. Four protocols were compared. Standard protocol involved 125 mL of iopamidol injected at 4 mL/sec. Total body weight (TBW) protocol involved 0.7 g iodine per kilogram of TBW. Calculated LBW and measured LBW protocols involved 0.86 g of iodine per kilogram and 0.92 g of iodine per kilogram calculated or measured LBW for men and women, respectively. Injection rate used for the three experimental protocols was determined proportionally on the basis of the calculated volume of contrast material. Postcontrast attenuation measurements during portal venous phase were obtained in liver, portal vein, and aorta for each group and were summed for each patient. Patient-to-patient enhancement variability in same group was measured with Levene test. Two-tailed t test was used to compare the three experimental protocols with the standard protocol. Data analysis was performed in 101 patients (25 or 26 patients per group), including 56 men and 45 women (mean age, 53 years). Average summed attenuation values for standard, TBW, calculated LBW, and measured LBW protocols were 419 HU +/- 50 (standard deviation), 443 HU +/- 51, 433 HU +/- 50, and 426 HU +/- 33, respectively (P = not significant for all). Levene test results for summed attenuation data for standard, TBW, calculated LBW, and measured LBW protocols were 40 +/- 29, 38 +/- 33 (P = .83), 35 +/- 35 (P = .56), and 26 +/- 19 (P = .05), respectively. By excluding highly variable but poorly perfused adipose tissue from calculation of contrast medium dose, the measured LBW protocol may lessen patient-to-patient enhancement variability while maintaining satisfactory hepatic and vascular enhancement.

Numerical Analysis of Organ Doses Delivered During Computed Tomography Examinations Using Japanese Adult Phantoms with the WAZA-ARI Dosimetry System.

PubMed

Takahashi, Fumiaki; Sato, Kaoru; Endo, Akira; Ono, Koji; Ban, Nobuhiko; Hasegawa, Takayuki; Katsunuma, Yasushi; Yoshitake, Takayasu; Kai, Michiaki

2015-08-01

A dosimetry system for computed tomography (CT) examinations, named WAZA-ARI, is being developed to accurately assess radiation doses to patients in Japan. For dose calculations in WAZA-ARI, organ doses were numerically analyzed using average adult Japanese male (JM) and female (JF) phantoms with the Particle and Heavy Ion Transport code System (PHITS). Experimental studies clarified the photon energy distribution of emitted photons and dose profiles on the table for some multi-detector row CT (MDCT) devices. Numerical analyses using a source model in PHITS could specifically take into account emissions of x rays from the tube to the table with attenuation of photons through a beam-shaping filter for each MDCT device based on the experiment results. The source model was validated by measuring the CT dose index (CTDI). Numerical analyses with PHITS revealed a concordance of organ doses with body sizes of the JM and JF phantoms. The organ doses in the JM phantoms were compared with data obtained using previously developed systems. In addition, the dose calculations in WAZA-ARI were verified with previously reported results by realistic NUBAS phantoms and radiation dose measurement using a physical Japanese model (THRA1 phantom). The results imply that numerical analyses using the Japanese phantoms and specified source models can give reasonable estimates of dose for MDCT devices for typical Japanese adults.

Safe cervical spine clearance in adult obtunded blunt trauma patients on the basis of a normal multidetector CT scan--a meta-analysis and cohort study.

PubMed

Raza, Mushahid; Elkhodair, Samer; Zaheer, Asif; Yousaf, Sohail

2013-11-01

A true gold standard to rule out a significant cervical spine injury in subset of blunt trauma patients with altered sensorium is still to be agreed upon. The objective of this study is to determine whether in obtunded adult patients with blunt trauma, a clinically significant injury to the cervical spine be ruled out on the basis of a normal multidetector cervical spine computed tomography. Comprehensive database search was conducted to include all the prospective and retrospective studies on blunt trauma patients with altered sensorium undergoing cervical spine multidetector CT scan as core imaging modality to "clear" the cervical spine. The studies used two main gold standards, magnetic resonance imaging of the cervical spine and/or prolonged clinical follow-up. The data was extracted to report true positive, true negatives, false positives and false negatives. Meta-analysis of sensitivity, specificity, negative and positive predictive values was performed using Meta Analyst Beta 3.13 software. We also performed a retrospective investigation comparing a robust clinical follow-up and/or cervical spine MR findings in 53 obtunded blunt trauma patients, who previously had undergone a normal multidetector CT scan of the cervical spine reported by a radiologist. A total of 10 studies involving 1850 obtunded blunt trauma patients with initial cervical spine CT scan reported as normal were included in the final meta-analysis. The cumulative negative predictive value and specificity of cervical spine CT of the ten studies was 99.7% (99.4-99.9%, 95% confidence interval). The positive predictive value and sensitivity was 93.7% (84.0-97.7%, 95% confidence interval). In the retrospective review of our obtunded blunt trauma patients, none was later diagnosed to have significant cervical spine injury that required a change in clinical management. In a blunt trauma patient with altered sensorium, a normal cervical spine CT scan is conclusive to safely rule out a clinically significant cervical spine injury. The results of this meta-analysis strongly support the removal of cervical precautions in obtunded blunt trauma patient after normal cervical spine computed tomography. Any further imaging like magnetic resonance imaging of the cervical spine should be performed on case-to-case basis. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

USDA-ARS?s Scientific Manuscript database

Homozygous familial hypercholesterolemia (HoFH) is a rare disorder characterized by the early onset of atherosclerosis, often at the ostia of coronary arteries. In this study we document for the first time that aortic and coronary atherosclerosis can be detected using 64 slice multiple detector row ...

Femoral head avascular necrosis: a frequently missed incidental finding on multidetector CT.

PubMed

Barille, M F; Wu, Jim S; McMahon, Colm J

2014-03-01

To determine the incidence of missed femoral head avascular necrosis (AVN) on pelvic computed tomography (CT) performed for clinical indications other than assessment for AVN. The study was a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. The picture archiving and communication system (PACS) database was queried for patients with diagnosis of femoral head AVN on magnetic resonance imaging (MRI), who also underwent pelvic multidetector CT after or <30 days before the MRI examination. The MRI and CT images of 144 hips of 72 patients (39 patients with reported AVN on MRI and 33 age-matched controls; mean age = 60 years, 28 male, 44 female), were reviewed in consensus by two readers in a randomized, blinded manner. Using MRI-proven CT-visible AVN as a reference standard, the incidence of missed AVN on initial CT interpretation was determined. Readers confirmed AVN in 33 patients on the MRI images. Nine hips with AVN underwent joint replacement of the affected joint(s) prior to subsequent CT and were excluded. Forty-three MRI-proven AVN cases in 28 patients (15 bilateral, 13 unilateral) were available for analysis. The study readers diagnosed 35/43 (81%) MRI-proven AVN cases in 22/28 (79%) patients. Four of the 35 (11%) cases of MRI-proven, CT-visible AVN were prospectively reported in 3/22 (14%) patients at initial clinical interpretation, with a miss rate of 89% per hip and 86% per patient. Multidetector CT has high accuracy for detection of AVN; however, this is frequently missed as an incidental finding (89% missed in the present study). Assessment for signs of femoral AVN should be part of routine search pattern in interpretation of pelvic CT. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Multidetector CT of musculoskeletal disease in the pediatric patient: principles, techniques, and clinical applications.

PubMed

Fayad, Laura M; Johnson, Pamela; Fishman, Elliot K

2005-01-01

Computed tomography (CT) plays an important role in the evaluation of musculoskeletal disease in the pediatric patient. With the advent of high-performance 16-section multidetector CT, images can be produced with subsecond gantry rotation times and with submillimeter acquisition, which yields true isotropic high-resolution volume data sets; these features are not attainable with older spiral CT technology. Such capabilities are particularly helpful in the evaluation of pediatric patients by virtually eliminating the need for sedation and minimizing dependence on patient cooperation. The role of three-dimensional (3D) volume imaging in the evaluation of pediatric musculoskeletal disease continues to evolve, with this technique becoming increasingly important in detection and characterization of lesions as well as in decisions about patient care. Specific designs and protocols for multidetector CT studies can be selected to minimize radiation dose to the patient. Principal clinical applications of 3D CT in evaluation of the pediatric musculoskeletal system include developmental abnormalities, trauma, neoplasms, and postoperative imaging.

Multidetector CT of blunt traumatic venous injuries in the chest, abdomen, and pelvis.

PubMed

Holly, Brian P; Steenburg, Scott D

2011-01-01

Venous injuries as a result of blunt trauma are rare. Even though current protocols for multidetector computed tomography (CT) of patients with trauma are designed to evaluate primarily the solid organs and arteries, blunt venous injuries may nevertheless be identified, or at least suspected, on the basis of the multidetector CT findings. Venous injuries are associated with high morbidity and mortality rates. Diagnosis of a possible venous injury is crucial because the physical findings of a venous injury are nonspecific and may be absent. This article aims to make the radiologist aware of various venous injuries caused by blunt trauma and to provide helpful hints to aid in the identification of venous injuries. Multidetector CT technology, in combination with interactive manipulation of the raw dataset, can be useful in the creation of multiplanar reconstructed images and in the identification of a venous injury caused by blunt trauma. Familiarity with direct and indirect signs of venous injuries, as well as with examples of blunt traumatic venous injuries in the chest, abdomen, and pelvis, will help in the diagnosis of these injuries.

Myocardial perfusion 320-row multidetector computed tomography-guided treatment strategy for the clinical management of patients with recent acute-onset chest pain: Design of the CArdiac cT in the treatment of acute CHest pain (CATCH)-2 randomized controlled trial.

PubMed

Sørgaard, Mathias; Linde, Jesper J; Hove, Jens D; Petersen, Jan R; Jørgensen, Tem B S; Abdulla, Jawdat; Heitmann, Merete; Kragelund, Charlotte; Hansen, Thomas Fritz; Udholm, Patricia M; Pihl, Christian; Kühl, J Tobias; Engstrøm, Thomas; Jensen, Jan Skov; Høfsten, Dan E; Kelbæk, Henning; Kofoed, Klaus F

2016-09-01

Patients admitted with chest pain are a diagnostic challenge because the majority does not have coronary artery disease (CAD). Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed tomography perfusion (CTP) has been shown to increase the specificity when added to CCTA, without lowering the sensitivity. This article describes the design of a randomized controlled trial, CATCH-2, comparing a clinical diagnostic management strategy of CCTA alone against CCTA in combination with CTP. Patients with acute-onset chest pain older than 50 years and with at least one cardiovascular risk factor for CAD are being prospectively enrolled to this study from 6 different clinical sites since October 2013. A total of 600 patients will be included. Patients are randomized 1:1 to clinical management based on CCTA or on CCTA in combination with CTP, determining the need for further testing with invasive coronary angiography including measurement of the fractional flow reserve in vessels with coronary artery lesions. Patients are scanned with a 320-row multidetector computed tomography scanner. Decisions to revascularize the patients are taken by the invasive cardiologist independently of the study allocation. The primary end point is the frequency of revascularization. Secondary end points of clinical outcome are also recorded. The CATCH-2 will determine whether CCTA in combination with CTP is diagnostically superior to CCTA alone in the management of patients with acute-onset chest pain. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of simethicone-coated cellulose as a negative oral contrast agent for abdominal CT.

PubMed

Sahani, Dushyant V; Jhaveri, Kartik S; D'souza, Roy V; Varghese, Jose C; Halpern, Elkan; Harisinghani, Mukesh G; Hahn, Peter F; Saini, Sanjay

2003-05-01

Because of the increased clinical use of computed tomography (CT) for imaging the abdominal vasculature and urinary tract, there is a need for negative contrast agents. The authors undertook this study to assess the suitability of simethicone-coated cellulose (SCC), which is approved for use as an oral contrast agent in sonography, for use as a negative oral contrast agent in abdominal CT. This prospective study involved 40 adult patients scheduled to undergo abdominal CT for the evaluation of hematuria. Prior to scanning, 20 subjects received 800 mL of SCC and 20 received 800 mL of water as an oral contrast agent. Imaging was performed with a multi-detector row helical scanner in two phases, according to the abdominal CT protocol used for hematuria evaluation at the authors' institution. The first, "early" phase began an average of 15 minutes after the ingestion of contrast material; the second, "late" phase began an average of 45 minutes after the ingestion of contrast material. Blinded analysis was performed by three abdominal radiologists separately, using a three-point scale (0 = poor, 1 = acceptable, 2 = excellent) to assess the effectiveness of SCC for marking the proximal, middle, and distal small bowel. Average scores for enhancement with SCC and with water were obtained and compared. Statistical analysis was performed with a Wilcoxon signed-rank test. SCC was assigned higher mean scores than water for enhancement in each segment of the bowel, both on early-phase images (0.8-1.35 for SCC vs 0.6-1.1 for water) and on late-phase images (1.1-1.4 vs 0.81-0.96). Bowel marking with SCC, particularly in the jejunum and ileum, also was rated better than that with water in a high percentage of patients. The differences between the scores for water and for SCC, however, were not statistically significant (P > .05). SCC is effective as a negative oral contrast agent for small bowel marking at CT.

Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography.

PubMed

Caro-Domínguez, Pablo; Compton, Gregory; Humpl, Tilman; Manson, David E

2016-09-01

The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children. To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children. We calculated the multi-detector CT ratio of MPA to ascending aorta diameter in 44 children with documented pulmonary arterial hypertension by right heart catheterization and in 44 age- and gender-matched control children with no predisposing factors for pulmonary arterial hypertension. We compared this multi-detector-CT-determined ratio with the MPA pressure in the study group, as well as with the ratio of MPA to ascending aorta in the control group. A threshold ratio value was calculated to accurately identify children with pulmonary arterial hypertension. Children with documented primary pulmonary arterial hypertension have a significantly higher ratio of MPA to ascending aorta (1.46) than children without pulmonary arterial hypertension (1.11). A ratio of 1.3 carries a positive likelihood of 34 and a positive predictive value of 97% for the diagnosis of pulmonary arterial hypertension. The pulmonary arteries were larger in children with pulmonary arterial hypertension than in a control group of normal children. A CT-measured ratio of MPA to ascending aorta of 1.3 should raise the suspicion of pulmonary arterial hypertension in children.

CT features and common causes of arc of Riolan expansion: an analysis with 64-detector-row computed tomographic angiography

PubMed Central

Xie, Yuanliang; Jin, Chaolin; Zhang, Shutong; Wang, Xiang; Jiang, Yanping

2015-01-01

Objective: To study the manifestations of arc of Riolan expansion (ARE) using multi-detector computed tomography angiography (MDCTA). Materials and methods: The manifestations and clinical data of 626 consecutive mesentery CTA images were retrospectively analyzed. The 47 cases with ARE and 47 patients without expansion were involved. The average diameter of arc of Riolan was measured. Two radiologists after reaching consensus analyzed the shapes of mesenteric artery, CT findings and the occurrence and causes of ARE. Results: The mean diameter of arc of Riolan was 1.2 mm, 4.6 mm, 2.5 mm, 2.3 mm, 1.9 mm, 2.5 mm, and 2.0 mm at baseline and following obstruction of superior mesenteric artery (SMA), stenosis of SMA, obstruction of inferior mesenteric artery (IMA), stenosis of IMA, colon cancer, and active ulcerative colitis, respectively. The expansion of arc of Riolan was the most significant following obstruction of SMA. The diameters of arc of Riolan were significantly different between the upward flow group and the downward or the two-way flow groups, and between the colon tumor group and the active ulcerative colitis group. CT findings such as bowel wall thickening, contrast enhancement, intestinal obstruction, marginal artery expansion, lymph node enlargement varied and were help to identify the cause of ARE. Conclusions: ARE often suggests the occurrence of obstructed intestinal feeding artery or intestinal lesions. MDCTA can clearly display the situation of arc of Riolan and collateral circulation, and together with CT symptoms, can guide the selection of diagnosis and treatment schemes in clinic. PMID:26064208

The effects of misinterpretation of an artefact on multidetector row CT scans in children.

PubMed

du Plessis, Anne-Marie; Theron, Salomine; Andronikou, Savvas

2009-02-01

Artefacts reflect problems with radiographic technique rather than true pathology. These may be misinterpreted as pathology with serious consequences. An artefact caused such problems in one paediatric imaging department. To determine the incidence, and consequences of misinterpretation, of a CT artefact in a paediatric imaging department. A retrospective review of images and reports of paediatric CT scans over a set period with a known artefact was performed. Reports were correlated with reviewers' evaluation of the presence of artefact and reviewed for correct identification of artefact, misinterpretation as pathology, and action taken as a result. A total of 74 CT scans had been performed over the study period and an artefact detected by reviewers on 32 (43%). Six (18.75%) of these were misinterpreted as pathology, of which three (9.4%) were reported as tuberculous granulomas, two (6.2%) as haemorrhages and one (3.1%) as an unknown hyperdensity. Two patients (6.2%) had subsequent MRI studies performed, and treatment for tuberculosis was continued in one patient (3.1%). No initial report identified the artefact. One-fifth of the scans with the artefact were misinterpreted as pathology and half of these misinterpretations led to further action. Artefacts result in false diagnoses and unnecessary investigations; vigilance is needed.

Comparison of image quality and radiation dose between fixed tube current and combined automatic tube current modulation in craniocervical CT angiography.

PubMed

Lee, E J; Lee, S K; Agid, R; Howard, P; Bae, J M; terBrugge, K

2009-10-01

The combined automatic tube current modulation (ATCM) technique adapts and modulates the x-ray tube current in the x-y-z axis according to the patient's individual anatomy. We compared image quality and radiation dose of the combined ATCM technique with those of a fixed tube current (FTC) technique in craniocervical CT angiography performed with a 64-section multidetector row CT (MDCT) system. A retrospective review of craniocervical CT angiograms (CTAs) by using combined ATCM (n = 25) and FTC techniques (n = 25) was performed. Other CTA parameters, such as kilovolt (peak), matrix size, FOV, section thickness, pitch, contrast agent, and contrast injection techniques, were held constant. We recorded objective image noise in the muscles at 2 anatomic levels: radiation exposure doses (CT dose index volume and dose-length product); and subjective image quality parameters, such as vascular delineation of various arterial vessels, visibility of small arterial detail, image artifacts, and certainty of diagnosis. The Mann-Whitney U test was used for statistical analysis. No significant difference was detected in subjective image quality parameters between the FTC and combined ATCM techniques. Most subjects in both study groups (49/50, 98%) had acceptable subjective artifacts. The objective image noise values at shoulder level did not show a significant difference, but the noise value at the upper neck was higher with the combined ATCM (P < .05) technique. Significant reduction in radiation dose (18% reduction) was noted with the combined ATCM technique (P < .05). The combined ATCM technique for craniocervical CTA performed at 64-section MDCT substantially reduced radiation exposure dose but maintained diagnostic image quality.

Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions.

PubMed

Sakamoto, Takashi; Mitsuzaki, Katsuhiko; Utsunomiya, Daisuke; Matsuda, Katsuhiko; Yamamura, Sadahiro; Urata, Joji; Kawakami, Megumi; Yamashita, Yasuyuki

2012-09-01

Although the screening of small, flat polyps is clinically important, the role of CT colonography (CTC) screening in their detection has not been thoroughly investigated. To evaluate the detection capability and usefulness of CTC in the screening of flat and polypoid lesions by comparing CTC with optic colonoscopy findings as the gold standard. We evaluated the CTC detection capability for flat colorectal polyps with a flat surface and a height not exceeding 3 mm (n = 42) by comparing to conventional polypoid lesions (n = 418) according to the polyp diameter. Four types of reconstruction images including multiplanar reconstruction, volume rendering, virtual gross pathology, and virtual endoscopic images were used for visual analysis. We compared the abilities of the four reconstructions for polyp visualization. Detection sensitivity for flat polyps was 31.3%, 44.4%, and 87.5% for lesions measuring 2-3 mm, 4-5 mm, and ≥6 mm, respectively; the corresponding sensitivity for polypoid lesions was 47.6%, 79.0%, and 91.7%. The overall sensitivity for flat lesions (47.6%) was significantly lower than polypoid lesions (64.1%). Virtual endoscopic imaging showed best visualization among the four reconstructions. Colon cancers were detected in eight patients by optic colonoscopy, and CTC detected colon cancers in all eight patients. CTC using 64-row multidetector CT is useful for colon cancer screening to detect colorectal polyps while the detection of small, flat lesions is still challenging.

Hepatocellular carcinoma in cirrhotic patients at multidetector CT: hepatic venous phase versus delayed phase for the detection of tumour washout

PubMed Central

Furlan, A; Marin, D; Vanzulli, A; Patera, G Palermo; Ronzoni, A; Midiri, M; Bazzocchi, M; Lagalla, R; Brancatelli, G

2011-01-01

Objectives Our aim was to compare retrospectively hepatic venous and delayed phase images for the detection of tumour washout during multiphasic multidetector row CT (MDCT) of the liver in patients with hepatocellular carcinoma (HCC). Methods 30 cirrhotic patients underwent multiphasic MDCT in the 90 days before liver transplantation. MDCT was performed before contrast medium administration and during hepatic arterial hepatic venous and delayed phases, images were obtained at 12, 55 and 120 s after trigger threshold. Two radiologists qualitatively evaluated images for lesion attenuation. Tumour washout was evaluated subjectively and objectively. Tumour-to-liver contrast (TLC) was measured for all pathologically proven HCCs. Results 48 HCCs were detected at MDCT. 46 of the 48 tumours (96%) appeared as either hyper- or isoattenuating during the hepatic arterial phase subjective washout was present in 15 HCCs (33%) during the hepatic venous phase and in 35 (76%) during the delayed phase (p<0.001, McNemar’s test). Objective washout was present in 30 of the 46 HCCs (65%) during the hepatic venous phase and in 42 of the HCCs (91%) during the delayed phase (p=0.001). The delayed phase yielded significantly higher mean TLC absolute values compared with the hepatic venous phase (−16.1±10.8 HU vs −10.5±10.2 HU; p<0.001). Conclusions The delayed phase is superior to the hepatic venous phase for detection of tumour washout of pathologically proven HCC in cirrhotic patients. PMID:21081569

Role of (68)Ga-DOTATATE PET/CT in patients with multiple endocrine neoplasia type 1 (MEN1).

PubMed

Lastoria, Secondo; Marciello, Francesca; Faggiano, Antongiulio; Aloj, Luigi; Caracò, Corradina; Aurilio, Michela; D'Ambrosio, Laura; Di Gennaro, Francesca; Ramundo, Valeria; Camera, Luigi; De Luca, Leonardo; Fonti, Rosa; Napolitano, Vincenzo; Colao, Annamaria

2016-06-01

Multiple endocrine neoplasia type 1 (MEN1) is a hereditary syndrome predisposing to many endocrine and neuroendocrine tumors (NET). Conventional imaging (CI) cannot provide satisfactory results for all the different types of MEN1-related tumors. Objective of this prospective observational study was to evaluate the role of (68)Ga-DOTATATE PET/CT in MEN1 compared to CI. Diagnostic performance of (68)Ga-DOTATATE PET/CT for the detection of NET was evaluated as well as the prognostic role of SUVmax. Eighteen patients with genetically confirmed MEN1 were evaluated by (68)Ga-DOTATATE PET/CT, endoscopic ultrasounds, multidetector-row computed tomography, magnetic resonance imaging, and hormone/markers serum measurements. Four MEN1-related tumor sites (pancreas, pituitary, parathyroids, adrenals) were considered. Sensitivity and specificity of (68)Ga-DOTATATE PET/CT for the detection of NET were calculated. There was (68)Ga-DOTATATE PET/CT uptake in 11/11 patients with pancreatic lesions, in 9/12 with pituitary adenoma, in 5/15 with parathyroid enlargements, and in 5/7 with adrenal lesions. (68)Ga-DOTATATE PET/CT showed sensitivity and specificity of 100 and 100 % in pancreas, 75 and 83 % in pituitary, 28 and 100 % in parathyroids, and 62.5 and 100 % in adrenals, respectively. Compared with CI, no significant difference in sensitivity for pancreas, pituitary, and adrenals was found, while CI had a better sensitivity for parathyroids (p = 0.002). On the ROC analysis, progression of pancreatic lesions was significantly associated to SUVmax <12.3 (p < 0.05). (68)Ga-DOTATATE PET/CT is greatly helpful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. There is also a prognostic role of (68)Ga-PET in patients with MEN1-pancreatic lesions.

Importance of preoperative imaging with 64-row three-dimensional multidetector computed tomography for safer video-assisted thoracic surgery in lung cancer.

PubMed

Akiba, Tadashi; Marushima, Hideki; Harada, Junta; Kobayashi, Susumu; Morikawa, Toshiaki

2009-01-01

Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. 3D-MDCT imaging is useful for preoperatively understanding the individual thoracic anatomy in lung cancer surgery. This modality can therefore contribute to safer anatomical pulmonary operations, especially in VATS.

Bronchial and non-bronchial systemic arteries: value of multidetector CT angiography in diagnosis and angiographic embolisation feasibility analysis.

PubMed

Lin, Yuning; Chen, Ziqian; Yang, Xizhang; Zhong, Qun; Zhang, Hongwen; Yang, Li; Xu, Shangwen; Li, Hui

2013-12-01

The aim of this study is to evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation. Fifty-two patients with haemoptysis between January 2010 and July 2011 underwent both preoperative multidetector CTA and digital subtraction angiography (DSA) imaging. Diagnostic performance of CTA in depicting arteries causing haemoptysis was assessed on a per-patient and a per-artery basis. The feasibility of the endovascular treatment evaluated by CTA was analysed. Sensitivity, specificity, and positive and negative predictive values for those analyses were determined. Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P = 0.25) nor DSA (P = 1.00) showed statistical difference in the detection of arteries causing haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P = 1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA. Multidetector CTA is an accurate imaging method in depicting the presence and number of arteries causing haemoptysis. This modality is also useful for determining the feasibility of angiographic embolisation for haemoptysis. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

Limitations of Airway Dimension Measurement on Images Obtained Using Multi-Detector Row Computed Tomography

PubMed Central

Oguma, Tsuyoshi; Hirai, Toyohiro; Niimi, Akio; Matsumoto, Hisako; Muro, Shigeo; Shigematsu, Michio; Nishimura, Takashi; Kubo, Yoshiro; Mishima, Michiaki

2013-01-01

Objectives (a) To assess the effects of computed tomography (CT) scanners, scanning conditions, airway size, and phantom composition on airway dimension measurement and (b) to investigate the limitations of accurate quantitative assessment of small airways using CT images. Methods An airway phantom, which was constructed using various types of material and with various tube sizes, was scanned using four CT scanner types under different conditions to calculate airway dimensions, luminal area (Ai), and the wall area percentage (WA%). To investigate the limitations of accurate airway dimension measurement, we then developed a second airway phantom with a thinner tube wall, and compared the clinical CT images of healthy subjects with the phantom images scanned using the same CT scanner. The study using clinical CT images was approved by the local ethics committee, and written informed consent was obtained from all subjects. Data were statistically analyzed using one-way ANOVA. Results Errors noted in airway dimension measurement were greater in the tube of small inner radius made of material with a high CT density and on images reconstructed by body algorithm (p<0.001), and there was some variation in error among CT scanners under different fields of view. Airway wall thickness had the maximum effect on the accuracy of measurements with all CT scanners under all scanning conditions, and the magnitude of errors for WA% and Ai varied depending on wall thickness when airways of <1.0-mm wall thickness were measured. Conclusions The parameters of airway dimensions measured were affected by airway size, reconstruction algorithm, composition of the airway phantom, and CT scanner types. In dimension measurement of small airways with wall thickness of <1.0 mm, the accuracy of measurement according to quantitative CT parameters can decrease as the walls become thinner. PMID:24116105

Differentiation of nonneoplastic and neoplastic gallbladder polyps 1 cm or bigger with multi-detector row computed tomography.

PubMed

Park, Ko Woon; Kim, Seong Hyun; Choi, Seong Ho; Lee, Won Jae

2010-01-01

To evaluate useful computed tomographic features to differentiate nonneoplastic and neoplastic gallbladder polyps 1 cm or bigger. Thirty-one patients with 32 nonneoplastic polyps and 67 patients with 73 neoplastic polyps 1 cm or bigger underwent unenhanced and dual-phase (arterial and portal venous phases) multi-detector row computed tomography. Gallbladder polyps were diagnosed by cholecystectomy. Computed tomographic features including size (1.5 cm), surface (smooth or irregular), shape (pedunculated or sessile), accompanying wall thickening, basal indentation, perception on unenhanced images, and enhancement pattern between 2 groups were compared using univariate and multivariate analyses. On univariate analysis, age 55 years or older (P = 0.0019), size bigger than 1.5 cm (P < 0.0001), irregular surface (P = 0.0033), sessile shape (P = 0.0016), accompanying wall thickening (P = 0.0056), basal indentation (P = 0.0236), and perception on unenhanced images (P < 0.0001) were significantly more frequent in neoplastic polyps as compared with nonneoplastic polyps. On multivariate analysis, size bigger than 1.5 cm (P = 0.0260), sessile shape (P = 0.0397), and perception on unenhanced images (P < 0.0001) were statistically significant. Size bigger than 1.5 cm, sessile shape, and perception on unenhanced images are the main factors that differentiate neoplastic from nonneoplastic gallbladder polyps 1 cm or bigger.

Radiological and clinical difficulties in the management of chronic maxillary sinusitis in β Thalassemic paediatric patients.

PubMed

Di Mauro, R; Greco, L; Melis, M; Manenti, G; Floris, R; Giacomini, P G; Di Girolamo, M; Di Girolamo, S

2016-05-01

Beta thalassemia is a blood dyscrasia that caused a marked expansion of active marrow spaces and extramedullary haematopoiesis results. In these patients various alterations and abnormalities affects different body areas, including increased risk of sinusitis. The marrow expansion in the facial bones results in delay in pneumatisation of the sinuses, overgrowth of the maxillae, and forward displacement of the upper incisors with skeletal deformities. In current literature, maxillary sinuses are not deeply evaluated by CT scan studies in these kind of patients. The aim of our study was to investigate the presence of maxillary sinuses abnormalities by the use of CT in patients with beta-thalassemia major and to compare these findings with a control group free from this disease. A retrospective analysis of 22 paediatric patients with beta-thalassemia major and 22 control subjects without sinonasal diseases was performed. CT was done using a 64-multidetector-row CT scanner without contrast injection, obtained in axial plane using thin-slice technique. Evaluated parameters were: bone thickness of the lateral and anterior wall, density and volume of the maxillary sinuses. Significant difference was found between the study group and control group in the evaluation of all the parameters examined. The maxillary sinus of β thalassemic patients was smaller respect of controls, the bone was more dense and thick in the side and anterior wall. Beta-thalassemic patients have a relative risk of 2.87 to develop a maxillary sinusitis. In these patients there is an increased incidence of sinonasal infections due to the abnormal development of cranio facial skeleton. These bone alterations might confuse the physicians and lead to an increased rate of sinusitis diagnoses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Heart CT scan

MedlinePlus

... Computed tomography scan - heart; Calcium scoring; Multi-detector CT scan - heart; Electron beam computed tomography - heart; Agatston ... table that slides into the center of the CT scanner. You will lie on your back with ...

Applied Imagistics of Ischaemic Heart a Survey. From the Epidemiology of Stable Angina In Order to Better Prevent Sudden Cardiac Death

NASA Astrophysics Data System (ADS)

Petruse, Radu Emanuil; Batâr, Sergiu; Cojan, Adela; Maniţiu, Ioan

2014-11-01

Coronary computed tomography angiography (CCTA) allows coronary artery visualization and the detection of coronary stenoses. In addition; it has been suggested as a novel, noninvasive modality for coronary atherosclerotic plaque detection, characterization, and quantification. Accurate identification of coronary plaques is challenging, especially for the noncalcified plaques, due to many factors such as the small size of coronary arteries, reconstruction artifacts caused by irregular heartbeats, beam hardening, and partial volume averaging. The development of 16, 32, 64 and the latest 320 row multidetector CT not only increases the spatial and the temporal resolution significantly, but also increases the number of images to be interpreted by radiologists substantially. Radiologists have to visually examine each coronary artery for suspicious stenosis using visualization tools such as multiplanar reformatting (MPR) and curved planar reformatting (CPR) provided by the review workstation in clinical practice

[Three-dimensional 3D modeling: First applications in radioanatomy and interventional radiology under CT guidance].

PubMed

Aubry, S; Pousse, A; Sarliève, P; Laborie, L; Delabrousse, E; Kastler, B

2006-11-01

To model vertebrae in 3D to improve radioanatomic knowledge of the spine with the vascular and nerve environment and simulate CT-guided interventions. Vertebra acquisitions were made with multidetector CT. We developed segmentation software and specific viewer software using the Delphi programming environment. This segmentation software makes it possible to model 3D high-resolution segments of vertebrae and their environment from multidetector CT acquisitions. Then the specific viewer software provides multiplanar reconstructions of the CT volume and the possibility to select different 3D objects of interest. This software package improves radiologists' radioanatomic knowledge through a new 3D anatomy presentation. Furthermore, the possibility of inserting virtual 3D objects in the volume can simulate CT-guided intervention. The first volumetric radioanatomic software has been born. Furthermore, it simulates CT-guided intervention and consequently has the potential to facilitate learning interventions using CT guidance.

A Comparison of the Use of Contrast Media with Different Iodine Concentrations for Multidetector CT of the Kidney

PubMed Central

Jung, Seung Chai; Cho, Jeong Yeon

2011-01-01

Objective To determine the optimal iodine concentration of contrast media for kidney multidetector computed tomography (MDCT) by comparing the degree of renal parenchymal enhancement and the severity of the renal streak artifact with contrast media of different iodine concentrations. Materials and Methods A 16-row MDCT was performed in 15 sedated rabbits by injection of 2 mL contrast media/kg body weight at a rate of 0.3 mL/sec. Monomeric nonionic contrast media of 250, 300, and 370 mg iodine/mL were injected at 1-week intervals. Mean attenuation values were measured in each renal structure with attenuation differences among the structures. The artifact was evaluated by CT window width/level and three grading methods. The values were compared with iodine concentrations. Results The 370 mg iodine/mL concentration showed significantly higher cortical enhancement than 250 mg iodine/mL in all phases (p < 0.05). There was however no significant difference in the degree of enhancement between the 300 mg iodine/mL and 370 mg iodine/mL concentrations in all phases. There is a significant difference in attenuation for the cortex-outer medulla between 250 mg iodine/mL and 300 mg iodine/mL (p < 0.05). The artifact was more severe with a medium of 370 mg iodine/mL than with 250 mg iodine/mL by all grading methods (p < 0.05). Conclusion The 300 mg iodine/mL is considered to be the most appropriate iodine concentration in an aspect of the enhancement and artifact on a kidney MDCT scan. PMID:22043154

Anatomical Variations of the Right Adrenal Vein: Concordance Between Multidetector Computed Tomography and Catheter Venography.

PubMed

Omura, Kensuke; Ota, Hideki; Takahashi, Yuuki; Matsuura, Tomonori; Seiji, Kazumasa; Arai, Yoichi; Morimoto, Ryo; Satoh, Fumitoshi; Takase, Kei

2017-03-01

Adrenal venous sampling is the most reliable diagnostic procedure to determine surgical indications in primary aldosteronism. Because guidelines recommend multidetector computed tomography (CT) to evaluate the adrenal gland, some past reports used multidetector CT as a guide for adrenal venous sampling. However, the detailed anatomy of the right adrenal vein and its relationship with an accessory hepatic vein remains uncertain. The purpose of this study was to describe detailed anatomical variations of the right adrenal vein and to determine the concordance between CT and catheter venography in patients with primary aldosteronism. In total, 440 consecutive patients who underwent adrenal venous sampling were included. Four-phase dynamic CT was performed. Anatomical locations and variations of the right adrenal vein and its relationship with the accessory hepatic vein were compared with catheter venographic findings. Successful catheterization was achieved in 437 patients (99%). The right adrenal vein was visualized in the late arterial phase with CT in 420 patients (95%). The right adrenal vein formed a common trunk with the accessory hepatic vein in 87 patients (20%). CT identified the correct craniocaudal level of the orifice in 354 patients (84%). Anatomical variations, location, and angle of inflow of the right adrenal vein based on CT demonstrated high concordance with catheter venography. CT may provide useful information for preparation before adrenal venous sampling. © 2017 American Heart Association, Inc.

Heterogeneity of pulmonary perfusion as a mechanistic image-based phenotype in emphysema susceptible smokers.

PubMed

Alford, Sara K; van Beek, Edwin J R; McLennan, Geoffrey; Hoffman, Eric A

2010-04-20

Recent evidence suggests that endothelial dysfunction and pathology of pulmonary vascular responses may serve as a precursor to smoking-associated emphysema. Although it is known that emphysematous destruction leads to vasculature changes, less is known about early regional vascular dysfunction which may contribute to and precede emphysematous changes. We sought to test the hypothesis, via multidetector row CT (MDCT) perfusion imaging, that smokers showing early signs of emphysema susceptibility have a greater heterogeneity in regional perfusion parameters than emphysema-free smokers and persons who had never smoked (NS). Assuming that all smokers have a consistent inflammatory response, increased perfusion heterogeneity in emphysema-susceptible smokers would be consistent with the notion that these subjects may have the inability to block hypoxic vasoconstriction in patchy, small regions of inflammation. Dynamic ECG-gated MDCT perfusion scans with a central bolus injection of contrast were acquired in 17 NS, 12 smokers with normal CT imaging studies (SNI), and 12 smokers with subtle CT findings of centrilobular emphysema (SCE). All subjects had normal spirometry. Quantitative image analysis determined regional perfusion parameters, pulmonary blood flow (PBF), and mean transit time (MTT). Mean and coefficient of variation were calculated, and statistical differences were assessed with one-way ANOVA. MDCT-based MTT and PBF measurements demonstrate globally increased heterogeneity in SCE subjects compared with NS and SNI subjects but demonstrate similarity between NS and SNI subjects. These findings demonstrate a functional lung-imaging measure that provides a more mechanistically oriented phenotype that differentiates smokers with and without evidence of emphysema susceptibility.

CT colonography: Project of High National Interest No. 2005062137 of the Italian Ministry of Education, University and Research (MIUR).

PubMed

Neri, E; Laghi, A; Regge, D; Sacco, P; Gallo, T; Turini, F; Talini, E; Ferrari, R; Mellaro, M; Rengo, M; Marchi, S; Caramella, D; Bartolozzi, C

2008-12-01

The aim of this paper is to describe the Web site of the Italian Project on CT Colonography (Research Project of High National Interest, PRIN No. 2005062137) and present the prototype of the online database. The Web site was created with Microsoft Office Publisher 2003 software, which allows the realisation of multiple Web pages linked through a main menu located on the home page. The Web site contains a database of computed tomography (CT) colonography studies in the Digital Imaging and Communications in Medicine (DICOM) standard, all acquired with multidetector-row CT according to the parameters defined by the European Society of Abdominal and Gastrointestinal Radiology (ESGAR). The cases present different bowel-cleansing and tagging methods, and each case has been anonymised and classified according to the Colonography Reporting and Data System (C-RADS). The Web site is available at http address www.ctcolonography.org and is composed of eight pages. Download times for a 294-Mbyte file were 33 min from a residential ADSL (6 Mbit/s) network, 200 s from a local university network (100 Mbit/s) and 2 h and 50 min from a remote academic site in the USA. The Web site received 256 accesses in the 22 days since it went online. The Web site is an immediate and up-to-date tool for publicising the activity of the research project and a valuable learning resource for CT colonography.

Trapping volumetric measurement by multidetector CT in chronic obstructive pulmonary disease: Effect of CT threshold

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

Wang, Xiaohua; Yuan, Huishu; Duan, Jianghui

2013-08-15

Purpose: The purpose of this study was to evaluate the effect of various computed tomography (CT) thresholds on trapping volumetric measurements by multidetector CT in chronic obstructive pulmonary disease (COPD).Methods: Twenty-three COPD patients were scanned with a 64-slice CT scanner in both the inspiratory and expiratory phase. CT thresholds of −950 Hu in inspiration and −950 to −890 Hu in expiration were used, after which trapping volumetric measurements were made using computer software. Trapping volume percentage (Vtrap%) under the different CT thresholds in the expiratory phase and below −950 Hu in the inspiratory phase was compared and correlated with lungmore » function.Results: Mean Vtrap% was similar under −930 Hu in the expiratory phase and below −950 Hu in the inspiratory phase, being 13.18 ± 9.66 and 13.95 ± 6.72 (both lungs), respectively; this difference was not significant (P= 0.240). Vtrap% under −950 Hu in the inspiratory phase and below the −950 to −890 Hu threshold in the expiratory phase was moderately negatively correlated with the ratio of forced expiratory volume in one second to forced vital capacity and the measured value of forced expiratory volume in one second as a percentage of the predicted value.Conclusions: Trapping volumetric measurement with multidetector CT is a promising method for the quantification of COPD. It is important to know the effect of various CT thresholds on trapping volumetric measurements.« less

The efficacy of 320-detector row computed tomography for the assessment of preoperative pulmonary vasculature of candidates for pulmonary segmentectomy.

PubMed

Tane, Shinya; Ohno, Yoshiharu; Hokka, Daisuke; Ogawa, Hiroyuki; Tauchi, Shunsuke; Nishio, Wataru; Yoshimura, Masahiro; Okita, Yutaka; Maniwa, Yoshimasa

2013-12-01

The purpose of this study was to compare the efficacy of 320-detector row computed tomography (CT) with that of 64-detector row CT for three-dimensional assessment of pulmonary vasculature of candidates for pulmonary segmentectomy. We included 32 patients who underwent both 320- and 64-detector CT before pulmonary segmentectomy, which was performed by cutting the pulmonary artery and bronchi of the affected segment followed by dissection of the intersegmental plane along the intersegmental vein. Before the operation, three-dimensional pulmonary vasculature images were obtained for each patient, and the arteries and intersegmental veins of the affected segments were identified. Two thoracic surgeons independently assessed the vessels with visual scoring systems, and kappa analysis was used to determine interobserver agreement. The Wilcoxon signed-rank test was used to compare the visual scores for the assessment of the visualization capabilities of the two methods. In addition, the final determination of pulmonary vasculature at a given site was made by consensus from thoracic surgeons during operation, and receiver operating characteristic analysis was performed to compare their efficacy of pulmonary vasculature assessment. Sensitivity, specificity and accuracy of either method were also compared by means of McNemar's test. Of the 32 cases, there were no operative complications, but 1 patient died of postoperative idiopathic interstitial pneumonia. Visualization scores for the pulmonary vessels were significantly higher for 320- than those for 64-detector CT (P < 0.0001 for the affected arteries and P < 0.0001 for the intersegmental veins). As for pulmonary vasculature assessment, the areas under the curve showed no statistically significant differences in between the two methods, while the specificity and accuracy of intersegemental vein assessment were significantly better for 320- than those for 64-detector row CT (P < 0.05). Interobserver agreement for the assessment yielded by either method was almost perfect for all cases. Three hundred and twenty-detector row CT is more useful than conventional 64-detector row CT for preoperative three-dimensional assessment of pulmonary vasculature, especially when we identify the intersegmental veins, in candidates for pulmonary segmentectomy.

Computed tomographic anatomy of the heads of blue-and-gold macaws (Ara ararauna), African grey parrots (Psittacus erithacus), and monk parakeets (Myiopsitta monachus).

PubMed

Veladiano, Irene A; Banzato, Tommaso; Bellini, Luca; Montani, Alessandro; Catania, Salvatore; Zotti, Alessandro

2016-12-01

OBJECTIVE To create an atlas of the normal CT anatomy of the head of blue-and-gold macaws (Ara ararauna), African grey parrots (Psittacus erithacus), and monk parakeets (Myiopsitta monachus). ANIMALS 3 blue-and-gold macaws, 5 African grey parrots, and 6 monk parakeets and cadavers of 4 adult blue-and-gold macaws, 4 adult African grey parrots, and 7 monk parakeets. PROCEDURES Contrast-enhanced CT imaging of the head of the live birds was performed with a 4-multidetector-row CT scanner. Cadaveric specimens were stored at -20°C until completely frozen, and each head was then sliced at 5-mm intervals to create reference cross sections. Frozen cross sections were cleaned with water and photographed on both sides. Anatomic structures within each head were identified with the aid of the available literature, labeled first on anatomic photographs, and then matched to and labeled on corresponding CT images. The best CT reconstruction filter, window width, and window level for obtaining diagnostic images of each structure were also identified. RESULTS Most of the clinically relevant structures of the head were identified in both the cross-sectional photographs and corresponding CT images. Optimal visibility of the bony structures was achieved via CT with a standard soft tissue filter and pulmonary window. The use of contrast medium allowed a thorough evaluation of the soft tissues. CONCLUSIONS AND CLINICAL RELEVANCE The labeled CT images and photographs of anatomic structures of the heads of common pet parrot species created in this study may be useful as an atlas to aid interpretation of images obtained with any imaging modality.

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.

Contrast Enhancement of the Right Ventricle during Coronary CT Angiography--Is It Necessary?

PubMed

Kok, Madeleine; Kietselaer, Bas L J H; Mihl, Casper; Altintas, Sibel; Nijssen, Estelle C; Wildberger, Joachim E; Das, Marco

2015-01-01

It is unclear if prolonged contrast media injection, to improve right ventricular visualization during coronary CT angiography, leads to increased detection of right ventricle pathology. The purpose of this study was to evaluate right ventricle enhancement and subsequent detection of right ventricle disease during coronary CT angiography. 472 consecutive patients referred for screening coronary CT angiography were retrospectively evaluated. Every patient underwent multidetector-row CT of the coronary arteries: 128x 0.6mm coll., 100-120kV, rot. time 0.28s, ref. mAs 350 and received an individualized (P3T) contrast bolus injection of iodinated contrast medium (300 mgI/ml). Patient data were analyzed to assess right ventricle enhancement (HU) and right ventricle pathology. Image quality was defined good when right ventricle enhancement >200HU, moderate when 140-200HU and poor when <140HU. Good image quality was found in 372 patients, moderate in 80 patients and poor in 20 patients. Mean enhancement of the right ventricle cavity was 268HU±102. Patients received an average bolus of 108±24 ml at an average peak flow rate of 6.1±2.2 ml/s. In only three out of 472 patients (0.63%) pathology of the right ventricle was found (dilatation) No other right ventricle pathology was detected. Right ventricle pathology was detected in three out of 472 patients; the dilatation observed in these three cases may have been picked up even without dedicated enhancement of the right ventricle. Based on our findings, right ventricle enhancement can be omitted during screening coronary CT angiography.

Life-threatening gastrointestinal system bleeding in Hodgkin disease: multidetector CT findings and review of the literature.

PubMed

Akpinar, Erhan; Türkbey, Bariş; Cil, Barbaros Erhan; Canyiğit, Murat; Dündar, Ziya; Balkanci, Ferhun

2007-06-01

Acute lower gastrointestinal system (GIS) bleeding is a life-threatening condition. Immediate determination of the origin of the bleeding is crucial, since hemostatic management must be initiated as rapidly as possible. Colonoscopy, radionuclide studies, and conventional angiography are considered the most important methods for assessing the origin of the bleeding. There are few published reports about the feasibility of computed tomography (CT) in acute GIS bleeding. We present multidetector CT (MDCT) findings in a case of Hodgkin disease status one month post-chemotherapy (CHOP protocol; cyclophosphamide, doxorubicin, vincristine, prednisone) that presented with acute lower GIS bleeding.

Multi-detector CT imaging in the postoperative orthopedic patient with metal hardware.

PubMed

Vande Berg, Bruno; Malghem, Jacques; Maldague, Baudouin; Lecouvet, Frederic

2006-12-01

Multi-detector CT imaging (MDCT) becomes routine imaging modality in the assessment of the postoperative orthopedic patients with metallic instrumentation that degrades image quality at MR imaging. This article reviews the physical basis and CT appearance of such metal-related artifacts. It also addresses the clinical value of MDCT in postoperative orthopedic patients with emphasis on fracture healing, spinal fusion or arthrodesis, and joint replacement. MDCT imaging shows limitations in the assessment of the bone marrow cavity and of the soft tissues for which MR imaging remains the imaging modality of choice despite metal-related anatomic distortions and signal alteration.

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.

Coronary artery calcium: a multi-institutional, multimanufacturer international standard for quantification at cardiac CT.

PubMed

McCollough, Cynthia H; Ulzheimer, Stefan; Halliburton, Sandra S; Shanneik, Kaiss; White, Richard D; Kalender, Willi A

2007-05-01

To develop a consensus standard for quantification of coronary artery calcium (CAC). A standard for CAC quantification was developed by a multi-institutional, multimanufacturer international consortium of cardiac radiologists, medical physicists, and industry representatives. This report specifically describes the standardization of scan acquisition and reconstruction parameters, the use of patient size-specific tube current values to achieve a prescribed image noise, and the use of the calcium mass score to eliminate scanner- and patient size-based variations. An anthropomorphic phantom containing calibration inserts and additional phantom rings were used to simulate small, medium-size, and large patients. The three phantoms were scanned by using the recommended protocols for various computed tomography (CT) systems to determine the calibration factors that relate measured CT numbers to calcium hydroxyapatite density and to determine the tube current values that yield comparable noise values. Calculation of the calcium mass score was standardized, and the variance in Agatston, volume, and mass scores was compared among CT systems. Use of the recommended scanning parameters resulted in similar noise for small, medium-size, and large phantoms with all multi-detector row CT scanners. Volume scores had greater interscanner variance than did Agatston and calcium mass scores. Use of a fixed calcium hydroxyapatite density threshold (100 mg/cm(3)), as compared with use of a fixed CT number threshold (130 HU), reduced interscanner variability in Agatston and calcium mass scores. With use of a density segmentation threshold, the calcium mass score had the smallest variance as a function of patient size. Standardized quantification of CAC yielded comparable image noise, spatial resolution, and mass scores among different patient sizes and different CT systems and facilitated reduced radiation dose for small and medium-size patients.

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.

A comparative study of FDG PET/CT and enhanced multi-detector CT for detecting liver metastasis according to the size and location.

PubMed

Park, Jung Mi; Kim, Il Young; Kim, Sang Won; Lee, Sang Mi; Kim, Hyun Gi; Kim, Shin Young; Shin, Hyung Chul

2013-04-01

The aim of this study was to compare the diagnosability between (18)F-fluorodeoxyglucose (FDG) PET/CT and enhanced multi-detector CT (MDCT) for the detection of liver metastasis (LM) according to the size and location in liver and to evaluate standard maximum standardized uptake values (SUVmax) of all liver metastatic lesions. One hundred two consecutive patients with malignancy who underwent both FDG PET/CT and MDCT for LM evaluation were retrospectively reviewed. Among them, 56 patients with LM were enrolled in this study. LM was confirmed by follow-up imaging studies after at least 6 months or by histopathology. FDG PET/CT and MDCT images were visually analyzed using three-point scale by the consensus of two radiologists and two nuclear medicine physicians. The size and location (central vs. sub-capsular) of the all liver lesions were evaluated using MDCT images. Furthermore, SUVmax of all liver lesions on FDG PET/CT images were calculated. A total of 146 liver lesions were detected by FDG PET/CT and MDCT and 142 of the lesions were diagnosed as LM. The detection rates of MDCT and FDG PET/CT for LM by visual analysis were 77 and 78%, respectively. There was no significant difference of detection rate according to the overall location and size of the lesions. However, FDG PET/CT was more sensitive than MDCT for detecting small and sub-capsular LM. The detection rate of FDG PET/CT for LM was 68% by the cutoff SUVmax of 2.7. Although the diagnosabilities of MDCT and FDG PET/CT for detecting LM were comparable, FDG PET/CT is superior to MDCT for detecting small LM located in the sub-capsular portion of liver.

The development of an automatically produced cholangiography procedure using the reconstruction of portal-phase multidetector-row computed tomography images: preliminary experience.

PubMed

Hirose, Tomoaki; Igami, Tsuyoshi; Koga, Kusuto; Hayashi, Yuichiro; Ebata, Tomoki; Yokoyama, Yukihiro; Sugawara, Gen; Mizuno, Takashi; Yamaguchi, Junpei; Mori, Kensaku; Nagino, Masato

2017-03-01

Fusion angiography using reconstructed multidetector-row computed tomography (MDCT) images, and cholangiography using reconstructed images from MDCT with a cholangiographic agent include an anatomical gap due to the different periods of MDCT scanning. To conquer such gaps, we attempted to develop a cholangiography procedure that automatically reconstructs a cholangiogram from portal-phase MDCT images. The automatically produced cholangiography procedure utilized an original software program that was developed by the Graduate School of Information Science, Nagoya University. This program structured 5 candidate biliary tracts, and automatically selected one as the candidate for cholangiography. The clinical value of the automatically produced cholangiography procedure was estimated based on a comparison with manually produced cholangiography. Automatically produced cholangiograms were reconstructed for 20 patients who underwent MDCT scanning before biliary drainage for distal biliary obstruction. The procedure showed the ability to extract the 5 main biliary branches and the 21 subsegmental biliary branches in 55 and 25 % of the cases, respectively. The extent of aberrant connections and aberrant extractions outside the biliary tract was acceptable. Among all of the cholangiograms, 5 were clinically applied with no correction, 8 were applied with modest improvements, and 3 produced a correct cholangiography before automatic selection. Although our procedure requires further improvement based on the analysis of additional patient data, it may represent an alternative to direct cholangiography in the future.

Physics of cardiac imaging with multiple-row detector CT.

PubMed

Mahesh, Mahadevappa; Cody, Dianna D

2007-01-01

Cardiac imaging with multiple-row detector computed tomography (CT) has become possible due to rapid advances in CT technologies. Images with high temporal and spatial resolution can be obtained with multiple-row detector CT scanners; however, the radiation dose associated with cardiac imaging is high. Understanding the physics of cardiac imaging with multiple-row detector CT scanners allows optimization of cardiac CT protocols in terms of image quality and radiation dose. Knowledge of the trade-offs between various scan parameters that affect image quality--such as temporal resolution, spatial resolution, and pitch--is the key to optimized cardiac CT protocols, which can minimize the radiation risks associated with these studies. Factors affecting temporal resolution include gantry rotation time, acquisition mode, and reconstruction method; factors affecting spatial resolution include detector size and reconstruction interval. Cardiac CT has the potential to become a reliable tool for noninvasive diagnosis and prevention of cardiac and coronary artery disease. (c) RSNA, 2007.

Multimodality Imaging of Ethiodized Oil–loaded Radiopaque Microspheres during Transarterial Embolization of Rabbits with VX2 Liver Tumors

PubMed Central

Tacher, Vania; Duran, Rafael; Lin, MingDe; Sohn, Jae Ho; Sharma, Karun V.; Wang, Zhijun; Chapiro, Julius; Gacchina Johnson, Carmen; Bhagat, Nikhil; Dreher, Matthew R.; Schäfer, Dirk; Woods, David L.; Lewis, Andrew L.; Tang, Yiqing; Grass, Michael; Wood, Bradford J.

2016-01-01

Purpose To assess the visibility of radiopaque microspheres during transarterial embolization (TAE) in the VX2 rabbit liver tumor model by using multimodality imaging, including single-snapshot radiography, cone-beam computed tomography (CT), multidetector CT, and micro-CT. Materials and Methods The study was approved by the institutional animal care and use committee. Fifteen VX2-tumor-bearing rabbits were assigned to three groups depending on the type of embolic agent injected: 70–150-μm radiopaque microspheres in saline (radiopaque microsphere group), 70–150-μm radiopaque microspheres in contrast material (radiopaque microsphere plus contrast material group), and 70–150-μm radiolucent microspheres in contrast material (nonradiopaque microsphere plus contrast material group). Rabbits were imaged with single-snapshot radiography, cone-beam CT, and multidetector CT. Three to 5 weeks after sacrifice, excised livers were imaged with micro-CT and histologic analysis was performed. The visibility of the embolic agent was assessed with all modalities before and after embolization by using a qualitative three-point scale score reading study and a quantitative assessment of the signal-to-noise ratio (SNR) change in various regions of interest, including the tumor and its feeding arteries. The Kruskal-Wallis test was used to compare the rabbit characteristics across groups, and the Wilcoxon signed rank test was used to compare SNR measurements before and after embolization. Results Radiopaque microspheres were qualitatively visualized within tumor feeding arteries and targeted tissue with all imaging modalities (P < .05), and their presence was confirmed with histologic examination. SNRs of radiopaque microsphere deposition increased after TAE on multidetector CT, cone-beam CT, and micro-CT images (P < .05). Similar results were obtained when contrast material was added to radiopaque microspheres, except for additional image attenuation due to tumor enhancement. For the group with nonradiopaque microspheres and contrast material, retained tumoral contrast remained qualitatively visible with all modalities except for micro-CT, which demonstrated soluble contrast material washout over time. Conclusion Radiopaque microspheres were visible with all imaging modalities and helped increase conspicuity of the tumor as well as its feeding arteries after TAE in a rabbit VX2 liver tumor model. © RSNA, 2015 PMID:26678453

Quantitative colorectal cancer perfusion measurement by multidetector-row CT: does greater tumour coverage improve measurement reproducibility?

PubMed

Goh, V; Halligan, S; Gartner, L; Bassett, P; Bartram, C I

2006-07-01

The purpose of this study was to determine if greater z-axis tumour coverage improves the reproducibility of quantitative colorectal cancer perfusion measurements using CT. A 65 s perfusion study was acquired following intravenous contrast administration in 10 patients with proven colorectal cancer using a four-detector row scanner. This was repeated within 48 h using identical technical parameters to allow reproducibility assessment. Quantitative tumour blood volume, blood flow, mean transit time and permeability measurements were determined using commercially available software (Perfusion 3.0; GE Healthcare, Waukesha, WI) for data obtained from a 5 mm z-axis tumour coverage, and from a 20 mm z-axis tumour coverage. Measurement reproducibility was assessed using Bland-Altman statistics, for a 5 mm z-axis tumour coverage, and 20 mm z-axis tumour coverage, respectively. The mean difference (95% limits of agreement) for blood volume, blood flow, mean transit time and permeability were 0.04 (-2.50 to +2.43) ml/100 g tissue; +8.80 (-50.5 to +68.0) ml/100 g tissue/min; -0.99 (-8.19 to +6.20) seconds; and +1.20 (-5.42 to +7.83) ml/100 g tissue/min, respectively, for a 5 mm coverage, and -0.04 (-2.61 to +2.53) ml/100 g tissue; +7.40 (-50.3 to +65.0) ml/100 g tissue/min; -2.46 (-12.61 to +7.69) seconds; and -0.23 (-8.31 to +7.85) ml/100 g tissue/min, respectively, for a 20 mm coverage, indicating similar levels of agreement. In conclusion, increasing z-axis coverage does not improve reproducibility of quantitative colorectal cancer perfusion measurements.

Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

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

Cunningham, Jane D., E-mail: janecunningham0708@gmail.com; McCusker, Mark W.; Power, Sarah

PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neckmore » lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.« less

Pulmonary nodules: effect of adaptive statistical iterative reconstruction (ASIR) technique on performance of a computer-aided detection (CAD) system-comparison of performance between different-dose CT scans.

PubMed

Yanagawa, Masahiro; Honda, Osamu; Kikuyama, Ayano; Gyobu, Tomoko; Sumikawa, Hiromitsu; Koyama, Mitsuhiro; Tomiyama, Noriyuki

2012-10-01

To evaluate the effects of ASIR on CAD system of pulmonary nodules using clinical routine-dose CT and lower-dose CT. Thirty-five patients (body mass index, 22.17 ± 4.37 kg/m(2)) were scanned by multidetector-row CT with tube currents (clinical routine-dose CT, automatically adjusted mA; lower-dose CT, 10 mA) and X-ray voltage (120 kVp). Each 0.625-mm-thick image was reconstructed at 0%-, 50%-, and 100%-ASIR: 0%-ASIR is reconstructed using only the filtered back-projection algorithm (FBP), while 100%-ASIR is reconstructed using the maximum ASIR and 50%-ASIR implies a blending of 50% FBP and ASIR. CAD output was compared retrospectively with the results of the reference standard which was established using a consensus panel of three radiologists. Data were analyzed using Bonferroni/Dunn's method. Radiation dose was calculated by multiplying dose-length product by conversion coefficient of 0.021. The consensus panel found 265 non-calcified nodules ≤ 30 mm (ground-glass opacity [GGO], 103; part-solid, 34; and solid, 128). CAD sensitivity was significantly higher at 100%-ASIR [clinical routine-dose CT, 71% (overall), 49% (GGO); lower-dose CT, 52% (overall), 67% (solid)] than at 0%-ASIR [clinical routine-dose CT, 54% (overall), 25% (GGO); lower-dose CT, 36% (overall), 50% (solid)] (p<0.001). Mean number of false-positive findings per examination was significantly higher at 100%-ASIR (clinical routine-dose CT, 8.5; lower-dose CT, 6.2) than at 0%-ASIR (clinical routine-dose CT, 4.6; lower-dose CT, 3.5; p<0.001). Effective doses were 10.77 ± 3.41 mSv in clinical routine-dose CT and 2.67 ± 0.17 mSv in lower-dose CT. CAD sensitivity at 100%-ASIR on lower-dose CT is almost equal to that at 0%-ASIR on clinical routine-dose CT. ASIR can increase CAD sensitivity despite increased false-positive findings. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Gadopentetate dimeglumine is potentially an alternative contrast agent for three-dimensional computed tomography angiography with multidetector-row helical scanning.

PubMed

Gupta, Atul K; Alberico, Ronald A; Litwin, Alan; Kanter, Peter; Grossman, Zachary D

2002-01-01

To demonstrate that gadopentetate dimeglumine is potentially an alternative contrast medium for computed tomographic angiography (CTA). One 12.2-kg Beagle dog was studied as proof of principle; the cervical vessels of three adult human patients were imaged for presurgical planning of the neck. Gadopentetate dimeglumine, 0.5 mol/l (Berlex Laboratories, Wayne, NJ, U.S.A.), a LightSpeed QX/i CT (General Electric Medical Systems, Milwaukee, WI, U.S.A.), and an Ultra Sparc II (SUN Microsystems, Santa Clara, CA, U.S.A.) running Advantage Windows 3.1 (General Electric Medical Systems) were used. Sufficient enhancement for CTA of the thoracic aorta, cervical vessels, and abdominal vessels was produced in the experimental dog, and the cervical vessels were clearly defined in all three patients. In that subset of patients with contraindications to iodinated contrast medium and for whom magnetic resonance angiography is inappropriate, gadopentetate dimeglumine may be an alternative contrast medium for CTA.

Reduction of thoracic aorta motion artifact with high-pitch 128-slice dual-source computed tomographic angiography: a historical control study.

PubMed

Nakagawa, Junichiro; Tasaki, Osamu; Watanabe, Yoshiyuki; Azuma, Takeo; Ohnishi, Mitsuo; Ukai, Isao; Tahara, Kenichi; Ogura, Hiroshi; Kuwagata, Yasuyuki; Hamasaki, Toshimitsu; Shimazu, Takeshi

2013-01-01

Electrocardiogram-gated imaging combined with multi-detector row computed tomography (MDCT) has reduced cardiac motion artifacts, but it was not practical in the emergency setting. The purpose of this study was to evaluate the ability of a high-pitch, 128-slice dual-source CT (DSCT) scanner to reduce motion artifacts in patients admitted to the emergency room. This study comprised 100 patients suspected of having thoracic aorta lesions. We examined 47 patients with the 128-slice DSCT scanner (DSCT group), and 53 patients were examined with a 64-slice MDCT scanner (MDCT group). Six anatomic areas in the thoracic aorta were evaluated. Computed tomography images in the DSCT group were distinct, and significant differences were observed in images of all areas between the 2 groups except for the descending aorta. The high-pitch DSCT scanner can reduce motion artifacts of the thoracic aorta and enable radiological diagnosis even in patients with tachycardia and without breath hold.

Prevalence of myocardial bridging detected with 64-slice multidetector coronary computed tomography angiography in asymptomatic adults.

PubMed

Atar, Eli; Kornowski, Ran; Fuchs, Shmuell; Naftali, Noa; Belenky, Alexander; Bachar, Gil N

2007-10-01

Myocardial bridging is a congenital condition in which a segment of an epicardial artery has an intramural course within the myocardium. The aim of the present study was to evaluate the prevalence of myocardial bridging and the ability of 64-slice coronary computed tomography angiography to identify myocardial bridging in asymptomatic adults. One hundred sixty-nine consecutive asymptomatic subjects underwent 64-row multidetector computed tomography (MDCT) of the coronary arteries. Two experienced CT radiologists identified myocardial bridging >1 mm in thickness, by consensus. We examined the frequency of myocardial bridging and evaluated the length, thickness, and coronary wall lesions. Myocardial bridges were found in 28 (17%) of 165 subjects. Twenty-one subjects (75%) had 1 bridge and 7 subjects (25%) had 2, for a total of 35 myocardial bridges. Twenty-one bridges (60%) were located in the left anterior descending, 8.5% in the diagonal branch, and 2.8% in the circumflex arteries. The segment beneath the myocardial bridge was always free of coronary wall plaques, but the arterial segment proximal to it had significant coronary wall plaques in 24 cases (68.6%). We found that the incidence of myocardial bridging in asymptomatic adults is 7%, which is in agreement with some pathologic studies in the literature. Our study shows that MDCT of the coronary arteries is a reliable and noninvasive technique, which can accurately locate the site of myocardial bridging, and measure its thickness, course, and length.

Correlation between preoperative tomographic staging and definitive histopathologic results in gastric cancer at the Hospital Central Militar.

PubMed

López-Ramírez, M A; Lever-Rosas, C D; Motta-Ramírez, G A; Rebollo-Hurtado, V; Guzmán-Bárcenas, J; Fonseca-Morales, J V; Carreño-Lomeli, M A

In relation to the number of new cases diagnosed, gastric cancer is the fourth most common cancer worldwide, and the second cause of cancer death. The development of multidetector tomography has improved the preoperative staging of gastric cancer. To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system. A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients. They all had upper endoscopy and preoperative multidetector tomography examinations, underwent surgical resection, and had the corresponding histopathology study. Statistical analysis was carried out with the SPSS version 15.0 software and the sensitivity and specificity calculations were made using the Excel 2011 program for Mac. The majority of the patients included in the case series had clinical stage iii and iv disease. When compared with the histopathologic result, the overall accuracy of multidetector CT was 83% (T0 96%, T1 94%, T2 93%, T3 67%, and T4 67%) for tumor size (T) and was 70% (N0 72%, N1 73%, N2 70%, and N3 66%) for lymph node involvement (N). Overall sensitivity was 48% (T0 100%, T1 0%, T2 33%, T3 44%, and T4 65%) for T and was 41% (N0 58%, N1 56%, N2 15%, and N3 35%) for N. A strong association between the multidetector CT results and the pathology results was demonstrated through the Spearman's correlation, especially in T4 and N3. Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

PubMed Central

Tonolini, Massimo

2016-01-01

Inguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since radiologists are increasingly requested to investigate suspected iatrogenic complications, this paper aims to provide an increased familiarity with early CT studies after IHR, including complications and normal postoperative appearances such as focal pseudolesions, in order to avoid misinterpretation and inappropriate management. PMID:27460285

Imaging of patent foramen ovale with 64-section multidetector CT.

PubMed

Saremi, Farhood; Channual, Stephanie; Raney, Aidan; Gurudevan, Swaminatha V; Narula, Jagat; Fowler, Steven; Abolhoda, Amir; Milliken, Jeffrey C

2008-11-01

To investigate the feasibility of 64-section multidetector computed tomography (CT) by using CT angiography (a) to demonstrate anatomic detail of the interatrial septum pertinent to the patent foramen ovale (PFO), and (b) to visually detect left-to-right PFO shunts and compare these findings in patients who also underwent transesophageal echocardiography (TEE). In this institutional review board-approved HIPAA-compliant study, electrocardiographically gated coronary CT angiograms in 264 patients (159 men, 105 women; mean age, 60 years) were reviewed for PFO morphologic features. The length and diameter of the opening of the PFO tunnel, presence of atrial septal aneurysm (ASA), and PFO shunts were evaluated. A left-to-right shunt was assigned a grade according to length of contrast agent jet (grade 1, 1 cm to 2 cm; grade 3, >2 cm). In addition, 23 patients who underwent both modalities were compared (Student t test and linear regression analysis). A difference with P < .05 was significant. A flap valve, seen in 101 (38.3%) patients, was patent at the entry into the right atrium (PFO) in 62 patients (61.4% of patients with flap valve, 23.5% of total patients). A left-to-right shunt was detected in 44 (16.7% of total) patients (grade 1, 61.4%; grade 2, 34.1%; grade 3, 4.5%). No shunt was seen in patients without a flap valve. Mean length of PFO tunnel was 7.1 mm in 44 patients with a shunt and 12.1 mm in 57 patients with a flap valve without a shunt (P < .0001). In patients with a tunnel length of 6 mm or shorter, 92.6% of the shunts were seen. ASA was seen in 11 (4.2%) patients; of these patients, a shunt was seen in seven (63.6%). In 23 patients who underwent CT angiography and TEE, both modalities showed a PFO shunt in seven. Multidetector CT provides detailed anatomic information about size, morphologic features, and shunt grade of the PFO. Shorter tunnel length and septal aneurysms are frequently associated with left-to-right shunts in patients with PFO. (c) RSNA, 2008.

Postmortem dynamic cerebral angiography for detecting aneurysm and bleeding sites in cases of subarachnoid hemorrhage.

PubMed

Inokuchi, Go; Yajima, Daisuke; Hayakawa, Mutsumi; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Makino, Yohsuke; Iwase, Hirotaro

2014-12-01

One of the advantages of postmortem imaging is its ability to obtain diagnostic findings in a non-destructive manner when autopsy is either difficult or may destroy forensic evidence. In recent years, efforts have been made to incorporate computed tomography (CT) based postmortem angiography into forensic pathology; however, it is not currently clear how well the modality can determine sites of bleeding in cases of subarachnoid hemorrhage. Therefore, in this study, we investigated the utility of postmortem cerebral angiography using multi-detector row CT (MDCT) by injecting a contrast medium through a catheter inserted into the internal carotid and vertebral arteries of 10 subarachnoid hemorrhage cases. While postmortem MDCT angiography (PMCTA) was capable of detecting aneurysms in a non-destructive manner, it was sometimes difficult to identify the aneurysm and bleeding sites because of a large amount of contrast medium leaking into the extravascular space. To overcome this problem, we developed the novel contrast imaging method "dynamic cerebral angiography," which involves scanning the same area multiple times while injecting contrast medium to enable real-time observation of the contrasted vasculature. Using multiphase contrast images acquired by this method, we successfully captured the moment when contrast medium leaked from the hemorrhage site. This method will be useful for identifying exact bleeding sites on PMCTA.

Multidetector row computed tomography and ultrasound characteristics of caudal vena cava duplication in dogs.

PubMed

Bertolini, Giovanna; Diana, Alessia; Cipone, Mario; Drigo, Michele; Caldin, Marco

2014-01-01

Caudal vena cava duplication has been rarely reported in small animals. The purpose of this retrospective study was to describe characteristics of duplicated caudal vena cava in a large group of dogs. Computed tomography (CT) and ultrasound databases from two hospitals were searched for canine reports having the diagnosis "double caudal vena cava." One observer reviewed CT images for 71 dogs and two observers reviewed ultrasound images for 21 dogs. In all CT cases, the duplication comprised two vessels that were bilaterally symmetrical and approximately the same calibre (similar to Type I complete duplication in humans). In all ultrasound cases, the duplicated caudal vena cava appeared as a distinct vessel running on the left side of the abdominal segment of the descending aorta and extending from the left common iliac vein to the left renal vein. The prevalence of caudal vena cava duplication was 0.46% for canine ultrasound studies and 2.08% for canine CT studies performed at these hospitals. Median body weight for affected dogs was significantly lower than that of unaffected dogs (P < 0.0001). Breeds with increased risk for duplicated caudal vena cava were Yorkshire Terrier (odds ratio [OR] = 6.41), Poodle (OR = 7.46), West Highland White Terrier (OR = 6.33), and Maltese (OR = 3.87). Presence of a duplicated caudal vena cava was significantly associated with presence of extrahepatic portosystemic shunt(s) (P < 0.004). While uncommon in dogs, caudal vena cava duplication should be differentiated from other vascular anomalies when planning surgeries and for avoiding misdiagnoses. © 2014 American College of Veterinary Radiology.

Assessment of regional ventilation and deformation using 4D-CT imaging for healthy human lungs during tidal breathing

PubMed Central

Jahani, Nariman; Choi, Jiwoong; Iyer, Krishna; Hoffman, Eric A.

2015-01-01

This study aims to assess regional ventilation, nonlinearity, and hysteresis of human lungs during dynamic breathing via image registration of four-dimensional computed tomography (4D-CT) scans. Six healthy adult humans were studied by spiral multidetector-row CT during controlled tidal breathing as well as during total lung capacity and functional residual capacity breath holds. Static images were utilized to contrast static vs. dynamic (deep vs. tidal) breathing. A rolling-seal piston system was employed to maintain consistent tidal breathing during 4D-CT spiral image acquisition, providing required between-breath consistency for physiologically meaningful reconstructed respiratory motion. Registration-derived variables including local air volume and anisotropic deformation index (ADI, an indicator of preferential deformation in response to local force) were employed to assess regional ventilation and lung deformation. Lobar distributions of air volume change during tidal breathing were correlated with those of deep breathing (R2 ≈ 0.84). Small discrepancies between tidal and deep breathing were shown to be likely due to different distributions of air volume change in the left and the right lungs. We also demonstrated an asymmetric characteristic of flow rate between inhalation and exhalation. With ADI, we were able to quantify nonlinearity and hysteresis of lung deformation that can only be captured in dynamic images. Nonlinearity quantified by ADI is greater during inhalation, and it is stronger in the lower lobes (P < 0.05). Lung hysteresis estimated by the difference of ADI between inhalation and exhalation is more significant in the right lungs than that in the left lungs. PMID:26316512

Comparative evaluation of image quality among different detector configurations using area detector computed tomography.

PubMed

Miura, Yohei; Ichikawa, Katsuhiro; Fujimura, Ichiro; Hara, Takanori; Hoshino, Takashi; Niwa, Shinji; Funahashi, Masao

2018-03-01

The 320-detector row computed tomography (CT) system, i.e., the area detector CT (ADCT), can perform helical scanning with detector configurations of 4-, 16-, 32-, 64-, 80-, 100-, and 160-detector rows for routine CT examinations. This phantom study aimed to compare the quality of images obtained using helical scan mode with different detector configurations. The image quality was measured using modulation transfer function (MTF) and noise power spectrum (NPS). The system performance function (SP), based on the pre-whitening theorem, was calculated as MTF 2 /NPS, and compared between configurations. Five detector configurations, i.e., 0.5 × 16 mm (16 row), 0.5 × 64 mm (64 row), 0.5 × 80 mm (80 row), 0.5 × 100 mm (100 row), and 0.5 × 160 mm (160 row), were compared using a constant volume CT dose index (CTDI vol ) of 25 mGy, simulating the scan of an adult abdomen, and with a constant effective mAs value. The MTF was measured using the wire method, and the NPS was measured from images of a 20-cm diameter phantom with uniform content. The SP of 80-row configuration was the best, for the constant CTDI vol , followed by the 64-, 160-, 16-, and 100-row configurations. The decrease in the rate of the 100- and 160-row configurations from the 80-row configuration was approximately 30%. For the constant effective mAs, the SPs of the 100-row and 160-row configurations were significantly lower, compared with the other three detector configurations. The 80- and 64-row configurations were adequate in cases that required dose efficiency rather than scan speed.

Initial clinical experience with a 64-MDCT whole-body scanner in an emergency department: better time management and diagnostic quality?

PubMed

Rieger, Michael; Czermak, Benedikt; El Attal, Rene; Sumann, Günther; Jaschke, Werner; Freund, Martin

2009-03-01

The objective of this study was to assess time management and diagnostic quality when using a 64-multidetector-row computed tomography (MDCT) whole-body scanner to evaluate polytraumatized patients in an emergency department. Eighty-eight consecutive polytraumatized patients with injury severity score (ISS) > or = 18 (mean ISS = 29) were included in this study. Documented and evaluated data were crash history, trauma mechanism, number and pattern of injuries, injury severity, diagnostics, time flow, and missed diagnoses. Data were stored in our hospital information system. Seven time intervals were evaluated. In particular, attention was paid to the "acquisition interval," the "reformatting and evaluation time" as well as the "CT time" (time from CT start to preliminary diagnosis). A standardized whole-body CT was performed. The acquired CT data together with automatically generated multiplanar reformatted images ("direct MPR") were transferred to a 3D rendering workstation. Diagnostic quality was determined on the basis of missed diagnoses. Head-to-toe scout images were possible because volume coverage was up to 2 m. Experienced radiologists at an affiliated workstation performed radiologic evaluation of the acquired datasets immediately after acquisition. The "acquisition interval" was 12 minutes +/- 4.9 minutes, the "reformatting and evaluation interval" 7.0 minutes +/- 2.1 minutes, and the "CT time" 19 minutes +/- 6.1 minutes. Altogether, 7 of 486 lesions were recognized but not communicated in the "reformatting and evaluation interval", and 10 injuries were initially missed and detected during follow-up. This study indicates that 64-MDCT saves time, especially in the "reformatting and evaluation interval." Diagnostic quality is high, as reflected by the small number of missed diagnoses.

Imaging in traumatic mandibular fractures

PubMed Central

Gemal, Hugo; Reed, Duncan

2017-01-01

A fracture of the mandible is a common trauma presentation amongst young males and represents one of the most frequently encountered fractured bones within the viscerocranium. Historically, assault was the dominant contributing factor but now due to the increased number of vehicles used per capita, motor vehicle accidents are the primary cause. Mandibular fractures can be classified anatomically, by dentition, by muscle group and by severity. The fracture may also be closed, open, comminuted, displaced or pathological. It is important that the imaging modality used identifies the classification as this will decide definitive treatment. X-ray projections have typically been used to detect a mandibular fracture, but are limited to an anteroposterior (AP), lateral and oblique view in an unstable trauma patient. These views are inadequate to detail the level of fracture displacement and show poor detail of the condylar region. Computer tomography (CT) is the imaging modality of choice when assessing a traumatic mandibular injury and can demonstrate a 100% sensitivity in detecting a fracture. This is through use of a multidetector-row CT, which reduces motion blur and therefore produces accurate coronal and sagittal reconstructions. Furthermore, reconstructive three-dimensional CT images gained from planar views, allows a better understanding of the spatial relationship of the fracture with other anatomical landmarks. This ensures a better appreciation of the severity and classification of a mandibular fracture, which therefore influences operative planning. Ultrasound is another useful modality in detecting a mandibular fracture when the patient is too unstable to be transferred to a CT scanner. The sensitivity however is less in comparison to a CT series of images and provides limited detail on the fracture pattern. Magnetic resonance imaging demonstrates use in assessing soft tissue injury of the temporomandibular joint but this is unlikely to be of priority when initially assessing a trauma patient. PMID:28932703

Contrast-enhanced multidetector computerized tomography for odontogenic cysts and cystic-appearing tumors of the jaws: is it useful?

PubMed

Kakimoto, Naoya; Chindasombatjaroen, Jira; Tomita, Seiki; Shimamoto, Hiroaki; Uchiyama, Yuka; Hasegawa, Yoko; Kishino, Mitsunobu; Murakami, Shumei; Furukawa, Souhei

2013-01-01

The purpose of this study was to investigate the usefulness of computerized tomography (CT), particularly contrast-enhanced CT, in differentiation of jaw cysts and cystic-appearing tumors. We retrospectively analyzed contrast-enhanced CT images of 90 patients with odontogenic jaw cysts or cystic-appearing tumors. The lesion size and CT values were measured and the short axis to long axis (S/L) ratio, contrast enhancement (CE) ratio, and standard deviation ratio were calculated. The lesion size and the S/L ratio of keratocystic odontogenic tumors were significantly different from those of radicular cysts and follicular cysts. There were no significant differences in the CE ratio among the lesions. Multidetector CT provided diagnostic information about the size of odontogenic cysts and cystic-appearing tumors of the jaws that was related to the lesion type, but showed no relation between CE ratio and the type of these lesions. Copyright © 2013 Elsevier Inc. All rights reserved.

Broad ligament hernia successfully treated by laparoscopy: Case report and review of literature.

PubMed

Matsunami, Masatoshi; Kusanagi, Hiroshi; Hayashi, Ken; Yamada, Shigetoshi; Kano, Nobuyasu

2014-11-01

We report a case of a 36-year-old woman with a history of caesarean section who presented with small bowel obstruction. Abdominal multi-detector CT showed discontinuity of the small bowel near the broad ligament on the left. We made a provisional diagnosis of an internal hernia through a defect in the broad ligament and performed laparoscopic exploration, which revealed a viable ileal loop incarcerated by the broad ligament. Multi-detector CT may be useful for diagnosing this type of defect preoperatively, whereby open surgery can be avoided. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

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.

Evaluation of computer-aided diagnosis (CAD) software for the detection of lung nodules on multidetector row computed tomography (MDCT): JAFROC study for the improvement in radiologists' diagnostic accuracy.

PubMed

Hirose, Tomohiro; Nitta, Norihisa; Shiraishi, Junji; Nagatani, Yukihiro; Takahashi, Masashi; Murata, Kiyoshi

2008-12-01

The aim of this study was to evaluate the usefulness of computer-aided diagnosis (CAD) software for the detection of lung nodules on multidetector-row computed tomography (MDCT) in terms of improvement in radiologists' diagnostic accuracy in detecting lung nodules, using jackknife free-response receiver-operating characteristic (JAFROC) analysis. Twenty-one patients (6 without and 15 with lung nodules) were selected randomly from 120 consecutive thoracic computed tomographic examinations. The gold standard for the presence or absence of nodules in the observer study was determined by consensus of two radiologists. Six expert radiologists participated in a free-response receiver operating characteristic study for the detection of lung nodules on MDCT, in which cases were interpreted first without and then with the output of CAD software. Radiologists were asked to indicate the locations of lung nodule candidates on the monitor with their confidence ratings for the presence of lung nodules. The performance of the CAD software indicated that the sensitivity in detecting lung nodules was 71.4%, with 0.95 false-positive results per case. When radiologists used the CAD software, the average sensitivity improved from 39.5% to 81.0%, with an increase in the average number of false-positive results from 0.14 to 0.89 per case. The average figure-of-merit values for the six radiologists were 0.390 without and 0.845 with the output of the CAD software, and there was a statistically significant difference (P < .0001) using the JAFROC analysis. The CAD software for the detection of lung nodules on MDCT has the potential to assist radiologists by increasing their accuracy.

Morphometric analysis of sex differences in contemporary Japanese pelves using multidetector computed tomography.

PubMed

Torimitsu, Suguru; Makino, Yohsuke; Saitoh, Hisako; Sakuma, Ayaka; Ishii, Namiko; Yajima, Daisuke; Inokuchi, Go; Motomura, Ayumi; Chiba, Fumiko; Yamaguchi, Rutsuko; Hashimoto, Mari; Hoshioka, Yumi; Iwase, Hirotaro

2015-12-01

Sex estimation of decomposed or skeletal remains is clearly important in forensic contexts. Recently, contemporary population-specific data has been obtained using multidetector computed tomography (MDCT) scanning. The main purpose of this study was to investigate skeletal pelvic dimorphism in a contemporary Japanese forensic sample and to quantify the accuracy of sex estimation using various pelvic measurements obtained from three-dimensional (3D) CT images. This study used a total of 208 cadavers (104 males, 104 females) of which postmortem CT scanning and subsequent forensic autopsy were conducted between December 2011 and August 2014. Eleven measurements of each pelvis were obtained from 3D CT reconstructed images that extracted only bone data. The measurements were analyzed using descriptive statistics and discriminant function analyses. All except one measurement were dimorphic in terms of sex differences. Univariate discriminant function analyses using these measurements provided sex classification accuracy rates of 62.0-98.1%. The subpubic angle was found to contribute most significantly to accurate sex estimation. Multivariate discriminant functions yielded sex prediction accuracy rates of 63.9-98.1%. In conclusion, the pelvic measurements obtained from 3D CT images of a contemporary Japanese population successfully demonstrated sexual dimorphism and may be useful for the estimation of skeletal sex in the field of forensic anthropology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Sensitivity and specificity of 3-D texture analysis of lung parenchyma is better than 2-D for discrimination of lung pathology in stage 0 COPD

NASA Astrophysics Data System (ADS)

Xu, Ye; Sonka, Milan; McLennan, Geoffrey; Guo, Junfeng; Hoffman, Eric

2005-04-01

Lung parenchyma evaluation via multidetector-row CT (MDCT), has significantly altered clinical practice in the early detection of lung disease. Our goal is to enhance our texture-based tissue classification ability to differentiate early pathologic processes by extending our 2-D Adaptive Multiple Feature Method (AMFM) to 3-D AMFM. We performed MDCT on 34 human volunteers in five categories: emphysema in severe Chronic Obstructive Pulmonary Disease (COPD) as EC, emphysema in mild COPD (MC), normal appearing lung in COPD (NC), non-smokers with normal lung function (NN), smokers with normal function (NS). We volumetrically excluded the airway and vessel regions, calculated 24 volumetric texture features for each Volume of Interest (VOI); and used Bayesian rules for discrimination. Leave-one-out and half-half methods were used for testing. Sensitivity, specificity and accuracy were calculated. The accuracy of the leave-one-out method for the four-class classification in the form of 3-D/2-D is: EC: 84.9%/70.7%, MC: 89.8%/82.7%; NC: 87.5.0%/49.6%; NN: 100.0%/60.0%. The accuracy of the leave-one-out method for the two-class classification in the form of 3-D/2-D is: NN: 99.3%/71.6%; NS: 99.7%/74.5%. We conclude that 3-D AMFM analysis of the lung parenchyma improves discrimination compared to 2-D analysis of the same images.

Multidetector computed tomographic pulmonary angiography in patients with a high clinical probability of pulmonary embolism.

PubMed

Moores, L; Kline, J; Portillo, A K; Resano, S; Vicente, A; Arrieta, P; Corres, J; Tapson, V; Yusen, R D; Jiménez, D

2016-01-01

ESSENTIALS: When high probability of pulmonary embolism (PE), sensitivity of computed tomography (CT) is unclear. We investigated the sensitivity of multidetector CT among 134 patients with a high probability of PE. A normal CT alone may not safely exclude PE in patients with a high clinical pretest probability. In patients with no clear alternative diagnosis after CTPA, further testing should be strongly considered. Whether patients with a negative multidetector computed tomographic pulmonary angiography (CTPA) result and a high clinical pretest probability of pulmonary embolism (PE) should be further investigated is controversial. This was a prospective investigation of the sensitivity of multidetector CTPA among patients with a priori clinical assessment of a high probability of PE according to the Wells criteria. Among patients with a negative CTPA result, the diagnosis of PE required at least one of the following conditions: ventilation/perfusion lung scan showing a high probability of PE in a patient with no history of PE, abnormal findings on venous ultrasonography in a patient without previous deep vein thrombosis at that site, or the occurrence of venous thromboembolism (VTE) in a 3-month follow-up period after anticoagulation was withheld because of a negative multidetector CTPA result. We identified 498 patients with a priori clinical assessment of a high probability of PE and a completed CTPA study. CTPA excluded PE in 134 patients; in these patients, the pooled incidence of VTE was 5.2% (seven of 134 patients; 95% confidence interval [CI] 1.5-9.0). Five patients had VTEs that were confirmed by an additional imaging test despite a negative CTPA result (five of 48 patients; 10.4%; 95% CI 1.8-19.1), and two patients had objectively confirmed VTEs that occurred during clinical follow-up of at least 3 months (two of 86 patients; 2.3%; 95% CI 0-5.5). None of the patients had a fatal PE during follow-up. A normal multidetector CTPA result alone may not safely exclude PE in patients with a high clinical pretest probability. © 2015 International Society on Thrombosis and Haemostasis.

CT liver volumetry using three-dimensional image data in living donor liver transplantation: Effects of slice thickness on volume calculation

PubMed Central

Hori, Masatoshi; Suzuki, Kenji; Epstein, Mark L.; Baron, Richard L.

2011-01-01

The purpose was to evaluate a relationship between slice thickness and calculated volume on CT liver volumetry by comparing the results for images with various slice thicknesses including three-dimensional images. Twenty adult potential liver donors (12 men, 8 women; mean age, 39 years; range, 24–64) underwent CT with a 64-section multi-detector row CT scanner after intra-venous injection of contrast material. Four image sets with slice thicknesses of 0.625 mm, 2.5 mm, 5 mm, and 10 mm were used. First, a program developed in our laboratory for automated liver extraction was applied to CT images, and the liver boundary was obtained automatically. Then, an abdominal radiologist reviewed all images on which automatically extracted boundaries were superimposed, and edited the boundary on each slice to enhance the accuracy. Liver volumes were determined by counting of the voxels within the liver boundary. Mean whole liver volumes estimated with CT were 1322.5 cm3 on 0.625-mm, 1313.3 cm3 on 2.5-mm, 1310.3 cm3 on 5-mm, and 1268.2 cm3 on 10-mm images. Volumes calculated for three-dimensional (0.625-mm-thick) images were significantly larger than those for thicker images (P<.0001). Partial liver volumes of right lobe, left lobe, and lateral segment were also evaluated in a similar manner. Estimated maximum differences in calculated volumes of lateral segment was −10.9 cm3 (−4.6%) between 0.625-mm and 5-mm images. In conclusion, liver volumes calculated on 2.5-mm or thicker images were significantly smaller than volumes calculated on three-dimensional images. If a maximum error of 5% in the calculated graft volume is within the range of having an insignificant clinical impact, 5-mm thick images are acceptable for CT volumetry. If not, three-dimensional images could be essential. PMID:21850689

MDCT detection of anomalous origins of the left main coronary artery: report of 2 cases.

PubMed

Matsumoto, Naoya; Sato, Yuichi; Kunimasa, Taeko; Yoda, Shunichi; Yokoyama, Shinichiro; Takayama, Tadateru; Komatsu, Sei; Achenbach, Stephan; Saito, Satoshi; Hirayama, Atsushi

2008-11-28

The left main coronary artery (LMCA) arising either from the right sinus of Valsalva, separately from the right coronary artery (RCA), or from the RCA as a single coronary artery is an extremely rare coronary artery anomaly. We report 2 cases of anomalous origins of the LMCA detected by multidetector-row computed tomography.

Automated contrast medium monitoring system for computed tomography--Intra-institutional audit.

PubMed

Lauretti, Dario Luca; Neri, Emanuele; Faggioni, Lorenzo; Paolicchi, Fabio; Caramella, Davide; Bartolozzi, Carlo

2015-12-01

The aim of this study was to analyze the usage and the data recorded by a RIS-PACS-connected contrast medium (CM) monitoring system (Certegra(®), Bayer Healthcare, Leverkusen, Germany) over 19 months of CT activity. The system used was connected to two dual syringe power injectors (each associated with a 16-row and a high definition 64-row multidetector CT scanner, respectively), allowing to manage contrast medium injection parameters and to send and retrieve CT study-related information via RIS/PACS for any scheduled contrast-enhanced CT examination. The system can handle up to 64 variables and can be accessed via touchscreen by CT operators as well as via a web interface by registered users with three different hierarchy levels. Data related to CM injection parameters (i.e. iodine concentration, volume and flow rate of CM, iodine delivery rate and iodine dose, CM injection pressure, and volume and flow rate of saline), patient weight and height, and type of CT study over a testing period spanning from 1 June 2013 to 10 January 2015 were retrieved from the system. Technical alerts occurred for each injection event (such as system disarm due to technical failure, disarm due to operator's stop, incomplete filling of patient data fields, or excessively high injection pressure), as well as interoperability issues related to data sending and receiving to/from the RIS/PACS were also recorded. During the testing period, the CM monitoring system generated a total of 8609 reports, of which 7629 relative to successful injection events (88.6%). 331 alerts were generated, of which 40 resulted in injection interruption and 291 in CM flow rate limitation due to excessively high injection pressure (>325 psi). Average CM volume and flow rate were 93.73 ± 17.58 mL and 3.53 ± 0.89 mL/s, and contrast injection pressure ranged between 5 and 167 psi. A statistically significant correlation was found between iodine concentration and peak IDR (rs=0.2744, p<0.0001), as well as between iodine concentration and iodine dose (rs=0.3862, p<0.0001) for all CT studies. Automated contrast management systems can provide a full report of contrast use with the possibility to systematically compare different contrast injection protocols, minimize errors, and optimize organ-specific contrast enhancement for any given patient and clinical application. This can be useful to improve and harmonize the quality and consistency of contrast CT procedures within the same radiological department and across the hospital, as well as to monitor potential adverse events and overall costs. Copyright © 2015 Elsevier Ltd. All rights reserved.

CT cardiac imaging: evolution from 2D to 3D backprojection

NASA Astrophysics Data System (ADS)

Tang, Xiangyang; Pan, Tinsu; Sasaki, Kosuke

2004-04-01

The state-of-the-art multiple detector-row CT, which usually employs fan beam reconstruction algorithms by approximating a cone beam geometry into a fan beam geometry, has been well recognized as an important modality for cardiac imaging. At present, the multiple detector-row CT is evolving into volumetric CT, in which cone beam reconstruction algorithms are needed to combat cone beam artifacts caused by large cone angle. An ECG-gated cardiac cone beam reconstruction algorithm based upon the so-called semi-CB geometry is implemented in this study. To get the highest temporal resolution, only the projection data corresponding to 180° plus the cone angle are row-wise rebinned into the semi-CB geometry for three-dimensional reconstruction. Data extrapolation is utilized to extend the z-coverage of the ECG-gated cardiac cone beam reconstruction algorithm approaching the edge of a CT detector. A helical body phantom is used to evaluate the ECG-gated cone beam reconstruction algorithm"s z-coverage and capability of suppressing cone beam artifacts. Furthermore, two sets of cardiac data scanned by a multiple detector-row CT scanner at 16 x 1.25 (mm) and normalized pitch 0.275 and 0.3 respectively are used to evaluate the ECG-gated CB reconstruction algorithm"s imaging performance. As a reference, the images reconstructed by a fan beam reconstruction algorithm for multiple detector-row CT are also presented. The qualitative evaluation shows that, the ECG-gated cone beam reconstruction algorithm outperforms its fan beam counterpart from the perspective of cone beam artifact suppression and z-coverage while the temporal resolution is well maintained. Consequently, the scan speed can be increased to reduce the contrast agent amount and injection time, improve the patient comfort and x-ray dose efficiency. Based up on the comparison, it is believed that, with the transition of multiple detector-row CT into volumetric CT, ECG-gated cone beam reconstruction algorithms will provide better image quality for CT cardiac applications.

Patient-related factors influencing detectability of coronary arteries in 320-row CT angiography in infants with complex congenital heart disease.

PubMed

Yamasaki, Yuzo; Kawanami, Satoshi; Kamitani, Takeshi; Sagiyama, Koji; Shin, Seitaro; Hino, Takuya; Nagata, Hazumu; Yabuuchi, Hidetake; Nagao, Michinobu; Honda, Hiroshi

2018-05-05

To investigate the performance of second-generation 320-row computed tomographic (CT) angiography (CTA) in detecting coronary arteries and identify factors influencing visibility of the coronary arteries in infants with complex congenital heart disease (CHD). Data of 60 infants (aged 0-2 years, median 2 months) with complex CHD who underwent examination using 320-row CTA with low-dose prospective electrocardiogram-triggered volume target scanning were reviewed. The coronary arteries of each infant were assessed using a 0-4-point scoring system based on the number of coronary segments with a visible course. Clinical parameters, the CT value in the ascending aorta, image noise, and the radiation dose were subjected to univariate and multivariate analyses. The mean coronary score for all examinations was 2.6 ± 1.5 points. The mean attenuation in the ascending aorta was 306.7 ± 66.2 HU and the mean standard deviation was 21.7 ± 4.4. The mean effective radiation dose was 1.27 ± 0.39 mSv. Multivariate regression analysis showed significant correlations between coronary score and body weight (p < 0.05) and between coronary score and the CT value in the ascending aorta (p < 0.02). Second-generation 320-row CTA with prospective electrocardiogram-triggered volume target scanning and hybrid iterative reconstruction allows good visibility of the coronary arteries in infants with complex CHD. Body weight and the CT value in the ascending aorta are important factors influencing the visibility of the coronary arteries in infants.

Diagnostic and prognostic role of computed tomography in extracorporeal shock wave lithotripsy complications

PubMed Central

Telegrafo, Michele; Carluccio, Davide Antonio; Rella, Leonarda; Ianora, Amato Antonio Stabile; Angelelli, Giuseppe; Moschetta, Marco

2016-01-01

Purpose: To evaluate the role of multidetector computed tomography (MDCT) in recognizing the complications of extracorporeal shock wave lithotripsy (ESWL) and providing a prognostic grading system for the therapeutic approach. Materials and Methods: A total of 43 patients who underwent ESWL because of urinary stone disease were assessed by 320-row MDCT examination before and after ESWL. Pre-ESWL CT unenhanced scans were performed for diagnosing stone disease. Post-ESWL CT scans were acquired before and after intravenous injection of contrast medium searching for peri-renal fluid collection or hyper-density, pyelic or ureteral wall thickening, blood clots in the urinary tract, peri- or intra-renal hematoma or abscess, active bleeding. A severity grading system of ESWL complications was established. Results: Patients were affected by renal (n = 36) or ureteral (n = 7) lithiasis. Post-ESWL CT examination detected small fluid collections and hyper-density of peri-renal fat tissue in 35/43 patients (81%), pyelic or ureteral wall thickening in 2/43 (4%), blood clots in the urinary tract in 9/43 (21%), renal abscesses or hematomas with a diameter of <2 cm in 10/43 (23%), large retroperitoneal collections in 3/43 (7%), active bleeding from renal vessels in 1/43 (2%). Mild complications were found in 30 cases; moderate in 9; severe in 4. The therapeutic choice was represented by clinical follow-up (n = 20), clinical and CT follow-up (n = 10), ureteral stenting (n = 9), drainage of large retroperitoneal collections (n = 3), and arterial embolization (n = 1). Conclusion: MDCT plays a crucial role in the diagnosis of urolithiasis and follow-up of patients treated with ESWL recognizing its complications and providing therapeutic and prognostic indications. PMID:27141186

Diagnostic and prognostic role of computed tomography in extracorporeal shock wave lithotripsy complications.

PubMed

Telegrafo, Michele; Carluccio, Davide Antonio; Rella, Leonarda; Ianora, Amato Antonio Stabile; Angelelli, Giuseppe; Moschetta, Marco

2016-01-01

To evaluate the role of multidetector computed tomography (MDCT) in recognizing the complications of extracorporeal shock wave lithotripsy (ESWL) and providing a prognostic grading system for the therapeutic approach. A total of 43 patients who underwent ESWL because of urinary stone disease were assessed by 320-row MDCT examination before and after ESWL. Pre-ESWL CT unenhanced scans were performed for diagnosing stone disease. Post-ESWL CT scans were acquired before and after intravenous injection of contrast medium searching for peri-renal fluid collection or hyper-density, pyelic or ureteral wall thickening, blood clots in the urinary tract, peri- or intra-renal hematoma or abscess, active bleeding. A severity grading system of ESWL complications was established. Patients were affected by renal (n = 36) or ureteral (n = 7) lithiasis. Post-ESWL CT examination detected small fluid collections and hyper-density of peri-renal fat tissue in 35/43 patients (81%), pyelic or ureteral wall thickening in 2/43 (4%), blood clots in the urinary tract in 9/43 (21%), renal abscesses or hematomas with a diameter of <2 cm in 10/43 (23%), large retroperitoneal collections in 3/43 (7%), active bleeding from renal vessels in 1/43 (2%). Mild complications were found in 30 cases; moderate in 9; severe in 4. The therapeutic choice was represented by clinical follow-up (n = 20), clinical and CT follow-up (n = 10), ureteral stenting (n = 9), drainage of large retroperitoneal collections (n = 3), and arterial embolization (n = 1). MDCT plays a crucial role in the diagnosis of urolithiasis and follow-up of patients treated with ESWL recognizing its complications and providing therapeutic and prognostic indications.

Radiation dose management in thoracic CT: an international survey.

PubMed

Molinari, Francesco; Tack, Denis M; Boiselle, Philip; Ngo, Long; Mueller-Mang, Christina; Litmanovich, Diana; Bankier, Alexander A

2013-01-01

We aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. An electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. Of the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%-53%]) had no formal training in dose reduction, with "self-study of the literature" being the most common form of training (54/146, 37% [29%-45%]). One hundred and seventeen (80% [74%-87%]) had automatic exposure control, and 76 (65% [56%-74%]) used it in all patients. Notably, most respondents (89% [84%-94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%-59%]), and 59% (51%-67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. Efforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists.

Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy.

PubMed

Bahadir, Osman; Kosucu, Polat

2012-12-01

To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy. Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides. The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45±1.48 to 3.54±1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55±1.62cm(3) vs. 5.10±1.47cm(3), (P<0.01); left: 6.72±1.53cm(3) vs. 5.00±1.37cm(3), (P<0.01)] respectively. Radiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Pacemaker-induced Metallic Artifacts in Coronary Computed Tomography Angiography: Clinical Feasibility of Single Energy Metal Artifact Reduction Technique.

PubMed

Takayanagi, Tomoya; Arai, Takehiro; Amanuma, Makoto; Sano, Tomonari; Ichiba, Masato; Ishizaka, Kazumasa; Sekine, Takako; Matsutani, Hideyuki; Morita, Hitomi; Takase, Shinichi

2017-01-01

Coronary computed tomography angiography (CCTA) in patients with pacemaker suffers from metallic lead-induced artifacts, which often interfere with accurate assessment of coronary luminal stenosis. The purpose of this study was to assess a frequency of the lead-induced artifacts and artifact-suppression effect by the single energy metal artifact reduction (SEMAR) technique. Forty-one patients with a dual-chamber pacemaker were evaluated using a 320 multi-detector row CT (MDCT). Among them, 22 patients with motion-free full data reconstruction images were the final candidates. Images with and without the SMEAR technique were subjectively compared, and the degree of metallic artifacts was compared. On images without SEMAR, severe metallic artifacts were often observed in the right coronary artery (#1, #2, #3) and distal anterior descending branch (#8). These artifacts were effectively suppressed by SEMAR, and the luminal accessibility was significantly improved in #3 and #8. While pacemaker leads often cause metallic-induced artifacts, SEMAR technique reduced the artifacts and significantly improved the accessibility of coronary lumen in #3 and #8.

Role of Computer Aided Diagnosis (CAD) in the detection of pulmonary nodules on 64 row multi detector computed tomography.

PubMed

Prakashini, K; Babu, Satish; Rajgopal, K V; Kokila, K Raja

2016-01-01

To determine the overall performance of an existing CAD algorithm with thin-section computed tomography (CT) in the detection of pulmonary nodules and to evaluate detection sensitivity at a varying range of nodule density, size, and location. A cross-sectional prospective study was conducted on 20 patients with 322 suspected nodules who underwent diagnostic chest imaging using 64-row multi-detector CT. The examinations were evaluated on reconstructed images of 1.4 mm thickness and 0.7 mm interval. Detection of pulmonary nodules, initially by a radiologist of 2 years experience (RAD) and later by CAD lung nodule software was assessed. Then, CAD nodule candidates were accepted or rejected accordingly. Detected nodules were classified based on their size, density, and location. The performance of the RAD and CAD system was compared with the gold standard that is true nodules confirmed by consensus of senior RAD and CAD together. The overall sensitivity and false-positive (FP) rate of CAD software was calculated. Of the 322 suspected nodules, 221 were classified as true nodules on the consensus of senior RAD and CAD together. Of the true nodules, the RAD detected 206 (93.2%) and 202 (91.4%) by the CAD. CAD and RAD together picked up more number of nodules than either CAD or RAD alone. Overall sensitivity for nodule detection with the CAD program was 91.4%, and FP detection per patient was 5.5%. The CAD showed comparatively higher sensitivity for nodules of size 4-10 mm (93.4%) and nodules in hilar (100%) and central (96.5%) location when compared to RAD's performance. CAD performance was high in detecting pulmonary nodules including the small size and low-density nodules. CAD even with relatively high FP rate, assists and improves RAD's performance as a second reader, especially for nodules located in the central and hilar region and for small nodules by saving RADs time.

How accurate is unenhanced multidetector-row CT (MDCT) for localization of renal calculi?

PubMed

Goetschi, Stefan; Umbehr, Martin; Ullrich, Stephan; Glenck, Michael; Suter, Stefan; Weishaupt, Dominik

2012-11-01

To investigate the correlation between unenhanced MDCT and intraoperative findings with regard to the exact anatomical location of renal calculi. Fifty-nine patients who underwent unenhanced MDCT for suspected urinary stone disease, and who underwent subsequent flexible ureterorenoscopy (URS) as treatment of nephrolithiasis were included in this retrospective study. All MDCT data sets were independently reviewed by three observers with different degrees of experience in reading CT. Each observer was asked to indicate presence and exact anatomical location of any calcification within pyelocaliceal system, renal papilla or renal cortex. Results were compared to intraoperative findings which have been defined as standard of reference. Calculi not described at surgery, but present on MDCT data were counted as renal cortex calcifications. Overall 166 calculi in 59 kidneys have been detected on MDCT, 100 (60.2%) were located in the pyelocaliceal system and 66 (39.8%) in the renal parenchyma. Of the 100 pyelocaliceal calculi, 84 (84%) were correctly located on CT data sets by observer 1, 62 (62%) by observer 2, and 71 (71%) by observer 3. Sensitivity/specificity was 90-94% and 50-100% if only pyelocaliceal calculi measuring >4 mm in size were considered. For pyelocaliceal calculi≤4 mm in size diagnostic performance of MDCT was inferior. Compared to flexible URS, unenhanced MDCT is accurate for distinction between pyelocaliceal calculi and renal parenchyma calcifications if renal calculi are >4 mm in size. For smaller renal calculi, unenhanced MDCT is less accurate and distinction between a pyelocaliceal calculus and renal parenchyma calcification is difficult. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Combined anatomical and functional imaging using coronary CT angiography and myocardial perfusion SPECT in symptomatic adults with abnormal origin of a coronary artery.

PubMed

Uebleis, C; Groebner, M; von Ziegler, F; Becker, A; Rischpler, C; Tegtmeyer, R; Becker, C; Lehner, S; Haug, A R; Cumming, P; Bartenstein, P; Franz, W M; Hacker, M

2012-10-01

There has been a lack of standardized workup guidelines for patients with congenital abnormal origin of a coronary artery from the opposite sinus (ACAOS). We aimed to evaluate the use of cardiac hybrid imaging using multi-detector row CT (MDCT) for coronary CT angiography (Coronary CTA) and stress-rest myocardial perfusion SPECT (MPS) for comprehensive diagnosis of symptomatic adult patients with ACAOS. Seventeen symptomatic patients (12 men; 54 ± 13 years) presenting with ACAOS underwent coronary CTA and MPS. Imaging data were analyzed by conventional means, and with additional use of 3D image fusion to allocate stress induced perfusion defects (PD) to their supplying coronary arteries. An anomalous RCA arose from the left anterior sinus in eight patients, an abnormal origin from the right sinus was detected in nine patients (5 left coronary arteries, LCA and 4 LCx). Five of the 17 patients (29%) demonstrated a reversible PD in MPS. There was no correlation between the anatomical variants of ACAOS and the presence of myocardial ischemia. Image fusion enabled the allocation of reversible PD to the anomalous vessel in three patients (two cases in the RCA and the other in the LCA territory); PD in two patients were allocated to the territory of artery giving rise to the anomalies, rather than the anomalies themselves. In a small cohort of adult symptomatic patients with ACAOS anomaly there was no relation found between the specific anatomical variant and the appearance of stress induced myocardial ischemia using cardiac hybrid imaging.

Evaluation of bowel distension and mural visualisation using neutral oral contrast agents for multidetector-row computed tomography.

PubMed

Lim, Bee Kuan; Bux, Shaik Ismail; Rahmat, Kartini; Lam, Sze Yin; Liew, Yew Wai

2012-11-01

We compared the effectiveness of different types of non-commercial neutral oral contrast agents for bowel distension and mural visualisation in computed tomographic (CT) enterography. 90 consecutive patients from a group of 108 were randomly assigned to receive water (n = 30), 3.8% milk (n = 30) or 0.1% gastrografin (n = 30) as oral contrast agent. The results were independently reviewed by two radiologists who were blinded to the contrast agents used. The degree of bowel distension was qualitatively scored on a four-point scale. The discrimination of bowel loops, mural visualisation and visualisation of mucosal folds were evaluated on a 'yes' or 'no' basis. Side effects of the various agents were also recorded. 3.8% milk was significantly superior to water for bowel distension (jejunum, ileum and terminal ileum), discrimination of bowel loops (jejunum and ileum), mural visualisation and visualisation of mucosal folds (ileum and terminal ileum). It was also significantly superior to 0.1% gastrografin for bowel distension, discrimination of bowel loops, mural visualisation and visualisation of mucosal folds (jejunum, ileum and terminal ileum). However, 10% of patients who received 3.8% milk reported immediate post-test diarrhoea. No side effects were documented for patients who received water and 0.1% gastrografin. 3.8% milk is an effective and superior neutral oral contrast agent for the assessment of the jejunum, ileum and terminal ileum in CT enterography. However, further studies are needed to explore other suitable oral contrast agents for CT enterography in lactose- or cow's milk-intolerant patients.

Aortic annulus and ascending aorta: comparison of preoperative and periooperative measurement in patients with aortic stenosis.

PubMed

Smíd, Michal; Ferda, Jirí; Baxa, Jan; Cech, Jakub; Hájek, Tomás; Kreuzberg, Boris; Rokyta, Richard

2010-04-01

Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Comparison of image features calculated in different dimensions for computer-aided diagnosis of lung nodules

NASA Astrophysics Data System (ADS)

Xu, Ye; Lee, Michael C.; Boroczky, Lilla; Cann, Aaron D.; Borczuk, Alain C.; Kawut, Steven M.; Powell, Charles A.

2009-02-01

Features calculated from different dimensions of images capture quantitative information of the lung nodules through one or multiple image slices. Previously published computer-aided diagnosis (CADx) systems have used either twodimensional (2D) or three-dimensional (3D) features, though there has been little systematic analysis of the relevance of the different dimensions and of the impact of combining different dimensions. The aim of this study is to determine the importance of combining features calculated in different dimensions. We have performed CADx experiments on 125 pulmonary nodules imaged using multi-detector row CT (MDCT). The CADx system computed 192 2D, 2.5D, and 3D image features of the lesions. Leave-one-out experiments were performed using five different combinations of features from different dimensions: 2D, 3D, 2.5D, 2D+3D, and 2D+3D+2.5D. The experiments were performed ten times for each group. Accuracy, sensitivity and specificity were used to evaluate the performance. Wilcoxon signed-rank tests were applied to compare the classification results from these five different combinations of features. Our results showed that 3D image features generate the best result compared with other combinations of features. This suggests one approach to potentially reducing the dimensionality of the CADx data space and the computational complexity of the system while maintaining diagnostic accuracy.

[Sigmoid endometriosis: a diagnostic dilemma on multidetector CT].

PubMed

Telegrafo, Michele; Lorusso, Valentina; Rubini, Giuseppe; Rella, Leonarda; Pezzolla, Angela; Stabile Ianora, Amato Antonio; Moschetta, Marco

2013-01-01

Intestinal endometriosis represents a common condition that occurs particularly in women of reproductive age. The gastrointestinal tract is the third most common localization of endometriosis, after the ovaries and the peritoneum, and recto-sigmoid tract is involved in 70% of cases. Recto-sigmoid endometriosis has to be differentiated from other diseases of large bowel, especially in patients without a history of endometriosis. We report a case of sigmoid endometriosis which represented a diagnostic dilemma on multidetector computed tomography.

Multidetector row computed tomography evaluation of the micropig kidney as a potential renal donor.

PubMed

Yoon, Woong; Lee, Min Young; Ryu, Jung Min; Moon, Yong Ju; Lee, Sang Hun; Park, Jae Hong; Yun, Seung Pil; Jang, Min Woo; Park, Sung Su; Han, Ho Jae

2010-03-01

Multidetector row computed tomography (MDCT) provides anatomical information about the kidney and other internal organs. Presently, the suitability of 64-channel MDCT to assess the kidney of healthy micropigs was evaluated. Morphological evaluations of the kidney and the major renal vessels of six healthy micropigs were carried out using MDCT, recording kidney volume and the diameter and length of renal arteries and veins. The mean diameters and lengths of the renal artery were 0.44 +/- 0.05 and 4.51 +/- 0.55 cm on the right side and 0.46 +/- 0.06 and 3.36 +/- 0.27 cm on the left side, respectively. The mean diameters and lengths of the renal vein were 1.44 +/- 0.52 and 4.22 +/- 1.29 cm on the right side and 1.38 +/- 0.17 and 5.15 +/- 0.87 cm on the left side, respectively. The mean volume of the right kidney was 79.3 +/- 14.5 mL and of the left kidney was 78.0 +/- 13.9 mL. The data presented in this study suggest that the MDCT offers a noninvasive, rapid, and accurate method for the evaluation of the renal anatomy in living kidney donors. It also provides sufficient information about extra-renal anatomy important for donor surgery and determination of organ suitability.

CT of Normal Developmental and Variant Anatomy of the Pediatric Skull: Distinguishing Trauma from Normality.

PubMed

Idriz, Sanjin; Patel, Jaymin H; Ameli Renani, Seyed; Allan, Rosemary; Vlahos, Ioannis

2015-01-01

The use of computed tomography (CT) in clinical practice has been increasing rapidly, with the number of CT examinations performed in adults and children rising by 10% per year in England. Because the radiology community strives to reduce the radiation dose associated with pediatric examinations, external factors, including guidelines for pediatric head injury, are raising expectations for use of cranial CT in the pediatric population. Thus, radiologists are increasingly likely to encounter pediatric head CT examinations in daily practice. The variable appearance of cranial sutures at different ages can be confusing for inexperienced readers of radiologic images. The evolution of multidetector CT with thin-section acquisition increases the clarity of some of these sutures, which may be misinterpreted as fractures. Familiarity with the normal anatomy of the pediatric skull, how it changes with age, and normal variants can assist in translating the increased resolution of multidetector CT into more accurate detection of fractures and confident determination of normality, thereby reducing prolonged hospitalization of children with normal developmental structures that have been misinterpreted as fractures. More important, the potential morbidity and mortality related to false-negative interpretation of fractures as normal sutures may be avoided. The authors describe the normal anatomy of all standard pediatric sutures, common variants, and sutural mimics, thereby providing an accurate and safe framework for CT evaluation of skull trauma in pediatric patients. (©)RSNA, 2015.

Magnetic resonance imaging of pulmonary infection in immunocompromised children: comparison with multidetector computed tomography.

PubMed

Ozcan, H Nursun; Gormez, Ayşegul; Ozsurekci, Yasemin; Karakaya, Jale; Oguz, Berna; Unal, Sule; Cetin, Mualla; Ceyhan, Mehmet; Haliloglu, Mithat

2017-02-01

Computed tomography (CT) is commonly used to detect pulmonary infection in immunocompromised children. To compare MRI and multidetector CT findings of pulmonary abnormalities in immunocompromised children. Seventeen neutropaenic children (6 girls; ages 2-18 years) were included. Non-contrast-enhanced CT was performed with a 64-detector CT scanner. Axial and coronal non-enhanced thoracic MRI was performed using a 1.5-T scanner within 24 h of the CT examination (true fast imaging with steady-state free precession, fat-saturated T2-weighted turbo spin echo with motion correction, T2-weighted half-Fourier single-shot turbo spin echo [HASTE], fat-saturated T1-weighted spoiled gradient echo). Pulmonary abnormalities (nodules, consolidations, ground glass opacities, atelectasis, pleural effusion and lymph nodes) were evaluated and compared among MRI sequences and between MRI and CT. The relationship between MRI sequences and nodule sizes was examined by chi- square test. Of 256 CT lesions, 207 (81%, 95% confidence interval [CI] 76-85%) were detected at MRI. Of 202 CT-detected nodules, 157 (78%, 95% CI 71-83%) were seen at motion-corrected MRI. Of the 1-5-mm nodules, 69% were detected by motion-corrected T2-weighted MRI and 38% by HASTE MRI. Sensitivity of MRI (both axial fat-saturated T2-weighted turbo spin echo with variable phase encoding directions (BLADE) images and HASTE sequences) to detect pulmonary abnormalities is promising.

Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis.

PubMed

Tonolini, Massimo; Ierardi, Anna Maria; Bracchi, Elena; Magistrelli, Paolo; Vella, Adriana; Carrafiello, Gianpaolo

2017-10-01

Despite availability of effective therapies, peptic ulcer disease (PUD) remains a major global disease, resulting from a combination of persistent Helicobacter pylori infection and widespread use of nonsteroidal anti-inflammatory drugs. Albeit endoscopy definitely represents the mainstay diagnostic technique, patients presenting to emergency departments with unexplained abdominal pain generally undergo multidetector CT as an initial investigation. Although superficial ulcers generally remain inconspicuous, careful multiplanar CT interpretation may allow to detect deep ulcers, secondary mural and extraluminal signs of peptic gastroduodenitis, thereby allowing timely endoscopic verification and appropriate treatment. This pictorial essay aims to provide radiologists with an increased familiarity with CT diagnosis of non-perforated PUD, with emphasis on differential diagnosis. Following an overview of current disease epidemiology and complications, it explains the appropriate CT acquisition and interpretation techniques, and reviews with several examples the cross-sectional findings of uncomplicated PUD. Afterwards, the CT features of PUD complications such as ulcer haemorrhage, gastric outlet obstruction, biliary and pancreatic fistulisation are presented. • Gastric and duodenal peptic ulcers are increasingly caused by nonsteroidal anti-inflammatory drugs • Multiplanar CT interpretation allows detecting deep ulcers and secondary signs of gastroduodenitis • CT diagnosis of uncomplicated peptic disease relies on direct and indirect signs • Currently the commonest complication, haemorrhage may be treated with transarterial embolisation • Other uncommon complications include gastric outlet obstruction and biliopancreatic fistulisation.

Multidetector-row computed tomography enterographic assessment of the ileal-anal pouch: descriptive radiologic analysis with endoscopic and pathologic correlation.

PubMed

Liszewski, Mark C; Sahni, V Anik; Shyn, Paul B; Friedman, Sonia; Hornick, Jason L; Erturk, Sukru M; Mortele, Koenraad J

2012-01-01

To describe the multidetector-row computed tomography enterographic (MD-CTE) features of the ileal-anal pouch after ileal pouch anal anastomosis (IPAA) surgery and correlate them with pouch endoscopy and histopathologic findings. All MD-CTE examinations performed on patients who underwent IPAA from July 1, 2005 to December 1, 2010 (n = 35; 16 [45.7%] men; mean age, 37.7 years; age range, 22-72 years) were retrospectively evaluated in consensus by 2 radiologists. All studies were evaluated for the presence of multiple imaging features. Two radiographic scores were then calculated: a total radiographic score and a radiographic active inflammation score. In patients who underwent MD-CTE, pouch endoscopy, and biopsy within 30 days (n = 13), both scores were correlated with findings on pouch endoscopy and histopathology. Of the 35 patients, 33 (94%) had at least one MD-CTE finding of active or chronic pouch inflammation and 27 patients (77%) had at least one MD-CTE finding of active pouch inflammation. Of the 13 patients who underwent endoscopy and biopsy, the total radiographic score demonstrated a strong positive correlation with endoscopic score (r = 0.81; P = 0.001) and a moderate positive correlation with histopathologic score (r = 0.56; P = 0.047). The radiographic active inflammation score demonstrated a strong positive correlation with endoscopic score (r = 0.83; P = 0.0004), but only a weak nonsignificant positive correlation with histopathologic score (r = 0.492, P = 0.087). In patients who had IPAA surgery, findings on MD-CTE correlate positively with findings on pouch endoscopy and histopathology and are sensitive measures for pouch inflammation with high positive predictive value. Thus, MD-CTE can be a useful noninvasive test in the early evaluation of symptomatic patients.

Study of Image Quality From CT Scanner Multi-Detector by using Americans College of Radiology (ACR) Phantom

NASA Astrophysics Data System (ADS)

Mulyadin; Dewang, Syamsir; Abdullah, Bualkar; Tahir, Dahlang

2018-03-01

In this study, the image quality of CT scan using phantom American College of Radiology (ACR) was determined. Scanning multidetector CT is used to know the image quality parameters by using a solid phantom containing four modules and primarily from materials that are equivalent to water. Each module is 4 cm in diameter and 20 cm in diameter. There is white alignment marks painted white to reflect the alignment laser and there are also “HEAD”, “FOOT”, and “TOP” marks on the phantom to help align. This test obtains CT images of each module according to the routine inspection protocol of the head. Acceptance of image quality obtained for determination: CT Number Accuracy (CTN), CT Number Uniformity and Noise, Linearity CT Number, Slice Technique, Low Contrast Resolution and High Contrast Resolution represent image quality parameters. In testing CT Number Accuracy (CTN), CT Uniform number and Noise are in the range of tolerable values allowed. In the test, Linearity CT Number obtained correlation value above 0.99 is the relationship between electron density and CT Number. In a low contrast resolution test, the smallest contrast groups are visible. In contrast, the high resolution is seen up to 7 lp/cm. The quality of GE CT Scan is very high, as all the image quality tests obtained are within the tolerance brackets of values permitted by the Nuclear Power Control Agency (BAPETEN). Image quality test is a way to get very important information about the accuracy of snoring result by using phantom ACR.

Multicenter Evaluation Of Coronary Dual-Source CT angiography in patients with intermediate Risk of Coronary Artery Stenoses (MEDIC): study design and rationale.

PubMed

Marwan, Mohamed; Hausleiter, Jörg; Abbara, Suhny; Hoffmann, Udo; Becker, Christoph; Ovrehus, Kristian; Ropers, Dieter; Bathina, Ravi; Berman, Dan; Anders, Katharina; Uder, Michael; Meave, Aloha; Alexánderson, Erick; Achenbach, Stephan

2014-01-01

The diagnostic performance of multidetector row CT to detect coronary artery stenosis has been evaluated in numerous single-center studies, with only limited data from large cohorts with low-to-intermediate likelihood of coronary disease and in multicenter trials. The Multicenter Evaluation of Coronary Dual-Source CT Angiography in Patients with Intermediate Risk of Coronary Artery Stenoses (MEDIC) trial determines the accuracy of dual-source CT (DSCT) to identify persons with at least 1 coronary artery stenosis among patients with low-to-intermediate pretest likelihood of disease. The MEDIC trial was designed as a prospective, multicenter, international trial to evaluate the diagnostic performance of DSCT for the detection of coronary artery stenosis compared with invasive coronary angiography. The study includes 8 sites in Germany, India, Mexico, the United States, and Denmark. The study population comprises patients referred for a diagnostic coronary angiogram because of suspected coronary artery disease with an intermediate pretest likelihood as determined by sex, age, and symptoms. All evaluations are performed by blinded core laboratory readers. The primary outcome of the MEDIC trial is the accuracy of DSCT to identify the presence of coronary artery stenoses with a luminal diameter narrowing of 50% or more on a per-vessel basis. Secondary outcome parameters include per-patient and per-segment diagnostic accuracy for 50% stenoses and accuracy to identify stenoses of 70% or more. Furthermore, secondary outcome parameters include the influence of heart rate, Agatston score, body weight, body mass index, image quality, and diagnostic confidence on the accuracy to detect coronary artery stenoses >50% on a per-vessel basis. The results of the MEDIC trial will assess the clinical utility of coronary CT angiography in the evaluation of patients with intermediate pretest likelihood of coronary artery disease. Copyright © 2014 Society of Cardiovascular Computed Tomography. All rights reserved.

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2016-01-01

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

Pathogenesis of chronic rhinosinusitis in patients affected by β-thalassemia major and sickle cell anaemia post allogenic bone marrow transplant.

PubMed

Martino, F; Di Mauro, R; Paciaroni, K; Gaziev, J; Alfieri, C; Greco, L; Floris, R; Di Girolamo, S; Di Girolamo, M

2018-03-01

Sickle cell anemia (SCA) and β -thalassemia major are well-recognized beta-globin gene disorders of red blood cells associated to mortality and morbidity included bone morbidities due to ineffective erythropoiesis and bone marrow expansion, which affect every part of the skeleton. While there are an abundance of described disease manifestations of the head and neck, the manner of paranasal sinuses involvement and its relations to β-thalassemia and SCA process was not studied yet. Therefore, the aim of this study was to investigate a possible increased risk of rhinosinusitis and the real pathogenetic mechanism of it, comparing these two hematological diseases using msCT, gold standard for paranasal sinuses evaluation. A retrospective analysis of 90 patients affected by β-thalassemia major or SCA (respectively 59 and 31) underwent allogeneic bone marrow transplantation (BMT), and 44 control subjects was performed. Both patient categories and control group have been subjected to hematological and radiological evaluation using 64-multidetector-row CT scanner without contrast injection. Statistical analysis reveals that patients of the two study groups exhibit a significantly increased risk of sinusitis in comparison with the normal controls (RR: 3.55 for β-thalassemic pediatric subjects; RR: 3.35 for SCA pediatric subjects). A significant difference (p < 0,5) was found between the β -thalassemic patients on the one side, and SCA and control group on the other side, with regard to the evaluation of the typical anatomic alteration of maxillary sinus: β-thalassemic children had significant increase in the bone thickness of anterior and lateral sinus walls and significant reduction in volume and density compared to SCA patients and control group, with normal conditions of these parameters. In these hematological patients, there is an increased incidence of sinonasal infections due their therapy-induced immunosuppression post transplantation. In β-thalassemic patients, furthermore, the specific anatomical variants play an important confounding factor in radiological interpretation of CT images. Therefore, a cranio-facial CT scan evaluation could be a useful tool in the management of upper airway infections after BMT and should be a routinely exams in order to avoid useless surgical or antibiotic approaches. Copyright © 2018 Elsevier B.V. All rights reserved.

Multidetector CT diagnosis of massive hemobilia due to gallbladder polyposis in a child with metachromatic leukodystrophy.

PubMed

Wanner, Matthew R; Karmazyn, Boaz; Fan, Rong

2015-12-01

Hemobilia secondary to gallbladder polyposis is rare in children but has been reported in a few children with metachromatic leukodystrophy. We present a case with preoperative multidetector computed tomography (MDCT) diagnosis of massive hemobilia caused by gallbladder polyposis in a patient with metachromatic leukodystrophy. Our report highlights the importance of both awareness of the association of gallbladder polyposis with other syndromes such as metachromatic leukodystrophy as well as the possibility of this entity presenting with life-threatening bleeding.

Stomach arteriovenous malformation resected by laparoscopy-assisted surgery: A case report.

PubMed

Hotta, Masahiro; Yamamoto, Kazuhito; Cho, Kazumitsu; Takao, Yoshimune; Fukuoka, Takeshi; Uchida, Eiji

2016-05-01

Arteriovenous malformations of the stomach are an uncommon cause of upper GI bleeding. We report a case of stomach arteriovenous malformation in an 85-year-old Asian man who presented with massive hematemesis. Initial esophagogastroduodenoscopy did not detect this lesion, but contrast multi-detector CT confirmed GI bleeding. Multi-detector CT revealed a mass of blood vessels underlying the submucosa that arose from the right gastroepiploic artery. Repeat esophagogastroduodenoscopy showed that the lesion was a submucosal tumor with erosion and without active bleeding in the lower body of the stomach on the greater curvature. We performed partial gastrectomy via laparoscopy-assisted surgery. The histopathological diagnosis was arteriovenous malformation. © 2016 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

Evaluation of prosthetic valve thrombosis by 64-row multi-detector computed tomography. .

PubMed

Tarzia, Vincenzo; Bortolussi, Giacomo; Rubino, Maurizio; Gallo, Michele; Bottio, Tomaso; Gerosa, Gino

2015-03-01

Multi-detector computed tomography (MDCT), combined with retrospective electrocardiographic gating, permits cardiac imaging with high accuracy. Recent advances in MDCT have seemed to respond adequately to the need for a non-invasive and reliable assessment of the coronary artery lumen. Two patients with prosthetic aortic valves (one bioprosthetic, one mechanical) presented at the authors' institution with dyspnea and syncopal episodes. MDCT was performed to evaluate thrombus characteristics and exclude coronary artery disease (CAD). Based on the MDCT coronary artery assessment, neither patient underwent preoperative invasive coronary angiography, abolishing the risk of any iatrogenic thrombus fragmentation and subsequent embolization. One patient underwent surgical treatment without complications, while medical therapy was successful in the other case. MDCT can be used for the accurate imaging of thrombi on prosthetic aortic valves, and to correctly assess possible CAD.

Validation of multi-detector computed tomography as a non-invasive method for measuring ovarian volume in macaques (Macaca fascicularis).

PubMed

Jones, Jeryl C; Appt, Susan E; Werre, Stephen R; Tan, Joshua C; Kaplan, Jay R

2010-06-01

The purpose of this study was to validate low radiation dose, contrast-enhanced, multi-detector computed tomography (MDCT) as a non-invasive method for measuring ovarian volume in macaques. Computed tomography scans of four known-volume phantoms and nine mature female cynomolgus macaques were acquired using a previously described, low radiation dose scanning protocol, intravenous contrast enhancement, and a 32-slice MDCT scanner. Immediately following MDCT, ovaries were surgically removed and the ovarian weights were measured. The ovarian volumes were determined using water displacement. A veterinary radiologist who was unaware of actual volumes measured ovarian CT volumes three times, using a laptop computer, pen display tablet, hand-traced regions of interest, and free image analysis software. A statistician selected and performed all tests comparing the actual and CT data. Ovaries were successfully located in all MDCT scans. The iliac arteries and veins, uterus, fallopian tubes, cervix, ureters, urinary bladder, rectum, and colon were also consistently visualized. Large antral follicles were detected in six ovaries. Phantom mean CT volume was 0.702+/-SD 0.504 cc and the mean actual volume was 0.743+/-SD 0.526 cc. Ovary mean CT volume was 0.258+/-SD 0.159 cc and mean water displacement volume was 0.257+/-SD 0.145 cc. For phantoms, the mean coefficient of variation for CT volumes was 2.5%. For ovaries, the least squares mean coefficient of variation for CT volumes was 5.4%. The ovarian CT volume was significantly associated with actual ovarian volume (ICC coefficient 0.79, regression coefficient 0.5, P=0.0006) and the actual ovarian weight (ICC coefficient 0.62, regression coefficient 0.6, P=0.015). There was no association between the CT volume accuracy and mean ovarian CT density (degree of intravenous contrast enhancement), and there was no proportional or fixed bias in the CT volume measurements. Findings from this study indicate that MDCT is a valid non-invasive technique for measuring the ovarian volume in macaques.

Carotid stenosis assessment with multi-detector CT angiography: comparison between manual and automatic segmentation methods.

PubMed

Zhu, Chengcheng; Patterson, Andrew J; Thomas, Owen M; Sadat, Umar; Graves, Martin J; Gillard, Jonathan H

2013-04-01

Luminal stenosis is used for selecting the optimal management strategy for patients with carotid artery disease. The aim of this study is to evaluate the reproducibility of carotid stenosis quantification using manual and automated segmentation methods using submillimeter through-plane resolution Multi-Detector CT angiography (MDCTA). 35 patients having carotid artery disease with >30 % luminal stenosis as identified by carotid duplex imaging underwent contrast enhanced MDCTA. Two experienced CT readers quantified carotid stenosis from axial source images, reconstructed maximum intensity projection (MIP) and 3D-carotid geometry which was automatically segmented by an open-source toolkit (Vascular Modelling Toolkit, VMTK) using NASCET criteria. Good agreement among the measurement using axial images, MIP and automatic segmentation was observed. Automatic segmentation methods show better inter-observer agreement between the readers (intra-class correlation coefficient (ICC): 0.99 for diameter stenosis measurement) than manual measurement of axial (ICC = 0.82) and MIP (ICC = 0.86) images. Carotid stenosis quantification using an automatic segmentation method has higher reproducibility compared with manual methods.

Comparison of CT and MRI in diagnosis of cerebrospinal leak induced by multiple fractures of skull base

PubMed Central

Wang, Xuhui; Xu, Minhui; Liang, Hong; Xu, Lunshan

2011-01-01

Background Multiple basilar skull fracture and cerebrospinal leak are common complications of traumatic brain injury, which required a surgical repair. But due to the complexity of basilar skull fracture after severe trauma, preoperatively an exact radiological location is always difficult. Multi-row spiral CT and MRI are currently widely applied in the clinical diagnosis. The present study was performed to compare the accuracy of cisternography by multi-row spiral CT and MRI in the diagnosis of cerebrospinal leak. Methods A total of 23 patients with multiple basilar skull fracture after traumatic brain injury were included. The radiological and surgical data were retrospectively analyzed. 64-row CT (mm/row) scan and three-dimensional reconstruction were performed in 12 patients, while MR plain scan and cisternography were performed in another 11 patients. The location of cerebrospinal leak was diagnosed by 2 experienced physicians majoring neurological radiology. Surgery was performed in all patients. The cerebrospinal leak location was confirmed and repaired during surgery. The result was considered as accurate when cerebrospinal leak was absent after surgery. Results According to the surgical exploration, the preoperative diagnosis of the active cerebrospinal leak location was accurate in 9 out of 12 patients with CT scan. The location could not be confirmed by CT because of multiple fractures in 2 patients and the missed diagnosis occurred in 1 patient. The preoperative diagnosis was accurate in 10 out of 11 patients with MRI examination. Conclusions MRI cisternography is more advanced than multi-row CT scan in multiple basilar skull fracture. The combination of the two examinations may increase the diagnostic ratio of active cerebrospinal leak. PMID:22933941

Systems for Lung Volume Standardization during Static and Dynamic MDCT-based Quantitative Assessment of Pulmonary Structure and Function

PubMed Central

Fuld, Matthew K.; Grout, Randall; Guo, Junfeng; Morgan, John H.; Hoffman, Eric A.

2013-01-01

Rationale and Objectives Multidetector-row Computed Tomography (MDCT) has emerged as a tool for quantitative assessment of parenchymal destruction, air trapping (density metrics) and airway remodeling (metrics relating airway wall and lumen geometry) in chronic obstructive pulmonary disease (COPD) and asthma. Critical to the accuracy and interpretability of these MDCT-derived metrics is the assurance that the lungs are scanned during a breath-hold at a standardized volume. Materials and Methods A computer monitored turbine-based flow meter system was developed to control patient breath-holds and facilitate static imaging at fixed percentages of the vital capacity. Due to calibration challenges with gas density changes during multi-breath xenon-CT an alternative system was required. The design incorporated dual rolling seal pistons. Both systems were tested in a laboratory environment and human subject trials. Results The turbine-based system successfully controlled lung volumes in 32/37 subjects, having a linear relationship for CT measured air volume between repeated scans: for all scans, the mean and confidence interval of the differences (scan1-scan2) was −9 ml (−169, 151); for TLC alone 6 ml (−164, 177); for FRC alone, −23 ml (−172, 126). The dual-piston system successfully controlled lung volume in 31/41 subjects. Study failures related largely to subject non-compliance with verbal instruction and gas leaks around the mouthpiece. Conclusion We demonstrate the successful use of a turbine-based system for static lung volume control and demonstrate its inadequacies for dynamic xenon-CT studies. Implementation of a dual-rolling seal spirometer has been shown to adequately control lung volume for multi-breath wash-in xenon-CT studies. These systems coupled with proper patient coaching provide the tools for the use of CT to quantitate regional lung structure and function. The wash-in xenon-CT method for assessing regional lung function, while not necessarily practical for routine clinical studies, provides for a dynamic protocol against which newly emerging single breath, dual-energy xenon-CT measures can be validated. PMID:22555001

Systems for lung volume standardization during static and dynamic MDCT-based quantitative assessment of pulmonary structure and function.

PubMed

Fuld, Matthew K; Grout, Randall W; Guo, Junfeng; Morgan, John H; Hoffman, Eric A

2012-08-01

Multidetector-row computed tomography (MDCT) has emerged as a tool for quantitative assessment of parenchymal destruction, air trapping (density metrics), and airway remodeling (metrics relating airway wall and lumen geometry) in chronic obstructive pulmonary disease (COPD) and asthma. Critical to the accuracy and interpretability of these MDCT-derived metrics is the assurance that the lungs are scanned during a breathhold at a standardized volume. A computer monitored turbine-based flow meter system was developed to control patient breathholds and facilitate static imaging at fixed percentages of the vital capacity. Because of calibration challenges with gas density changes during multibreath xenon CT, an alternative system was required. The design incorporated dual rolling seal pistons. Both systems were tested in a laboratory environment and human subject trials. The turbine-based system successfully controlled lung volumes in 32/37 subjects, having a linear relationship for CT measured air volume between repeated scans: for all scans, the mean and confidence interval of the differences (scan1-scan2) was -9 mL (-169, 151); for total lung capacity alone 6 mL (-164, 177); for functional residual capacity alone, -23 mL (-172, 126). The dual-piston system successfully controlled lung volume in 31/41 subjects. Study failures related largely to subject noncompliance with verbal instruction and gas leaks around the mouthpiece. We demonstrate the successful use of a turbine-based system for static lung volume control and demonstrate its inadequacies for dynamic xenon CT studies. Implementation of a dual-rolling seal spirometer has been shown to adequately control lung volume for multibreath wash-in xenon CT studies. These systems coupled with proper patient coaching provide the tools for the use of CT to quantitate regional lung structure and function. The wash-in xenon CT method for assessing regional lung function, although not necessarily practical for routine clinical studies, provides for a dynamic protocol against which newly emerging single breath, dual-energy xenon CT measures can be validated. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Blunt trauma of bone structures of the chest--computed tomography vs multidetector computed tomography.

PubMed

Petrović, Kosta; Turkalj, Ivan; Stojanović, Sanja; Vucaj-Cirilović, Viktorija; Nikolić, Olivera; Stojiljković, Dragana

2013-08-01

Computerized tomography (CT), especially multidetector CT (MDCT), has had a revolutionary impact in diagnostic in traumatized patients. The aim of the study was to identify and compare the frequency of injuries to bone structures of the thorax displayed with 5-mm-thick axial CT slices and thin-slice (MDCT) examination with the use of 3D reconstructions, primarily multiplanar reformations (MPR). This prospective study included 61 patients with blunt trauma submitted to CT scan of the thorax as initial assessment. The two experienced radiologists inde pendently and separately described the findings for 5-mm-thick axial CT slices (5 mm CT) as in monoslice CT examination; MPR and other 3D reconstructions along with thin-slice axial sections which were available in modern MDCT technologies. After describing thin-slice examination in case of disagreement in the findings, the examiners redescribed thin-slice examination together which was ultimately considered as a real, true finding. No statistically significant difference in interobserver evaluation of 5 mm CT examination was recorded (p > 0.05). Evaluation of fractures of sternum with 5 mm CT and MDCT showed a statistically significant difference (p < 0.05) in favor of better display of injury by MDCT examination. MDCT is a powerful diagnostic tool that can describe higher number of bone fractures of the chest in traumatized patients compared to 5 mm CT, especially in the region of sternum for which a statistical significance was obtained using MPR. Moreover, the importance of MDCT is also set by easier and more accurate determination of the level of bone injury.

Pulmonary 3 T MRI with ultrashort TEs: influence of ultrashort echo time interval on pulmonary functional and clinical stage assessments of smokers.

PubMed

Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Seki, Shinichiro; Obara, Makoto; van Cauteren, Marc; Takahashi, Masaya; Sugimura, Kazuro

2014-04-01

To assess the influence of ultrashort TE (UTE) intervals on pulmonary magnetic resonance imaging (MRI) with UTEs (UTE-MRI) for pulmonary functional loss assessment and clinical stage classification of smokers. A total 60 consecutive smokers (43 men and 17 women; mean age 70 years) with and without COPD underwent thin-section multidetector row computed tomography (MDCT), UTE-MRI, and pulmonary functional measurements. For each smoker, UTE-MRI was performed with three different UTE intervals (UTE-MRI A: 0.5 msec, UTE-MRI B: 1.0 msec, UTE-MRI C: 1.5 msec). By using the GOLD guidelines, the subjects were classified as: "smokers without COPD," "mild COPD," "moderate COPD," and "severe or very severe COPD." Then the mean T2* value from each UTE-MRI and CT-based functional lung volume (FLV) were correlated with pulmonary function test. Finally, Fisher's PLSD test was used to evaluate differences in each index among the four clinical stages. Each index correlated significantly with pulmonary function test results (P < 0.05). CT-based FLV and mean T2* values obtained from UTE-MRI A and B showed significant differences among all groups except between "smokers without COPD" and "mild COPD" groups (P < 0.05). UTE-MRI has a potential for management of smokers and the UTE interval is suggested as an important parameter in this setting. Copyright © 2013 Wiley Periodicals, Inc.

Assessing vertebral fracture risk on volumetric quantitative computed tomography by geometric characterization of trabecular bone structure

NASA Astrophysics Data System (ADS)

Checefsky, Walter A.; Abidin, Anas Z.; Nagarajan, Mahesh B.; Bauer, Jan S.; Baum, Thomas; Wismüller, Axel

2016-03-01

The current clinical standard for measuring Bone Mineral Density (BMD) is dual X-ray absorptiometry, however more recently BMD derived from volumetric quantitative computed tomography has been shown to demonstrate a high association with spinal fracture susceptibility. In this study, we propose a method of fracture risk assessment using structural properties of trabecular bone in spinal vertebrae. Experimental data was acquired via axial multi-detector CT (MDCT) from 12 spinal vertebrae specimens using a whole-body 256-row CT scanner with a dedicated calibration phantom. Common image processing methods were used to annotate the trabecular compartment in the vertebral slices creating a circular region of interest (ROI) that excluded cortical bone for each slice. The pixels inside the ROI were converted to values indicative of BMD. High dimensional geometrical features were derived using the scaling index method (SIM) at different radii and scaling factors (SF). The mean BMD values within the ROI were then extracted and used in conjunction with a support vector machine to predict the failure load of the specimens. Prediction performance was measured using the root-mean-square error (RMSE) metric and determined that SIM combined with mean BMD features (RMSE = 0.82 +/- 0.37) outperformed MDCT-measured mean BMD (RMSE = 1.11 +/- 0.33) (p < 10-4). These results demonstrate that biomechanical strength prediction in vertebrae can be significantly improved through the use of SIM-derived texture features from trabecular bone.

Cardiac Computed Tomography (Multidetector CT, or MDCT)

MedlinePlus

... other tests, such as chest X-rays , electrocardiograms (ECG) , echocardiograms (echocardiography) , or stress tests , don’t give ... be attached to your chest to monitor your ECG. The ECG is also needed to help the ...

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

PubMed

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

2014-01-01

The increase in the frequency of abdominal aortic aneurysms (AAA) and the widely accepted use of endovascular aneurysm repair (EVAR) as a first-line treatment or as an alternative to conventional surgery make it necessary for radiologists to have thorough knowledge of the pre- and post-treatment findings. The high image quality provided by multidetector computed tomography (MDCT) enables CT angiography to play a fundamental role in the study of AAA and in planning treatment. The objective of this article is to review the cases of AAA in which CT angiography was the main imaging technique, so that radiologists will be able to detect the signs related to this disease, to diagnose it, to plan treatment, and to detect complications in the postoperative period. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

A semi-automated volumetric software for segmentation and perfusion parameter quantification of brain tumors using 320-row multidetector computed tomography: a validation study.

PubMed

Chae, Soo Young; Suh, Sangil; Ryoo, Inseon; Park, Arim; Noh, Kyoung Jin; Shim, Hackjoon; Seol, Hae Young

2017-05-01

We developed a semi-automated volumetric software, NPerfusion, to segment brain tumors and quantify perfusion parameters on whole-brain CT perfusion (WBCTP) images. The purpose of this study was to assess the feasibility of the software and to validate its performance compared with manual segmentation. Twenty-nine patients with pathologically proven brain tumors who underwent preoperative WBCTP between August 2012 and February 2015 were included. Three perfusion parameters, arterial flow (AF), equivalent blood volume (EBV), and Patlak flow (PF, which is a measure of permeability of capillaries), of brain tumors were generated by a commercial software and then quantified volumetrically by NPerfusion, which also semi-automatically segmented tumor boundaries. The quantification was validated by comparison with that of manual segmentation in terms of the concordance correlation coefficient and Bland-Altman analysis. With NPerfusion, we successfully performed segmentation and quantified whole volumetric perfusion parameters of all 29 brain tumors that showed consistent perfusion trends with previous studies. The validation of the perfusion parameter quantification exhibited almost perfect agreement with manual segmentation, with Lin concordance correlation coefficients (ρ c ) for AF, EBV, and PF of 0.9988, 0.9994, and 0.9976, respectively. On Bland-Altman analysis, most differences between this software and manual segmentation on the commercial software were within the limit of agreement. NPerfusion successfully performs segmentation of brain tumors and calculates perfusion parameters of brain tumors. We validated this semi-automated segmentation software by comparing it with manual segmentation. NPerfusion can be used to calculate volumetric perfusion parameters of brain tumors from WBCTP.

Elucidating early CT after pancreatico-duodenectomy: a primer for radiologists.

PubMed

Tonolini, Massimo; Ierardi, Anna Maria; Carrafiello, Gianpaolo

2018-04-13

Pancreatico-duodenectomy (PD) represents the standard surgical treatment for resectable malignancies of the pancreatic head, distal common bile duct, periampullary region and duodenum, and is also performed to manage selected benign tumours and refractory chronic pancreatitis. Despite improved surgical techniques and acceptable mortality, PD remains a technically demanding, high-risk operation burdened with high morbidity (complication rates 40-50% of patients). Multidetector computed tomography (CT) represents the mainstay modality to rapidly investigate the postoperative abdomen, and to provide a consistent basis for an appropriate choice between conservative, interventional or surgical treatment. However, radiologists require familiarity with the surgically altered anatomy, awareness of expected imaging appearances and possible complications to correctly interpret early post-PD CT studies. This paper provides an overview of surgical indications and techniques, discusses risk factors and clinical manifestations of the usual postsurgical complications, and suggests appropriate techniques and indications for early postoperative CT imaging. Afterwards, the usual, normal early post-PD CT findings are presented, including transient fluid, pneumobilia, delayed gastric emptying, identification of pancreatic gland remnant and of surgical anastomoses. Finally, several imaging examples review the most common and some unusual complications such as pancreatic fistula, bile leaks, abscesses, intraluminal and extraluminal haemorrhage, and acute pancreatitis. • Pancreatico-duodenectomy (PD) is a technically demanding surgery burdened with high morbidity (40-50%). • Multidetector CT is the mainstay technique to investigate suspected complications following PD. • Interpreting post-PD CT requires knowledge of surgically altered anatomy and expected findings. • CT showing collection at surgical site supports clinico-biological diagnosis of pancreatic fistula. • Other complications include biliary leaks, haemorrhage, abscesses and venous thrombosis.

Improved motion compensation in 3D-CT using respiratory-correlated segment reconstruction: diagnostic and radiotherapy applications.

PubMed

Mori, S; Endo, M; Kohno, R; Minohara, S

2006-09-01

Conventional respiratory-gated CT and four-dimensional CT (4DCT) are disadvantaged by their low temporal resolution, which results in the inclusion of anatomic motion-induced artefacts. These represent a significant source of error both in radiotherapy treatment planning for the thorax and upper abdomen and in diagnostic procedures. In particular, temporal resolution and image quality are vitally important to accurate diagnosis and the minimization of planning target volume margin due to respiratory motion. To improve both temporal resolution and signal-to-noise ratio (SNR), we developed a respiratory-correlated segment reconstruction method (RS) and adapted it to the Feldkamp-Davis-Kress algorithm (FDK) with a 256 multidetector row CT (256MDCT). The 256MDCT scans approximately 100 mm in the craniocaudal direction with a 0.5 mm slice thickness in one rotation. Data acquisition for the RS-FDK relies on the assistance of a respiratory sensing system operating in cine scan mode (continuous axial scan with the table stationary). We evaluated the RS-FDK for volume accuracy and image noise in a phantom study with the 256MDCT and compared results with those for a full scan (FS-FDK), which is usually employed in conventional 4DCT and in half scan (HS-FDK). Results showed that the RS-FDK gave a more accurate volume than the others and had the same SNR as the FS-FDK. In a subsequent animal study, we demonstrated a practical sorting process for projection data which was unaffected by variations in respiratory period, and found that the RS-FDK gave the clearest visualization among the three algorithms of the margins of the liver and pulmonary vessels. In summary, the RS-FDK algorithm provides multi-phase images with higher temporal resolution and better SNR. This method should prove useful when combined with new radiotherapeutic and diagnostic techniques.

Thoracic wall trauma—misdiagnosed lesions on radiographs and usefulness of ultrasound, multidetector computed tomography and magnetic resonance imaging

PubMed Central

Facenda, Catherine; Vaz, Nuno; Castañeda, Edgar Augusto; del Amo, Montserrat; Garcia-Diez, Ana Isabel; Pomes, Jaime

2017-01-01

Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has been done in computed tomography (CT) and multidetector CT (MDCT) imaging. This technique is considered the “gold-standard” for those traumatic patients, due to its fast acquisition covering the whole area of interest in axial plane, reconstructing multiplanar (2D, 3D) volume-rendered images with a superb quality and angiographic CT capabilities for evaluating vascular damage. Complementary techniques such as ultrasonography (US) and magnetic resonance imaging (MRI) may improve the diagnostic accuracy due to its great capacity in visualising soft-tissue trauma (muscle-tendinous tears) and subtle fractures. All these imaging methods have an important role in quantifying the severity of chest wall trauma. The findings of this study have been exposed with cases of our archives in a didactic way. PMID:28932697

Computed tomographic angiography in stroke imaging: fundamental principles, pathologic findings, and common pitfalls.

PubMed

Gupta, Rajiv; Jones, Stephen E; Mooyaart, Eline A Q; Pomerantz, Stuart R

2006-06-01

The development of multidetector row computed tomography (MDCT) now permits visualization of the entire vascular tree that is relevant for the management of stroke within 15 seconds. Advances in MDCT have brought computed tomography angiography (CTA) to the frontline in evaluation of stroke. CTA is a rapid and noninvasive modality for evaluating the neurovasculature. This article describes the role of CTA in the management of stroke. Fundamentals of contrast delivery, common pathologic findings, artifacts, and pitfalls in CTA interpretation are discussed.

Polyarteritis nodosa: MDCT as a 'One-Stop Shop' Modality for Whole-Body Arterial Evaluation

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

Tsai, W.-L.; Tsai, I-C.; Lee Tain, E-mail: s841082@ym.edu.t

Polyarteritis nodosa is a rare disease, which is characterized by aneurysm formation and occlusion in the arteries of multiple systems. Due to its extensive involvement, whole-body evaluation is necessary for diagnosis and treatment monitoring. We report a case of polyarteritis nodosa using multidetector-row computed tomography (MDCT) as a 'one-stop shop' modality for whole-body arterial evaluation. With precise protocol design, MDCT can be used as a reliable noninvasive modality providing comprehensive whole-body arterial evaluation.

CT colonography: automated measurement of colonic polyps compared with manual techniques--human in vitro study.

PubMed

Taylor, Stuart A; Slater, Andrew; Halligan, Steve; Honeyfield, Lesley; Roddie, Mary E; Demeshski, Jamshid; Amin, Hamdam; Burling, David

2007-01-01

To prospectively investigate the relative accuracy and reproducibility of manual and automated computer software measurements by using polyps of known size in a human colectomy specimen. Institutional review board approval was obtained for the study; written consent for use of the surgical specimen was obtained. A colectomy specimen containing 27 polyps from a 16-year-old male patient with familial adenomatous polyposis was insufflated, submerged in a container with solution, and scanned at four-section multi-detector row computed tomography (CT). A histopathologist measured the maximum dimension of all polyps in the opened specimen. Digital photographs and line drawings were produced to aid CT-histologic measurement correlation. A novice (radiographic technician) and an experienced (radiologist) observer independently estimated polyp diameter with three methods: manual two-dimensional (2D) and manual three-dimensional (3D) measurement with software calipers and automated measurement with software (automatic). Data were analyzed with paired t tests and Bland-Altman limits of agreement. Seven polyps (

32. TYPICAL BRYANT ITEMS FROM THE 1930S; TOP ROW LEFT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

32. TYPICAL BRYANT ITEMS FROM THE 1930S; TOP ROW LEFT TO RIGHT: PORCELAIN CASED SWITCH, ROTARY SWITCH, SHORTING PLUG TO BYPASS FUSE; SECOND ROW: BRASS INCANDESCENT LAMP SURFACE RECEPTACLE, INCANDESCENT LAMPHOLDER WITH ADAPTER FOR GLASS GLOBE; THIRD ROW: PORCELAIN BASE ROTARY SWITCH, APPLIANCE BREAKER WITH COVER REMOVED, APPLIANCE BREAKER - Bryant Electric Company, 1421 State Street, Bridgeport, Fairfield County, CT

Role of Computer Aided Diagnosis (CAD) in the detection of pulmonary nodules on 64 row multi detector computed tomography

PubMed Central

Prakashini, K; Babu, Satish; Rajgopal, KV; Kokila, K Raja

2016-01-01

Aims and Objectives: To determine the overall performance of an existing CAD algorithm with thin-section computed tomography (CT) in the detection of pulmonary nodules and to evaluate detection sensitivity at a varying range of nodule density, size, and location. Materials and Methods: A cross-sectional prospective study was conducted on 20 patients with 322 suspected nodules who underwent diagnostic chest imaging using 64-row multi-detector CT. The examinations were evaluated on reconstructed images of 1.4 mm thickness and 0.7 mm interval. Detection of pulmonary nodules, initially by a radiologist of 2 years experience (RAD) and later by CAD lung nodule software was assessed. Then, CAD nodule candidates were accepted or rejected accordingly. Detected nodules were classified based on their size, density, and location. The performance of the RAD and CAD system was compared with the gold standard that is true nodules confirmed by consensus of senior RAD and CAD together. The overall sensitivity and false-positive (FP) rate of CAD software was calculated. Observations and Results: Of the 322 suspected nodules, 221 were classified as true nodules on the consensus of senior RAD and CAD together. Of the true nodules, the RAD detected 206 (93.2%) and 202 (91.4%) by the CAD. CAD and RAD together picked up more number of nodules than either CAD or RAD alone. Overall sensitivity for nodule detection with the CAD program was 91.4%, and FP detection per patient was 5.5%. The CAD showed comparatively higher sensitivity for nodules of size 4–10 mm (93.4%) and nodules in hilar (100%) and central (96.5%) location when compared to RAD's performance. Conclusion: CAD performance was high in detecting pulmonary nodules including the small size and low-density nodules. CAD even with relatively high FP rate, assists and improves RAD's performance as a second reader, especially for nodules located in the central and hilar region and for small nodules by saving RADs time. PMID:27578931

Sixteen-slice multidetector computed tomographic virtual cystoscopy in the evaluation of a patient with suspected bladder tumor and history of bladder carcinoma operation.

PubMed

Basak, Muzaffer; Ozkurt, Huseyin; Tanriverdi, Orhan; Cay, Esra; Aydin, Mustafa; Miroglu, Cengiz

2009-01-01

The purpose of this study was to evaluate the use of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with suspected bladder tumors and histories of bladder carcinoma operation. Thirty-six patients (29 men and 7 women) with a mean age of 66 years (range, 24-88 years) with suspected bladder tumors and histories of bladder carcinoma operation were included in this prospective study. Virtual cystoscopy was performed by 16-slice multidetector CT scanner. The bladder was filled with diluted contrast material solution through a Foley catheter. Then, all patients underwent conventional cystoscopy examination. Two reviewers found 18 lesions detected by virtual cystoscopy by consensus, whereas 19 lesions were depicted by conventional cystoscopy. At virtual and conventional cystoscopies, the conditions of 3 patients, 2 with chronic inflammations and 1 with foreign body reaction, were wrongly diagnosed as tumors. At conventional cystoscopy, one patient's result was wrongly interpreted as normal. In pathologic evaluation, all tumors were diagnosed as transitional cell carcinoma. Bladder tumor can be noninvasively diagnosed using virtual cystoscopy. Use of virtual cystoscopy should be considered inpatients who present with hematuria or have histories of bladder carcinoma operation and are for follow-up because of its lesser complication risk and its being a less invasive, easily applied procedure without need of anesthesia. In the future, owing to the development of the CT technology and image processing technique, virtual cystoscopy may have a part in the detection of bladder cancer.

Fourier crosstalk analysis of multislice and cone-beam helical CT

NASA Astrophysics Data System (ADS)

La Riviere, Patrick J.

2004-05-01

Multi-slice helical CT scanners allow for much faster scanning and better x-ray utilization than do their single-slice predecessors, but they engender considerably more complicated data sampling patterns due to the interlacing of the samples from different rows as the patient is translated. Characterizing and optimizing this sampling is challenging because the conebeam geometry of such scanners means that the projections measured by each detector row are at least slightly oblique, making it difficult to apply standard multidimensional sampling analyses. In this study, we seek to apply a more general framework for analyzing sampled imaging systems known as Fourier crosstalk analysis. Our purpose in this preliminary work is to compare the information content of the data acquired in three different scanner geometries and operating conditions with ostensibly equivalent volume coverage and average longitudinal sampling interval: a single-slice scanner operating at pitch 1, a four-slice scanner operating at pitch 3 and a 15-slice scanner operating at pitch 15. We find that moving from a single-slice to a multi-slice geometry introduces longitudinal crosstalk characteristic of the longitudinal sampling interval between periods of individual each detector row, and not of the overall interlaced sampling pattern. This is attributed to data inconsistencies caused by the obliqueness of the projections in a multi-slice/conebeam configuration. However, these preliminary results suggest that the significance of this additional crosstalk actually decreases as the number of detector rows increases.

Pitfalls in 16-detector row CT of the coronary arteries.

PubMed

Nakanishi, Tadashi; Kayashima, Yasuyo; Inoue, Rintaro; Sumii, Kotaro; Gomyo, Yukihiko

2005-01-01

Recently developed 16-detector row computed tomography (CT) has been introduced as a reliable noninvasive imaging modality for evaluating the coronary arteries. In most cases, with appropriate premedication that includes beta-blockers and nitroglycerin, ideal data sets can be acquired from which to obtain excellent-quality coronary CT angiograms, most often with multiplanar reformation, thin-slab maximum intensity projection, and volume rendering. However, various artifacts associated with data creation and reformation, postprocessing methods, and image interpretation can hamper accurate diagnosis. These artifacts can be related to pulsation (nonassessable segments, pseudostenosis) as well as rhythm disorders, respiratory issues, partial volume averaging effect, high-attenuation entities, inappropriate scan pitch, contrast material enhancement, and patient body habitus. Some artifacts have already been resolved with technical advances, whereas others represent partially inherent limitations of coronary CT angiography. Familiarity with the pitfalls of coronary angiography with 16-detector row CT, coupled with the knowledge of both the normal anatomy and anatomic variants of the coronary arteries, can almost always help radiologists avoid interpretive errors in the diagnosis of coronary artery stenosis. (c) RSNA, 2005.

Usefulness and limitations of postmortem computed tomography in forensic analysis of gunshot injuries: Three case reports.

PubMed

Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Kozakai, Masataka; Saito, Haruo; Funayama, Masato

2016-01-01

Gunshot injury has always been an important field of investigation in postmortem forensic radiology. The localization and retrieval of the bullet and of potentially important fragments are vital to these cases. Using postmortem multidetector-row computed tomography (MDCT) prior to forensic autopsy, we sought to illustrate the importance of this modality in the noninvasive characterization of gunshot wounds. We obtained and analyzed MDCT images in three cases of gunshot wounds (accidental close-range shotgun shooting, suicidal contact gunshot to the head and accidental long-range buckshot shooting). We discuss the value of postmortem MDCT findings in gunshot wound cases by comparing with forensic autopsy findings in Japan, a developing country with miserably low autopsy rate. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography.

PubMed

Ugurel, M S; Battal, B; Bozlar, U; Nural, M S; Tasar, M; Ors, F; Saglam, M; Karademir, I

2010-08-01

The purpose of our investigation was to determine the anatomical variations in the coeliac trunk-hepatic arterial system and the renal arteries in patients who underwent multidetector CT (MDCT) angiography of the abdominal aorta for various reasons. A total of 100 patients were analysed retrospectively. The coeliac trunk, hepatic arterial system and renal arteries were analysed individually and anatomical variations were recorded. Statistical analysis of the relationship between hepatocoeliac variations and renal artery variations was performed using a chi(2) test. There was a coeliac trunk trifurcation in 89% and bifurcation in 8% of the cases. Coeliac trunk was absent in 1%, a hepatosplenomesenteric trunk was seen in 1% and a splenomesenteric trunk was present in 1%. Hepatic artery variation was present in 48% of patients. Coeliac trunk and/or hepatic arterial variation was present in 23 (39.7%) of the 58 patients with normal renal arteries, and in 27 (64.3%) of the 42 patients with accessory renal arteries. There was a statistically significant correlation between renal artery variations and coeliac trunk-hepatic arterial system variations (p = 0.015). MDCT angiography permits a correct and detailed evaluation of hepatic and renal vascular anatomy. The prevalence of variations in the coeliac trunk and/or hepatic arteries is increased in people with accessory renal arteries. For that reason, when undertaking angiographic examinations directed towards any single organ, the possibility of variations in the vascular structure of other organs should be kept in mind.

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.

Adrenal and nephrogenic hypertension: an image quality study of low tube voltage, low-concentration contrast media combined with adaptive statistical iterative reconstruction.

PubMed

Li, Zhen; Li, Qiong; Shen, Yaqi; Li, Anqin; Li, Haojie; Liang, Lili; Hu, Yao; Hu, Xuemei; Hu, Daoyu

2016-09-01

The aim of this study was to investigate the effect of using low tube voltage, low-concentration contrast media and adaptive statistical iterative reconstruction (ASIR) for reducing the radiation and iodine contrast doses in adrenal and nephrogenic hypertension patients. A total of 148 hypertension patients who were suspected for adrenal lesions or renal artery stenoses were assigned to two groups and. Group A (n=74) underwent a low tube voltage, low molecular weight dextran enhanced multi-detector row spiral CT (MDCT) (80 kVp, 270 mg I/mL contrast agent), and the raw data were reconstructed with standard filtered back projection (FBP) and ASIR at four different levels of blending (20%, 40%, 60% and 80%, respectively). The control group (Group B, n=74) underwent conventional MDCT (120 kVp, 370 mg I/mL contrast agent), and the data were reconstructed with FBP. The CT values, standard deviation (SD), signal-noise-ratio (SNR) and contrast-noise-ratio (CNR) were measured in the renal vessels, normal adrenal tissue, adrenal neoplasms and subcutaneous fat. The volume CT dose index (CTDIvol ) and dose length product (DLP) were recorded, and an effective dose (ED) was obtained. Two-tailed independent t-tests, paired Chi-square tests and Kappa consistency tests were used for statistical analysis of the data. The CTDIvol , DLP and total iodine dose in group A were decreased by 47.8%, 49.0% and 26.07%, respectively, compared to group B (P<.001). In the qualitative quality analysis, the radiologists rated the 60% ASIR the highest. The mean value of noise (SD) was significantly lower in the 40%, 60% and 80% ASIR-A groups compared with FBP-B for all comparisons. Compared to FBP-B, CNR was significantly higher, with 40%, 60% and 80% ASIR in renal artery stems (P<.05). Compared with FBP-B, a significant increase in the SNR of 40%, 60%, or 80% ASIR was observed in all cases (P<.05). Compared with conventional protocols, the use of low tube voltage, low-concentration contrast media and 60% ASIR provides similar enhancement and image quality with a reduced radiation dose and contrast iodine dose. © 2016 John Wiley & Sons Ltd.

Assessment methodologies and statistical issues for computer-aided diagnosis of lung nodules in computed tomography: contemporary research topics relevant to the lung image database consortium.

PubMed

Dodd, Lori E; Wagner, Robert F; Armato, Samuel G; McNitt-Gray, Michael F; Beiden, Sergey; Chan, Heang-Ping; Gur, David; McLennan, Geoffrey; Metz, Charles E; Petrick, Nicholas; Sahiner, Berkman; Sayre, Jim

2004-04-01

Cancer of the lung and bronchus is the leading fatal malignancy in the United States. Five-year survival is low, but treatment of early stage disease considerably improves chances of survival. Advances in multidetector-row computed tomography technology provide detection of smaller lung nodules and offer a potentially effective screening tool. The large number of images per exam, however, requires considerable radiologist time for interpretation and is an impediment to clinical throughput. Thus, computer-aided diagnosis (CAD) methods are needed to assist radiologists with their decision making. To promote the development of CAD methods, the National Cancer Institute formed the Lung Image Database Consortium (LIDC). The LIDC is charged with developing the consensus and standards necessary to create an image database of multidetector-row computed tomography lung images as a resource for CAD researchers. To develop such a prospective database, its potential uses must be anticipated. The ultimate applications will influence the information that must be included along with the images, the relevant measures of algorithm performance, and the number of required images. In this article we outline assessment methodologies and statistical issues as they relate to several potential uses of the LIDC database. We review methods for performance assessment and discuss issues of defining "truth" as well as the complications that arise when truth information is not available. We also discuss issues about sizing and populating a database.

Craniofacial and dental malformations in Costello syndrome: A detailed evaluation using multi-detector row computed tomography.

PubMed

Takahashi, Masashi; Ohashi, Hirofumi

2013-06-01

Costello syndrome is a rare multiple congenital anomaly syndrome caused by heterozygous germline HRAS mutations, which is characterized by intellectual disability, growth retardation, distinctive facies, loose skin, cardiomyopathy and a preposition to malignancies. Although teeth abnormalities have been encountered in nearly two-thirds of the patients in literature, the evaluation tended to be limited to the extent which can be obtained from physical examination. We investigated detailed craniofacial, oral and dental findings in four patients with Costello syndrome. In this study, images reconstructed by multi-detector row computed tomography (MDCT) were used as substitutes for dental cast study and panoramic and lateral cephalometric radiograph studies to evaluate dental arches, tooth size, relationships between craniofacial and dental structures, and hypodontia. All four patients showed true/relative macrocephaly with facial bone hypoplasia and gingival hypertrophy. Occlusal attrition, malocclusion, small dental arches, microdontia, and convex face were noted in three patients. In addition, one patient showed dental caries, conic tooth and gingivitis, and another patient showed hypodontia. Our study suggests that craniofacial and dental abnormalities are common in Costello syndrome patients and comprehensive dental care should be provided from early infancy. To our knowledge, this is the first study of thorough craniofacial and dental evaluation by using MDCT in Costello syndrome. MDCT is a useful tool for precise evaluation of craniofacial and oral manifestations in patients with congenital anomaly/intellectual disability syndromes. © 2012 The Authors. Congenital Anomalies © 2012 Japanese Teratology Society.

Study of extracerebral contamination for three cerebral oximeters by Monte Carlo simulation using CT data

NASA Astrophysics Data System (ADS)

Tarasov, A. P.; Egorov, A. I.; Rogatkin, D. A.

2017-07-01

Using multidetector computed tomography, thicknesses of bone squame and soft tissues of human head were assessed. MC simulation revealed impropriety of source-detector separation distances for 3 oximeters, which can cause extracerebral contamination.

Radiofrequency ablation of liver metastases-software-assisted evaluation of the ablation zone in MDCT: tumor-free follow-up versus local recurrent disease.

PubMed

Keil, Sebastian; Bruners, Philipp; Schiffl, Katharina; Sedlmair, Martin; Mühlenbruch, Georg; Günther, Rolf W; Das, Marco; Mahnken, Andreas H

2010-04-01

The purpose of this study was to investigate differences in change of size and CT value between local recurrences and tumor-free areas after CT-guided radiofrequency ablation (RFA) of hepatic metastases during follow-up by means of dedicated software for automatic evaluation of hepatic lesions. Thirty-two patients with 54 liver metastases from breast or colorectal cancer underwent triphasic contrast-enhanced multidetector-row computed tomography (MDCT) to evaluate hepatic metastatic spread and localization before CT-guided RFA and for follow-up after intervention. Sixteen of these patients (65.1 + or - 10.3 years) with 30 metastases stayed tumor-free (group 1), while the other group (n = 16 with 24 metastases; 62.0 + or - 13.8 years) suffered from local recurrent disease (group 2). Applying an automated software tool (SyngoCT Oncology; Siemens Healthcare, Forchheim, Germany), size parameters (volume, RECIST, WHO) and attenuation were measured within the lesions before, 1 day after, and 28 days after RFA treatment. The natural logarithm (ln) of the quotient of the volume 1 day versus 28 days after RFA treament was computed: lnQ1//28/0(volume). Analogously, ln ratios of RECIST, WHO, and attenuation were computed and statistically evaluated by repeated-measures ANOVA. One lesion in group 2 was excluded from further evaluation due to automated missegmentation. Statistically significant differences between the two groups were observed with respect to initial volume, RECIST, and WHO (p < 0.05). Furthermore, ln ratios corresponding to volume, RECIST, and WHO differed significantly between the two groups. Attenuation evaluations showed no significant differences, but there was a trend toward attenuation assessment for the parameter lnQ28/0(attenuation) (p = 0.0527), showing higher values for group 1 (-0.4 + or - 0.3) compared to group 2 (-0.2 + or - 0.2). In conclusion, hepatic metastases and their zone of coagulation necrosis after RFA differed significantly between tumor-free and local-recurrent ablation zones with respect to the corresponding size parameters. A new parameter (lnQ1//28/0(volume/RECIST/WHO/attenuation)) was introduced, which appears to be of prognostic value at early follow-up CT.

Characterizing trabecular bone structure for assessing vertebral fracture risk on volumetric quantitative computed tomography

NASA Astrophysics Data System (ADS)

Nagarajan, Mahesh B.; Checefsky, Walter A.; Abidin, Anas Z.; Tsai, Halley; Wang, Xixi; Hobbs, Susan K.; Bauer, Jan S.; Baum, Thomas; Wismüller, Axel

2015-03-01

While the proximal femur is preferred for measuring bone mineral density (BMD) in fracture risk estimation, the introduction of volumetric quantitative computed tomography has revealed stronger associations between BMD and spinal fracture status. In this study, we propose to capture properties of trabecular bone structure in spinal vertebrae with advanced second-order statistical features for purposes of fracture risk assessment. For this purpose, axial multi-detector CT (MDCT) images were acquired from 28 spinal vertebrae specimens using a whole-body 256-row CT scanner with a dedicated calibration phantom. A semi-automated method was used to annotate the trabecular compartment in the central vertebral slice with a circular region of interest (ROI) to exclude cortical bone; pixels within were converted to values indicative of BMD. Six second-order statistical features derived from gray-level co-occurrence matrices (GLCM) and the mean BMD within the ROI were then extracted and used in conjunction with a generalized radial basis functions (GRBF) neural network to predict the failure load of the specimens; true failure load was measured through biomechanical testing. Prediction performance was evaluated with a root-mean-square error (RMSE) metric. The best prediction performance was observed with GLCM feature `correlation' (RMSE = 1.02 ± 0.18), which significantly outperformed all other GLCM features (p < 0.01). GLCM feature correlation also significantly outperformed MDCTmeasured mean BMD (RMSE = 1.11 ± 0.17) (p< 10-4). These results suggest that biomechanical strength prediction in spinal vertebrae can be significantly improved through characterization of trabecular bone structure with GLCM-derived texture features.

Effects of pure and hybrid iterative reconstruction algorithms on high-resolution computed tomography in the evaluation of interstitial lung disease.

PubMed

Katsura, Masaki; Sato, Jiro; Akahane, Masaaki; Mise, Yoko; Sumida, Kaoru; Abe, Osamu

2017-08-01

To compare image quality characteristics of high-resolution computed tomography (HRCT) in the evaluation of interstitial lung disease using three different reconstruction methods: model-based iterative reconstruction (MBIR), adaptive statistical iterative reconstruction (ASIR), and filtered back projection (FBP). Eighty-nine consecutive patients with interstitial lung disease underwent standard-of-care chest CT with 64-row multi-detector CT. HRCT images were reconstructed in 0.625-mm contiguous axial slices using FBP, ASIR, and MBIR. Two radiologists independently assessed the images in a blinded manner for subjective image noise, streak artifacts, and visualization of normal and pathologic structures. Objective image noise was measured in the lung parenchyma. Spatial resolution was assessed by measuring the modulation transfer function (MTF). MBIR offered significantly lower objective image noise (22.24±4.53, P<0.01 among all pairs, Student's t-test) compared with ASIR (39.76±7.41) and FBP (51.91±9.71). MTF (spatial resolution) was increased using MBIR compared with ASIR and FBP. MBIR showed improvements in visualization of normal and pathologic structures over ASIR and FBP, while ASIR was rated quite similarly to FBP. MBIR significantly improved subjective image noise (P<0.01 among all pairs, the sign test), and streak artifacts (P<0.01 each for MBIR vs. the other 2 image data sets). MBIR provides high-quality HRCT images for interstitial lung disease by reducing image noise and streak artifacts and improving spatial resolution compared with ASIR and FBP. Copyright © 2017 Elsevier B.V. All rights reserved.

An evaluation of the use of oral contrast media in abdominopelvic CT.

PubMed

Buttigieg, Erica Lauren; Grima, Karen Borg; Cortis, Kelvin; Soler, Sandro Galea; Zarb, Francis

2014-11-01

To evaluate the diagnostic efficacy of different oral contrast media (OCM) for abdominopelvic CT examinations performed for follow-up general oncological indications. The objectives were to establish anatomical image quality criteria for abdominopelvic CT; use these criteria to evaluate and compare image quality using positive OCM, neutral OCM and no OCM; and evaluate possible benefits for the medical imaging department. Forty-six adult patients attending a follow-up abdominopelvic CT for general oncological indications and who had a previous abdominopelvic CT with positive OCM (n = 46) were recruited and prospectively placed into either the water (n = 25) or no OCM (n = 21) group. Three radiologists performed absolute visual grading analysis (VGA) to assess image quality by grading the fulfilment of 24 anatomical image quality criteria. Visual grading characteristics (VGC) analysis of the data showed comparable image quality with regards to reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three OCM protocols. All three OCM protocols provided similar image quality for follow-up abdominopelvic CT for general oncological indications. • Positive oral contrast media are routinely used for abdominopelvic multidetector computed tomography • Experimental study comparing image quality using three different oral contrast materials • Three different oral contrast materials result in comparable CT image quality • Benefits for patients and medical imaging department.

Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: Patent ductus arteriosus and vascular rings

PubMed Central

2011-01-01

Background Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT) was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography. Results Electrocardiography (ECG)-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats. Conclusions Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional information can be of help with regard to improved diagnoses of thoracic anomalies and the planning of surgical interventions. PMID:21943366

Radiation dose reduction in abdominal computed tomography during the late hepatic arterial phase using a model-based iterative reconstruction algorithm: how low can we go?

PubMed

Husarik, Daniela B; Marin, Daniele; Samei, Ehsan; Richard, Samuel; Chen, Baiyu; Jaffe, Tracy A; Bashir, Mustafa R; Nelson, Rendon C

2012-08-01

The aim of this study was to compare the image quality of abdominal computed tomography scans in an anthropomorphic phantom acquired at different radiation dose levels where each raw data set is reconstructed with both a standard convolution filtered back projection (FBP) and a full model-based iterative reconstruction (MBIR) algorithm. An anthropomorphic phantom in 3 sizes was used with a custom-built liver insert simulating late hepatic arterial enhancement and containing hypervascular liver lesions of various sizes. Imaging was performed on a 64-section multidetector-row computed tomography scanner (Discovery CT750 HD; GE Healthcare, Waukesha, WI) at 3 different tube voltages for each patient size and 5 incrementally decreasing tube current-time products for each tube voltage. Quantitative analysis consisted of contrast-to-noise ratio calculations and image noise assessment. Qualitative image analysis was performed by 3 independent radiologists rating subjective image quality and lesion conspicuity. Contrast-to-noise ratio was significantly higher and mean image noise was significantly lower on MBIR images than on FBP images in all patient sizes, at all tube voltage settings, and all radiation dose levels (P < 0.05). Overall image quality and lesion conspicuity were rated higher for MBIR images compared with FBP images at all radiation dose levels. Image quality and lesion conspicuity on 25% to 50% dose MBIR images were rated equal to full-dose FBP images. This phantom study suggests that depending on patient size, clinically acceptable image quality of the liver in the late hepatic arterial phase can be achieved with MBIR at approximately 50% lower radiation dose compared with FBP.

Pulmonary involvement in rheumatoid arthritis: multidetector computed tomography findings.

PubMed

Yuksekkaya, Ruken; Celikyay, Fatih; Yilmaz, Ayse; Arslan, Sule; Inanir, Ahmet; Inonu, Handan; Deniz, Caglar

2013-12-01

Pulmonary involvement in rheumatoid arthritis (RA) is common and encompasses a large spectrum of disease with different treatment options and prognoses. Therefore, assessment of these patients with multidetector computed tomography (MDCT) is vital. To evaluate the MDCT pulmonary findings of patients with RA and to compare these findings with the clinical status. Chest MDCT scans of 85 patients with RA between 2006-2012 were assessed. One patient with a pulmonary infection was excluded from the study. MDCT findings and distribution of the CT findings were examined, and patients were classified according to the predominant CT pattern. The pulmonary function test (PFT) results and categories, demographic characteristics, and clinical status of some of the patients for whom the results were obtained were evaluated, and the CT findings, PFT results, demographic characteristics, and clinical status were compared. The study group consisted of 20 men (mean age, 58.1 years ± 13.1; range, 15-77 years) and 64 women (mean age, 55.3 years ± 11.5; range, 30-84 years). The most frequent findings were nodules (78.6%) and pleural thickening (48.8%). The most common CT patterns were follicular bronchiolitis (FB) in 28 (33.3%) patients and nodular disease (ND) in 12 (14.3%) others. There was no statistically significant difference between the CT findings and PFT results, and no statistically significant difference was noted in the CT findings between symptomatic and asymptomatic patients. In addition, there were some patients who exhibited no symptoms and/or had abnormal PFT results but had abnormal CT findings. Rheumatoid arthritis is associated with a high frequency of CT findings and CT patterns, with nodules and pleural thickening being the most common CT findings and FB and ND being the most common CT patterns. MDCT identification of patients with RA may be helpful in the evaluation of pulmonary disease, even in patients without symptoms and PFT abnormalities.

Subtraction coronary CT angiography using second-generation 320-detector row CT.

PubMed

Yoshioka, Kunihiro; Tanaka, Ryoichi; Muranaka, Kenta; Sasaki, Tadashi; Ueda, Takanori; Chiba, Takuya; Takeda, Kouta; Sugawara, Tsuyoshi

2015-06-01

The purpose of this study was to explore the feasibility of subtraction coronary computed tomography angiography (CCTA) by second-generation 320-detector row CT in patients with severe coronary artery calcification using invasive coronary angiography (ICA) as the gold standard. This study was approved by the institutional board, and all subjects provided written consent. Twenty patients with calcium scores of >400 underwent conventional CCTA and subtraction CCTA followed by ICA. A total of 82 segments were evaluated for image quality using a 4-point scale and the presence of significant (>50 %) luminal stenosis by two independent readers. The average image quality was 2.3 ± 0.8 with conventional CCTA and 3.2 ± 0.6 with subtraction CCTA (P < 0.001). The percentage of segments with non-diagnostic image quality was 43.9 % on conventional CCTA versus 8.5 % on subtraction CCTA (P = 0.004). The segment-based diagnostic accuracy for detecting significant stenosis according to ICA revealed an area under the receiver operating characteristics curve of 0.824 (95 % confidence interval [CI], 0.750-0.899) for conventional CCTA and 0.936 (95 % CI 0.889-0.936) for subtraction CCTA (P = 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value for conventional CCTA were 88.2, 62.5, 62.5, and 88.2 %, respectively, and for subtraction CCTA they were 94.1, 85.4, 82.1, and 95.3 %, respectively. As compared to conventional, subtraction CCTA using a second-generation 320-detector row CT showed improvement in diagnostic accuracy at segment base analysis in patients with severe calcifications.

Acute Perforated Diverticulitis: Assessment With Multidetector Computed Tomography.

PubMed

Sessa, Barbara; Galluzzo, Michele; Ianniello, Stefania; Pinto, Antonio; Trinci, Margherita; Miele, Vittorio

2016-02-01

Colonic diverticulitis is a common condition in the western population. Complicated diverticulitis is defined as the presence of extraluminal air or abscess, peritonitis, colon occlusion, or fistulas. Multidetector row computed tomography (MDCT) is the modality of choice for the diagnosis and the staging of diverticulitis and its complications, which enables performing an accurate differential diagnosis and addressing the patients to a correct management. MDCT is accurate in diagnosing the site of perforation in approximately 85% of cases, by the detection of direct signs (focal bowel wall discontinuity, extraluminal gas, and extraluminal enteric contrast) and indirect signs, which are represented by segmental bowel wall thickening, abnormal bowel wall enhancement, perivisceral fat stranding of fluid, and abscess. MDCT is accurate in the differentiation from complicated colon diverticulitis and colon cancer, often with a similar imaging. The computed tomography-guided classification is recommended to discriminate patients with mild diverticulitis, generally treated with antibiotics, from those with severe diverticulitis with a large abscess, which may be drained with a percutaneous approach. Copyright © 2016 Elsevier Inc. All rights reserved.

The use of maxillary sinus dimensions in gender determination: a thin-slice multidetector computed tomography assisted morphometric study.

PubMed

Ekizoglu, Oguzhan; Inci, Ercan; Hocaoglu, Elif; Sayin, Ibrahim; Kayhan, Fatma Tulin; Can, Ismail Ozgur

2014-05-01

Gender determination is an important step in identification. For gender determination, anthropometric evaluation is one of the main forensic evaluations. In the present study, morphometric analysis of maxillary sinuses was performed to determine gender. For morphometric analysis, coronal and axial paranasal sinus computed tomography (CT) scan with 1-mm slice thickness was used. For this study, 140 subjects (70 women and 70 men) were enrolled (age ranged between 18 and 63). The size of each subject's maxillary sinuses was measured in anteroposterior, transverse, cephalocaudal, and volume directions. In each measurement, the size of the maxillary sinus is significantly small in female gender (P < 0.001). When discrimination analysis was performed, the accuracy rate was detected as 80% for women and 74.3% for men with an overall rate of 77.15%. With the use of 1-mm slice thickness CT, morphometric analysis of maxillary sinuses will be helpful for gender determination.

Variability in CT lung-nodule volumetry: Effects of dose reduction and reconstruction methods.

PubMed

Young, Stefano; Kim, Hyun J Grace; Ko, Moe Moe; Ko, War War; Flores, Carlos; McNitt-Gray, Michael F

2015-05-01

Measuring the size of nodules on chest CT is important for lung cancer staging and measuring therapy response. 3D volumetry has been proposed as a more robust alternative to 1D and 2D sizing methods. There have also been substantial advances in methods to reduce radiation dose in CT. The purpose of this work was to investigate the effect of dose reduction and reconstruction methods on variability in 3D lung-nodule volumetry. Reduced-dose CT scans were simulated by applying a noise-addition tool to the raw (sinogram) data from clinically indicated patient scans acquired on a multidetector-row CT scanner (Definition Flash, Siemens Healthcare). Scans were simulated at 25%, 10%, and 3% of the dose of their clinical protocol (CTDIvol of 20.9 mGy), corresponding to CTDIvol values of 5.2, 2.1, and 0.6 mGy. Simulated reduced-dose data were reconstructed with both conventional filtered backprojection (B45 kernel) and iterative reconstruction methods (SAFIRE: I44 strength 3 and I50 strength 3). Three lab technologist readers contoured "measurable" nodules in 33 patients under each of the different acquisition/reconstruction conditions in a blinded study design. Of the 33 measurable nodules, 17 were used to estimate repeatability with their clinical reference protocol, as well as interdose and inter-reconstruction-method reproducibilities. The authors compared the resulting distributions of proportional differences across dose and reconstruction methods by analyzing their means, standard deviations (SDs), and t-test and F-test results. The clinical-dose repeatability experiment yielded a mean proportional difference of 1.1% and SD of 5.5%. The interdose reproducibility experiments gave mean differences ranging from -5.6% to -1.7% and SDs ranging from 6.3% to 9.9%. The inter-reconstruction-method reproducibility experiments gave mean differences of 2.0% (I44 strength 3) and -0.3% (I50 strength 3), and SDs were identical at 7.3%. For the subset of repeatability cases, inter-reconstruction-method mean/SD pairs were (1.4%, 6.3%) and (-0.7%, 7.2%) for I44 strength 3 and I50 strength 3, respectively. Analysis of representative nodules confirmed that reader variability appeared unaffected by dose or reconstruction method. Lung-nodule volumetry was extremely robust to the radiation-dose level, down to the minimum scanner-supported dose settings. In addition, volumetry was robust to the reconstruction methods used in this study, which included both conventional filtered backprojection and iterative methods.

Three-dimensional quadratic modeling and quantitative evaluation of the diaphragm on a volumetric CT scan in patients with chronic obstructive pulmonary disease

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

Chang, Yongjun

Purpose: In patients with chronic obstructive pulmonary disease (COPD), diaphragm function may deteriorate due to reduced muscle fiber length. Quantitative analysis of the morphology of the diaphragm is therefore important. In the authors current study, they propose a diaphragm segmentation method for COPD patients that uses volumetric chest computed tomography (CT) data, and they provide a quantitative analysis of the diaphragmatic dimensions. Methods: Volumetric CT data were obtained from 30 COPD patients and 10 normal control patients using a 16-row multidetector CT scanner (Siemens Sensation 16) with 0.75-mm collimation. Diaphragm segmentation using 3D ray projections on the lower surface ofmore » the lungs was performed to identify the draft diaphragmatic lung surface, which was modeled using quadratic 3D surface fitting and robust regression in order to minimize the effects of segmentation error and parameterize diaphragm morphology. This result was visually evaluated by an expert thoracic radiologist. To take into consideration the shape features of the diaphragm, several quantification parameters—including the shape index on the apex (SIA) (which was computed using gradient set to 0), principal curvatures on the apex on the fitted diaphragm surface (CA), the height between the apex and the base plane (H), the diaphragm lengths along the x-, y-, and z-axes (XL, YL, ZL), quadratic-fitted diaphragm lengths on the z-axis (FZL), average curvature (C), and surface area (SA)—were measured using in-house software and compared with the pulmonary function test (PFT) results. Results: The overall accuracy of the combined segmentation method was 97.22% ± 4.44% while the visual accuracy of the models for the segmented diaphragms was 95.28% ± 2.52% (mean ± SD). The quantitative parameters, including SIA, CA, H, XL, YL, ZL, FZL, C, and SA were 0.85 ± 0.05 (mm{sup −1}), 0.01 ± 0.00 (mm{sup −1}), 17.93 ± 10.78 (mm), 129.80 ± 11.66 (mm), 163.19 ± 13.45 (mm), 71.27 ± 17.52 (mm), 61.59 ± 16.98 (mm), 0.01 ± 0.00 (mm{sup −1}), and 34 380.75 ± 6680.06 (mm{sup 2}), respectively. Several parameters were correlated with the PFT parameters. Conclusions: The authors propose an automatic method for quantitatively evaluating the morphological parameters of the diaphragm on volumetric chest CT in COPD patients. By measuring not only the conventional length and surface area but also the shape features of the diaphragm using quadratic 3D surface modeling, the proposed method is especially useful for quantifying diaphragm characteristics. Their method may be useful for assessing morphological diaphragmatic changes in COPD patients.« less

Estimation of Eye Lens Dose During Brain Scans Using Gafchromic Xr-QA2 Film in Various Multidetector CT Scanners.

PubMed

Akhilesh, Philomina; Kulkarni, Arti R; Jamhale, Shramika H; Sharma, S D; Kumar, Rajesh; Datta, D

2017-04-25

The purpose of this study was to estimate eye lens dose during brain scans in 16-, 64-, 128- and 256-slice multidetector computed tomography (CT) scanners in helical acquisition mode and to test the feasibility of using radiochromic film as eye lens dosemeter during CT scanning. Eye lens dose measurements were performed using Gafchromic XR-QA2 film on a polystyrene head phantom designed with outer dimensions equivalent to the head size of a reference Indian man. The response accuracy of XR-QA2 film was validated by using thermoluminescence dosemeters. The eye lens dose measured using XR-QA2 film on head phantom for plain brain scanning in helical mode ranged from 43.8 to 45.8 mGy. The XR-QA2 film measured dose values were in agreement with TLD measured dose values within a maximum variation of 8.9%. The good correlation between the two data sets confirms the viability of using XR-QA2 film for eye lens dosimetry. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

320-Row wide volume CT significantly reduces density heterogeneity observed in the descending aorta: comparisons with 64-row helical CT.

PubMed

Yamashiro, Tsuneo; Miyara, Tetsuhiro; Honda, Osamu; Kamiya, Ayano; Tanaka, Yuko; Murayama, Sadayuki

2014-01-01

The aim of this study was to compare density heterogeneity on wide volume (WV) scans with that on helical CT scans. 22 subjects underwent chest CT using 320-WV and 64-helical modes. Density heterogeneity of the descending aorta was evaluated quantitatively and qualitatively. At qualitative assessment, the heterogeneity was judged to be smaller on WV scans than on helical scans (p<0.0001). Mean changes in aortic density between two contiguous slices were 1.64 HU (3.40%) on WV scans and 2.29 HU (5.19%) on helical scans (p<0.0001). CT density of thoracic organs is more homogeneous and reliable on WV scans than on helical scans. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of eye lens dose on neuroimaging protocols between 16- and 64-section multidetector CT: achieving the lowest possible dose.

PubMed

Tan, J S P; Tan, K-L; Lee, J C L; Wan, C-M; Leong, J-L; Chan, L-L

2009-02-01

To our knowledge, there has been no study that compares the radiation dose delivered to the eye lens by 16- and 64-section multidetector CT (MDCT) for standard clinical neuroimaging protocols. Our aim was to assess radiation-dose differences between 16- and 64-section MDCT from the same manufacturer, by using near-identical neuroimaging protocols. Three cadaveric heads were scanned on 16- and 64-section MDCT by using standard neuroimaging CT protocols. Eye lens dose was measured by using thermoluminescent dosimeters (TLD), and each scanning was repeated to reduce random error. The dose-length product, volume CT dose index (CTDI(vol)), and TLD readings for each imaging protocol were averaged and compared between scanners and protocols, by using the paired Student t test. Statistical significance was defined at P < .05. The radiation dose delivered and eye lens doses were lower by 28.1%-45.7% (P < .000) on the 64-section MDCT for near-identical imaging protocols. On the 16-section MDCT, lens dose reduction was greatest (81.1%) on a tilted axial mode, compared with a nontilted helical mode for CT brain scans. Among the protocols studied, CT of the temporal bone delivered the greatest radiation dose to the eye lens. Eye lens radiation doses delivered by the 64-section MDCT are significantly lower, partly due to improvements in automatic tube current modulation technology. However, where applicable, protection of the eyes from the radiation beam by either repositioning the head or tilting the gantry remains the best way to reduce eye lens dose.

Optimization of coronary attenuation in coronary computed tomography angiography using diluted contrast material.

PubMed

Kawaguchi, Naoto; Kurata, Akira; Kido, Teruhito; Nishiyama, Yoshiko; Kido, Tomoyuki; Miyagawa, Masao; Ogimoto, Akiyoshi; Mochizuki, Teruhito

2014-01-01

The purpose of this study was to evaluate a personalized protocol with diluted contrast material (CM) for coronary computed tomography angiography (CTA). One hundred patients with suspected coronary artery disease underwent retrospective electrocardiogram-gated coronary CTA on a 256-slice multidetector-row CT scanner. In the diluted CM protocol (n=50), the optimal scan timing and CM dilution rate were determined by the timing bolus scan, with 20% CM dilution (5ml/s during 10s) being considered suitable to achieve the target arterial attenuation of 350 Hounsfield units (HU). In the body weight (BW)-adjusted protocol (n=50, 222mg iodine/kg), only the optimal scan timing was determined by the timing bolus scan. The injection rate and volume in the timing bolus scan and real scan were identical between the 2 protocols. We compared the means and variations in coronary attenuation between the 2 protocols. Coronary attenuation (mean±SD) in the diluted CM and BW-adjusted protocols was 346.1±23.9 HU and 298.8±45.2 HU, respectively. The diluted CM protocol provided significantly higher coronary attenuation and lower variance than did the BW-adjusted protocol (P<0.05, in each). The diluted CM protocol facilitates more uniform attenuation on coronary CTA in comparison with the BW-adjusted protocol.  

Three-Dimensional Weighting in Cone Beam FBP Reconstruction and Its Transformation Over Geometries.

PubMed

Tang, Shaojie; Huang, Kuidong; Cheng, Yunyong; Niu, Tianye; Tang, Xiangyang

2018-06-01

With substantially increased number of detector rows in multidetector CT (MDCT), axial scan with projection data acquired along a circular source trajectory has become the method-of-choice in increasing clinical applications. Recognizing the practical relevance of image reconstruction directly from the projection data acquired in the native cone beam (CB) geometry, especially in scenarios wherein the most achievable in-plane resolution is desirable, we present a three-dimensional (3-D) weighted CB-FBP algorithm in such geometry in this paper. We start the algorithm's derivation in the cone-parallel geometry. Via changing of variables, taking the Jacobian into account and making heuristic and empirical assumptions, we arrive at the formulas for 3-D weighted image reconstruction in the native CB geometry. Using the projection data simulated by computer and acquired by an MDCT scanner, we evaluate and verify performance of the proposed algorithm for image reconstruction directly from projection data acquired in the native CB geometry. The preliminary data show that the proposed algorithm performs as well as the 3-D weighted CB-FBP algorithm in the cone-parallel geometry. The proposed algorithm is anticipated to find its utility in extensive clinical and preclinical applications wherein the reconstruction of images in the native CB geometry, i.e., the geometry for data acquisition, is of relevance.

[Measurement of scatter radiation on MDCT equipment using an OSL dosimeter].

PubMed

Tomita, Hironobu; Morozumi, Kunihiko

2004-11-01

The recent introduction of multi-detector row computed tomography (MDCT) has made it possible to scan the entire abdomen within approximately 10 sec in procedures such as interventional radiology computed tomography (IVRCT), which are associated with operator exposure. Therefore, anxious patients and patients who are not able to remain still can be examined with an assistant. In the present study, radiation exposure to the assistant was estimated, and the distribution of scattered radiation near the gantry was measured using an optically stimulated luminescence (OSL) dosimeter. Simultaneous measurements were obtained using a direction storage (DIS) dosimeter for reference. The maximum value of 1.47 mSv per examination was obtained at the point closest to the gantry's center (50 cm from the center at a height of 150 cm above the floor) . In addition, scattered radiation decreased as the measurement point was moved further from the gantry's center, falling below the limit of detection (0.1 mSv or less) at 200 cm and at the sides of the gantry. OSL dosimeters are also employed as personal dosimeters, permitting reliable values to be obtained easily. They were found to be an effective tool for the measurement of scattered radiation, as in the present study, helping to provide better understanding of the distribution of scattered radiation within the CT room.

Contour variations of the body and tail of the pancreas: evaluation with MDCT.

PubMed

Omeri, Ahmad Khalid; Matsumoto, Shunro; Kiyonaga, Maki; Takaji, Ryo; Yamada, Yasunari; Kosen, Kazuhisa; Mori, Hiromu; Miyake, Hidetoshi

2017-06-01

To analyze morphology/contour variations of the pancreatic body and tail in subjects free of pancreatic disease. We retrospectively reviewed triple-phase, contrast-enhanced multi-detector row computed tomography (3P-CE-MDCT) examinations of 449 patients who had no clinical or CT evidence of pancreatic diseases. These patients were evaluated for morphologic/contour variations of the pancreatic body and tail, which were classified into two types. In Type I, a portion of normal pancreatic parenchyma protrudes >1 cm in maximum diameter from the body or tail (Ia-anteriorly; Ib-posteriorly). Type II was defined as a morphologic anomaly of the pancreatic tail (IIa-globular; IIb-lobulated; IIc-tapered; IId-bifid). Thirty-eight (8.5%) out of 449 patients had body or tail variations. Of those, 23 patients showed Type I variant: Ia in 21 and Ib in two. Type II variant was identified in 15 patients: IIa in eight, IIb in two, IIc in two and IId in three. Protrusion of the anterior surface of the normal pancreas, especially in the tail, was the most frequently occurring variant. Recognizing the types and subtypes of morphology/contour variations of the pancreatic body and tail could help prevent misinterpretation of normal variants as pancreatic tumors on unenhanced MDCT.

Differentiation of benign and malignant ampullary obstruction by multi-row detector CT.

PubMed

Angthong, Wirana; Jiarakoop, Kran; Tangtiang, Kaan

2018-05-21

To determine useful CT parameters to differentiate ampullary carcinomas from benign ampullary obstruction. This study included 93 patients who underwent abdominal CT, 31 patients with ampullary carcinomas, and 62 patients with benign ampullary obstruction. Two radiologists independently evaluated CT parameters then reached consensus decisions. Statistically significant CT parameters were identified through univariate and multivariate analyses. In univariate analysis, the presence of ampullary mass, asymmetric, abrupt narrowing of distal common bile duct (CBD), dilated intrahepatic bile duct (IHD), dilated pancreatic duct (PD), peripancreatic lymphadenopathy, duodenal wall thickening, and delayed enhancement were more frequently in ampullary carcinomas observed (P < 0.05). Multivariate logistic regression analysis using significant CT parameters and clinical data from univariate analysis, and clinical symptom with jaundice (P = 0.005) was an independent predictor of ampullary carcinomas. For multivariate analysis using only significant CT parameters, abrupt narrowing of distal CBD was an independent predictor of ampullary carcinomas (P = 0.019). Among various CT criteria, abrupt narrowing of distal CBD and dilated IHD had highest sensitivity (77.4%) and highest accuracy (90.3%). The abrupt narrowing of distal CBD and dilated IHD is useful for differentiation of ampullary carcinomas from benign entity in patients without the presence of mass.

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis.

PubMed

Luo, Mingxu; Song, Hongmei; Liu, Gang; Lin, Yikai; Luo, Lintao; Zhou, Xin; Chen, Bo

2017-10-13

The diagnostic values of diffusion weighted imaging (DWI) and 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) for N-staging of gastric cancer (GC) were identified and compared. After a systematic search to identify relevant articles, meta-analysis was used to summarize the sensitivities, specificities, and areas under curves (AUCs) for DWI and PET/CT. To better understand the diagnostic utility of DWI and PET/CT for N-staging, the performance of multi-detector computed tomography (MDCT) was used as a reference. Fifteen studies were analyzed. The pooled sensitivity, specificity, and AUC with 95% confidence intervals of DWI were 0.79 (0.73-0.85), 0.69 (0.61-0.77), and 0.81 (0.77-0.84), respectively. For PET/CT, the corresponding values were 0.52 (0.39-0.64), 0.88 (0.61-0.97), and 0.66 (0.62-0.70), respectively. Comparison of the two techniques revealed DWI had higher sensitivity and AUC, but no difference in specificity. DWI exhibited higher sensitivity but lower specificity than MDCT, and 18 F-FDG PET/CT had lower sensitivity and equivalent specificity. Overall, DWI performed better than 18 F-FDG PET/CT for preoperative N-staging in GC. When the efficacy of MDCT was taken as a reference, DWI represented a complementary imaging technique, while 18 F-FDG PET/CT had limited utility for preoperative N-staging.

Controversies in imaging of hepatocellular carcinoma: multidetector CT (MDCT)

PubMed Central

Silverman, Paul M; Szklaruk, Janio

2005-01-01

Primary hepatocellular carcinoma (HCC) is a significant tumor worldwide and represents the most common primary hepatic neoplasm. Staging criteria are important for appreciation of timely work up of these neoplasms in contradiction with surgical colleagues. This article demonstrates the appearance of HCC on multiphasic, multidetector CT (MDCT) and relates these findings to current staging criteria. The variable appearance on different planes of contrast is critical to appreciate in staging this neoplasm. The hypervascular nature of the primary tumor makes MDCT and three-phase imaging a critical feature in the detection and characterization of this tumor. This is especially critical in the patients who are candidates for surgical resection. Additionally, MDCT has allowed arterial phase imaging to define the vascular supply of the tumor. An accurate representation of the size and number of lesions is critical in not only the initial staging but also the follow-up of hepatocellular carcinoma. The post-treatment features including the appearance post-surgically and after radiofrequency ablation can be well appreciated on MDCT. PMID:16361147

Gunshot injuries in the neck area: ballistics elements and forensic issues.

PubMed

Pinto, Antonio; Brunese, Luca; Scaglione, Mariano; Scuderi, Maria Giuseppina; Romano, Luigia

2009-06-01

The neck is an interesting structure as far as penetrating trauma is concerned because of the multiple vital structures that are concentrated in a small anatomic area. Gunshot wounding is an interaction between the penetrating projectile, the anatomy of the wounded subject, and the chance occurrences that determine the exact missile path. The mass and velocity of the projectile establish the upper limit of possible tissue damage. Management of gunshot neck injuries depends on a clear understanding of the anatomy of the neck. The radiologist can contribute substantially to the successful treatment of the patient with a gunshot wound. Important analysis includes the assessment of the missile path in emergency conditions by using plain film and multidetector row computed tomography. The radiologist further evaluates the extent of wounding by determining missile fragmentation and secondary missile paths.

Prevalence of ear disease in dogs undergoing multidetector thin-slice computed tomography of the head.

PubMed

Foster, Allison; Morandi, Federica; May, Elizabeth

2015-01-01

Previous reports describing the prevalence of ear diseases in dogs have primarily been based on dogs presenting with clinical signs of disease. The prevalence of subclinical ear disease remains unknown. The purpose of this cross-sectional retrospective study was to describe the prevalence of lesions consistent with middle and external ear disease in dogs presented for multidetector computed tomography (CT) of the head and/or cranial cervical spine at our hospital during the period of July 2011 and August 2013. For each included dog, data recorded were signalment, CT findings, diagnosis, and treatment. A total of 199 dogs met inclusion criteria. Nineteen dogs (9.5%) were referred for evaluation of suspected ear disease and 27 dogs (13.5%) had histories or physical examination findings consistent with otitis externa. A total of 163 dogs (81.9%) had CT lesions consistent with external ear disease (i.e. ear canal mineralization, external canal thickening, and/or narrowing of the external canal). Thirty-nine dogs (19.5%) had CT lesions consistent with middle ear disease (i.e. soft tissue attenuating/fluid material in the tympanic bullae, bulla wall thickening or lysis, and/or periosteal proliferation of the temporal bone). Findings from this study indicated that the prevalence of external and middle ear disease in dogs could be higher than that previously reported. © 2014 American College of Veterinary Radiology.

[New methods for the evaluation of bone quality. Assessment of bone structural property using imaging.

PubMed

Ito, Masako

Structural property of bone includes micro- or nano-structural property of the trabecular and cortical bone, and macroscopic geometry. Radiological technique is useful to analyze the bone structural property;multi-detector row CT(MDCT)or high-resolution peripheral QCT(HR-pQCT)is available to analyze human bone in vivo . For the analysis of hip geometry, CT-based hip structure analysis(HSA)is available as well as DXA-based HSA. These structural parameters are related to biomechanical property, and these assessment tools provide information of pathological changes or the effects of anti-osteoporotic agents on bone.

[Evaluation of Organ Dose Estimation from Indices of CT Dose Using Dose Index Registry].

PubMed

Iriuchijima, Akiko; Fukushima, Yasuhiro; Ogura, Akio

Direct measurement of each patient organ dose from computed tomography (CT) is not possible. Most methods to estimate patient organ dose is using Monte Carlo simulation with dedicated software. However, dedicated software is too expensive for small scale hospitals. Not every hospital can estimate organ dose with dedicated software. The purpose of this study was to evaluate the simple method of organ dose estimation using some common indices of CT dose. The Monte Carlo simulation software Radimetrics (Bayer) was used for calculating organ dose and analysis relationship between indices of CT dose and organ dose. Multidetector CT scanners were compared with those from two manufactures (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare). Using stored patient data from Radimetrics, the relationships between indices of CT dose and organ dose were indicated as each formula for estimating organ dose. The accuracy of estimation method of organ dose was compared with the results of Monte Carlo simulation using the Bland-Altman plots. In the results, SSDE was the feasible index for estimation organ dose in almost organs because it reflected each patient size. The differences of organ dose between estimation and simulation were within 23%. In conclusion, our estimation method of organ dose using indices of CT dose is convenient for clinical with accuracy.

[Study of radiation dose to the eye lens by multi-detector row computed tomography of the temporal bone].

PubMed

Hirakuri, Ayaka; Numasawa, Kanako; Takeishi, Hideki; Satomura, Minato; Takeda, Hiromitsu; Harada, Kuniaki; Asanuma, Osamu; Sakata, Motomichi

2012-01-01

The exposure of the eye lens caused by multi-detector row computed tomography (MDCT) of the temporal bone is a serious problem. Our aim was to evaluate the radiation dose to the eye lens by different scan baselines (orbitomeatal line; OML, acanthiomeatal line; AML) and examine the difference of the depiction of the temporal bone structures. Measurement of the exposure to the eye lens was performed by means of MDCT of the temporal bone with a radio-photoluminescence glass dosimeter using a rand phantom. Moreover, we studied only one volunteer (58-year-old male) who had no symptom and was not suspected of having any ear abnormalities with a two scan baseline. Visualization of the major anatomical structures of the temporal bone (the tympanic portion of the facial nerve canal, the body of the incus, stapes superstructures, vestibule etc.) was performed on the volunteer. The average absorbed dose was 6.42 mGy by the OML and 1.59 mGy by the AML, respectively. With regard to visualization of the temporal bone structures, all structures were of equal quality with the two scan baseline. With the AML line, the radiation dose to the eye lens was reduced to 75%. Therefore, the authors recommended an AML for use for MDCT of the temporal bone. In clinical practice, the optimization of scanning factor (kVp, mAs etc.) and the use of the radio-protection should be implemented for radiation dose reduction of the eye lens by MDCT of the temporal bone.

Computed tomographic characteristics of collateral venous pathways in dogs with caudal vena cava obstruction.

PubMed

Specchi, Swan; d'Anjou, Marc-André; Carmel, Eric Norman; Bertolini, Giovanna

2014-01-01

Collateral venous pathways develop in dogs with obstruction or increased blood flow resistance at any level of the caudal vena cava in order to maintain venous drainage to the right atrium. The purpose of this retrospective study was to describe the sites, causes of obstruction, and configurations of venous collateral pathways for a group of dogs with caudal vena cava obstruction. Computed tomography databases from two veterinary hospitals were searched for dogs with a diagnosis of caudal vena cava obstruction and multidetector row computed tomographic angiographic (CTA) scans that included the entire caudal vena cava. Images for each included dog were retrieved and collateral venous pathways were characterized using image postprocessing and a classification system previously reported for humans. A total of nine dogs met inclusion criteria and four major collateral venous pathways were identified: deep (n = 2), portal (n = 2), intermediate (n = 7), and superficial (n = 5). More than one collateral venous pathway was present in 5 dogs. An alternative pathway consisting of renal subcapsular collateral veins, arising mainly from the caudal pole of both kidneys, was found in three dogs. In conclusion, findings indicated that collateral venous pathway patterns similar to those described in humans are also present in dogs with caudal vena cava obstruction. These collateral pathways need to be distinguished from other vascular anomalies in dogs. Postprocessing of multidetector-row CTA images allowed delineation of the course of these complicated venous pathways and may be a helpful adjunct for treatment planning in future cases. © 2014 American College of Veterinary Radiology.

Comparison between Carotid Artery Wall Thickness Measured by Multidetector Row Computed Tomography Angiography and Intimae-Media Thickness Measured by Sonography

PubMed Central

Savić, Živorad N.; Soldatović, Ivan I.; Brajović, Milan D.; Pavlović, Aleksandra M.; Mladenović, Dušan R.; Škodrić-Trifunović, Vesna D.

2011-01-01

The increased thickness of the carotid wall >1 mm is a significant predictor of coronary and cerebrovascular diseases. The purpose of our study was to assess the agreement between multidetector row computed tomography angiography (MDCTA) in measuring carotid artery wall thickness (CAWT) and color Doppler ultrasound (CD-US) in measuring intimae-media thickness (IMT). Eighty-nine patients (aged 35–81) were prospectively analyzed using a 64-detector MDCTA and a CD-US scanner. Continuous data were described as the mean value ± standard deviation, and were compared using the Mann–Whitney U test. A p value <0.05 was considered significant. Bland–Altman statistics were employed to measure the agreement between MDCTA and CD-US. CAWT ranged from 0.62 to 1.60 mm, with a mean value of 1.09 mm. IMT ranged from 0.60 to 1.55 mm, with a mean value of 1.06 mm. We observed an excellent agreement between CD-US and MDCTA in the evaluation of the common carotid artery thickness, with a bias between methods of 0.029 mm (which is a highly statistically important difference of absolute values [t = 43.289; p < 0.01] obtained by paired T test), and limits of agreement from 0.04 to 0.104. Pearson correlation coefficient was 0.9997 (95% CI 0.9996–0.9998; p < 0.01). We conclude that there is an excellent correlation between CAWT and IMT measurements obtained with the MDCTA and CD-US. PMID:22224072

The relevance of image quality indices for dose optimization in abdominal multi-detector row CT in children: experimental assessment with pediatric phantoms

NASA Astrophysics Data System (ADS)

Brisse, H. J.; Brenot, J.; Pierrat, N.; Gaboriaud, G.; Savignoni, A.; DeRycke, Y.; Neuenschwander, S.; Aubert, B.; Rosenwald, J.-C.

2009-04-01

This study assessed and compared various image quality indices in order to manage the dose of pediatric abdominal MDCT protocols and to provide guidance on dose reduction. PMMA phantoms representing average body diameters at birth, 1 year, 5 years, 10 years and 15 years of age were scanned in a four-channel MDCT with a standard pediatric abdominal CT protocol. Image noise (SD, standard deviation of CT number), noise derivative (ND, derivative of the function of noise with respect to dose) and contrast-to-noise ratio (CNR) were measured. The 'relative' low-contrast detectability (rLCD) was introduced as a new quantity to adjust LCD to the various phantom diameters on the basis of the LCD1% assessed in a Catphan® phantom and a constant central absorbed dose. The required variations of CTDIvol16 with respect to phantom size were analyzed in order to maintain each image quality index constant. The use of a fixed SD or CNR level leads to major dose ratios between extreme patient sizes (factor 22.7 to 44 for SD, 31.7 to 51.5 for CNR2.8%), whereas fixed ND and rLCD result in acceptable dose ratios ranging between factors of 2.9 and 3.9 between extreme phantom diameters. For a 5-9 mm rLCD1%, adjusted ND values range between -0.84 and -0.11 HU mGy-1. Our data provide guidance on dose reduction on the basis of patient dimensions and the required rLCD (e.g., to get a constant 7 mm rLCD1% for abdominal diameters of 10, 13, 16, 20 and 25 cm, tube current-time product should be adjusted in order to obtain CTDIvol16 values of 6.2, 7.2, 8.8, 11.6 and 17.7 mGy, respectively).

Comparison of the diagnostic accuracy of FBP, ASiR, and MBIR reconstruction during CT angiography in the evaluation of a vessel phantom with calcified stenosis in a distal superficial femoral artery in a cadaver extremity.

PubMed

Tsukada, Jitsuro; Yamada, Minoru; Yamada, Yoshitake; Yamazaki, Shun; Imanishi, Nobuaki; Tamura, Kentaro; Hashimoto, Masahiro; Nakatsuka, Seishi; Jinzaki, Masahiro

2016-07-01

To investigate whether adaptive statistical iterative reconstruction (ASiR) or model-based iterative reconstruction (MBIR) improves the diagnostic performance of computed tomography angiography (CTA) for small-vessel calcified lesions relative to filtered back projection (FBP) using cadaver extremities and a calcified stenosis phantom. A cadaver was used in accordance with our institutional regulations, and a calcified stenosis phantom simulating 4 grades of stenosis was prepared. The phantom was inserted within the distal superficial femoral artery of the cadaver leg. Ten CT images per reconstruction type and stenosis grade were acquired using a 64-slice multidetector-row CTA.As an objective measurement, the first and second derivatives of the CT value function profiles were calculated. As a subjective measurement, 2 blinded reviewers measured the stenosis ratio using a quantitative scale. The Wilcoxon rank-sum test was used to evaluate the data. Objective measurements of both 25% and 50% stenosis differed significantly (P < 0.01) between MBIR (25/50%: 25.80/50.30 ± 3.88/3.86%) and FBP (25/50%: 35.60/83.80 ± 3.44/26.10%), whereas significant differences were not observed between ASiR and FBP.Reviewer 2's subjective measurements of 25% stenosis differed significantly (P < 0.01) between MBIR (35.13 ± 3.25%) and ASiR (40.89 ± 3.14%), and the measurements of 50% stenosis differed significantly (P < 0.01) between MBIR (reviewers 1/2, 62.36/54.78 ± 2.78/4.96%) and FBP (reviewers 1/2, 62.36/74.84 ± 2.78/18.10%). Significant differences in the subjective measurements were not observed between ASiR and FBP. MBIR improves the diagnostic performance of CTA for small-vessel calcified lesions relative to FBP.

Comparison of the diagnostic accuracy of FBP, ASiR, and MBIR reconstruction during CT angiography in the evaluation of a vessel phantom with calcified stenosis in a distal superficial femoral artery in a cadaver extremity

PubMed Central

Tsukada, Jitsuro; Yamada, Minoru; Yamada, Yoshitake; Yamazaki, Shun; Imanishi, Nobuaki; Tamura, Kentaro; Hashimoto, Masahiro; Nakatsuka, Seishi; Jinzaki, Masahiro

2016-01-01

Abstract Purpose: To investigate whether adaptive statistical iterative reconstruction (ASiR) or model-based iterative reconstruction (MBIR) improves the diagnostic performance of computed tomography angiography (CTA) for small-vessel calcified lesions relative to filtered back projection (FBP) using cadaver extremities and a calcified stenosis phantom. Methods: A cadaver was used in accordance with our institutional regulations, and a calcified stenosis phantom simulating 4 grades of stenosis was prepared. The phantom was inserted within the distal superficial femoral artery of the cadaver leg. Ten CT images per reconstruction type and stenosis grade were acquired using a 64-slice multidetector-row CTA. As an objective measurement, the first and second derivatives of the CT value function profiles were calculated. As a subjective measurement, 2 blinded reviewers measured the stenosis ratio using a quantitative scale. The Wilcoxon rank-sum test was used to evaluate the data. Results: Objective measurements of both 25% and 50% stenosis differed significantly (P < 0.01) between MBIR (25/50%: 25.80/50.30 ± 3.88/3.86%) and FBP (25/50%: 35.60/83.80 ± 3.44/26.10%), whereas significant differences were not observed between ASiR and FBP. Reviewer 2's subjective measurements of 25% stenosis differed significantly (P < 0.01) between MBIR (35.13 ± 3.25%) and ASiR (40.89 ± 3.14%), and the measurements of 50% stenosis differed significantly (P < 0.01) between MBIR (reviewers 1/2, 62.36/54.78 ± 2.78/4.96%) and FBP (reviewers 1/2, 62.36/74.84 ± 2.78/18.10%). Significant differences in the subjective measurements were not observed between ASiR and FBP. Conclusion: MBIR improves the diagnostic performance of CTA for small-vessel calcified lesions relative to FBP. PMID:27399123

INTERIOR SECOND FLOOR EAST END LOOKING WEST AT NORTH ROW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

INTERIOR SECOND FLOOR- EAST END LOOKING WEST AT NORTH ROW OF MUSHROOM COLUMNS. - Colt Fire Arms Company, South Armory Building, 36-150 Huyshope Avenue, 17-170 Van Dyke Avenue, 49 Vredendale Avenue, Hartford, Hartford County, CT

A resource for the assessment of lung nodule size estimation methods: database of thoracic CT scans of an anthropomorphic phantom◊

PubMed Central

Gavrielides, Marios A.; Kinnard, Lisa M.; Myers, Kyle J.; Peregoy, Jennifer; Pritchard, William F.; Zeng, Rongping; Esparza, Juan; Karanian, John; Petrick, Nicholas

2010-01-01

A number of interrelated factors can affect the precision and accuracy of lung nodule size estimation. To quantify the effect of these factors, we have been conducting phantom CT studies using an anthropomorphic thoracic phantom containing a vasculature insert to which synthetic nodules were inserted or attached. Ten repeat scans were acquired on different multi-detector scanners, using several sets of acquisition and reconstruction protocols and various nodule characteristics (size, shape, density, location). This study design enables both bias and variance analysis for the nodule size estimation task. The resulting database is in the process of becoming publicly available as a resource to facilitate the assessment of lung nodule size estimation methodologies and to enable comparisons between different methods regarding measurement error. This resource complements public databases of clinical data and will contribute towards the development of procedures that will maximize the utility of CT imaging for lung cancer screening and tumor therapy evaluation. PMID:20640011

Multi-detector CT angiography of the aortic valve—Part 2: disease specific findings

PubMed Central

Ganeshan, Arul

2014-01-01

The aortic valve and adjacent structures should be routinely evaluated on all thoracic cross-sectional imaging studies. Echocardiography and magnetic resonance imaging (MRI) are the main imaging techniques used for assessment of the aortic valve and related pathology but multi-detector computed tomography (MDCT) can offer valuable complimentary information in some clinical scenarios. MDCT is the definite means of assessing aortic valvular calcification, acute aortic syndrome and for non-invasive assessment of the coronary arteries. MDCT also has an emerging role in the planning and follow-up of trans-catheter aortic valve replacement. This article reviews the spectrum of aortic valve disease highlighting the key MDCT imaging features. PMID:25202663

Performance evaluation of a 64-slice CT system with z-flying focal spot.

PubMed

Flohr, T; Stierstorfer, K; Raupach, R; Ulzheimer, S; Bruder, H

2004-12-01

The meanwhile established generation of 16-slice CT systems enables routine sub-millimeter imaging at short breath-hold times. Clinical progress in the development of multidetector row CT (MDCT) technology beyond 16 slices can more likely be expected from further improvement in spatial and temporal resolution rather than from a mere increase in the speed of volume coverage. We present an evaluation of a recently introduced 64-slice CT system (SOMATOM Sensation 64, Siemens AG, Forchheim, Germany), which uses a periodic motion of the focal spot in longitudinal direction (z-flying focal spot) to double the number of simultaneously acquired slices. This technique acquires 64 overlapping 0.6 mm slices per rotation. The sampling scheme corresponds to that of a 64 x 0.3 mm detector, with the goal of improved longitudinal resolution and reduced spiral artifacts. After an introduction to the detector design, we discuss the basics of z-flying focal spot technology (z-Sharp). We present phantom and specimen scans for performance evaluation. The measured full width at half maximum (FWHM) of the thinnest spiral slice is 0.65 mm. All spiral slice widths are almost independent of the pitch, with deviations of less than 0.1 mm from the nominal value. Using a high-resolution bar pattern phantom (CATPHAN, Phantom Laboratories, Salem, NY), the longitudinal resolution can be demonstrated to be up to 15 lp/cm at the isocenter independent of the pitch, corresponding to a bar diameter of 0.33 mm. Longitudinal resolution is only slightly degraded for off-center locations. At a distance of 100 mm from the isocenter, 14 lp/cm can be resolved in the z-direction, corresponding to a bar diameter of 0.36 mm. Spiral "windmill" artifacts presenting as hyper- and hypodense structures around osseous edges are effectively reduced by the z-flying focal spot technique. Cardiac scanning benefits from the short gantry rotation time of 0.33 s, providing up to 83 ms temporal resolution with 2-segment ECG-gated reconstruction.

Comparison of DWI and 18F-FDG PET/CT for assessing preoperative N-staging in gastric cancer: evidence from a meta-analysis

PubMed Central

Luo, Mingxu; Song, Hongmei; Liu, Gang; Lin, Yikai; Luo, Lintao; Zhou, Xin; Chen, Bo

2017-01-01

The diagnostic values of diffusion weighted imaging (DWI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for N-staging of gastric cancer (GC) were identified and compared. After a systematic search to identify relevant articles, meta-analysis was used to summarize the sensitivities, specificities, and areas under curves (AUCs) for DWI and PET/CT. To better understand the diagnostic utility of DWI and PET/CT for N-staging, the performance of multi-detector computed tomography (MDCT) was used as a reference. Fifteen studies were analyzed. The pooled sensitivity, specificity, and AUC with 95% confidence intervals of DWI were 0.79 (0.73–0.85), 0.69 (0.61–0.77), and 0.81 (0.77–0.84), respectively. For PET/CT, the corresponding values were 0.52 (0.39–0.64), 0.88 (0.61–0.97), and 0.66 (0.62–0.70), respectively. Comparison of the two techniques revealed DWI had higher sensitivity and AUC, but no difference in specificity. DWI exhibited higher sensitivity but lower specificity than MDCT, and 18F-FDG PET/CT had lower sensitivity and equivalent specificity. Overall, DWI performed better than 18F-FDG PET/CT for preoperative N-staging in GC. When the efficacy of MDCT was taken as a reference, DWI represented a complementary imaging technique, while 18F-FDG PET/CT had limited utility for preoperative N-staging. PMID:29137440

4. VIEW NORTHWEST, INTERIOR OF GATEHOUSE, SHOWING ROW OF GATE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. VIEW NORTHWEST, INTERIOR OF GATEHOUSE, SHOWING ROW OF GATE OPERATING MECHANISMS; HEIGHT OF STEMS INDICATES FOREGROUND GATE IS OPEN - Norwich Water Power Company, Headgates, West bank of Shetucket River opposite Fourteenth Street, Greenville section, Norwich, New London County, CT

Multi-detector thoracic CT findings in cerebro-costo-mandibular syndrome: rib gaps and failure of costo-vertebral separation.

PubMed

Watson, Tom Anthony; Arthurs, Owen John; Muthialu, Nagarajan; Calder, Alistair Duncan

2014-02-01

Cerebro-costo-mandibular syndrome (CCMS) describes a triad of mandibular hypoplasia, brain dysfunction and posterior rib defects ("rib gaps"). We present the CT imaging for a 2-year-old girl with CCMS that highlights the rib gap defects and shows absent transverse processes with abnormal fusion of the ribs directly to the vertebral bodies. We argue that this is likely to relate to abnormal lateral sclerotome development in embryology, with the failure of normal costo-vertebral junctions compounding impaired thoracic function. The case also highlights the use of CT for specific indications in skeletal dysplasia.

Application of MPVR and TL-VR with 64-row MDCT in neonates with congenital EA and distal TEF.

PubMed

Wen, Yang; Peng, Yun; Zhai, Ren-You; Li, Ying-Zi

2011-03-28

To assess the application of multiple planar volume reconstruction (MPVR) and three-dimensional (3D) transparency lung volume rendering (TL-VR) with 64-row multidetector-row computed tomography (MDCT) in neonates with congenital esophageal atresia (EA) and distal tracheoesophageal fistula (TEF). Twenty neonates (17 boys, 3 girls) with EA and distal TEF at a mean age of 4.6 d (range 1-16 d) were enrolled in this study. A helical scan of 64-row MDCT was performed at the 64 mm × 0.625 mm collimation. EA and TEF were reconstructed with MPVR and TL-VR, respectively. Initial diagnosis of EA was made by chest radiography showing the inserted catheter in the proximal blind-ended esophageal pouch. Manifestations of MDCT images were compared with the findings at surgery. MDCT showed the proximal and distal esophageal pouches in 20 cases. No significant difference was observed in gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR. The lengths of gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR correlated well with the findings at surgery (R = 0.87, P < 0.001). The images of MPVR revealed the orifice of TEF in 13 cases, while TL-VR images showed the orifice of TEF in 4 cases. EA and distal TEF can be reconstructed using MPVR and TL-VR of 64-row MDCT, which is a noninvasive technique to demonstrate the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

Evaluation of hepatic arterial anatomy by multidetector computed tomographic angiography in living donor liver transplantation.

PubMed

Keles, Papatya; Yuce, Ihsan; Keles, Sait; Kantarci, Mecit

2016-06-01

The aim of this study was to define the different courses and percentages of hepatic artery that were detected during preoperative evaluation of living liver donors by multidetector computed tomographic angiography (MDCTA). We evaluated 150 donors before hepatic transplantation. All of the donors were evaluated by multislice CT scan with 256 detectors. For each patient, arterial, portal and venous phase images were obtained. The hepatic arterial variations were evaluated by the same radiologist according to Michels' classification. Common hepatic arterial anatomy (type I) was observed in 95 donors (63.3%). Other arterial variations were determined in the remaining 55 donors (36.6%). The second common variation was type XI which did not match with the description of Michels' classification variation in 15 donors (10%). The remaining variations described in Michels' classification were seen at lower rates. Type VII or X variation was not seen. MDCTA is a useful method to identify the blood supply of the liver before the liver transplantations, and surgeons can make their plan on the basis of CT data.

Estimating radiation dose to organs of patients undergoing conventional and novel multidetector CT exams using Monte Carlo simulations

NASA Astrophysics Data System (ADS)

Angel, Erin

Advances in Computed Tomography (CT) technology have led to an increase in the modality's diagnostic capabilities and therefore its utilization, which has in turn led to an increase in radiation exposure to the patient population. As a result, CT imaging currently constitutes approximately half of the collective exposure to ionizing radiation from medical procedures. In order to understand the radiation risk, it is necessary to estimate the radiation doses absorbed by patients undergoing CT imaging. The most widely accepted risk models are based on radiosensitive organ dose as opposed to whole body dose. In this research, radiosensitive organ dose was estimated using Monte Carlo based simulations incorporating detailed multidetector CT (MDCT) scanner models, specific scan protocols, and using patient models based on accurate patient anatomy and representing a range of patient sizes. Organ dose estimates were estimated for clinical MDCT exam protocols which pose a specific concern for radiosensitive organs or regions. These dose estimates include estimation of fetal dose for pregnant patients undergoing abdomen pelvis CT exams or undergoing exams to diagnose pulmonary embolism and venous thromboembolism. Breast and lung dose were estimated for patients undergoing coronary CTA imaging, conventional fixed tube current chest CT, and conventional tube current modulated (TCM) chest CT exams. The correlation of organ dose with patient size was quantified for pregnant patients undergoing abdomen/pelvis exams and for all breast and lung dose estimates presented. Novel dose reduction techniques were developed that incorporate organ location and are specifically designed to reduce close to radiosensitive organs during CT acquisition. A generalizable model was created for simulating conventional and novel attenuation-based TCM algorithms which can be used in simulations estimating organ dose for any patient model. The generalizable model is a significant contribution of this work as it lays the foundation for the future of simulating TCM using Monte Carlo methods. As a result of this research organ dose can be estimated for individual patients undergoing specific conventional MDCT exams. This research also brings understanding to conventional and novel close reduction techniques in CT and their effect on organ dose.

Multidetector CT features of pulmonary focal ground-glass opacity: differences between benign and malignant

PubMed Central

Fan, L; Liu, S-Y; Li, Q-C; Yu, H; Xiao, X-S

2012-01-01

Objective To evaluate different features between benign and malignant pulmonary focal ground-glass opacity (fGGO) on multidetector CT (MDCT). Methods 82 pathologically or clinically confirmed fGGOs were retrospectively analysed with regard to demographic data, lesion size and location, attenuation value and MDCT features including shape, margin, interface, internal characteristics and adjacent structure. Differences between benign and malignant fGGOs were analysed using a χ2 test, Fisher's exact test or Mann–Whitney U-test. Morphological characteristics were analysed by binary logistic regression analysis to estimate the likelihood of malignancy. Results There were 21 benign and 61 malignant lesions. No statistical differences were found between benign and malignant fGGOs in terms of demographic data, size, location and attenuation value. The frequency of lobulation (p=0.000), spiculation (p=0.008), spine-like process (p=0.004), well-defined but coarse interface (p=0.000), bronchus cut-off (p=0.003), other air-containing space (p=0.000), pleural indentation (p=0.000) and vascular convergence (p=0.006) was significantly higher in malignant fGGOs than that in benign fGGOs. Binary logistic regression analysis showed that lobulation, interface and pleural indentation were important indicators for malignant diagnosis of fGGO, with the corresponding odds ratios of 8.122, 3.139 and 9.076, respectively. In addition, a well-defined but coarse interface was the most important indicator of malignancy among all interface types. With all three important indicators considered, the diagnostic sensitivity, specificity and accuracy were 93.4%, 66.7% and 86.6%, respectively. Conclusion An fGGO with lobulation, a well-defined but coarse interface and pleural indentation gives a greater than average likelihood of being malignant. PMID:22128130

X-ray computed microtomography analysis of the influence of different agricultural treatments on the topsoil porosity of a Grey Brown Luvisol from Ontario

NASA Astrophysics Data System (ADS)

Taina, I. A.; Heck, R. J.; Scaiff, N. T.

2009-05-01

One of the most important applications of X-ray computed tomography (CT) for the study of soil is the characterization of the shape and spatial distribution of pores. Analysis of 3D X-ray CT image data, related to different pore categories, can provide insight to soil structural changes, which have implications in water infiltration and soil aeration, resulting from agricultural practices. The aim of this study was to evaluate changes in the spatial characteristics of voids, due to tillage practices, in the Ap horizon of an Orthic Grey- Brown Luvisol (located at the Elora Research Station of the University of Guelph). Undisturbed oriented soil samples were collected from ten plots representing different tillage treatments: spring moldboard plow, spring moldboard plow, cultivate and pack, fall moldboard plow, cultivate and pack, spring tandem disc, no cultivator, fall offset disc, fall offset disc, cultivate and pack, fall chisel plow, cultivate and pack, zero zone till (soys twin rows), zero tillage (long term), and zero tillage (corn residue removed in row, soys twin rows). Since the utilization of standardized classes, in the quantification of similar features, proved to be necessary in order to obtain comparable results, categories of pores, separated according to their size, circularity and orientation were considered in the interpretation of data. Total volume of pores and volume percentage of each class were calculated, revealing substantial differences among the analyzed soil samples.

Multidetector CT evaluation of the postoperative pancreas.

PubMed

Yamauchi, Fernando I; Ortega, Cinthia D; Blasbalg, Roberto; Rocha, Manoel S; Jukemura, José; Cerri, Giovanni G

2012-01-01

Several pancreatic diseases may require surgical treatment, with most of these procedures classified as resection or drainage. Resection procedures, which are usually performed to remove pancreatic tumors, include pancreatoduodenectomy, central pancreatectomy, distal pancreatectomy, and total pancreatectomy. Drainage procedures are usually performed to treat chronic pancreatitis after the failure of medical therapy and include the Puestow and Frey procedures. The type of surgery depends not only on the patient's symptoms and the location of the disease, but also on the expertise of the surgeon. Radiologists should become familiar with these surgical procedures to better understand postoperative changes in anatomic findings. Multidetector computed tomography is the modality of choice for identifying normal findings after surgery, postoperative complications, and tumor recurrence in patients who have undergone pancreatic surgery. RSNA, 2012

Metallic artifacts from internal scaphoid fracture fixation screws: comparison between C-arm flat-panel, cone-beam, and multidetector computed tomography.

PubMed

Finkenstaedt, Tim; Morsbach, Fabian; Calcagni, Maurizio; Vich, Magdalena; Pfirrmann, Christian W A; Alkadhi, Hatem; Runge, Val M; Andreisek, Gustav; Guggenberger, Roman

2014-08-01

The aim of this study was to compare image quality and extent of artifacts from scaphoid fracture fixation screws using different computed tomography (CT) modalities and radiation dose protocols. Imaging of 6 cadaveric wrists with artificial scaphoid fractures and different fixation screws was performed in 2 screw positions (45° and 90° orientation in relation to the x/y-axis) using multidetector CT (MDCT) and 2 flat-panel CT modalities, C-arm flat-panel CT (FPCT) and cone-beam CT (CBCT), the latter 2 with low and standard radiation dose protocols. Mean cartilage attenuation and metal artifact-induced absolute Hounsfield unit changes (= artifact extent) were measured. Two independent radiologists evaluated different image quality criteria using a 5-point Likert-scale. Interreader agreements (Cohen κ) were calculated. Mean absolute Hounsfield unit changes and quality ratings were compared using Friedman and Wilcoxon signed-rank tests. Artifact extent was significantly smaller for MDCT and standard-dose FPCT compared with CBCT low- and standard-dose acquisitions (all P < 0.05). No significant differences in artifact extent among different screw types and scanning positions were noted (P > 0.05). Both MDCT and FPCT standard-dose protocols showed equal ratings for screw bone interface, fracture line, and trabecular bone evaluation (P = 0.06, 0.2, and 0.2, respectively) and performed significantly better than FPCT low- and CBCT low- and standard-dose acquisitions (all P < 0.05). Good interreader agreement was found for image quality comparisons (Cohen κ = 0.76-0.78). Both MDCT and FPCT standard-dose acquisition showed comparatively less metal-induced artifacts and better overall image quality compared with FPCT low-dose and both CBCT acquisitions. Flat-panel CT may provide sufficient image quality to serve as a versatile CT alternative for postoperative imaging of internally fixated wrist fractures.

The value of dual-source multidetector-row computed tomography in determining pulmonary blood supply in patients with pulmonary atresia with ventricular septal defect.

PubMed

Chaosuwannakit, N; Makarawate, P

2018-01-01

Primary evaluation of patients with pulmonary atresia with ventricular septal defect (PA-VSD) traditionally relies upon echocardiography and conventional cardiac angiography (CCA). Cardiac angiography is considered the gold standard for delineation of anatomy in children with PA-VSD. Data comparing CCA and dual-source multidetector-row computed tomography angiography (MDCT) in PA-VSD patients is limited. The objective of this study was to test the hypothesis that MDCT is equivalent to CCA for anatomic delineation in these patients. Twenty-eight patients with PA-VSD underwent CCA and MDCT in close proximity to each other without interval therapy. A retrospective review of these 28 patients was performed. All MDCT data of pulmonary artery morphology, major aortopulmonary collateral arteries (MAPCAs) and type of blood supply (dual vs. single supply) were evaluated by blinded experts and results were compared with CCA. Twenty-eight patients had adequate size right and left pulmonary arteries (21 confluent and 7 non-confluent). Seven patients had complete absence of native pulmonary artery and 3 patients had stenosis of distal branches of pulmonary arteries; all had MAPCAs from descending thoracic aorta and/or subclavian arteries. Sensitivity, specificity, positive and negative predictive value of MDCT for detecting confluent of pulmonary arteries, absence of native pulmonary artery and stenosis of pulmonary arteries were all 100%. Moreover, accuracy of detecting MAPCAs was excellent. These results suggest that MDCT and CCA are equivalent in their ability to delineate pulmonary artery anatomy and MAPCAs. Dual source MDCT provides high diagnostic accuracy in evaluation of pulmonary blood supply in patients with PA-VSD and allows precise characterisation of the condition of pulmonary arteries and MAPCAs which is of paramount importance in managing patients with PA-VSD. (Folia Morphol 2018; 77, 1: 116-122).

Influence of the Quantity of Aortic Valve Calcium on the Agreement Between Automated 3-Dimensional Transesophageal Echocardiography and Multidetector Row Computed Tomography for Aortic Annulus Sizing.

PubMed

Podlesnikar, Tomaz; Prihadi, Edgard A; van Rosendael, Philippe J; Vollema, E Mara; van der Kley, Frank; de Weger, Arend; Ajmone Marsan, Nina; Naji, Franjo; Fras, Zlatko; Bax, Jeroen J; Delgado, Victoria

2018-01-01

Accurate aortic annulus sizing is key for selection of appropriate transcatheter aortic valve implantation (TAVI) prosthesis size. The present study compared novel automated 3-dimensional (3D) transesophageal echocardiography (TEE) software and multidetector row computed tomography (MDCT) for aortic annulus sizing and investigated the influence of the quantity of aortic valve calcium (AVC) on the selection of TAVI prosthesis size. A total of 83 patients with severe aortic stenosis undergoing TAVI were evaluated. Maximal and minimal aortic annulus diameter, perimeter, and area were measured. AVC was assessed with computed tomography. The low and high AVC burden groups were defined according to the median AVC score. Overall, 3D TEE measurements slightly underestimated the aortic annulus dimensions as compared with MDCT (mean differences between maximum, minimum diameter, perimeter, and area: -1.7 mm, 0.5 mm, -2.7 mm, and -13 mm 2 , respectively). The agreement between 3D TEE and MDCT on aortic annulus dimensions was superior among patients with low AVC burden (<3,025 arbitrary units) compared with patients with high AVC burden (≥3,025 arbitrary units). The interobserver variability was excellent for both methods. 3D TEE and MDCT led to the same prosthesis size selection in 88%, 95%, and 81% of patients in the total population, the low, and the high AVC burden group, respectively. In conclusion, the novel automated 3D TEE imaging software allows accurate and highly reproducible measurements of the aortic annulus dimensions and shows excellent agreement with MDCT to determine the TAVI prosthesis size, particularly in patients with low AVC burden. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis.

PubMed

Tanis, W; Budde, R P J; van der Bilt, I A C; Delemarre, B; Hoohenkerk, G; van Rooden, J-K; Scholtens, A M; Habets, J; Chamuleau, S

2016-02-01

Prosthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission tomography including low-dose CT (FDG-PET) and three-dimensional transoesophageal echocardiography (3D-TEE) may have additional value. This paper reviews the role of these novel imaging tools in the field of PHV obstruction and endocarditis.For acquired PHV obstruction, MDCT is of additional value in mechanical PHVs to differentiate pannus from thrombus as well as to dynamically study leaflet motion and opening/closing angles. For biological PHV obstruction, additional imaging is not beneficial as it does not change patient management. When performed on top of 2D-TTE/TEE, MDCT has additional value for the detection of both vegetations and pseudoaneurysms/abscesses in PHV endocarditis. FDG-PET has no complementary value for the detection of vegetations; however, it appears more sensitive in the early detection of pseudoaneurysms/abscesses. Furthermore, FDG-PET enables the detection of metastatic and primary extra-cardiac infections. Evidence for the additional value of 3D-TEE is scarce.As clinical implications are major, clinicians should have a low threshold to perform additional MDCT in acquired mechanical PHV obstruction. For suspected PHV endocarditis, both FDG-PET and MDCT have complementary value.

High-definition multidetector computed tomography for evaluation of coronary artery stents: comparison to standard-definition 64-detector row computed tomography.

PubMed

Min, James K; Swaminathan, Rajesh V; Vass, Melissa; Gallagher, Scott; Weinsaft, Jonathan W

2009-01-01

The assessment of coronary stents with present-generation 64-detector row computed tomography scanners that use filtered backprojection and operating at standard definition of 0.5-0.75 mm (standard definition, SDCT) is limited by imaging artifacts and noise. We evaluated the performance of a novel, high-definition 64-slice CT scanner (HDCT), with improved spatial resolution (0.23 mm) and applied statistical iterative reconstruction (ASIR) for evaluation of coronary artery stents. HDCT and SDCT stent imaging was performed with the use of an ex vivo phantom. HDCT was compared with SDCT with both smooth and sharp kernels for stent intraluminal diameter, intraluminal area, and image noise. Intrastent visualization was assessed with an ASIR algorithm on HDCT scans, compared with the filtered backprojection algorithms by SDCT. Six coronary stents (2.5, 2.5, 2.75, 3.0, 3.5, 4.0mm) were analyzed by 2 independent readers. Interobserver correlation was high for both HDCT and SDCT. HDCT yielded substantially larger luminal area visualization compared with SDCT, both for smooth (29.4+/-14.5 versus 20.1+/-13.0; P<0.001) and sharp (32.0+/-15.2 versus 25.5+/-12.0; P<0.001) kernels. Stent diameter was higher with HDCT compared with SDCT, for both smooth (1.54+/-0.59 versus1.00+/-0.50; P<0.0001) and detailed (1.47+/-0.65 versus 1.08+/-0.54; P<0.0001) kernels. With detailed kernels, HDCT scans that used algorithms showed a trend toward decreased image noise compared with SDCT-filtered backprojection algorithms. On the basis of this ex vivo study, HDCT provides superior detection of intrastent luminal area and diameter visualization, compared with SDCT. ASIR image reconstruction techniques for HDCT scans enhance the in-stent assessment while decreasing image noise.

Usefulness of Single Photon Emission Computed Tomography/Computed Tomography Fusion-Hybrid Imaging to Evaluate Coronary Artery Disorders in Patients with a History of Kawasaki Disease.

PubMed

Abe, Masanori; Fukazawa, Ryuji; Ogawa, Shunichi; Watanabe, Makoto; Fukushima, Yoshimitsu; Kiriyama, Tomonari; Hayashi, Hiromitsu; Itoh, Yasuhiko

2016-01-01

The coronary arterial lesions of Kawasaki disease are mainly dilative lesions, aneurysms, and stenotic lesions formed before, after, and between aneurysms; these lesions develop in multiple branches resulting in complex coronary hemodynamics. Diagnosis of myocardial ischemia and infarction and evaluation of the culprit coronary arteries and regions is critical to evaluating the treatment and prognosis of patients. This study used hybrid imaging, in which multidetector computed tomographic (CT) images for coronary CT angiography (CCTA) and stress myocardial perfusion single-photon emission CT (SPECT) images were fused. We investigated the diagnosis of blood vessels and regions responsible for myocardial ischemia and infarction in patients with complex coronary arterial lesions; in addition, we evaluated myocardial lesions that developed directly under giant coronary artery aneurysms. The subjects were 17 patients with Kawasaki disease with multiple coronary arterial lesions (median age, 18.0 years; 16 male). Both CCTA using 64-row CT and adenosine-loading myocardial SPECT were performed. Three branches, the right coronary artery (RCA), left anterior descending branch (LAD), and left circumflex branch, were evaluated with the conventional side-by-side interpretation, in which the images were lined up for diagnosis, and hybrid imaging, in which the CCTA and SPECT images were fused with computer processing. In addition, the myocardial lesions directly under giant coronary artery aneurysms were investigated with fusion imaging. Images sufficient for evaluation were acquired in all 17 patients. In the RCA, coronary arterial lesions were detected with CCTA in 16 patients. The evaluations were consistent between the side-by-side and fusion interpretation in 14 patients, and the blood vessel responsible for the myocardial ischemic region was identified in 2 patients. In the left circumflex branch, coronary arterial lesions were confirmed with 3-dimensional CT in 5 patients, and the the culprit coronary arteries for myocardial ischemia/infarction were confirmed with the fusion interpretation but not with the side-by-side interpretation. In the LAD, coronary arterial lesions were present in all patients, and the diagnosis was made with the fusion interpretation in 10 patients. In the LAD, small-range infarct lesions were detected directly under the giant coronary artery aneurysm in 8 patients, but were not confirmed with the side-by-side interpretation. Fusion imaging was capable of accurately evaluating myocardial ischemia/infarction as cardiovascular sequelae of Kawasaki disease and confirming the culprit coronary arteries. In addition, analysis of fusion images confirmed that small-range infarct lesions were concomitantly present directly under giant coronary artery aneurysms in the anterior descending coronary artery.

Latest generation of flat detector CT as a peri-interventional diagnostic tool: a comparative study with multidetector CT.

PubMed

Leyhe, Johanna Rosemarie; Tsogkas, Ioannis; Hesse, Amélie Carolina; Behme, Daniel; Schregel, Katharina; Papageorgiou, Ismini; Liman, Jan; Knauth, Michael; Psychogios, Marios-Nikos

2017-12-01

Flat detector CT (FDCT) has been used as a peri-interventional diagnostic tool in numerous studies with mixed results regarding image quality and detection of intracranial lesions. We compared the diagnostic aspects of the latest generation FDCT with standard multidetector CT (MDCT). 102 patients were included in our retrospective study. All patients had undergone interventional procedures. FDCT was acquired peri-interventionally and compared with postinterventional MDCT regarding depiction of ventricular/subarachnoidal spaces, detection of intracranial hemorrhage, and delineation of ischemic lesions using an ordinal scale. Ischemic lesions were quantified with the Alberta Stroke Program Early CT Scale (ASPECTS) on both examinations. Two neuroradiologists with varying grades of experience and a medical student scored the anonymized images separately, blinded to the clinical history. The two methods were of equal diagnostic value regarding evaluation of the ventricular system and the subarachnoidal spaces. Subarachnoidal, intraventricular, and parenchymal hemorrhages were detected with a sensitivity of 95%, 97%, and 100% and specificity of 97%, 100%, and 99%, respectively, using FDCT. Gray-white differentiation was feasible in the majority of FDCT scans, and ischemic lesions were detected with a sensitivity of 71% on FDCT, compared with MDCT scans. The mean difference in ASPECTS values on FDCT and MDCT was 0.5 points (95% CI 0.12 to 0.88). The latest generation of FDCT is a reliable and accurate tool for the detection of intracranial hemorrhage. Gray-white differentiation is feasible in the supratentorial region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effects of dose reduction on multi-detector computed tomographic images in evaluating the maxilla and mandible for pre-surgical implant planning: a cadaveric study.

PubMed

Koizumi, Hiroshi; Sur, Jaideep; Seki, Kenji; Nakajima, Koh; Sano, Tsukasa; Okano, Tomohiro

2010-08-01

To assess effects of dose reduction on image quality in evaluating maxilla and mandible for pre-surgical implant planning using cadavers. Six cadavers were used for the study using multi-detector computed tomography (CT) operated at 120 kV and the variable tube current of 80, 40, 20 and 10 mA. A slice thickness of 0.625 mm and pitch 1 were used. Multi-planar images perpendicular and parallel to dentitions were created. The images were evaluated by five oral radiologists in terms of visibility of the anatomical landmarks including alveolar crest, mandibular canal, floors of the maxillary sinus and nasal cavity, contours/cortical layer of jaw bones and the details of trabecular bone. Observers were asked to determine the quality of the images in comparison with 80 mA images based on the criteria: excellent, good, fair or non-diagnostic. The average scores of all observers were calculated for each specimen in all exposure conditions. The 40 mA images could visualize such landmarks and were evaluated to be same or almost equivalent in quality to the 80 mA images. Even the 20 mA images could be accepted just for diagnostic purpose for implant with substantial deterioration of the image quality. The 10 mA images may not be accepted because of the obscured contour caused by image noise. Significant dose reduction by lowering mA can be utilized for pre-surgical implant planning in multi-detector CT.

Peripheral Quantitative CT (pQCT) Using a Dedicated Extremity Cone-Beam CT Scanner

PubMed Central

Muhit, A. A.; Arora, S.; Ogawa, M.; Ding, Y.; Zbijewski, W.; Stayman, J. W.; Thawait, G.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Bingham, C.O.; Means, K.; Carrino, J. A.; Siewerdsen, J. H.

2014-01-01

Purpose We describe the initial assessment of the peripheral quantitative CT (pQCT) imaging capabilities of a cone-beam CT (CBCT) scanner dedicated to musculoskeletal extremity imaging. The aim is to accurately measure and quantify bone and joint morphology using information automatically acquired with each CBCT scan, thereby reducing the need for a separate pQCT exam. Methods A prototype CBCT scanner providing isotropic, sub-millimeter spatial resolution and soft-tissue contrast resolution comparable or superior to standard multi-detector CT (MDCT) has been developed for extremity imaging, including the capability for weight-bearing exams and multi-mode (radiography, fluoroscopy, and volumetric) imaging. Assessment of pQCT performance included measurement of bone mineral density (BMD), morphometric parameters of subchondral bone architecture, and joint space analysis. Measurements employed phantoms, cadavers, and patients from an ongoing pilot study imaged with the CBCT prototype (at various acquisition, calibration, and reconstruction techniques) in comparison to MDCT (using pQCT protocols for analysis of BMD) and micro-CT (for analysis of subchondral morphometry). Results The CBCT extremity scanner yielded BMD measurement within ±2–3% error in both phantom studies and cadaver extremity specimens. Subchondral bone architecture (bone volume fraction, trabecular thickness, degree of anisotropy, and structure model index) exhibited good correlation with gold standard micro-CT (error ~5%), surpassing the conventional limitations of spatial resolution in clinical MDCT scanners. Joint space analysis demonstrated the potential for sensitive 3D joint space mapping beyond that of qualitative radiographic scores in application to non-weight-bearing versus weight-bearing lower extremities and assessment of phalangeal joint space integrity in the upper extremities. Conclusion The CBCT extremity scanner demonstrated promising initial results in accurate pQCT analysis from images acquired with each CBCT scan. Future studies will include improved x-ray scatter correction and image reconstruction techniques to further improve accuracy and to correlate pQCT metrics with known pathology. PMID:25076823

Diagnostic capability of gadoxetate disodium-enhanced liver MRI for diagnosis of hepatocellular carcinoma: comparison with multi-detector CT.

PubMed

Toyota, Naoyuki; Nakamura, Yuko; Hieda, Masashi; Akiyama, Naoko; Terada, Hiroaki; Matsuura, Noriaki; Nishiki, Masayo; Kono, Hirotaka; Kohno, Hiroshi; Irei, Toshimitsu; Yoshikawa, Yukinobu; Kuraoka, Kazuya; Taniyama, Kiyomi; Awai, Kazuo

2013-09-01

The purpose of this study was to evaluate the diagnostic capability of gadoxetate disodium (Gd-EOB)-MRI for the detection of hepatocellular carcinoma (HCC) compared with multidetector CT (MDCT). Fifty patients with 57 surgically proven HCCs who underwent Gd-EOB-MRI and MDCT from March 2008 to June 2011 were evaluated. Two observers evaluated MR and CT on a lesion-by-lesion basis. We analyzed sensitivity by grading on a 5-point scale, the degree of arterial enhancement and the differences in histological grades in the diffusion-weighted images (DWI). The results showed that the sensitivity of Gd-EOB-MRI was higher than that of MDCT especially for HCCs that were 1 cm in diameter or smaller. The hepatobiliary phase was useful for the detecting of small HCC. We had few cases in which it was difficult to judge HCC in the arterial enhancement between MRI and MDCT. In the diffusion-weighted image, well differentiated HCC tended to show a low signal intensity, and poorly differentiated HCC tended to show a high signal intensity. In moderately differentiated HCC's, the mean diameter of the high signal intensity group was larger than that of the low signal intensity group (24.5 mm vs. 15.8 mm). In conclusion, Gd-EOB-MRI tended to show higher sensitivity compared to MDCT in the detection of HCC.

Dose reduction in paediatric MDCT: general principles.

PubMed

Paterson, A; Frush, D P

2007-06-01

The number of multi-detector array computed tomography (MDCT) examinations performed per annum continues to increase in both the adult and paediatric populations. Estimates from 2003 suggested that CT contributed 17% of a radiology department's workload, yet was responsible for up to 75% of the collective population dose from medical radiation. The effective doses for some CT examinations today overlap with those argued to have an increased risk of cancer. This is especially pertinent for paediatric CT, as children are more radiosensitive than adults (and girls more radiosensitive than boys). In addition, children have a longer life ahead of them, in which radiation induced cancers may become manifest. Radiologists must be aware of these facts and practise the ALARA (as low as is reasonably achievable) principle, when it comes to deciding CT protocols and parameters.

SimDoseCT: dose reporting software based on Monte Carlo simulation for a 320 detector-row cone-beam CT scanner and ICRP computational adult phantoms

NASA Astrophysics Data System (ADS)

Cros, Maria; Joemai, Raoul M. S.; Geleijns, Jacob; Molina, Diego; Salvadó, Marçal

2017-08-01

This study aims to develop and test software for assessing and reporting doses for standard patients undergoing computed tomography (CT) examinations in a 320 detector-row cone-beam scanner. The software, called SimDoseCT, is based on the Monte Carlo (MC) simulation code, which was developed to calculate organ doses and effective doses in ICRP anthropomorphic adult reference computational phantoms for acquisitions with the Aquilion ONE CT scanner (Toshiba). MC simulation was validated by comparing CTDI measurements within standard CT dose phantoms with results from simulation under the same conditions. SimDoseCT consists of a graphical user interface connected to a MySQL database, which contains the look-up-tables that were generated with MC simulations for volumetric acquisitions at different scan positions along the phantom using any tube voltage, bow tie filter, focal spot and nine different beam widths. Two different methods were developed to estimate organ doses and effective doses from acquisitions using other available beam widths in the scanner. A correction factor was used to estimate doses in helical acquisitions. Hence, the user can select any available protocol in the Aquilion ONE scanner for a standard adult male or female and obtain the dose results through the software interface. Agreement within 9% between CTDI measurements and simulations allowed the validation of the MC program. Additionally, the algorithm for dose reporting in SimDoseCT was validated by comparing dose results from this tool with those obtained from MC simulations for three volumetric acquisitions (head, thorax and abdomen). The comparison was repeated using eight different collimations and also for another collimation in a helical abdomen examination. The results showed differences of 0.1 mSv or less for absolute dose in most organs and also in the effective dose calculation. The software provides a suitable tool for dose assessment in standard adult patients undergoing CT examinations in a 320 detector-row cone-beam scanner.

SimDoseCT: dose reporting software based on Monte Carlo simulation for a 320 detector-row cone-beam CT scanner and ICRP computational adult phantoms.

PubMed

Cros, Maria; Joemai, Raoul M S; Geleijns, Jacob; Molina, Diego; Salvadó, Marçal

2017-07-17

This study aims to develop and test software for assessing and reporting doses for standard patients undergoing computed tomography (CT) examinations in a 320 detector-row cone-beam scanner. The software, called SimDoseCT, is based on the Monte Carlo (MC) simulation code, which was developed to calculate organ doses and effective doses in ICRP anthropomorphic adult reference computational phantoms for acquisitions with the Aquilion ONE CT scanner (Toshiba). MC simulation was validated by comparing CTDI measurements within standard CT dose phantoms with results from simulation under the same conditions. SimDoseCT consists of a graphical user interface connected to a MySQL database, which contains the look-up-tables that were generated with MC simulations for volumetric acquisitions at different scan positions along the phantom using any tube voltage, bow tie filter, focal spot and nine different beam widths. Two different methods were developed to estimate organ doses and effective doses from acquisitions using other available beam widths in the scanner. A correction factor was used to estimate doses in helical acquisitions. Hence, the user can select any available protocol in the Aquilion ONE scanner for a standard adult male or female and obtain the dose results through the software interface. Agreement within 9% between CTDI measurements and simulations allowed the validation of the MC program. Additionally, the algorithm for dose reporting in SimDoseCT was validated by comparing dose results from this tool with those obtained from MC simulations for three volumetric acquisitions (head, thorax and abdomen). The comparison was repeated using eight different collimations and also for another collimation in a helical abdomen examination. The results showed differences of 0.1 mSv or less for absolute dose in most organs and also in the effective dose calculation. The software provides a suitable tool for dose assessment in standard adult patients undergoing CT examinations in a 320 detector-row cone-beam scanner.

Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system.

PubMed

Demehri, S; Muhit, A; Zbijewski, W; Stayman, J W; Yorkston, J; Packard, N; Senn, R; Yang, D; Foos, D; Thawait, G K; Fayad, L M; Chhabra, A; Carrino, J A; Siewerdsen, J H

2015-06-01

To assess visualization tasks using cone-beam CT (CBCT) compared to multi-detector CT (MDCT) for musculoskeletal extremity imaging. Ten cadaveric hands and ten knees were examined using a dedicated CBCT prototype and a clinical multi-detector CT using nominal protocols (80 kVp-108mAs for CBCT; 120 kVp- 300 mAs for MDCT). Soft tissue and bone visualization tasks were assessed by four radiologists using five-point satisfaction (for CBCT and MDCT individually) and five-point preference (side-by-side CBCT versus MDCT image quality comparison) rating tests. Ratings were analyzed using Kruskal-Wallis and Wilcoxon signed-rank tests, and observer agreement was assessed using the Kappa-statistic. Knee CBCT images were rated "excellent" or "good" (median scores 5 and 4) for "bone" and "soft tissue" visualization tasks. Hand CBCT images were rated "excellent" or "adequate" (median scores 5 and 3) for "bone" and "soft tissue" visualization tasks. Preference tests rated CBCT equivalent or superior to MDCT for bone visualization and favoured the MDCT for soft tissue visualization tasks. Intraobserver agreement for CBCT satisfaction tests was fair to almost perfect (κ ~ 0.26-0.92), and interobserver agreement was fair to moderate (κ ~ 0.27-0.54). CBCT provided excellent image quality for bone visualization and adequate image quality for soft tissue visualization tasks. • CBCT provided adequate image quality for diagnostic tasks in extremity imaging. • CBCT images were "excellent" for "bone" and "good/adequate" for "soft tissue" visualization tasks. • CBCT image quality was equivalent/superior to MDCT for bone visualization tasks.

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.

Early detection of coronary artery disease by 64-slice multidetector computed tomography in asymptomatic hypertensive high-risk patients.

PubMed

Gaudio, Carlo; Mirabelli, Francesca; Pelliccia, Francesco; Francone, Marco; Tanzilli, Gaetano; Di Michele, Sara; Leonetti, Stefania; De Vincentis, Giuseppe; Carbone, Iacopo; Mangieri, Enrico; Catalano, Carlo; Passariello, Roberto

2009-07-10

The 64-slice multidetector-row computed tomography (MDCT) is an accurate noninvasive technique for assessing the degree of luminal narrowing in coronary arteries of patients with chronic ischemic disease. Aim of this study was to determine the value of MDCT in comparison to invasive coronary angiography (ICA) for detecting the presence and extent of coronary atherosclerotic plaques in a population of asymptomatic, hypertensive patients considered to be at high risk for cardiovascular events. We studied 67 asymptomatic, hypertensive patients at high-risk (Euro Score >5%). All patients had negative or nondiagnostic findings at exercise stress testing and therefore underwent both MDCT and ICA. In the per-patient analysis, MDCT correctly identified 16/17 (94%) patients with significant coronary artery disease involving at least 1 vessel and 48/50 (96%) normal subjects. In the per-segment analysis, MDCT correctly detected 21/22 (95%) coronary segments with a stenosis >or=50% and 856/868 (98%) normal segments, with a high negative predictivity of normal scans (100%). There was a good concordance between MDCT and ICA, with a high Pearson correlation coefficient between the coronary narrowings with the two techniques (r=0.84, p<0.01). Mean coronary calcium score was higher for the 17 patients with significant coronary artery disease on ICA than in the 50 patients without (422+/-223 HU vs 72+/-21 HU p<0.001). The ROC curves identified 160 as the best calcium volumetric score cut-off value able to identify >or=1 significant coronary stenosis with sensitivity 88% and specificity 85%. MDCT is an excellent noninvasive technique for early identification of significant coronary stenoses in high risk asymptomatic hypertensive patients and might provide unique information for the screening of this broad population.

Effects of dose reduction on bone strength prediction using finite element analysis

NASA Astrophysics Data System (ADS)

Anitha, D.; Subburaj, Karupppasamy; Mei, Kai; Kopp, Felix K.; Foehr, Peter; Noel, Peter B.; Kirschke, Jan S.; Baum, Thomas

2016-12-01

This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests were used to compare the results obtained, using the highest CT dose (500 mAs) as reference. Dose reduction had no significant impact on FE-predicted fracture loads, with significant correlations obtained with reference to 500 mAs, for 80 mAs (R2  = 0.997, p < 0.001), 150 mAs (R2 = 0.998, p < 0.001) and 220 mAs (R2 = 0.987, p < 0.001). There were no significant differences in volume quantification between the different doses examined. CT imaging radiation dose could be reduced substantially to 64% with no impact on strength estimates obtained from FE analysis. Reduced CT dose will enable early diagnosis and advanced monitoring of osteoporosis and associated fracture risk.

Sample size requirements for estimating effective dose from computed tomography using solid-state metal-oxide-semiconductor field-effect transistor dosimetry

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

Trattner, Sigal; Cheng, Bin; Pieniazek, Radoslaw L.

2014-04-15

Purpose: Effective dose (ED) is a widely used metric for comparing ionizing radiation burden between different imaging modalities, scanners, and scan protocols. In computed tomography (CT), ED can be estimated by performing scans on an anthropomorphic phantom in which metal-oxide-semiconductor field-effect transistor (MOSFET) solid-state dosimeters have been placed to enable organ dose measurements. Here a statistical framework is established to determine the sample size (number of scans) needed for estimating ED to a desired precision and confidence, for a particular scanner and scan protocol, subject to practical limitations. Methods: The statistical scheme involves solving equations which minimize the sample sizemore » required for estimating ED to desired precision and confidence. It is subject to a constrained variation of the estimated ED and solved using the Lagrange multiplier method. The scheme incorporates measurement variation introduced both by MOSFET calibration, and by variation in MOSFET readings between repeated CT scans. Sample size requirements are illustrated on cardiac, chest, and abdomen–pelvis CT scans performed on a 320-row scanner and chest CT performed on a 16-row scanner. Results: Sample sizes for estimating ED vary considerably between scanners and protocols. Sample size increases as the required precision or confidence is higher and also as the anticipated ED is lower. For example, for a helical chest protocol, for 95% confidence and 5% precision for the ED, 30 measurements are required on the 320-row scanner and 11 on the 16-row scanner when the anticipated ED is 4 mSv; these sample sizes are 5 and 2, respectively, when the anticipated ED is 10 mSv. Conclusions: Applying the suggested scheme, it was found that even at modest sample sizes, it is feasible to estimate ED with high precision and a high degree of confidence. As CT technology develops enabling ED to be lowered, more MOSFET measurements are needed to estimate ED with the same precision and confidence.« less

Sample size requirements for estimating effective dose from computed tomography using solid-state metal-oxide-semiconductor field-effect transistor dosimetry

PubMed Central

Trattner, Sigal; Cheng, Bin; Pieniazek, Radoslaw L.; Hoffmann, Udo; Douglas, Pamela S.; Einstein, Andrew J.

2014-01-01

Purpose: Effective dose (ED) is a widely used metric for comparing ionizing radiation burden between different imaging modalities, scanners, and scan protocols. In computed tomography (CT), ED can be estimated by performing scans on an anthropomorphic phantom in which metal-oxide-semiconductor field-effect transistor (MOSFET) solid-state dosimeters have been placed to enable organ dose measurements. Here a statistical framework is established to determine the sample size (number of scans) needed for estimating ED to a desired precision and confidence, for a particular scanner and scan protocol, subject to practical limitations. Methods: The statistical scheme involves solving equations which minimize the sample size required for estimating ED to desired precision and confidence. It is subject to a constrained variation of the estimated ED and solved using the Lagrange multiplier method. The scheme incorporates measurement variation introduced both by MOSFET calibration, and by variation in MOSFET readings between repeated CT scans. Sample size requirements are illustrated on cardiac, chest, and abdomen–pelvis CT scans performed on a 320-row scanner and chest CT performed on a 16-row scanner. Results: Sample sizes for estimating ED vary considerably between scanners and protocols. Sample size increases as the required precision or confidence is higher and also as the anticipated ED is lower. For example, for a helical chest protocol, for 95% confidence and 5% precision for the ED, 30 measurements are required on the 320-row scanner and 11 on the 16-row scanner when the anticipated ED is 4 mSv; these sample sizes are 5 and 2, respectively, when the anticipated ED is 10 mSv. Conclusions: Applying the suggested scheme, it was found that even at modest sample sizes, it is feasible to estimate ED with high precision and a high degree of confidence. As CT technology develops enabling ED to be lowered, more MOSFET measurements are needed to estimate ED with the same precision and confidence. PMID:24694150

Correlation Between Findings of Multislice Helical Computed Tomography (CT), Endoscopic Examinations, Endovascular Procedures, and Surgery in Patients with Symptoms of Acute Gastrointestinal Bleeding.

PubMed

Konecki, Dariusz; Grabowska-Derlatka, Laretta; Pacho, Ryszard; Rowiński, Olgierd

2017-01-01

Endoscopic methods (gastroscopy and colonoscopy) are considered fundamental for the diagnosis of gastrointestinal bleeding. In recent years, multidetector computed tomography (MDCT) has also gained importance in diagnosing gastrointestinal bleeding, particularly in hemodynamically unstable patients and in cases with suspected lower gastrointestinal tract bleeding. CT can detect both the source and the cause of active gastrointestinal bleeding, thereby expediting treatment initiation. The study group consisted of 16 patients with clinical symptoms of gastrointestinal bleeding in whom features of active bleeding were observed on CT. In all patients, bleeding was verified by means of other methods such as endoscopic examinations, endovascular procedures, or surgery. The bleeding source was identified on CT in all 16 patients. In 14 cases (87.5%), bleeding was confirmed by other methods. CT is an efficient, fast, and readily available tool for detecting the location of acute gastrointestinal bleeding.

Temporal resolution measurement of 128-slice dual source and 320-row area detector computed tomography scanners in helical acquisition mode using the impulse method.

PubMed

Hara, Takanori; Urikura, Atsushi; Ichikawa, Katsuhiro; Hoshino, Takashi; Nishimaru, Eiji; Niwa, Shinji

2016-04-01

To analyse the temporal resolution (TR) of modern computed tomography (CT) scanners using the impulse method, and assess the actual maximum TR at respective helical acquisition modes. To assess the actual TR of helical acquisition modes of a 128-slice dual source CT (DSCT) scanner and a 320-row area detector CT (ADCT) scanner, we assessed the TRs of various acquisition combinations of a pitch factor (P) and gantry rotation time (R). The TR of the helical acquisition modes for the 128-slice DSCT scanner continuously improved with a shorter gantry rotation time and greater pitch factor. However, for the 320-row ADCT scanner, the TR with a pitch factor of <1.0 was almost equal to the gantry rotation time, whereas with pitch factor of >1.0, it was approximately one half of the gantry rotation time. The maximum TR values of single- and dual-source helical acquisition modes for the 128-slice DSCT scanner were 0.138 (R/P=0.285/1.5) and 0.074s (R/P=0.285/3.2), and the maximum TR values of the 64×0.5- and 160×0.5-mm detector configurations of the helical acquisition modes for the 320-row ADCT scanner were 0.120 (R/P=0.275/1.375) and 0.195s (R/P=0.3/0.6), respectively. Because the TR of a CT scanner is not accurately depicted in the specifications of the individual scanner, appropriate acquisition conditions should be determined based on the actual TR measurement. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Influence of detector collimation and beam pitch for identification and image quality of ground-glass attenuation and nodules on 16- and 64-detector row CT systems: experimental study using chest phantom.

PubMed

Ohno, Yoshiharu; Koyama, Hisanobu; Kono, Astushi; Terada, Mari; Inokawa, Hiroyasu; Matsumoto, Sumiaki; Sugimura, Kazuro

2007-12-01

The purpose of the present study was to determine the influence of detector collimation and beam pitch for identification and image quality of ground-glass attenuation (GGA) and nodules on 16- and 64-detector row CTs, by using a commercially available chest phantom. A chest CT phantom including simulated GGAs and nodules was scanned with different detector collimations, beam pitches and tube currents. The probability and image quality of each simulated abnormality was visually assessed with a five-point scoring system. ROC-analysis and ANOVA were then performed to compare the identification and image quality of either protocol with standard values. Detection rates of low-dose CTs were significantly reduced when tube currents were set at 40mA or less by using detector collimation 16 and 64x0.5mm and 16 and 32mmx1.0mm for low pitch, and at 100mA or less by using detector collimation 16 and 64x0.5mm and 16 and 32mmx1.0mm for high pitch (p<0.05). Image qualities of low-dose CTs deteriorated significantly when tube current was set at 100mA or less by using detector collimation 16 and 64x0.5mm and 16 and 32x1.0mm for low pitch, and at 150mA or less by using detector collimation 16 and 64x0.5mm and 16 and 32x1.0mm for high pitch (p<0.05). Detector collimation and beam pitch were important factors for the image quality and identification of GGA and nodules by 16- and 64-detector row CT.

320-row CT renal perfusion imaging in patients with aortic dissection: A preliminary study.

PubMed

Liu, Dongting; Liu, Jiayi; Wen, Zhaoying; Li, Yu; Sun, Zhonghua; Xu, Qin; Fan, Zhanming

2017-01-01

To investigate the clinical value of renal perfusion imaging in patients with aortic dissection (AD) using 320-row computed tomography (CT), and to determine the relationship between renal CT perfusion imaging and various factors of aortic dissection. Forty-three patients with AD who underwent 320-row CT renal perfusion before operation were prospectively enrolled in this study. Diagnosis of AD was confirmed by transthoracic echocardiography. Blood flow (BF) of bilateral renal perfusion was measured and analyzed. CT perfusion imaging signs of AD in relation to the type of AD, number of entry tears and the false lumen thrombus were observed and compared. The BF values of patients with type A AD were significantly lower than those of patients with type B AD (P = 0.004). No significant difference was found in the BF between different numbers of intimal tears (P = 0.288), but BF values were significantly higher in cases with a false lumen without thrombus and renal arteries arising from the true lumen than in those with thrombus (P = 0.036). The BF values measured between the true lumen, false lumen and overriding groups were different (P = 0.02), with the true lumen group having the highest. Also, the difference in BF values between true lumen and false lumen groups was statistically significant (P = 0.016), while no statistical significance was found in the other two groups (P > 0.05). The larger the size of intimal entry tears, the greater the BF values (P = 0.044). This study shows a direct correlation between renal CT perfusion changes and AD, with the size, number of intimal tears, different types of AD, different renal artery origins and false lumen thrombosis, significantly affecting the perfusion values.

Dual-energy CT revisited with multidetector CT: review of principles and clinical applications.

PubMed

Karçaaltıncaba, Muşturay; Aktaş, Aykut

2011-09-01

Although dual-energy CT (DECT) was first conceived in the 1970s, it was not widely used for CT indications. Recently, the simultaneous acquisition of volumetric dual-energy data has been introduced using multidetector CT (MDCT) with two X-ray tubes and rapid kVp switching (gemstone spectral imaging). Two major advantages of DECT are material decomposition by acquiring two image series with different kVp and the elimination of misregistration artifacts. Hounsfield unit measurements by DECT are not absolute and can change depending on the kVp used for an acquisition. Typically, a combination of 80/140 kVp is used for DECT, but for some applications, 100/140 kVp is preferred. In this study, we summarized the clinical applications of DECT and included images that were acquired using the dual-source CT and rapid kVp switching. In general, unenhanced images can be avoided by using DECT for body and neurological applications; iodine can be removed from the image, and a virtual, non-contrast (water) image can be obtained. Neuroradiological applications allow for the removal of bone and calcium from the carotid and brain CT angiography. Thorax applications include perfusion imaging in patients with pulmonary thromboemboli and other chest diseases, xenon ventilation-perfusion imaging and solitary nodule characterization. Cardiac applications include dual-energy cardiac perfusion, viability and cardiac iron detection. The removal of calcific plaques from arteries, bone removal and aortic stent graft evaluation may be achieved in the vascular system. Abdominal applications include the detection and characterization of liver and pancreas masses, the diagnosis of steatosis and iron overload, DECT colonoscopy and CT cholangiography. Urinary system applications are urinary calculi characterization (uric acid vs. non-uric acid), renal cyst characterization and mass characterization. Musculoskeletal applications permit the differentiation of gout from pseudogout and a reduction of metal artifacts. Recent introduction of iterative reconstruction techniques can increase the use of DECT techniques; the use of dual energy in patients with a high BMI is limited due to noise and the radiation dose. DECT may be a good alternative to PET-CT. Iodine map images can quantify iodine uptake, and this approach may be more effective than obtaining non-contrast and post-contrast images for the diagnosis of a solid mass. Thus, computer-aided detection may be used more effectively in CT applications. DECT is a promising technique with potential clinical applications.

Observer variability in the assessment of CT coronary angiography and coronary artery calcium score: substudy of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial

PubMed Central

Williams, Michelle C; Golay, Saroj K; Hunter, Amanda; Weir-McCall, Jonathan R; Mlynska, Lucja; Dweck, Marc R; Uren, Neal G; Reid, John H; Lewis, Steff C; Berry, Colin; van Beek, Edwin J R; Roditi, Giles; Newby, David E; Mirsadraee, Saeed

2015-01-01

Introduction Observer variability can influence the assessment of CT coronary angiography (CTCA) and the subsequent diagnosis of angina pectoris due to coronary heart disease. Methods We assessed 210 CTCAs from the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial for intraobserver and interobserver variability. Calcium score, coronary angiography and image quality were evaluated. Coronary artery disease was defined as none (<10%), mild (10–49%), moderate (50–70%) and severe (>70%) luminal stenosis and classified as no (<10%), non-obstructive (10–70%) or obstructive (>70%) coronary artery disease. Post-CTCA diagnosis of angina pectoris due to coronary heart disease was classified as yes, probable, unlikely or no. Results Patients had a mean body mass index of 29 (28, 30) kg/m2, heart rate of 58 (57, 60)/min and 62% were men. Intraobserver and interobserver agreements for the presence or absence of coronary artery disease were excellent (95% agreement, κ 0.884 (0.817 to 0.951) and good (91%, 0.791 (0.703 to 0.879)). Intraobserver and interobserver agreement for the presence or absence of angina pectoris due to coronary heart disease were excellent (93%, 0.842 (0.918 to 0.755) and good (86%, 0.701 (0.799 to 0.603)), respectively. Observer variability of calcium score was excellent for calcium scores below 1000. More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, p<0.001) but there was no difference in observer variability. Conclusions Multicentre multidetector CTCA has excellent agreement in patients under investigation for suspected angina due to coronary heart disease. Trial registration number NCT01149590. PMID:26019881

Manual, semiautomated, and fully automated measurement of the aortic annulus for planning of transcatheter aortic valve replacement (TAVR/TAVI): analysis of interchangeability.

PubMed

Lou, Junyang; Obuchowski, Nancy A; Krishnaswamy, Amar; Popovic, Zoran; Flamm, Scott D; Kapadia, Samir R; Svensson, Lars G; Bolen, Michael A; Desai, Milind Y; Halliburton, Sandra S; Tuzcu, E Murat; Schoenhagen, Paul

2015-01-01

Preprocedural 3-dimensional CT imaging of the aortic annular plane plays a critical role for transcatheter aortic valve replacement (TAVR) planning; however, manual reconstructions are complex. Automated analysis software may improve reproducibility and agreement between readers but is incompletely validated. In 110 TAVR patients (mean age, 81 years; 37% female) undergoing preprocedural multidetector CT, automated reconstruction of the aortic annular plane and planimetry of the annulus was performed with a prototype of now commercially available software (syngo.CT Cardiac Function-Valve Pilot; Siemens Healthcare, Erlangen, Germany). Fully automated, semiautomated, and manual annulus measurements were compared. Intrareader and inter-reader agreement, intermodality agreement, and interchangeability were analyzed. Finally, the impact of these measurements on recommended valve size was evaluated. Semiautomated analysis required major correction in 5 patients (4.5%). In the remaining 95.5%, only minor correction was performed. Mean manual annulus area was significantly smaller than fully automated results (P < .001 for both readers) but similar to semiautomated measurements (5.0 vs 5.4 vs 4.9 cm(2), respectively). The frequency of concordant recommendations for valve size increased if manual analysis was replaced with the semiautomated method (60% agreement was improved to 82.4%; 95% confidence interval for the difference [69.1%-83.4%]). Semiautomated aortic annulus analysis, with minor correction by the user, provides reliable results in the context of TAVR annulus evaluation. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Assessment of aortic valve calcium load by multidetector computed tomography. Anatomical validation, impact of scanner settings and incremental diagnostic value.

PubMed

Boulif, Jamila; Gerber, Bernhard; Slimani, Alisson; Lazam, Siham; de Meester, Christophe; Piérard, Sophie; Pasquet, Agnès; Pouleur, Anne-Catherine; Vancraeynest, David; El Khoury, Gébrine; de Kerchove, Laurent; Noirhomme, Philippe; Vanoverschelde, Jean-Louis

To validate aortic valve calcium (AVC) load measurements by multidetector row computed tomography (MDCT), to evaluate the impact of tube potential and slice thickness on AVC scores, to examine the accuracy of AVC load in distinguishing severe from nonsevere aortic stenosis (AS) and to investigate its effectiveness as an alternative diagnosis method when echocardiography remains inconclusive. We prospectively studied 266 consecutive patients with moderate to severe AS who underwent MDCT to measure AVC load and a comprehensive echocardiographic examination to assess AS severity. AVC load was validated against valve weight in 57 patients undergoing aortic valve replacement. The dependence of AVC scores on tube potential and slice thickness was also tested, as well as the relationship between AVC load and echocardiographic criteria of AS severity. MDCT Agatston score correlated well with valve weight (r = 0.82, p < 0.001) and hemodynamic indices of AS severity (all p < 0.001). Ex-vivo Agatston scores decreased significantly with increasing tube potential and slice thickness (repeated measures ANOVA p < 0.001). Multivariate analysis identified mean gradient, the indexed effective orifice area, male gender and left ventricular outflow tract cross-sectional area as independent correlates of the in-vivo AVC load. MDCT-derived AVC load correlated well with valve weight and hemodynamic indices of AS severity. It also depends on tube potential and slice thickness, thus suggesting that these parameters should be standardized to optimize reproducibility and accuracy. Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.

PubMed

Stratis, Andreas; Zhang, Guozhi; Lopez-Rendon, Xochitl; Politis, Constantinus; Hermans, Robert; Jacobs, Reinhilde; Bogaerts, Ria; Shaheen, Eman; Bosmans, Hilde

2017-09-01

To calculate organ doses and estimate the effective dose for justification purposes in patients undergoing orthognathic treatment planning purposes and temporal bone imaging in dental cone beam CT (CBCT) and Multidetector CT (MDCT) scanners. The radiation dose to the ICRP reference male voxel phantom was calculated for dedicated orthognathic treatment planning acquisitions via Monte Carlo simulations in two dental CBCT scanners, Promax 3D Max (Planmeca, FI) and NewTom VGi evo (QR s.r.l, IT) and in Somatom Definition Flash (Siemens, DE) MDCT scanner. For temporal bone imaging, radiation doses were calculated via MC simulations for a CBCT protocol in NewTom 5G (QR s.r.l, IT) and with the use of a software tool (CT-expo) for Somatom Force (Siemens, DE). All procedures had been optimized at the acceptance tests of the devices. For orthognathic protocols, dental CBCT scanners deliver lower doses compared to MDCT scanners. The estimated effective dose (ED) was 0.32mSv for a normal resolution operation mode in Promax 3D Max, 0.27mSv in VGi-evo and 1.18mSv in the Somatom Definition Flash. For temporal bone protocols, the Somatom Force resulted in an estimated ED of 0.28mSv while for NewTom 5G the ED was 0.31 and 0.22mSv for monolateral and bilateral imaging respectively. Two clinical exams which are carried out with both a CBCT or a MDCT scanner were compared in terms of radiation dose. Dental CBCT scanners deliver lower doses for orthognathic patients whereas for temporal bone procedures the doses were similar. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Dynamic CT perfusion imaging of the myocardium: a technical note on improvement of image quality.

PubMed

Muenzel, Daniela; Kabus, Sven; Gramer, Bettina; Leber, Vivian; Vembar, Mani; Schmitt, Holger; Wildgruber, Moritz; Fingerle, Alexander A; Rummeny, Ernst J; Huber, Armin; Noël, Peter B

2013-01-01

To improve image and diagnostic quality in dynamic CT myocardial perfusion imaging (MPI) by using motion compensation and a spatio-temporal filter. Dynamic CT MPI was performed using a 256-slice multidetector computed tomography scanner (MDCT). Data from two different patients-with and without myocardial perfusion defects-were evaluated to illustrate potential improvements for MPI (institutional review board approved). Three datasets for each patient were generated: (i) original data (ii) motion compensated data and (iii) motion compensated data with spatio-temporal filtering performed. In addition to the visual assessment of the tomographic slices, noise and contrast-to-noise-ratio (CNR) were measured for all data. Perfusion analysis was performed using time-density curves with regions-of-interest (ROI) placed in normal and hypoperfused myocardium. Precision in definition of normal and hypoperfused areas was determined in corresponding coloured perfusion maps. The use of motion compensation followed by spatio-temporal filtering resulted in better alignment of the cardiac volumes over time leading to a more consistent perfusion quantification and improved detection of the extend of perfusion defects. Additionally image noise was reduced by 78.5%, with CNR improvements by a factor of 4.7. The average effective radiation dose estimate was 7.1±1.1 mSv. The use of motion compensation and spatio-temporal smoothing will result in improved quantification of dynamic CT MPI using a latest generation CT scanner.

Preoperative evaluation of hilar vessel anatomy with 3-D computerized tomography in living kidney donors.

PubMed

Tombul, S T; Aki, F T; Gunay, M; Inci, K; Hazirolan, T; Karcaaltincaba, M; Erkan, I; Bakkaloglu, A; Yasavul, U; Bakkaloglu, M

2008-01-01

Digital subtract angiography is the gold standard for anatomic assessment of renal vasculature for living renal donors. However, multidetector-row computerized tomography (MDCT) is less invasive than digital subtract angiography and provides information of kidney stones and other intra-abdominal organs. In this study, preoperative MDCT angiography results were compared with the peroperative findings to evaluate the accuracy of MDCT for the evaluation of renal anatomy. From December 2002 to May 2007, all 60 consecutive living kidney donors were evaluated with MDCT angiography preoperatively. We reported the number and origin of renal arteries, presence of early branching arteries, and any intrinsic renal artery disease. Renal venous anatomy was evaluated for the presence of accessory, retroaortic, and circumaortic veins using venous phase axial images. The calyces and ureters were assessed with delayed topograms. The results of the MDCT angiography were compared with the peroperative findings. A total of 67 renal arteries were seen peroperatively in 60 renal units. Preoperative MDCT angiography detected 64 of them. The two arteries not detected by MDCT had diameters less than 3 mm. Anatomic variations were present in nine veins, five of which were detected by CT angiography. Sensitivity of MDCT angiography for arteries and veins was 95% and 93%, respectively. Positive predictive values were 100% for both arteries and veins. MDCT angiography offers a less invasive, rapid, and accurate preoperative investigation modality for vascular anatomy in living kidney donors. It also provides sufficient information about extrarenal anatomy important for donor surgery.

Estimation of absorbed doses from paediatric cone-beam CT scans: MOSFET measurements and Monte Carlo simulations.

PubMed

Kim, Sangroh; Yoshizumi, Terry T; Toncheva, Greta; Frush, Donald P; Yin, Fang-Fang

2010-03-01

The purpose of this study was to establish a dose estimation tool with Monte Carlo (MC) simulations. A 5-y-old paediatric anthropomorphic phantom was computed tomography (CT) scanned to create a voxelised phantom and used as an input for the abdominal cone-beam CT in a BEAMnrc/EGSnrc MC system. An X-ray tube model of the Varian On-Board Imager((R)) was built in the MC system. To validate the model, the absorbed doses at each organ location for standard-dose and low-dose modes were measured in the physical phantom with MOSFET detectors; effective doses were also calculated. In the results, the MC simulations were comparable to the MOSFET measurements. This voxelised phantom approach could produce a more accurate dose estimation than the stylised phantom method. This model can be easily applied to multi-detector CT dosimetry.

Accessory oral cavity associated with duplication of the tongue and the mandible in a newborn: a rare case of Diprosopus. Multi-row detector computed tomography diagnostic role.

PubMed

Morabito, Rosa; Colonna, Michele R; Mormina, Enricomaria; Stagno d'Alcontres, Ferdinando; Salpietro, Vincenzo; Blandino, Alfredo; Longo, Marcello; Granata, Francesca

2014-12-01

Craniofacial duplication is a very rare malformation. The phenotype comprises a wide spectrum, ranging from partial duplication of few facial structures to complete dicephalus. We report the case of a newborn with an accessory oral cavity associated to duplication of the tongue and the mandible diagnosed by multi-row detector Computed Tomography, few days after her birth. Our case of partial craniofacial duplication can be considered as Type II of Gorlin classification or as an intermediate form between Type I and Type II of Sun classification. Our experience demonstrates that CT scan, using appropriate reconstruction algorithms, permits a detailed evaluation of the different structures in an anatomical region. Multi-row CT scan is also the more accurate diagnostic procedure for the pre-surgical evaluation of craniofacial malformations. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Balancing Radiation and Contrast Media Dose in Single-Pass Abdominal Multidetector CT: Prospective Evaluation of Image Quality.

PubMed

Camera, Luigi; Romano, Federica; Liccardo, Immacolata; Liuzzi, Raffaele; Imbriaco, Massimo; Mainenti, Pier Paolo; Pizzuti, Laura Micol; Segreto, Sabrina; Maurea, Simone; Brunetti, Arturo

2015-11-01

As both contrast and radiation dose affect the quality of CT images, a constant image quality in abdominal contrast-enhanced multidetector computed tomography (CE-MDCT) could be obtained balancing radiation and contrast media dose according to the age of the patients. Seventy-two (38 Men; 34 women; aged 20-83 years) patients underwent a single-pass abdominal CE-MDCT. Patients were divided into three different age groups: A (20-44 years); B (45-65 years); and C (>65 years). For each group, a different noise index (NI) and contrast media dose (370 mgI/mL) was selected as follows: A (NI, 15; 2.5 mL/kg), B (NI, 12.5; 2 mL/kg), and C (NI, 10; 1.5 mL/kg). Radiation exposure was reported as dose-length product (DLP) in mGy × cm. For quantitative analysis, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated for both the liver (L) and the abdominal aorta (A). Statistical analysis was performed with a one-way analysis of variance. Standard imaging criteria were used for qualitative analysis. Although peak hepatic enhancement was 152 ± 16, 128 ± 12, and 101 ± 14 Hounsfield units (P < .001) for groups A, B, and C, respectively, no significant differences were observed in the corresponding SNRL with 9.2 ± 1.4, 9.1 ± 1.2, and 9.2 ± 3. Radiation (mGy × cm) and contrast media dose (mL) administered were 476 ± 147 and 155 ± 27 for group A, 926 ± 291 and 130 ± 16 for group B, and 1981 ± 451 and 106 ± 15 for group C, respectively (P < .001). None of the studies was graded as poor or inadequate by both readers, and the prevalence-adjusted bias-adjusted kappa ranged between 0.48 and 0.93 for all but one criteria. A constant image quality in CE-MDCT can be obtained balancing radiation and contrast media dose administered to patients of different age. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

MDCT imaging of the stomach: advances and applications

PubMed Central

Prakash, Anjali; Pradhan, Gaurav; Vidholia, Aditi; Nagpal, Nishant; Saboo, Sachin S; Kuehn, David M; Khandelwal, Ashish

2017-01-01

The stomach may be involved by a myriad of pathologies ranging from benign aetiologies like inflammation to malignant aetiologies like carcinoma or lymphoma. Multidetector CT (MDCT) of the stomach is the first-line imaging for patients with suspected gastric pathologies. Conventionally, CT imaging had the advantage of simultaneous detection of the mural and extramural disease extent, but advances in MDCT have allowed mucosal assessment by virtual endoscopy (VE). Also, better three-dimensional (3D) post-processing techniques have enabled more robust and accurate pre-operative planning in patients undergoing gastrectomy and even predict the response to surgery for patients undergoing laparoscopic sleeve gastrectomy for weight loss. The ability of CT to obtain stomach volume (for bariatric surgery patients) and 3D VE images depends on various patient and protocol factors that are important for a radiologist to understand. We review the appropriate CT imaging protocol in the patients with suspected gastric pathologies and highlight the imaging pearls of various gastric pathologies on CT and VE. PMID:27785936

MDCT imaging of the stomach: advances and applications.

PubMed

Nagpal, Prashant; Prakash, Anjali; Pradhan, Gaurav; Vidholia, Aditi; Nagpal, Nishant; Saboo, Sachin S; Kuehn, David M; Khandelwal, Ashish

2017-01-01

The stomach may be involved by a myriad of pathologies ranging from benign aetiologies like inflammation to malignant aetiologies like carcinoma or lymphoma. Multidetector CT (MDCT) of the stomach is the first-line imaging for patients with suspected gastric pathologies. Conventionally, CT imaging had the advantage of simultaneous detection of the mural and extramural disease extent, but advances in MDCT have allowed mucosal assessment by virtual endoscopy (VE). Also, better three-dimensional (3D) post-processing techniques have enabled more robust and accurate pre-operative planning in patients undergoing gastrectomy and even predict the response to surgery for patients undergoing laparoscopic sleeve gastrectomy for weight loss. The ability of CT to obtain stomach volume (for bariatric surgery patients) and 3D VE images depends on various patient and protocol factors that are important for a radiologist to understand. We review the appropriate CT imaging protocol in the patients with suspected gastric pathologies and highlight the imaging pearls of various gastric pathologies on CT and VE.

Correlation Between Findings of Multislice Helical Computed Tomography (CT), Endoscopic Examinations, Endovascular Procedures, and Surgery in Patients with Symptoms of Acute Gastrointestinal Bleeding

PubMed Central

Konecki, Dariusz; Pacho, Ryszard; Rowiński, Olgierd

2017-01-01

Summary Background Endoscopic methods (gastroscopy and colonoscopy) are considered fundamental for the diagnosis of gastrointestinal bleeding. In recent years, multidetector computed tomography (MDCT) has also gained importance in diagnosing gastrointestinal bleeding, particularly in hemodynamically unstable patients and in cases with suspected lower gastrointestinal tract bleeding. CT can detect both the source and the cause of active gastrointestinal bleeding, thereby expediting treatment initiation. Material/Methods The study group consisted of 16 patients with clinical symptoms of gastrointestinal bleeding in whom features of active bleeding were observed on CT. In all patients, bleeding was verified by means of other methods such as endoscopic examinations, endovascular procedures, or surgery. Results The bleeding source was identified on CT in all 16 patients. In 14 cases (87.5%), bleeding was confirmed by other methods. Conclusions CT is an efficient, fast, and readily available tool for detecting the location of acute gastrointestinal bleeding. PMID:29662594

CT angiography of the renal arteries and veins: normal anatomy and variants.

PubMed

Hazırolan, Tuncay; Öz, Meryem; Türkbey, Barış; Karaosmanoğlu, Ali Devrim; Oğuz, Berna Sayan; Canyiğit, Murat

2011-03-01

Conventional angiography has long been regarded as gold standard imaging modality for evaluation of the renal vasculature. Introduction of multidetector computed tomography (MDCT) angiography had a groundbreaking impact on evaluation of the renal vessels and is gradually replacing conventional angiography as standard imaging. Herein, we review and illustrate the normal and variant anatomy of renal vessels with special emphasis on imaging protocols and reconstruction techniques in MDCT.

Respiratory-gated segment reconstruction for radiation treatment planning using 256-slice CT-scanner during free breathing

NASA Astrophysics Data System (ADS)

Mori, Shinichiro; Endo, Masahiro; Kohno, Ryosuke; Minohara, Shinichi; Kohno, Kazutoshi; Asakura, Hiroshi; Fujiwara, Hideaki; Murase, Kenya

2005-04-01

The conventional respiratory-gated CT scan technique includes anatomic motion induced artifacts due to the low temporal resolution. They are a significant source of error in radiotherapy treatment planning for the thorax and upper abdomen. Temporal resolution and image quality are important factors to minimize planning target volume margin due to the respiratory motion. To achieve high temporal resolution and high signal-to-noise ratio, we developed a respiratory gated segment reconstruction algorithm and adapted it to Feldkamp-Davis-Kress algorithm (FDK) with a 256-detector row CT. The 256-detector row CT could scan approximately 100 mm in the cranio-caudal direction with 0.5 mm slice thickness in one rotation. Data acquisition for the RS-FDK relies on the assistance of the respiratory sensing system by a cine scan mode (table remains stationary). We evaluated RS-FDK in phantom study with the 256-detector row CT and compared it with full scan (FS-FDK) and HS-FDK results with regard to volume accuracy and image noise, and finally adapted the RS-FDK to an animal study. The RS-FDK gave a more accurate volume than the others and it had the same signal-to-noise ratio as the FS-FDK. In the animal study, the RS-FDK visualized the clearest edges of the liver and pulmonary vessels of all the algorithms. In conclusion, the RS-FDK algorithm has a capability of high temporal resolution and high signal-to-noise ratio. Therefore it will be useful when combined with new radiotherapy techniques including image guided radiation therapy (IGRT) and 4D radiation therapy.

Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma

PubMed Central

Tsili, Athina C; Argyropoulou, Maria I

2015-01-01

Renal cell carcinoma (RCC) accounts for approximately 90%-95% of kidney tumors. With the widespread use of cross-sectional imaging modalities, more than half of RCCs are detected incidentally, often diagnosed at an early stage. This may allow the planning of more conservative treatment strategies. Computed tomography (CT) is considered the examination of choice for the detection and staging of RCC. Multidetector CT (MDCT) with the improvement of spatial resolution and the ability to obtain multiphase imaging, multiplanar and three-dimensional reconstructions in any desired plane brought about further improvement in the evaluation of RCC. Differentiation of RCC from benign renal tumors based on MDCT features is improved. Tumor enhancement characteristics on MDCT have been found closely to correlate with the histologic subtype of RCC, the nuclear grade and the cytogenetic characteristics of clear cell RCC. Important information, including tumor size, localization, and organ involvement, presence and extent of venous thrombus, possible invasion of adjacent organs or lymph nodes, and presence of distant metastases are provided by MDCT examination. The preoperative evaluation of patients with RCC was improved by depicting the presence or absence of renal pseudocapsule and by assessing the possible neoplastic infiltration of the perirenal fat tissue and/or renal sinus fat compartment. PMID:26120380

Posterior semicircular canal dehiscence: value of VEMP and multidetector CT.

PubMed

Vanspauwen, R; Salembier, L; Van den Hauwe, L; Parizel, P; Wuyts, F L; Van de Heyning, P H

2006-01-01

To illustrate that posterior semicircular canal dehiscence can present similarly to superior semicircular canal dehiscence. The symptomatology initially presented as probable Menière's disease evolving into a mixed conductive hearing loss with a Carhart notch-type perceptive component suggestive of otosclerosis-type stapes fixation. A small hole stapedotomy resulted in a dead ear and a horizontal semicircular canal hypofunction. Recurrent incapacitating vertigo attacks developed. Vestibular evoked myogenic potential (VEMP) testing demonstrated intact vestibulocollic reflexes. Additional evaluation with high resolution multidetector computed tomography (MDCT) of the temporal bone showed a dehiscence of the left posterior semicircular canal. Besides superior semicircular canal dehiscence, posterior semicircular canal dehiscence has to be included in the differential diagnosis of atypical Menière's disease and/or low tone conductive hearing loss. The value of performing MDCT before otosclerosis-type surgery is stressed. VEMP might contribute to establishing the differential diagnosis.

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis.

PubMed

Zhu, Caisong; Liu, Wei; Yang, Jun; Yang, Jing; Shao, Kangwei; Yuan, Lixin; Chen, Hairong; Lu, Wei; Zhu, Ying

2016-07-01

The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (P<0.05). MDCT features such as ill-defined margin, absence of capsule or incomplete capsule or homogeneous enhancement were more likely to be present in the malignant nodules (P<0.05). Nevertheless, no significant difference was observed in the enhancement degree at arterial or venous phase between benign and malignant nodules (P>0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice.

Osteoporosis Imaging: State of the Art and Advanced Imaging

PubMed Central

2012-01-01

Osteoporosis is becoming an increasingly important public health issue, and effective treatments to prevent fragility fractures are available. Osteoporosis imaging is of critical importance in identifying individuals at risk for fractures who would require pharmacotherapy to reduce fracture risk and also in monitoring response to treatment. Dual x-ray absorptiometry is currently the state-of-the-art technique to measure bone mineral density and to diagnose osteoporosis according to the World Health Organization guidelines. Motivated by a 2000 National Institutes of Health consensus conference, substantial research efforts have focused on assessing bone quality by using advanced imaging techniques. Among these techniques aimed at better characterizing fracture risk and treatment effects, high-resolution peripheral quantitative computed tomography (CT) currently plays a central role, and a large number of recent studies have used this technique to study trabecular and cortical bone architecture. Other techniques to analyze bone quality include multidetector CT, magnetic resonance imaging, and quantitative ultrasonography. In addition to quantitative imaging techniques measuring bone density and quality, imaging needs to be used to diagnose prevalent osteoporotic fractures, such as spine fractures on chest radiographs and sagittal multidetector CT reconstructions. Radiologists need to be sensitized to the fact that the presence of fragility fractures will alter patient care, and these fractures need to be described in the report. This review article covers state-of-the-art imaging techniques to measure bone mineral density, describes novel techniques to study bone quality, and focuses on how standard imaging techniques should be used to diagnose prevalent osteoporotic fractures. © RSNA, 2012 PMID:22438439

Likelihood of aneurysmal subarachnoid haemorrhage in patients with normal unenhanced CT, CSF xanthochromia on spectrophotometry and negative CT angiography.

PubMed

Rana, A K; Turner, H E; Deans, K A

2013-01-01

Patients with suspected subarachnoid haemorrhage, a normal noncontrast computed tomography (CT) and cerebrospinal fluid (CSF) evidence of haemoglobin breakdown products often undergo CT angiography (CTA). If this is normal, then invasive catheter angiography may be offered. In current clinical practice, haemoglobin breakdown products are detected by spectrophotometry rather than visible xanthochromia, and CTA is performed on multidetector scanners. The aim of this study was to determine if such patients should still have a catheter angiography, given the associated risks. Patients positive for CSF spectrophotometry (n=26) were retrospectively identified from the clinical biochemistry information system and imaging data from the electronic radiology records were reviewed. Discharge letters were consulted to relate the biochemistry and radiology results to the final diagnosis. 15 patients with CT angiography were found. Nine patients had normal CT angiography. No causative aneurysms had been missed. One patient had small, coincidental aneurysms missed on initial reading of the CTA. The likelihood of a clinically significant aneurysm in a patient who is CT negative, lumbar puncture positive and CTA negative is low. Double reporting of negative CT angiograms may be advisable.

Characterizing string-of-pearls colloidal silica by multidetector hydrodynamic chromatography and comparison to multidetector size-exclusion chromatography, off-line multiangle static light scattering, and transmission electron microscopy.

PubMed

Brewer, Amandaa K; Striegel, André M

2011-04-15

The string-of-pearls-type morphology is ubiquitous, manifesting itself variously in proteins, vesicles, bacteria, synthetic polymers, and biopolymers. Characterizing the size and shape of analytes with such morphology, however, presents a challenge, due chiefly to the ease with which the "strings" can be broken during chromatographic analysis or to the paucity of information obtained from the benchmark microscopy and off-line light scattering methods. Here, we address this challenge with multidetector hydrodynamic chromatography (HDC), which has the ability to determine, simultaneously, the size, shape, and compactness and their distributions of string-of-pearls samples. We present the quadruple-detector HDC analysis of colloidal string-of-pearls silica, employing static multiangle and quasielastic light scattering, differential viscometry, and differential refractometry as detection methods. The multidetector approach shows a sample that is broadly polydisperse in both molar mass and size, with strings ranging from two to five particles, but which also contains a high concentration of single, unattached "pearls". Synergistic combination of the various size parameters obtained from the multiplicity of detectors employed shows that the strings with higher degrees of polymerization have a shape similar to the theory-predicted shape of a Gaussian random coil chain of nonoverlapping beads, while the strings with lower degrees of polymerization have a prolate ellipsoidal shape. The HDC technique is contrasted experimentally with multidetector size-exclusion chromatography, where, even under extremely gentle conditions, the strings still degraded during analysis. Such degradation is shown to be absent in HDC, as evidenced by the fact that the molar mass and radius of gyration obtained by HDC with multiangle static light scattering detection (HDC/MALS) compare quite favorably to those determined by off-line MALS analysis under otherwise identical conditions. The multidetector HDC results were also comparable to those obtained by transmission electron microscopy (TEM). Unlike off-line MALS or TEM, however, multidetector HDC is able to provide complete particle analysis based on the molar mass, size, shape, and compactness and their distributions for the entire sample population in less than 20 min. © 2011 American Chemical Society

Dynamic CT myocardial perfusion imaging: detection of ischemia in a porcine model with FFR verification

NASA Astrophysics Data System (ADS)

Fahmi, Rachid; Eck, Brendan L.; Vembar, Mani; Bezerra, Hiram G.; Wilson, David L.

2014-03-01

Dynamic cardiac CT perfusion (CTP) is a high resolution, non-invasive technique for assessing myocardial blood ow (MBF), which in concert with coronary CT angiography enable CT to provide a unique, comprehensive, fast analysis of both coronary anatomy and functional ow. We assessed perfusion in a porcine model with and without coronary occlusion. To induce occlusion, each animal underwent left anterior descending (LAD) stent implantation and angioplasty balloon insertion. Normal ow condition was obtained with balloon completely de ated. Partial occlusion was induced by balloon in ation against the stent with FFR used to assess the extent of occlusion. Prospective ECG-triggered partial scan images were acquired at end systole (45% R-R) using a multi-detector CT (MDCT) scanner. Images were reconstructed using FBP and a hybrid iterative reconstruction (iDose4, Philips Healthcare). Processing included: beam hardening (BH) correction, registration of image volumes using 3D cubic B-spline normalized mutual-information, and spatio-temporal bilateral ltering to reduce partial scan artifacts and noise variation. Absolute blood ow was calculated with a deconvolutionbased approach using singular value decomposition (SVD). Arterial input function was estimated from the left ventricle (LV) cavity. Regions of interest (ROIs) were identi ed in healthy and ischemic myocardium and compared in normal and occluded conditions. Under-perfusion was detected in the correct LAD territory and ow reduction agreed well with FFR measurements. Flow was reduced, on average, in LAD territories by 54%.

The prevalence of lumbar spondylolysis in young children: a retrospective analysis using CT.

PubMed

Lemoine, Thibaut; Fournier, Joseph; Odent, Thierry; Sembély-Taveau, Catherine; Merenda, Pauline; Sirinelli, Dominique; Morel, Baptiste

2018-05-01

Although lumbar spondylolysis is encountered in general population with an incidence estimated to be 3-10%, limited information is available for children. The aim of the study is to determine the prevalence of spondylolysis according to associated vertebral bony malformation and spinopelvic parameters in children under eight requiring CT evaluation for unrelated lumbar conditions. Seven hundred and seventeen abdominal and pelvic multi-detector CT scans were obtained in patients under 8 years of age were reviewed. Two board certificated radiologists and two resident radiologists retrospectively evaluated CT scans for lumbar spondylolysis and associated malformations. Pelvic incidence and spondylolisthesis were reported. Our analysis included 717 CT scans in 532 children (259 girls and 273 boys). Twenty-five cases of spondylolysis were diagnosed (16 bilateral and 9 unilateral, 64 and 36%, respectively) in 14 boys (56%) and 11 girls (44%), associating with 12 grade I spondylolisthesis. The mean normal pelvic incidence was 45° (median 44°, SD 7°). The prevalence of spondylolysis was 1% in children under age 3 (n = 3 among 292 patients), 3.7% in children under age 6 (n = 17 among 454 patients) and 4.7% among the 532 patients. Unilateral spondylolysis was significantly associated with a spinal malformation (p = 0.04, Fisher's exact test), with normal pelvic incidence. Half of the patients with bilateral spondylolysis had high pelvic incidence. We observed a prevalence peak of unilateral spondylolysis in the context of a specific malformation in young infants under age 4 with normal pelvic incidence, and, then, a progressive increase in the prevalence of bilateral isolated spondylolysis.

Thoracic-abdominal imaging with a novel dual-layer spectral detector CT: intra-individual comparison of image quality and radiation dose with 128-row single-energy acquisition.

PubMed

Haneder, Stefan; Siedek, Florian; Doerner, Jonas; Pahn, Gregor; Grosse Hokamp, Nils; Maintz, David; Wybranski, Christian

2018-01-01

Background A novel, multi-energy, dual-layer spectral detector computed tomography (SDCT) is commercially available now with the vendor's claim that it yields the same or better quality of polychromatic, conventional CT images like modern single-energy CT scanners without any radiation dose penalty. Purpose To intra-individually compare the quality of conventional polychromatic CT images acquired with a dual-layer spectral detector (SDCT) and the latest generation 128-row single-energy-detector (CT128) from the same manufacturer. Material and Methods Fifty patients underwent portal-venous phase, thoracic-abdominal CT scans with the SDCT and prior CT128 imaging. The SDCT scanning protocol was adapted to yield a similar estimated dose length product (DLP) as the CT128. Patient dose optimization by automatic tube current modulation and CT image reconstruction with a state-of-the-art iterative algorithm were identical on both scanners. CT image contrast-to-noise ratio (CNR) was compared between the SDCT and CT128 in different anatomic structures. Image quality and noise were assessed independently by two readers with 5-point-Likert-scales. Volume CT dose index (CTDI vol ), and DLP were recorded and normalized to 68 cm acquisition length (DLP 68 ). Results The SDCT yielded higher mean CNR values of 30.0% ± 2.0% (26.4-32.5%) in all anatomic structures ( P < 0.001) and excellent scores for qualitative parameters surpassing the CT128 (all P < 0.0001) with substantial inter-rater agreement (κ ≥ 0.801). Despite adapted scan protocols the SDCT yielded lower values for CTDI vol (-10.1 ± 12.8%), DLP (-13.1 ± 13.9%), and DLP 68 (-15.3 ± 16.9%) than the CT128 (all P < 0.0001). Conclusion The SDCT scanner yielded better CT image quality compared to the CT128 and lower radiation dose parameters.

Dual-phase CT for the assessment of acute vascular injuries in high-energy blunt trauma: the imaging findings and management implications.

PubMed

Iacobellis, Francesca; Ierardi, Anna M; Mazzei, Maria A; Magenta Biasina, Alberto; Carrafiello, Gianpaolo; Nicola, Refky; Scaglione, Mariano

2016-01-01

Acute vascular injuries are the second most common cause of fatalities in patients with multiple traumatic injuries; thus, prompt identification and management is essential for patient survival. Over the past few years, multidetector CT (MDCT) using dual-phase scanning protocol has become the imaging modality of choice in high-energy deceleration traumas. The objective of this article was to review the role of dual-phase MDCT in the identification and management of acute vascular injuries, particularly in the chest and abdomen following multiple traumatic injuries. In addition, this article will provide examples of MDCT features of acute vascular injuries with correlative surgical and interventional findings.

Recent advances in imaging cancer of the kidney and urinary tract.

PubMed

Hilton, Susan; Jones, Lisa P

2014-10-01

Modern radiologic imaging is an aid to treatment planning for localized renal cancer, enabling characterization of mass lesions. For patients who present with advanced renal cancer, new imaging techniques enable a functional assessment of treatment response not possible using anatomic measurements alone. Multidetector CT urography permits simultaneous assessment of the kidneys and urinary tract for patients with unexplained hematuria. Both CT and MRI play a significant role in staging and follow up of patients treated for urothelial cancer. Newer imaging methods such as diffusion-weighted MRI have shown promising results for improving accuracy of staging and follow up of urothelial cancer. Copyright © 2014 Elsevier Inc. All rights reserved.

Automated characterization of normal and pathologic lung tissue by topological texture analysis of multidetector CT

NASA Astrophysics Data System (ADS)

Boehm, H. F.; Fink, C.; Becker, C.; Reiser, M.

2007-03-01

Reliable and accurate methods for objective quantitative assessment of parenchymal alterations in the lung are necessary for diagnosis, treatment and follow-up of pulmonary diseases. Two major types of alterations are pulmonary emphysema and fibrosis, emphysema being characterized by abnormal enlargement of the air spaces distal to the terminal, nonrespiratory bronchiole, accompanied by destructive changes of the alveolar walls. The main characteristic of fibrosis is coursening of the interstitial fibers and compaction of the pulmonary tissue. With the ability to display anatomy free from superimposing structures and greater visual clarity, Multi-Detector-CT has shown to be more sensitive than the chest radiograph in identifying alterations of lung parenchyma. In automated evaluation of pulmonary CT-scans, quantitative image processing techniques are applied for objective evaluation of the data. A number of methods have been proposed in the past, most of which utilize simple densitometric tissue features based on the mean X-ray attenuation coefficients expressed in terms of Hounsfield Units [HU]. Due to partial volume effects, most of the density-based methodologies tend to fail, namely in cases, where emphysema and fibrosis occur within narrow spatial limits. In this study, we propose a methodology based upon the topological assessment of graylevel distribution in the 3D image data of lung tissue which provides a way of improving quantitative CT evaluation. Results are compared to the more established density-based methods.

Volumetric gain of the human pancreas after left partial pancreatic resection: A CT-scan based retrospective study.

PubMed

Phillip, Veit; Zahel, Tina; Danninger, Assiye; Erkan, Mert; Dobritz, Martin; Steiner, Jörg M; Kleeff, Jörg; Schmid, Roland M; Algül, Hana

2015-01-01

Regeneration of the pancreas has been well characterized in animal models. However, there are conflicting data on the regenerative capacity of the human pancreas. The aim of the present study was to assess the regenerative capacity of the human pancreas. In a retrospective study, data from patients undergoing left partial pancreatic resection at a single center were eligible for inclusion (n = 185). Volumetry was performed based on 5 mm CT-scans acquired through a 256-slice CT-scanner using a semi-automated software. Data from 24 patients (15 males/9 females) were included. Mean ± SD age was 68 ± 11 years (range, 40-85 years). Median time between surgery and the 1st postoperative CT was 9 days (range, 0-27 days; IQR, 7-13), 55 days (range, 21-141 days; IQR, 34-105) until the 2nd CT, and 191 days (range, 62-1902; IQR, 156-347) until the 3rd CT. The pancreatic volumes differed significantly between the first and the second postoperative CT scans (median volume 25.6 mL and 30.6 mL, respectively; p = 0.008) and had significantly increased further by the 3rd CT scan (median volume 37.9 mL; p = 0.001 for comparison with 1st CT scan and p = 0.003 for comparison with 2nd CT scan). The human pancreas shows a measurable and considerable potential of volumetric gain after partial resection. Multidetector-CT based semi-automated volume analysis is a feasible method for follow-up of the volume of the remaining pancreatic parenchyma after partial pancreatectomy. Effects on exocrine and endocrine pancreatic function have to be evaluated in a prospective manner. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Monte Carlo simulations to assess the effects of tube current modulation on breast dose for multidetector CT

NASA Astrophysics Data System (ADS)

Angel, Erin; Yaghmai, Nazanin; Matilda Jude, Cecilia; DeMarco, John J.; Cagnon, Christopher H.; Goldin, Jonathan G.; Primak, Andrew N.; Stevens, Donna M.; Cody, Dianna D.; McCollough, Cynthia H.; McNitt-Gray, Michael F.

2009-02-01

Tube current modulation was designed to reduce radiation dose in CT imaging while maintaining overall image quality. This study aims to develop a method for evaluating the effects of tube current modulation (TCM) on organ dose in CT exams of actual patient anatomy. This method was validated by simulating a TCM and a fixed tube current chest CT exam on 30 voxelized patient models and estimating the radiation dose to each patient's glandular breast tissue. This new method for estimating organ dose was compared with other conventional estimates of dose reduction. Thirty detailed voxelized models of patient anatomy were created based on image data from female patients who had previously undergone clinically indicated CT scans including the chest area. As an indicator of patient size, the perimeter of the patient was measured on the image containing at least one nipple using a semi-automated technique. The breasts were contoured on each image set by a radiologist and glandular tissue was semi-automatically segmented from this region. Previously validated Monte Carlo models of two multidetector CT scanners were used, taking into account details about the source spectra, filtration, collimation and geometry of the scanner. TCM data were obtained from each patient's clinical scan and factored into the model to simulate the effects of TCM. For each patient model, two exams were simulated: a fixed tube current chest CT and a tube current modulated chest CT. X-ray photons were transported through the anatomy of the voxelized patient models, and radiation dose was tallied in the glandular breast tissue. The resulting doses from the tube current modulated simulations were compared to the results obtained from simulations performed using a fixed mA value. The average radiation dose to the glandular breast tissue from a fixed tube current scan across all patient models was 19 mGy. The average reduction in breast dose using the tube current modulated scan was 17%. Results were size dependent with smaller patients getting better dose reduction (up to 64% reduction) and larger patients getting a smaller reduction, and in some cases the dose actually increased when using tube current modulation (up to 41% increase). The results indicate that radiation dose to glandular breast tissue generally decreases with the use of tube current modulated CT acquisition, but that patient size (and in some cases patient positioning) may affect dose reduction.

Carotid artery stents on CT angiography: in vitro comparison of different stent designs and sizes using 16-, 64- and 320-row CT scanners.

PubMed

Lettau, Michael; Kotter, Elmar; Bendszus, Martin; Hähnel, Stefan

2014-10-01

CT angiography (CTA) is an increasingly used method for evaluation of stented vessel segments. Our aim was to compare the appearance of different carotid artery stents in vitro on CTA using different CT scanners. Of particular interest was the measurement of artificial lumen narrowing (ALN) caused by the stent material within the stented vessel segment to determine whether CTA can be used to detect in-stent restenosis. CTA appearances of 16 carotid artery stents of different designs and sizes (4.0 to 11.0 mm) were investigated in vitro. CTA was performed using 16-, 64- and 320-row CT scanners. For each stent, artificial lumen narrowing (ALN) was calculated. ALN ranged from 18.77% to 59.86%. ALN in different stents differed significantly. In most stents, ALN decreased with increasing stent diameter. In all but one stents, ALN using sharp image kernels was significantly lower than ALN using medium image kernels. Considering all stents, ALN did not significantly differ using different CT scanners or imaging protocols. CTA evaluation of vessel patency after stent placement is possible, but is considerably impaired by ALN. Investigators should be informed about the method of choice for every stent and stent manufacturers should be aware of potential artifacts caused by their stents during noninvasive diagnostic methods such as CTA. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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.

Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography.

PubMed

Dong, Zhi-Hui; Yang, Zhi-Gang; Chen, Tian-Wu; Chu, Zhi-Gang; Deng, Wen; Shao, Heng

2011-01-01

Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT). We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; p<0.001). Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05) or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05) were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01). Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01). Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001). Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.

Thoracic Injuries in earthquake-related versus non-earthquake-related trauma patients: differentiation via Multi-detector Computed Tomography

PubMed Central

Dong, Zhi-hui; Yang, Zhi-gang; Chen, Tian-wu; Chu, Zhi-gang; Deng, Wen; Shao, Heng

2011-01-01

PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT). METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; p<0.001). Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR = 1.2; p<0.05) or flail chest (45/143 vs. 11/66 patients, RR = 1.9; p<0.05) were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR = 1.7; p<0.01). Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR = 1.4; p<0.01). Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR = 1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001). Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. CONCLUSIONS: Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries. PMID:21789386

Intramural location and size of arterial calcification are associated with stenosis at carotid bifurcation.

PubMed

Yamada, Shigeki; Oshima, Marie; Watanabe, Yoshihiko; Ogata, Hideki; Hashimoto, Kenji; Miyake, Hidenori

2014-06-01

The purpose of this study was to investigate the association between internal carotid artery (ICA) stenosis and intramural location and size of calcification at the ICA origins and the origins of the cervical arteries proximal to the ICA. A total of 1139 ICAs were evaluated stenosis and calcification on the multi-detector row CT angiography. The intramural location was categorized into none, outside and inside location. The calcification size was evaluated on the 4-point grading scale. The multivariate analyses were adjusted for age, serum creatinine level, hypertension, hyperlipidemia, diabetes mellitus, smoking and alcohol habits. Outside calcification at the ICA origins showed the highest multivariate odds ratio (OR) for the presence of ICA stenosis (30.0) and severe calcification (a semicircle or more of calcification at the arterial cross-sectional surfaces) did the second (14.3). In the subgroups of >70% ICA stenosis, the multivariate OR of outside location increased to 44.8 and that of severe calcification also increased to 32.7. Four of 5 calcified carotid plaque specimens extracted by carotid endarterectomy were histologically confirmed to be calcified burdens located outside the internal elastic lamia which were defined as arterial medial calcification. ICA stenosis was strongly associated with severe calcification located mainly outside the carotid plaque. Outside calcification at the ICA origins should be evaluated separately from inside calcification, as a marker for the ICA stenosis. Additionally, we found that calcification at the origins of the cervical arteries proximal to the ICA was significantly associated with the ICA stenosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Geographic Distribution of CT, MRI and PET Devices in Japan: A Longitudinal Analysis Based on National Census Data.

PubMed

Matsumoto, Masatoshi; Koike, Soichi; Kashima, Saori; Awai, Kazuo

2015-01-01

Japan has the most CT and MRI scanners per unit population in the world; however, the geographic distribution of these technologies is currently unknown. Moreover, nothing is known of the cause-effect relationship between the number of diagnostic imaging devices and their geographic distribution. Data on the number of CT, MRI and PET devices and that of their utilizations in all 1829 municipalities of Japan was generated, based on the Static Survey of Medical Institutions conducted by the government. The inter-municipality equity of the number of devices or utilizations was evaluated with Gini coefficient. Between 2005 and 2011, the number of CT, MRI and PET devices in Japan increased by 47% (8789 to 12945), 19% (5034 to 5990) and 70% (274 to 466), respectively. Gini coefficient of the number of devices was largest for PET and smallest for CT (p for PET-MRI difference <0.001; MRI-CT difference <0.001). For all three modalities, Gini coefficient steadily decreased (p for 2011-2005 difference: <0.001 for CT; 0.003 for MRI; and <0.001 for PET). The number of devices in old models (single-detector CT, MRI<1.5 tesla, and conventional PET) decreased, while that in new models (multi-detector CT, MRI≥1.5 tesla, and PET-CT) increased. Gini coefficient of the old models increased or remained unchanged (increase rate of 9%, 3%, and -1%; p for 2011-2008 difference <0.001, 0.072, and 0.562, respectively), while Gini coefficient of the new models decreased (-10%, -9%, and -10%; p for 2011-2008 difference <0.001, <0.001, and <0.001 respectively). Similar results were observed in terms of utilizations. The more abundant a modality, the more equal the modality's distribution. Any increase in the modality made its distribution more equal. The geographic distribution of the diagnostic imaging technology in Japan appears to be affected by spatial competition derived from a market force.

Use of a thin-section archive and enterprise 3D software for long-term storage of thin-slice CT data sets.

PubMed

Meenan, Christopher; Daly, Barry; Toland, Christopher; Nagy, Paul

2006-01-01

Rapid advances are changing the technology and applications of multidetector computed tomography (CT) scanners. The major increase in data associated with this new technology, however, breaks most commercial picture archiving and communication system (PACS) architectures by preventing them from delivering data in real time to radiologists and outside clinicians. We proposed a phased model for 3D workflow, installed a thin-slice archive and measured thin-slice data storage over a period of 5 months. A mean of 1,869 CT studies were stored per month, with an average of 643 images per study and a mean total volume of 588 GB/month. We also surveyed 48 radiologists to determine diagnostic use, impressions of thin-slice value, and requirements for retention times. The majority of radiologists thought thin slice was helpful for diagnosis and regularly used the application. Permanent storage of thin slice CT is likely to become best practice and a mission-critical pursuit for the health care enterprise.

Small-airway obstruction and emphysema in chronic obstructive pulmonary disease.

PubMed

McDonough, John E; Yuan, Ren; Suzuki, Masaru; Seyednejad, Nazgol; Elliott, W Mark; Sanchez, Pablo G; Wright, Alexander C; Gefter, Warren B; Litzky, Leslie; Coxson, Harvey O; Paré, Peter D; Sin, Don D; Pierce, Richard A; Woods, Jason C; McWilliams, Annette M; Mayo, John R; Lam, Stephen C; Cooper, Joel D; Hogg, James C

2011-10-27

The major sites of obstruction in chronic obstructive pulmonary disease (COPD) are small airways (<2 mm in diameter). We wanted to determine whether there was a relationship between small-airway obstruction and emphysematous destruction in COPD. We used multidetector computed tomography (CT) to compare the number of airways measuring 2.0 to 2.5 mm in 78 patients who had various stages of COPD, as judged by scoring on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) scale, in isolated lungs removed from patients with COPD who underwent lung transplantation, and in donor (control) lungs. MicroCT was used to measure the extent of emphysema (mean linear intercept), the number of terminal bronchioles per milliliter of lung volume, and the minimum diameters and cross-sectional areas of terminal bronchioles. On multidetector CT, in samples from patients with COPD, as compared with control samples, the number of airways measuring 2.0 to 2.5 mm in diameter was reduced in patients with GOLD stage 1 disease (P=0.001), GOLD stage 2 disease (P=0.02), and GOLD stage 3 or 4 disease (P<0.001). MicroCT of isolated samples of lungs removed from patients with GOLD stage 4 disease showed a reduction of 81 to 99.7% in the total cross-sectional area of terminal bronchioles and a reduction of 72 to 89% in the number of terminal bronchioles (P<0.001). A comparison of the number of terminal bronchioles and dimensions at different levels of emphysematous destruction (i.e., an increasing value for the mean linear intercept) showed that the narrowing and loss of terminal bronchioles preceded emphysematous destruction in COPD (P<0.001). These results show that narrowing and disappearance of small conducting airways before the onset of emphysematous destruction can explain the increased peripheral airway resistance reported in COPD. (Funded by the National Heart, Lung, and Blood Institute and others.).

Update on the imaging diagnosis of otosclerosis.

PubMed

Gredilla Molinero, J; Mancheño Losa, M; Santamaría Guinea, N; Arévalo Galeano, N; Grande Bárez, M

2016-01-01

Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT (MDCT), the imaging technique of choice, is sometimes necessary. The objective of this article is to systematically review the usefulness of imaging techniques for the diagnosis and postsurgical assessment of otosclerosis, fundamentally the role of MDCT, to decrease the surgical risk. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Detection of attenuated plaque in stable angina with 64-multidetector computed tomography: a comparison with intravascular ultrasound.

PubMed

Jinzaki, Masahiro; Okabe, Teruo; Endo, Ayaka; Kawamura, Akio; Koga, Seiko; Yamada, Minoru; Fukuda, Keiichi; Kuribayashi, Sachio

2012-01-01

To clarify multidetector computed tomography (MDCT) findings of attenuated plaque detected by intravascular ultrasound (IVUS). One hundred and fifty-four patients with stable angina underwent MDCT before IVUS. The attenuated plaque was identified in the targeted artery with IVUS, and the same artery was analyzed with MDCT for the presence of a high density area (HDA) >130 Hounsfield units (HU), and a low density area (LDA) <30 HU. A HDA in attenuated plaque was compared with that in calcified plaque. Ten attenuated plaques and 15 calcified plaques were identified in 9 of 154 patients (males=9, 66.2 ± 9.5 years). Eight of the 10 attenuated plaques and all 15 calcified plaques were accompanied with a HDA on MDCT. The HDA ranged from 174 to 667 HU (mean 389.0 ± 148.3 HU) in the 8 attenuated plaques, and from 545 to 1,205 HU (mean 920.9 ± 215.9 HU) in 15 calcified plaques. There was a significant difference in CT density of the HDA between the attenuated and calcified plaque (P<0.001). All attenuated plaques contained LDA <30 HU in the portions without HDA. MDCT has the ability to demonstrate attenuated plaque as the combination of HDA (approximately 400 HU on average) and LDA <30 HU. The HDA can be differentiated from calcified plaque by its lower CT density value.

Radiation dose of digital tomosynthesis for sinonasal examination: comparison with multi-detector CT.

PubMed

Machida, Haruhiko; Yuhara, Toshiyuki; Tamura, Mieko; Numano, Tomokazu; Abe, Shinji; Sabol, John M; Suzuki, Shigeru; Ueno, Eiko

2012-06-01

Using an anthropomorphic phantom, we have investigated the feasibility of digital tomosynthesis (DT) of flat-panel detector (FPD) radiography to reduce radiation dose for sinonasal examination compared to multi-detector computed tomography (MDCT). A female Rando phantom was scanned covering frontal to maxillary sinus using the clinically routine protocol by both 64-detector CT (120 kV, 200 mAs, and 1.375-pitch) and DT radiography (80 kV, 1.0 mAs per projection, 60 projections, 40° sweep, and posterior-anterior projections). Glass dosimeters were used to measure the radiation dose to internal organs including the thyroid gland, brain, submandibular gland, and the surface dose at various sites including the eyes during those scans. We compared the radiation dose to those anatomies between both modalities. In DT radiography, the doses of the thyroid gland, brain, submandibular gland, skin, and eyes were 230 ± 90 μGy, 1770 ± 560 μGy, 1400 ± 80 μGy, 1160 ± 2100 μGy, and 112 ± 6 μGy, respectively. These doses were reduced to approximately 1/5, 1/8, 1/12, 1/17, and 1/290 of the respective MDCT dose. For sinonasal examinations, DT radiography enables dramatic reduction in radiation exposure and dose to the head and neck region, particularly to the lens of the eye. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Multidetector computerized tomographic fistulography in the evaluation of congenital branchial cleft fistulae and sinuses.

PubMed

Sun, Zhipeng; Fu, Kaiyuan; Zhang, Zuyan; Zhao, Yanping; Ma, Xuchen

2012-05-01

The aim of this study was to primarily investigate the usefulness of computerized tomographic (CT) fistulography in the diagnosis and management of branchial cleft fistulae and sinuses. Fifteen patients with confirmed branchial fistulae or sinuses who had undergone CT fistulography were included. The diagnoses were confirmed by clinical, radiologic, or histopathologic examinations. The internal openings, distribution, and neighboring relationship of the lesions presented by CT fistulography were analyzed to evaluate the usefulness in comparison with x-ray fistulography. Nine patients were diagnosed with first branchial fistulae or sinuses, 2 with second branchial fistulae, and 4 with third or fourth branchial fistulae. The presence and location of the lesions could be seen on x-ray fistulography. The distribution of the lesions, internal openings, and neighboring relationship with parotid gland, carotid sheath, and submandibular gland could be clearly demonstrated on CT cross-sectional or volume-rendering images. CT fistulography could provide valuable information and benefit surgical planning by demonstrating the courses of branchial anomalies in detail. Copyright © 2012 Elsevier Inc. 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.

Quantitative computed tomography of pulmonary emphysema and ventricular function in chronic obstructive pulmonary disease patients with pulmonary hypertension.

PubMed

Huang, Yu-Sen; Hsu, Hsao-Hsun; Chen, Jo-Yu; Tai, Mei-Hwa; Jaw, Fu-Shan; Chang, Yeun-Chung

2014-01-01

This study strived to evaluate the relationship between degree of pulmonary emphysema and cardiac ventricular function in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) using electrocardiographic-gated multidetector computed tomography (CT). Lung transplantation candidates with the diagnosis of COPD and PH were chosen for the study population, and a total of 15 patients were included. The extent of emphysema is defined as the percentage of voxels below -910 Hounsfield units in the lung windows in whole lung CT without intravenous contrast. Heart function parameters were measured by electrocardiographic-gated CT angiography. Linear regression analysis was conducted to examine the associations between percent emphysema and heart function indicators. Significant correlations were found between percent emphysema and right ventricular (RV) measurements, including RV end-diastolic volume (R(2) = 0.340, p = 0.023), RV stroke volume (R(2) = 0.406, p = 0.011), and RV cardiac output (R(2) = 0.382, p = 0.014); the correlations between percent emphysema and left ventricular function indicators were not observed. The study revealed that percent emphysema is correlated with RV dysfunction among COPD patients with PH. Based on our findings, percent emphysema can be considered for use as an indicator to predict the severity of right ventricular dysfunction among COPD patients.

CT, MRI and PET imaging in peritoneal malignancy

PubMed Central

Sahdev, Anju; Reznek, Rodney H.

2011-01-01

Abstract Imaging plays a vital role in the evaluation of patients with suspected or proven peritoneal malignancy. Nevertheless, despite significant advances in imaging technology and protocols, assessment of peritoneal pathology remains challenging. The combination of complex peritoneal anatomy, an extensive surface area that may host tumour deposits and the considerable overlap of imaging appearances of various peritoneal diseases often makes interpretation difficult. Contrast-enhanced multidetector computed tomography (MDCT) remains the most versatile tool in the imaging of peritoneal malignancy. However, conventional and emerging magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT techniques offer significant advantages over MDCT in detection and surveillance. This article reviews established and new techniques in CT, MRI and PET imaging in both primary and secondary peritoneal malignancies and provides an overview of peritoneal anatomy, function and modes of disease dissemination with illustration of common sites and imaging features of peritoneal malignancy. PMID:21865109

Volumetric topological analysis: a novel approach for trabecular bone classification on the continuum between plates and rods.

PubMed

Saha, Punam K; Xu, Yan; Duan, Hong; Heiner, Anneliese; Liang, Guoyuan

2010-11-01

Trabecular bone (TB) is a complex quasi-random network of interconnected plates and rods. TB constantly remodels to adapt to the stresses to which it is subjected (Wolff's Law). In osteoporosis, this dynamic equilibrium between bone formation and resorption is perturbed, leading to bone loss and structural deterioration. Both bone loss and structural deterioration increase fracture risk. Bone's mechanical behavior can only be partially explained by variations in bone mineral density, which led to the notion of bone structural quality. Previously, we developed digital topological analysis (DTA) which classifies plates, rods, profiles, edges, and junctions in a TB skeletal representation. Although the method has become quite popular, a major limitation of DTA is that it provides only hard classifications of different topological entities, failing to distinguish between narrow and wide plates. Here, we present a new method called volumetric topological analysis (VTA) for regional quantification of TB topology. At each TB location, the method uniquely classifies its topology on the continuum between perfect plates and perfect rods, facilitating early detections of TB alterations from plates to rods according to the known etiology of osteoporotic bone loss. Several new ideas, including manifold distance transform, manifold scale, and feature propagation have been introduced here and combined with existing DTA and distance transform methods, leading to the new VTA technology. This method has been applied to multidetector computed tomography (CT) and micro-computed tomography ( μCT) images of four cadaveric distal tibia and five distal radius specimens. Both intra- and inter-modality reproducibility of the method has been examined using repeat CT and μCT scans of distal tibia specimens. Also, the method's ability to predict experimental biomechanical properties of TB via CT imaging under in vivo conditions has been quantitatively examined and the results found are very encouraging.

Whole brain CT perfusion deficits using 320-detector-row CT scanner in TIA patients are associated with ABCD2 score.

PubMed

Mehta, Bijal K; Mustafa, Ghulam; McMurtray, Aaron; Masud, Mohammed W; Gunukula, Sameer K; Kamal, Haris; Kandel, Amit; Beltagy, Abdelrahman; Li, Ping

2014-01-01

Transient ischemic attacks (TIA) are cerebral ischemic events without infarction. The uses of CT perfusion (CTP) techniques such as cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT) and cerebral blood flow (CBF) provide real time data about ischemia. It has been shown that CTP changes occur in less sensitive CTP scanners in patients with TIA. Larger detector row CTP (whole brain perfusion studies) may show that CTP abnormalities are more prevalent than previously noted. It is also unclear if these changes are associated with TIA severity. To demonstrate that TIA patients are associated with perfusion deficits using whole brain 320-detector-row CT perfusion, and to determine an association between ABCD2 score and perfusion deficit using whole brain perfusion. We retrospectively reviewed all TIA patients for CTP deficits from 2008-2010. Perfusion imaging was reviewed at admission; and it was determined if a perfusion deficit was present along with vascular territory involved. Of 364 TIA patients, 62 patients had CTP deficits. The largest group of patients had MCA territory involved with 48 of 62 patients (77.42%). The most common perfusion abnormality was increased TTP with 46 patients (74.19%). The ABCD2 score was reviewed in association with perfusion deficit. Increased age >60, severe hypertension (>180/100 mmHg), patients with speech abnormalities, and duration of symptoms >10 min were associated with a perfusion deficit but history of diabetes or minimal/moderate hypertension (140/90-179/99 mmHg) was not. There was no association between motor deficit and perfusion abnormality. Perfusion deficits are found in TIA patients using whole brain CTP and associated with components of the ABCD2 score.

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

Bilateral subclavian origin of the bronchial arteries combined with absence of other origins.

PubMed

Jie, Bing; Sun, Xi-Wen; Yu, Dong; Jiang, Sen

2014-08-01

There are numerous anatomical variations of the sites of origin of the bronchial arteries (BAs). A subclavian origin of a BA involves an aberrant artery that originates from the subclavian artery (SCA) or its branches. However, the aberrant artery usually originates directly from the SCA, and an SCA-origin BA arising from the branches of the SCA is rare. We herein present an extremely rare case of a right BA arising from the ipsilateral costocervical trunk, and a left BA arising from the ipsilateral thyrocervical trunk, in the absence of other origins of the BA. This anatomical variation was detected during pretherapeutic evaluation by multidetector-row computed tomography and confirmed by selective angiography. Recognition of these anatomic variations is important to surgical, diagnostic, and interventional radiologic procedures in the thorax.

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

PubMed Central

ZHU, CAISONG; LIU, WEI; YANG, JUN; YANG, JING; SHAO, KANGWEI; YUAN, LIXIN; CHEN, HAIRONG; LU, WEI; ZHU, YING

2016-01-01

The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (P<0.05). MDCT features such as ill-defined margin, absence of capsule or incomplete capsule or homogeneous enhancement were more likely to be present in the malignant nodules (P<0.05). Nevertheless, no significant difference was observed in the enhancement degree at arterial or venous phase between benign and malignant nodules (P>0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice. PMID:27347131

Cardiac Multi-detector CT Segmentation Based on Multiscale Directional Edge Detector and 3D Level Set.

PubMed

Antunes, Sofia; Esposito, Antonio; Palmisano, Anna; Colantoni, Caterina; Cerutti, Sergio; Rizzo, Giovanna

2016-05-01

Extraction of the cardiac surfaces of interest from multi-detector computed tomographic (MDCT) data is a pre-requisite step for cardiac analysis, as well as for image guidance procedures. Most of the existing methods need manual corrections, which is time-consuming. We present a fully automatic segmentation technique for the extraction of the right ventricle, left ventricular endocardium and epicardium from MDCT images. The method consists in a 3D level set surface evolution approach coupled to a new stopping function based on a multiscale directional second derivative Gaussian filter, which is able to stop propagation precisely on the real boundary of the structures of interest. We validated the segmentation method on 18 MDCT volumes from healthy and pathologic subjects using manual segmentation performed by a team of expert radiologists as gold standard. Segmentation errors were assessed for each structure resulting in a surface-to-surface mean error below 0.5 mm and a percentage of surface distance with errors less than 1 mm above 80%. Moreover, in comparison to other segmentation approaches, already proposed in previous work, our method presented an improved accuracy (with surface distance errors less than 1 mm increased of 8-20% for all structures). The obtained results suggest that our approach is accurate and effective for the segmentation of ventricular cavities and myocardium from MDCT images.

Detection of biliary and vascular anatomy in living liver donors: value of gadobenate dimeglumine enhanced MR and MDCT angiography.

PubMed

Artioli, Diana; Tagliabue, Marianna; Aseni, Paolo; Sironi, Sandro; Vanzulli, Angelo

2010-11-01

To evaluate the performance of magnetic resonance (MR) and multidetector computed tomography (MDCT) in the assessment of living donor's vascular and biliary anatomy, having surgical findings as reference standard. Thirty-two living liver donors underwent MR cholangiography (1.5-T; standard cholangiography pulse sequences and delayed acquisitions after administration of biliary contrast agent) for biliary anatomy evaluation. MDCT (16-row multidetector scanner, multiphase protocol, 3mm slice thickness) was also performed in all cases for the assessment of vascular anatomy before transplantation. Hepatic veins (<4mm in diameter) were not considered. MR and MDCT images interpretation was performed by two reviewers by consensus, based on source axial images, multiplanar reformats, and three-dimensional (3D) postprocessing images. Surgical intraoperative findings were used as standard of reference. At surgery, 17 biliary anomalies, 3 portal anomalies, 32 venous and 8 arterial variants were found in the 32 patients. MR correctly identified 15/17 biliary anomalies, with a sensitivity of 88% and a specificity of 93%. MDCT correctly identified 8/8 arterial, 3/3 portal and 29/32 venous variants, with a sensitivity of 100% and 91%, respectively, and a specificity of 100%. MR and MDCT proved to be efficient in evaluating living liver donor's biliary and vascular anatomy. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations

NASA Astrophysics Data System (ADS)

Gu, J.; Bednarz, B.; Caracappa, P. F.; Xu, X. G.

2009-05-01

The latest multiple-detector technologies have further increased the popularity of x-ray CT as a diagnostic imaging modality. There is a continuing need to assess the potential radiation risk associated with such rapidly evolving multi-detector CT (MDCT) modalities and scanning protocols. This need can be met by the use of CT source models that are integrated with patient computational phantoms for organ dose calculations. Based on this purpose, this work developed and validated an MDCT scanner using the Monte Carlo method, and meanwhile the pregnant patient phantoms were integrated into the MDCT scanner model for assessment of the dose to the fetus as well as doses to the organs or tissues of the pregnant patient phantom. A Monte Carlo code, MCNPX, was used to simulate the x-ray source including the energy spectrum, filter and scan trajectory. Detailed CT scanner components were specified using an iterative trial-and-error procedure for a GE LightSpeed CT scanner. The scanner model was validated by comparing simulated results against measured CTDI values and dose profiles reported in the literature. The source movement along the helical trajectory was simulated using the pitch of 0.9375 and 1.375, respectively. The validated scanner model was then integrated with phantoms of a pregnant patient in three different gestational periods to calculate organ doses. It was found that the dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. The paper also discusses how these fetal dose values can be used to evaluate imaging procedures and to assess risk using recommendations of the report from AAPM Task Group 36. This work demonstrates the ability of modeling and validating an MDCT scanner by the Monte Carlo method, as well as assessing fetal and organ doses by combining the MDCT scanner model and the pregnant patient phantom.

Automated Quantification of Pneumothorax in CT

PubMed Central

Do, Synho; Salvaggio, Kristen; Gupta, Supriya; Kalra, Mannudeep; Ali, Nabeel U.; Pien, Homer

2012-01-01

An automated, computer-aided diagnosis (CAD) algorithm for the quantification of pneumothoraces from Multidetector Computed Tomography (MDCT) images has been developed. Algorithm performance was evaluated through comparison to manual segmentation by expert radiologists. A combination of two-dimensional and three-dimensional processing techniques was incorporated to reduce required processing time by two-thirds (as compared to similar techniques). Volumetric measurements on relative pneumothorax size were obtained and the overall performance of the automated method shows an average error of just below 1%. PMID:23082091

Osteochondral lesions about the ankle.

PubMed

Naran, Ketan N; Zoga, Adam C

2008-11-01

Osteochondral lesions (OCLs) about the foot and ankle often manifest clinically as prolonged joint pain after trauma, often an ankle sprain, which is refractory to conventional, conservative therapeutic treatment. Noncontrast MR imaging is the standard of care imaging modality for diagnosing and classifying osteochondral lesions, but equivocal or difficult lesions can be assessed more specifically with direct MR arthrography or in conjunction with multidetector CT. Once an OCL has been identified, the imager should make every effort to determine whether it is stable or potentially unstable.

Comparison of Intraoperative Portable CT Scanners in Skull Base and Endoscopic Sinus Surgery: Single Center Case Series

PubMed Central

Conley, David B.; Tan, Bruce; Bendok, Bernard R.; Batjer, H. Hunt; Chandra, Rakesh; Sidle, Douglas; Rahme, Rudy J.; Adel, Joseph G.; Fishman, Andrew J.

2011-01-01

Precise and safe management of complex skull base lesions can be enhanced by intraoperative computed tomography (CT) scanning. Surgery in these areas requires real-time feedback of anatomic landmarks. Several portable CT scanners are currently available. We present a comparison of our clinical experience with three portable scanners in skull base and craniofacial surgery. We present clinical case series and the participants were from the Northwestern Memorial Hospital. Three scanners are studied: one conventional multidetector CT (MDCT), two digital flat panel cone-beam CT (CBCT) devices. Technical considerations, ease of use, image characteristics, and integration with image guidance are presented for each device. All three scanners provide good quality images. Intraoperative scanning can be used to update the image guidance system in real time. The conventional MDCT is unique in its ability to resolve soft tissue. The flat panel CBCT scanners generally emit lower levels of radiation and have less metal artifact effect. In this series, intraoperative CT scanning was technically feasible and deemed useful in surgical decision-making in 75% of patients. Intraoperative portable CT scanning has significant utility in complex skull base surgery. This technology informs the surgeon of the precise extent of dissection and updates intraoperative stereotactic navigation. PMID:22470270

Experimental benchmarking of a Monte Carlo dose simulation code for pediatric CT

NASA Astrophysics Data System (ADS)

Li, Xiang; Samei, Ehsan; Yoshizumi, Terry; Colsher, James G.; Jones, Robert P.; Frush, Donald P.

2007-03-01

In recent years, there has been a desire to reduce CT radiation dose to children because of their susceptibility and prolonged risk for cancer induction. Concerns arise, however, as to the impact of dose reduction on image quality and thus potentially on diagnostic accuracy. To study the dose and image quality relationship, we are developing a simulation code to calculate organ dose in pediatric CT patients. To benchmark this code, a cylindrical phantom was built to represent a pediatric torso, which allows measurements of dose distributions from its center to its periphery. Dose distributions for axial CT scans were measured on a 64-slice multidetector CT (MDCT) scanner (GE Healthcare, Chalfont St. Giles, UK). The same measurements were simulated using a Monte Carlo code (PENELOPE, Universitat de Barcelona) with the applicable CT geometry including bowtie filter. The deviations between simulated and measured dose values were generally within 5%. To our knowledge, this work is one of the first attempts to compare measured radial dose distributions on a cylindrical phantom with Monte Carlo simulated results. It provides a simple and effective method for benchmarking organ dose simulation codes and demonstrates the potential of Monte Carlo simulation for investigating the relationship between dose and image quality for pediatric CT patients.

6. Historic American Buildings Survey James Rainey, Photographer May 7, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Historic American Buildings Survey James Rainey, Photographer May 7, 1936 STAIRS FROM ROOM OF SECRETARY OF STATE SECOND FLOOR (Looking North) - Old State House, Main Street & Central Row, Hartford, Hartford County, CT

[In vivo anatomical study of inferior attachment of renal fascia in adult with acute pancreatitis as shown on multidetector computed tomography].

PubMed

Qi, Rui; Zhou, Xiangping; Yu, Jianqun; Li, Zhenlin

2014-04-01

This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.

Multidetector CT of Surgically Proven Blunt Bowel and Mesenteric Injury.

PubMed

Bates, David D B; Wasserman, Michael; Malek, Anita; Gorantla, Varun; Anderson, Stephan W; Soto, Jorge A; LeBedis, Christina A

2017-01-01

Blunt traumatic injury is one of the leading causes of morbidity and mortality in the United States. Unintentional injury represents the leading cause of death in the United States for all persons between the ages of 1 and 44 years. In the setting of blunt abdominal trauma, the reported rate of occurrence of bowel and mesenteric injuries ranges from 1% to 5%. Despite the relatively low rate of blunt bowel and mesenteric injury in patients with abdominal and pelvic trauma, delays in diagnosis are associated with increased rates of sepsis, a prolonged course in the intensive care unit, and increased mortality. During the past 2 decades, as multidetector computed tomography (CT) has emerged as an essential tool in emergency radiology, several direct and indirect imaging features have been identified that are associated with blunt bowel and mesenteric injury. The imaging findings in cases of blunt bowel and mesenteric injury can be subtle and may be seen in the setting of multiple complex injuries, such as multiple solid-organ injuries and spinal fractures. Familiarity with the various imaging features of blunt bowel and mesenteric injury, as well as an understanding of their clinical importance with regard to the care of the patient, is essential to making a timely diagnosis. Once radiologists are familiar with the spectrum of findings of blunt bowel and mesenteric injury, they will be able to make timely diagnoses that will lead to improved patient outcomes. © RSNA, 2017.

Cochlear Implant Electrode Localization Using an Ultra-High Resolution Scan Mode on Conventional 64-Slice and New Generation 192-Slice Multi-Detector Computed Tomography.

PubMed

Carlson, Matthew L; Leng, Shuai; Diehn, Felix E; Witte, Robert J; Krecke, Karl N; Grimes, Josh; Koeller, Kelly K; Bruesewitz, Michael R; McCollough, Cynthia H; Lane, John I

2017-08-01

A new generation 192-slice multi-detector computed tomography (MDCT) clinical scanner provides enhanced image quality and superior electrode localization over conventional MDCT. Currently, accurate and reliable cochlear implant electrode localization using conventional MDCT scanners remains elusive. Eight fresh-frozen cadaveric temporal bones were implanted with full-length cochlear implant electrodes. Specimens were subsequently scanned with conventional 64-slice and new generation 192-slice MDCT scanners utilizing ultra-high resolution modes. Additionally, all specimens were scanned with micro-CT to provide a reference criterion for electrode position. Images were reconstructed according to routine temporal bone clinical protocols. Three neuroradiologists, blinded to scanner type, reviewed images independently to assess resolution of individual electrodes, scalar localization, and severity of image artifact. Serving as the reference standard, micro-CT identified scalar crossover in one specimen; imaging of all remaining cochleae demonstrated complete scala tympani insertions. The 192-slice MDCT scanner exhibited improved resolution of individual electrodes (p < 0.01), superior scalar localization (p < 0.01), and reduced blooming artifact (p < 0.05), compared with conventional 64-slice MDCT. There was no significant difference between platforms when comparing streak or ring artifact. The new generation 192-slice MDCT scanner offers several notable advantages for cochlear implant imaging compared with conventional MDCT. This technology provides important feedback regarding electrode position and course, which may help in future optimization of surgical technique and electrode design.

Radiological protection in computed tomography and cone beam computed tomography.

PubMed

Rehani, M M

2015-06-01

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

Development of adaptive noise reduction filter algorithm for pediatric body images in a multi-detector CT

NASA Astrophysics Data System (ADS)

Nishimaru, Eiji; Ichikawa, Katsuhiro; Okita, Izumi; Ninomiya, Yuuji; Tomoshige, Yukihiro; Kurokawa, Takehiro; Ono, Yutaka; Nakamura, Yuko; Suzuki, Masayuki

2008-03-01

Recently, several kinds of post-processing image filters which reduce the noise of computed tomography (CT) images have been proposed. However, these image filters are mostly for adults. Because these are not very effective in small (< 20 cm) display fields of view (FOV), we cannot use them for pediatric body images (e.g., premature babies and infant children). We have developed a new noise reduction filter algorithm for pediatric body CT images. This algorithm is based on a 3D post-processing in which the output pixel values are calculated by nonlinear interpolation in z-directions on original volumetric-data-sets. This algorithm does not need the in-plane (axial plane) processing, so the spatial resolution does not change. From the phantom studies, our algorithm could reduce SD up to 40% without affecting the spatial resolution of x-y plane and z-axis, and improved the CNR up to 30%. This newly developed filter algorithm will be useful for the diagnosis and radiation dose reduction of the pediatric body CT images.

Patient- and cohort-specific dose and risk estimation for abdominopelvic CT: a study based on 100 patients

NASA Astrophysics Data System (ADS)

Tian, Xiaoyu; Li, Xiang; Segars, W. Paul; Frush, Donald P.; Samei, Ehsan

2012-03-01

The purpose of this work was twofold: (a) to estimate patient- and cohort-specific radiation dose and cancer risk index for abdominopelvic computer tomography (CT) scans; (b) to evaluate the effects of patient anatomical characteristics (size, age, and gender) and CT scanner model on dose and risk conversion coefficients. The study included 100 patient models (42 pediatric models, 58 adult models) and multi-detector array CT scanners from two commercial manufacturers (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare). A previously-validated Monte Carlo program was used to simulate organ dose for each patient model and each scanner, from which DLP-normalized-effective dose (k factor) and DLP-normalized-risk index values (q factor) were derived. The k factor showed exponential decrease with increasing patient size. For a given gender, q factor showed exponential decrease with both increasing patient size and patient age. The discrepancies in k and q factors across scanners were on average 8% and 15%, respectively. This study demonstrates the feasibility of estimating patient-specific organ dose and cohort-specific effective dose and risk index in abdominopelvic CT requiring only the knowledge of patient size, gender, and age.

Trabecular bone class mapping across resolutions: translating methods from HR-pQCT to clinical CT

NASA Astrophysics Data System (ADS)

Valentinitsch, Alexander; Fischer, Lukas; Patsch, Janina M.; Bauer, Jan; Kainberger, Franz; Langs, Georg; DiFranco, Matthew

2015-03-01

Quantitative assessment of 3D bone microarchitecture in high-resolution peripheral quantitative computed tomography (HR-pQCT) has shown promise in fracture risk assessment and biomechanics, but is limited to the distal radius and tibia. Trabecular microarchitecture classes (TMACs), based on voxel-wise clustering texture and structure tensor features in HRpQCT, is extended in this paper to quantify trabecular bone classes in clinical multi-detector CT (MDCT) images. Our comparison of TMACs in 12 cadaver radii imaged using both HRpQCT and MDCT yields a mean Dice score of up to 0.717+/-0.40 and visually concordant bone quality maps. Further work to develop clinically viable bone quantitative imaging using HR-pQCT validation could have a significant impact on overall bone health assessment.

That liver lesion on MDCT in the oncology patient: is it important?

PubMed Central

Thakrar, Kiran H.; Wenzke, Daniel R.; Newmark, Geraldine M.; Mehta, Uday K.; Berlin, Jonathan W.

2012-01-01

Abstract Multidetector-row computed tomography (MDCT) has become the primary imaging test for the staging and follow-up of most malignancies that originate outside of the central nervous system. Technical advances in this imaging technique have led to significant improvement in the detection of metastatic disease to the liver. An unintended by-product of this improving diagnostic acumen is the discovery of incidental hepatic lesions in oncology patients that in the past remained undetected. These ubiquitous, incidentally identified hepatic lesions have created a management dilemma for both clinicians and radiologists: are these lesions benign or do they represent metastases? Naturally, the answer to this question has profound prognostic and therapeutic implications. In this review, guidelines concerning the diagnosis and management of some of the more common hepatic incidental lesions detected in patients with extrahepatic malignancies are presented. PMID:23023318

Evaluation of the influence of acquisition and reconstruction parameters for 16-row multidetector CT on coronary calcium scoring using a stationary and dynamic cardiac phantom.

PubMed

Begemann, Philipp G C; van Stevendaal, Udo; Koester, Ralph; Mahnken, Andreas H; Koops, Andreas; Adam, Gerhard; Grass, Michael; Nolte-Ernsting, Claus

2007-08-01

A calcium-scoring phantom with hydroxyapatite-filled cylindrical holes (0.5 to 4 mm) was used. High-resolution scans were performed for an accuracy baseline. The phantom was mounted to a moving heart phantom. Non-moving data with the implementation of an ECG-signal were acquired for different pitches (0.2/0.3), heart rates (60/80/95 bpm) and collimations (16 x 0.75/16 x 1.5 mm). Images were reconstructed with a cone-beam multi-cycle algorithm at a standard thickness/increment of 3 mm/1.5 mm and the thinnest possible thickness (0.8/0.4 and 2/1). Subsequently, ECG-gated moving calcium-scoring phantom data were acquired. The calcium volume and Agatston score were measured. The temporal resolution and reconstruction cycles were calculated. High-resolution scans determine the calcium volume with a high accuracy (mean overestimation, 0.8%). In the non-moving measurements, the volume underestimation ranged from about 6% (16 x 0.75 mm; 0.8/0.4 mm) to nearly 25% (16 x 1.5 mm; 3/1.5 mm). Moving scans showed increased measurement errors depending on the reconstructed RR interval, collimation, pitch, heart rate and gantry rotation time. Also, a correlation with the temporal resolution could be found. The reliability of calcium-scoring results can be improved with the use of a narrower collimation, a lower pitch and the reconstruction of thinner images, resulting in higher patient doses. The choice of the correct cardiac phase within the RR interval is essential to minimize measurement errors.

Spatial anatomy of the round ligament, gallbladder, and intrahepatic vessels in patients with right-sided round ligament of the liver.

PubMed

Ibukuro, Kenji; Takeguchi, Takaya; Fukuda, Hozumi; Abe, Shoko; Tobe, Kimiko

2016-11-01

To analyze the vascular structure of the liver in patients with a right-sided round ligament. We reviewed 16 patients with a right-sided round ligament and 3 polysplenia and situs inversus patients with a left-sided round ligament who underwent multidetector row CT with contrast media. The patient population consisted of 13 men and 6 women (mean 62 years). We analyzed the axial and volume-rendered images for the location of the round ligament, gallbladder, portal veins, hepatic veins, and hepatic artery. The following imaging findings for the patients with polysplenia and situs inversus were horizontally reversed. The prevalence of a right-sided round ligament with and without polysplenia was 75 and 0.11 %, respectively. The gallbladder was located to the right, below, and left of the round ligament in 27.7, 38.8 and 33.3 %, respectively. Independent branching of the right posterior portal vein was noted in 57.8 %. PV4 was difficult to identify in 36.8 %. The middle hepatic vein was located to the left of the round ligament. Two branching patterns for the lateral and medial branches of the right anterior hepatic artery were noted: the common (44.4 %) and separated types (55.5 %). Both of the right anterior hepatic artery and portal vein ramified into two segments; the lateral segment with many branches and the medial segment with a few branches. The right-sided round ligament divided the right anterior section into the lateral and medial segments based on the portal vein and hepatic artery anatomy.

Influence of detector collimation on SNR in four different MDCT scanners using a reconstructed slice thickness of 5 mm.

PubMed

Verdun, F R; Noel, A; Meuli, R; Pachoud, M; Monnin, P; Valley, J-F; Schnyder, P; Denys, A

2004-10-01

The purpose of this paper is to compare the influence of detector collimation on the signal-to-noise ratio (SNR) for a 5.0 mm reconstructed slice thickness for four multi-detector row CT (MDCT) units. SNRs were measured on Catphan test phantom images from four MDCT units: a GE LightSpeed QX/I, a Marconi MX 8000, a Toshiba Aquilion and a Siemens Volume Zoom. Five-millimetre-thick reconstructed slices were obtained from acquisitions performed using detector collimations of 2.0-2.5 mm and 5.0 mm, 120 kV, a 360 degrees tube rotation time of 0.5 s, a wide range of mA and pitch values in the range of 0.75-0.85 and 1.25-1.5. For each set of acquisition parameters, a Wiener spectrum was also calculated. Statistical differences in SNR for the different acquisition parameters were evaluated using a Student's t-test (P<0.05). The influence of detector collimation on the SNR for a 5.0-mm reconstructed slice thickness is different for different MDCT scanners. At pitch values lower than unity, the use of a small detector collimation to produce 5.0-mm thick slices is beneficial for one unit and detrimental for another. At pitch values higher than unity, using a small detector collimation is beneficial for two units. One manufacturer uses different reconstruction filters when switching from a 2.5- to a 5.0-mm detector collimation. For a comparable reconstructed slice thickness, using a smaller detector collimation does not always reduce image noise. Thus, the impact of the detector collimation on image noise should be determined by standard deviation calculations, and also by assessing the power spectra of the noise. Copyright 2004 Springer-Verlag

Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT.

PubMed

Pessis, Eric; Campagna, Raphaël; Sverzut, Jean-Michel; Bach, Fabienne; Rodallec, Mathieu; Guerini, Henri; Feydy, Antoine; Drapé, Jean-Luc

2013-01-01

With arthroplasty being increasingly used to relieve joint pain, imaging of patients with metal implants can represent a significant part of the clinical work load in the radiologist's daily practice. Computed tomography (CT) plays an important role in the postoperative evaluation of patients who are suspected of having metal prosthesis-related problems such as aseptic loosening, bone resorption or osteolysis, infection, dislocation, metal hardware failure, or periprosthetic bone fracture. Despite advances in detector technology and computer software, artifacts from metal implants can seriously degrade the quality of CT images, sometimes to the point of making them diagnostically unusable. Several factors may help reduce the number and severity of artifacts at multidetector CT, including decreasing the detector collimation and pitch, increasing the kilovolt peak and tube charge, and using appropriate reconstruction algorithms and section thickness. More recently, dual-energy CT has been proposed as a means of reducing beam-hardening artifacts. The use of dual-energy CT scanners allows the synthesis of virtual monochromatic spectral (VMS) images. Monochromatic images depict how the imaged object would look if the x-ray source produced x-ray photons at only a single energy level. For this reason, VMS imaging is expected to provide improved image quality by reducing beam-hardening artifacts.

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

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.

[Preoperative imaging/operation planning for liver surgery].

PubMed

Schoening, W N; Denecke, T; Neumann, U P

2015-12-01

The currently established standard for planning liver surgery is multistage contrast media-enhanced multidetector computed tomography (CM-CT), which as a rule enables an appropriate resection planning, e.g. a precise identification and localization of primary and secondary liver tumors as well as the anatomical relation to extrahepatic and/or intrahepatic vascular and biliary structures. Furthermore, CM-CT enables the measurement of tumor volume, total liver volume and residual liver volume after resection. Under the condition of normal liver function a residual liver volume of 25 % is nowadays considered sufficient and safe. Recent studies in patients with liver metastases of colorectal cancer showed a clear staging advantage of contrast media-enhanced magnetic resonance imaging (CM-MRI) versus CM-CT. In addition, most recent data showed that the use of liver-specific MRI contrast media further increases the sensitivity and specificity of detection of liver metastases. This imaging technology seems to lead closer to the ideal "one stop shopping" diagnostic tool in preoperative planning of liver resection.

TU-G-204-03: Dynamic CT Myocardial Perfusion Measurement Using First Pass Analysis and Maximum Slope Models

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

Hubbard, L; Ziemer, B; Sadeghi, B

Purpose: To evaluate the accuracy of dynamic CT myocardial perfusion measurement using first pass analysis (FPA) and maximum slope models. Methods: A swine animal model was prepared by percutaneous advancement of an angioplasty balloon into the proximal left anterior descending (LAD) coronary artery to induce varying degrees of stenosis. Maximal hyperaemia was achieved in the LAD with an intracoronary adenosine drip (240 µg/min). Serial microsphere and contrast (370 mg/mL iodine, 30 mL, 5mL/s) injections were made over a range of induced stenoses, and dynamic imaging was performed using a 320-row CT scanner at 100 kVp and 200 mA. The FPAmore » CT perfusion technique was used to make vessel-specific myocardial perfusion measurements. CT perfusion measurements using the FPA and maximum slope models were validated using colored microspheres as the reference gold standard. Results: Perfusion measurements using the FPA technique (P-FPA) showed good correlation with minimal offset when compared to perfusion measurements using microspheres (P- Micro) as the reference standard (P -FPA = 0.96 P-Micro + 0.05, R{sup 2} = 0.97, RMSE = 0.19 mL/min/g). In contrast, the maximum slope model technique (P-MS) was shown to underestimate perfusion when compared to microsphere perfusion measurements (P-MS = 0.42 P -Micro −0.48, R{sup 2} = 0.94, RMSE = 3.3 mL/min/g). Conclusion: The results indicate the potential for significant improvements in accuracy of dynamic CT myocardial perfusion measurement using the first pass analysis technique as compared with the standard maximum slope model.« less

SU-E-I-24: Method for CT Automatic Exposure Control Verification

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

Gracia, M; Olasolo, J; Martin, M

Purpose: Design of a phantom and a simple method for the automatic exposure control (AEC) verification in CT. This verification is included in the computed tomography (CT) Spanish Quality Assurance Protocol. Methods: The phantom design is made from the head and the body phantom used for the CTDI measurement and PMMA plates (35×35 cm2) of 10 cm thickness. Thereby, three different thicknesses along the longitudinal axis are obtained which permit to evaluate the longitudinal AEC performance. Otherwise, the existent asymmetry in the PMMA layers helps to assess angular and 3D AEC operation.Recent acquisition in our hospital (August 2014) of Nomexmore » electrometer (PTW), together with the 10 cm pencil ionization chamber, led to register dose rate as a function of time. Measurements with this chamber fixed at 0° and 90° on the gantry where made on five multidetector-CTs from principal manufacturers. Results: Individual analysis of measurements shows dose rate variation as a function of phantom thickness. The comparative analysis shows that dose rate is kept constant in the head and neck phantom while the PMMA phantom exhibits an abrupt variation between both results, being greater results at 90° as the thickness of the phantom is 3.5 times larger than in the perpendicular direction. Conclusion: Proposed method is simple, quick and reproducible. Results obtained let a qualitative evaluation of the AEC and they are consistent with the expected behavior. A line of future development is to quantitatively study the intensity modulation and parameters of image quality, and a possible comparative study between different manufacturers.« less

[CT measurement and clinical application of double-row suture anchor reconstruction for the treatment of Tossy type III acromioclavicular joint dislocation].

PubMed

Zhang, Chuan-Kai; Liu, Chen; Han, Bing; Feng, Hui; Chen, Qi-Zhong; Sunx, Sun Yi-Yan

2017-04-25

To study feasibility and reliability of reconstruction of the acromioclavicular ligament with double-row suture anchor for the treatment of acromioclavicular joint dislocation through coracoid coronal CT measurement, and to provide a new operation method for treating acromioclavicular joint dislocation. Total 60 healthy people received CT examination of shoulder joint, including 30 males and 30 females, ranging in age from 18 to 50 years old. The coronal width, thickness and 20 degree camber angle in the medial part of the toot of coronal were measured using CT scan. The results were applied to clinical treatment for 12 patients with acromioclavicular joint dislocation of Tossy III type. The width in the medial part of the root of the coracoid was(17.65±1.82) mm(left side) and (17.67±1.80) mm(right side) in males; (16.55±1.78) mm(left side) and (16.52±1.74) mm (right side) in females. The vertical thickness of the roots of the coracoid: (13.11±2.11) mm(left side) and (13.16±2.09) mm(right side) in males;(12.79±2.21) mm(left side) and (12.76±2.19) mm (right side) in females. The thickness of 20 degrees camber angle of the coracoid roots: (16.32±1.74) mm (left side) and (16.30±1.69) mm(right side) in males; (15.68±1.44) mm(left side) and (15.67±1.43) mm(right side) in females. Total 12 patients were treated with anchor nail with extraversion 20 degrees. The postoperative X-ray films showed bone anchors were located in the coracoid process, no bone splitting. Double-row suture anchor of 5 mm diameter nails can be placed into coracoid with extraversion 20 degrees, which is safety.

Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists

PubMed Central

Neubauer, Jakob; Benndorf, Matthias; Reidelbach, Carolin; Krauß, Tobias; Lampert, Florian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Fiebich, Martin; Goerke, Sebastian M.

2016-01-01

Purpose To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. Methods As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. Results Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = < .004). No significant differences were detected concerning the modalities’ specificities (with values between P = .98). Raters' confidence was higher in RED-MDCT and RED-CBCT compared to radiography (P < .001). Conclusion The diagnostic accuracy of RED-MDCT and RED-CBCT for wrist fractures proved to be similar and in some parts even higher compared to radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run. PMID:27788215

Multidetector computed tomographic morphology of ovaries in cynomolgus macaques (Macaca fascicularis).

PubMed

Jones, Jeryl C; Appt, Susan E; Bourland, J Daniel; Hoyer, Patricia B; Clarkson, Thomas B; Kaplan, Jay R

2007-09-01

Macaques are important models for menopause and associated diseases in women. A sensitive, noninvasive technique for quantifying changes in ovarian morphology would facilitate longitudinal studies focused on the health-related sequelae of naturally occurring or experimentally induced alterations in ovarian structure and function. Multidetector computed tomography (MDCT) is a fast, non-invasive imaging technique that uses X-rays, multiple rows of detectors, and computers to generate detailed slice images of structures. The purpose of this study was to describe the utility of MDCT for reliably characterizing ovarian morphology in macaques. Five macaques were scanned using contrast-enhanced MDCT. The following characteristics were described: 1) appearance of ovaries and adjacent landmarks, 2) effects of varying technical protocols on ovarian image quality, 3) radiation doses delivered to the pelvic region during scanning, and 4) MDCT estimates of ovarian volume and antral follicle counts versus those measured directly in ovarian tissue. Ovaries were distinguishable in all MDCT scans and exhibited heterogeneous contrast enhancement. Antral follicles appeared as focal areas of nonenhancement. Ovarian image quality with 5 pediatric scanning protocols was sufficient for discriminating ovarian margins. Pelvic region radiation doses ranged from 0.5 to 0.7 rad. Antral follicles counted using MDCT ranged from 3 to 5 compared with 3 to 4 counted using histology. Ovarian volumes measured using MDCT ranged from 0.41 to 0.67 ml compared with 0.40 to 0.65 ml by water displacement. MDCT is a promising technique for measuring longitudinal changes in macaque ovarian morphology reliably and noninvasively.

A systematic review of the need for MRI for the clearance of cervical spine injury in obtunded blunt trauma patients after normal cervical spine CT.

PubMed

James, Iyore Ao; Moukalled, Ahmad; Yu, Elizabeth; Tulman, David B; Bergese, Sergio D; Jones, Christian D; Stawicki, Stanislaw Pa; Evans, David C

2014-10-01

Clearance of cervical spine injury (CSI) in the obtunded or comatose blunt trauma patient remains controversial. In patients with unreliable physical examination and no evidence of CSI on computed tomography (CT), magnetic resonance imaging of the cervical spine (CS-MRI) is the typical follow-up study. There is a growing body of evidence suggesting that CS-MRI is unnecessary with negative findings on a multi-detector CT (MDCT) scan. This review article systematically analyzes current literature to address the controversies surrounding clearance of CSI in obtunded blunt trauma patients. A literature search through MEDLINE database was conducted using all databases on the National Center for Biotechnology Information (NCBI) website (www.ncbi.nlm.nih.gov) for keywords: "cervical spine injury," "obtunded," and "MRI." The search was limited to studies published within the last 10 years and with populations of patients older than 18 years old. Eleven studies were included in the analysis yielding data on 1535 patients. CS-MRI detected abnormalities in 256 patients (16.6%). The abnormalities reported on CS-MRI resulted in prolonged rigid c-collar immobilization in 74 patients (4.9%). Eleven patients (0.7%) had unstable injury detected on CS-MRI alone that required surgical intervention. In the obtunded blunt trauma patient with unreliable clinical examination and a normal CT scan, there is still a role for CS-MRI in detecting clinically significant injuries when MRI resources are available. However, when a reliable clinical exam reveals intact gross motor function, CS-MRI may be unnecessary.

Attenuation-based size metric for estimating organ dose to patients undergoing tube current modulated CT exams

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

Bostani, Maryam, E-mail: mbostani@mednet.ucla.edu; McMillan, Kyle; Lu, Peiyun

2015-02-15

Purpose: Task Group 204 introduced effective diameter (ED) as the patient size metric used to correlate size-specific-dose-estimates. However, this size metric fails to account for patient attenuation properties and has been suggested to be replaced by an attenuation-based size metric, water equivalent diameter (D{sub W}). The purpose of this study is to investigate different size metrics, effective diameter, and water equivalent diameter, in combination with regional descriptions of scanner output to establish the most appropriate size metric to be used as a predictor for organ dose in tube current modulated CT exams. Methods: 101 thoracic and 82 abdomen/pelvis scans frommore » clinically indicated CT exams were collected retrospectively from a multidetector row CT (Sensation 64, Siemens Healthcare) with Institutional Review Board approval to generate voxelized patient models. Fully irradiated organs (lung and breasts in thoracic scans and liver, kidneys, and spleen in abdominal scans) were segmented and used as tally regions in Monte Carlo simulations for reporting organ dose. Along with image data, raw projection data were collected to obtain tube current information for simulating tube current modulation scans using Monte Carlo methods. Additionally, previously described patient size metrics [ED, D{sub W}, and approximated water equivalent diameter (D{sub Wa})] were calculated for each patient and reported in three different ways: a single value averaged over the entire scan, a single value averaged over the region of interest, and a single value from a location in the middle of the scan volume. Organ doses were normalized by an appropriate mAs weighted CTDI{sub vol} to reflect regional variation of tube current. Linear regression analysis was used to evaluate the correlations between normalized organ doses and each size metric. Results: For the abdominal organs, the correlations between normalized organ dose and size metric were overall slightly higher for all three differently (global, regional, and middle slice) reported D{sub W} and D{sub Wa} than they were for ED, but the differences were not statistically significant. However, for lung dose, computed correlations using water equivalent diameter calculated in the middle of the image data (D{sub W,middle}) and averaged over the low attenuating region of lung (D{sub W,regional}) were statistically significantly higher than correlations of normalized lung dose with ED. Conclusions: To conclude, effective diameter and water equivalent diameter are very similar in abdominal regions; however, their difference becomes noticeable in lungs. Water equivalent diameter, specifically reported as a regional average and middle of scan volume, was shown to be better predictors of lung dose. Therefore, an attenuation-based size metric (water equivalent diameter) is recommended because it is more robust across different anatomic regions. Additionally, it was observed that the regional size metric reported as a single value averaged over a region of interest and the size metric calculated from a single slice/image chosen from the middle of the scan volume are highly correlated for these specific patient models and scan types.« less

Development and performance evaluation of an experimental fine pitch detector multislice CT scanner.

PubMed

Imai, Yasuhiro; Nukui, Masatake; Ishihara, Yotaro; Fujishige, Takashi; Ogata, Kentaro; Moritake, Masahiro; Kurochi, Haruo; Ogata, Tsuyoshi; Yahata, Mitsuru; Tang, Xiangyang

2009-04-01

The authors have developed an experimental fine pitch detector multislice CT scanner with an ultrasmall focal spot x-ray tube and a high-density matrix detector through current CT technology. The latitudinal size of the x-ray tube focal spot was 0.4 mm. The detector dimension was 1824 channels (azimuthal direction) x 32 rows (longitudinal direction) at row width of 0.3125 mm, in which a thinner reflected separator surrounds each detector cell coupled with a large active area photodiode. They were mounted on a commercial 64-slice CT scanner gantry while the scan field of view (50 cm) and gantry rotation speed (0.35 s) can be maintained. The experimental CT scanner demonstrated the spatial resolution of 0.21-0.22 mm (23.8-22.7 lp/cm) with the acrylic slit phantom and in-plane 50%-MTF 9.0 lp/cm and 10%-MTF 22.0 lp/cm. In the longitudinal direction, it demonstrated the spatial resolution of 0.24 mm with the high-resolution insert of the CATPHAN phantom and 0.34 mm as the full width at half maximum of the slice sensitivity profile. In low-contrast detectability, 3 mm at 0.3% was visualized at the CTDI(vol) of 47.2 mGy. Two types of 2.75 mm diameter vessel phantoms with in-stent stenosis at 25%, 50%, and 75% stair steps were scanned, and the reconstructed images can clearly resolve the stenosis at each case. The experimental CT scanner provides high-resolution imaging while maintaining low-contrast detectability, demonstrating the potentiality for clinical applications demanding high spatial resolution, such as imaging of inner ear, lung, and bone, or low-contrast detectability, such as imaging of coronary artery.

Tracheobronchomegaly associated tracheomalacia: analysis by sleep study.

PubMed

Sundaram, P; Joshi, J M

2004-01-01

Tracheobronchomegaly (TBM) occasionally may progress to extensive tracheomalacia which leads to respiratory failure. Spirometry, dynamic expiratory multidetector computed tomography (CT), bronchoscopy are used to diagnose patients of suspected tracheobronchomalacia. We used the technique of night-time monitoring of respiratory variables to show the presence of respiratory abnormalities during sleep and which was corrected by applying nasal continuous positive airway pressure (CPAP). The study showed the presence of both apnoea and hypopnoeas, which were obstructive in nature with an apnoea-hypopnoea index (AHI) of 11, no snoring and associated oxygen desaturation of 75 per cent. A second overnight study with nasal continuous positive airway pressure at a critical pressure of 8 cm, the AHI decreased to 3 along with no drop in oxygen saturation. This non-invasive technique should be considered as a diagnostic tool in tracheobronchomalacia and to know the outcome of CPAP, surgical or stent therapy in this condition.

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.

CBCT-based bone quality assessment: are Hounsfield units applicable?

PubMed Central

Jacobs, R; Singer, S R; Mupparapu, M

2015-01-01

CBCT is a widely applied imaging modality in dentistry. It enables the visualization of high-contrast structures of the oral region (bone, teeth, air cavities) at a high resolution. CBCT is now commonly used for the assessment of bone quality, primarily for pre-operative implant planning. Traditionally, bone quality parameters and classifications were primarily based on bone density, which could be estimated through the use of Hounsfield units derived from multidetector CT (MDCT) data sets. However, there are crucial differences between MDCT and CBCT, which complicates the use of quantitative gray values (GVs) for the latter. From experimental as well as clinical research, it can be seen that great variability of GVs can exist on CBCT images owing to various reasons that are inherently associated with this technique (i.e. the limited field size, relatively high amount of scattered radiation and limitations of currently applied reconstruction algorithms). Although attempts have been made to correct for GV variability, it can be postulated that the quantitative use of GVs in CBCT should be generally avoided at this time. In addition, recent research and clinical findings have shifted the paradigm of bone quality from a density-based analysis to a structural evaluation of the bone. The ever-improving image quality of CBCT allows it to display trabecular bone patterns, indicating that it may be possible to apply structural analysis methods that are commonly used in micro-CT and histology. PMID:25315442

Volvulus of the ascending colon in a non-rotated midgut: Plain film and MDCT findings.

PubMed

Camera, Luigi; Calabrese, Milena; Mainenti, Pier Paolo; Masone, Stefania; Vecchio, Walter Del; Persico, Giovanni; Salvatore, Marco

2012-10-28

Colonic volvulus is a relatively uncommon cause of large bowel obstruction usually involving mobile, intra-peritoneal, colonic segments. Congenital or acquired anatomic variation may be associated with an increased risk of colonic volvulus which can occasionally involve retro-peritoneal segments. We report a case of 54-year-old female who presented to our Institution to perform a plain abdominal film series for acute onset of cramping abdominal pain. Both the upright and supine films showed signs of acute colonic obstruction which was thought to be due to an internal hernia of the transverse colon into the lesser sac. The patient was therefore submitted to a multi-detector contrast-enhanced computed tomography (CT). CT findings were initially thought to be consistent with the presumed diagnosis of internal hernia but further evaluation and coronal reformatting clearly depicted the presence of a colonic volvulus possibly resulting from a retro-gastric colon. At surgery, a volvulus of the ascending colon was found and a right hemi-colectomy had to be performed. However, a non rotated midgut with a right-sided duodeno-jejunal flexure and a left sided colon was also found at laparotomy and overlooked in the pre-operative CT. Retrospective evaluation of CT images was therefore performed and a number of CT signs of intestinal malrotation could be identified.

Computed Tomography of the Normal Bovine Tarsus.

PubMed

Hagag, U; Tawfiek, M; Brehm, W; Gerlach, K

2016-12-01

The objective of this study was to provide a detailed multiplanar computed tomographic (CT) anatomic reference for the bovine tarsus. The tarsal regions from twelve healthy adult cow cadavers were scanned in both soft and bone windows via a 16-slice multidetector CT scanner. Tarsi were frozen at -20 o C and sectioned to 10-mm-thick slices in transverse, dorsal and sagittal planes respecting the imaging protocol. The frozen sections were cleaned and then photographed. Anatomic structures were identified, labelled and compared with the corresponding CT images. The sagittal plane was indispensable for evaluation of bone contours, the dorsal plane was valuable in examination of the collateral ligaments, and both were beneficial for assessment of the tarsal joint articulations. CT images allowed excellent delineation between the cortex and medulla of bones, and the trabecular structure was clearly depicted. The tarsal soft tissues showed variable shades of grey, and the synovial fluid was the lowest attenuated structure. This study provided full assessment of the clinically relevant anatomic structures of the bovine tarsal joint. This technique may be of value when results from other diagnostic imaging techniques are indecisive. Images presented in this study should serve as a basic CT reference and assist in the interpretation of various bovine tarsal pathology. © 2016 Blackwell Verlag GmbH.

Advanced 3-D analysis, client-server systems, and cloud computing-Integration of cardiovascular imaging data into clinical workflows of transcatheter aortic valve replacement.

PubMed

Schoenhagen, Paul; Zimmermann, Mathis; Falkner, Juergen

2013-06-01

Degenerative aortic stenosis is highly prevalent in the aging populations of industrialized countries and is associated with poor prognosis. Surgical valve replacement has been the only established treatment with documented improvement of long-term outcome. However, many of the older patients with aortic stenosis (AS) are high-risk or ineligible for surgery. For these patients, transcatheter aortic valve replacement (TAVR) has emerged as a treatment alternative. The TAVR procedure is characterized by a lack of visualization of the operative field. Therefore, pre- and intra-procedural imaging is critical for patient selection, pre-procedural planning, and intra-operative decision-making. Incremental to conventional angiography and 2-D echocardiography, multidetector computed tomography (CT) has assumed an important role before TAVR. The analysis of 3-D CT data requires extensive post-processing during direct interaction with the dataset, using advance analysis software. Organization and storage of the data according to complex clinical workflows and sharing of image information have become a critical part of these novel treatment approaches. Optimally, the data are integrated into a comprehensive image data file accessible to multiple groups of practitioners across the hospital. This creates new challenges for data management requiring a complex IT infrastructure, spanning across multiple locations, but is increasingly achieved with client-server solutions and private cloud technology. This article describes the challenges and opportunities created by the increased amount of patient-specific imaging data in the context of TAVR.

In-Plane Shielding for CT: Effect of Off-Centering, Automatic Exposure Control and Shield-to-Surface Distance

PubMed Central

Dang, Pragya; Singh, Sarabjeet; Saini, Sanjay; Shepard, Jo-Anne O.

2009-01-01

Objective To assess effects of off-centering, automatic exposure control, and padding on attenuation values, noise, and radiation dose when using in-plane bismuth-based shields for CT scanning. Materials and Methods A 30 cm anthropomorphic chest phantom was scanned on a 64-multidetector CT, with the center of the phantom aligned to the gantry isocenter. Scanning was repeated after placing a bismuth breast shield on the anterior surface with no gap and with 1, 2, and 6 cm of padding between the shield and the phantom surface. The "shielded" phantom was also scanned with combined modulation and off-centering of the phantom at 2 cm, 4 cm and 6 cm below the gantry isocenter. CT numbers, noise, and surface radiation dose were measured. The data were analyzed using an analysis of variance. Results The in-plane shield was not associated with any significant increment for the surface dose or CT dose index volume, which was achieved by comparing the radiation dose measured by combined modulation technique to the fixed mAs (p > 0.05). Irrespective of the gap or the surface CT numbers, surface noise increased to a larger extent compared to Hounsfield unit (HU) (0-6 cm, 26-55%) and noise (0-6 cm, 30-40%) in the center. With off-centering, in-plane shielding devices are associated with less dose savings, although dose reduction was still higher than in the absence of shielding (0 cm off-center, 90% dose reduction; 2 cm, 61%) (p < 0.0001). Streak artifacts were noted at 0 cm and 1 cm gaps but not at 2 cm and 6 cm gaps of shielding to the surface distances. Conclusion In-plane shields are associated with greater image noise, artifactually increased attenuation values, and streak artifacts. However, shields reduce radiation dose regardless of the extent of off-centering. Automatic exposure control did not increase radiation dose when using a shield. PMID:19270862

Usefulness of model-based iterative reconstruction in semi-automatic volumetry for ground-glass nodules at ultra-low-dose CT: a phantom study.

PubMed

Maruyama, Shuki; Fukushima, Yasuhiro; Miyamae, Yuta; Koizumi, Koji

2018-06-01

This study aimed to investigate the effects of parameter presets of the forward projected model-based iterative reconstruction solution (FIRST) on the accuracy of pulmonary nodule volume measurement. A torso phantom with simulated nodules [diameter: 5, 8, 10, and 12 mm; computed tomography (CT) density: - 630 HU] was scanned with a multi-detector CT at tube currents of 10 mA (ultra-low-dose: UL-dose) and 270 mA (standard-dose: Std-dose). Images were reconstructed with filtered back projection [FBP; standard (Std-FBP), ultra-low-dose (UL-FBP)], FIRST Lung (UL-Lung), and FIRST Body (UL-Body), and analyzed with a semi-automatic software. The error in the volume measurement was determined. The errors with UL-Lung and UL-Body were smaller than that with UL-FBP. The smallest error was 5.8% ± 0.3 for the 12-mm nodule with UL-Body (middle lung). Our results indicated that FIRST Body would be superior to FIRST Lung in terms of accuracy of nodule measurement with UL-dose CT.

Embryonic development of Python sebae - I: Staging criteria and macroscopic skeletal morphogenesis of the head and limbs.

PubMed

Boughner, Julia C; Buchtová, Marcela; Fu, Katherine; Diewert, Virginia; Hallgrímsson, Benedikt; Richman, Joy M

2007-01-01

This study explores the post-ovipositional craniofacial development of the African Rock Python (Python sebae). We first describe a staging system based on external characteristics and next use whole-mount skeletal staining supplemented with Computed tomography (CT) scanning to examine skeletal development. Our results show that python embryos are in early stages of organogenesis at the time of laying, with separate facial prominences and pharyngeal clefts still visible. Limb buds are also visible. By 11 days (stage 3), the chondrocranium is nearly fully formed; however, few intramembranous bones can be detected. One week later (stage 4), many of the intramembranous upper and lower jaw bones are visible but the calvaria are not present. Skeletal elements in the limbs also begin to form. Between stages 4 (day 18) and 7 (day 44), the complete set of intramembranous bones in the jaws and calvaria develops. Hindlimb development does not progress beyond stage 6 (33 days) and remains rudimentary throughout adult life. In contrast to other reptiles, there are two rows of teeth in the upper jaw. The outer tooth row is attached to the maxillary and premaxillary bones, whereas the inner row is attached to the pterygoid and palatine bones. Erupted teeth can be seen in whole-mount stage 10 specimens and are present in an unerupted, mineralized state at stage 7. Micro-CT analysis reveals that all the young membranous bones can be recognized even out of the context of the skull. These data demonstrate intrinsic patterning of the intramembranous bones, even though they form without a cartilaginous template. In addition, intramembranous bone morphology is established prior to muscle function, which can influence bone shape through differential force application. After careful staging, we conclude that python skeletal development occurs slowly enough to observe in good detail the early stages of craniofacial skeletogenesis. Thus, reptilian animal models will offer unique opportunities for understanding the early influences that contribute to perinatal bone shape.

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.

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.

Correlation of iodine uptake and perfusion parameters between dual-energy CT imaging and first-pass dual-input perfusion CT in lung cancer.

PubMed

Chen, Xiaoliang; Xu, Yanyan; Duan, Jianghui; Li, Chuandong; Sun, Hongliang; Wang, Wu

2017-07-01

To investigate the potential relationship between perfusion parameters from first-pass dual-input perfusion computed tomography (DI-PCT) and iodine uptake levels estimated from dual-energy CT (DE-CT).The pre-experimental part of this study included a dynamic DE-CT protocol in 15 patients to evaluate peak arterial enhancement of lung cancer based on time-attenuation curves, and the scan time of DE-CT was determined. In the prospective part of the study, 28 lung cancer patients underwent whole-volume perfusion CT and single-source DE-CT using 320-row CT. Pulmonary flow (PF, mL/min/100 mL), aortic flow (AF, mL/min/100 mL), and a perfusion index (PI = PF/[PF + AF]) were automatically generated by in-house commercial software using the dual-input maximum slope method for DI-PCT. For the dual-energy CT data, iodine uptake was estimated by the difference (λ) and the slope (λHU). λ was defined as the difference of CT values between 40 and 70 KeV monochromatic images in lung lesions. λHU was calculated by the following equation: λHU = |λ/(70 - 40)|. The DI-PCT and DE-CT parameters were analyzed by Pearson/Spearman correlation analysis, respectively.All subjects were pathologically proved as lung cancer patients (including 16 squamous cell carcinoma, 8 adenocarcinoma, and 4 small cell lung cancer) by surgery or CT-guided biopsy. Interobserver reproducibility in DI-PCT (PF, AF, PI) and DE-CT (λ, λHU) were relatively good to excellent (intraclass correlation coefficient [ICC]Inter = 0.8726-0.9255, ICCInter = 0.8179-0.8842; ICCInter = 0.8881-0.9177, ICCInter = 0.9820-0.9970, ICCInter = 0.9780-0.9971, respectively). Correlation coefficient between λ and AF, and PF were as follows: 0.589 (P < .01) and 0.383 (P < .05). Correlation coefficient between λHU and AF, and PF were as follows: 0.564 (P < .01) and 0.388 (P < .05).Both the single-source DE-CT and dual-input CT perfusion analysis method can be applied to assess blood supply of lung cancer patients. Preliminary results demonstrated that the iodine uptake relevant parameters derived from DE-CT significantly correlated with perfusion parameters derived from DI-PCT.

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

PubMed

Bardo, Dianna M E; Brown, Paul

2008-08-01

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

Estimating patient dose from CT exams that use automatic exposure control: Development and validation of methods to accurately estimate tube current values.

PubMed

McMillan, Kyle; Bostani, Maryam; Cagnon, Christopher H; Yu, Lifeng; Leng, Shuai; McCollough, Cynthia H; McNitt-Gray, Michael F

2017-08-01

The vast majority of body CT exams are performed with automatic exposure control (AEC), which adapts the mean tube current to the patient size and modulates the tube current either angularly, longitudinally or both. However, most radiation dose estimation tools are based on fixed tube current scans. Accurate estimates of patient dose from AEC scans require knowledge of the tube current values, which is usually unavailable. The purpose of this work was to develop and validate methods to accurately estimate the tube current values prescribed by one manufacturer's AEC system to enable accurate estimates of patient dose. Methods were developed that took into account available patient attenuation information, user selected image quality reference parameters and x-ray system limits to estimate tube current values for patient scans. Methods consistent with AAPM Report 220 were developed that used patient attenuation data that were: (a) supplied by the manufacturer in the CT localizer radiograph and (b) based on a simulated CT localizer radiograph derived from image data. For comparison, actual tube current values were extracted from the projection data of each patient. Validation of each approach was based on data collected from 40 pediatric and adult patients who received clinically indicated chest (n = 20) and abdomen/pelvis (n = 20) scans on a 64 slice multidetector row CT (Sensation 64, Siemens Healthcare, Forchheim, Germany). For each patient dataset, the following were collected with Institutional Review Board (IRB) approval: (a) projection data containing actual tube current values at each projection view, (b) CT localizer radiograph (topogram) and (c) reconstructed image data. Tube current values were estimated based on the actual topogram (actual-topo) as well as the simulated topogram based on image data (sim-topo). Each of these was compared to the actual tube current values from the patient scan. In addition, to assess the accuracy of each method in estimating patient organ doses, Monte Carlo simulations were performed by creating voxelized models of each patient, identifying key organs and incorporating tube current values into the simulations to estimate dose to the lungs and breasts (females only) for chest scans and the liver, kidney, and spleen for abdomen/pelvis scans. Organ doses from simulations using the actual tube current values were compared to those using each of the estimated tube current values (actual-topo and sim-topo). When compared to the actual tube current values, the average error for tube current values estimated from the actual topogram (actual-topo) and simulated topogram (sim-topo) was 3.9% and 5.8% respectively. For Monte Carlo simulations of chest CT exams using the actual tube current values and estimated tube current values (based on the actual-topo and sim-topo methods), the average differences for lung and breast doses ranged from 3.4% to 6.6%. For abdomen/pelvis exams, the average differences for liver, kidney, and spleen doses ranged from 4.2% to 5.3%. Strong agreement between organ doses estimated using actual and estimated tube current values provides validation of both methods for estimating tube current values based on data provided in the topogram or simulated from image data. © 2017 American Association of Physicists in Medicine.

Quantitative imaging of peripheral trabecular bone microarchitecture using MDCT.

PubMed

Chen, Cheng; Zhang, Xiaoliu; Guo, Junfeng; Jin, Dakai; Letuchy, Elena M; Burns, Trudy L; Levy, Steven M; Hoffman, Eric A; Saha, Punam K

2018-01-01

Osteoporosis associated with reduced bone mineral density (BMD) and microarchitectural changes puts patients at an elevated risk of fracture. Modern multidetector row CT (MDCT) technology, producing high spatial resolution at increasingly lower dose radiation, is emerging as a viable modality for trabecular bone (Tb) imaging. Wide variation in CT scanners raises concerns of data uniformity in multisite and longitudinal studies. A comprehensive cadaveric study was performed to evaluate MDCT-derived Tb microarchitectural measures. A human pilot study was performed comparing continuity of Tb measures estimated from two MDCT scanners with significantly different image resolution features. Micro-CT imaging of cadaveric ankle specimens (n=25) was used to examine the validity of MDCT-derived Tb microarchitectural measures. Repeat scan reproducibility of MDCT-based Tb measures and their ability to predict mechanical properties were examined. To assess multiscanner data continuity of Tb measures, the distal tibias of 20 volunteers (age:26.2±4.5Y,10F) were scanned using the Siemens SOMATOM Definition Flash and the higher resolution Siemens SOMATOM Force scanners with an average 45-day time gap between scans. The correlation of Tb measures derived from the two scanners over 30% and 60% peel regions at the 4% to 8% of distal tibia was analyzed. MDCT-based Tb measures characterizing bone network area density, plate-rod microarchitecture, and transverse trabeculae showed good correlations (r∈0.85,0.92) with the gold standard micro-CT-derived values of matching Tb measures. However, other MDCT-derived Tb measures characterizing trabecular thickness and separation, erosion index, and structure model index produced weak correlation (r<0.8) with their micro-CT-derived values. Most MDCT Tb measures were found repeatable (ICC∈0.94,0.98). The Tb plate-width measure showed a strong correlation (r = 0.89) with experimental yield stress, while the transverse trabecular measure produced the highest correlation (r = 0.81) with Young's modulus. The data continuity experiment showed that, despite significant differences in image resolution between two scanners (10% MTF along xy-plane and z-direction - Flash: 16.2 and 17.9 lp/cm; Force: 24.8 and 21.0 lp/cm), most Tb measures had high Pearson correlations (r > 0.95) between values estimated from the two scanners. Relatively lower correlation coefficients were observed for the bone network area density (r = 0.91) and Tb separation (r = 0.93) measures. Most MDCT-derived Tb microarchitectural measures are reproducible and their values derived from two scanners strongly correlate with each other as well as with bone strength. This study has highlighted those MDCT-derived measures which show the greatest promise for characterization of bone network area density, plate-rod and transverse trabecular distributions with a good correlation (r ≥ 0.85) compared with their micro-CT-derived values. At the same time, other measures representing trabecular thickness and separation, erosion index, and structure model index produced weak correlations (r < 0.8) with their micro-CT-derived values, failing to accurately portray the projected trabecular microarchitectural features. Strong correlations of Tb measures estimated from two scanners suggest that image data from different scanners can be used successfully in multisite and longitudinal studies with linear calibration required for some measures. In summary, modern MDCT scanners are suitable for effective quantitative imaging of peripheral Tb microarchitecture if care is taken to focus on appropriate quantitative metrics. © 2017 American Association of Physicists in Medicine.

Entrance surface dose measurements using a small OSL dosimeter with a computed tomography scanner having 320 rows of detectors.

PubMed

Takegami, Kazuki; Hayashi, Hiroaki; Yamada, Kenji; Mihara, Yoshiki; Kimoto, Natsumi; Kanazawa, Yuki; Higashino, Kousaku; Yamashita, Kazuta; Hayashi, Fumio; Okazaki, Tohru; Hashizume, Takuya; Kobayashi, Ikuo

2017-03-01

Entrance surface dose (ESD) measurements are important in X-ray computed tomography (CT) for examination, but in clinical settings it is difficult to measure ESDs because of a lack of suitable dosimeters. We focus on the capability of a small optically stimulated luminescence (OSL) dosimeter. The aim of this study is to propose a practical method for using an OSL dosimeter to measure the ESD when performing a CT examination. The small OSL dosimeter has an outer width of 10 mm; it is assumed that a partial dose may be measured because the slice thickness and helical pitch can be set to various values. To verify our method, we used a CT scanner having 320 rows of detectors and checked the consistencies of the ESDs measured using OSL dosimeters by comparing them with those measured using Gafchromic™ films. The films were calibrated using an ionization chamber on the basis of half-value layer estimation. On the other hand, the OSL dosimeter was appropriately calibrated using a practical calibration curve previously proposed by our group. The ESDs measured using the OSL dosimeters were in good agreement with the reference ESDs from the Gafchromic™ films. Using these data, we also estimated the uncertainty of ESDs measured with small OSL dosimeters. We concluded that a small OSL dosimeter can be considered suitable for measuring the ESD with an uncertainty of 30 % during CT examinations in which pitch factors below 1.000 are applied.

Pancreatitis-imaging approach

PubMed Central

Busireddy, Kiran K; AlObaidy, Mamdoh; Ramalho, Miguel; Kalubowila, Janaka; Baodong, Liu; Santagostino, Ilaria; Semelka, Richard C

2014-01-01

Pancreatitis is defined as the inflammation of the pancreas and considered the most common pancreatic disease in children and adults. Imaging plays a significant role in the diagnosis, severity assessment, recognition of complications and guiding therapeutic interventions. In the setting of pancreatitis, wider availability and good image quality make multi-detector contrast-enhanced computed tomography (MD-CECT) the most used imaging technique. However, magnetic resonance imaging (MRI) offers diagnostic capabilities similar to those of CT, with additional intrinsic advantages including lack of ionizing radiation and exquisite soft tissue characterization. This article reviews the proposed definitions of revised Atlanta classification for acute pancreatitis, illustrates a wide range of morphologic pancreatic parenchymal and associated peripancreatic changes for different types of acute pancreatitis. It also describes the spectrum of early and late chronic pancreatitis imaging findings and illustrates some of the less common types of chronic pancreatitis, with special emphasis on the role of CT and MRI. PMID:25133027

Image quality improvement in MDCT cardiac imaging via SMART-RECON method

NASA Astrophysics Data System (ADS)

Li, Yinsheng; Cao, Ximiao; Xing, Zhanfeng; Sun, Xuguang; Hsieh, Jiang; Chen, Guang-Hong

2017-03-01

Coronary CT angiography (CCTA) is a challenging imaging task currently limited by the achievable temporal resolution of modern Multi-Detector CT (MDCT) scanners. In this paper, the recently proposed SMARTRECON method has been applied in MDCT-based CCTA imaging to improve the image quality without any prior knowledge of cardiac motion. After the prospective ECG-gated data acquisition from a short-scan angular span, the acquired data were sorted into several sub-sectors of view angles; each corresponds to a 1/4th of the short-scan angular range. Information of the cardiac motion was thus encoded into the data in each view angle sub-sector. The SMART-RECON algorithm was then applied to jointly reconstruct several image volumes, each of which is temporally consistent with the data acquired in the corresponding view angle sub-sector. Extensive numerical simulations were performed to validate the proposed technique and investigate the performance dependence.

Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree.

PubMed

Behera, G; Tripathy, N; Maru, Y K; Mundra, R K; Gupta, Y; Lodha, M

2014-12-01

Multidetector computed tomography virtual bronchoscopy is a non-invasive diagnostic tool which provides a three-dimensional view of the tracheobronchial airway. This study aimed to evaluate the usefulness of virtual bronchoscopy in cases of vegetable foreign body aspiration in children. The medical records of patients with a history of foreign body aspiration from August 2006 to August 2010 were reviewed. Data were collected regarding their clinical presentation and chest X-ray, virtual bronchoscopy and rigid bronchoscopy findings. Cases of metallic and other non-vegetable foreign bodies were excluded from the analysis. Patients with multidetector computed tomography virtual bronchoscopy showing features of vegetable foreign body were included in the analysis. For each patient, virtual bronchoscopy findings were reviewed and compared with those of rigid bronchoscopy. A total of 60 patients; all children ranging from 1 month to 8 years of age, were included. The mean age at presentation was 2.01 years. Rigid bronchoscopy confirmed the results of multidetector computed tomography virtual bronchoscopy (i.e. presence of foreign body, site of lodgement, and size and shape) in 59 patients. In the remaining case, a vegetable foreign body identified by virtual bronchoscopy was revealed by rigid bronchoscopy to be a thick mucus plug. Thus, the positive predictive value of virtual bronchoscopy was 98.3 per cent. Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.

Influence of Bony Defects on Preoperative Shoulder Function in Recurrent Anteroinferior Shoulder Instability.

PubMed

Wolke, Julia; Herrmann, Diem Anh; Krannich, Alexander; Scheibel, Markus

2016-05-01

Recurrent anteroinferior shoulder dislocations are often associated with bony glenoid and humeral defects. The influence of those bony lesions on the postoperative outcomes after arthroscopic shoulder stabilization procedures has been the subject of many studies. Little is known about the influence of those lesions on preoperative function. To evaluate the influence of glenoid and humeral bony defects on preoperative shoulder function in recurrent anteroinferior shoulder instability. Cross-sectional study; Level of evidence, 3. Included in the study were 90 patients (70 men, 20 women; mean age, 27.1 years; 24 patients with prior failed stabilization) with posttraumatic recurrent anteroinferior shoulder instability who underwent preoperative computed tomography (CT) of both shoulders. The glenoid index was used to measure glenoid defect on a 3-dimensional CT. Humeral head defect was measured on a 2-dimensional CT with evaluation of the Hill-Sachs quotient, product, sum, and difference. Preoperative evaluation also included the Rowe score, Constant score, Walch-Duplay score, Melbourne Instability Shoulder Score (MISS), Western Ontario Shoulder Instability Index (WOSI), and Subjective Shoulder Value (SSV). There was a weak but significant correlation of the Hill-Sachs quotient and the glenoid index with the Rowe score (P = .03, r = -0.22 and P = .03, r = 0.23, respectively). Furthermore, the Hill-Sachs product significantly correlated with the WOSI (P = .02); in particular, the physical symptoms subscore showed a significant correlation (P = .04). The glenoid index showed a significant correlation with the SSV (P < .01). No significant correlation was found between the Walch-Duplay score, Constant score, or MISS and bony defects. The results of this study show that objective and subjective scoring systems correlate significantly with the clinical condition of patients with recurrent shoulder instability and associated bony defects. It is recommended that clinicians use the Rowe score, WOSI, and SSV for the clinical evaluation of patients with recurrent anteroinferior shoulder instability and associated bony defects. These evaluation systems may provide an early clinical indication of bony defects. Furthermore, very poor results on these evaluations could underline the necessity of a CT scan for the diagnosis of bony defects in recurrent shoulder instability and might be helpful for decision making concerning the indication of a CT. © 2016 The Author(s).

Diagnostic value of imaging in infective endocarditis: a systematic review.

PubMed

Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

2017-01-01

Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of infective endocarditis; however, their diagnostic value is unclear. We did a systematic literature review to critically appraise the evidence for the diagnostic performance of these imaging modalities, according to PRISMA and GRADE criteria. We searched PubMed, Embase, and Cochrane databases. 31 studies were included that presented original data on the performance of electrocardiogram (ECG)-gated multidetector CT angiography (MDCTA), ECG-gated MRI, 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT, and leucocyte scintigraphy in diagnosis of native valve endocarditis, intracardiac prosthetic material-related infection, and extracardiac foci in adults. We consistently found positive albeit weak evidence for the diagnostic benefit of 18 F-FDG PET/CT and MDCTA. We conclude that additional imaging techniques should be considered if infective endocarditis is suspected. We propose an evidence-based diagnostic work-up for infective endocarditis including these non-invasive techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

Myocardial perfusion in patients with suspected coronary artery disease: comparison between 320-MDCT and rubidium-82 PET.

PubMed

Dantas, Roberto Nery; Assuncao, Antonildes Nascimento; Marques, Ismar Aguiar; Fahel, Mateus Guimaraes; Nomura, Cesar Higa; Avila, Luiz Francisco Rodrigues; Giorgi, Maria Clementina Pinto; Soares, Jose; Meneghetti, Jose Claudio; Parga, Jose Rodrigues

2018-06-01

Despite advances in non-invasive myocardial perfusion imaging (MPI) evaluation, computed tomography (CT) multiphase MPI protocols have not yet been compared with the highly accurate rubidium-82 positron emission tomography ( 82 RbPET) MPI. Thus, this study aimed to evaluate agreement between 82 RbPET and 320-detector row CT (320-CT) MPI using a multiphase protocol in suspected CAD patients. Forty-four patients referred for MPI evaluation were prospectively enrolled and underwent dipyridamole stress 82 RbPET and multiphase 320-CT MPI (five consecutive volumetric acquisitions during stress). Statistical analyses were performed using the R software. There was high agreement for recognizing summed stress scores ≥ 4 (kappa 0.77, 95% CI 0.55-0.98, p < 0.001) and moderate for detecting SDS ≥ 2 (kappa 0.51, 95% CI 0.23-0.80, p < 0.001). In a per segment analysis, agreement was high for the presence of perfusion defects during stress and rest (kappa 0.75 and 0.82, respectively) and was moderate for impairment severity (kappa 0.58 and 0.65, respectively). The 320-CT protocol was safe, with low radiation burden (9.3 ± 2.4 mSv). There was a significant agreement between dipyridamole stress 320-CT MPI and 82 RbPET MPI in the evaluation of suspected CAD patients of intermediate risk. The multiphase 320-CT MPI protocol was feasible, diagnostic and with relatively low radiation exposure. • Rubidium-82 PET and 320-MDCT can perform MPI studies for CAD investigation. • There is high agreement between rubidium-82 PET and 320-MDCT for MPI assessment. • Multiphase CT perfusion protocols are feasible and with low radiation. • Multiphase CT perfusion protocols can identify image artefacts.

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

Kruger, R.

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less

Blade row interaction effects on flutter and forced response

NASA Technical Reports Server (NTRS)

Buffum, Daniel H.

1993-01-01

In the flutter or forced response analysis of a turbomachine blade row, the blade row in question is commonly treated as if it is isolated from the neigboring blade rows. Disturbances created by vibrating blades are then free to propagate away from this blade row without being disturbed. In reality, neighboring blade rows will reflect some portion of this wave energy back toward the vibrating blades, causing additional unsteady forces on them. It is of fundamental importance to determine whether or not these reflected waves can have a significant effect on the aeroelastic stability or forced response of a blade row. Therefore, a procedure to calculate intra-blade-row unsteady aerodynamic interactions was developed which relies upon results available from isolated blade row unsteady aerodynamic analyses. In addition, an unsteady aerodynamic influence coefficient technique is used to obtain a model for the vibratory response in which the neighboring blade rows are also flexible. The flutter analysis shows that interaction effects can be destabilizing, and the forced response analysis shows that interaction effects can result in a significant increase in the resonant response of a blade row.

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

PubMed

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

2014-04-01

To evaluate the feasibility of CT pulmonary angiography for identification of naturally occurring pulmonary thromboembolism in dogs using predefined diagnostic criteria and to assess the ability of echocardiography, cardiac troponins, D-dimers and kaolin-activated thromboelastography to predict the presence of pulmonary thromboembolism in dogs. Twelve dogs with immune-mediated haemolytic anaemia and evidence of respiratory distress were prospectively evaluated. Dogs were sedated immediately before CT pulmonary angiography using intravenous butorphanol. Spiral CT pulmonary angiography was performed with a 16 detector-row CT scanner using a pressure injector to infuse contrast media through peripheral intravenous catheters. Pulmonary thromboembolism was diagnosed using predefined criteria. Contemporaneous tests included echocardiography, arterial blood gas analysis, kaolin-activated thromboelastography, D-dimers and cardiac troponins. Based on predefined criteria, four dogs were classified as pulmonary thromboembolism positive, three dogs were suspected to have pulmonary thromboembolism and the remaining five dogs had negative scans. The four dogs identified with pulmonary thromboembolism all had discrete filling defects in main or lobar pulmonary arteries. None of the contemporaneous tests was discriminant for pulmonary thromboembolism diagnosis, although the small sample size was limiting. CT pulmonary angiography can be successfully performed in dogs under sedation, even in at-risk patients with respiratory distress and can both confirm and rule out pulmonary thromboembolism in dogs. © 2014 British Small Animal Veterinary Association.

Approach to interpret images produced by new generations of multidetector CT scanners in post-operative spine.

PubMed

Zeitoun, Rania; Hussein, Manar

2017-11-01

To reach a practical approach to interpret MDCT findings in post-operative spine cases and to change the false belief of CT failure in the setting of instruments secondary to related artefacts. We performed observational retrospective analysis of premier, early and late MDCT scans in 68 post-operative spine patients, with emphasis on instruments related complications and osseous fusion status. We used a grading system for assessment of osseous fusion in 35 patients and we further analysed the findings in failure of fusion, grade (D). We observed a variety of instruments related complications (mostly screws medially penetrating the pedicle) and osseous fusion status in late scans. We graded 11 interbody and 14 posterolateral levels as osseous fusion failure, showing additional instruments related complications, end plates erosive changes, adjacent segments spondylosis and malalignment. Modern MDCT scanners provide high quality images and are strongly recommended in assessment of the instruments and status of osseous fusion. In post-operative imaging of the spine, it is essential to be aware for what you are looking for, in relevance to the date of surgery. Advances in knowledge: Modern MDCT scanners allow assessment of instruments position and integrity and osseous fusion status in post-operative spine. We propose a helpful algorithm to simplify interpreting post-operative spine imaging.

Methods for radiation detection and characterization using a multiple detector probe

DOEpatents

Akers, Douglas William; Roybal, Lyle Gene

2014-11-04

Apparatuses, methods, and systems relating to radiological characterization of environments are disclosed. Multi-detector probes with a plurality of detectors in a common housing may be used to substantially concurrently detect a plurality of different radiation activities and types. Multiple multi-detector probes may be used in a down-hole environment to substantially concurrently detect radioactive activity and contents of a buried waste container. Software may process, analyze, and integrate the data from the different multi-detector probes and the different detector types therein to provide source location and integrated analysis as to the source types and activity in the measured environment. Further, the integrated data may be used to compensate for differential density effects and the effects of radiation shielding materials within the volume being measured.

High-definition computed tomography for coronary artery stents imaging compared with standard-definition 64-row multidectector computed tomography: an initial in vivo study.

PubMed

Yang, Wen Jie; Zhang, Huan; Xiao, Hua; Li, Jian Ying; Liu, Yan; Pan, Zi Lai; Chen, Ke Min

2012-01-01

The evaluation of coronary stents by computed tomography (CT) remains difficult. We assessed the imaging performance of a high-definition CT scanner (HDCT) by comparing with a conventional 64-row standard-definition CT (SDCT). One hundred thirty-eight consecutive stented patients underwent coronary CT angiography, among whom 66 patients were examined by HDCT, and 72 patients by SDCT (LightSpeed VCT XT; GE Healthcare, Waukesha, Wis). The image quality score, the inner stent diameter (ISD), and the radiation dose were analyzed. All data were statistically tested by SPSS 13.0 software (SPSS Inc, Chicago, Ill). In 72 patients examined using SDCT, 135 stents were detected; in 66 patients examined using HDCT, 119 stents were detected. The image quality score on HDCT was significantly better than that on SDCT (1.4 [SD, 0.7] vs 1.9 [SD, 0.8]). The ISD on HDCT was significantly higher than that on SDCT (1.8 [SD, 0.5] vs 1.6 [SD, 0.4]). There was no significant difference of either image quality score or ISD between the HDCT and SDCT groups in stents with 2.5-mm diameter. Images on HDCT showed significantly better image quality score and larger ISD than images on SDCT in 2.75-, 3-, and 3.5-mm stents. For patients examined by retrospective electrocardiogram-gated technique, the radiation dose on HDCT was significantly lower than that on SDCT (11.3 [SD, 2.9] vs 15.1 [SD, 3.8] mSv). High-definition CT scanner offered improved image quality and measurement accuracy for imaging coronary stents compared with conventional SDCT, providing higher spatial resolution and lower dose for evaluating coronary stents with 2.75- to 3.5-mm diameter.

Is multidetector CT-based bone mineral density and quantitative bone microstructure assessment at the spine still feasible using ultra-low tube current and sparse sampling?

PubMed

Mei, Kai; Kopp, Felix K; Bippus, Rolf; Köhler, Thomas; Schwaiger, Benedikt J; Gersing, Alexandra S; Fehringer, Andreas; Sauter, Andreas; Münzel, Daniela; Pfeiffer, Franz; Rummeny, Ernst J; Kirschke, Jan S; Noël, Peter B; Baum, Thomas

2017-12-01

Osteoporosis diagnosis using multidetector CT (MDCT) is limited to relatively high radiation exposure. We investigated the effect of simulated ultra-low-dose protocols on in-vivo bone mineral density (BMD) and quantitative trabecular bone assessment. Institutional review board approval was obtained. Twelve subjects with osteoporotic vertebral fractures and 12 age- and gender-matched controls undergoing routine thoracic and abdominal MDCT were included (average effective dose: 10 mSv). Ultra-low radiation examinations were achieved by simulating lower tube currents and sparse samplings at 50%, 25% and 10% of the original dose. BMD and trabecular bone parameters were extracted in T10-L5. Except for BMD measurements in sparse sampling data, absolute values of all parameters derived from ultra-low-dose data were significantly different from those derived from original dose images (p<0.05). BMD, apparent bone fraction and trabecular thickness were still consistently lower in subjects with than in those without fractures (p<0.05). In ultra-low-dose scans, BMD and microstructure parameters were able to differentiate subjects with and without vertebral fractures, suggesting osteoporosis diagnosis is feasible. However, absolute values differed from original values. BMD from sparse sampling appeared to be more robust. This dose-dependency of parameters should be considered for future clinical use. • BMD and quantitative bone parameters are assessable in ultra-low-dose in vivo MDCT scans. • Bone mineral density does not change significantly when sparse sampling is applied. • Quantitative trabecular bone microstructure measurements are sensitive to dose reduction. • Osteoporosis subjects could be differentiated even at 10% of original dose. • Radiation exposure should be considered when comparing quantitative bone parameters.

Validation of automated lobe segmentation on paired inspiratory-expiratory chest CT in 8-14 year-old children with cystic fibrosis.

PubMed

Konietzke, Philip; Weinheimer, Oliver; Wielpütz, Mark O; Savage, Dasha; Ziyeh, Tiglath; Tu, Christin; Newman, Beverly; Galbán, Craig J; Mall, Marcus A; Kauczor, Hans-Ulrich; Robinson, Terry E

2018-01-01

Densitometry on paired inspiratory and expiratory multidetector computed tomography (MDCT) for the quantification of air trapping is an important approach to assess functional changes in airways diseases such as cystic fibrosis (CF). For a regional analysis of functional deficits, an accurate lobe segmentation algorithm applicable to inspiratory and expiratory scans is beneficial. We developed a fully automated lobe segmentation algorithm, and subsequently validated automatically generated lobe masks (ALM) against manually corrected lobe masks (MLM). Paired inspiratory and expiratory CTs from 16 children with CF (mean age 11.1±2.4) acquired at 4 time-points (baseline, 3mon, 12mon, 24mon) with 2 kernels (B30f, B60f) were segmented, resulting in 256 ALM. After manual correction spatial overlap (Dice index) and mean differences in lung volume and air trapping were calculated for ALM vs. MLM. The mean overlap calculated with Dice index between ALM and MLM was 0.98±0.02 on inspiratory, and 0.86±0.07 on expiratory CT. If 6 lobes were segmented (lingula treated as separate lobe), the mean overlap was 0.97±0.02 on inspiratory, and 0.83±0.08 on expiratory CT. The mean differences in lobar volumes calculated in accordance with the approach of Bland and Altman were generally low, ranging on inspiratory CT from 5.7±52.23cm3 for the right upper lobe to 17.41±14.92cm3 for the right lower lobe. Higher differences were noted on expiratory CT. The mean differences for air trapping were even lower, ranging from 0±0.01 for the right upper lobe to 0.03±0.03 for the left lower lobe. Automatic lobe segmentation delivers excellent results for inspiratory and good results for expiratory CT. It may become an important component for lobe-based quantification of functional deficits in cystic fibrosis lung disease, reducing necessity for user-interaction in CT post-processing.

Adjunctive role of preoperative liver magnetic resonance imaging for potentially resectable pancreatic cancer.

PubMed

Kim, Hyoung Woo; Lee, Jong-Chan; Paik, Kyu-Hyun; Kang, Jingu; Kim, Young Hoon; Yoon, Yoo-Seok; Han, Ho-Seong; Kim, Jaihwan; Hwang, Jin-Hyeok

2017-06-01

The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group). By adding hepatic magnetic resonance imaging during preoperative evaluation, hepatic metastases were newly discovered in 3 of 58 patients (5%) without hepatic lesions on pCT and 17 of 53 patients (32%) with indeterminate hepatic lesions on pCT. Patients with borderline resectability, a tumor size >3 cm, or preoperative carbohydrate antigen 19-9 level >1,000 U/mL had a greater rate of hepatic metastasis on subsequent hepatic magnetic resonance imaging. Among 167 patients in whom R0/R1 resection was achieved, the median overall survival was 18.2 vs 24.7 months (P = .020) and the disease-free survival was 8.5 vs 10.0 months (P = .016) in the CT and magnetic resonance imaging groups, respectively (median follow-up, 18.3 months). Recurrence developed in 82 (80%) and 43 (66%) patients in the CT and magnetic resonance imaging groups, respectively. The cumulative hepatic recurrence rate was greater in the CT group than in the magnetic resonance imaging group (P < .001). Preoperative hepatic magnetic resonance imaging should be considered in patients with potentially resectable pancreatic ductal adenocarcinoma, especially those with high tumor burden. Copyright © 2017 Elsevier Inc. All rights reserved.

Early ligation of the dorsal pancreatic artery with a mesenteric approach reduces intraoperative blood loss during pancreatoduodenectomy.

PubMed

Iede, Kiyotsugu; Nakao, Akimasa; Oshima, Kenji; Suzuki, Ryota; Yamada, Hironori; Oshima, Yukiko; Kobayashi, Hironobu; Kimura, Yasunori

2018-05-10

Early ligation of the inferior pancreatoduodenal artery has been advocated to reduce blood loss during pancreatoduodenectomy. However, the impact of early ligation of the dorsal pancreatic artery (DPA) remains unclear. This study was performed to investigate the clinical implications of early ligation of the DPA. From October 2014 to April 2017, 34 consecutive patients underwent pancreatoduodenectomy using a mesenteric approach. The patients were divided into the early DPA ligation group (n = 15) and late DPA ligation group (n = 19). The clinical features were retrospectively compared between the two groups (H29-044). Preoperative multidetector row computed tomography and intraoperative findings revealed that the right branch of the DPA supplied the pancreatic head region in all cases. Intraoperative blood loss was significantly lower in the early than late ligation group (median, 609 ml [range, 94-1013 ml] vs. 764 ml [range, 367-1828 ml], respectively; P = 0.008]. Multivariable analysis revealed that early DPA ligation was independently associated with blood loss (P = 0.023). The DPAs arising from the superior mesenteric artery underwent early ligation at a significantly higher rate. Early ligation of the DPA during pancreaticoduodenectomy with a mesenteric approach could reduce intraoperative blood loss. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

User's Guide for MSAP2D: A Program for Unsteady Aerodynamic and Aeroelastic (Flutter and Forced Response) Analysis of Multistage Compressors and Turbines. 1.0

NASA Technical Reports Server (NTRS)

Reddy, T. S. R.; Srivastava, R.

1996-01-01

This guide describes the input data required for using MSAP2D (Multi Stage Aeroelastic analysis Program - Two Dimensional) computer code. MSAP2D can be used for steady, unsteady aerodynamic, and aeroelastic (flutter and forced response) analysis of bladed disks arranged in multiple blade rows such as those found in compressors, turbines, counter rotating propellers or propfans. The code can also be run for single blade row. MSAP2D code is an extension of the original NPHASE code for multiblade row aerodynamic and aeroelastic analysis. Euler equations are used to obtain aerodynamic forces. The structural dynamic equations are written for a rigid typical section undergoing pitching (torsion) and plunging (bending) motion. The aeroelastic equations are solved in time domain. For single blade row analysis, frequency domain analysis is also provided to obtain unsteady aerodynamic coefficients required in an eigen analysis for flutter. In this manual, sample input and output are provided for a single blade row example, two blade row example with equal and unequal number of blades in the blade rows.

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

Relevant incidental findings at abdominal multi-detector contrast-enhanced computed tomography: A collateral screening?

PubMed Central

Sconfienza, Luca Maria; Mauri, Giovanni; Muzzupappa, Claudia; Poloni, Alessandro; Bandirali, Michele; Esseridou, Anastassia; Tritella, Stefania; Secchi, Francesco; Di Leo, Giovanni; Sardanelli, Francesco

2015-01-01

AIM: To investigate the prevalence of relevant incidental findings (RIFs) detected during routine abdominal contrast-enhanced computed tomography (CeCT). METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal CeCT studies performed between January and May 2013. For each report, patients’ age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs (if needing additional workup) was noted. RESULTS: One thousand forty abdominal CeCT were performed in 949 patients (528 males, mean age 66 ± 14 years). No significant difference was found between inpatients and outpatients age and sex distribution (P > 0.472). RIFs were found in 195/1040 (18.8%) CeCT [inpatients = 108/470 (23.0%); outpatients = 87/570 (15.2%); P = 0.002]. RIFs were found in 30/440 (6.8%) CeCT with a previous exam and in 165/600 (27.5%) without a previous exam (P < 0.001). Radiologists’ distribution between inpatients or outpatients was significantly different (P < 0.001). RIFs prevalence increased with aging, except for a peak in 40-49 year group. Most involved organs were kidneys, gallbladder, and lungs. CONCLUSION: A RIF is detected in 1/5 patients undergoing abdominal CeCT. Risk of overdiagnosis should be taken into account. PMID:26516432

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.

CT Angiography of Peripheral Arterial Disease by 256-Slice Scanner: Accuracy, Advantages and Disadvantages Compared to Digital Subtraction Angiography.

PubMed

Mishra, Atul; Jain, Narendra; Bhagwat, Anand

2017-07-01

Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision. The aim of this retrospective study was to compare the CT angiograms (CTAs) of all cases of PAOD done by 256-slice CT scanner at a tertiary care vascular center and comparing these images with the digital subtraction angiograms (DSAs) of these patients. The retrospective study included 53 patients who underwent both CTA and DSA at our center over a period of 3 years from March 2013 to March 2016. The CTA showed high sensitivity (93%) and specificity (92.7%) for overall assessment of degree of stenosis in a vascular segment in cases of aortic and lower limb occlusive disease. The assessment of lesions of infrapopliteal segment was comparatively inferior (sensitivity 91.6%, accuracy 73.3%, and positive predictive value 78.5%), more so in the presence of significant calcification. The advantages of CTA were its noninvasive nature, ability to image large area of body, almost no adverse effects to the patients, and better assessment of vessel wall disease. However, the CTA assessment of collaterals was inferior with a sensitivity of only 62.7% as compared to DSA. Overall, 256-slice CTA provides fast and accurate imaging of vascular tree which can restrict DSA only in few selected cases as a problem-solving tool where clinico-radiological mismatch is present.

WE-B-207-02: CT Lung Cancer Screening and the Medical Physicist: A Dosimetry Summary of CT Participants in the National Lung Cancer Screening Trial (NLST)

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

Lee, C.

2015-06-15

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less

Automatic tube current modulation technique for multidetector CT: is it effective with a 64-detector CT?

PubMed

Funama, Yoshinori; Awai, Kazuo; Hatemura, Masahiro; Shimamura, Masamitchi; Yanaga, Yumi; Oda, Seitaro; Yamashita, Yasuyuki

2008-01-01

To investigate whether it is possible to obtain adequate images at uniform image noise levels and reduced radiation exposure with our automatic tube current modulation (ATCM) technique for 64-detector CT. The study population consisted of 64 patients with known or suspected lung or abdominal disease. We used a 64-detector CT scanner (LightSpeed VCT, GE Healthcare, Waukesha, WI, USA) and a combined angular and longitudinal tube current modulation technique (Smart mA, GE Healthcare, Waukesha, WI, USA) to examine 34 patients. The scanning parameters were identical; the minimum and maximum tube current thresholds were 50 and 800 mA, respectively. For study of the constant tube current technique, 30 additional patients were examined at 350 mA. The CT number and image noise (SD of the CT number) were measured in the 64 patients at six levels, i.e., the center of the left ventricle, the liver dome, the porta hepatis, the center of the spleen and the right and left renal pelvis. When we used the ATCM technique, the mean image noise ranged from 8.40 at the center of the left ventricle to 11.31 at the porta hepatis; the mean tube current ranged from 105.9 mAs at the center of the left ventricle to 169.6 mAs at the center of the spleen. The mean dose reduction rate per constant tube current at 175 mAs ranged from 3.1 to 39.5%. By use of the ATCM technique, it is possible to maintain a constant image noise level with a 64-detector CT.

CT liver volumetry using geodesic active contour segmentation with a level-set algorithm

NASA Astrophysics Data System (ADS)

Suzuki, Kenji; Epstein, Mark L.; Kohlbrenner, Ryan; Obajuluwa, Ademola; Xu, Jianwu; Hori, Masatoshi; Baron, Richard

2010-03-01

Automatic liver segmentation on CT images is challenging because the liver often abuts other organs of a similar density. Our purpose was to develop an accurate automated liver segmentation scheme for measuring liver volumes. We developed an automated volumetry scheme for the liver in CT based on a 5 step schema. First, an anisotropic smoothing filter was applied to portal-venous phase CT images to remove noise while preserving the liver structure, followed by an edge enhancer to enhance the liver boundary. By using the boundary-enhanced image as a speed function, a fastmarching algorithm generated an initial surface that roughly estimated the liver shape. A geodesic-active-contour segmentation algorithm coupled with level-set contour-evolution refined the initial surface so as to more precisely fit the liver boundary. The liver volume was calculated based on the refined liver surface. Hepatic CT scans of eighteen prospective liver donors were obtained under a liver transplant protocol with a multi-detector CT system. Automated liver volumes obtained were compared with those manually traced by a radiologist, used as "gold standard." The mean liver volume obtained with our scheme was 1,520 cc, whereas the mean manual volume was 1,486 cc, with the mean absolute difference of 104 cc (7.0%). CT liver volumetrics based on an automated scheme agreed excellently with "goldstandard" manual volumetrics (intra-class correlation coefficient was 0.95) with no statistically significant difference (p(F<=f)=0.32), and required substantially less completion time. Our automated scheme provides an efficient and accurate way of measuring liver volumes.

Soil aggregates and their associated carbon and nitrogen content in winter annual pastures using different tillage management options

USDA-ARS?s Scientific Manuscript database

Traditionally, winter annual pastures are established on grazing areas that are steeply sloping and not regarded as suitable for row-crop production. Using conventional (CT) tillage methods to prepare these fragile lands for winter annual pastures leads to increased erosion and rapid soil degradatio...

Evaluation of a dedicated MDCT protocol using iterative image reconstruction after cervical spine trauma.

PubMed

Geyer, L L; Körner, M; Hempel, R; Deak, Z; Mueck, F G; Linsenmaier, U; Reiser, M F; Wirth, S

2013-07-01

To evaluate radiation exposure for 64-row computed tomography (CT) of the cervical spine comparing two optimized protocols using filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASIR), respectively. Sixty-seven studies using FBP (scanner 1) were retrospectively compared with 80 studies using ASIR (scanner 2). The key scanning parameters were identical (120 kV dose modulation, 64 × 0.625 mm collimation, pitch 0.531:1). In protocol 2, the noise index (NI) was increased from 5 to 25, and ASIR and the high-definition (HD) mode were used. The scan length, CT dose index (CTDI), and dose-length product (DLP) were recorded. The image quality was analysed subjectively by using a three-point scale (0; 1; 2), and objectively by using a region of interest (ROI) analysis. Mann-Whitney U and Wilcoxon's test were used. In the FBP group, the mean CTDI was 21.43 mGy, mean scan length 186.3 mm, and mean DLP 441.15 mGy cm. In the ASIR group, the mean CTDI was 9.57 mGy, mean scan length 195.21 mm, and mean DLP 204.23 mGy cm. The differences were significant for CTDI and DLP (p < 0.001) and scan length (p = 0.01). There was no significant difference in the subjective image quality (p > 0.05). The estimated mean effective dose decreased from 2.38 mSv (FBP) to 1.10 mSv (ASIR). The radiation dose of 64-row MDCT can be reduced to a level comparable to plain radiography without loss of subjective image quality by implementation of ASIR in a dedicated cervical spine trauma protocol. These results might contribute to an improved relative risk-to-benefit ratio and support the justification of CT as a first-line imaging tool to evaluate cervical spine trauma. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

In vitro dose measurements in a human cadaver with abdomen/pelvis CT scans.

PubMed

Zhang, Da; Padole, Atul; Li, Xinhua; Singh, Sarabjeet; Khawaja, Ranish Deedar Ali; Lira, Diego; Liu, Tianyu; Shi, Jim Q; Otrakji, Alexi; Kalra, Mannudeep K; Xu, X George; Liu, Bob

2014-09-01

To present a study of radiation dose measurements with a human cadaver scanned on a clinical CT scanner. Multiple point dose measurements were obtained with high-accuracy Thimble ionization chambers placed inside the stomach, liver, paravertebral gutter, ascending colon, left kidney, and urinary bladder of a human cadaver (183 cm in height and 67.5 kg in weight) whose abdomen/pelvis region was scanned repeatedly with a multidetector row CT. The flat energy response and precision of the dosimeters were verified, and the slight differences in each dosimeter's response were evaluated and corrected to attain high accuracy. In addition, skin doses were measured for radiosensitive organs outside the scanned region with OSL dosimeters: the right eye, thyroid, both nipples, and the right testicle. Three scan protocols were used, which shared most scan parameters but had different kVp and mA settings: 120-kVp automA, 120-kVp 300 mA, and 100-kVp 300 mA. For each protocol three repeated scans were performed. The tube starting angle (TSA) was found to randomly vary around two major conditions, which caused large fluctuations in the repeated point dose measurements: for the 120-kVp 300 mA protocol this angle changed from approximately 110° to 290°, and caused 8%-25% difference in the point dose measured at the stomach, liver, colon, and urinary bladder. When the fluctuations of the TSA were small (within 5°), the maximum coefficient of variance was approximately 3.3%. The soft tissue absorbed doses averaged from four locations near the center of the scanned region were 27.2±3.3 and 16.5±2.7 mGy for the 120 and 100-kVp fixed-mA scans, respectively. These values were consistent with the corresponding size specific dose estimates within 4%. The comparison of the per-100-mAs tissue doses from the three protocols revealed that: (1) dose levels at nonsuperficial locations in the TCM scans could not be accurately deduced by simply scaling the fix-mA doses with local mA values; (2) the general power law relationship between dose and kVp varied from location to location, with the power index ranged between 2.7 and 3.5. The averaged dose measurements at both nipples, which were about 0.6 cm outside the prescribed scan region, ranged from 23 to 27 mGy at the left nipple, and varied from 3 to 20 mGy at the right nipple over the three scan protocols. Large fluctuations over repeated scans were also observed, as a combined result of helical scans of large pitch (1.375) and small active areas of the skin dosimeters. In addition, the averaged skin dose fell off drastically with the distance to the nearest boundary of the scanned region. This study revealed the complexity of CT dose fluctuation and variation with a human cadaver.

Cutting blade dentitions in squaliform sharks form by modification of inherited alternate tooth ordering patterns

PubMed Central

Smith, Moya Meredith

2016-01-01

The squaliform sharks represent one of the most speciose shark clades. Many adult squaliforms have blade-like teeth, either on both jaws or restricted to the lower jaw, forming a continuous, serrated blade along the jaw margin. These teeth are replaced as a single unit and successor teeth lack the alternate arrangement present in other elasmobranchs. Micro-CT scans of embryos of squaliforms and a related outgroup (Pristiophoridae) revealed that the squaliform dentition pattern represents a highly modified version of tooth replacement seen in other clades. Teeth of Squalus embryos are arranged in an alternate pattern, with successive tooth rows containing additional teeth added proximally. Asynchronous timing of tooth production along the jaw and tooth loss prior to birth cause teeth to align in oblique sets containing teeth from subsequent rows; these become parallel to the jaw margin during ontogeny, so that adult Squalus has functional tooth rows comprising obliquely stacked teeth of consecutive developmental rows. In more strongly heterodont squaliforms, initial embryonic lower teeth develop into the oblique functional sets seen in adult Squalus, with no requirement to form, and subsequently lose, teeth arranged in an initial alternate pattern. PMID:28018617

Cutting blade dentitions in squaliform sharks form by modification of inherited alternate tooth ordering patterns

NASA Astrophysics Data System (ADS)

Underwood, Charlie; Johanson, Zerina; Smith, Moya Meredith

2016-11-01

The squaliform sharks represent one of the most speciose shark clades. Many adult squaliforms have blade-like teeth, either on both jaws or restricted to the lower jaw, forming a continuous, serrated blade along the jaw margin. These teeth are replaced as a single unit and successor teeth lack the alternate arrangement present in other elasmobranchs. Micro-CT scans of embryos of squaliforms and a related outgroup (Pristiophoridae) revealed that the squaliform dentition pattern represents a highly modified version of tooth replacement seen in other clades. Teeth of Squalus embryos are arranged in an alternate pattern, with successive tooth rows containing additional teeth added proximally. Asynchronous timing of tooth production along the jaw and tooth loss prior to birth cause teeth to align in oblique sets containing teeth from subsequent rows; these become parallel to the jaw margin during ontogeny, so that adult Squalus has functional tooth rows comprising obliquely stacked teeth of consecutive developmental rows. In more strongly heterodont squaliforms, initial embryonic lower teeth develop into the oblique functional sets seen in adult Squalus, with no requirement to form, and subsequently lose, teeth arranged in an initial alternate pattern.

Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?

PubMed Central

Jehle, Dietrich; Chae, Floria; Wai, Jonathan; Cloud, Sam; Pierce, David; Meyer, Michael

2012-01-01

CT angiography (CTA) has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably identify small cerebral aneurysms, even those <3mm. In addition, it is estimated that CT followed by lumbar puncture (LP) misses up to 4% of symptomatic aneurysms. We present a series of cases that illustrates how CT followed by CTA may be replacing CT-LP as the standard of care in working up patients for symptomatic cerebral aneurysms and the importance of performing three dimensional (3D) reconstructions. A series of seven cases of symptomatic cerebral aneurysms were identified that illustrate the sensitivity of CT-CTA versus CT-LP and the importance of 3D reconstruction in identifying these aneurysms. Surgical treatment was recommended for 6 of the 7 patients with aneurysms and strict hypertension control was recommended for the seventh patient. Some of these patients demonstrated subarachnoid hemorrhage on presentation while others had negative LPs. A number of these patients with negative LPs were clearly symptomatic from their aneurysms. At least one of these cerebral aneurysms was not apparent on CTA without 3D reconstruction. 3D reconstruction of CTA is crucial to adequately identify cerebral aneurysms. This case series helps reinforce the importance of 3D reconstruction. There is some data to suggest that 64 slice CT-CTA may be equivalent or superior to CT-LP in the detection of symptomatic cerebral aneurysms. PMID:22593806

Can multidetector CT detect the site of gastrointestinal tract injury in trauma? – A retrospective study

PubMed Central

Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Das, Ranjita; Paliwal, Swati; Gupta, Amit; Kumar, Subodh

2017-01-01

PURPOSE We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization. METHODS CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated. RESULTS Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs. CONCLUSION CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites. PMID:27924777

Soil management practice in Croatian vineyard affect CO2 fluxes and soil degradation in trafficking zones. First results

NASA Astrophysics Data System (ADS)

Bogunovic, Igor; Bilandzija, Darija; Andabaka, Zeljko; Stupic, Domagoj; Cacic, Marija; Brezinscak, Luka; Maletic, Edi; Pereira, Paulo; Kisic, Ivica

2017-04-01

Vineyards represent one of the most degradation prone types of intensively managed land on Earth. Steep slopes encourage grape producers to adopt environmental friendly soil management like mulching or continuous no-tillage. In this context, producers have concerns about efficient fertilisation practices and water competitions between vine and grasses in continuous no-tillage inter rows. Vineyards in semi-humid areas like Continental Croatia mostly not suffer from water deficit during growth. Nevertheless, lack of research of different soil management practices open dilemma about soil compaction concerns in intensively trafficked soils in vineyard of semi-humid areas. Soil compaction, determined by bulk density (BD), soil water content (SWC) and CO2 fluxes from trafficked inter row positions were recorded in 2016 in an experiment in which four different soil management systems were compared in a vineyard raised on a silty clay loam soil, near Zagreb, Croatia: No-tillage (NT) system, continuous tillage (CT) and yearly inversed grass covered (INV-GC) and tillage managed (INV-T) inter rows are subjected to intensive traffic. Grape yield and must quality of grape variety Chardonnay was also monitored. Tractor traffic increased the soil BD at 0-10 and 10-20 cm, but especially at the 0-10 cm depth. CT treatment record lowest compaction at 0-10 cm because of tillage. Soil water content showed better conservation possibilities of INV-GC in drier period. In wet period SWC possibilities are similar between treatments. The results of soil compaction under different management indicate that vineyard soil differently response to traffic intensity and impact on microfauna activity and CO2 emissions. INV-GC and NT managed soils record lower CO2 fluxes from vineyard soil compared to CT and INV-T treatments. Management treatments did not statistically influenced on grape yields. Several years of investigation is needed to confirm the overall impact of different management treatments on the proportion of degradation process and their response to proportion of tractor circulation impacts.

Validation of a Monte Carlo model used for simulating tube current modulation in computed tomography over a wide range of phantom conditions/challenges

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

Bostani, Maryam, E-mail: mbostani@mednet.ucla.edu; McMillan, Kyle; Cagnon, Chris H.

2014-11-01

Purpose: Monte Carlo (MC) simulation methods have been widely used in patient dosimetry in computed tomography (CT), including estimating patient organ doses. However, most simulation methods have undergone a limited set of validations, often using homogeneous phantoms with simple geometries. As clinical scanning has become more complex and the use of tube current modulation (TCM) has become pervasive in the clinic, MC simulations should include these techniques in their methodologies and therefore should also be validated using a variety of phantoms with different shapes and material compositions to result in a variety of differently modulated tube current profiles. The purposemore » of this work is to perform the measurements and simulations to validate a Monte Carlo model under a variety of test conditions where fixed tube current (FTC) and TCM were used. Methods: A previously developed MC model for estimating dose from CT scans that models TCM, built using the platform of MCNPX, was used for CT dose quantification. In order to validate the suitability of this model to accurately simulate patient dose from FTC and TCM CT scan, measurements and simulations were compared over a wide range of conditions. Phantoms used for testing range from simple geometries with homogeneous composition (16 and 32 cm computed tomography dose index phantoms) to more complex phantoms including a rectangular homogeneous water equivalent phantom, an elliptical shaped phantom with three sections (where each section was a homogeneous, but different material), and a heterogeneous, complex geometry anthropomorphic phantom. Each phantom requires varying levels of x-, y- and z-modulation. Each phantom was scanned on a multidetector row CT (Sensation 64) scanner under the conditions of both FTC and TCM. Dose measurements were made at various surface and depth positions within each phantom. Simulations using each phantom were performed for FTC, detailed x–y–z TCM, and z-axis-only TCM to obtain dose estimates. This allowed direct comparisons between measured and simulated dose values under each condition of phantom, location, and scan to be made. Results: For FTC scans, the percent root mean square (RMS) difference between measurements and simulations was within 5% across all phantoms. For TCM scans, the percent RMS of the difference between measured and simulated values when using detailed TCM and z-axis-only TCM simulations was 4.5% and 13.2%, respectively. For the anthropomorphic phantom, the difference between TCM measurements and detailed TCM and z-axis-only TCM simulations was 1.2% and 8.9%, respectively. For FTC measurements and simulations, the percent RMS of the difference was 5.0%. Conclusions: This work demonstrated that the Monte Carlo model developed provided good agreement between measured and simulated values under both simple and complex geometries including an anthropomorphic phantom. This work also showed the increased dose differences for z-axis-only TCM simulations, where considerable modulation in the x–y plane was present due to the shape of the rectangular water phantom. Results from this investigation highlight details that need to be included in Monte Carlo simulations of TCM CT scans in order to yield accurate, clinically viable assessments of patient dosimetry.« less

Washout of hepatocellular carcinoma on portal venous phase of multidetector computed tomography in a pre-transplant population.

PubMed

Kitzing, Yu Xuan; Ng, Bernard H K; Kitzing, Bjoern; Waugh, Richard; Kench, James G; Strasser, Simone I; McCormack, Samuel

2015-12-01

Washout is an important diagnostic imaging feature of hepatocellular carcinoma (HCC) on computed tomography (CT). The primary aim of this study is to evaluate the prevalence and the interobserver variation in the detection of portal venous phase (PVP) washout of HCCs using CT in a transplant population. The secondary aim is to evaluate factors influencing the detection of PVP washout. Forty-five patients who underwent CT liver imaging within the 60 days before transplantation had viable HCCs confirmed on pathology. Two radiologists retrospectively reviewed the images for HCCs including features of arterial enhancement and PVP washout. Clinical data, peak kilovoltage, imaging features of portal hypertension, region of interest attenuation measurements of the individual lesions, background liver parenchyma and portal vein were obtained. Liver to lesion attenuation ratio was also calculated. Statistical analysis was performed. The two readers identified 50 arterially enhancing HCCs in 45 patients. In consensus, the two readers identified washout in 60% of the HCCs with a substantial interobserver agreement (kappa = 0.633). PVP washout was associated with larger lesion size, increased background liver parenchyma attenuation, increased liver to lesion attenuation ratio, increased portal vein attenuation and hepatitis B viral status (P = 0.027, 0.008, 0.014, 0.017 and 0.037 respectively). In our transplant population, portal venous phase washout was seen in 60% of the hypervascular HCCs. Factors influencing the presence of PVP washout include lesion size as well as the liver and portal vein attenuation reflective of the portal haemodynamics. © 2015 The Royal Australian and New Zealand College of Radiologists.

CT triage for lung malignancy: coronal multiplanar reformation versus images in three orthogonal planes.

PubMed

Kusk, Martin Weber; Karstoft, Jens; Mussmann, Bo Redder

2015-11-01

Generation of multiplanar reformation (MPR) images has become automatic on most modern computed tomography (CT) scanners, potentially increasing the workload of the reporting radiologists. It is not always clear if this increases diagnostic performance in all clinical tasks. To assess detection performance using only coronal multiplanar reformations (MPR) when triaging patients for lung malignancies with CT compared to images in three orthogonal planes, and to evaluate performance comparison of novice and experienced readers. Retrospective study of 63 patients with suspicion of lung cancer, scanned on 64-slice multidetector computed tomography (MDCT) with images reconstructed in three planes. Coronal images were presented to four readers, two novice and two experienced. Readers decided whether the patients were suspicious for malignant disease, and indicated their confidence on a five-point scale. Sensitivity and specificity on per-patient basis was calculated with regards to a reference standard of histological diagnosis, and compared with the original report using McNemar's test. Receiver operating characteristic (ROC) curves were plotted to compare the performance of the four readers, using the area under the curve (AUC) as figure of merit. No statistically significant difference of sensitivity and specificity was found for any of the readers when compared to the original reports. ROC analysis yielded AUCs in the range of 0.92-0.93 for all readers with no significant difference. Inter-rater agreement was substantial (kappa = 0.72). Sensitivity and specificity were comparable to diagnosis using images in three planes. No significant difference was found between experienced and novice readers. © The Foundation Acta Radiologica 2014.

Clinical evaluation of the reproducibility of volume measurements of pulmonary nodules

NASA Astrophysics Data System (ADS)

Wormanns, Dag; Kohl, Gerhard; Klotz, Ernst; Heindel, Walter; Diederich, Stefan

2002-05-01

High reproducibility of volumetric measurements is an important prerequisite for follow-up of small lung nodules in order to differentiate malignant from benign lesions in a lung cancer screening setting. This study was aimed to evaluate the measurement reproducibility of a new software tool for pulmonary nodule volumetry. In an ongoing study, 147 pulmonary nodules (size 1.6-17.5 mm) were examined with low-dose multidetector CT (Siemens Somatom Volume Zoom, 120 kVp, 20 mAs, detector collimation 4x1 mm, normalized pitch 1.75, slice thickness 1.25 mm, reconstruction increment 0.8 mm). Two consecutive low-dose scans covering the whole lung volume were performed within a few minutes. Between both scans, patients were asked to leave the CT scanner, and the second scan was planned independently from the first one. For all visually detected pulmonary nodules with a diameter <20 mm nodule volume was determined on both scans using a software prototype containing segmentation and volumetry algorithms. Results from both scans were compared. Nodule volume differences were determined as difference between the first and second measurement and ranged from 169 to 87%. The performance of the diagnostic test was measured using ROC analysis. For the detection of a volume doubling the area under curve (Az) was 0.98, for a growth of 50% the Az was 0.89. Further refinement of the segmentation algorithm should lead to more consistent measurements in ill-defined nodules. In conclusion, volumetric measurement of pulmonary nodules in multislice CT data sets is a reliable tool for the detection of growth in small pulmonary nodules.

TU-G-204-01: BEST IN PHYSICS (IMAGING): Dynamic CT Myocardial Perfusion Measurement and Its Comparison to Fractional Flow Reserve

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

Ziemer, B; Hubbard, L; Groves, E

2015-06-15

Purpose: To evaluate a first pass analysis (FPA) technique for CT perfusion measurement in a swine animal and its validation using fractional flow reserve (FFR) as a reference standard. Methods: Swine were placed under anesthesia and relevant physiologic parameters were continuously recorded. Intra-coronary adenosine was administered to induce maximum hyperemia. A pressure wire was advanced distal to the first diagonal branch of the left anterior descending (LAD) artery for FFR measurements and a balloon dilation catheter was inserted over the pressure wire into the proximal LAD to create varying levels of stenosis. Images were acquired with a 320-row wide volumemore » CT scanner. Three main coronary perfusion beds were delineated in the myocardium using arteries extracted from CT angiography images using a minimum energy hypothesis. The integrated density in the perfusion bed was used to calculate perfusion using the FPA technique. The perfusion in the LAD bed over a range of stenosis severity was measured. The measured fractional perfusion was compared to FFR and linear regression was performed. Results: The measured fractional perfusion using the FPA technique (P-FPA) and FFR were related as P-FPA = 1.06FFR – 0.06 (r{sup 2} = 0.86). The perfusion measurements were calculated with only three to five total CT volume scans, which drastically reduces the radiation dose as compared with the existing techniques requiring 15–20 volume scans. Conclusion: The measured perfusion using the first pass analysis technique showed good correlation with FFR measurements as a reference standard. The technique for perfusion measurement can potentially make a substantial reduction in radiation dose as compared with the existing techniques.« less

WE-B-207-00: CT Lung Cancer Screening Part 1

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

NONE

2015-06-15

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less

Timeliness of contact tracing among flight passengers for influenza A/H1N1 2009

PubMed Central

2011-01-01

Background During the initial containment phase of influenza A/H1N1 2009, close contacts of cases were traced to provide antiviral prophylaxis within 48 h after exposure and to alert them on signs of disease for early diagnosis and treatment. Passengers seated on the same row, two rows in front or behind a patient infectious for influenza, during a flight of ≥ 4 h were considered close contacts. This study evaluates the timeliness of flight-contact tracing (CT) as performed following national and international CT requests addressed to the Center of Infectious Disease Control (CIb/RIVM), and implemented by the Municipal Health Services of Schiphol Airport. Methods Elapsed days between date of flight arrival and the date passenger lists became available (contact details identified - CI) was used as proxy for timeliness of CT. In a retrospective study, dates of flight arrival, onset of illness, laboratory diagnosis, CT request and identification of contacts details through passenger lists, following CT requests to the RIVM for flights landed at Schiphol Airport were collected and analyzed. Results 24 requests for CT were identified. Three of these were declined as over 4 days had elapsed since flight arrival. In 17 out of 21 requests, contact details were obtained within 7 days after arrival (81%). The average delay between arrival and CI was 3,9 days (range 2-7), mainly caused by delay in diagnosis of the index patient after arrival (2,6 days). In four flights (19%), contacts were not identified or only after > 7 days. CI involving Dutch airlines was faster than non-Dutch airlines (P < 0,05). Passenger locator cards did not improve timeliness of CI. In only three flights contact details were identified within 2 days after arrival. Conclusion CT for influenza A/H1N1 2009 among flight passengers was not successful for timely provision of prophylaxis. CT had little additional value for alerting passengers for disease symptoms, as this information already was provided during and after the flight. Public health authorities should take into account patient delays in seeking medical advise and laboratory confirmation in relation to maximum time to provide postexposure prophylaxis when deciding to install contact tracing measures. International standardization of CT guidelines is recommended. PMID:22204494

Dose reduction in whole-body computed tomography of multiple injuries (DoReMI): protocol for a prospective cohort study

PubMed Central

2014-01-01

Background Single-pass, contrast-enhanced whole body multidetector computed tomography (MDCT) emerged as the diagnostic standard for evaluating patients with major trauma. Modern iterative image algorithms showed high image quality at a much lower radiation dose in the non-trauma setting. This study aims at investigating whether the radiation dose can safely be reduced in trauma patients without compromising the diagnostic accuracy and image quality. Methods/Design Prospective observational study with two consecutive cohorts of patients. Setting: A high-volume, academic, supra-regional trauma centre in Germany. Study population: Consecutive male and female patients who 1. had been exposed to a high-velocity trauma mechanism, 2. present with clinical evidence or high suspicion of multiple trauma (predicted Injury Severity Score [ISS] ≥16) and 3. are scheduled for primary MDCT based on the decision of the trauma leader on call. Imaging protocols: In a before/after design, a consecutive series of 500 patients will undergo single-pass, whole-body 128-row multi-detector computed tomography (MDCT) with a standard, as low as possible radiation dose. This will be followed by a consecutive series of 500 patients undergoing an approved ultra-low dose MDCT protocol using an image processing algorithm. Data: Routine administrative data and electronic patient records, as well as digital images stored in a picture archiving and communications system will serve as the primary data source. The protocol was approved by the institutional review board. Main outcomes: (1) incidence of delayed diagnoses, (2) diagnostic accuracy, as correlated to the reference standard of a synopsis of all subsequent clinical, imaging, surgical and autopsy findings, (3) patients’ safety, (4) radiation exposure (e.g. effective dose), (5) subjective image quality (assessed independently radiologists and trauma surgeons on a 100-mm visual analogue scale), (6) objective image quality (e.g., contrast-to-noise ratio). Analysis: Multivariate regression will be employed to adjust and correct the findings for time and cohort effects. An exploratory interim analysis halfway after introduction of low-dose MDCT will be conducted to assess whether this protocol is clearly inferior or superior to the current standard. Discussion Although non-experimental, this study will generate first large-scale data on the utility of imaging-enhancing algorithms in whole-body MDCT for major blunt trauma. Trial registration Current Controlled Trials ISRCTN74557102. PMID:24589310

Quantitative Analysis of First-Pass Contrast-Enhanced Myocardial Perfusion Multidetector CT Using a Patlak Plot Method and Extraction Fraction Correction During Adenosine Stress

NASA Astrophysics Data System (ADS)

Ichihara, Takashi; George, Richard T.; Silva, Caterina; Lima, Joao A. C.; Lardo, Albert C.

2011-02-01

The purpose of this study was to develop a quantitative method for myocardial blood flow (MBF) measurement that can be used to derive accurate myocardial perfusion measurements from dynamic multidetector computed tomography (MDCT) images by using a compartment model for calculating the first-order transfer constant (K1) with correction for the capillary transit extraction fraction (E). Six canine models of left anterior descending (LAD) artery stenosis were prepared and underwent first-pass contrast-enhanced MDCT perfusion imaging during adenosine infusion (0.14-0.21 mg/kg/min). K1 , which is the first-order transfer constant from left ventricular (LV) blood to myocardium, was measured using the Patlak plot method applied to time-attenuation curve data of the LV blood pool and myocardium. The results were compared against microsphere MBF measurements, and the extraction fraction of contrast agent was calculated. K1 is related to the regional MBF as K1=EF, E=(1-exp(-PS/F)), where PS is the permeability-surface area product and F is myocardial flow. Based on the above relationship, a look-up table from K1 to MBF can be generated and Patlak plot-derived K1 values can be converted to the calculated MBF. The calculated MBF and microsphere MBF showed a strong linear association. The extraction fraction in dogs as a function of flow (F) was E=(1-exp(-(0.2532F+0.7871)/F)) . Regional MBF can be measured accurately using the Patlak plot method based on a compartment model and look-up table with extraction fraction correction from K1 to MBF.

Normal renal arterial anatomy assessed by multidetector CT angiography: are there differences between men and women?

PubMed

Turba, Ulku Cenk; Uflacker, Renan; Bozlar, Ugur; Hagspiel, Klaus D

2009-03-01

The purpose of this study was to determine renal arterial anatomy and gender differences in adults without renovascular disease using multidetector computed tomography angiography (MDCTA). MDCTA datasets of 399 patients were retrospectively reviewed. Measurements of the aortorenal diameters, the angulation of the renal ostia and pedicles as well as the distance between the origins of the renal arteries were measured. Differences in measurements between genders were tested for statistical significance using analysis of variance (ANOVA) and Pearson's Chi-Square tests. A total of 798 renal arteries were available for analysis in 207 female (mean age = 52.91 years) and 192 male patients (mean age = 53.04 years). Female patients were found to have smaller aortae (at the level of the right renal ostium) and bilateral renal arteries than males (mean aortic diameter M/F = 18.33/15.89 mm, mean right renal artery ostial diameter M/F = 5.06/4.59 mm, mean left ostial renal diameter M/F = 5.14/4.66 mm) (p < .001). There was no statistical significance for the renal ostia level in relation to the vertebrae and the majority of renal arteries originated at the L1 and L2 levels. The longitudinal distance between right and left renal artery ostia ranged from 0 to 32 mm (mean = 4,6 mm, median = 5mm). The mean anteroposterior orientation of the right renal ostia was M/F = 29.45 degrees/28.20 degrees , and M/F = -7.96 degrees/-11.14 degrees for left renal artery ostia. The mean anteroposterior orientation of the right renal pedicle was M/F = 41.37 degrees/44.34 degrees and M/F = 42.31 degrees/43.95 degrees for the left pedicle. There are some differences in normal renal arterial anatomy between genders. Normal renal arterial information is useful not only for planning and performing of endovascular and laparoscopic urologic procedures, but also for medical device development. Copyright 2009 Wiley-Liss, Inc.

Anatomical variation of celiac axis, superior mesenteric artery, and hepatic artery: Evaluation with multidetector computed tomography angiography.

PubMed

Farghadani, Maryam; Momeni, Mohammad; Hekmatnia, Ali; Momeni, Fateme; Baradaran Mahdavi, Mohammad Mehdi

2016-01-01

The celiac axis, superior mesenteric artery (SMA), and hepatic artery are the most important branches of abdominal aorta due to their vascularization field. The aim of our study was to evaluate the prevalence of different anatomical variation of celiac axis, SMA, hepatic artery, and its branches with multidetector computed tomography (MDCT) angiography of upper abdomen arteries. MDCT of 607 kidney donor and traumatic patients that referred to MDCT unit at Al Zahra Hospital in Isfahan from 2012 to 2015 were retrospectively evaluated. We excluded patients with history of abdominal vascular surgery and hepatic or pancreatic surgery. Computed tomography images of the patient were obtained with 64-row MDCT scanner and anatomical variations were analyzed. Three hundred and eighty-eight (63.9%) of the 607 patients had classic arterial anatomy and 219 (36.1%) patients had variant types. The most common type of variation was the origin of the right hepatic artery (RHA) from SMA (9.6%), and the next common variation was the origin of the left hepatic artery (LHA) from the left gastric artery (6.9%). Variations in the origin of the common hepatic artery (CHA) were seen in 16 (2.6%) patients. Buhler arc was identified in two patients. The RHA originated from the celiac axis in 11 (1.8%) patients and from the aorta in 8 (1.3%) patients. Trifurcation of CHA into gastroduodenal artery, RHA, and LHA was detected in 11 (1.8%) patients. The results of the present study showed that anatomical variation occurs in a high percentage of patients. Detection of these variations can guide surgical and radiological interventional planning.

Imaging in rectal cancer with emphasis on local staging with MRI

PubMed Central

Arya, Supreeta; Das, Deepak; Engineer, Reena; Saklani, Avanish

2015-01-01

Imaging in rectal cancer has a vital role in staging disease, and in selecting and optimizing treatment planning. High-resolution MRI (HR-MRI) is the recommended method of first choice for local staging of rectal cancer for both primary staging and for restaging after preoperative chemoradiation (CT-RT). HR-MRI helps decide between upfront surgery and preoperative CT-RT. It provides high accuracy for prediction of circumferential resection margin at surgery, T category, and nodal status in that order. MRI also helps assess resectability after preoperative CT-RT and decide between sphincter saving or more radical surgery. Accurate technique is crucial for obtaining high-resolution images in the appropriate planes for correct staging. The phased array external coil has replaced the endorectal coil that is no longer recommended. Non-fat suppressed 2D T2-weighted (T2W) sequences in orthogonal planes to the tumor are sufficient for primary staging. Contrast-enhanced MRI is considered inappropriate for both primary staging and restaging. Diffusion-weighted sequence may be of value in restaging. Multidetector CT cannot replace MRI in local staging, but has an important role for evaluating distant metastases. Positron emission tomography-computed tomography (PET/CT) has a limited role in the initial staging of rectal cancer and is reserved for cases with resectable metastatic disease before contemplating surgery. This article briefly reviews the comprehensive role of imaging in rectal cancer, describes the role of MRI in local staging in detail, discusses the optimal MRI technique, and provides a synoptic report for both primary staging and restaging after CT-RT in routine practice. PMID:25969638

Perfusion CT to assess angiogenesis in colon cancer: technical limitations and practical challenges.

PubMed

Dighe, S; Castellano, E; Blake, H; Jeyadevan, N; Koh, M U; Orten, M; Swift, I; Brown, G

2012-10-01

Perfusion CT may have the potential to quantify the degree of angiogenesis of solid tumours in vivo. This study aims to identify the practical and technical challenges inherent to the technique, and evaluate its feasibility in colorectal tumours. 51 patients from 2 institutions prospectively underwent a single perfusion CT on 2 different multidetector scanners. The patients were advised to breath-hold as long as possible, followed by shallow breathing, and were given intravenous buscopan to reduce movement. Numerous steps were explored to identify the challenges. 43 patients successfully completed the perfusion CT as per protocol. Inability to detect the tumour (n=3), misplacement of dynamic sequence co-ordinates (n=2), failure of contrast injection (n=2) and displacement of tumour (n=1) were the reasons for failure. In 14 cases excessive respiratory motion displaced the tumour out of the scanning field along the temporal sequence, leading to erroneous data capture. In nine patients, minor displacements of the tumour were corrected by repositioning the region of interest (ROI) to its original position after reviewing each dynamic sequence slice. In 20 patients the tumour was stable, and data captured from the ROI were representative, and could have been analysed by commercially available Body Tumor Perfusion 3.0® software (GE Healthcare, Waukesha, WI). Hence all data were manually analysed by MATLAB® processing software (MathWorks, Cambridge, UK). Perfusion CT in tumours susceptible to motion during acquisition makes accurate data capture challenging and requires meticulous attention to detail. Motion correction software is essential if perfusion CT is to be used routinely in colorectal cancer.

Diagnostic performance and radiation dose of lower extremity CT angiography using a 128-slice dual source CT at 80 kVp and high pitch.

PubMed

Kim, Jin Woo; Choo, Ki Seok; Jeon, Ung Bae; Kim, Tae Un; Hwang, Jae Yeon; Yeom, Jeong A; Jeong, Hee Seok; Choi, Yoon Young; Nam, Kyung Jin; Kim, Chang Won; Jeong, Dong Wook; Lim, Soo Jin

2016-07-01

Multi-detector computed tomography (MDCT) angiography is now used for the diagnosing patients with peripheral arterial disease. The dose of radiation is related to variable factors, such as tube current, tube voltage, and helical pitch. To assess the diagnostic performance and radiation dose of lower extremity CT angiography (CTA) using a 128-slice dual source CT at 80 kVp and high pitch in patients with critical limb ischemia (CLI). Twenty-eight patients (mean, 64.1 years; range, 39-80 years) with CLI were enrolled in this retrospective study and underwent CTA using a 128-slice dual source CT at 80 kVp and high pitch and subsequent intra-arterial digital subtraction angiography (DSA), which was used as a reference standard for assessing diagnostic performance. For arterial segments with significant disease (>50% stenosis), overall sensitivity, specificity, and accuracy of lower extremity CTA were 94.8% (95% CI, 91.7-98.0%), 91.5% (95% CI, 87.7-95.2%), and 93.1% (95% CI, 90.6-95.6%), respectively, and its positive and negative predictive values were 91.0% (95% CI, 87.1-95.0%), and 95.1% (95% CI, 92.1-98.1%), respectively. Mean radiation dose delivered to lower extremities was 266.6 mGy.cm. Lower extremity CTA using a 128-slice dual source CT at 80 kVp and high pitch was found to have good diagnostic performance for the assessment of patients with CLI using an extremely low radiation dose. © The Foundation Acta Radiologica 2015.

Multi-detector CT features of acute intestinal ischemia and their prognostic correlations.

PubMed

Moschetta, Marco; Telegrafo, Michele; Rella, Leonarda; Stabile Ianora, Amato Antonio; Angelelli, Giuseppe

2014-05-28

Acute intestinal ischemia is an abdominal emergency occurring in nearly 1% of patients presenting with acute abdomen. The causes can be occlusive or non occlusive. Early diagnosis is important to improve survival rates. In most cases of late or missed diagnosis, the mortality rate from intestinal infarction is very high, with a reported value ranging from 60% to 90%. Multi-detector computed tomography (MDCT) is a fundamental imaging technique that must be promptly performed in all patients with suspected bowel ischemia. Thanks to the new dedicated reconstruction program, its diagnostic potential is much improved compared to the past and currently it is superior to that of any other noninvasive technique. The increased spatial and temporal resolution, high-quality multi-planar reconstructions, maximum intensity projections, vessel probe, surface-shaded volume rending and tissue transition projections make MDCT the gold standard for the diagnosis of intestinal ischemia, with reported sensitivity, specificity, positive and negative predictive values of 64%-93%, 92%-100%, 90%-100% and 94%-98%, respectively. MDCT contributes to appropriate treatment planning and provides important prognostic information thanks to its ability to define the nature and extent of the disease. The purpose of this review is to examine the diagnostic and prognostic role of MDCT in bowel ischemia with special regard to the state of art new reconstruction software.

Multidetector Computed Tomography Features in Differentiating Exophytic Renal Angiomyolipoma from Retroperitoneal Liposarcoma

PubMed Central

Wang, Qiushi; Juan, Yu-Hsiang; Li, Yong; Xie, Jia-Jun; Liu, Hui; Huang, Hongfei; Liu, Zaiyi; Zheng, Junhui; Saboo, Ujwala S.; Saboo, Sachin S.; Liang, Changhong

2015-01-01

Abstract This study aims to evaluate the multidetector computed tomography (CT) imaging features in differentiating exophytic renal angiomyolipoma (AML) from retroperitoneal liposarcoma. We retrospectively enrolled 42 patients with confirmed exophytic renal AML (31 patients) or retroperitoneal liposarcoma (11 patients) during 8 years period to assess: renal parenchymal defect at site of tumor contact, supply from branches of renal artery, tumoral vessel extending through the renal parenchyma, dilated intratumoral vessels, hemorrhage, non–fat-containing intratumoral nodules with postcontrast enhancement, calcification, renal sinus enlargement, anterior displacement of kidneys, and other associated AML. Renal parenchymal defect, renal arterial blood supply, tumoral vessel through the renal parenchyma, dilated intratumoral vessels, intratumoral/perirenal hemorrhage, renal sinus enlargement, and associated AML were seen only or mainly in exophytic renal AML (all P value < 0.05); however, non–fat-attenuating enhancing intratumoral nodules, intratumoral calcification, and anterior displacement of the kidney were more common in liposarcoma (all P value < 0.05). AMLs reveal renal parenchymal defect at the site of tumor contact, supply from renal artery, tumoral vessel extending through the renal parenchyma, dilated intratumoral vessels, intratumoral and/or perirenal hemorrhage, renal sinus enlargement, and associated AML. Non–fat-attenuating enhancing intratumoral nodules, intratumoral calcifications, and anterior displacement of kidney were more commonly seen in liposarcoma. PMID:26376398

Multidetector CT angiography in living donor renal transplantation: accuracy and discrepancies in right venous anatomy.

PubMed

Kulkarni, S; Emre, S; Arvelakis, A; Asch, W; Bia, M; Formica, R; Israel, G

2011-01-01

Multidetector computed tomography (MDCT) angiography is a reliable technique for assessing pre-operative renal anatomy in living kidney donors. The method has largely evolved into protocols that eliminate dedicated venous phase and instead utilize a combined arterial/venous phase to delineate arterial and venous anatomy simultaneously. Despite adoption of this protocol, there has been no study to assess its accuracy. To assess whether or not MDCT angiography compares favorably to intra-operative findings, 102 donors underwent MDCT angiography without a dedicated venous phase with surgical interpretation of renal anatomy. Anatomical variants included multiple arteries (12%), multiple veins (7%), early arterial bifurcation (13%), late venous confluence (5%), circumaortic renal veins (5%), retroaortic vein (1%), and ureteral duplication (2%). The sensitivity and specificity of multiple arterial anomalies were 100% and 97%, respectively. The sensitivity and specificity of multiple venous anomalies were 92% and 98%, respectively. The most common discrepancy was noted exclusively in the interpretation of right venous anatomy as it pertained to the renal vein/vena cava confluence (3%). MDCT angiography using a combined arterial/venous contrast-enhanced phase provides suitable depiction of renal donor anatomy. Careful consideration should be given when planning a right donor nephrectomy whether the radiographic interpretation is suggestive of a late confluence. © 2010 John Wiley & Sons A/S.

The Abernethy malformation-myriad imaging manifestations of a single entity.

PubMed

Ghuman, Samarjit S; Gupta, Saumya; Buxi, T B S; Rawat, Kishan S; Yadav, Anurag; Mehta, Naimish; Sud, Seema

2016-01-01

Abernethy malformation, also known as congenital extrahepatic portosystemic shunts (CEPS) is a rare clinical entity and manifests with different clinical symptoms. CEPS are abnormalities of vascular development where there is shunting of portal blood into the systemic venous system. Multidetector computed tomography (MDCT) is a fast and effective modality for evaluation of CEPS. CT displays all the information desired by the surgeon as well as the clinician including the anatomy of the splenic and superior mesenteric veins, size and site of the shunt, presence or absence of the portal vein radicles, and helps to plan the therapy and even the follow-up of these patients. Contrast-enhanced magnetic resonance imaging (MRI) has also emerged as a promising tool for the evaluation of liver lesions associated with the malformation. The Radiologist should be aware of the various imaging appearances of this entity including its complications. In this article, we describe the imaging appearances of CEPS, their complications, and their imaging appearances on CT and MRI. We have also described various associated anomalies.

The Abernethy malformation—myriad imaging manifestations of a single entity

PubMed Central

Ghuman, Samarjit S; Gupta, Saumya; Buxi, T B S; Rawat, Kishan S; Yadav, Anurag; Mehta, Naimish; Sud, Seema

2016-01-01

Abernethy malformation, also known as congenital extrahepatic portosystemic shunts (CEPS) is a rare clinical entity and manifests with different clinical symptoms. CEPS are abnormalities of vascular development where there is shunting of portal blood into the systemic venous system. Multidetector computed tomography (MDCT) is a fast and effective modality for evaluation of CEPS. CT displays all the information desired by the surgeon as well as the clinician including the anatomy of the splenic and superior mesenteric veins, size and site of the shunt, presence or absence of the portal vein radicles, and helps to plan the therapy and even the follow-up of these patients. Contrast-enhanced magnetic resonance imaging (MRI) has also emerged as a promising tool for the evaluation of liver lesions associated with the malformation. The Radiologist should be aware of the various imaging appearances of this entity including its complications. In this article, we describe the imaging appearances of CEPS, their complications, and their imaging appearances on CT and MRI. We have also described various associated anomalies. PMID:27857464

A new cubic phantom for PET/CT dosimetry: Experimental and Monte Carlo characterization

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

Belinato, Walmir; Silva, Rogerio M.V.; Souza, Divanizia N.

In recent years, positron emission tomography (PET) associated with multidetector computed tomography (MDCT) has become a diagnostic technique widely disseminated to evaluate various malignant tumors and other diseases. However, during PET/CT examinations, the doses of ionizing radiation experienced by the internal organs of patients may be substantial. To study the doses involved in PET/CT procedures, a new cubic phantom of overlapping acrylic plates was developed and characterized. This phantom has a deposit for the placement of the fluorine-18 fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) solution. There are also small holes near the faces for the insertion of optically stimulated luminescence dosimeters (OSLD). Themore » holes for OSLD are positioned at different distances from the {sup 18}F-FDG deposit. The experimental results were obtained in two PET/CT devices operating with different parameters. Differences in the absorbed doses were observed in OSLD measurements due to the non-orthogonal positioning of the detectors inside the phantom. This phantom was also evaluated using Monte Carlo simulations, with the MCNPX code. The phantom and the geometrical characteristics of the equipment were carefully modeled in the MCNPX code, in order to develop a new methodology form comparison of experimental and simulated results, as well as to allow the characterization of PET/CT equipments in Monte Carlo simulations. All results showed good agreement, proving that this new phantom may be applied for these experiments. (authors)« less

Efficacy of CT in diagnosis of transudates and exudates in patients with pleural effusion

PubMed Central

Çullu, Neşat; Kalemci, Serdar; Karakaş, Ömer; Eser, İrfan; Yalçın, Funda; Boyacı, Fatıma Nurefşan; Karakaş, Ekrem

2014-01-01

PURPOSE We aimed to evaluate the efficacy of multidetector computed tomography (CT) imaging in diagnosis of pleural exudates and transudates using attenuation values. MATERIALS AND METHODS This retrospective study included 106 patients who were diagnosed with pleural effusion between January 2010 and June 2012. After the patients underwent chest CT, thoracentesis was performed in the first week. The attenuation values of the pleural effusions were measured in all patients. RESULTS According to Light’s criteria, 30 of 106 patients with pleural effusions had transudates, and the remaining patients had exudates. The Hounsfield unit (HU) value of the exudates (median, 12.5; range, 4–33) was significantly higher than that of the transudates (median, 5; range, 2–15) (P = 0.001). Additionally, when evaluated by disease subgroups, congestive heart failure and empyema were predictable in terms of median HU values of the pleural effusions with high and moderate sensitivity and specificity values (84.6% and 81.2%, respectively; 76.9% and 66.7%, respectively). Compared with other patients, the empyema patients had significantly more loculation and pleural thickening. CONCLUSION CT attenuation values may be useful in differentiating exu-dates from transudates. Although there is an overlap in most effusions, exudate can be considered when the CT attenuation values are >15 HU. Because of overlapping HU values, close correlation with clinical findings is essential. Additional signs, such as fluid loculation and pleural thickness, should be considered and may provide further information for the differentiation. PMID:24100060

Efficacy of CT in diagnosis of transudates and exudates in patients with pleural effusion.

PubMed

Çullu, Neşat; Kalemci, Serdar; Karakaş, Ömer; Eser, İrfan; Yalçin, Funda; Boyacı, Fatıma Nurefşan; Karakaş, Ekrem

2014-01-01

We aimed to evaluate the efficacy of multidetector computed tomography (CT) imaging in diagnosis of pleural exudates and transudates using attenuation values. This retrospective study included 106 patients who were diagnosed with pleural effusion between January 2010 and June 2012. After the patients underwent chest CT, thoracentesis was performed in the first week. The attenuation values of the pleural effusions were measured in all patients. According to Light's criteria, 30 of 106 patients with pleural effusions had transudates, and the remaining patients had exudates. The Hounsfield unit (HU) value of the exudates (median, 12.5; range, 4-33) was significantly higher than that of the transudates (median, 5; range, 2-15) (P = 0.001). Additionally, when evaluated by disease subgroups, congestive heart failure and empyema were predictable in terms of median HU values of the pleural effusions with high and moderate sensitivity and specificity values (84.6% and 81.2%, respectively; 76.9% and 66.7%, respectively). Compared with other patients, the empyema patients had significantly more loculation and pleural thickening. CT attenuation values may be useful in differentiating exudates from transudates. Although there is an overlap in most effusions, exudate can be considered when the CT attenuation values are >15 HU. Because of overlapping HU values, close correlation with clinical findings is essential. Additional signs, such as fluid loculation and pleural thickness, should be considered and may provide further information for the differentiation.

A retrospective comparison of smart prep and test bolus multi-detector CT pulmonary angiography protocols

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

Suckling, Tara; Smith, Tony; Reed, Warren

2013-06-15

Optimal arterial opacification is crucial in imaging the pulmonary arteries using computed tomography (CT). This poses the challenge of precisely timing data acquisition to coincide with the transit of the contrast bolus through the pulmonary vasculature. The aim of this quality assurance exercise was to investigate if a change in CT pulmonary angiography (CTPA) scanning protocol resulted in improved opacification of the pulmonary arteries. Comparison was made between the smart prep protocol (SPP) and the test bolus protocol (TBP) for opacification in the pulmonary trunk. A total of 160 CTPA examinations (80 using each protocol) performed between January 2010 andmore » February 2011 were assessed retrospectively. CT attenuation coefficients were measured in Hounsfield Units (HU) using regions of interest at the level of the pulmonary trunk. The average pixel value, standard deviation (SD), maximum, and minimum were recorded. For each of these variables a mean value was then calculated and compared for these two CTPA protocols. Minimum opacification of 200 HU was achieved in 98% of the TBP sample but only 90% of the SPP sample. The average CT attenuation over the pulmonary trunk for the SPP was 329 (SD = ±21) HU, whereas for the TBP it was 396 (SD = ±22) HU (P = 0.0017). The TBP also recorded higher maximum (P = 0.0024) and minimum (P = 0.0039) levels of opacification. This study has found that a TBP resulted in significantly better opacification of the pulmonary trunk than the SPP.« less

Assessment of chest CT at CTDIvol less than 1 mGy with iterative reconstruction techniques.

PubMed

Padole, Atul; Digumarthy, Subba; Flores, Efren; Madan, Rachna; Mishra, Shelly; Sharma, Amita; Kalra, Mannudeep K

2017-03-01

To assess the image quality of chest CT reconstructed with image-based iterative reconstruction (SafeCT; MedicVision ® , Tirat Carmel, Israel), adaptive statistical iterative reconstruction (ASIR; GE Healthcare, Waukesha, WI) and model-based iterative reconstruction (MBIR; GE Healthcare, Waukesha, WI) techniques at CT dose index volume (CTDI vol ) <1 mGy. In an institutional review board-approved study, 25 patients gave written informed consent for acquisition of three reduced dose (0.25-, 0.4- and 0.8-mGy) chest CT after standard of care CT (8 mGy) on a 64-channel multidetector CT (MDCT) and reconstructed with SafeCT, ASIR and MBIR. Two board-certified thoracic radiologists evaluated images from the lowest to the highest dose of the reduced dose CT series and subsequently for standard of care CT. Out of the 182 detected lesions, the missed lesions were 35 at 0.25, 24 at 0.4 and 9 at 0.8 mGy with SafeCT, ASIR and MBIR, respectively. The most missed lesions were non-calcified lung nodules (NCLNs) 25/112 (<5 mm) at 0.25, 18/112 (<5 mm) at 0.4 and 3/112 (<4 mm) at 0.8 mGy. There were 78%, 84% and 97% lung nodules detected at 0.25, 0.4 and 0.8 mGy, respectively regardless of iterative reconstruction techniques (IRTs), Most mediastinum structures were not sufficiently seen at 0.25-0.8 mGy. NCLNs can be missed in chest CT at CTDI vol of <1 mGy (0.25, 0.4 and 0.8 mGy) regardless of IRTs. The most lung nodules (97%) were detected at CTDI vol of 0.8 mGy. The most mediastinum structures were not sufficiently seen at 0.25-0.8 mGy. Advances in knowledge: NCLNs can be missed regardless of IRTs in chest CT at CTDI vol of <1 mGy. The performance of ASIR, SafeCT and MBIR was similar for lung nodule detection at 0.25, 0.4 and 0.8 mGy.

Inter-algorithm lesion volumetry comparison of real and 3D simulated lung lesions in CT

NASA Astrophysics Data System (ADS)

Robins, Marthony; Solomon, Justin; Hoye, Jocelyn; Smith, Taylor; Ebner, Lukas; Samei, Ehsan

2017-03-01

The purpose of this study was to establish volumetric exchangeability between real and computational lung lesions in CT. We compared the overall relative volume estimation performance of segmentation tools when used to measure real lesions in actual patient CT images and computational lesions virtually inserted into the same patient images (i.e., hybrid datasets). Pathologically confirmed malignancies from 30 thoracic patient cases from Reference Image Database to Evaluate Therapy Response (RIDER) were modeled and used as the basis for the comparison. Lesions included isolated nodules as well as those attached to the pleura or other lung structures. Patient images were acquired using a 16 detector row or 64 detector row CT scanner (Lightspeed 16 or VCT; GE Healthcare). Scans were acquired using standard chest protocols during a single breath-hold. Virtual 3D lesion models based on real lesions were developed in Duke Lesion Tool (Duke University), and inserted using a validated image-domain insertion program. Nodule volumes were estimated using multiple commercial segmentation tools (iNtuition, TeraRecon, Inc., Syngo.via, Siemens Healthcare, and IntelliSpace, Philips Healthcare). Consensus based volume comparison showed consistent trends in volume measurement between real and virtual lesions across all software. The average percent bias (+/- standard error) shows -9.2+/-3.2% for real lesions versus -6.7+/-1.2% for virtual lesions with tool A, 3.9+/-2.5% and 5.0+/-0.9% for tool B, and 5.3+/-2.3% and 1.8+/-0.8% for tool C, respectively. Virtual lesion volumes were statistically similar to those of real lesions (< 4% difference) with p >.05 in most cases. Results suggest that hybrid datasets had similar inter-algorithm variability compared to real datasets.

Novel imaging detailing the origins of a pneumothorax.

PubMed

Nakanishi, Kozo; Goto, Hidenori; Ito, Tomokazu; Nagata, Yasuhito; Hayashi, Shinichi; Ishihara, Toshihiro

2018-01-01

This is a prospective clinical study aimed at introducing a method to visualise the location of an air leak and to identify the bulla responsible on three-dimensional (3-D) cine CT. In 10 patients with spontaneous pneumothorax, dynamic 320-detector row CT was performed with injection of 0.9% saline into the affected pleural cavity via a preplaced chest tube. In eight cases, 3-D cine CT thoracography revealed the location of the air leak and the bulla responsible (7 cases: air stream sign; 1 case: repeated collapse and expansion of a bulla with the patient's breathing). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Comparison of standard- and low-tube voltage 320-detector row volume CT angiography in detection of intracranial aneurysms with digital subtraction angiography as gold standard.

PubMed

Sun, Gang; Ding, Juan; Lu, Yang; Li, Min; Li, Li; Li, Guo-ying; Zhang, Xu-ping

2012-03-01

The aim of this study was to prospectively assess the effect of low-tube voltage (80 kVp) 320-detector row volume computed tomographic (CT) angiography (L-VCTA) in the detection of intracranial aneurysms, with three-dimensional (3D) spin digital subtraction angiography (DSA) as the gold standard. Forty-eight patients with clinically suspected subarachnoid hemorrhages were divided into two groups. One group underwent L-VCTA and DSA, while the other group underwent conventional-tube voltage (120 kVp) volume CT angiography (C-VCTA) and DSA. Vascular enhancement, image quality, detection accuracy of aneurysms, and radiation dose were compared between the two groups. For objective image quality, the L-VCTA group had higher mean vessel attenuation, correlated with higher image noise and lower signal-to-noise ratio, than the C-VCTA group. For subjective image quality, there were no significant differences between the two groups regarding scores for arterial enhancement, depiction of small arterial detail, interference of venous structures, and overall image quality scores. The mean effective dose for the L-VCTA group was significantly lower than for the C-VCTA group (0.56 ± 0.25 vs 1.84 ± 0.002 mSv), with a reduction of radiation dose of 69.73%. With 3D DSA as the reference standard, the sensitivity, specificity, and accuracy in the L-VCTA and C-VCTA groups were 94.12%, 100%, 94.4% and 100%, 100%, and 100%, respectively. In both groups, there were significant correlations for maximum aneurysm diameter measurements between volume CT angiography and 3D DSA; no statistical difference in the mean maximum diameter of each aneurysm was measured between volume CT angiography and 3D DSA. L-VCTA is helpful in detecting intracranial aneurysms, with results similar to those of 3D DSA, but at a lower radiation dose than C-VCTA. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Risk factors of postoperative pancreatic fistula after distal pancreatectomy using a triple-row stapler.

PubMed

Kawaida, Hiromichi; Kono, Hiroshi; Watanabe, Mitsuaki; Hosomura, Naohiro; Amemiya, Hidetake; Fujii, Hideki

2018-01-01

Postoperative pancreatic fistula (POPF) is one of the major complications in patients who undergo distal pancreatectomy (DP). Recently, dividing the pancreas by stapler is a commonly performed technique, however, POPF still occurs. Therefore, the purpose of this study was to investigate the risk factors for POPF after DP using a triple-row stapler. A total of 75 patients underwent DP using a triple-row stapler (Endo GIA™ Reloads with Tri-Staple™ Technology 60 mm; COVIDIEN, North Haven, CT, USA) at Yamanashi University from December 2012 to December 2016. The clinical risk factors for POPF after DP using a triple-row stapler were identified based on univariate and multivariate analyses. Clinical POPF (ISGPF Grade B and C) was seen in 7 of 75 patients (9.3%). The body mass index (BMI) was significantly higher in the patients with POPF (26.8 ± 0.5 kg/m 2 ) compared with the patients without POPF (21.4 ± 0.4 kg/m 2 ; a cut-off value; 25.7 kg/m 2 ). In addition, the patients with POPF were significantly younger than the patients without POPF (56.4 ± 5.6 vs 67.0 ± 1.5; a cut-off value was 57.0 years old). BMI and age were found to be significant risk factors for POPF after DP using a triple-row stapler.

Periportal low attenuation associated with liver metastasis from colorectal cancer: evaluation using multi-detector-row CT with pathological correlation.

PubMed

Takaji, Ryo; Matsumoto, Shunro; Kiyonaga, Maki; Yamada, Yasunari; Mori, Hiromu; Iwashita, Yukio; Ohta, Masayuki; Inomata, Masafumi; Hijiya, Naoki; Moriyama, Masatsugu; Takaki, Hajime; Fukuzawa, Kengo; Yonemasu, Hirotoshi

2017-01-01

Periportal low attenuation (PPLA) associated with metastatic liver cancer is occasionally seen on multi-detector-row CT (MDCT). The purpose of this study was to investigate the MDCT patterns of the PPLA and to correlate it with pathological findings. We retrospectively reviewed the MDCT images of 63 patients with metastatic liver cancers from colorectal adenocarcinoma. On MDCT scans, PPLA associated with liver metastasis was visualized in six patients with colorectal cancer. In these six patients who had undergone surgical resection, the radiologic-pathologic correlation was analyzed. All patients underwent a single contrast-enhanced MDCT within 1 month before surgical resection. The six liver cancers were pathologically proven to be moderately differentiated adenocarcinoma. We assessed the PPLA on MDCT concerning the distribution patterns and contrast enhancement with pathological correlation. In five of the patients, the PPLA extended to the hilar side from metastatic liver cancer. Pathologically, there was no cancer invasion into the intra-hepatic periportal area; however, massive lymphedema and fibrosis occurred in all six cases. PPLA on the hilar and peripheral sides of hepatic metastasis from colorectal cancer may be present suggesting lymphedema and fibrosis of portal tracts not always indicating cancer infiltration.

Overland flow connectivity in olive orchard plots with cover crops and conventional tillage, and under different rainfall scenarios

NASA Astrophysics Data System (ADS)

López-Vicente, Manuel; García-Ruiz, Roberto; Guzmán, Gema; Vicente-Vicente, José Luis; Gómez, José Alfonso

2016-04-01

The study of overland flow connectivity (QC) allows understanding the redistribution dynamics of runoff and soil components as an emergent property of the spatio-temporal interactions of hydrological and geomorphic processes. However, very few studies have dealt with runoff connectivity in olive orchards. In this study we simulated QC in four olive orchard plots, located on the Santa Marta farm (37° 20' 33.6" N, 6° 13' 44" W), in Seville province (Andalusia) in SW Spain. The olive plantation was established in 1985 with trees planted at 8 m x 6 m. Each bounded plot is 8 m wide (between 2 tree lines) and 60 m long (total area of 480 m2), laid out with the longest dimension parallel to the maximum slope and to the tree lines. The slope is uniform, with an average steepness of 11%. Two plots (P2 and P4) were devoted to conventional tillage (CT) consisting of regular chisel plow passes depending on weed growth. Another set of two plots had two types of cover crops (CC) in the inter tree rows (the area outside the vertical olive canopy projection): uniform CC of Lolium multiflorum (P3) and a mixture of L. rigidum and L. multiflorum together with other species (P5). The tree rows were treated with herbicide to keep bare soil. We selected the Index of runoff and sediment Connectivity (IC) of Borselli et al. (2008) to simulate three rainfall scenarios: i) low rainfall intensity (Sc-LowInt) and using the MD flow accumulation algorithm; ii) moderate rainfall intensity (Sc-ModInt) and using MD8; and iii) high rainfall intensity (Sc-HighInt) and using D8. After analysing the values of rainfall intensity during two hydrological years (Oct'09-Sep'10 and Oct'10-Sep'11) we associated the three scenarios with the followings months: Sc-LowInt during the period Jan-Mar, that summarizes 42% of all annual rainfall events; Sc-ModInt during Oct-Nov and Apr-May (32% of all events); and Sc-HighInt during the period Jun-Sep and in December (26% of all events). Instead of using the C-RUSLE factor as it is indicated in the original version of the IC model, we chosen the product between the C (cover-management) and P (support-practices) factors. Previous studies in olive orchards (Gómez et al., 2003) demonstrated that this product is advisable in soil erosion studies. We distinguished four areas within the plots: inter-row-CC, inter-row-CT, olive trees and bare soil under the tree line. Values of the C-RUSLE factor were obtained from previous studies (e.g. Moreira-Madueño, 1991 in Andalusia; Panagos et al., 2015 in Europe). The minimum, mean and maximum values of connectivity in the two plots with CC were lower (-8% on average) than the corresponding values in the two plots under CT. This trend remained by using any of the three algorithms. CC efficiently reduced overland flow connectivity. Areas with low connectivity (deposition-prone areas) appeared more frequently in inter-row-CC in comparison with CT. The assessment of the C-RUSLE factor for each month according to the phenology of the CC and the sowing practices will be explored in further research.

Association of aortic wall thickness on contrast-enhanced chest CT with major cerebro-cardiac events.

PubMed

Tresoldi, Silvia; Di Leo, Giovanni; Zoffoli, Elena; Munari, Alice; Primolevo, Alessandra; Cornalba, Gianpaolo; Sardanelli, Francesco

2014-11-01

There is a significant association between aortic atherosclerosis and previous major cardiovascular events. Particularly, thoracic aortic atherosclerosis is closely related to the degree of coronary and carotid artery disease. Thus, there is a rationale for screening the thoracic aorta in patients who undergo a chest computed tomography (CT) for any clinical question, in order to detect patients at increased risk of cerebro-cardiovascular (CCV) events. To estimate the association between either thoracic aortic wall thickness (AWT) or aortic total calcium score (ATCS) and CCV events. One hundred and forty-eight non-cardiac patients (78 men; 67 ± 12 years) underwent chest contrast-enhanced multidetector CT (MDCT). The AWT was measured at the level of the left atrium (AWTref) and at the maximum AWT (AWTmax). Correlation with clinical CCV patients' history was estimated. The value of AWTmax and of a semi-quantitative ATCS as a marker for CCV events was assessed using receiver-operating characteristic curve (ROC) analysis and multivariate regression analysis. Out of 148 patients, 59% reported sedentary lifestyle, 44% hypertension, 32% smoking, 23% hypercholesterolemia, 13% family history of cardiac disease, 12% diabetes, and 10% BMI ≥ 30 kg/m(2); 9% reported myocardial infarction, 8% aortic aneurism, 8% myocardial revascularization, and 2% ischemic stroke. Twenty-six percent of patients had a medium-to-high ATCS. Both AWTmax and AWTref correlated with hypertension and age (P < 0.002). At the ROC analysis, a 4.8 mm threshold was associated to a 90% specificity and an odds ratio of 6.3 (AUC = 0.735). Assuming as threshold the AWTmax median value (4.3 mm) of patients who suffered from at least one CCV event in their history, a negative predictive value of 90%, a RR of 3.6 and an OR of 6.3 were found. At the multivariate regression analysis, AWTmax was the only independent variable associated to the frequency of CCV events. Patients with increased thoracic AWTmax on chest MDCT could be considered at risk for CCV disease. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment.

PubMed

Faure, Marguerite E; Swart, Laurens E; Dijkshoorn, Marcel L; Bekkers, Jos A; van Straten, Marcel; Nieman, Koen; Parizel, Paul M; Krestin, Gabriel P; Budde, Ricardo P J

2018-05-01

Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP). We analysed 43 CT examinations. Mean image quality score was 4.1±1.4, 4.7±0.5 and 4.2±0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3±0.7. Mean image quality for leaflet motion was 3.9±1.4. Mean DLP was 28.2±17.1, 457.3±168.6 and 68.5±47.2 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569±208 mGy.cm and mean total radiation dose was 8.3±3.0 mSv (n=43). Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose. • Prosthetic heart valve dysfunction is a potentially life-threatening condition. • Dual-source CT can adequately assess valve leaflet motion and anatomy. • We assessed a comprehensive protocol with three acquisitions for PHV evaluation. • This protocol is associated with good image quality and limited dose.

Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures.

PubMed

Nosewicz, Tomasz L; Beerekamp, M Suzan H; De Muinck Keizer, Robert-Jan O; Schepers, Tim; Maas, Mario; Niek van Dijk, C; Goslings, J Carel

2016-08-01

Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level IV, observational study. © The Author(s) 2016.

Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb.

PubMed

Dudley-Javoroski, S; Petrie, M A; McHenry, C L; Amelon, R E; Saha, P K; Shields, R K

2016-03-01

This study examined the effect of a controlled dose of vibration upon bone density and architecture in people with spinal cord injury (who eventually develop severe osteoporosis). Very sensitive computed tomography (CT) imaging revealed no effect of vibration after 12 months, but other doses of vibration may still be useful to test. The purposes of this report were to determine the effect of a controlled dose of vibratory mechanical input upon individual trabecular bone regions in people with chronic spinal cord injury (SCI) and to examine the longitudinal bone architecture changes in both the acute and chronic state of SCI. Participants with SCI received unilateral vibration of the constrained lower limb segment while sitting in a wheelchair (0.6g, 30 Hz, 20 min, three times weekly). The opposite limb served as a control. Bone mineral density (BMD) and trabecular micro-architecture were measured with high-resolution multi-detector CT. For comparison, one participant was studied from the acute (0.14 year) to the chronic state (2.7 years). Twelve months of vibration training did not yield adaptations of BMD or trabecular micro-architecture for the distal tibia or the distal femur. BMD and trabecular network length continued to decline at several distal femur sub-regions, contrary to previous reports suggesting a "steady state" of bone in chronic SCI. In the participant followed from acute to chronic SCI, BMD and architecture decline varied systematically across different anatomical segments of the tibia and femur. This study supports that vibration training, using this study's dose parameters, is not an effective anti-osteoporosis intervention for people with chronic SCI. Using a high-spatial-resolution CT methodology and segmental analysis, we illustrate novel longitudinal changes in bone that occur after spinal cord injury.

The Relationship Between Pulmonary Emphysema and Kidney Function in Smokers

PubMed Central

Chandra, Divay; Stamm, Jason A.; Palevsky, Paul M.; Leader, Joseph K.; Fuhrman, Carl R.; Zhang, Yingze; Bon, Jessica; Duncan, Steven R.; Branch, Robert A.; Weissfeld, Joel; Gur, David; Gladwin, Mark T.

2012-01-01

Background: It has been reported that the prevalence of kidney dysfunction may be increased in patients exposed to tobacco with airflow obstruction. We hypothesized that kidney dysfunction would associate with emphysema rather than with airflow obstruction measured by the FEV1. Methods: Five hundred eight current and former smokers completed a chest CT scan, pulmonary function tests, medical questionnaires, and measurement of serum creatinine. Glomerular filtration rates (eGFRs) were estimated using the method of the Chronic Kidney Disease Epidemiology Collaboration. Quantitative determinants of emphysema and airway dimension were measured from multidetector chest CT scans. Results: The mean age was 66 ± 7 years, and mean eGFR was 101 ± 22 mL/min/1.73 m2. Univariate and multivariate analysis showed a significant association between radiographically measured emphysema and eGFR: Participants with 10% more emphysema had an eGFR that was lower by 4.4 mL/min/1.73 m2 (P = .01), independent of airflow obstruction (FEV1), age, sex, race, height, BMI, diabetes mellitus, hypertension, coronary artery disease, patient-reported dyspnea, pack-years of smoking, and current smoking. There was no association between eGFR and either FEV1 or quantitative CT scan measures of airway dimension. Conclusions: More severe emphysema, rather than airflow obstruction, is associated with kidney dysfunction in tobacco smokers, independent of common risk factors for kidney disease. This finding adds to recent observations of associations between emphysema and comorbidities of COPD, including osteoporosis and lung cancer, which are independent of the traditional measure of reduced FEV1. The mechanisms and clinical implications of kidney dysfunction in patients with emphysema need further investigation. PMID:22459775

Surface ECG and Fluoroscopy are Not Predictive of Right Ventricular Septal Lead Position Compared to Cardiac CT.

PubMed

Rowe, Matthew K; Moore, Peter; Pratap, Jit; Coucher, John; Gould, Paul A; Kaye, Gerald C

2017-05-01

Controversy exists regarding the optimal lead position for chronic right ventricular (RV) pacing. Placing a lead at the RV septum relies upon fluoroscopy assisted by a surface 12-lead electrocardiogram (ECG). We compared the postimplant lead position determined by ECG-gated multidetector contrast-enhanced computed tomography (MDCT) with the position derived from the surface 12-lead ECG. Eighteen patients with permanent RV leads were prospectively enrolled. Leads were placed in the RV septum (RVS) in 10 and the RV apex (RVA) in eight using fluoroscopy with anteroposterior and left anterior oblique 30° views. All patients underwent MDCT imaging and paced ECG analysis. ECG criteria were: QRS duration; QRS axis; positive or negative net QRS amplitude in leads I, aVL, V1, and V6; presence of notching in the inferior leads; and transition point in precordial leads at or after V4. Of the 10 leads implanted in the RVS, computed tomography (CT) imaging revealed seven to be at the anterior RV wall, two at the anteroseptal junction, and one in the true septum. For the eight RVA leads, four were anterior, two septal, and two anteroseptal. All leads implanted in the RVS met at least one ECG criteria (median 3, range 1-6). However, no criteria were specific for septal position as judged by MDCT. Mean QRS duration was 160 ± 24 ms in the RVS group compared with 168 ± 14 ms for RVA pacing (P = 0.38). We conclude that the surface ECG is not sufficiently accurate to determine RV septal lead tip position compared to cardiac CT. © 2017 Wiley Periodicals, Inc.

Toward assessing the diagnostic influence of dose reduction in pediatric CT: a study based on simulated lung nodules

NASA Astrophysics Data System (ADS)

Li, Xiang; Samei, Ehsan; DeLong, David M.; Jones, Robert P.; Colsher, James G.; Frush, Donald P.

2008-03-01

The purpose of this study is to evaluate the effect of reduced tube current, as a surrogate for radiation dose, on lung nodule detection in pediatric chest multi-detector CT (MDCT). Normal chest MDCT images of 13 patients aged 1 to 7 years old were used as templates for this study. The original tube currents were between 70 mA and 180 mA. Using proprietary noise addition software, noise was added to the images to create 13 cases at the lowest common mA (i.e. 70 mA), 13 cases at 35 mA (50% reduction), and 13 cases at 17.5 mA (75% reduction). Three copies of each case were made for a total of 117 series for simulated nodule insertion. A technique for three-dimensional simulation of small lung nodules was developed, validated through an observer study, and used to add nodules to the series. Care was taken to ensure that each of three lung zones (upper, middle, lower) contained 0 or 1 nodule. The series were randomized and the presence of a nodule in each lung zone was rated independently and blindly by three pediatric radiologists on a continuous scale between 0 (definitely absent) and 100 (definitely present). Receiver operating characteristic analysis of the data showed no general significant difference in diagnostic accuracy between the reduced mA values and 70 mA, suggesting a potential for dose reduction with preserved diagnostic quality. To our knowledge, this study is the first controlled, systematic, and task-specific assessment of the influence of dose reduction in pediatric chest CT.

[The role of multidetector computer tomography in diagnosis of acute pancreatitis].

PubMed

Lohanikhina, K Iu; Hordiienko, K P; Kozarenko, T M

2014-10-01

With the objective to improve the diagnostic semiotics of an acute pancreatitis (AP) 35 patients were examined, using 64-cut computeric tomograph Lightspeed VCT (GE, USA) with intravenous augmentation in arterial and portal phases. Basing on analysis of the investigations conducted, using multidetector computeric tomography (MDCT), the AP semiotics was systematized, which is characteristic for oedematous and destructive forms, diagnosed in 19 (44.2%) and 16 (45.8%) patients, accordingly. The procedure for estimation of preservation of the organ functional capacity in pancreonecrosis pres- ence was elaborated, promoting rising of the method diagnostic efficacy by 5.3 - 9.4%.

Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it.

PubMed

Paulus, Elena M; Fabian, Timothy C; Savage, Stephanie A; Zarzaur, Ben L; Botta, Vandana; Dutton, Wesley; Croce, Martin A

2014-02-01

Aggressive screening to diagnose blunt cerebrovascular injury (BCVI) results in early treatment, leading to improved outcomes and reduced stroke rates. While computed tomographic angiography (CTA) has been widely adopted for BCVI screening, evidence of its diagnostic sensitivity is marginal. Previous work from our institution using 32-channel multidetector CTA in 684 patients demonstrated an inadequate sensitivity of 51% (Ann Surg. 2011,253: 444-450). Digital subtraction angiography (DSA) continues to be the reference standard of diagnosis but has significant drawbacks of invasiveness and resource demands. There have been continued advances in CT technology, and this is the first report of an extensive experience with 64-channel multidetector CTA. Patients screened for BCVI using CTA and DSA (reference) at a Level 1 trauma center during the 12-month period ending in May 2012 were identified. Results of CTA and DSA, complications, and strokes were retrospectively reviewed and compared. A total of 594 patients met criteria for BCVI screening and underwent both CTA and DSA. One hundred twenty-eight patients (22% of those screened) had 163 injured vessels: 99 (61%) carotid artery injuries and 64 (39%) vertebral artery injuries. Sixty-four-channel CTA demonstrated an overall sensitivity per vessel of 68% and specificity of 92%. The 52 false-negative findings on CTA were composed of 34 carotid artery injuries and 18 vertebral artery injuries; 32 (62%) were Grade I injuries. Overall, positive predictive value was 36.2%, and negative predictive value was 97.5%. Six procedure-related complications (1%) occurred with DSA, including two iatrogenic dissections and one stroke. Sixty-four-channel CTA demonstrated a significantly improved sensitivity of 68% versus the 51% previously reported for the 32-channel CTA (p = 0.0075). Sixty-two percent of the false-negative findings occurred with low-grade injuries. Considering complications, cost, and resource demand associated with DSA, this study suggests that 64-channel CTA may replace DSA as the primary screening tool for BCVI. Diagnostic study, level III.

Submillisievert median radiation dose for coronary angiography with a second-generation 320-detector row CT scanner in 107 consecutive patients.

PubMed

Chen, Marcus Y; Shanbhag, Sujata M; Arai, Andrew E

2013-04-01

To (a) use a new second-generation wide-volume 320-detector row computed tomographic (CT) scanner to explore optimization of radiation exposure in coronary CT angiography in an unselected and consecutive cohort of patients referred for clinical purposes and (b) compare estimated radiation exposure and image quality with that from a cohort of similar patients who underwent imaging with a previous first-generation CT system. The study was approved by the institutional review board, and all subjects provided written consent. Coronary CT angiography was performed in 107 consecutive patients with a new second-generation 320-detector row unit. Estimated radiation exposure and image quality were compared with those from 100 consecutive patients who underwent imaging with a previous first-generation scanner. Effective radiation dose was estimated by multiplying the dose-length product by an effective dose conversion factor of 0.014 mSv/mGy ⋅ cm and reported with size-specific dose estimates (SSDEs). Image quality was evaluated by two independent readers. The mean age of the 107 patients was 55.4 years ± 12.0 (standard deviation); 57 patients (53.3%) were men. The median body mass index was 27.3 kg/m(2) (range, 18.1-47.2 kg/m(2)); however, 71 patients (66.4%) were overweight, obese, or morbidly obese. A tube potential of 100 kV was used in 97 patients (90.6%), single-volume acquisition was used in 104 (97.2%), and prospective electrocardiographic gating was used in 106 (99.1%). The mean heart rate was 57.1 beats per minute ± 11.2 (range, 34-96 beats per minute), which enabled single-heartbeat scans in 100 patients (93.4%). The median radiation dose was 0.93 mSv (interquartile range [IQR], 0.58-1.74 mSv) with the second-generation unit and 2.67 mSv (IQR, 1.68-4.00 mSv) with the first-generation unit (P < .0001). The median SSDE was 6.0 mGy (IQR, 4.1-10.0 mGy) with the second-generation unit and 13.2 mGy (IQR, 10.2-18.6 mGy) with the first-generation unit (P < .0001). Overall, the radiation dose was less than 0.5 mSv for 23 of the 107 CT angiography examinations (21.5%), less than 1 mSv for 58 (54.2%), and less than 4 mSv for 103 (96.3%). All studies were of diagnostic quality, with most having excellent image quality. Three of four image quality indexes were significantly better with the second-generation unit compared with the first-generation unit. The combination of a gantry rotation time of 275 msec, wide volume coverage, iterative reconstruction, automated exposure control, and larger x-ray power generator of the second-generation CT scanner provides excellent image quality over a wide range of body sizes and heart rates at low radiation doses. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13122621/-/DC1. RSNA, 2013

The vascularized groin lymph node flap (VGLN): Anatomical study and flap planning using multi-detector CT scanner. The golden triangle for flap harvesting.

PubMed

Zeltzer, Assaf A; Anzarut, Alexander; Braeckmans, Delphine; Seidenstuecker, Katrin; Hendrickx, Benoit; Van Hedent, Eddy; Hamdi, Moustapha

2017-09-01

A growing number of surgeons perform lymph node transfers for the treatment of lymphedema. When harvesting a vascularized lymph node groin flap (VGLNF) one of the major concerns is the potential risk of iatrogenic lymphedema of the donor-site. This article helps understanding of the lymph node distribution of the groin in order to minimize this risk. Fifty consecutive patients undergoing abdominal mapping by multi-detector CT scanner were included and 100 groins analyzed. The groin was divided in three zones (of which zone II is the safe zone) and lymph nodes were counted and mapped with their distances to anatomic landmarks. Further node units were plotted and counted. The average age was 48 years. A mean number of nodes of 6.5/groin was found. In zone II, which is our zone of interest a mean of 3.1 nodes were counted with a mean size of 7.8 mm. In three patients no nodes were found in zone II. In five patients nodes were seen in zone II but were not sufficient in size or number to be considered a lymph node unit. On average the lymph node unit in zone II was found to be 48.3 mm from the pubic tubercle when projected on a line from the pubic tubercle to the anterior superior iliac spine, 16.0 mm caudal to this line, and 20.4 mm above the groin crease. On average the lymph node unit was a mean of 41.7 mm lateral to the SCIV-SIEV confluence. This study provides increased understanding of the lymphatic anatomy in zone II of the groin flap and suggests a refined technique for designing the VGLNF. As with any flap there is a degree of individual patient variability. However, having information on the most common anatomy and flap design is of great value. © 2017 Wiley Periodicals, Inc.

SU-F-207-01: Comparison of Beam Characteristics and Organ Dose From Four Commercial Multidetector Computed Tomography Scanners

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

Ohno, T; Araki, F

2015-06-15

Purpose: To compare dosimetric properties and patient organ doses from four commercial multidetector CT (MDCT) using Monte Carlo (MC) simulation based on the absorbed dose measured using a Farmer chamber and cylindrical water phantoms according to AAPM TG-111. Methods: Four commercial MDCT were modeled using the GMctdospp (IMPS, Germany) based on the EGSnrc user code. The incident photon spectrum and bowtie filter for MC simulations were determined so that calculated values of aluminum half-value layer (Al-HVL) and off-center ratio (OCR) profile in air agreed with measured values. The MC dose was calibrated from absorbed dose measurements using a Farmer chambermore » and cylindrical water phantoms. The dose distributions of head, chest, and abdominal scan were calculated using patient CT images and mean organ doses were evaluated from dose volume histograms. Results: The HVLs at 120 kVp of Brilliance, LightSpeed, Aquilion, and SOMATOM were 9.1, 7.5, 7.2, and 8.7 mm, respectively. The calculated Al-HVLs agreed with measurements within 0.3%. The calculated and measured OCR profiles agreed within 5%. For adult head scans, mean doses for eye lens from Brilliance, LightSpeed, Aquilion, and SOMATOM were 21.7, 38.5, 47.2 and 28.4 mGy, respectively. For chest scans, mean doses for lung from Brilliance, LightSpeed, Aquilion, and SOMATOM were 21.1, 26.1, 35.3 and 24.0 mGy, respectively. For adult abdominal scans, the mean doses for liver from Brilliance, LightSpeed, Aquilion, and SOMATOM were 16.5, 21.3, 22.7, and 18.0 mGy, respectively. The absorbed doses increased with decreasing Al-HVL. The organ doses from Aquilion were two greater than those from Brilliance in head scan. Conclusion: MC dose distributions based on absorbed dose measurement in cylindrical water phantom are useful to evaluate individual patient organ doses.« less

A method of estimating conceptus doses resulting from multidetector CT examinations during all stages of gestation

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

Damilakis, John; Tzedakis, Antonis; Perisinakis, Kostas

Purpose: Current methods for the estimation of conceptus dose from multidetector CT (MDCT) examinations performed on the mother provide dose data for typical protocols with a fixed scan length. However, modified low-dose imaging protocols are frequently used during pregnancy. The purpose of the current study was to develop a method for the estimation of conceptus dose from any MDCT examination of the trunk performed during all stages of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study to model the Siemens Sensation 16 and Sensation 64 MDCT scanners. Four mathematical phantoms were used, simulatingmore » women at 0, 3, 6, and 9 months of gestation. The contribution to the conceptus dose from single simulated scans was obtained at various positions across the phantoms. To investigate the effect of maternal body size and conceptus depth on conceptus dose, phantoms of different sizes were produced by adding layers of adipose tissue around the trunk of the mathematical phantoms. To verify MCNP results, conceptus dose measurements were carried out by means of three physical anthropomorphic phantoms, simulating pregnancy at 0, 3, and 6 months of gestation and thermoluminescence dosimetry (TLD) crystals. Results: The results consist of Monte Carlo-generated normalized conceptus dose coefficients for single scans across the four mathematical phantoms. These coefficients were defined as the conceptus dose contribution from a single scan divided by the CTDI free-in-air measured with identical scanning parameters. Data have been produced to take into account the effect of maternal body size and conceptus position variations on conceptus dose. Conceptus doses measured with TLD crystals showed a difference of up to 19% compared to those estimated by mathematical simulations. Conclusions: Estimation of conceptus doses from MDCT examinations of the trunk performed on pregnant patients during all stages of gestation can be made using the method developed in the current study.« less

The Detection of Focal Liver Lesions Using Abdominal CT: A Comparison of Image Quality Between Adaptive Statistical Iterative Reconstruction V and Adaptive Statistical Iterative Reconstruction.

PubMed

Lee, Sangyun; Kwon, Heejin; Cho, Jihan

2016-12-01

To investigate image quality characteristics of abdominal computed tomography (CT) scans reconstructed with adaptive statistical iterative reconstruction V (ASIR-V) vs currently using applied adaptive statistical iterative reconstruction (ASIR). This institutional review board-approved study included 35 consecutive patients who underwent CT of the abdomen. Among these 35 patients, 27 with focal liver lesions underwent abdomen CT with a 128-slice multidetector unit using the following parameters: fixed noise index of 30, 1.25 mm slice thickness, 120 kVp, and a gantry rotation time of 0.5 seconds. CT images were analyzed depending on the method of reconstruction: ASIR (30%, 50%, and 70%) vs ASIR-V (30%, 50%, and 70%). Three radiologists independently assessed randomized images in a blinded manner. Imaging sets were compared to focal lesion detection numbers, overall image quality, and objective noise with a paired sample t test. Interobserver agreement was assessed with the intraclass correlation coefficient. The detection of small focal liver lesions (<10 mm) was significantly higher when ASIR-V was used when compared to ASIR (P <0.001). Subjective image noise, artifact, and objective image noise in liver were generally significantly better for ASIR-V compared to ASIR, especially in 50% ASIR-V. Image sharpness and diagnostic acceptability were significantly worse in 70% ASIR-V compared to various levels of ASIR. Images analyzed using 50% ASIR-V were significantly better than three different series of ASIR or other ASIR-V conditions at providing diagnostically acceptable CT scans without compromising image quality and in the detection of focal liver lesions. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Radiation dose reduction with chest computed tomography using adaptive statistical iterative reconstruction technique: initial experience.

PubMed

Prakash, Priyanka; Kalra, Mannudeep K; Digumarthy, Subba R; Hsieh, Jiang; Pien, Homer; Singh, Sarabjeet; Gilman, Matthew D; Shepard, Jo-Anne O

2010-01-01

To assess radiation dose reduction and image quality for weight-based chest computed tomographic (CT) examination results reconstructed using adaptive statistical iterative reconstruction (ASIR) technique. With local ethical committee approval, weight-adjusted chest CT examinations were performed using ASIR in 98 patients and filtered backprojection (FBP) in 54 weight-matched patients on a 64-slice multidetector CT. Patients were categorized into 3 groups: 60 kg or less (n = 32), 61 to 90 kg (n = 77), and 91 kg or more (n = 43) for weight-based adjustment of noise indices for automatic exposure control (Auto mA; GE Healthcare, Waukesha, Wis). Remaining scan parameters were held constant at 0.984:1 pitch, 120 kilovolts (peak), 40-mm table feed per rotation, and 2.5-mm section thickness. Patients' weight, scanning parameters, and CT dose index volume were recorded. Effective doses (EDs) were estimated. Image noise was measured in the descending thoracic aorta at the level of the carina. Data were analyzed using analysis of variance. Compared with FBP, ASIR was associated with an overall mean (SD) decrease of 27.6% in ED (ASIR, 8.8 [2.3] mSv; FBP, 12.2 [2.1] mSv; P < 0.0001). With the use of ASIR, the ED values were 6.5 (1.8) mSv (28.8% decrease), 7.3 (1.6) mSv (27.3% decrease), and 12.8 (2.3) mSv (26.8% decrease) for the weight groups of 60 kg or less, 61 to 90 kg, and 91 kg or more, respectively, compared with 9.2 (2.3) mSv, 10.0 (2.0) mSv, and 17.4 (2.1) mSv with FBP (P < 0.0001). Despite dose reduction, there was less noise with ASIR (12.6 [2.9] mSv) than with FBP (16.6 [6.2] mSv; P < 0.0001). Adaptive statistical iterative reconstruction helps reduce chest CT radiation dose and improve image quality compared with the conventionally used FBP image reconstruction.

Pulmonary intersegmental planes: imaging appearance and possible reasons leading to their visualization.

PubMed

Zuo, Yi-Zhi; Liu, Chao; Liu, Shu-Wei

2013-04-01

To describe the normal imaging appearance of pulmonary intersegmental planes on thoracic computed tomographic (CT) scans and determine the possible reasons related to their visualization in terms of aging and anatomy. The study was approved by the internal ethics review board. Informed consent was obtained. A retrospective review was undertaken of 104 thoracic multidetector CT scans of an older group (>65 years) and younger group (<55 years). The number, location, and appearance rate of intersegmental planes were assessed. Group comparisons were made, and linear regression analysis was used to assess relationships between age and visualization of intersegmental planes. Thirty lung samples (10 × 10 × 10 mm(3)) from autopsy were scanned by using micro-CT. Thicknesses of intersegmental planes were measured. Significant differences of the thickness between visible and invisible intersegmental planes were assessed with the independent t test. In five fetal specimens (17-21 weeks in gestational age), 7.0-T magnetic resonance (MR) imaging was performed to determine the congenital difference of thickness of intersegmental planes. Within the right lung, appearance rates of visible intersegmental planes were 71.2% at S1-S3, 54.8% at S4-S5, and 70.2% at S7-S10. Within the left lung, appearance rates of visible intersegmental planes were 39.4% at S1+2 to S3, 64.4% at S4-S5, 18.3% at S7-S8, and 89.4% at S7-S10. Appearance rates of visible intersegmental planes on thoracic CT scans were not significantly different (P ≥ .38) between younger and older groups. Mean thicknesses of visible and invisible intersegmental planes were 681.3 μm ± 75.3 (standard deviation) and 221.7 μm ± 54.1, respectively. Visible intersegmental planes were significantly thicker than invisible intersegmental planes (P < .05). Visible intersegmental planes were also seen on fetal lung 7.0-T MR images. The thickness of pulmonary intersegmental planes and variation of intersegmental veins were closely related to visualization of intersegmental planes on thoracic CT scans. Aging was excluded as the possible reason. RSNA, 2013

In vitro dose measurements in a human cadaver with abdomen/pelvis CT scans

PubMed Central

Zhang, Da; Padole, Atul; Li, Xinhua; Singh, Sarabjeet; Khawaja, Ranish Deedar Ali; Lira, Diego; Liu, Tianyu; Shi, Jim Q.; Otrakji, Alexi; Kalra, Mannudeep K.; Xu, X. George; Liu, Bob

2014-01-01

Purpose: To present a study of radiation dose measurements with a human cadaver scanned on a clinical CT scanner. Methods: Multiple point dose measurements were obtained with high-accuracy Thimble ionization chambers placed inside the stomach, liver, paravertebral gutter, ascending colon, left kidney, and urinary bladder of a human cadaver (183 cm in height and 67.5 kg in weight) whose abdomen/pelvis region was scanned repeatedly with a multidetector row CT. The flat energy response and precision of the dosimeters were verified, and the slight differences in each dosimeter's response were evaluated and corrected to attain high accuracy. In addition, skin doses were measured for radiosensitive organs outside the scanned region with OSL dosimeters: the right eye, thyroid, both nipples, and the right testicle. Three scan protocols were used, which shared most scan parameters but had different kVp and mA settings: 120-kVp automA, 120-kVp 300 mA, and 100-kVp 300 mA. For each protocol three repeated scans were performed. Results: The tube starting angle (TSA) was found to randomly vary around two major conditions, which caused large fluctuations in the repeated point dose measurements: for the 120-kVp 300 mA protocol this angle changed from approximately 110° to 290°, and caused 8% − 25% difference in the point dose measured at the stomach, liver, colon, and urinary bladder. When the fluctuations of the TSA were small (within 5°), the maximum coefficient of variance was approximately 3.3%. The soft tissue absorbed doses averaged from four locations near the center of the scanned region were 27.2 ± 3.3 and 16.5 ± 2.7 mGy for the 120 and 100-kVp fixed-mA scans, respectively. These values were consistent with the corresponding size specific dose estimates within 4%. The comparison of the per-100-mAs tissue doses from the three protocols revealed that: (1) dose levels at nonsuperficial locations in the TCM scans could not be accurately deduced by simply scaling the fix-mA doses with local mA values; (2) the general power law relationship between dose and kVp varied from location to location, with the power index ranged between 2.7 and 3.5. The averaged dose measurements at both nipples, which were about 0.6 cm outside the prescribed scan region, ranged from 23 to 27 mGy at the left nipple, and varied from 3 to 20 mGy at the right nipple over the three scan protocols. Large fluctuations over repeated scans were also observed, as a combined result of helical scans of large pitch (1.375) and small active areas of the skin dosimeters. In addition, the averaged skin dose fell off drastically with the distance to the nearest boundary of the scanned region. Conclusions: This study revealed the complexity of CT dose fluctuation and variation with a human cadaver. PMID:25186398

In vitro dose measurements in a human cadaver with abdomen/pelvis CT scans

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

Zhang, Da; Padole, Atul; Li, Xinhua

2014-09-15

Purpose: To present a study of radiation dose measurements with a human cadaver scanned on a clinical CT scanner. Methods: Multiple point dose measurements were obtained with high-accuracy Thimble ionization chambers placed inside the stomach, liver, paravertebral gutter, ascending colon, left kidney, and urinary bladder of a human cadaver (183 cm in height and 67.5 kg in weight) whose abdomen/pelvis region was scanned repeatedly with a multidetector row CT. The flat energy response and precision of the dosimeters were verified, and the slight differences in each dosimeter's response were evaluated and corrected to attain high accuracy. In addition, skin dosesmore » were measured for radiosensitive organs outside the scanned region with OSL dosimeters: the right eye, thyroid, both nipples, and the right testicle. Three scan protocols were used, which shared most scan parameters but had different kVp and mA settings: 120-kVp automA, 120-kVp 300 mA, and 100-kVp 300 mA. For each protocol three repeated scans were performed. Results: The tube starting angle (TSA) was found to randomly vary around two major conditions, which caused large fluctuations in the repeated point dose measurements: for the 120-kVp 300 mA protocol this angle changed from approximately 110° to 290°, and caused 8% − 25% difference in the point dose measured at the stomach, liver, colon, and urinary bladder. When the fluctuations of the TSA were small (within 5°), the maximum coefficient of variance was approximately 3.3%. The soft tissue absorbed doses averaged from four locations near the center of the scanned region were 27.2 ± 3.3 and 16.5 ± 2.7 mGy for the 120 and 100-kVp fixed-mA scans, respectively. These values were consistent with the corresponding size specific dose estimates within 4%. The comparison of the per-100-mAs tissue doses from the three protocols revealed that: (1) dose levels at nonsuperficial locations in the TCM scans could not be accurately deduced by simply scaling the fix-mA doses with local mA values; (2) the general power law relationship between dose and kVp varied from location to location, with the power index ranged between 2.7 and 3.5. The averaged dose measurements at both nipples, which were about 0.6 cm outside the prescribed scan region, ranged from 23 to 27 mGy at the left nipple, and varied from 3 to 20 mGy at the right nipple over the three scan protocols. Large fluctuations over repeated scans were also observed, as a combined result of helical scans of large pitch (1.375) and small active areas of the skin dosimeters. In addition, the averaged skin dose fell off drastically with the distance to the nearest boundary of the scanned region. Conclusions: This study revealed the complexity of CT dose fluctuation and variation with a human cadaver.« less

SU-F-207-03: Dosimetric Effect of the Position of Arms in Torso CT Scan with Tube Current Modulation

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

Liu, H; Rensselaer Polytechnic Institute, Troy, NY; Gao, Y

Purpose: To evaluate the patient organ dose differences between the arms-raised and arms-lowered postures in Torso multidetector computed tomography (MDCT) scan protocols with tube current modulation (TCM). Methods: Patient CT organ doses were simulated using the Monte Carlo method with human phantoms and a validated CT scanner model. A set of adult human phantoms with arms raised and arms lowered postures were developed using advanced BREP-based mesh surface geometries. Organ doses from routine Torso scan protocols such as chest, abdomen-pelvis, and CAP scans were simulated. The organ doses differences caused by two different posutres were investigated when tube current modulationmore » (TCM) were applied during the CT scan. Results: With TCM applied, organ doses of all the listed organs of arms-lowered posture phantom are larger than those of arms raised phantom. The dose difference for most of the organs or tissues are larger than 50%, and the skin doses difference for abdomen-pelvis scan even reaches 112.03%. This is due to the fact that the tube current for patient with arms-lowered is much higher than for the arms raised posture. Conclusion: Considering CT scan with TCM, which is commonly applied clinically, patients who could not raise their arms will receive higher radiation dose than the arms raised patient, with dose differences for some tissues such as the skin being larger than 100%. This is due to the additional tube current necessary to penetrate the arms while maintaining consistent image quality. National Nature Science Foundation of China(No.11475047)« less

Comparison of 0.625-mm source computed tomographic images versus 5-mm thick reconstructed images in the evaluation for renal calculi in at-risk patients.

PubMed

Berkenblit, Robert; Hoenig, David; Lerer, Daniel; Moses, Melanie; Minsky, Lloyd

2013-02-01

CT has become a well-established modality in the evaluation of urinary calculi. The advent of multidetector CT (MDCT) scanners and submillimeter thick slice acquisitions has yielded CT images with even greater resolution. MDCT scanners allow for source data slice acquisition with submillimeter slice thickness. These source images can then be reconstructed to thicker slices for more convenient interpretation of the CT scan. Previous authors have looked at the effect of slice thickness on detection of urinary calculi. We investigated whether the thin slice source images yielded detection of additional stones and the potential significance of detecting these additional stones. Ninety-five consecutive patients who were referred to our outpatient imaging center for CT, with a clinical history placing them at risk for urinary calculi, were included in the study. In 49 (52%) of the 95 patients, more calculi were visualized using the 0.625-mm thick images than with the 5-mm thick images. In 34 (69%) of these 49 patients, the additional findings were thought to be "clinically significant," while in the remaining 15 (31%) patients, the additional findings were not thought to be clinically significant. In 46 (48%) of the 95 patients, there were no additional urinary calculi identified on the 0.625-mm thick images compared with that observed on 5-mm thick images. The results from this study encourage reviewing the thin slice source images of MDCTs in patients at risk for urinary calculi, because important clinical decisions may hinge on the additional findings made on these images.

Accuracy in contouring of small and low contrast lesions: Comparison between diagnostic quality computed tomography scanner and computed tomography simulation scanner-A phantom study

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

Ho, Yick Wing, E-mail: mpr@hksh.com; Wong, Wing Kei Rebecca; Yu, Siu Ki

2012-01-01

To evaluate the accuracy in detection of small and low-contrast regions using a high-definition diagnostic computed tomography (CT) scanner compared with a radiotherapy CT simulation scanner. A custom-made phantom with cylindrical holes of diameters ranging from 2-9 mm was filled with 9 different concentrations of contrast solution. The phantom was scanned using a 16-slice multidetector CT simulation scanner (LightSpeed RT16, General Electric Healthcare, Milwaukee, WI) and a 64-slice high-definition diagnostic CT scanner (Discovery CT750 HD, General Electric Healthcare). The low-contrast regions of interest (ROIs) were delineated automatically upon their full width at half maximum of the CT number profile inmore » Hounsfield units on a treatment planning workstation. Two conformal indexes, CI{sub in}, and CI{sub out}, were calculated to represent the percentage errors of underestimation and overestimation in the automated contours compared with their actual sizes. Summarizing the conformal indexes of different sizes and contrast concentration, the means of CI{sub in} and CI{sub out} for the CT simulation scanner were 33.7% and 60.9%, respectively, and 10.5% and 41.5% were found for the diagnostic CT scanner. The mean differences between the 2 scanners' CI{sub in} and CI{sub out} were shown to be significant with p < 0.001. A descending trend of the index values was observed as the ROI size increases for both scanners, which indicates an improved accuracy when the ROI size increases, whereas no observable trend was found in the contouring accuracy with respect to the contrast levels in this study. Images acquired by the diagnostic CT scanner allow higher accuracy on size estimation compared with the CT simulation scanner in this study. We recommend using a diagnostic CT scanner to scan patients with small lesions (<1 cm in diameter) for radiotherapy treatment planning, especially for those pending for stereotactic radiosurgery in which accurate delineation of small-sized, low-contrast regions is important for dose calculation.« less

Monte Carlo simulations of adult and pediatric computed tomography exams: Validation studies of organ doses with physical phantoms

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

Long, Daniel J.; Lee, Choonsik; Tien, Christopher

2013-01-15

Purpose: To validate the accuracy of a Monte Carlo source model of the Siemens SOMATOM Sensation 16 CT scanner using organ doses measured in physical anthropomorphic phantoms. Methods: The x-ray output of the Siemens SOMATOM Sensation 16 multidetector CT scanner was simulated within the Monte Carlo radiation transport code, MCNPX version 2.6. The resulting source model was able to perform various simulated axial and helical computed tomographic (CT) scans of varying scan parameters, including beam energy, filtration, pitch, and beam collimation. Two custom-built anthropomorphic phantoms were used to take dose measurements on the CT scanner: an adult male and amore » 9-month-old. The adult male is a physical replica of University of Florida reference adult male hybrid computational phantom, while the 9-month-old is a replica of University of Florida Series B 9-month-old voxel computational phantom. Each phantom underwent a series of axial and helical CT scans, during which organ doses were measured using fiber-optic coupled plastic scintillator dosimeters developed at University of Florida. The physical setup was reproduced and simulated in MCNPX using the CT source model and the computational phantoms upon which the anthropomorphic phantoms were constructed. Average organ doses were then calculated based upon these MCNPX results. Results: For all CT scans, good agreement was seen between measured and simulated organ doses. For the adult male, the percent differences were within 16% for axial scans, and within 18% for helical scans. For the 9-month-old, the percent differences were all within 15% for both the axial and helical scans. These results are comparable to previously published validation studies using GE scanners and commercially available anthropomorphic phantoms. Conclusions: Overall results of this study show that the Monte Carlo source model can be used to accurately and reliably calculate organ doses for patients undergoing a variety of axial or helical CT examinations on the Siemens SOMATOM Sensation 16 scanner.« less

Value of tomosynthesis for lesion evaluation of small joints in osteoarthritic hands using the OARSI score.

PubMed

Martini, K; Becker, A S; Guggenberger, R; Andreisek, G; Frauenfelder, T

2016-07-01

To determine the diagnostic performance of tomosynthesis in depicting osteoarthritic lesions in comparison to conventional radiographs, with use of computed tomography (CT) as standard-of-reference. Imaging of 12 cadaveric hands was performed with tomosynthesis in dorso-palmar (dp) projection, conventional radiographs (dp) and multi-detector CT. Distal interphalangeal joint (DIP)II, DIPIII, proximal interphalangeal joint (PIP)II, PIPIII, first carpometacarpal (CMC) and scaphotrapezotrapezoidal joint (STT) were graded by two independent readers using the Osteoarthritis Research Society International (OARSI) score. The mean score for each feature was calculated for all modalities. Additional wrists were evaluated for presence of calcium pyrophosphate disease (CPPD). CT served as reference-standard. Inter-reader agreement (ICC) was calculated. Comparing tomosynthesis and conventional radiographs to CT, the sensitivity for the presence of osteophytes was 95,7% vs 65,2%; for joint space narrowing 95,8% vs 52,1%; for subchondral sclerosis 61,5% vs 51,3%; for lateral deformity 83.3% vs 83,3%; and for subchondral cysts 45,8% vs 29,2%. Erosions were not present. While tomosynthesis showed no significant difference in OARSI score grading to CT (mean OARSI-score CT: 16.8, SD = 10.6; mean OARSI-score Tomosynthesis: 16.3, SD = 9.6; P = 0.84), conventional radiographs had significant lower mean OARSI scores (mean OARSI-score X-ray: 11.1, SD = 8.3; P = 0.04). Inter-reader agreement for OARSI scoring was excellent (ICC = 0.99). CPPD calcifications present in CT, were also visible with tomosynthesis, but not with conventional radiography. In conclusion, tomosynthesis depicts more osteoarthritic changes in the small joints of the hand than conventional radiography using the OARSI scoring system and CT as the standard of reference. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Acquiring 4D Thoracic CT Scans Using Ciné CT Acquisition

NASA Astrophysics Data System (ADS)

Low, Daniel

One method for acquiring 4D thoracic CT scans is to use ciné acquisition. Ciné acquisition is conducted by rotating the gantry and acquiring x-ray projections while keeping the couch stationary. After a complete rotation, a single set of CT slices, the number corresponding to the number of CT detector rows, is produced. The rotation period is typically sub second so each image set corresponds to a single point in time. The ciné image acquisition is repeated for at least one breathing cycle to acquire images throughout the breathing cycle. Once the images are acquired at a single couch position, the couch is moved to the abutting position and the acquisition is repeated. Post-processing of the images sets typically resorts the sets into breathing phases, stacking images from a specific phase to produce a thoracic CT scan at that phase. Benefits of the ciné acquisition protocol include, the ability to precisely identify the phase with respect to the acquired image, the ability to resort images after reconstruction, and the ability to acquire images over arbitrarily long times and for arbitrarily many images (within dose constraints).

Meta-analysis of Clinical and Radiographic Outcomes After Arthroscopic Single-Row Versus Double-Row Rotator Cuff Repair

PubMed Central

Perser, Karen; Godfrey, David; Bisson, Leslie

2011-01-01

Context: Double-row rotator cuff repair methods have improved biomechanical performance when compared with single-row repairs. Objective: To review clinical outcomes of single-row versus double-row rotator cuff repair with the hypothesis that double-row rotator cuff repair will result in better clinical and radiographic outcomes. Data Sources: Published literature from January 1980 to April 2010. Key terms included rotator cuff, prospective studies, outcomes, and suture techniques. Study Selection: The literature was systematically searched, and 5 level I and II studies were found comparing clinical outcomes of single-row and double-row rotator cuff repair. Coleman methodology scores were calculated for each article. Data Extraction: Meta-analysis was performed, with treatment effect between single row and double row for clinical outcomes and with odds ratios for radiographic results. The sample size necessary to detect a given difference in clinical outcome between the 2 methods was calculated. Results: Three level I studies had Coleman scores of 80, 74, and 81, and two level II studies had scores of 78 and 73. There were 156 patients with single-row repairs and 147 patients with double-row repairs, both with an average follow-up of 23 months (range, 12-40 months). Double-row repairs resulted in a greater treatment effect for each validated outcome measure in 4 studies, but the differences were not clinically or statistically significant (range, 0.4-2.2 points; 95% confidence interval, –0.19, 4.68 points). Double-row repairs had better radiographic results, but the differences were also not statistically significant (P = 0.13). Two studies had adequate power to detect a 10-point difference between repair methods using the Constant score, and 1 study had power to detect a 5-point difference using the UCLA (University of California, Los Angeles) score. Conclusions: Double-row rotator cuff repair does not show a statistically significant improvement in clinical outcome or radiographic healing with short-term follow-up. PMID:23016017

Meta-analysis of Clinical and Radiographic Outcomes After Arthroscopic Single-Row Versus Double-Row Rotator Cuff Repair.

PubMed

Perser, Karen; Godfrey, David; Bisson, Leslie

2011-05-01

Double-row rotator cuff repair methods have improved biomechanical performance when compared with single-row repairs. To review clinical outcomes of single-row versus double-row rotator cuff repair with the hypothesis that double-row rotator cuff repair will result in better clinical and radiographic outcomes. Published literature from January 1980 to April 2010. Key terms included rotator cuff, prospective studies, outcomes, and suture techniques. The literature was systematically searched, and 5 level I and II studies were found comparing clinical outcomes of single-row and double-row rotator cuff repair. Coleman methodology scores were calculated for each article. Meta-analysis was performed, with treatment effect between single row and double row for clinical outcomes and with odds ratios for radiographic results. The sample size necessary to detect a given difference in clinical outcome between the 2 methods was calculated. Three level I studies had Coleman scores of 80, 74, and 81, and two level II studies had scores of 78 and 73. There were 156 patients with single-row repairs and 147 patients with double-row repairs, both with an average follow-up of 23 months (range, 12-40 months). Double-row repairs resulted in a greater treatment effect for each validated outcome measure in 4 studies, but the differences were not clinically or statistically significant (range, 0.4-2.2 points; 95% confidence interval, -0.19, 4.68 points). Double-row repairs had better radiographic results, but the differences were also not statistically significant (P = 0.13). Two studies had adequate power to detect a 10-point difference between repair methods using the Constant score, and 1 study had power to detect a 5-point difference using the UCLA (University of California, Los Angeles) score. Double-row rotator cuff repair does not show a statistically significant improvement in clinical outcome or radiographic healing with short-term follow-up.

Petamenophis (Padiamenemipet), an Egyptian Child Mummy Protected for Eternity: Revelation by Multidetector Computed Tomography.

PubMed

Martina, Maria Cristina; Cesarani, Federico; Boano, Rosa; Fiore Marochetti, Elisa; Gandini, Giovanni

The objective of our work was to report the most recent findings obtained with multidetector computed tomography of a child mummy from the Roman period (119-123 CE) housed at the Egyptian Museum in Turin, Italy. Multidetector computed tomography and postprocessing were applied to understand the embalming techniques, the nature of a foreign object, and anthropometrical values. The information was compared with that from other mummies that were buried in the same tomb, but today housed in different museums. New information regarding the embalming technique was revealed. Multidetector computed tomography allowed the identification of a knife-like metallic object, probably an amulet for the child's protection in the afterlife. Multidetector computed tomography and image postprocessing confirm their valuable role in noninvasive studies in ancient mummies and provided evidence of a unique cultural practice in the late history of Ancient Egypt such as placing a knife possibly as an amulet.

Battlefield radiology

PubMed Central

Graham, R N J

2012-01-01

With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010. PMID:22806621

PHACES syndrome associated with carcinoid endobronchial tumor.

PubMed

Mama, Nadia; H'mida, Dorra; Lahmar, Imen; Yacoubi, Mohamed Tahar; Tlili-Graiess, Kalthoum

2014-05-01

PHACES syndrome consists of the constellation of manifestations including posterior fossa anomalies of the brain (most commonly Dandy-Walker malformations), hemangiomas of the face and scalp, arterial abnormalities, cardiac defects, eye anomalies and sternal defects. We present a case with a possible PHACES syndrome including sternal cleft and supraumbilical raphé, precordial skin tag, persistent left superior vena cava and subtle narrowing of the aorta with an endobronchial carcinoid tumor. All these anomalies were discovered on chest multi-detector CT. This is a unique case of PHACES syndrome associated with carcinoid tumor. Review of the literature revealed 3 cases of PHACES syndrome with glial tumor. The authors tried to find the relationship between PHACES syndrome and carcinoid tumors or gliomas, which all derive from the neural crest cells.

The prevalence of transpancreatic common hepatic artery and coexisting variant anatomy.

PubMed

Ishigami, Kousei; Nishie, Akihiro; Asayama, Yoshiki; Ushijima, Yasuhiro; Takayama, Yukihisa; Okamoto, Daisuke; Fujita, Nobuhiro; Yoshizumi, Tomoharu; Harimoto, Norifumi; Ohtsuka, Takao; Nakata, Kohei; Honda, Hiroshi

2018-05-01

We studied the prevalence of the transpancreatic common hepatic artery (tp-CHA) and coexisting variant anatomy. The study group comprised 788 consecutive liver transplant donor candidates who had undergone thin-section multidetector-row computed tomography (MDCT) studies to investigate vascular anatomy. Multiplanar reformatted (MPR) images obtained from the arterial phase were retrospectively reviewed to assess the presence/absence of the tp-CHA. Five cases of tp-CHA with pancreaticobiliary tumors were also included in an investigation of the presence/absence of variant hepatic arteries, celiac stenosis, and circumportal pancreas. Three of the 788 (0.38%) donor candidates had a tp-CHA. Overall, eight tp-CHA cases were assessed for coexisting variant anatomy. Seven of these eight cases had a hepatomesenteric trunk, six had celiac stenosis, and two had a circumportal pancreas. The prevalence of the tp-CHA was 0.38% (approx. one in 260 in normal populations). A tp-CHA can commonly be associated with a hepatomesenteric trunk and celiac stenosis. A circumportal pancreas can also coexist with a tp-CHA. Clin. Anat. 31:598-604, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Saccular aortic aneurysm that resembled a mediastinal neoplasm

PubMed Central

Nose, Naohiro; Kataoka, Hiroumi; Hamada, Masakatsu; Kosako, Yukio; Matsuno, Yasuji; Ishii, Takahiro

2012-01-01

INTRODUCTION Saccular aortic arch aneurysms in unusual sites may be misdiagnosed as a neoplasm. We present the case of a rare saccular aortic arch aneurysm between trachea and esophagus that resembled a mediastinal neoplasm in the preoperative findings. PRESENTATION OF CASE A 63-year-old male with an abnormal mediastinal shadow on chest X-ray was referred to the hospital. An axial plain computed tomogram of the chest revealed mediastinal soft tissue next to the right side of the aortic arch resembling a neoplasm originating from the gap between the trachea and the esophagus. The coronal view constructed by enhanced 64-row multi detector computed tomography revealed the soft tissue was an aneurysm arising from the inner side of the aortic arch. An aortic arch replacement was performed via a median sternotomy. DISCUSSION A thoracic aortic aneurysm sometimes behaves like a mediastinal neoplasm. The multiple cross-sectional image from multidetector computed tomography was useful for the correct diagnosis of such an aneurysm. CONCLUSION The possibility of an aneurysm should be considered whenever a mass in contact with the aortic wall is identified. PMID:22995656

[Application of medical imaging to general thoracic surgery].

PubMed

Oizumi, Hiroyuki

2014-07-01

Medical imaging technology is rapidly progressing. Positron emission tomography (PET) has played major role in the staging and choice of treatment modality in lung cancer patients. Magnetic resonance imaging (MRI) is now routinely used for mediastinal tumors and the use of diffusion-weighted images (DWI) may help in the diagnosis of malignancies including lung cancers. The benefits of medical imaging technology are not limited to diagnostics, and include simulation or navigation for complex lung resection and other procedures. Multidetector row computed tomography (MDCT) shortens imaging time to obtain detailed and precise volume data, which improves diagnosis of small-sized lung cancers. 3-dimensional reconstruction of the volume data allows the safe performance of thoracoscopic surgery. For lung lobectomy, identification of the branching structures, diameter, and length of the arteries is useful in selecting the procedure for blood vessel treatment. For lung segmentectomy, visualization of venous branches in the affected segments and intersegmental veins has facilitated the preoperative determination of the anatomical intersegmental plane. Therefore, the application of medical imaging technology is useful in general thoracic surgery.

SU-E-I-33: Establishment of CT Diagnostic Reference Levels in Province Nova Scotia

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

Tonkopi, E; Abdolell, M; Duffy, S

2015-06-15

Purpose: To evaluate patient radiation dose from the most frequently performed CT examinations and to establish provincial diagnostic reference levels (DRLs) as a tool for protocol optimization. Methods: The study investigated the following CT examinations: head, chest, abdomen/pelvis, and chest/abdomen/pelvis (CAP). Dose data, volume CT dose index (CTDIvol) and dose-length product (DLP), were collected from 15 CT scanners installed during 2004–2014 in 11 hospital sites of Nova Scotia. All scanners had dose modulation options and multislice capability (16–128 detector rows). The sample for each protocol included 15 average size patients (70±20 kg). Provincial DRLs were calculated as the 75th percentilemore » of patient dose distributions. The differences in dose between hospitals were evaluated with a single factor ANOVA statistical test. Generalized linear modeling was used to determine the factors associated with higher radiation dose. A sample of 36 abdominal studies performed on three different scanners was blinded and randomized for an assessment by an experienced radiologist who graded the imaging quality of anatomic structures. Results: Data for 900 patients were collected. The DRLs were proposed using CTDIvol (mGy) and DLP (mGy*cm) values for CT head (67 and 1049, respectively), chest (12 and 393), abdomen/pelvis (16 and 717), and CAP (14 and 1034). These DRLs were lower than the published national data except for the head CTDIvol. The differences between the means of the dose distributions from each scanner were statistically significant (p<0.05) for all examinations. A very weak correlation was found between the dose and the scanner age or the number of slices with Pearson’s correlation coefficients of 0.011–0.315. The blinded analysis of image quality demonstrated no clinically significant difference except for the noise category. Conclusion: Provincial DRLs were established for typical CT examinations. The variations in dose between the hospitals suggested a large potential for optimization of examinations. Radiology Research Foundation grant.« less

MDCT of acute pancreatitis: Intraindividual comparison of single-phase versus dual-phase MDCT for initial assessment of acute pancreatitis using different CT scoring systems.

PubMed

Avanesov, Maxim; Weinrich, Julius M; Kraus, Thomas; Derlin, Thorsten; Adam, Gerhard; Yamamura, Jin; Karul, Murat

2016-11-01

The purpose of the retrospective study was to evaluate the additional value of dual-phase multidetector computed tomography (MDCT) protocols over a single-phase protocol on initial MDCT in patients with acute pancreatitis using three CT-based pancreatitis severity scores with regard to radiation dose. In this retrospective, IRB approved study MDCT was performed in 102 consecutive patients (73 males; 55years, IQR48-64) with acute pancreatitis. Inclusion criteria were CT findings of interstitial edematous pancreatitis (IP) or necrotizing pancreatitis (NP) and a contrast-enhanced dual-phase (arterial phase and portal-venous phase) abdominal CT performed at ≥72h after onset of symptoms. The severity of pancreatic and extrapancreatic changes was independently assessed by 2 observers using 3 validated CT-based scoring systems (CTSI, mCTSI, EPIC). All scores were applied to arterial phase and portal venous phase scans and compared to score results of portal venous phase scans, assessed ≥14days after initial evaluation. For effective dose estimation, volume CT dose index (CTDIvol) and dose length product (DLP) were recorded in all examinations. In neither of the CT severity scores a significant difference was observed after application of a dual-phase protocol compared with a single-phase protocol (IP: CTSI: 2.7 vs. 2.5, p=0.25; mCTSI: 4.0 vs. 4.0, p=0.10; EPIC: 2.0 vs. 2.0, p=0.41; NP: CTSI: 8.0 vs. 7.0, p=0.64; mCTSI: 8.0 vs. 8.0, p=0.10; EPIC: 3.0 vs. 3.0, p=0.06). The application of a single-phase CT protocol was associated with a median effective dose reduction of 36% (mean dose reduction 31%) compared to a dual-phase CT scan. An initial dual-phase abdominal CT after ≥72h after onset of symptoms of acute pancreatitis was not superior to a single-phase protocol for evaluation of the severity of pancreatic and extrapancreatic changes. However, the effective radiation dose may be reduced by 36% using a single-phase protocol. Copyright © 2016. Published by Elsevier Ireland Ltd.

Functional Imaging of the Lungs with Gas Agents

PubMed Central

Kruger, Stanley J.; Nagle, Scott K.; Couch, Marcus J.; Ohno, Yoshiharu; Albert, Mitchell; Fain, Sean B.

2015-01-01

This review focuses on the state-of-the-art of the three major classes of gas contrast agents used in magnetic resonance imaging (MRI) – hyperpolarized (HP) gas, molecular oxygen, and fluorinated gas – and their application to clinical pulmonary research. During the past several years there has been accelerated development of pulmonary MRI. This has been driven in part by concerns regarding ionizing radiation using multi-detector computed tomography (CT). However, MRI also offers capabilities for fast multi-spectral and functional imaging using gas agents that are not technically feasible with CT. Recent improvements in gradient performance and radial acquisition methods using ultra-short echo time (UTE) have contributed to advances in these functional pulmonary MRI techniques. Relative strengths and weaknesses of the main functional imaging methods and gas agents are compared and applications to measures of ventilation, diffusion, and gas exchange are presented. Functional lung MRI methods using these gas agents are improving our understanding of a wide range of chronic lung diseases, including chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis (CF) in both adults and children. PMID:26218920

The diagnostic test accuracy of magnetic resonance imaging, magnetic resonance arthrography and computer tomography in the detection of chondral lesions of the hip.

PubMed

Smith, Toby O; Simpson, Michael; Ejindu, Vivian; Hing, Caroline B

2013-04-01

The purpose of this study was to assess the diagnostic test accuracy of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA) and multidetector arrays in CT arthrography (MDCT) for assessing chondral lesions in the hip joint. A review of the published and unpublished literature databases was performed to identify all studies reporting the diagnostic test accuracy (sensitivity/specificity) of MRI, MRA or MDCT for the assessment of adults with chondral (cartilage) lesions of the hip with surgical comparison (arthroscopic or open) as the reference test. All included studies were reviewed using the quality assessment of diagnostic accuracy studies appraisal tool. Pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratios were calculated with 95 % confidence intervals using a random-effects meta-analysis for MRI, MRA and MDCT imaging. Eighteen studies satisfied the eligibility criteria. These included 648 hips from 637 patients. MRI indicated a pooled sensitivity of 0.59 (95 % CI: 0.49-0.70) and specificity of 0.94 (95 % CI: 0.90-0.97), and MRA sensitivity and specificity values were 0.62 (95 % CI: 0.57-0.66) and 0.86 (95 % CI: 0.83-0.89), respectively. The diagnostic test accuracy for the detection of hip joint cartilage lesions is currently superior for MRI compared with MRA. There were insufficient data to perform meta-analysis for MDCT or CTA protocols. Based on the current limited diagnostic test accuracy of the use of magnetic resonance or CT, arthroscopy remains the most accurate method of assessing chondral lesions in the hip joint.

Relationship between the triglyceride glucose index and coronary artery calcification in Korean adults.

PubMed

Kim, Min Kyung; Ahn, Chul Woo; Kang, Shinae; Nam, Ji Sun; Kim, Kyung Rae; Park, Jong Suk

2017-08-23

The triglyceride glucose (TyG) index has been considered a simple surrogate marker of insulin resistance. However, few studies have investigated the relationship between the TyG index and coronary artery calcification (CAC). Thus, we investigated the relationship between the TyG index and CAC in healthy Korean adults. In total, 4319 participants who underwent cardiac computed tomography (CT) in a health promotion center were enrolled. Anthropometric profiles and multiple cardiovascular risk factors were measured. The TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2], and the insulin resistance index of homeostasis model assessment (HOMA-IR) was estimated. The CAC was measured using multidetector CT, and CAC presence was defined as an Agatston score of >0. All subjects were stratified into four groups based on their TyG indices. Significant differences were observed in cardiovascular parameters among the groups, and the prevalence of CAC significantly increased with increasing TyG index. In the logistic regression analysis after adjustment for multiple risk factors, the odds ratio for the prevalence of CAC, when comparing the highest and lowest quartiles of the TyG index was 1.95 (95% CI 1.23-3.11; P for trend = 0.01); the odds ratio for the prevalence of CAC, when comparing the highest and lowest quartiles of HOMA-IR was 1.64 (95% CI 1.12-2.40; P for trend = 0.04). In the receiver operating characteristics analysis, the TyG index was superior to HOMA-IR in predicting CAC. The TyG index is more independently associated with the presence of coronary artery atherosclerosis than is HOMA-IR in healthy Korean adults.

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

PubMed

Talakić, Emina; Schaffellner, Silvia; Kniepeiss, Daniela; Mueller, Helmut; Stauber, Rudolf; Quehenberger, Franz; Schoellnast, Helmut

2017-10-01

To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. The Spearman correlation coefficient was -0.53 (p < 0.05) between SAF and HVPG, and -0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG. CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. • SAF and SCL are statistically significantly correlated with HVPG • SCL showed stronger correlation with HVPG than SAF • 125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH • HAF, PVF and HPI showed no statistically significant correlation with HVPG.

A general tool for the evaluation of spiral CT interpolation algorithms: revisiting the effect of pitch in multislice CT.

PubMed

Bricault, Ivan; Ferretti, Gilbert

2005-01-01

While multislice spiral computed tomography (CT) scanners are provided by all major manufacturers, their specific interpolation algorithms have been rarely evaluated. Because the results published so far relate to distinct particular cases and differ significantly, there are contradictory recommendations about the choice of pitch in clinical practice. In this paper, we present a new tool for the evaluation of multislice spiral CT z-interpolation algorithms, and apply it to the four-slice case. Our software is based on the computation of a "Weighted Radiation Profile" (WRP), and compares WRP to an expected ideal profile in terms of widening and heterogeneity. It provides a unique scheme for analyzing a large variety of spiral CT acquisition procedures. Freely chosen parameters include: number of detector rows, detector collimation, nominal slice width, helical pitch, and interpolation algorithm with any filter shape and width. Moreover, it is possible to study any longitudinal and off-isocenter positions. Theoretical and experimental results show that WRP, more than Slice Sensitivity Profile (SSP), provides a comprehensive characterization of interpolation algorithms. WRP analysis demonstrates that commonly "preferred helical pitches" are actually nonoptimal regarding the formerly distinguished z-sampling gap reduction criterion. It is also shown that "narrow filter" interpolation algorithms do not enable a general preferred pitch discussion, since they present poor properties with large longitudinal and off-center variations. In the more stable case of "wide filter" interpolation algorithms, SSP width or WRP widening are shown to be almost constant. Therefore, optimal properties should no longer be sought in terms of these criteria. On the contrary, WRP heterogeneity is related to variable artifact phenomena and can pertinently characterize optimal pitches. In particular, the exemplary interpolation properties of pitch = 1 "wide filter" mode are demonstrated.

Can computed tomography esophagography reliably diagnose traumatic penetrating upper digestive tract injuries?

PubMed

Conradie, Wilhelmus Jacobus; Gebremariam, Fekade Admassu

2015-01-01

To determine the sensitivity and specificity of computed tomography (CT) esophagography in diagnosing penetrating esophageal and hypopharyngeal injuries in trauma patients and to see if it can be used as the only imaging method in diagnosing these injuries. The confidence of radiologists using only CT esophagography was also measured. A prospective cross-sectional analytic study was done on haemodinamically stable patients requiring multidetector CT after external penetrating neck or chest trauma. Each patient was given oral contrast consisting of 50 ml 50% iohexol solution, within 5 min of commencement of the CT examination and in the supine position. An attempt was made to confirm all CT esophagography findings with at least one secondary method. Images were evaluated separately by two general departmental radiologists who were blinded to the results of the confirmation method. Between December 2012 and November 2014, 102 patients were included, of which 93 (91.2%) were male. Stab wounds were responsible for 85.3% (n=87) of penetrating wounds. Ninety-four patients (92.2%) had CT angiography (CTA) in conjunction with CT esophagography. There were 20 confirmed upper digestive tract injuries; 11 (55.0%) in the hypopharynx and 9 (45.0%) in the esophagus. With the exception of one case, all upper digestive tract injuries were diagnosed using only CT esophagography. No upper digestive tract injuries were correctly identified in 70 and 75 out of 82 true negative cases respectively, suggesting a sensitivity of 95.0% for both radiologists and specificity of 85.4% and 91.5% for CT esophagography. A number of false positive diagnoses were reported when CT esophagography was done in conjunction with CTA, resulting in a positive predictive value of 61.3% and 79.1% for this technique. Reviewers were positive to very confident about the CT esophagography findings in 90.0% and 100% of patients with injuries and 79.0% and 87.0%, respectively, in the no injury group. CT esophagography is reliable in diagnosing penetrating upper digestive tract injuries. In conjunction with CTA, false positive findings may occur. Radiologists were generally positive to very confident about their CT esophagography findings, not needing further imaging in more than 60% of cases. Copyright © 2015 Elsevier Inc. All rights reserved.

Low-tube-voltage selection for non-contrast-enhanced CT: Comparison of the radiation dose in pediatric and adult phantoms.

PubMed

Shimonobo, Toshiaki; Funama, Yoshinori; Utsunomiya, Daisuke; Nakaura, Takeshi; Oda, Seitaro; Kiguchi, Masao; Masuda, Takanori; Sakabe, Daisuke; Yamashita, Yasuyuki; Awai, Kazuo

2016-01-01

We used pediatric and adult anthropomorphic phantoms to compare the radiation dose of low- and standard tube voltage chest and abdominal non-contrast-enhanced computed tomography (CT) scans. We also discuss the optimal low tube voltage for non-contrast-enhanced CT. Using a female adult- and three differently-sized pediatric anthropomorphic phantoms we acquired chest and abdominal non-contrast-enhanced scans on a 320-multidetector CT volume scanner. The tube voltage was set at 80-, 100-, and 120 kVp. The tube current was automatically assigned on the CT scanner in response to the set image noise level. On each phantom and at each tube voltage we measured the surface and center dose using high-sensitivity metal-oxide-semiconductor field-effect transistor detectors. The mean surface dose of chest and abdominal CT scans in 5-year olds was 4.4 and 5.3 mGy at 80 kVp, 4.5 and 5.4 mGy at 100 kV, and 4.0 and 5.0 mGy at 120 kVp, respectively. These values were similar in our 3-pediatric phantoms (p > 0.05). The mean surface dose in the adult phantom increased from 14.7 to 19.4 mGy for chest- and from 18.7 to 24.8 mGy for abdominal CT as the tube voltage decreased from 120 to 80 kVp (p < 0.01). Compared to adults, the surface and center dose for pediatric patients is almost the same despite a decrease in the tube voltage and the low tube voltage technique can be used for non-contrast-enhanced chest- and abdominal scanning. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Size-based emphysema cluster analysis on low attenuation area in 3D volumetric CT: comparison with pulmonary functional test

NASA Astrophysics Data System (ADS)

Lee, Minho; Kim, Namkug; Lee, Sang Min; Seo, Joon Beom; Oh, Sang Young

2015-03-01

To quantify low attenuation area (LAA) of emphysematous regions according to cluster size in 3D volumetric CT data of chronic obstructive pulmonary disease (COPD) patients and to compare these indices with their pulmonary functional test (PFT). Sixty patients with COPD were scanned by a more than 16-multi detector row CT scanner (Siemens Sensation 16 and 64) within 0.75mm collimation. Based on these LAA masks, a length scale analysis to estimate each emphysema LAA's size was performed as follows. At first, Gaussian low pass filter from 30mm to 1mm kernel size with 1mm interval on the mask was performed from large to small size, iteratively. Centroid voxels resistant to the each filter were selected and dilated by the size of the kernel, which was regarded as the specific size emphysema mask. The slopes of area and number of size based LAA (slope of semi-log plot) were analyzed and compared with PFT. PFT parameters including DLco, FEV1, and FEV1/FVC were significantly (all p-value< 0.002) correlated with the slopes (r-values; -0.73, 0.54, 0.69, respectively) and EI (r-values; -0.84, -0.60, -0.68, respectively). In addition, the D independently contributed regression for FEV1 and FEV1/FVC (adjust R sq. of regression study: EI only, 0.70, 0.45; EI and D, 0.71, 0.51, respectively). By the size based LAA segmentation and analysis, we evaluated the Ds of area, number, and distribution of size based LAA, which would be independent factors for predictor of PFT parameters.

Factor levels for density comparisons in the split-block spacing design

Treesearch

Kurt H. Riitters; Brian J. Stanton; Robbert H. Walkup

1989-01-01

The split-block spacing design is a compact test of the effects of within-row and between-row spacings. But the sometimes awkward analysis of density (i.e., trees/ha) effects may deter use of the design. The analysis is simpler if the row spacings are chosen to obtain a balanced set of equally spaced density and rectangularity treatments. A spacing study in poplar (...

Multisource inverse-geometry CT. Part II. X-ray source design and prototype

PubMed Central

Neculaes, V. Bogdan; Caiafa, Antonio; Cao, Yang; De Man, Bruno; Edic, Peter M.; Frutschy, Kristopher; Gunturi, Satish; Inzinna, Lou; Reynolds, Joseph; Vermilyea, Mark; Wagner, David; Zhang, Xi; Zou, Yun; Pelc, Norbert J.; Lounsberry, Brian

2016-01-01

Purpose: This paper summarizes the development of a high-power distributed x-ray source, or “multisource,” designed for inverse-geometry computed tomography (CT) applications [see B. De Man et al., “Multisource inverse-geometry CT. Part I. System concept and development,” Med. Phys. 43, 4607–4616 (2016)]. The paper presents the evolution of the source architecture, component design (anode, emitter, beam optics, control electronics, high voltage insulator), and experimental validation. Methods: Dispenser cathode emitters were chosen as electron sources. A modular design was adopted, with eight electron emitters (two rows of four emitters) per module, wherein tungsten targets were brazed onto copper anode blocks—one anode block per module. A specialized ceramic connector provided high voltage standoff capability and cooling oil flow to the anode. A matrix topology and low-noise electronic controls provided switching of the emitters. Results: Four modules (32 x-ray sources in two rows of 16) have been successfully integrated into a single vacuum vessel and operated on an inverse-geometry computed tomography system. Dispenser cathodes provided high beam current (>1000 mA) in pulse mode, and the electrostatic lenses focused the current beam to a small optical focal spot size (0.5 × 1.4 mm). Controlled emitter grid voltage allowed the beam current to be varied for each source, providing the ability to modulate beam current across the fan of the x-ray beam, denoted as a virtual bowtie filter. The custom designed controls achieved x-ray source switching in <1 μs. The cathode-grounded source was operated successfully up to 120 kV. Conclusions: A high-power, distributed x-ray source for inverse-geometry CT applications was successfully designed, fabricated, and operated. Future embodiments may increase the number of spots and utilize fast read out detectors to increase the x-ray flux magnitude further, while still staying within the stationary target inherent thermal limitations. PMID:27487878

Multisource inverse-geometry CT. Part II. X-ray source design and prototype

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

Neculaes, V. Bogdan, E-mail: neculaes@ge.com; Caia

2016-08-15

Purpose: This paper summarizes the development of a high-power distributed x-ray source, or “multisource,” designed for inverse-geometry computed tomography (CT) applications [see B. De Man et al., “Multisource inverse-geometry CT. Part I. System concept and development,” Med. Phys. 43, 4607–4616 (2016)]. The paper presents the evolution of the source architecture, component design (anode, emitter, beam optics, control electronics, high voltage insulator), and experimental validation. Methods: Dispenser cathode emitters were chosen as electron sources. A modular design was adopted, with eight electron emitters (two rows of four emitters) per module, wherein tungsten targets were brazed onto copper anode blocks—one anode blockmore » per module. A specialized ceramic connector provided high voltage standoff capability and cooling oil flow to the anode. A matrix topology and low-noise electronic controls provided switching of the emitters. Results: Four modules (32 x-ray sources in two rows of 16) have been successfully integrated into a single vacuum vessel and operated on an inverse-geometry computed tomography system. Dispenser cathodes provided high beam current (>1000 mA) in pulse mode, and the electrostatic lenses focused the current beam to a small optical focal spot size (0.5 × 1.4 mm). Controlled emitter grid voltage allowed the beam current to be varied for each source, providing the ability to modulate beam current across the fan of the x-ray beam, denoted as a virtual bowtie filter. The custom designed controls achieved x-ray source switching in <1 μs. The cathode-grounded source was operated successfully up to 120 kV. Conclusions: A high-power, distributed x-ray source for inverse-geometry CT applications was successfully designed, fabricated, and operated. Future embodiments may increase the number of spots and utilize fast read out detectors to increase the x-ray flux magnitude further, while still staying within the stationary target inherent thermal limitations.« less

Parametric analysis of synthetic aperture radar data acquired over truck garden vegetation

NASA Technical Reports Server (NTRS)

Wu, S. T.

1984-01-01

An airborne X-band SAR acquired multipolarization and multiflight pass SAR images over a truck garden vegetation area. Based on a variety of land cover and row crop direction variations, the vertical (VV) polarization data contain the highest contrast, while cross polarization contains the least. When the radar flight path is parallel to the row direction, both horizontal (HH) and VV polarization data contain very high return which masks out the specific land cover that forms the row structure. Cross polarization data are not that sensitive to row orientation. The inclusion of like and cross polarization data help delineate special surface features (e.g., row crop against non-row-oriented land cover, very-rough-surface against highly row-oriented surface).

CFD simulation of hemodynamics in sequential and individual coronary bypass grafts based on multislice CT scan datasets.

PubMed

Hajati, Omid; Zarrabi, Khalil; Karimi, Reza; Hajati, Azadeh

2012-01-01

There is still controversy over the differences in the patency rates of the sequential and individual coronary artery bypass grafting (CABG) techniques. The purpose of this paper was to non-invasively evaluate hemodynamic parameters using complete 3D computational fluid dynamics (CFD) simulations of the sequential and the individual methods based on the patient-specific data extracted from computed tomography (CT) angiography. For CFD analysis, the geometric model of coronary arteries was reconstructed using an ECG-gated 64-detector row CT. Modeling the sequential and individual bypass grafting, this study simulates the flow from the aorta to the occluded posterior descending artery (PDA) and the posterior left ventricle (PLV) vessel with six coronary branches based on the physiologically measured inlet flow as the boundary condition. The maximum calculated wall shear stress (WSS) in the sequential and the individual models were estimated to be 35.1 N/m(2) and 36.5 N/m(2), respectively. Compared to the individual bypass method, the sequential graft has shown a higher velocity at the proximal segment and lower spatial wall shear stress gradient (SWSSG) due to the flow splitting caused by the side-to-side anastomosis. Simulated results combined with its surgical benefits including the requirement of shorter vein length and fewer anastomoses advocate the sequential method as a more favorable CABG method.

Pediatric chest and abdominopelvic CT: organ dose estimation based on 42 patient models.

PubMed

Tian, Xiaoyu; Li, Xiang; Segars, W Paul; Paulson, Erik K; Frush, Donald P; Samei, Ehsan

2014-02-01

To estimate organ dose from pediatric chest and abdominopelvic computed tomography (CT) examinations and evaluate the dependency of organ dose coefficients on patient size and CT scanner models. The institutional review board approved this HIPAA-compliant study and did not require informed patient consent. A validated Monte Carlo program was used to perform simulations in 42 pediatric patient models (age range, 0-16 years; weight range, 2-80 kg; 24 boys, 18 girls). Multidetector CT scanners were modeled on those from two commercial manufacturers (LightSpeed VCT, GE Healthcare, Waukesha, Wis; SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). Organ doses were estimated for each patient model for routine chest and abdominopelvic examinations and were normalized by volume CT dose index (CTDI(vol)). The relationships between CTDI(vol)-normalized organ dose coefficients and average patient diameters were evaluated across scanner models. For organs within the image coverage, CTDI(vol)-normalized organ dose coefficients largely showed a strong exponential relationship with the average patient diameter (R(2) > 0.9). The average percentage differences between the two scanner models were generally within 10%. For distributed organs and organs on the periphery of or outside the image coverage, the differences were generally larger (average, 3%-32%) mainly because of the effect of overranging. It is feasible to estimate patient-specific organ dose for a given examination with the knowledge of patient size and the CTDI(vol). These CTDI(vol)-normalized organ dose coefficients enable one to readily estimate patient-specific organ dose for pediatric patients in clinical settings. This dose information, and, as appropriate, attendant risk estimations, can provide more substantive information for the individual patient for both clinical and research applications and can yield more expansive information on dose profiles across patient populations within a practice. © RSNA, 2013.

Active hemorrhage and vascular injuries in splenic trauma: utility of the arterial phase in multidetector CT.

PubMed

Uyeda, Jennifer W; LeBedis, Christina A; Penn, David R; Soto, Jorge A; Anderson, Stephan W

2014-01-01

To determine whether the addition of arterial phase computed tomography (CT) to the standard combination of portal venous and delayed phase imaging increases sensitivity in the diagnosis of active hemorrhage and/or contained vascular injuries in patients with splenic trauma. The institutional review board approved this HIPAA-compliant retrospective study; the requirement to obtain informed consent was waived. The study included all patients aged 15 years and older who sustained a splenic injury from blunt or penetrating trauma and who underwent CT in the arterial and portal venous phases of image acquisition during a 74-month period (September 2005 to November 2011). CT scans were reviewed by three radiologists, and a consensus interpretation was made to classify the splenic injuries according to the American Association for the Surgery of Trauma splenic injury scale. One radiologist independently recorded the presence of contained vascular injuries or active hemorrhage and the phase or phases at which these lesions were seen. Clinical outcome was assessed by reviewing medical records. The relationship between imaging findings and clinical management was assessed with the Fisher exact test. One hundred forty-seven patients met the inclusion criteria; 32 patients (22%) had active hemorrhage and 22 (15%) had several contained vascular injuries. In 13 of the 22 patients with contained injuries, the vascular lesion was visualized only at the arterial phase of image acquisition; the other nine contained vascular injuries were seen at all phases. Surgery or embolization was performed in 11 of the 22 patients with contained vascular injury. The arterial phase of image acquisition improves detection of traumatic contained splenic vascular injuries and should be considered to optimize detection of splenic injuries in trauma with CT. ©RSNA, 2013.

Changes in entrance surface dose in relation to the location of shielding material in chest computed tomography

NASA Astrophysics Data System (ADS)

Kang, Y. M.; Cho, J. H.; Kim, S. C.

2015-07-01

This study examined the effects of entrance surface dose (ESD) on the abdomen and pelvis of the patient when undergoing chest computed tomography (CT) procedure, and evaluated the effects of ESD reduction depending on the location of radiation shield. For CT scanner, the 64-slice multi-detector computed tomography was used. The alderson radiation therapy phantom and optically stimulated luminescence dosimeter (OSLD), which enabled measurement from low to high dose, were also used. For measurement of radiation dose, the slice number from 9 to 21 of the phantom was set as the test range, which included apex up to both costophrenic angles. A total of 10 OSLD nanoDots were attached for measurement of the front and rear ESD. Cyclic tests were performed using the low-dose chest CT and high-resolution CT (HRCT) protocol on the following set-ups: without shielding; shielding only on the front side; shielding only on the rear side; and shielding for both front and rear sides. According to the test results, ESD for both front and rear sides was higher in HRCT than low-dose CT when radiation shielding was not used. It was also determined that, compared to the set-up that did not use the radiation shield, locating the radiation shield on the front side was effective in reducing front ESD, while locating the radiation shield on the rear side reduced rear ESD level. Shielding both the front and rear sides resulted in ESD reduction. In conclusion, it was confirmed that shielding the front and rear sides was the most effective method to reduce the ESD effect caused by scatter ray during radiography.

3D ECG- and respiratory-gated non-contrast-enhanced (CE) perfusion MRI for postoperative lung function prediction in non-small-cell lung cancer patients: A comparison with thin-section quantitative computed tomography, dynamic CE-perfusion MRI, and perfusion scan.

PubMed

Ohno, Yoshiharu; Seki, Shinichiro; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Takenaka, Daisuke; Kassai, Yoshimori; Yui, Masao; Sugimura, Kazuro

2015-08-01

To compare predictive capabilities of non-contrast-enhanced (CE)- and dynamic CE-perfusion MRIs, thin-section multidetector computed tomography (CT) (MDCT), and perfusion scan for postoperative lung function in non-small cell lung cancer (NSCLC) patients. Sixty consecutive pathologically diagnosed NSCLC patients were included and prospectively underwent thin-section MDCT, non-CE-, and dynamic CE-perfusion MRIs and perfusion scan, and had their pre- and postoperative forced expiratory volume in one second (FEV1 ) measured. Postoperative percent FEV1 (po%FEV1 ) was then predicted from the fractional lung volume determined on semiquantitatively assessed non-CE- and dynamic CE-perfusion MRIs, from the functional lung volumes determined on quantitative CT, from the number of segments observed on qualitative CT, and from uptakes detected on perfusion scans within total and resected lungs. Predicted po%FEV1 s were then correlated with actual po%FEV1 s, which were %FEV1 s measured postoperatively. The limits of agreement were also determined. All predicted po%FEV1 s showed significant correlation (0.73 ≤ r ≤ 0.93, P < 0.0001) and limits of agreement with actual po%FEV1 (non-CE-perfusion MRI: 0.3 ± 10.0%, dynamic CE-perfusion MRI: 1.0 ± 10.8%, perfusion scan: 2.2 ± 14.1%, quantitative CT: 1.2 ± 9.0%, qualitative CT: 1.5 ± 10.2%). Non-CE-perfusion MRI may be able to predict postoperative lung function more accurately than qualitatively assessed MDCT and perfusion scan. © 2014 Wiley Periodicals, Inc.

Multidetector-Row Computed Tomography in the Evaluation of Transjugular Intrahepatic Portosystemic Shunt Performed with Expanded-Polytetrafluoroethylene-Covered Stent-Graft

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

Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Bezzi, Mario; Bruni, Antonio

2011-02-15

We assessed, in a prospective study, the efficacy of multidetector spiral computed tomography (MDCT) in the evaluation of transjugular intrahepatic portosystemic shunt (TIPS) patency in patients treated with the Viatorr (Gore, Flagstaff, AZ) expanded-polytetrafluoroethylene (e-PTFE)-covered stent-graft. Eighty patients who underwent TIPS procedure using the Viatorr self-expanding e-PTFE stent-graft were evaluated at follow-up of 1, 3, 6, and 12 months with clinical and laboratory tests as well as ultrasound-color Doppler (USCD) imaging. In case of varices, upper gastrointestinal endoscopy was also performed. In addition, the shunt was evaluated using MDCT at 6 and 12 months. In all cases of abnormal findingsmore » and discrepancy between MDCT and USCD, invasive control venography was performed. MDCT images were acquired before and after injection of intravenous contrast media on the axial plane and after three-dimensional reconstruction using different algorithms. MDCT was successfully performed in all patients. No artefacts correlated to the Viatorr stent-graft were observed. A missing correlation between UCSD and MDCT was noticed in 20 of 80 (25%) patients. Invasive control venography confirmed shunt patency in 16 (80%) cases and shunt malfunction in 4 (20%) cases. According to these data, MDCT sensitivity was 95.2%; specificity was 96.6%; and positive (PPV) and negative predictive values (NPV) were 90.9 and 98.2%, respectively. USCD sensitivity was 90%; specificity was 75%; and PPV and NPV were 54.5 and 95.7%, respectively. A high correlation (K value = 0.85) between MDCT and invasive control venography was observed. On the basis of these results, MDCT shows superior sensitivity and specificity compared with USCD in those patients in whom TIPS was performed with the Viatorr stent-graft. MDCT can be considered a valid tool in the follow-up of these patients.« less

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.

Probabilistic Aeroelastic Analysis of Turbomachinery Components

NASA Technical Reports Server (NTRS)

Reddy, T. S. R.; Mital, S. K.; Stefko, G. L.

2004-01-01

A probabilistic approach is described for aeroelastic analysis of turbomachinery blade rows. Blade rows with subsonic flow and blade rows with supersonic flow with subsonic leading edge are considered. To demonstrate the probabilistic approach, the flutter frequency, damping and forced response of a blade row representing a compressor geometry is considered. The analysis accounts for uncertainties in structural and aerodynamic design variables. The results are presented in the form of probabilistic density function (PDF) and sensitivity factors. For subsonic flow cascade, comparisons are also made with different probabilistic distributions, probabilistic methods, and Monte-Carlo simulation. The approach shows that the probabilistic approach provides a more realistic and systematic way to assess the effect of uncertainties in design variables on the aeroelastic instabilities and response.

Impact of Indoxyl Sulfate on Coronary Plaques in Patients on Hemodialysis.

PubMed

Asami, Masahiko; Tanabe, Kengo; Ito, Shunsuke; Yoshida, Eri; Aoki, Jiro; Tanimoto, Shuzou; Horiuchi, Yu; Yoshida, Masayuki

2018-05-30

Serum indoxyl sulfate (IS; a uremic toxin) levels, which are significantly higher in patients with chronic kidney disease, including those undergoing hemodialysis, than in the robust, are associated with both cardiovascular disease (CVD) and CVD-related mortality. Furthermore, coronary artery calcium (CAC) is an independent predictor of cardiovascular events in patients undergoing hemodialysis. This study aimed to interpret the association between serum IS levels and coronary plaque burden (CPB) or CAC.A total of 30 consecutive patients on hemodialysis, who underwent 320-row coronary multidetector computed tomography (MDCT) angiography for suspected coronary artery disease, were enrolled in this prospective study. Coronary artery percent atheroma volume (a CPB marker) and percent calcium volume (a CAC marker) assessed using MDCT were evaluated. Furthermore, various oxidative and inflammatory markers typified by serum IS levels at a dialysis-free day were measured. Using these data, we investigated correlation between the inflammatory marker IS and CPB or CAC.Multivariable analysis indicated that serum IS levels were positively correlated with CAC [partial regression coefficient, 2.89; 95% confidence interval (CI), 0.35-5.43; P = 0.03] but not with CPB, even after adjustment for cofounders. Composite cardiovascular events, namely, as all-cause death, non-fatal myocardial infarction, disabling stroke, and hospital admission for other cardiovascular events, were reported to be 50% in all patients (95% CI, 32.1-67.9).In patients undergoing hemodialysis, serum IS levels were significantly associated with CAC but not with CPB.

Obsidian provenance determination by using the beam stability controlled BSC-XRF and the PIXE-alpha portable spectrometers of the LANDIS laboratory of the LNS-INFN and IBAM-CNR in Catania (Italy)

NASA Astrophysics Data System (ADS)

Pappalardo, L.; Bracchitta, D.; Palio, O.; Pappalardo, G.; Rizzo, F.

2012-04-01

About 1300 obsidian artefacts coming from various archaeological sites of Sicily were analyzed by using the BSC-XRF (Beam Stability Controlled - X-ray Fluorescence) and PIXE-alpha (Particle Induced X-ray Emission, using low energy alpha particles) portable spectrometers developed at the Landis laboratory at the LNS-INF and IBAM-CNR in Catania (Italy). The portable BSC-XRF system allows the non-destructive analysis of the Rb, Sr, Y, Zr and Nb trace concentrations, which are considered to be characteristic of the obsidian samples and consequently are indicative of the provenance quarries. Quantitative data on Rb, Sr, Y, Zr, Nb trace element concentrations where deduced through the use of a method that makes use of a multi parameter linear regression, previously The portable PIXE-alpha spectrometer allows the quantitative determination of the matrix major elements, from Na to Zn. In the present work the two instrumental devices are presented. The data are from: Milena (Cl), Ustica (Pa), Rocchicella (Ct), Poggio dell'Acquila (Ct), San Marco (Ct), Villaggio del Petraro* (Sr) and Licodia Eubea* (Ct). Results on compositional data for trace elements and major elements allowed to identify Lipari and Pantelleria islands as the only two sources of the analysed samples. Analyses carried out on vitreous artefact found in Rocchicella, showed for the first time that the Palagonite was used as row material. *Preliminary data. Topic of conference: Application of XRS in archaeometry Kind of presentation: oral

Meta-Analysis of Stress Myocardial Perfusion Imaging

ClinicalTrials.gov

2017-06-06

Coronary Disease; Echocardiography; Fractional Flow Reserve, Myocardial; Hemodynamics; Humans; Magnetic Resonance Imaging; Myocardial Perfusion Imaging; Perfusion; Predictive Value of Tests; Single Photon Emission Computed Tomography; Positron Emission Tomography; Multidetector Computed Tomography; Echocardiography, Stress; Coronary Angiography

Cumulative doses analysis in young trauma patients: a single-centre experience.

PubMed

Salerno, Sergio; Marrale, Maurizio; Geraci, Claudia; Caruso, Giuseppe; Lo Re, Giuseppe; Lo Casto, Antonio; Midiri, Massimo

2016-02-01

Multidetector computed tomography (MDCT) represents the main source of radiation exposure in trauma patients. The radiation exposure of young patients is a matter of considerable medical concern due to possible long-term effects. Multiple MDCT studies have been observed in the young trauma population with an increase in radiation exposure. We have identified 249 young adult patients (178 men and 71 women; age range 14-40 years) who had received more than one MDCT study between June 2010 and June 2014. According to the International Commission on Radiological Protection publication, we have calculated the cumulative organ dose tissue-weighting factors by using CT-EXPO software(®). We have observed a mean cumulative dose of about 27 mSv (range from 3 to 297 mSv). The distribution analysis is characterised by low effective dose, below 20 mSv, in the majority of the patients. However, in 29 patients, the effective dose was found to be higher than 20 mSv. Dose distribution for the various organs analysed (breasts, ovaries, testicles, heart and eye lenses) shows an intense peak for lower doses, but in some cases high doses were recorded. Even though cumulative doses may have long-term effects, which are still under debate, high doses are observed in this specific group of young patients.

Coronary Artery Disease: Analysis of Diagnostic Performance of CT Perfusion and MR Perfusion Imaging in Comparison with Quantitative Coronary Angiography and SPECT-Multicenter Prospective Trial.

PubMed

Rief, Matthias; Chen, Marcus Y; Vavere, Andrea L; Kendziora, Benjamin; Miller, Julie M; Bandettini, W Patricia; Cox, Christopher; George, Richard T; Lima, João; Di Carli, Marcelo; Plotkin, Michail; Zimmermann, Elke; Laule, Michael; Schlattmann, Peter; Arai, Andrew E; Dewey, Marc

2018-02-01

Purpose To compare the diagnostic performance of stress myocardial computed tomography (CT) perfusion with that of stress myocardial magnetic resonance (MR) perfusion imaging in the detection of coronary artery disease (CAD). Materials and Methods All patients gave written informed consent prior to inclusion in this institutional review board-approved study. This two-center substudy of the prospective Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Row Computed Tomography (CORE320) multicenter trial included 92 patients (mean age, 63.1 years ± 8.1 [standard deviation]; 73% male). All patients underwent perfusion CT and perfusion MR imaging with either adenosine or regadenoson stress. The predefined reference standards were combined quantitative coronary angiography (QCA) and single-photon emission CT (SPECT) or QCA alone. Results from coronary CT angiography were not included, and diagnostic performance was evaluated with the Mantel-Haenszel test stratified by disease status. Results The prevalence of CAD was 39% (36 of 92) according to QCA and SPECT and 64% (59 of 92) according to QCA alone. When compared with QCA and SPECT, per-patient diagnostic accuracy of perfusion CT and perfusion MR imaging was 63% (58 of 92) and 75% (69 of 92), respectively (P = .11); sensitivity was 92% (33 of 36) and 83% (30 of 36), respectively (P = .45); and specificity was 45% (25 of 56) and 70% (39 of 56), respectively (P < .01). When compared with QCA alone, diagnostic accuracy of CT perfusion and MR perfusion imaging was 82% (75 of 92) and 74% (68 of 92), respectively (P = .27); sensitivity was 90% (53 of 59) and 69% (41 of 59), respectively (P < .01); and specificity was 67% (22 of 33) and 82% (27 of 33), respectively (P = .27). Conclusion This multicenter study shows that the diagnostic performance of perfusion CT is similar to that of perfusion MR imaging in the detection of CAD. © RSNA, 2017 Online supplemental material is available for this article.

Death row inmate characteristics, adjustment, and confinement: a critical review of the literature.

PubMed

Cunningham, Mark D; Vigen, Mark P

2002-01-01

This article reviews and summarizes research on death row inmates. The contributions and weaknesses of death row demographic data, clinical studies, and research based on institutional records are critiqued. Our analysis shows that death row inmates are overwhelmingly male and disproportionately Southern. Racial representation remains controversial. Frequently death row inmates are intellectually limited and academically deficient. Histories of significant neurological insult are common, as are developmental histories of trauma, family disruption, and substance abuse. Rates of psychological disorder among death row inmates are high, with conditions of confinement appearing to precipitate or aggravate these disorders. Contrary to expectation, the extant research indicates that the majority of death row inmates do not exhibit violence in prison even in more open institutional settings. These findings have implications for forensic mental health sentencing evaluations, competent attorney representation, provision of mental health services, racial disparity in death sentences, death row security and confinement policies, and moral culpability considerations. Future research directions on death row populations are suggested. Copyright 2002 John Wiley & Sons, Ltd.

Broad ligament hernia successfully repaired by single-incision laparoscopy: A case report.

PubMed

Takeyama, Hiroshi; Kogita, Yuya; Nishigaki, Takahiko; Yamashita, Masafumi; Aikawa, Eriko; Hoshi, Minako; Taniguchi, Hirokazu; Maruyama, Yasuki; Nakajima, Kazuhiro; Yamamoto, Yoshimitsu; Adachi, Kazushige; Yamamoto, Hitoshi; Ikeda, Kimimasa; Kurokawa, Eiji

2017-11-08

A 52-year-old woman with a history of two parturitions presented with lower abdominal pain. Multi-detector CT of the abdomen showed discontinuity of the sigmoid colon near the broad ligament on the left side. We assigned a provisional diagnosis of an internal hernia progressing through a defect in the broad ligament. SILS revealed a total broad ligament defect on the left side but no signs of ischemic, necrotic bowel. We successfully repaired the broad ligament defect with suturing. At the 2-month follow-up, the patient remained well with no signs of recurrence. This case appears to be the first report of a broad ligament hernia successfully diagnosed and repaired by SILS. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

Evaluation of the anterior ethmoidal artery by 3D dual volume rotational digital subtraction angiography and native multidetector CT with multiplanar reformations. Initial findings.

PubMed

Pandolfo, Ignazio; Vinci, Sergio; Salamone, Ignazio; Granata, Francesca; Mazziotti, Silvio

2007-06-01

Our purpose is to codify the anterior ethmoidal artery (AEA) course and its relationship with adjacent structures. Twenty patients with cerebrovascular disease underwent selective internal carotid dual volume angiography. Fusion of the vascular and bony images was obtained successively on a second console. MDCT of the cranium was performed in all patients. To identify the AEA course, multiplanar CT reformations were obtained. In all cases the entry-point of AEA and its course were identified by means of dual volume angiography. The information was confirmed by MDCT. In a second phase, we studied another 78 patients affected by inflammatory disease and polyposis only by means of MDCT, in order to confirm the previous data obtained by comparison between angiography and MDCT. In this second phase, 110/156 vessels were indirectly detected by means of visualization of the ethmoidal entry point. In the remaining cases, AEA was directly shown due to integrity of the thin ethmoidal bone lamellae or bony canal. Dual volume angiography is essential to identify the course of the AEA (standard of reference for the interpretation of CT). In patients with benign rhinosinusal pathology, where invasivity techniques are not justified, MPR reconstructions were of pivotal importance in the evaluation of the course of the artery with particular reference to its relationship with the frontal recess.

The effects of emphysema on airway disease: correlations between multi-detector CT and pulmonary function tests in smokers.

PubMed

Yahaba, Misuzu; Kawata, Naoko; Iesato, Ken; Matsuura, Yukiko; Sugiura, Toshihiko; Kasai, Hajime; Sakurai, Yoriko; Terada, Jiro; Sakao, Seiichiro; Tada, Yuji; Tanabe, Nobuhiro; Tatsumi, Koichiro

2014-06-01

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and small airway narrowing. Quantitative evaluation of airway dimensions by multi-detector computed tomography (MDCT) has revealed a correlation between airway dimension and airflow limitation. However, the effect of emphysema on this correlation is unclear. The goal of this study was to determine whether emphysematous changes alter the relationships between airflow limitation and airway dimensions as measured by inspiratory and expiratory MDCT. Ninety-one subjects underwent inspiratory and expiratory MDCT. Images were evaluated for mean airway luminal area (Ai), wall area percentage (WA%) from the third to the fifth generation of three bronchi (B1, B5, B8) in the right lung, and low attenuation volume percent (LAV%). Correlations between each airway index and airflow limitation were determined for each patient and compared between patients with and without evidence of emphysema. In patients without emphysema, Ai and WA% from both the inspiratory and expiratory scans were significantly correlated with FEV1. No correlation was detected in patients with emphysema. In addition, emphysematous COPD patients with GOLD stage 1 or 2 disease had significantly lower changes in B8 Ai than non-emphysematous patients. A significant correlation exists between airway parameters and FEV1 in patients without emphysema. Emphysema may influence airway dimensions even in patients with mild to moderate COPD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Health economic assessment of Gd-EOB-DTPA MRI versus ECCM-MRI and multi-detector CT for diagnosis of hepatocellular carcinoma in China

PubMed Central

He, Xiaoning; Holtorf, Anke-Peggy; Rinde, Harald; Xie, Shuangshuang; Shen, Wen; Hou, Jiancun; Li, Xuehua; Li, Ziping; Lai, Jiaming; Wang, Yuting; Zhang, Lin; Wang, Jian; Li, Xuesong; Ma, Kuansheng; Ye, Feng; Ouyang, Han; Zhao, Hong

2018-01-01

Limited data exists in China on the comparative cost of gadolinium ethoxybenzyl diethylenetriamine magnetic resonance imaging (Gd-EOB-DTPA-MRI) with other imaging techniques. This study compared the total cost of Gd-EOB-DTPA-MRI with multidetector computed tomography (MDCT) and extracellular contrast media–enhanced MRI (ECCM-MRI) as initial imaging procedures in patients with suspected hepatocellular carcinoma (HCC). We developed a decision-tree model on the basis of the Chinese clinical guidelines for HCC, which was validated by clinical experts from China. The model compared the diagnostic accuracy and costs of alternative initial imaging procedures. Compared with MDCT and ECCM-MRI, Gd-EOB-DTPA-MRI imaging was associated with higher rates of diagnostic accuracy, i.e. higher proportions of true positives (TP) and true negatives (TN) with lower false positives (FP). Total diagnosis and treatment cost per patient after the initial Gd-EOB-DTPA-MRI evaluation was similar to MDCT (¥30,360 vs. ¥30,803) and lower than that reported with ECCM-MRI (¥30,360 vs. ¥31,465). Lower treatment cost after initial Gd-EOB-DTPA-MRI was driven by reduced utilization of confirmatory diagnostic procedures and unnecessary treatments. The findings reported that Gd-EOB-DTPA-MRI offered higher diagnostic accuracy compared with MDCT and ECCM-MRI at a comparable cost, which indicates Gd-EOB-DTPA-MRI could be the preferred initial imaging procedure for the diagnosis of HCC in China. PMID:29324837

Single-source dual-energy spectral multidetector CT of pancreatic adenocarcinoma: optimization of energy level viewing significantly increases lesion contrast.

PubMed

Patel, B N; Thomas, J V; Lockhart, M E; Berland, L L; Morgan, D E

2013-02-01

To evaluate lesion contrast in pancreatic adenocarcinoma patients using spectral multidetector computed tomography (MDCT) analysis. The present institutional review board-approved, Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant retrospective study evaluated 64 consecutive adults with pancreatic adenocarcinoma examined using a standardized, multiphasic protocol on a single-source, dual-energy MDCT system. Pancreatic phase images (35 s) were acquired in dual-energy mode; unenhanced and portal venous phases used standard MDCT. Lesion contrast was evaluated on an independent workstation using dual-energy analysis software, comparing tumour to non-tumoural pancreas attenuation (HU) differences and tumour diameter at three energy levels: 70 keV; individual subject-optimized viewing energy level (based on the maximum contrast-to-noise ratio, CNR); and 45 keV. The image noise was measured for the same three energies. Differences in lesion contrast, diameter, and noise between the different energy levels were analysed using analysis of variance (ANOVA). Quantitative differences in contrast gain between 70 keV and CNR-optimized viewing energies, and between CNR-optimized and 45 keV were compared using the paired t-test. Thirty-four women and 30 men (mean age 68 years) had a mean tumour diameter of 3.6 cm. The median optimized energy level was 50 keV (range 40-77). The mean ± SD lesion contrast values (non-tumoural pancreas - tumour attenuation) were: 57 ± 29, 115 ± 70, and 146 ± 74 HU (p = 0.0005); the lengths of the tumours were: 3.6, 3.3, and 3.1 cm, respectively (p = 0.026); and the contrast to noise ratios were: 24 ± 7, 39 ± 12, and 59 ± 17 (p = 0.0005) for 70 keV, the optimized energy level, and 45 keV, respectively. For individuals, the mean ± SD contrast gain from 70 keV to the optimized energy level was 59 ± 45 HU; and the mean ± SD contrast gain from the optimized energy level to 45 keV was 31 ± 25 HU (p = 0.007). Significantly increased pancreatic lesion contrast was noted at lower viewing energies using spectral MDCT. Individual patient CNR-optimized energy level images have the potential to improve lesion conspicuity. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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

PubMed

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

2016-07-01

The development of multidetector computed tomography has triggered a revolution in the study of the aorta and other large vessels and has replaced angiography in the diagnosis of congenital anomalies of the aortic arch, particularly vascular rings. The major advantage of multidetector computed tomography is that it permits clear 3-dimensional assessment of not only vascular structures, but also airway and esophageal compression. The current update aims to summarize the embryonic development of the aortic arch and the developmental anomalies leading to vascular ring formation and to discuss the current diagnostic and therapeutic role of multidetector computed tomography in this field. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

A fast 3D region growing approach for CT angiography applications

NASA Astrophysics Data System (ADS)

Ye, Zhen; Lin, Zhongmin; Lu, Cheng-chang

2004-05-01

Region growing is one of the most popular methods for low-level image segmentation. Many researches on region growing have focused on the definition of the homogeneity criterion or growing and merging criterion. However, one disadvantage of conventional region growing is redundancy. It requires a large memory usage, and the computation-efficiency is very low especially for 3D images. To overcome this problem, a non-recursive single-pass 3D region growing algorithm named SymRG is implemented and successfully applied to 3D CT angiography (CTA) applications for vessel segmentation and bone removal. The method consists of three steps: segmenting one-dimensional regions of each row; doing region merging to adjacent rows to obtain the region segmentation of each slice; and doing region merging to adjacent slices to obtain the final region segmentation of 3D images. To improve the segmentation speed for very large volume 3D CTA images, this algorithm is applied repeatedly to newly updated local cubes. The next new cube can be estimated by checking isolated segmented regions on all 6 faces of the current local cube. This local non-recursive 3D region-growing algorithm is memory-efficient and computation-efficient. Clinical testings of this algorithm on Brain CTA show this technique could effectively remove whole skull, most of the bones on the skull base, and reveal the cerebral vascular structures clearly.

Is Weight-Based Adjustment of Automatic Exposure Control Necessary for the Reduction of Chest CT Radiation Dose?

PubMed Central

Prakash, Priyanka; Gilman, Matthew D.; Shepard, Jo-Anne O.; Digumarthy, Subba R.

2010-01-01

Objective To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. Materials and Methods With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Results Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 ± 3.1) and weight-adjusted (16.1 ± 5.6) AEC techniques (p > 0.05). Conclusion The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT. PMID:20046494

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans

PubMed Central

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2018-01-01

The goal of this study is to develop a generalized source model (GSM) for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology. PMID:28079526

Radiological diagnosis in lung disease: factoring treatment options into the choice of diagnostic modality.

PubMed

Wielpütz, Mark O; Heußel, Claus P; Herth, Felix J F; Kauczor, Hans-Ulrich

2014-03-14

Chest X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) each have characteristic advantages and disadvantages that need to be considered in clinical decision-making. This point is discussed in reference to the main types of lung disease that are encountered in practice. A selective literature search was performed in the PubMed and Google Scholar databases. Existing clinical guidelines on the main types of lung disease and studies concerning radiological diagnosis were also con - sidered in this review. There have been no more than a few large-scale, controlled comparative trials of different radiological techniques. Chest X-ray provides general orientation as an initial diagnostic study and is especially useful in the diagnosis of pneumonia, cancer, and chronic obstructive pulmonary disease (COPD). Multi-detector CT affords nearly isotropic spatial resolution at a radiation dose of only 0.2-5 mSv, much lower than before. Its main indications, according to current guidelines, are tumors, acute pulmonary embolism, pulmonary hypertension, pulmonary fibrosis, advanced COPD, and pneumonia in a high-risk patient. MRI is used in the diagnosis of cystic fibrosis, pulmonary embolism, pulmonary hypertension, and bronchial carcinoma. The positive predictive value (PPV) of a chest X-ray in outpatients with pneumonia is only 27% (gold standard, CT); in contrast, an initial, non-randomized trial of MRI in nosocomial pneumonia revealed a PPV of 95%. For the staging of mediastinal lymph nodes in bronchial carcinoma, MRI has a PPV of 88% and positron emission tomography with CT (PET/CT) has a PPV of 79%, while CT alone has a PPV of 41% (gold standard, histology). The choice of radiologicalal technique for the detection, staging, follow-up, and quantification of lung disease should be based on the individual clinical options, so that appropriate treatment can be provided without excessive use of diagnostic testing.

Is weight-based adjustment of automatic exposure control necessary for the reduction of chest CT radiation dose?

PubMed

Prakash, Priyanka; Kalra, Mannudeep K; Gilman, Matthew D; Shepard, Jo-Anne O; Digumarthy, Subba R

2010-01-01

To assess the effects of radiation dose reduction in the chest CT using a weight-based adjustment of the automatic exposure control (AEC) technique. With Institutional Review Board Approval, 60 patients (mean age, 59.1 years; M:F = 35:25) and 57 weight-matched patients (mean age, 52.3 years, M:F = 25:32) were scanned using a weight-adjusted AEC and non-weight-adjusted AEC, respectively on a 64-slice multidetector CT with a 0.984:1 pitch, 0.5 second rotation time, 40 mm table feed/rotation, and 2.5 mm section thickness. Patients were categorized into 3 weight categories; < 60 kg (n = 17), 60-90 kg (n = 52), and > 90 kg (n = 48). Patient weights, scanning parameters, CT dose index volumes (CTDIvol) and dose length product (DLP) were recorded, while effective dose (ED) was estimated. Image noise was measured in the descending thoracic aorta. Data were analyzed using a standard statistical package (SAS/STAT) (Version 9.1, SAS institute Inc, Cary, NC). Compared to the non-weight-adjusted AEC, the weight-adjusted AEC technique resulted in an average decrease of 29% in CTDIvol and a 27% effective dose reduction (p < 0.0001). With weight-adjusted AEC, the CTDIvol decreased to 15.8, 15.9, and 27.3 mGy for the < 60, 60-90 and > 91 kg weight groups, respectively, compared to 20.3, 27.9 and 32.8 mGy, with non-weight-adjusted AEC. No significant difference was observed for objective image noise between the chest CT acquired with the non-weight-adjusted (15.0 +/- 3.1) and weight-adjusted (16.1 +/- 5.6) AEC techniques (p > 0.05). The results of this study suggest that AEC should be tailored according to patient weight. Without weight-based adjustment of AEC, patients are exposed to a 17 - 43% higher radiation-dose from a chest CT.

The role of 18F-fluorodeoxyglucose positron emission tomography in the management of patients with pancreatic adenocarcinoma.

PubMed

Kadhim, Lujaien A; Dholakia, Avani S; Herman, Joseph M; Wahl, Richard L; Chaudhry, Muhammad A

2013-12-01

Pancreatic cancer continues to have a grim prognosis with 5-year survival rates at less than 5 %. It is a particularly challenging health problem given these poor survival outcomes, aggressive tumor biology, and late onset of symptoms. Most patients present with advanced unresectable cancer however, margin-negative resection provides a rare chance for cure for patients with resectable disease. The standard imaging modality for the diagnosis and management of pancreatic cancer is contrast-enhanced multidetector computed tomography. Remarkable advances in CT technology have led to improvements in the ability to detect small tumors and intricate vasculature involvement by the tumor, yet CT is still restricted to providing a morphological portrait of the tumor. Diagnosis can be challenging due to similar appearance of certain benign and malignant disease. Distant metastatic disease can be silent on CT leading to improper staging, and thus management, of certain patients. Furthermore, radiation-induced fibrosis and necrosis complicate assessment of treatment response by CT alone. F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) is becoming a prevalent tool employed by physicians to improve accuracy in these clinical scenarios. Malignant transformation causes a high metabolic activity of cancer cells. 18 F-FDG-PET captures this functional activity of malignancies by capturing areas with high glucose utilization rates. Imaging function rather than morphological appearance, 18 F-FDG-PET has a unique role in the management of oncology patients with the ability to detect regions of tumor involvement that may be silent on conventional imaging. Literature on the sensitivity and specificity of 18 F-FDG-PET fails to reach a consensus, and improvements resulting in hybridization of 18 F-FDG-PET and CT imaging techniques are preliminary. Here we review the potential role of 18 F-FDG-PET and PET/CT in improving accuracy in the initial evaluation and subsequent steps in the management of pancreatic cancer patients.

A measurement-based generalized source model for Monte Carlo dose simulations of CT scans

NASA Astrophysics Data System (ADS)

Ming, Xin; Feng, Yuanming; Liu, Ransheng; Yang, Chengwen; Zhou, Li; Zhai, Hezheng; Deng, Jun

2017-03-01

The goal of this study is to develop a generalized source model for accurate Monte Carlo dose simulations of CT scans based solely on the measurement data without a priori knowledge of scanner specifications. The proposed generalized source model consists of an extended circular source located at x-ray target level with its energy spectrum, source distribution and fluence distribution derived from a set of measurement data conveniently available in the clinic. Specifically, the central axis percent depth dose (PDD) curves measured in water and the cone output factors measured in air were used to derive the energy spectrum and the source distribution respectively with a Levenberg-Marquardt algorithm. The in-air film measurement of fan-beam dose profiles at fixed gantry was back-projected to generate the fluence distribution of the source model. A benchmarked Monte Carlo user code was used to simulate the dose distributions in water with the developed source model as beam input. The feasibility and accuracy of the proposed source model was tested on a GE LightSpeed and a Philips Brilliance Big Bore multi-detector CT (MDCT) scanners available in our clinic. In general, the Monte Carlo simulations of the PDDs in water and dose profiles along lateral and longitudinal directions agreed with the measurements within 4%/1 mm for both CT scanners. The absolute dose comparison using two CTDI phantoms (16 cm and 32 cm in diameters) indicated a better than 5% agreement between the Monte Carlo-simulated and the ion chamber-measured doses at a variety of locations for the two scanners. Overall, this study demonstrated that a generalized source model can be constructed based only on a set of measurement data and used for accurate Monte Carlo dose simulations of patients’ CT scans, which would facilitate patient-specific CT organ dose estimation and cancer risk management in the diagnostic and therapeutic radiology.

Analysis of left atrial respiratory and cardiac motion for cardiac ablation therapy

NASA Astrophysics Data System (ADS)

Rettmann, M. E.; Holmes, D. R.; Johnson, S. B.; Lehmann, H. I.; Robb, R. A.; Packer, D. L.

2015-03-01

Cardiac ablation therapy is often guided by models built from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans. One of the challenges in guiding a procedure from a preoperative model is properly synching the preoperative models with cardiac and respiratory motion through computational motion models. In this paper, we describe a methodology for evaluating cardiac and respiratory motion in the left atrium and pulmonary veins of a beating canine heart. Cardiac catheters were used to place metal clips within and near the pulmonary veins and left atrial appendage under fluoroscopic and ultrasound guidance and a contrast-enhanced, 64-slice multidetector CT scan was collected with the clips in place. Each clip was segmented from the CT scan at each of the five phases of the cardiac cycle at both end-inspiration and end-expiration. The centroid of each segmented clip was computed and used to evaluate both cardiac and respiratory motion of the left atrium. A total of three canine studies were completed, with 4 clips analyzed in the first study, 5 clips in the second study, and 2 clips in the third study. Mean respiratory displacement was 0.2+/-1.8 mm in the medial/lateral direction, 4.7+/-4.4 mm in the anterior/posterior direction (moving anterior on inspiration), and 9.0+/-5.0 mm superior/inferior (moving inferior with inspiration). At end inspiration, the mean left atrial cardiac motion at the clip locations was 1.5+/-1.3 mm in the medial/lateral direction, and 2.1+/-2.0 mm in the anterior/posterior and 1.3+/-1.2 mm superior/inferior directions. At end expiration, the mean left atrial cardiac motion at the clip locations was 2.0+/-1.5mm in the medial/lateral direction, 3.0+/-1.8mm in the anterior/posterior direction, and 1.5+/-1.5 mm in the superior/inferior directions.

Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb

PubMed Central

Dudley-Javoroski, S.; Petrie, M. A.; McHenry, C. L.; Amelon, R. E.; Saha, P. K.

2015-01-01

Summary This study examined the effect of a controlled dose of vibration upon bone density and architecture in people with spinal cord injury (who eventually develop severe osteoporosis). Very sensitive computed tomography (CT) imaging revealed no effect of vibration after 12 months, but other doses of vibration may still be useful to test. Introduction The purposes of this report were to determine the effect of a controlled dose of vibratory mechanical input upon individual trabecular bone regions in people with chronic spinal cord injury (SCI) and to examine the longitudinal bone architecture changes in both the acute and chronic state of SCI. Methods Participants with SCI received unilateral vibration of the constrained lower limb segment while sitting in a wheelchair (0.6g, 30 Hz, 20 min, three times weekly). The opposite limb served as a control. Bone mineral density (BMD) and trabecular micro-architecture were measured with high-resolution multi-detector CT. For comparison, one participant was studied from the acute (0.14 year) to the chronic state (2.7 years). Results Twelve months of vibration training did not yield adaptations of BMD or trabecular micro-architecture for the distal tibia or the distal femur. BMD and trabecular network length continued to decline at several distal femur sub-regions, contrary to previous reports suggesting a “steady state” of bone in chronic SCI. In the participant followed from acute to chronic SCI, BMD and architecture decline varied systematically across different anatomical segments of the tibia and femur. Conclusions This study supports that vibration training, using this study’s dose parameters, is not an effective antiosteoporosis intervention for people with chronic SCI. Using a high-spatial-resolution CT methodology and segmental analysis, we illustrate novel longitudinal changes in bone that occur after spinal cord injury. PMID:26395887

Small Bowel Gastrointestinal Stromal Tumors: Multidetector Computed Tomography Enhancement Pattern and Risk of Progression.

PubMed

Verde, Franco; Hruban, Ralph H; Fishman, Elliot K

Small bowel gastrointestinal stromal tumors (SB-GISTs) are rare lesions with a variable appearance on computed tomography (CT). This case series analyzes the CT enhancement pattern with the histologic risk assessment of tumor progression. Local institutional pathology database was searched for SB-GISTs from 2000 to 2015. Pathology reports and clinical notes were reviewed. Imaging was qualitatively reviewed for pattern of enhancement categorized into homogeneous or heterogeneous groups. Nonparametric statistical analysis was performed comparing enhancement to segment of bowel involved, presence of necrosis, tumor size, histologic grade (ie, G1 or G2), and histologic risk of progression (ie low, moderate, high). For simplicity, risk of progression was binned into low-risk or non-low-risk groups. Twenty-six pathology-proven, first presentation, nonmetastatic SB-GISTs were included into study. Seventeen were located in duodenum, 7 in jejunum, and 2 within the ileum. Dual phase (arterial and venous) CT imaging was available for 22 cases. Four cases did not have dual phase (three venous phase and one arterial phase only). Seventeen cases demonstrated heterogeneous enhancement and 9 cases homogeneous enhancement. Statistically significant difference was found between size versus enhancement groups (3.1 cm for homogeneous versus 6.8 cm for heterogeneous) (Mann-Whitney U test, n = 26, P = 0.002). Presence of necrosis versus enhancement group was statistically significant (Pearson χ, P = 0.001). Low-risk and non-low-risk groups versus enhancement groups was very significant (P = 0.001). Bowel segment involvement and histologic grading versus enhancement group did not reach statistical significance (P = 0.174 and P = 0.07, respectively). This case series reveals an important significant association between heterogeneous enhancement and non-low risk (ie, moderate/high) SB-GISTs. Beyond just describing the tumor, using enhancing pattern, the interpreting radiologist can preoperatively suggest additional prognostic information, potentially helpful for surgical planning.

Contribution of postmortem multidetector CT scanning to identification of the deceased in a mass disaster: Experience gained from the 2009 Victorian bushfires.

PubMed

O'Donnell, C; Iino, M; Mansharan, K; Leditscke, J; Woodford, N

2011-02-25

CT scanning of the deceased is an established technique performed on all individuals admitted to VIFM over the last 5 years. It is used primarily to assist pathologists in determining cause and manner of death but is also invaluable for identification of unknown deceased individuals where traditional methods are not possible. Based on this experience, CT scanning was incorporated into phase 2 of the Institute's DVI process for the 2009 Victorian bushfires. All deceased individuals and fragmented remains admitted to the mortuary were CT scanned in their body bags using established protocols. Images were reviewed by 2 teams of 2 radiologists experienced in forensic imaging and the findings transcribed onto a data sheet constructed specifically for the DVI exercise. The contents of 255 body bags were examined in the 28 days following the fires. 164 missing persons were included in the DVI process with 163 deceased individuals eventually identified. CT contributed to this identification in 161 persons. In 2 cases, radiologists were unable to recognize commingled remains. CT was utilized in the initial triage of each bag's contents. If radiological evaluation determined that bodies were incomplete then this information was provided to search teams who revisited the scenes of death. CT was helpful in differentiation of human from non-human remains in 8 bags, recognition of human/animal commingling in 10 bags and human commingling in 6 bags. In 61% of cases gender was able to be determined on CT using a novel technique of genitalia detection and in all but 2 cases this was correct. Age range was able to be determined on CT in 94% with an accuracy of 76%. Specific identification features detected on CT included the presence of disease (14 disease entities in 13 cases), medical devices (26 devices in 19 cases) and 274 everyday metallic items associated with the remains of 135 individuals. CT scanning provided useful information prior to autopsy by flagging likely findings including the presence of non-human remains, at the time of autopsy by assisting in the localization of identifying features in heavily disfigured bodies, and after autopsy by retrospective review of images for clarification of issues that arose at the time of pathologist case review. In view of the success of CT scanning in this mass disaster, DVI administrators should explore the incorporation of CT services into their disaster plans. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Safety of Tofacitinib in the Treatment of Rheumatoid Arthritis in Latin America Compared With the Rest of the World Population.

PubMed

Castañeda, Oswaldo M; Romero, Felix J; Salinas, Ariel; Citera, Gustavo; Mysler, Eduardo; Rillo, Oscar; Radominski, Sebastiao C; Cardiel, Mario H; Jaller, Juan J; Alvarez-Moreno, Carlos; Ponce de Leon, Dario; Castelli, Graciela; García, Erika G; Kwok, Kenneth; Rojo, Ricardo

2017-06-01

Rheumatoid arthritis (RA) is a chronic, autoimmune disease characterized by joint destruction. Tofacitinib is an oral Janus kinase inhibitor for the treatment of RA. This post hoc analysis assessed the safety of tofacitinib in Latin American (LA) patients with RA versus the Rest of World (RoW) population. Data were pooled from 14 clinical studies of tofacitinib: six Phase 2, six Phase 3 and two long-term extension studies. Incidence rates (IRs; patients with events/100 patient-years of treatment exposure) were calculated for safety events of special interest combined across tofacitinib doses. 95% confidence intervals (CI) for IRs were calculated using the maximum likelihood method. Descriptive comparisons were made between LA and RoW (excluding LA) populations. This analysis included data from 984 LA patients and 4687 RoW patients. IRs for safety events of special interest were generally similar between LA and RoW populations, with overlapping 95% CIs. IRs for discontinuation due to adverse events, serious infections, tuberculosis, all herpes zoster (HZ), serious HZ, malignancies (excluding non-melanoma skin cancer) and major adverse cardiovascular events were numerically lower for LA versus RoW patients; IR for mortality was numerically higher. No lymphoma was reported in the LA population versus eight cases in the RoW population. Exposure (extent and length) was lower in the LA population (2148.33 patient-years [mean = 2.18 years]) versus RoW (10515.68 patient-years [mean = 2.24 years]). This analysis of pooled data from clinical studies of tofacitinib in patients with RA demonstrates that tofacitinib has a consistent safety profile across LA and RoW patient populations.

[Contrast-enhanced ultrasound in animal models].

PubMed

Paprottka, P M; Zengel, P; Ingrisch, M; Cyran, C C; Eichhorn, M; Reiser, M F; Nikolaou, K; Clevert, D-A

2011-06-01

In the past the detection of tumor perfusion was achieved solely via invasive procedures, such as intravital microscopy or with the help of costly modalities, such as multidetector computed tomography (MDCT), magnetic resonance tomography (MRT) or the combined use of positron emission tomography and computed tomography (PET/CT). Ultrasound offers the non-invasive display of organs without usage of ionizing radiation and it is widely available. However, colour-coded ultrasound and power Doppler do not allow the detection of tumor microcirculation. The introduction of contrast-enhanced ultrasound (CEUS) as well as new high-frequency ultrasound probes made it possible to detect and quantify tumor microcirculation with high resolution. CEUS has been used clinically on human beings for more than 10 years. During the last years different tumor models in experimental animals were used for the establishment of this new technique, e.g. in rats, hamsters and mice. CEUS allows the detection of functional parameters, such as the angiogenetic metabolic status of tissue pretreatment and posttreatment. Further research is required to solve the problems of absolute quantification of these perfusion parameters to allow the comparison of CEUS with other modalities (e.g. MRT and CT).

Estimation of computed tomography dose index in cone beam computed tomography: MOSFET measurements and Monte Carlo simulations.

PubMed

Kim, Sangroh; Yoshizumi, Terry; Toncheva, Greta; Yoo, Sua; Yin, Fang-Fang; Frush, Donald

2010-05-01

To address the lack of accurate dose estimation method in cone beam computed tomography (CBCT), we performed point dose metal oxide semiconductor field-effect transistor (MOSFET) measurements and Monte Carlo (MC) simulations. A Varian On-Board Imager (OBI) was employed to measure point doses in the polymethyl methacrylate (PMMA) CT phantoms with MOSFETs for standard and low dose modes. A MC model of the OBI x-ray tube was developed using BEAMnrc/EGSnrc MC system and validated by the half value layer, x-ray spectrum and lateral and depth dose profiles. We compared the weighted computed tomography dose index (CTDIw) between MOSFET measurements and MC simulations. The CTDIw was found to be 8.39 cGy for the head scan and 4.58 cGy for the body scan from the MOSFET measurements in standard dose mode, and 1.89 cGy for the head and 1.11 cGy for the body in low dose mode, respectively. The CTDIw from MC compared well to the MOSFET measurements within 5% differences. In conclusion, a MC model for Varian CBCT has been established and this approach may be easily extended from the CBCT geometry to multi-detector CT geometry.

Effects of stroke resistance on rowing economy in club rowers post-season.

PubMed

Kane, D A; Mackenzie, S J; Jensen, R L; Watts, P B

2013-02-01

In the sport of rowing, increasing the impulse applied to the oar handle during the stroke can result in greater boat velocities; this may be facilitated by increasing the surface area of the oar blade and/or increasing the length of the oars. The purpose of this study was to compare the effects of different rowing resistances on the physiological response to rowing. 5 male and 7 female club rowers completed progressive, incremental exercise tests on an air-braked rowing ergometer, using either low (LO; 100) or high (HI; 150) resistance (values are according to the adjustable "drag factor" setting on the ergometer). Expired air, blood lactate concentration, heart rate, rowing cadence, and ergometer power output were monitored during the tests. LO rowing elicited significantly greater cadences (P<0.01) and heart rates (P<0.05), whereas rowing economy (J · L O(2) equivalents(-1)) was significantly greater during HI rowing (P<0.05). These results suggest that economically, rowing with a greater resistance may be advantageous for performance. Moreover, biomechanical analysis of ergometer rowing support the notion that the impulse generated during the stroke increases positively as a function of rowing resistance. We conclude that an aerobic advantage associated with greater resistance parallels the empirical trend toward larger oar blades in competitive rowing. This may be explained by a greater stroke impulse at the higher resistance. © Georg Thieme Verlag KG Stuttgart · New York.

Does double-row rotator cuff repair improve functional outcome of patients compared with single-row technique? A systematic review.

PubMed

DeHaan, Alexander M; Axelrad, Thomas W; Kaye, Elizabeth; Silvestri, Lorenzo; Puskas, Brian; Foster, Timothy E

2012-05-01

The advantage of single-row versus double-row arthroscopic rotator cuff repair techniques has been a controversial issue in sports medicine and shoulder surgery. There is biomechanical evidence that double-row techniques are superior to single-row techniques; however, there is no clinical evidence that the double-row technique provides an improved functional outcome. When compared with single-row rotator cuff repair, double-row fixation, although biomechanically superior, has no clinical benefit with respect to retear rate or improved functional outcome. Systematic review. The authors reviewed prospective studies of level I or II clinical evidence that compared the efficacy of single- and double-row rotator cuff repairs. Functional outcome scores included the American Shoulder and Elbow Surgeons (ASES) shoulder scale, the Constant shoulder score, and the University of California, Los Angeles (UCLA) shoulder rating scale. Radiographic failures and complications were also analyzed. A test of heterogeneity for patient demographics was also performed to determine if there were differences in the patient profiles across the included studies. Seven studies fulfilled our inclusion criteria. The test of heterogeneity across these studies showed no differences. The functional ASES, Constant, and UCLA outcome scores revealed no difference between single- and double-row rotator cuff repairs. The total retear rate, which included both complete and partial retears, was 43.1% for the single-row repair and 27.2% for the double-row repair (P = .057), representing a trend toward higher failures in the single-row group. Through a comprehensive literature search and meta-analysis of current arthroscopic rotator cuff repairs, we found that the single-row repairs did not differ from the double-row repairs in functional outcome scores. The double-row repairs revealed a trend toward a lower radiographic proven retear rate, although the data did not reach statistical significance. There may be a concerning trend toward higher retear rates in patients undergoing a single-row repair, but further studies are required.