The multislice CT findings of renal carcinoma associated with XP11.2 translocation/TFE gene fusion and collecting duct carcinoma.

PubMed

Zhu, Qing-Qiang; Wang, Zhong-Qiu; Zhu, Wen-Rong; Chen, Wen-Xin; Wu, Jing-Tao

2013-04-01

Renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusion (Xp11.2/TFE RCC), and collecting duct carcinoma (CDC) are uncommon subtypes of renal cell carcinomas. To investigate the multislice CT (MSCT) characteristics of these two tumor types. Nine patients with Xp11.2/TFE RCC and 10 patients with CDC were studied retrospectively. MSCT was undertaken to investigate differences in tumor characteristics and enhancement patterns. All patients had single tumors centered in the renal medulla. Two patients with each tumor type had lymph node involvement and there was a single case of hepatic metastasis (Xp11.2/TFE RCC). The mean tumor diameter of Xp11.2/TFE RCC tumors was significantly larger than for CDC tumors. Two patients with Xp11.2/TFE RCC had cystic components as did eight patients with CDC (P < 0.05). Calcifications were present in six patients, each with CDC. Clear tumor boundaries were visible in two patients with CDC and in nine with Xp11.2/TFE RCC (P < 0.05). The density of Xp11.2/TFE RCC tumors was greater than that of CDC tumors, normal renal cortex, or medulla on unenhanced CT. Enhancement was higher with Xp11.2/TFE RCC than with CDC tumors during all phases. Xp11.2/TFE RCC enhancement was higher than in the renal medulla during cortical and medullary phase but lower than in normal renal medulla during the delayed phase. CDC tumor enhancement was lower than that for normal renal medulla during all enhanced phases. Both tumor types originated from the renal medulla. Distinguishing features included density on unenhanced CT, enhancement patterns, and capsule signs. Identifying these differences may aid diagnosis.

Into the decomposed body-forensic digital autopsy using multislice-computed tomography.

PubMed

Thali, M J; Yen, K; Schweitzer, W; Vock, P; Ozdoba, C; Dirnhofer, R

2003-07-08

It is impossible to obtain a representative anatomical documentation of an entire body using classical X-ray methods, they subsume three-dimensional bodies into a two-dimensional level. We used the novel multislice-computed tomography (MSCT) technique in order to evaluate a case of homicide with putrefaction of the corpse before performing a classical forensic autopsy. This non-invasive method showed gaseous distension of the decomposing organs and tissues in detail as well as a complex fracture of the calvarium. MSCT also proved useful in screening for foreign matter in decomposing bodies, and full-body scanning took only a few minutes. In conclusion, we believe postmortem MSCT imaging is an excellent vizualisation tool with great potential for forensic documentation and evaluation of decomposed bodies.

Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64.

PubMed

Miller, Julie M; Dewey, Marc; Vavere, Andrea L; Rochitte, Carlos E; Niinuma, Hiroyuki; Arbab-Zadeh, Armin; Paul, Narinder; Hoe, John; de Roos, Albert; Yoshioka, Kunihiro; Lemos, Pedro A; Bush, David E; Lardo, Albert C; Texter, John; Brinker, Jeffery; Cox, Christopher; Clouse, Melvin E; Lima, João A C

2009-04-01

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective "CORE-64" trial ("Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors"). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows.

Quantification of bone quality using different cone beam computed tomography devices: Accuracy assessment for edentulous human mandibles.

PubMed

Van Dessel, Jeroen; Nicolielo, Laura Ferreira Pinheiro; Huang, Yan; Slagmolen, Pieter; Politis, Constantinus; Lambrichts, Ivo; Jacobs, Reinhilde

To determine the accuracy of the latest cone beam computed tomography (CBCT) machines in comparison to multi-slice computer tomography (MSCT) and micro computed tomography (micro-CT) for objectively assessing trabecular and cortical bone quality prior to implant placement. Eight edentulous human mandibular bone samples were scanned with seven CBCT scanners (3D Accuitomo 170, i-CAT Next Generation, ProMax 3D Max, Scanora 3D, Cranex 3D, Newtom GiANO and Carestream 9300) and one MSCT system (Somatom Definition Flash) using the clinical exposure protocol with the highest resolution. Micro-CT (SkyScan 1174) images served as a gold standard. A volume of interest (VOI) comprising trabecular and cortical bone only was delineated on the micro-CT. After spatial alignment of all scan types, micro-CT VOIs were overlaid on the CBCT and MSCT images. Segmentation was applied and morphometric parameters were calculated for each scanner. CBCT and MSCT morphometric parameters were compared with micro-CT using mixed-effect models. Intraclass correlation analysis was used to grade the accuracy of each scanner in assessing trabecular and cortical quality in comparison with the gold standard. Bone structure patterns of each scanner were compared with micro-CT in 2D and 3D to facilitate the interpretation of the morphometric analysis. Morphometric analysis showed an overestimation of the cortical and trabecular bone quantity during CBCT and MSCT evaluation compared to the gold standard micro-CT. The trabecular thickness (Tb.Th) was found to be significantly (P < 0.05) different and the smallest overestimation was found for the ProMax 3D Max (180 µm), followed by the 3D Accuitomo 170 (200 µm), Carestream 9300 (220 µm), Newtom GiANO (240 µm), Cranex 3D (280 µm), Scanora 3D (300 µm), high resolution MSCT (310 µm), i-CAT Next Generation (430 µm) and standard resolution MSCT (510 µm). The underestimation of the cortical thickness (Ct.Th) in ProMax 3D Max (-10 µm), the overestimation in Newtom GiANO (10 µm) and the high resolution MSCT (10 µm) were neglible. However, a significant overestimation (P < 0.05) was found for 3D Accuitomo 170 (110 µm), Scanora 3D (140 µm), standard resolution MSCT (150 µm), Carestream 9300 (190 µm), Cranex 3D (190 µm) and i-CAT Next Generation (230 µm). Comparison of the 2D network and 3D surface distance confirmed the overestimation in bone quantity, but only demonstrated a deviant trabecular network for the i-CAT Next Generation and the standard resolution MSCT. Intraclass correlation coefficients (ICCs) showed a significant (P < 0.05) high intra-observer reliability (ICC > 0.70) in morphometric evaluation between micro-CT and commercially available CBCT scanners (3D Accuitomo 170, Newtom GiANO and ProMax 3D Max). The ICC for Tb.Th and Ct.Th were 0.72 and 0.98 (3D Accuitomo 170), 0.71 and 0.96 (Newtom GiANO), and 0.87 and 0.92 (ProMax 3D Max), respectively. High resolution CBCT offers a clinical alternative to MSCT to objectively determine the bone quality prior to implant placement. However, not all tested CBCT machines have sufficient resolution to accurately depict the trabecular network or cortical bone. Conflict-of-interest statement: There is no conflict of interest to declare. Fellowship support came from Research Foundation Flanders (FWO) from the Belgian government, and Coordination for the Improvement of Higher Education Personnel (CAPES) program and Science without borders from the Brazilian government.

Micro computed tomography features of laryngeal fractures in a case of fatal manual strangulation.

PubMed

Fais, Paolo; Giraudo, Chiara; Viero, Alessia; Miotto, Diego; Bortolotti, Federica; Tagliaro, Franco; Montisci, Massimo; Cecchetto, Giovanni

2016-01-01

Cases of subtle fatal neck compression are often complicated by the lack of specificity of the post-mortem signs of asphyxia and by the lack of clear signs of neck compression. Herein we present a forensic case of a 45-year-old schizophrenic patient found on the floor of the bedroom of a psychiatric ward in cardiopulmonary arrest and who died after two days in a vegetative state. The deposition of the roommate of the deceased, who claimed responsibility for the killing of the victim by neck compression, was considered unreliable by the prosecutor. Autopsy, toxicological analyses, and multi-slice computed tomography (MSCT), micro computed tomography (micro-CT) and histology of the larynx complex were performed. Particularly, micro-CT analysis of the thyroid cartilage revealed the bilateral presence of ossified triticeous cartilages and the complete fragmentation of the right superior horn of the thyroid, but it additionally demonstrated a fracture on the contralateral superior horns, which was not clearly diagnosable at MSCT. On the basis of the evidence of intracartilaginous laryngeal hemorrhages and bilateral microfracture at the base of the superior horns of the larynx, the death was classified as a case of asphyxia due to manual strangulation. Micro-CT was confirmed as a useful tool in cases of subtle fatal neck compression, for the detection of minute laryngeal cartilage fractures, especially in complex cases with equivocal findings on MSCT. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A comparative study for image quality and radiation dose of a cone beam computed tomography scanner and a multislice computed tomography scanner for paranasal sinus imaging.

PubMed

De Cock, Jens; Zanca, Federica; Canning, John; Pauwels, Ruben; Hermans, Robert

2015-07-01

To evaluate image quality and radiation dose of a state of the art cone beam computed tomography (CBCT) system and a multislice computed tomography (MSCT) system in patients with sinonasal poliposis. In this retrospective study two radiologists evaluated 57 patients with sinonasal poliposis who underwent a CBCT or MSCT sinus examination, along with a control group of 90 patients with normal radiological findings. Tissue doses were measured using a phantom model with thermoluminescent dosimeters (TLD). Overall image quality in CBCT was scored significantly higher than in MSCT in patients with normal radiologic findings (p-value: 0.00001). In patients with sinonasal poliposis, MSCT scored significantly higher than CBCT (p-value: 0.00001). The average effective dose for MSCT was 42% higher compared to CBCT (108 μSv vs 63 μSv). CBCT and MSCT are both suited for the evaluation of sinonasal poliposis. In patients with sinonasal poliposis, clinically important structures of the paranasal sinuses can be better delineated with MSCT, whereas in patients without sinonasal poliposis, CBCT turns out to define the important structures of the sinonasal region better. However, given the lower radiation dose, CBCT can be considered for the evaluation of the sinonasal structures in patients with sinonasal poliposis. • CBCT and MSCT are both suited for evaluation of sinonasal poliposis. • Effective dose for MSCT was 42% higher compared to CBCT. • In patients with sinonasal poliposis, clinically important anatomical structures are better delineated with MSCT. • In patients with normal radiological findings, clinically important anatomical structures are better delineated with CBCT.

Use of automatic exposure control in multislice computed tomography of the coronaries: comparison of 16‐slice and 64‐slice scanner data with conventional coronary angiography

PubMed Central

Deetjen, Anja; Möllmann, Susanne; Conradi, Guido; Rolf, Andreas; Schmermund, Axel; Hamm, Christian W; Dill, Thorsten

2007-01-01

Objective To evaluate the radiation‐dose‐reduction potential of automatic exposure control (AEC) in 16‐slice and 64‐slice multislice computed tomography (MSCT) of the coronary arteries (computed tomography angiography, CTA) in patients. The rapid growth in MSCT CTA emphasises the necessity of adjusting technique factors to reduce radiation dose exposure. Design A retrospective data analysis was performed for 154 patients who had undergone MSCT CTA. Group 1 (n = 56) had undergone 16‐slice MSCT without AEC, and group 2 (n = 51), with AEC. In group 1, invasive coronary angiography (ICA) had been performed in addition. Group 3 (n = 47) had been examined using a 64‐slice scanner (with AEC, without ECG‐triggered tube current modulation). Results In group 1, the mean (SD) effective dose (ED) for MSCT CTA was 9.76 (1.84) mSv and for ICA it was 2.6 (1.27) mSv. In group 2, the mean ED for MSCT CTA was 5.83 (1.73) mSv, which signifies a 42.8% dose reduction for CTA by the use of AEC. In comparison to ICA, MSCT CTA without AEC shows a 3.8‐fold increase in radiation dose, and the radiation dose of CTA with AEC was increased by a factor of 1.9. In group 3, the mean ED for MSCT CTA was 13.58 (2.80) mSV. Conclusions This is the first study to show the significant dose‐reduction potential (42.8%) of AEC in MSCT CTA in patients. This relatively new technique can be used to optimise the radiation dose levels in MSCT CTA. PMID:17395667

Variability of dental cone beam CT grey values for density estimations

PubMed Central

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

2013-01-01

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

Imaging of the midpalatal suture in a porcine model: flat-panel volume computed tomography compared with multislice computed tomography.

PubMed

Hahn, Wolfram; Fricke-Zech, Susanne; Fialka-Fricke, Julia; Dullin, Christian; Zapf, Antonia; Gruber, Rudolf; Sennhenn-kirchner, Sabine; Kubein-Meesenburg, Dietmar; Sadat-Khonsari, Reza

2009-09-01

An investigation was conducted to compare the image quality of prototype flat-panel volume computed tomography (fpVCT) and multislice computed tomography (MSCT) of suture structures. Bone samples were taken from the midpalatal suture of 5 young (16 weeks) and 5 old (200 weeks) Sus scrofa domestica and fixed in formalin solution. An fpVCT prototype and an MSCT were used to obtain images of the specimens. The facial reformations were assessed by 4 observers using a 1 (excellent) to 5 (poor) rating scale for the weighted criteria visualization of the suture structure. A linear mixed model was used for statistical analysis. Results with P < .05 were considered to be statistically significant. The visualization of the suture of young specimens was significantly better than that of older animals (P < .001). The visualization of the suture with fpVCT was significantly better than that with MSCT (P < .001). Compared with MSCT, fpVCT produces superior results in the visualization of the midpalatal suture in a Sus scrofa domestica model.

The potential of multi-slice computed tomography based volumetry for demonstrating reverse remodeling induced by cardiac resynchronization therapy.

PubMed

Langer, Christoph; Schroeder, Janina; Peterschroeder, Andreas; Vaske, Bernhard; Faber, Lothar; Welge, Dirk; Niethammer, Matthias; Lamp, Barbara; Butz, Thomas; Bitter, Thomas; Oldenburg, Olaf; Horstkotte, Dieter

2010-07-01

Multi-slice computed tomography (MSCT) was proved to provide precise cardiac volumetric assessment. Cardiac resynchronization therapy (CRT) is an effective treatment for selected patients with heart failure and reduced ejection fraction (HFREF). In HFREF patients we investigated the potential of MSCT based wall motion analysis in order to demonstrate CRT-induced reversed remodeling. Besides six patients with normal cardiac pump function serving as control group seven HFREF patients underwent contrast enhanced MSCT before and after CRT. Short cardiac axis views of the left ventricle (LV) in end-diastole (ED) and end-systole (ES) served for planimetry. Pre- and post-CRT MSCT based volumetry was compared with 2D echo. To demonstrate CRT-induced reverse remodeling, MSCT based multi-segment color-coded polar maps were introduced. With regard to the HFREF patients pre-CRT MSCT based volumetry correlated with 2D echo data for LV-EDV (MSCT 278.3+/-75.0mL vs. echo 274.4+/-85.6mL) r=0.380, p=0.401, LV-ESV (MSCT 226.7+/-75.4mL vs. echo 220.1+/-74.0mL) r=0.323, p=0.479 and LV-EF (MSCT 20.2+/-8.8% vs. echo 20.0+/-11.9%) r=0.617, p=0.143. Post-CRT MSCT correlated well with 2D echo: LV-EDV (MSCT 218.9+/-106.4mL vs. echo 188.7+/-93.1mL) r=0.87, p=0.011, LV-ESV (MSCT 145+/-71.5mL vs. echo 125.6+/-78mL) r=0.84, p=0.018 and LV-EF (MSCT 29.6+/-11.3mL vs. echo 38.6+/-14.6mL) r=0.89, p=0.007. There was a significant increase of the mid-ventricular septum in terms of absolute LV wall thickening of the responders (pre 0.9+/-2.1mm vs. post 3.3+/-2.2mm; p<0.0005). MSCT based volumetry involving multi-segment color-coded polar maps offers wall motion analysis to demonstrate CRT-induced reverse remodeling which needs to be further validated. 2010 Elsevier Ltd. All rights reserved.

Three-Dimensional Planning in Maxillofacial Fracture Surgery: Computer-Aided Design/Computer-Aided Manufacture Surgical Splints by Integrating Cone Beam Computerized Tomography Images Into Multislice Computerized Tomography Images.

PubMed

Ren, Jiayin; Zhou, Zhongwei; Li, Peng; Tang, Wei; Guo, Jixiang; Wang, Hu; Tian, Weidong

2016-09-01

This study aimed to evaluate an innovative workflow for maxillofacial fracture surgery planning and surgical splint designing. The maxillofacial multislice computerized tomography (MSCT) data and dental cone beam computerized tomography (CBCT) data both were obtained from 40 normal adults and 58 adults who suffered fractures. The each part of the CBCT dentition image was registered into MSCT image by the use of the iterative closest point algorithm. Volume evaluation of the virtual splints that were designed by the registered MSCT images and MSCT images of the same object was performed. Eighteen patients (group 1) were operated without any splint. Twenty-one (group 2) and 19 patients (group 3) used the splints designed according to the MSCT images and registered MSCT images, respectively. The authors' results showed that the mean errors between the 2 models ranged from 0.53 to 0.92 mm and the RMS errors ranged from 0.38 to 0.69 mm in fracture patients. The mean errors between the 2 models ranged from 0.47 to 0.85 mm and the RMS errors ranged from 0.33 to 0.71 mm in normal adults. 72.22% patients in group 1 recovered occlusion. 85.71% patients in group 2, and 94.73% patients in group 3 reconstructed occlusion. There was a statistically significant difference between the MSCT images based splints' volume and the registered MSCT splints' volume in patients (P <0.05). The MSCT images based splints' volume was statistically significantly distinct from the registered MSCT splints' volume in normal adults (P <0.05). There was a statistically significant difference between the MSCT images based splints' volume and the registered MSCT splints' volume in patients and normal adults (P <0.05). The occlusion recovery rate of group 3 was better than that of group 1 and group 2. The way of integrating CBCT images into MSCT images for splints designing was feasible. The volume of the splints designed by MSCT images tended to be smaller than the splints designed by the integrated MSCT images. The patients operated with splints tended to regain occlusion. The patients who were operated with the splints which were designed according to registered MSCT images tended to get occlusal recovered.

Assessment of global and regional left ventricular function using 64-slice multislice computed tomography and 2D echocardiography: a comparison with cardiac magnetic resonance.

PubMed

Annuar, Bin Rapaee; Liew, Chee Khoon; Chin, Sze Piaw; Ong, Tiong Kiam; Seyfarth, M Tobias; Chan, Wei Ling; Fong, Yean Yip; Ang, Choon Kiat; Lin, Naing; Liew, Houng Bang; Sim, Kui Hian

2008-01-01

To compare the assessment of global and regional left ventricular (LV) function using 64-slice multislice computed tomography (MSCT), 2D echocardiography (2DE) and cardiac magnetic resonance (CMR). Thirty-two consecutive patients (mean age, 56.5+/-9.7 years) referred for evaluation of coronary artery using 64-slice MSCT also underwent 2DE and CMR within 48h. The global left ventricular function which include left ventricular ejection fraction (LVEF), left ventricular end diastolic volume (LVdV) and left ventricular end systolic volume (LVsV) were determine using the three modalities. Regional wall motion (RWM) was assessed visually in all three modalities. The CMR served as the gold standard for the comparison between 64-slice MSCT with CMR and 2DE with CMR. Statistical analysis included Pearson correlation coefficient, Bland-Altman plots and kappa-statistics. The 64-slice MSCT agreed well with CMR for assessment of LVEF (r=0.92; p<0.0001), LVdV (r=0.98; p<0.0001) and LVsV (r=0.98; p<0.0001). In comparison with 64-slice MSCT, 2DE showed moderate correlation with CMR for the assessment of LVEF (r=0.84; p<0.0001), LVdV (r=0.83; p<0.0001) and LVsV (r=0.80; p<0.0001). However in RWM analysis, 2DE showed better accuracy than 64-slice MSCT (94.3% versus 82.4%) and closer agreement (kappa=0.89 versus 0.63) with CMR. 64-Slice MSCT correlates strongly with CMR in global LV function however in regional LV function 2DE showed better agreement with CMR than 64-slice MSCT.

Multi-slice computed tomography 5-minute delayed scan is superior to immediate scan after contrast media application in characterization of intracranial tuberculosis.

PubMed

Hou, Dailun; Qu, Huifang; Zhang, Xu; Li, Ning; Liu, Cheng; Ma, Xiangxing

2014-09-02

The aim of this study was to determine whether the diagnosis of intracranial tuberculosis (TB) can be improved when multi-slice computed tomography (MSCT) scans are taken with a 5-min delay after contrast media application. Pre- and post-contrast CT scans of the head were obtained from 30 patients using a 16-slice spiral CT. Dual-phase acquisition was performed immediately and 5 min after contrast agent injection. Diagnostic values of different images were compared using a scoring system applied by 2 experienced radiologists. We found 526 lesions in 30 patients, including 22 meningeal thickenings, 235 meningeal tuberculomas/tubercles, and 269 parenchymal tuberculomas/tubercles. Images obtained with 5-min delayed scan time were superior in terms of lesion size and meningeal thickening outlining in all disease types (P<0.01). The ability to distinguish between vascular sections from the cerebral sulcus and tubercle was also improved (P<0.01). Image acquisition with 5-min delay after contrast agent injection should be performed as a standard scanning protocol to diagnose intracranial TB.

Cardiac volumetry in patients with heart failure and reduced ejection fraction: a comparative study correlating multi-slice computed tomography and magnetic resonance tomography. Reasons for intermodal disagreement.

PubMed

Schroeder, Janina; Peterschroeder, Andreas; Vaske, Bernhard; Butz, Thomas; Barth, Peter; Oldenburg, Olaf; Bitter, Thomas; Burchert, Wolfgang; Horstkotte, Dieter; Langer, Christoph

2009-11-01

In humans with normal hearts multi-slice computed tomography (MSCT) based volumetry was shown to correlate well with the gold standard, cardiac magnetic resonance imaging (CMR). We correlated both techniques in patients with various degrees of heart failure and reduced ejection fraction (HFREF) resulting from cardiac dilatation. Twenty-four patients with a left ventricular enddiastolic volume (LV-EDV) of C 150 ml measured by angiography underwent MSCT and CMR scanning for left and right ventricular (LV, RV) volumetry. MSCT based short cardiac axis views were obtained beginning at the cardiac base advancing to the apex. These were reconstructed in 20 different time windows of the RR-interval (0-95%) serving for identification of enddiastole (ED) and end-systole (ES) and for planimetry. ED and ES volumes and the ejection fraction (EF) were calculated for LV and RV. MSCT based volumetry was compared with CMR. MSCT based LV volumetry significantly correlates with CMR as follows: LV-EDV r = 0.94, LV-ESV r = 0.98 and LV-EF r = 0.93, but significantly overestimates LV-EDV and LV-ESV and underestimates EF (P \\ 0.0001). MSCT based RV volumetry significantly correlates with CMR as follows: RV-EDV r = 0.79, RVESV r = 0.78 and RV-EF r = 0.73, but again significantly overestimates RV-EDV and RV-ESV and underestimates RV-EF (P \\ 0.0001). When compared with CMR a continuous overestimation of volumes and underestimation of EF needs to be considered when applying MSCT in HFREF patients.

Diagnostic Accuracy of Computed Tomography Angiography as Compared to Conventional Angiography in Patients Undergoing Noncoronary Cardiac Surgery

PubMed Central

Joshi, Hasit; Shah, Ronak; Prajapati, Jayesh; Bhangdiya, Vipin; Shah, Jayal; Kandre, Yogini; Shah, Komal

2016-01-01

Objective: To compare the diagnostic accuracy of multi-slice computed tomography (MSCT) angiography with conventional angiography in patients undergoing major noncoronary cardiac surgeries. Materials and Methods: We studied fifty major noncoronary cardiac surgery patients scheduled for invasive coronary angiography, 29 (58%) female and 21 (42%) male. Inclusion criteria of the study were age of the patients ≥40 years, having low or intermediate probability of coronary artery disease (CAD), left ventricular ejection fraction (LVEF) >35%, and patient giving informed consent for undergoing MSCT and conventional coronary angiography. The patients with LVEF <35%, high pretest probability of CAD, and hemodynamically unstable were excluded from the study. Results: The diagnostic accuracy of CT coronary angiography was evaluated regarding true positive, true negative values. The overall sensitivity and specificity of CT angiography technique was 100% (95% confidence interval [CI]: 39.76%–100%) and 91.30% (95% CI: 79.21%–97.58%). The positive (50%; 95% CI: 15.70%–84.30%) and negative predictive values (100%; 95% CI: 91.59%–100%) of CT angiography were also fairly high in these patients. Conclusion: Our study suggests that this non-invasive technique may improve perioperative risk stratification in patients undegoing non-cardiac surgery. PMID:27867455

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.

PubMed

Suomalainen, Anni; Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K

2015-12-01

The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination - multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Rapid prototyping, radiology, computed tomography, cone beam computed tomography.

Diagnostic Accuracy of Full-Body Linear X-Ray Scanning in Multiple Trauma Patients in Comparison to Computed Tomography.

PubMed

Jöres, A P W; Heverhagen, J T; Bonél, H; Exadaktylos, A; Klink, T

2016-02-01

The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. The overall sensitivity of LS was 49.2 %, the specificity was 93.3 %, the positive predictive value was 91 %, and the negative predictive value was 57.5 %. The overall sensitivity for vertebral fractures was 16.7 %, and the specificity was 100 %. The sensitivity was 48.7 % and the specificity 98.2 % for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS. 40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT.  The overall sensitivity of LS for truncal skeleton injuries in multiple-trauma patients was < 50 %. The diagnostic reference standard MSCT is the preferred and reliable imaging modality. LS may be valuable for quick detection of extremity fractures. © Georg Thieme Verlag KG Stuttgart · New York.

Multislice spiral computed tomography for the evaluation of stent patency after left main coronary artery stenting: a comparison with conventional coronary angiography and intravascular ultrasound.

PubMed

Van Mieghem, Carlos A G; Cademartiri, Filippo; Mollet, Nico R; Malagutti, Patrizia; Valgimigli, Marco; Meijboom, Willem B; Pugliese, Francesca; McFadden, Eugene P; Ligthart, Jurgen; Runza, Giuseppe; Bruining, Nico; Smits, Pieter C; Regar, Evelyn; van der Giessen, Willem J; Sianos, Georgios; van Domburg, Ron; de Jaegere, Peter; Krestin, Gabriel P; Serruys, Patrick W; de Feyter, Pim J

2006-08-15

Surveillance conventional coronary angiography (CCA) is recommended 2 to 6 months after stent-supported left main coronary artery (LMCA) percutaneous coronary intervention due to the unpredictable occurrence of in-stent restenosis (ISR), with its attendant risks. Multislice computed tomography (MSCT) is a promising technique for noninvasive coronary evaluation. We evaluated the diagnostic performance of high-resolution MSCT to detect ISR after stenting of the LMCA. Seventy-four patients were prospectively identified from a consecutive patient population scheduled for follow-up CCA after LMCA stenting and underwent MSCT before CCA. Until August 2004, a 16-slice scanner was used (n = 27), but we switched to the 64-slice scanner after that period (n = 43). Patients with initial heart rates > 65 bpm received beta-blockers, which resulted in a mean periscan heart rate of 57 +/- 7 bpm. Among patients with technically adequate scans (n = 70), MSCT correctly identified all patients with ISR (10 of 70) but misclassified 5 patients without ISR (false-positives). Overall, the accuracy of MSCT for detection of angiographic ISR was 93%. The sensitivity, specificity, and positive and negative predictive values were 100%, 91%, 67%, and 100%, respectively. When analysis was restricted to patients with stenting of the LMCA with or without extension into a single major side branch, accuracy was 98%. When both branches of the LMCA bifurcation were stented, accuracy was 83%. For the assessment of stent diameter and area, MSCT showed good correlation with intravascular ultrasound (r = 0.78 and 0.73, respectively). An intravascular ultrasound threshold value > or = 1 mm was identified to reliably detect in-stent neointima hyperplasia with MSCT. Current MSCT technology, in combination with optimal heart rate control, allows reliable noninvasive evaluation of selected patients after LMCA stenting. MSCT is safe to exclude left main ISR and may therefore be an acceptable first-line alternative to CCA.

Non-invasive coronary angiography with multislice computed tomography. Technology, methods, preliminary experience and prospects.

PubMed

Traversi, Egidio; Bertoli, Giuseppe; Barazzoni, Giancarlo; Baldi, Maurizia; Tramarin, Roberto

2004-02-01

The recent technical developments in multislice computed tomography (MSCT), with ECG retro-gated image reconstruction, have elicited great interest in the possibility of accurate non-invasive imaging of the coronary arteries. The latest generation of MSCT systems with 8-16 rows of detectors permits acquisition of the whole cardiac volume during a single 15-20 s breath-hold with a submillimetric definition of the images and an outstanding signal-to-noise ratio. Thus the race which, between MSCT, electron beam computed tomography and cardiac magnetic resonance imaging, can best provide routine and reliable imaging of the coronary arteries in clinical practice has recommenced. Currently available MSCT systems offer different options for both cardiac image acquisition and reconstruction, including multiplanar and curved multiplanar reconstruction, three-dimensional volume rendering, maximum intensity projection, and virtual angioscopy. In our preliminary experience including 176 patients suffering from known or suspected coronary artery disease, MSCT was feasible in 161 (91.5%) and showed a sensitivity of 80.4% and a specificity of 80.3%, with respect to standard coronary angiography, in detecting critical stenosis in coronary arteries and artery or venous bypass grafts. These results correspond to a positive predictive value of 58.6% and a negative predictive value of 92.2%. The true role that MSCT is likely to play in the future in non-invasive coronary imaging is still to be defined. Nevertheless, the huge amount of data obtainable by MSCT along with the rapid technological advances, shorter acquisition times and reconstruction algorithm developments will make the technique stronger, and possible applications are expected not only for non-invasive coronary angiography, but also for cardiac function and myocardial perfusion evaluation, as an all-in-one examination.

A comparative study of accuracy of linear measurements using cone beam and multi-slice computed tomographies for evaluation of mandibular canal location in dry mandibles.

PubMed

Naser, Asieh Zamani; Mehr, Bahar Behdad

2013-01-01

Cross- sectional tomograms have been used for optimal pre-operative planning of dental implant placement. The aim of the present study was to assess the accuracy of Cone Beam Computed Tomography (CBCT) measurements of specific distances around the mandibular canal by comparing them to those obtained from Multi-Slice Computed Tomography (MSCT) images. Ten hemi-mandible specimens were examined using CBCT and MSCT. Before imaging, wires were placed at 7 locations between the anterior margin of the third molar and the anterior margin of the second premolar as reference points. Following distances were measured by two observers on each cross-sectional CBCT and MSCT image: Mandibular Width (W), Length (L), Upper Distance (UD), Lower Distance (LD), Buccal Distance (BD), and Lingual Distance (LID). The obtained data were evaluated using SPSS software, applying paired t-test and intra-class correlation coefficient (ICC). There was a significant difference between the values obtained by MSCT and CBCT measurement for all areas such as H, W, UD, LD, BD, and LID, (P < 0.001), with a difference less than 1 mm. The ICC for all distances by both techniques, measured by a single observer with a one week interval and between 2 observers was 99% and 98%, respectively. Comparing the obtained data of both techniques indicates that the difference between two techniques is 2.17% relative to MSCT. The results of this study showed that there is significant difference between measurements obtained by CBCT and MSCT. However, the difference is not clinically significant.

Coronary imaging of anomalous origins and aneurysms of the left coronary artery by multislice computed tomography.

PubMed

Castorina, Sergio; Luca, Tonia; Privitera, Giovanna; Riccioli, Vincenzo

2010-01-01

In this paper, we describe two cases of anomalous origin of the left coronary artery and two cases of aneurysm on the left coronary artery. Detailed three-dimensional images were acquired by the multislice computed tomography (MSCT) SOMATOM Sensation Cardiac 64 during clinical studies of cardiac diseases. Copyright 2010. Published by Elsevier Inc.

Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study

PubMed Central

Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K.

2015-01-01

Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination – multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. Conclusions The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Key words:Rapid prototyping, radiology, computed tomography, cone beam computed tomography. PMID:26644837

Assessment of calcium scoring performance in cardiac computed tomography.

PubMed

Ulzheimer, Stefan; Kalender, Willi A

2003-03-01

Electron beam tomography (EBT) has been used for cardiac diagnosis and the quantitative assessment of coronary calcium since the late 1980s. The introduction of mechanical multi-slice spiral CT (MSCT) scanners with shorter rotation times opened new possibilities of cardiac imaging with conventional CT scanners. The purpose of this work was to qualitatively and quantitatively evaluate the performance for EBT and MSCT for the task of coronary artery calcium imaging as a function of acquisition protocol, heart rate, spiral reconstruction algorithm (where applicable) and calcium scoring method. A cardiac CT semi-anthropomorphic phantom was designed and manufactured for the investigation of all relevant image quality parameters in cardiac CT. This phantom includes various test objects, some of which can be moved within the anthropomorphic phantom in a manner that mimics realistic heart motion. These tools were used to qualitatively and quantitatively demonstrate the accuracy of coronary calcium imaging using typical protocols for an electron beam (Evolution C-150XP, Imatron, South San Francisco, Calif.) and a 0.5-s four-slice spiral CT scanner (Sensation 4, Siemens, Erlangen, Germany). A special focus was put on the method of quantifying coronary calcium, and three scoring systems were evaluated (Agatston, volume, and mass scoring). Good reproducibility in coronary calcium scoring is always the result of a combination of high temporal and spatial resolution; consequently, thin-slice protocols in combination with retrospective gating on MSCT scanners yielded the best results. The Agatston score was found to be the least reproducible scoring method. The hydroxyapatite mass, being better reproducible and comparable on different scanners and being a physical quantitative measure, appears to be the method of choice for future clinical studies. The hydroxyapatite mass is highly correlated to the Agatston score. The introduced phantoms can be used to quantitatively assess the performance characteristics of, for example, different scanners, reconstruction algorithms, and quantification methods in cardiac CT. This is especially important for quantitative tasks, such as the determination of the amount of calcium in the coronary arteries, to achieve high and constant quality in this field.

MRI vs. CT for orthodontic applications: comparison of two MRI protocols and three CT (multislice, cone-beam, industrial) technologies.

PubMed

Detterbeck, Andreas; Hofmeister, Michael; Hofmann, Elisabeth; Haddad, Daniel; Weber, Daniel; Hölzing, Astrid; Zabler, Simon; Schmid, Matthias; Hiller, Karl-Heinz; Jakob, Peter; Engel, Jens; Hiller, Jochen; Hirschfelder, Ursula

2016-07-01

To examine the relative usefulness and suitability of magnetic resonance imaging (MRI) in daily clinical practice as compared to various technologies of computed tomography (CT) in addressing questions of orthodontic interest. Three blinded raters evaluated 2D slices and 3D reconstructions created from scans of two pig heads. Five imaging modalities were used, including three CT technologies-multislice (MSCT), cone-beam CT (CBCT), and industrial (µCT)-and two MRI protocols with different scan durations. Defined orthodontic parameters were rated one by one on the 2D slices and the 3D reconstructions, followed by final overall ratings for each modality. A mixed linear model was used for statistical analysis. Based on the 2D slices, the parameter of visualizing tooth-germ topography did not yield any significantly different ratings for MRI versus any of the CT scans. While some ratings for the other parameters did involve significant differences, how these should be interpreted depends greatly on the relevance of each parameter. Based on the 3D reconstructions, the only significant difference between technologies was noted for the parameter of visualizing root-surface morphology. Based on the final overall ratings, the imaging performance of the standard MRI protocol was noninferior to the performance of the three CT technologies. On comparing the imaging performance of MRI and CT scans, it becomes clear that MRI has a huge potential for applications in daily clinical practice. Given its additional benefits of a good contrast ratio and complete absence of ionizing radiation, further studies are needed to explore this clinical potential in greater detail.

Assessment of effective radiation dose of an extremity CBCT, MSCT and conventional X ray for knee area using MOSFET dosemeters.

PubMed

Koivisto, Juha; Kiljunen, Timo; Wolff, Jan; Kortesniemi, Mika

2013-12-01

The objective of this study was to assess and compare the organ and effective doses in the knee area resulting from different commercially available multislice computed tomography devices (MSCT), one cone beam computed tomography device (CBCT) and one conventional X-ray radiography device using MOSFET dosemeters and an anthropomorphic RANDO knee phantom. Measurements of the MSCT devices resulted in effective doses ranging between 27 and 48 µSv. The CBCT measurements resulted in an effective dose of 12.6 µSv. The effective doses attained using the conventional radiography device were 1.8 µSv for lateral and 1.2 µSv for anterior-posterior projections. The effective dose resulting from conventional radiography was considerably lower than those recorded for the CBCT and MSCT devices. The MSCT effective dose results were two to four times higher than those measured on the CBCT device. This study demonstrates that CBCT can be regarded as a potential low-dose 3D imaging technique for knee examinations.

The impact of different cone beam computed tomography and multi-slice computed tomography scan parameters on virtual three-dimensional model accuracy using a highly precise ex vivo evaluation method.

PubMed

Matta, Ragai-Edward; von Wilmowsky, Cornelius; Neuhuber, Winfried; Lell, Michael; Neukam, Friedrich W; Adler, Werner; Wichmann, Manfred; Bergauer, Bastian

2016-05-01

Multi-slice computed tomography (MSCT) and cone beam computed tomography (CBCT) are indispensable imaging techniques in advanced medicine. The possibility of creating virtual and corporal three-dimensional (3D) models enables detailed planning in craniofacial and oral surgery. The objective of this study was to evaluate the impact of different scan protocols for CBCT and MSCT on virtual 3D model accuracy using a software-based evaluation method that excludes human measurement errors. MSCT and CBCT scans with different manufacturers' predefined scan protocols were obtained from a human lower jaw and were superimposed with a master model generated by an optical scan of an industrial noncontact scanner. To determine the accuracy, the mean and standard deviations were calculated, and t-tests were used for comparisons between the different settings. Averaged over 10 repeated X-ray scans per method and 19 measurement points per scan (n = 190), it was found that the MSCT scan protocol 140 kV delivered the most accurate virtual 3D model, with a mean deviation of 0.106 mm compared to the master model. Only the CBCT scans with 0.2-voxel resolution delivered a similar accurate 3D model (mean deviation 0.119 mm). Within the limitations of this study, it was demonstrated that the accuracy of a 3D model of the lower jaw depends on the protocol used for MSCT and CBCT scans. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit.

PubMed

Pedicelli, Alessandro; Verdolotti, Tommaso; Pompucci, Angelo; Desiderio, Flora; D'Argento, Francesco; Colosimo, Cesare; Bonomo, Lorenzo

2011-12-01

The aim of this paper is to demonstrate the usefulness of 2D multiplanar reformatting images (MPR) obtained from rotational acquisitions with cone-beam computed tomography technology during percutaneous extra-vascular spinal procedures performed in the angiography suite. We used a 3D rotational angiographic unit with a flat panel detector. MPR images were obtained from a rotational acquisition of 8 s (240 images at 30 fps), tube rotation of 180° and after post-processing of 5 s by a local work-station. Multislice CT (MSCT) is the best guidance system for spinal approaches permitting direct tomographic visualization of each spinal structure. Many operators, however, are trained with fluoroscopy, it is less expensive, allows real-time guidance, and in many centers the angiography suite is more frequently available for percutaneous procedures. We present our 6-year experience in fluoroscopy-guided spinal procedures, which were performed under different conditions using MPR images. We illustrate cases of vertebroplasty, epidural injections, selective foraminal nerve root block, facet block, percutaneous treatment of disc herniation and spine biopsy, all performed with the help of MPR images for guidance and control in the event of difficult or anatomically complex access. The integrated use of "CT-like" MPR images allows the execution of spinal procedures under fluoroscopy guidance alone in all cases of dorso-lumbar access, with evident limitation of risks and complications, and without need for recourse to MSCT guidance, thus eliminating CT-room time (often bearing high diagnostic charges), and avoiding organizational problems for procedures that need, for example, combined use of a C-arm in the CT room.

Accuracy and reproducibility of aortic annular measurements obtained from echocardiographic 3D manual and semi-automated software analyses in patients referred for transcatheter aortic valve implantation: implication for prosthesis size selection.

PubMed

Stella, Stefano; Italia, Leonardo; Geremia, Giulia; Rosa, Isabella; Ancona, Francesco; Marini, Claudia; Capogrosso, Cristina; Giglio, Manuela; Montorfano, Matteo; Latib, Azeem; Margonato, Alberto; Colombo, Antonio; Agricola, Eustachio

2018-02-06

A 3D transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced. The system automatically configures a geometric model of the aortic root and performs quantitative analysis of these structures. We compared the measurements of the aortic annulus (AA) obtained by semi-automated 3D-TOE quantitative software and manual analysis vs. multislice computed tomography (MSCT) ones. One hundred and seventy-five patients (mean age 81.3 ± 6.3 years, 77 men) who underwent both MSCT and 3D-TOE for annulus assessment before transcatheter aortic valve implantation were analysed. Hypothetical prosthetic valve sizing was evaluated using the 3D manual, semi-automated measurements using manufacturer-recommended CT-based sizing algorithm as gold standard. Good correlation between 3D-TOE methods vs. MSCT measurements was found, but the semi-automated analysis demonstrated slightly better correlations for AA major diameter (r = 0.89), perimeter (r = 0.89), and area (r = 0.85) (all P < 0.0001) than manual one. Both 3D methods underestimated the MSCT measurements, but semi-automated measurements showed narrower limits of agreement and lesser bias than manual measurements for most of AA parameters. On average, 3D-TOE semi-automated major diameter, area, and perimeter underestimated the respective MSCT measurements by 7.4%, 3.5%, and 4.4%, respectively, whereas minor diameter was overestimated by 0.3%. Moderate agreement for valve sizing for both 3D-TOE techniques was found: Kappa agreement 0.5 for both semi-automated and manual analysis. Interobserver and intraobserver agreements for the AA measurements were excellent for both techniques (intraclass correlation coefficients for all parameters >0.80). The 3D-TOE semi-automated analysis of AA is feasible and reliable and can be used in clinical practice as an alternative to MSCT for AA assessment. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.

Comparison of intravascular ultrasound to contrast-enhanced 64-slice computed tomography to assess the significance of angiographically ambiguous coronary narrowings.

PubMed

Okabe, Teruo; Weigold, Wm Guy; Mintz, Gary S; Roswell, Robert; Joshi, Subodh; Lee, Sung Yun; Lee, Bongryeol; Steinberg, Daniel H; Roy, Probal; Slottow, Tina L Pinto; Smith, Kimberly; Torguson, Rebecca; Xue, Zhenyi; Satler, Lowell F; Kent, Kenneth M; Pichard, Augusto D; Weissman, Neil J; Lindsay, Joseph; Waksman, Ron

2008-10-15

The efficacy of contrast-enhanced multislice computed tomography (MSCT) for assessment of ambiguous lesions is unknown. We compared both quantitative coronary angiography (QCA) and MSCT to the gold standard for a significant stenosis-minimum luminal area (MLA) by intravascular ultrasound (IVUS)-in 51 patients (64 +/- 10 years old, 19 men) with 69 angiographically ambiguous, nonleft main lesions. The MSCT was performed 17 +/- 18 days before IVUS analysis. Overall diameter stenosis by QCAwas 51.0 +/- 9.8%; 39 of 51 patients (76%) eventually underwent revascularization (38 by percutaneous coronary intervention and 1 by coronary artery bypass graft). By univariate analysis, minimum luminal diameter, MLA, lumen visibility by MSCT, and minimum luminal diameter by QCA were significant predictors of MLA by IVUS

Impact of electrocardiogram-gated multi-slice computed tomography-based aortic annular measurement in the evaluation of paravalvular leakage following transcatheter aortic valve replacement: the efficacy of the OverSized AortiC Annular ratio (OSACA ratio) in TAVR.

PubMed

Maeda, Koichi; Kuratani, Toru; Torikai, Kei; Shimamura, Kazuo; Mizote, Isamu; Ichibori, Yasuhiro; Takeda, Yasuharu; Daimon, Takashi; Nakatani, Satoshi; Nanto, Shinsuke; Sawa, Yoshiki

2013-07-01

Even mild paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) is associated with increased late mortality. Electrocardiogram-gated multi-slice computed tomography (MSCT) enables detailed aortic annulus assessment. We describe the impact of MSCT for PVL following TAVR. Congruence between the prosthesis and annulus diameters affects PVL; therefore, we calculated the OverSized AortiC Annular ratio (OSACA ratio) and OSACA (transesophageal echocardiography, TEE) ratio as prosthesis diameter/annulus diameter on MSCT or TEE, respectively, and compared their relationship with PVL ≤ trace following TAVR. Of 36 consecutive patients undergoing TAVR (Group A), the occurrence of PVL ≤ trace (33.3%) was significantly related to the OSACA ratio (p = 0.00020). In receiver-operating characteristics analysis, the cutoff value of 1.03 for the OSACA ratio had the highest sum of sensitivity (75.0%) and specificity (91.7%; AUC = 0.87) with significantly higher discriminatory performance for PVL as compared to the OSACA (TEE) ratio (AUC = 0.69, p = 0.028). In nine consecutive patients (Group B) undergoing TAVR based on guidelines formulated from our experience with Group A, PVL ≤ trace was significantly more frequent (88.9%) than that in Group A (p = 0.0060). The OSACA ratio has a significantly higher discriminatory performance for PVL ≤ trace than the OSACA (TEE) ratio, and aortic annular measurement from MSCT is more accurate than that from TEE. © 2013 Wiley Periodicals, Inc.

Development of modern human subadult age and sex estimation standards using multi-slice computed tomography images from medical examiner's offices

NASA Astrophysics Data System (ADS)

Stock, Michala K.; Stull, Kyra E.; Garvin, Heather M.; Klales, Alexandra R.

2016-10-01

Forensic anthropologists are routinely asked to estimate a biological profile (i.e., age, sex, ancestry and stature) from a set of unidentified remains. In contrast to the abundance of collections and techniques associated with adult skeletons, there is a paucity of modern, documented subadult skeletal material, which limits the creation and validation of appropriate forensic standards. Many are forced to use antiquated methods derived from small sample sizes, which given documented secular changes in the growth and development of children, are not appropriate for application in the medico-legal setting. Therefore, the aim of this project is to use multi-slice computed tomography (MSCT) data from a large, diverse sample of modern subadults to develop new methods to estimate subadult age and sex for practical forensic applications. The research sample will consist of over 1,500 full-body MSCT scans of modern subadult individuals (aged birth to 20 years) obtained from two U.S. medical examiner's offices. Statistical analysis of epiphyseal union scores, long bone osteometrics, and os coxae landmark data will be used to develop modern subadult age and sex estimation standards. This project will result in a database of information gathered from the MSCT scans, as well as the creation of modern, statistically rigorous standards for skeletal age and sex estimation in subadults. Furthermore, the research and methods developed in this project will be applicable to dry bone specimens, MSCT scans, and radiographic images, thus providing both tools and continued access to data for forensic practitioners in a variety of settings.

Proof of live birth using postmortem multislice computed tomography (pmMSCT) in cases of suspected neonaticide: advantages of diagnostic imaging compared to conventional autopsy.

PubMed

Guddat, Saskia S; Gapert, René; Tsokos, Michael; Oesterhelweg, Lars

2013-03-01

Proof of live birth is of major importance in suspected neonaticide cases. Although not without controversy the lung flotation test is the main method used to asses this in different jurisdictions worldwide. The present study examines the usefulness of postmortem multislice computed tomography (pmMSCT) in the detection of live birth signs. Body scans were conducted on four infants, one was stillborn, another died a day after birth and the other two were classified as neonaticides. The appearance of the lungs, gastrointestinal tract and vascular system of the liver was compared in these cases. Clear differences were discernable between the lungs of the stillborn and the 1 day old infant. The aerated lungs and air in the stomach and duodenum were clearly visible in the latter case while the stillborn infant lacked these signs. The two neonaticide cases demonstrated similarly aerated lung tissue to the 1 day old infant. The hepatic vessels did not show any putrefactive gas changes in any of the cases. The extent of aeration of the peripheral alveoli was easily observable on the pmMSCT, thus making it a useful tool in the possible differentiation between artificially and naturally aerated lungs. During the four autopsies the classic flotation tests were performed and similar positive aeration of the lungs in the two neonaticides was shown. The stillborn's tests, on the other hand were negative for aeration. The results of this study clearly demonstrate the advantages of using pmMSCT before commencing a conventional autopsy in cases of suspected neonaticide.

Non-invasive coronary angiography for patients with acute atypical chest pain discharged after negative screening including maximal negative treadmill stress test. A prospective study.

PubMed

Bonello, L; Armero, S; Jacquier, A; Com, O; Sarran, A; Sbragia, P; Panuel, M; Arques, S; Paganelli, F

2009-05-01

Among patients admitted in the emergency department for acute atypical chest pain those with an acute coronary syndrome (ACS) who are mistakenly discharged home have high mortality. A recent retrospective study has demonstrated that multislice computed tomography (MSCT) coronary angiography could improve triage of these patients. We aimed to prospectively confirm these data on patients with a negative screening including maximal treadmill stress. 30 patients discharged from the emergency department after negative screening for an ACS were included. All patients underwent MSCT angiography of the coronary artery. Patients with coronary atheroma on MSCT had an invasive coronary angiography to confirm these findings. Seven patients (23%) had obstructive coronary artery disease on MSCT. Invasive coronary angiography (ICA) confirmed the diagnosis in all patients. In patients with no previously known coronary artery disease admitted to the emergency department with atypical acute chest pain and discharged after negative screening, including maximal treadmill stress test, MSCT coronary angiography is useful for the diagnosis of obstructive coronary artery disease.

Localization accuracy of sphere fiducials in computed tomography images

NASA Astrophysics Data System (ADS)

Kobler, Jan-Philipp; Díaz Díaz, Jesus; Fitzpatrick, J. Michael; Lexow, G. Jakob; Majdani, Omid; Ortmaier, Tobias

2014-03-01

In recent years, bone-attached robots and microstereotactic frames have attracted increasing interest due to the promising targeting accuracy they provide. Such devices attach to a patient's skull via bone anchors, which are used as landmarks during intervention planning as well. However, as simulation results reveal, the performance of such mechanisms is limited by errors occurring during the localization of their bone anchors in preoperatively acquired computed tomography images. Therefore, it is desirable to identify the most suitable fiducials as well as the most accurate method for fiducial localization. We present experimental results of a study focusing on the fiducial localization error (FLE) of spheres. Two phantoms equipped with fiducials made from ferromagnetic steel and titanium, respectively, are used to compare two clinically available imaging modalities (multi-slice CT (MSCT) and cone-beam CT (CBCT)), three localization algorithms as well as two methods for approximating the FLE. Furthermore, the impact of cubic interpolation applied to the images is investigated. Results reveal that, generally, the achievable localization accuracy in CBCT image data is significantly higher compared to MSCT imaging. The lowest FLEs (approx. 40 μm) are obtained using spheres made from titanium, CBCT imaging, template matching based on cross correlation for localization, and interpolating the images by a factor of sixteen. Nevertheless, the achievable localization accuracy of spheres made from steel is only slightly inferior. The outcomes of the presented study will be valuable considering the optimization of future microstereotactic frame prototypes as well as the operative workflow.

3D-MSCT imaging of bullet trajectory in 3D crime scene reconstruction: two case reports.

PubMed

Colard, T; Delannoy, Y; Bresson, F; Marechal, C; Raul, J S; Hedouin, V

2013-11-01

Postmortem investigations are increasingly assisted by three-dimensional multi-slice computed tomography (3D-MSCT) and have become more available to forensic pathologists over the past 20years. In cases of ballistic wounds, 3D-MSCT can provide an accurate description of the bullet location, bone fractures and, more interestingly, a clear visual of the intracorporeal trajectory (bullet track). These forensic medical examinations can be combined with tridimensional bullet trajectory reconstructions created by forensic ballistic experts. These case reports present the implementation of tridimensional methods and the results of 3D crime scene reconstruction in two cases. The authors highlight the value of collaborations between police forensic experts and forensic medicine institutes through the incorporation of 3D-MSCT data in a crime scene reconstruction, which is of great interest in forensic science as a clear visual communication tool between experts and the court. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Incidental findings in multislice computed tomography prior to transcatheter aortic valve implantation: frequency, clinical relevance and outcome.

PubMed

Trenkwalder, Teresa; Lahmann, Anna Lena; Nowicka, Magdalena; Pellegrini, Costanza; Rheude, Tobias; Mayr, N Patrick; Voss, Stephanie; Bleiziffer, Sabine; Lange, Rüdiger; Joner, Michael; Kasel, Albert M; Kastrati, Adnan; Schunkert, Heribert; Husser, Oliver; Hadamitzky, Martin; Hengstenberg, Christian

2018-02-21

Multislice computed tomography (MSCT) has emerged as the mainstay in patients planned for transcatheter aortic valve implantation (TAVI). Incidental findings (IF) in MSCT are common. However, the exact incidence, clinical relevance and further consequences of IF are unclear and it is controversial whether IF adversely affect patients' outcome. We analyzed MSCT data of 1050 patients screened for TAVI between January 2011 and December 2014. Median follow-up of patients was 20 months. In total, 3194 IF were identified, which were classified into clinically non-relevant IF (2872, 90%) and clinically relevant IF (322, 10%). In 25% of patients (258/1050) at least one clinically relevant IF was present. Age (80 ± 7 vs. 80 ± 7 years; p = 0.198) and EuroSCORE II (3.6% [2.1-5.7] vs. 3.6% [2.1-5.9]; p = 0.874) was similar between patients with and without a clinically relevant IF. TAVI was performed less frequently in patients with a clinically relevant IF (76% vs. 85%; p < 0.001), with more patients receiving surgical aortic valve replacement in that group (14% vs. 11%; p = 0.042), possibly due to the high rate of incidental aneurysms of the ascending aorta (n = 48). If TAVI was performed mortality did not differ (30-days: 4% vs. 3%; p = 0.339, 1-year: 11% vs. 14%; p = 0.226) between patients with and without a clinically relevant IF. Our study is the largest study to analyze prevalence, clinical relevance and therapeutic consequences of IF during screening for TAVI. IF in pre-procedural MSCT are common and clinically relevant in one-quarter of patients. However, these findings had no impact on overall mortality.

Lipomatous hypertrophy of the interatrial septum in ECG-gated multislice computed tomography of the heart.

PubMed

Czekajska-Chehab, Elżbieta; Tomaszewska, Monika; Olchowik, Grażyna; Tomaszewski, Marek; Adamczyk, Piotr; Drop, Andrzej

2012-07-01

Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign disorder characterized by fat accumulation in the interatrial septum (IAS). The purpose of the study was to analyze the incidental detection of LHIS in patients with various clinical conditions, referred to ECG-gated multislice computed tomography (ECG-MSCT) examinations of the heart. The ECG-MSCT examinations of 5786 patients (2839 women; 2947 men), were analyzed. The examinations were performed using 8-row (1015 patients) and 64-row (4771 patients) MSCT, in pre- and postcontrast scanning. We analyzed the shape of the IAS, density and maximal thickness of IAS, the thickness of the epicardial adipose tissue, and the degree of contact of IAS with the ascending aorta and superior vena cava. We also determined body mass index (BMI) in patients with LHIS. LHIS was detected in 56 (0.96%) patients, with an average age of 61.5±9.8 years. The mean BMI in the analyzed group was 30.1±4.86. During the end-diastolic phase the thickness of IAS was significantly higher (p<0.0001), and on average equaled 18.3 mm. The mean optical density of the IAS was conspicuously higher (p<0.0001) in post-contrast phase than in pre-contrast phase. The thickness of the epicardial adipose tissue in the region of the left atrioventricular groove was on average 15 mm. In all cases the dumbbell shape of IAS was observed. The incidental frequency of LHIS occurrence in patients diagnosed with the ECG-MSCT examinations is about 1%. In most subjects it is linked with a higher BMI and increased thickness of the epicardial adipose tissue.

Forensic veterinary radiology: ballistic-radiological 3D computertomographic reconstruction of an illegal lynx shooting in Switzerland.

PubMed

Thali, Michael J; Kneubuehl, Beat P; Bolliger, Stephan A; Christe, Andreas; Koenigsdorfer, Urs; Ozdoba, Christoph; Spielvogel, Elke; Dirnhofer, Richard

2007-08-24

The lynx, which was reintroduced to Switzerland after being exterminated at the beginning of the 20th century, is protected by Swiss law. However, poaching occurs from time to time, which makes criminal investigations necessary. In the presented case, an illegally shot lynx was examined by conventional plane radiography and three-dimensional multislice computertomography (3D MSCT), of which the latter yielded superior results with respect to documentation and reconstruction of the inflicted gunshot wounds. We believe that 3D MSCT, already described in human forensic-pathological cases, is also a suitable and promising new technique for veterinary pathology.

Assessment of left atrial volume and function: a comparative study between echocardiography, magnetic resonance imaging and multi slice computed tomography.

PubMed

Kühl, J Tobias; Lønborg, Jacob; Fuchs, Andreas; Andersen, Mads J; Vejlstrup, Niels; Kelbæk, Henning; Engstrøm, Thomas; Møller, Jacob E; Kofoed, Klaus F

2012-06-01

Measurement of left atrial (LA) maximal volume (LA(max)) using two-dimensional transthoracic echocardiography (TTE) provides prognostic information in several cardiac diseases. However, the relationship between LA(max) and LA function is poorly understood and TTE is less well suited for measuring dynamic LA volume changes. Conversely, cardiac magnetic resonance imaging (CMR) and multi-slice computed tomography (MSCT) appears more appropriate for such measures. We sought to determine the relationship between LA size assessed with TTE and LA size and function assessed with CMR and MSCT. Fifty-four patients were examined 3 months post myocardial infarction with echocardiography, CMR and MSCT. Left atrial volumes and LA reservoir function were assessed by TTE. LA time-volume curves were determined and LA reservoir function (cyclic change and fractional change), passive emptying function (reservoir volume) and pump function (left atrial ejection fraction-LAEF) were derived using CMR and MSCT. Left atrial fractional change and left atrial ejection fraction (LAEF) determined with CMR and MSCT were unrelated to LA(max) enlargement by echocardiography (P = NS). There was an overall good agreement between CMR and MSCT, with a small to moderate bias in LA(max) (4.9 ± 10.4 ml), CC (3.1 ± 9.1 ml) and reservoir volume (3.4 ± 9.1 ml). TTE underestimates LA(max) with up to 32% compared with CMR and MSCT (P < 0.001). Left atrial function assessed with MSCT and CMR as LA fractional change and LAEF is not significantly related to LA(max) measured by TTE. TTE systematically underestimated LA volumes, whereas there are good agreements between MSCT and CMR for volumetric and functional properties.

Effect of Edge-Preserving Adaptive Image Filter on Low-Contrast Detectability in CT Systems: Application of ROC Analysis

PubMed Central

Okumura, Miwa; Ota, Takamasa; Kainuma, Kazuhisa; Sayre, James W.; McNitt-Gray, Michael; Katada, Kazuhiro

2008-01-01

Objective. For the multislice CT (MSCT) systems with a larger number of detector rows, it is essential to employ dose-reduction techniques. As reported in previous studies, edge-preserving adaptive image filters, which selectively eliminate only the noise elements that are increased when the radiation dose is reduced without affecting the sharpness of images, have been developed. In the present study, we employed receiver operating characteristic (ROC) analysis to assess the effects of the quantum denoising system (QDS), which is an edge-preserving adaptive filter that we have developed, on low-contrast resolution, and to evaluate to what degree the radiation dose can be reduced while maintaining acceptable low-contrast resolution. Materials and Methods. The low-contrast phantoms (Catphan 412) were scanned at various tube current settings, and ROC analysis was then performed for the groups of images obtained with/without the use of QDS at each tube current to determine whether or not a target could be identified. The tube current settings for which the area under the ROC curve (Az value) was approximately 0.7 were determined for both groups of images with/without the use of QDS. Then, the radiation dose reduction ratio when QDS was used was calculated by converting the determined tube current to the radiation dose. Results. The use of the QDS edge-preserving adaptive image filter allowed the radiation dose to be reduced by up to 38%. Conclusion. The QDS was found to be useful for reducing the radiation dose without affecting the low-contrast resolution in MSCT studies. PMID:19043565

An in vitro comparison of subjective image quality of panoramic views acquired via 2D or 3D imaging.

PubMed

Pittayapat, P; Galiti, D; Huang, Y; Dreesen, K; Schreurs, M; Souza, P Couto; Rubira-Bullen, I R F; Westphalen, F H; Pauwels, R; Kalema, G; Willems, G; Jacobs, R

2013-01-01

The objective of this study is to compare subjective image quality and diagnostic validity of cone-beam CT (CBCT) panoramic reformatting with digital panoramic radiographs. Four dry human skulls and two formalin-fixed human heads were scanned using nine different CBCTs, one multi-slice CT (MSCT) and one standard digital panoramic device. Panoramic views were generated from CBCTs in four slice thicknesses. Seven observers scored image quality and visibility of 14 anatomical structures. Four observers repeated the observation after 4 weeks. Digital panoramic radiographs showed significantly better visualization of anatomical structures except for the condyle. Statistical analysis of image quality showed that the 3D imaging modalities (CBCTs and MSCT) were 7.3 times more likely to receive poor scores than the 2D modality. Yet, image quality from NewTom VGi® and 3D Accuitomo 170® was almost equivalent to that of digital panoramic radiographs with respective odds ratio estimates of 1.2 and 1.6 at 95% Wald confidence limits. A substantial overall agreement amongst observers was found. Intra-observer agreement was moderate to substantial. While 2D-panoramic images are significantly better for subjective diagnosis, 2/3 of the 3D-reformatted panoramic images are moderate or good for diagnostic purposes. Panoramic reformattings from particular CBCTs are comparable to digital panoramic images concerning the overall image quality and visualization of anatomical structures. This clinically implies that a 3D-derived panoramic view can be generated for diagnosis with a recommended 20-mm slice thickness, if CBCT data is a priori available for other purposes.

Image Quality and Radiation Dose for Prospectively Triggered Coronary CT Angiography: 128-Slice Single-Source CT versus First-Generation 64-Slice Dual-Source CT

NASA Astrophysics Data System (ADS)

Gu, Jin; Shi, He-Shui; Han, Ping; Yu, Jie; Ma, Gui-Na; Wu, Sheng

2016-10-01

This study sought to compare the image quality and radiation dose of coronary computed tomography angiography (CCTA) from prospectively triggered 128-slice CT (128-MSCT) versus dual-source 64-slice CT (DSCT). The study was approved by the Medical Ethics Committee at Tongji Medical College of Huazhong University of Science and Technology. Eighty consecutive patients with stable heart rates lower than 70 bpm were enrolled. Forty patients were scanned with 128-MSCT, and the other 40 patients were scanned with DSCT. Two radiologists independently assessed the image quality in segments (diameter >1 mm) according to a three-point scale (1: excellent; 2: moderate; 3: insufficient). The CCTA radiation dose was calculated. Eighty patients with 526 segments in the 128-MSCT group and 544 segments in the DSCT group were evaluated. The image quality 1, 2 and 3 scores were 91.6%, 6.9% and 1.5%, respectively, for the 128-MSCT group and 97.6%, 1.7% and 0.7%, respectively, for the DSCT group, and there was a statistically significant inter-group difference (P ≤ 0.001). The effective doses were 3.0 mSv in the 128-MSCT group and 4.5 mSv in the DSCT group (P ≤ 0.001). Compared with DSCT, CCTA with prospectively triggered 128-MSCT had adequate image quality and a 33.3% lower radiation dose.

[Diagnostic values of bronchoscopy and multi-slice spiral CT for congenital dysplasia of the respiratory system in infants: a comparative study].

PubMed

Wang, Xing-Lu; Huang, Ying; Li, Qu-Bei; Dai, Ji-Hong

2013-09-01

To investigate and compare the diagnostic values of bronchoscopy and multi-slice spiral computed tomography (CT) for congenital dysplasia of the respiratory system in infants. Analysis was performed on the clinical data, bronchoscopic findings and multi-slice spiral CT findings of 319 infants (≤1 years old) who underwent bronchoscopy and/or multi-slice spiral CT and were diagnosed with congenital dysplasia of the respiratory system. A total of 476 cases of congenital dysplasia of the respiratory system were found in the 319 infants, including primary dysplasia of the respiratory system (392 cases) and compressive dysplasia of the respiratory system (84 cases). Of the 392 cases of primary dysplasia of the respiratory system, 225 (57.4%) were diagnosed by bronchoscopy versus 167 (42.6%) by multi-slice spiral CT. There were significant differences in etiological diagnosis between bronchoscopy and multi-slice spiral CT in infants with congenital dysplasia of the respiratory system (P<0.05). All 76 cases of primary dysplasia of the respiratory system caused by tracheobronchomalacia were diagnosed by bronchoscopy and all 17 cases of primary dysplasia of the respiratory system caused by lung tissue dysplasia were diagnosed by multi-slice spiral CT. Of the 84 cases of compressive dysplasia of the respiratory system, 74 cases were diagnosed by multi-slice spiral CT and only 10 cases were diagnosed by bronchoscopy. Compared with multi-slice spiral CT, bronchoscopy can detect primary dysplasia of the respiratory system more directly. Bronchoscopy is valuable in the confirmed diagnosis of tracheobronchomalacia. Multi-slice spiral CT has a higher diagnostic value for lung tissue dysplasia than bronchoscopy.

Four-dimensional multislice computed tomography for determination of respiratory lung tumor motion in conformal radiotherapy

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

Leter, Edward M.; Cademartiri, Filippo; Levendag, Peter C.

2005-07-01

Purpose: We used four-dimensional multislice spiral computed tomography (MSCT) to determine respiratory lung-tumor motion and compared this strategy to common clinical practice in conformal radiotherapy treatment-planning imaging. Methods and Materials: The entire lung volume of 10 consecutive patients with 14 lung metastases were scanned by a 16-slice MSCT. During the scans, patients were instructed to breathe through a spirometer that was connected to a laptop computer. For each patient, 10 stacks of 1.5-mm slices, equally distributed throughout the respiratory cycle, were reconstructed from the acquired MSCT data. The lung tumors were manually contoured in each data set. For each patient,more » the tumor-volume contours of all data sets were copied to 1 data set, which allowed determination of the volume that encompassed all 10 lung-tumor positions (i.e., the tumor-traversed volume [TTV]) during the respiratory cycle. The TTV was compared with the 10 tumor volumes contoured for each patient, to which an empiric respiratory-motion margin was added. The latter target volumes were designated internal-motion included tumor volume (IMITV). Results: The TTV measurements were significantly smaller than the reference IMITV measurements (5.2 {+-} 10.2 cm{sup 3} and 10.1 {+-} 13.7 cm{sup 3}, respectively). All 10 IMITVs for 2 of the 4 tumors in 1 subject completely encompassed the TTV. All 10 IMITVs for 3 tumors in 2 patients did not show overlap with up to 35% of the corresponding TTV. The 10 IMITVs for the remaining tumors either completely encompassed the corresponding TTV or did not show overlap with up to 26% of the corresponding TTV. Conclusions: We found that individualized determination of respiratory lung-tumor motion by four-dimensional respiratory-gated MSCT represents a better and simple strategy to incorporate periodic physiologic motion compared with a generalized approach. The former strategy can, therefore, improve common and state-of-the-art clinical practice in conformal radiotherapy.« less

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

Johnston, H; UT Southwestern Medical Center, Dallas, TX; Hilts, M

Purpose: To commission a multislice computed tomography (CT) scanner for fast and reliable readout of radiation therapy (RT) dose distributions using CT polymer gel dosimetry (PGD). Methods: Commissioning was performed for a 16-slice CT scanner using images acquired through a 1L cylinder filled with water. Additional images were collected using a single slice machine for comparison purposes. The variability in CT number associated with the anode heel effect was evaluated and used to define a new slice-by-slice background image subtraction technique. Image quality was assessed for the multislice system by comparing image noise and uniformity to that of the singlemore » slice machine. The consistency in CT number across slices acquired simultaneously using the multislice detector array was also evaluated. Finally, the variability in CT number due to increasing x-ray tube load was measured for the multislice scanner and compared to the tube load effects observed on the single slice machine. Results: Slice-by-slice background subtraction effectively removes the variability in CT number across images acquired simultaneously using the multislice scanner and is the recommended background subtraction method when using a multislice CT system. Image quality for the multislice machine was found to be comparable to that of the single slice scanner. Further study showed CT number was consistent across image slices acquired simultaneously using the multislice detector array for each detector configuration of the slice thickness examined. In addition, the multislice system was found to eliminate variations in CT number due to increasing x-ray tube load and reduce scanning time by a factor of 4 when compared to imaging a large volume using a single slice scanner. Conclusion: A multislice CT scanner has been commissioning for CT PGD, allowing images of an entire dose distribution to be acquired in a matter of minutes. Funding support provided by the Natural Sciences and Engineering Research Council of Canada (NSERC)« less

Experimental flat-panel high-spatial-resolution volume CT of the temporal bone.

PubMed

Gupta, Rajiv; Bartling, Soenke H; Basu, Samit K; Ross, William R; Becker, Hartmut; Pfoh, Armin; Brady, Thomas; Curtin, Hugh D

2004-09-01

A CT scanner employing a digital flat-panel detector is capable of very high spatial resolution as compared with a multi-section CT (MSCT) scanner. Our purpose was to determine how well a prototypical volume CT (VCT) scanner with a flat-panel detector system defines fine structures in temporal bone. Four partially manipulated temporal-bone specimens were imaged by use of a prototypical cone-beam VCT scanner with a flat-panel detector system at an isometric resolution of 150 microm at the isocenter. These specimens were also depicted by state-of-the-art multisection CT (MSCT). Forty-two structures imaged by both scanners were qualitatively assessed and rated, and scores assigned to VCT findings were compared with those of MSCT. Qualitative assessment of anatomic structures, lesions, cochlear implants, and middle-ear hearing aids indicated that image quality was significantly better with VCT (P < .001). Structures near the spatial-resolution limit of MSCT (e.g., bony covering of the tympanic segment of the facial canal, the incudo-stapedial joint, the proximal vestibular aqueduct, the interscalar septum, and the modiolus) had higher contrast and less partial-volume effect with VCT. The flat-panel prototype provides better definition of fine osseous structures of temporal bone than that of currently available MSCT scanners. This study provides impetus for further research in increasing spatial resolution beyond that offered by the current state-of-the-art scanners.

Non-invasive coronary angiography: the clinical value of multi-slice computed tomography in the assessment of patients with prior coronary bypass surgery. Evaluating grafts and native vessels.

PubMed

von Kiedrowski, Helge; Wiemer, Marcus; Franzke, Krista; Preuss, Rainer; Vaske, Bernhard; Butz, Thomas; Oldenburg, Olaf; Bitter, Thomas; Mahmood, Khalid; Burchert, Wolfram; Horstkotte, Dieter; Langer, Christoph

2009-02-01

Contrast enhanced multi-slice computed tomography (MSCT) is the leading modality in non-invasive coronary angiography (CTA) today. We investigated MSCT based assessment of coronary artery bypass grafts (CABG) by analyzing assets and drawbacks of CTA in order to define demands on latest technology. In a clinical setting 39 CABG patients (69.2 +/- 1.4 years; male n = 36) underwent CTA (collimation 16 x 0.75 mm, contrast medium 100 ml; 320 mAs, 120 KV). Ninety-seven CABG (61 venous, 36 arterial grafts) were evaluated. A subgroup of 18 patients underwent additional invasive coronary angiography (CA). CTA for CABG assessment resulted in an overall sensitivity (sens.) of 100%, specificity (spec.) of 92.4% and positive and negative predictive values (PPV, NPV) of 60% and 100%, respectively. CABG anastomoses showed slightly inferior diagnostic accuracy than other CABG segments. Limitations in imaging quality caused 21% unevaluable segments of the CABG anastomoses. Evaluation of native vessel segments proximal and distal to the anastomoses resulted in a sens, spec, PPV and NPV of 57.5, 94.6, 92 and 67.3%, respectively. With 28.5% unevaluable segments, the native vessel segments showed serious limitations in imaging quality. Radiation exposure was 9.88 +/- 3.20 mSv (9.69 +/- 3.25 mSv male; 12.08 +/- 1.35 mSv female). 16-slice MSCT based CABG assessment offers sufficient diagnostic accuracy. However, focussing on the bypass anastomoses and the native revascularized coronary arteries, clinical value is limited.

Dose measurements for dental cone-beam CT: a comparison with MSCT and panoramic imaging

NASA Astrophysics Data System (ADS)

Deman, P.; Atwal, P.; Duzenli, C.; Thakur, Y.; Ford, N. L.

2014-06-01

To date there is a lack of published information on appropriate methods to determine patient doses from dental cone-beam computed tomography (CBCT) equipment. The goal of this study is to apply and extend the methods recommended in the American Association of Physicists in Medicine (AAPM) Report 111 for CBCT equipment to characterize dose and effective dose for a range of dental imaging equipment. A protocol derived from the one proposed by Dixon et al (2010 Technical Report 111, American Association of Physicist in Medicine, MD, USA), was applied to dose measurements of multi-slice CT, dental CBCT (small and large fields of view (FOV)) and a dental panoramic system. The computed tomography dose index protocol was also performed on the MSCT to compare both methods. The dose distributions in a cylindrical polymethyl methacrylate phantom were characterized using a thimble ionization chamber and Gafchromic™ film (beam profiles). Gafchromic™ films were used to measure the dose distribution in an anthropomorphic phantom. A method was proposed to extend dose estimates to planes superior and inferior to the central plane. The dose normalized to 100 mAs measured in the center of the phantom for the large FOV dental CBCT (11.4 mGy/100 mAs) is two times lower than that of MSCT (20.7 mGy/100 mAs) for the same FOV, but approximately 15 times higher than for a panoramic system (0.6 mGy/100 mAs). The effective dose per scan (in clinical conditions) found for the dental CBCT are 167.60 ± 3.62, 61.30 ± 3.88 and 92.86 ± 7.76 mSv for the Kodak 9000 (fixed scan length of 3.7 cm), and the iCAT Next Generation for 6 cm and 13 cm scan lengths respectively. The method to extend the dose estimates from the central slice to superior and inferior slices indicates a good agreement between theory and measurement. The Gafchromic™ films provided useful beam profile data and 2D distributions of dose in phantom.

Lethal visceral traumatic injuries secondary to child abuse: a case of practical application of autopsy, radiological and microscopic studies.

PubMed

Dedouit, Fabrice; Mallinger, Béatrice; Guilbeau-Frugier, Céline; Rougé, Daniel; Rousseau, Hervé; Telmon, Norbert

2011-03-20

A 3-year-old boy child died at home. The circumstances of death appeared unclear to the police investigators and a medicolegal autopsy was carried out. External examination revealed diffuse ecchymoses of varying colours. Postmortem imaging using plain X-rays and multislice computed tomography (MSCT) was performed prior to autopsy and pathological study. These investigations revealed fractures at the posterior arch of the ninth left rib. No cerebral and pericerebral traumatic lesions were diagnosed. In the abdomen, haemoperitoneum and pneumoperitoneum secondary to duodenal perforation and liver laceration were observed. At autopsy, a complete pancreatic fracture and duodenal transection were noted, accounting for the MSCT appearance. Furthermore, autopsy revealed the presence of bilateral intramuscular intercostal haemorrhages and a fracture of the eighth left rib at its posterior arch. This case report illustrates the valuable assistance rendered by MSCT as well as its limitations in diagnosing abuse when a child dies in unclear circumstances. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Morphometric analysis of stab wounds by MSCT and MRI after the instillation of contrast medium.

PubMed

Fais, Paolo; Cecchetto, Giovanni; Boscolo-Berto, Rafael; Toniolo, Matteo; Viel, Guido; Miotto, Diego; Montisci, Massimo; Tagliaro, Franco; Giraudo, Chiara

2016-06-01

To analyze the morphology and depth of stab wounds experimentally produced on human legs amputated for medical reasons using multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) after the instillation of a single contrast medium solution (CMS). For morphological analysis, MSCT and MRI scans were performed before and after the instillation of CMS into the wound cavity. Depth measurements were performed on the sagittal view only after CMS instillation. Subsequently, each wound was dissected using the layer-by-layer technique and the depth was measured by a ruler. One-way between-groups pairwise analysis of variance (ANOVA) and Bland-Altman plot analysis were used for comparing radiological and anatomical measurements. Unenhanced MSCT images did not identify the wound channels, whereas unenhanced MRI evidenced the wound cavity in 50 % of cases. After the instillation of CMS, both MSCT and MRI depicted the wound channel in all the investigated stabbings, although the morphology of the cavity was irregular and did not resemble the shape of the blade. The radiological measurements of the wounds' depth, after the application of CMS, exhibited a high level of agreement (about 95 % at Bland-Altman plot analysis) with the anatomical measurements at dissection. A similar systematic underestimation, however, has been evidenced for MSCT (average 11.4 %; 95 % CI 7-17) and MRI (average 9.6 %; 95 % CI 6-13) data after the instillation of CMS with respect to wound dissection measurements. MSCT and MRI after the instillation of CMS can be used for depicting the morphometric features of stab wounds, although depth measurements are affected by a slight systematic underestimation compared to layer-by-layer dissection.

Sex determination from chest measurements in a sample of Egyptian adults using Multislice Computed Tomography.

PubMed

Darwish, Ragaa T; Abdel-Aziz, Manal H; El Nekiedy, Abdel-Aziz M; Sobh, Zahraa K

2017-11-01

In forensic sciences to determine one's sex is quite important during the identity defining stage. The reliability of sex determination depends on the completeness of the remains and the degree of sexual dimorphism inherent in the population. Computed Tomography is the imaging modality of choice for two- and three-dimensional documentation and analysis of many autopsy findings. The aim of the present work was to assess the reliability of Three-dimensional Multislice Computed Tomography (3D MSCT) to determine sexual dimorphism from certain chest measurements; sternum and fourth rib using the 3D MSCT and to develop equations for sex determination from these bones among adult Egyptians sample. The present study was performed on 60 adult Egyptians. Their age ranged from 21 up to 74 years and they were equally divided between both sexes. Sixty virtual chests (reconstructed Multislice Computed Tomography 3D images) were examined for detection of Sternal measurements; Manubrium length (ML), Sternal body length (BL), Manubrium width (MW), Sternal body widths(BWa&BWb), Sternal area (SA) [(ML + BL) × (MW + BWa + BWb)/3]and Fourth rib width (FRW). All the studied measurements were significantly higher in males than in females. Multiple regression analysis was used to and three significant regression equations were developed for predicting sex using the different studied chest measurements; the sternal measurements, the sternal area and the widths of the right and left fourth ribs with their accuracies 96.67%.95.0%.72.68% respectively. Sterunm and fourth rib width revealed significant metric sex differences with the use of Multislice Computed Tomography 3D images thus provide a great advantage in the analysis of skeletal remains and badly decomposed bodies. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Left atrial accessory appendages, diverticula, and left-sided septal pouch in multi-slice computed tomography. Association with atrial fibrillation and cerebrovascular accidents.

PubMed

Hołda, Mateusz K; Koziej, Mateusz; Wszołek, Karolina; Pawlik, Wiesław; Krawczyk-Ożóg, Agata; Sorysz, Danuta; Łoboda, Piotr; Kuźma, Katarzyna; Kuniewicz, Marcin; Lelakowski, Jacek; Dudek, Dariusz; Klimek-Piotrowska, Wiesława

2017-10-01

The aim of this study is to provide a morphometric description of the left-sided septal pouch (LSSP), left atrial accessory appendages, and diverticula using cardiac multi-slice computed tomography (MSCT) and to compare results between patient subgroups. Two hundred and ninety four patients (42.9% females) with a mean of 69.4±13.1years of age were investigated using MSCT. The presence of the LSSP, left atrial accessory appendages, and diverticula was evaluated. Multiple logistic regression analysis was performed to check whether the presence of additional left atrial structures is associated with increased risk of atrial fibrillation and cerebrovascular accidents. At least one additional left atrial structure was present in 51.7% of patients. A single LSSP, left atrial diverticulum, and accessory appendage were present in 35.7%, 16.0%, and 4.1% of patients, respectively. After adjusting for other risk factors via multiple logistic regression, patients with LSSP are more likely to have atrial fibrillation (OR=2.00, 95% CI=1.14-3.48, p=0.01). The presence of a LSSP was found to be associated with an increased risk of transient ischemic attack using multiple logistic regression analysis after adjustment for other risk factors (OR=3.88, 95% CI=1.10-13.69, p=0.03). In conclusion LSSPs, accessory appendages, and diverticula are highly prevalent anatomic structures within the left atrium, which could be easily identified by MSCT. The presence of LSSP is associated with increased risk for atrial fibrillation and transient ischemic attack. Copyright © 2017 Elsevier B.V. All rights reserved.

The incidence of coronary anomalies on routine coronary computed tomography scans

PubMed Central

Karabay, Kanber Ocal; Yildiz, Abdulmelik; Bagirtan, Bayram; Geceer, Gurkan; Uysal, Ender

2013-01-01

Summary Objective This study aimed to assess the incidence of coronary anomalies using 64-multi-slice coronary computed tomography (MSCT). Methods The diagnostic MSCT scans of 745 consecutive patients were reviewed. Results The incidence of coronary anomalies was 4.96%. The detected coronary anomalies included the conus artery originating separately from the right coronary sinus (RCS) (n = 8, 1.07%), absence of the left main artery (n = 7, 0.93%), a superior right coronary artery (RCA) (n = 7, 0.93%), the circumflex artery (CFX) arising from the RCS (n = 4, 0.53%), the CFX originating from the RCA (n = 2, 0.26%), a posterior RCA (n = 1, 0.13%), a coronary fistula from the left anterior descending artery and RCA to the pulmonary artery (n = 1, 0.13%), and a coronary aneurysm (n = 1, 0.13%). Conclusions This study indicated that MSCT can be used to detect common coronary anomalies, and shows it has the potential to aid cardiologists and cardiac surgeons by revealing the origin and course of the coronary vessels. PMID:24042853

Onset of recent exertional dyspnoea in a firefighter with left bundle-branch block

PubMed Central

De Rosa, Roberto; Ratti, Gennaro; Lamberti, Monica

2014-01-01

Background The presence of a left bundle-branch block (LBBB) among firefighters raises questions about stratifying risk of subsequent cardiovascular events as this conduction disorder may mask underlying coronary artery disease. This report describes the case of a firefighter with a history LBBB with exertional dyspnoea of recent onset after work activity. Case report A 39-year-old male firefighter with LBBB developed exertional dyspnoea after a prolonged session of work. ECG and treadmill test only showed a permanent LBBB; echocardiography and myocardial scintigraphy did not add to this. However, multislice CT (MSCT) showed a significant stenosis in the mid-left anterior descending artery (LAD). Coronary angiography confirmed the stenosis with subsequent placement of a coronary stent. Conclusions An occupational physician should take into account that factors such as age and low cardiovascular risk do not always exclude heart disease, especially when there are conduction system abnormalities that can mask possible coronary artery disease. PMID:25352387

Onset of recent exertional dyspnoea in a firefighter with left bundle-branch block.

PubMed

De Rosa, Roberto; Ratti, Gennaro; Lamberti, Monica

2014-10-28

The presence of a left bundle-branch block (LBBB) among firefighters raises questions about stratifying risk of subsequent cardiovascular events as this conduction disorder may mask underlying coronary artery disease. This report describes the case of a firefighter with a history LBBB with exertional dyspnoea of recent onset after work activity. A 39-year-old male firefighter with LBBB developed exertional dyspnoea after a prolonged session of work. ECG and treadmill test only showed a permanent LBBB; echocardiography and myocardial scintigraphy did not add to this. However, multislice CT (MSCT) showed a significant stenosis in the mid-left anterior descending artery (LAD). Coronary angiography confirmed the stenosis with subsequent placement of a coronary stent. An occupational physician should take into account that factors such as age and low cardiovascular risk do not always exclude heart disease, especially when there are conduction system abnormalities that can mask possible coronary artery disease. 2014 BMJ Publishing Group Ltd.

Determination of multislice computed tomography dose index (CTDI) using optically stimulated luminescence technology.

PubMed

Ruan, Chun; Yukihara, Eduardo G; Clouse, William J; Gasparian, Patricia B R; Ahmad, Salahuddin

2010-07-01

The extensive use of multislice computed tomography (MSCT) and the associated increase in patient dose calls for an accurate dose evaluation technique. Optically stimulated luminescence (OSL) dosimetry provides a potential solution to the arising concerns over patient dose. This study was intended to evaluate the feasibility and accuracy of OSL dosimeter systems in the diagnostic CT x-ray beam energy range. MSCT dose profiles were measured by irradiating OSL strips placed inside the extended PMMA head and body phantoms at different scan conditions by varying kVp settings (100, 120, and 140 kVp) and collimated beam widths (5, 10, 20, and 40 mm). All scans in this study were performed using a GE Lightspeed VCT scanner in axial mode. The exposed strips were then read out using a custom-made OSL strip reader and corrected with field-specific conversion factors. Based on the corrected OSL dose profile, the CTDI(450-OSL) and CTDI(l00-OSL) were evaluated. CTDI(100-IC) was also obtained using a 100 mm long pencil ionization chamber for accuracy verification. CTDI(100-efficiency) can be further evaluated by calculating the ratio of CTDI(100-OSL) and CTDI(450-OSL), which was compared to results from previous studies as well. The OSL detectors were found to have good sensitivity and dose response over a wide range of diagnostic CT x-ray beam energy viz. the primary beam and the scatter tail section of the dose profile. The differences between CTDI100 values obtained using the OSL strips and those obtained with 100 mm long pencil ionization chamber were < +/- 5% for all scan conditions, indicating good accuracy of the OSL system. It was also found that the CTDI(100-efficiency) did not significantly change as the beam width increased and tube voltage changed. The average CTDI(100-efficiency) at the center of the head and body phantoms were 72.6% and 56.2%, respectively. The corresponding values for the periphery of the head and body phantoms were 85.0% and 81.7%. These results agreed very well with previous results from the literature using other detection techniques or Monte Carlo simulations. The LED-based OSL system can be an accurate alternative device for CT dose evaluations. CTDI100 measurement with the use of a 100 mm pencil ionization chamber substantially underestimates the CTDIinfinity value even with 5 mm collimated beam width. The established complete set of CTDI(100-efficiency) correction factors for various scan parameters allows for accurately estimating CTDIinfinity with the current use of pencil chamber and dose phantoms. Combined with the simple calibration, it gives this work great potential to be used not only in routine clinical quality assurance checks but also as a promising tool for patient organ dose assessment.

A Case of an Upper Gastrointestinal Bleeding Due to a Ruptured Dissection of a Right Aortic Arch

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

Born, Christine; Forster, Andreas; Rock, Clemens

2003-09-15

We report a case of severe upper gastrointestinal hemorrhage with a rare underlying cause. The patient was unconscious when he was admitted to the hospital. No chest radiogram was performed. Routine diagnostic measures, including endoscopy, failed to reveal the origin of the bleeding, which was believed to originate from the esophagus secondary to a peptic ulcer or varices. Exploratory laparotomy added no further information, but contrast-enhanced multislice computed tomography (MSCT) of the chest showed dextroposition of the widened aortic arch with a ruptured type-B dissection and a consecutive aorto-esophageal fistula (AEF). The patient died on the day of admission. Noninvasivemore » MSCT angiography gives rapid diagnostic information on patients with occult upper gastrointestinal bleeding and should be considered before more invasive conventional angiography or surgery.« less

Organ dose assessment in pediatric fluoroscopy and CT via a tomographic computational phantom of the newborn patient

NASA Astrophysics Data System (ADS)

Staton, Robert J.

Of the various types of imaging modalities used in pediatric radiology, fluoroscopy and computed tomography (CT) have the highest associated radiation dose. While these examinations are commonly used for pediatric patients, little data exists on the magnitude of the organ and effective dose values for these procedures. Calculation of these dose values is necessary because of children's increased sensitivity to radiation and their long life expectancy for which to express radiation's latent effects. In this study, a newborn tomographic phantom has been implemented in a radiation transport code to evaluate organ and effective doses for newborn patients in commonly performed fluoroscopy and CT examinations. Organ doses were evaluated for voiding cystourethrogram (VCUG) fluoroscopy studies of infant patients. Time-sequence analysis was performed for videotaped VCUG studies of five different patients. Organ dose values were then estimated for each patient through Monte Carlo (MC) simulations. The effective dose values of the VCUG examination for five patients ranged from 0.6 mSv to 3.2 mSv, with a mean of 1.8 +/- 0.9 mSv. Organ doses were also assessed for infant upper gastrointestinal (UGI) fluoroscopy exams. The effective dose values of the UGI examinations for five patients ranged from 1.05 mSv to 5.92 mSv, with a mean of 2.90 +/- 1.97 mSv. MC simulations of helical multislice CT (MSCT) exams were also completed using, the newborn tomographic phantom and a stylized newborn phantom. The helical path of the source, beam shaping filter, beam profile, patient table, were all included in the MC simulations of the helical MSCT scanner. Organ doses and effective doses and their dependence on scan parameters were evaluated for newborn patients. For all CT scans, the effective dose was found to range approximately 1-13 mSv, with the largest values occurring for CAP scans. Tube current modulation strategies to reduce patient dose were also evaluated for newborn patients. Overall, utilization of the newborn tomographic phantom in MC simulations has shown the need for and usefulness of pediatric tomographic phantoms. The newborn tomographic model has shown more versatility and realistic anatomical modeling when compared to the existing stylized newborn phantom. This work has provided important organ dose data for infant patients in common examinations in pediatric radiology.

Multislice CT urography: state of the art.

PubMed

Noroozian, M; Cohan, R H; Caoili, E M; Cowan, N C; Ellis, J H

2004-01-01

Recent improvements in helical CT hardware and software have provided imagers with the tools to obtain an increasingly large number of very thin axial images. As a result, a number of new applications for multislice CT have recently been developed, one of which is CT urography. The motivation for performing CT urography is the desire to create a single imaging test that can completely assess the kidneys and urinary tract for urolithiasis, renal masses and mucosal abnormalities of the renal collecting system, ureters and bladder. Although the preferred technique for performing multislice CT urography has not yet been determined and results are preliminary, early indications suggest that this examination can detect even subtle benign and malignant urothelial abnormalities and that it has the potential to completely replace excretory urography within the next several years. An important limitation of multislice CT urography is increased patient radiation exposure encountered when some of the more thorough recommended techniques are utilized.

Digital forensic osteology--possibilities in cooperation with the Virtopsy project.

PubMed

Verhoff, Marcel A; Ramsthaler, Frank; Krähahn, Jonathan; Deml, Ulf; Gille, Ralf J; Grabherr, Silke; Thali, Michael J; Kreutz, Kerstin

2008-01-30

The present study was carried out to check whether classic osteometric parameters can be determined from the 3D reconstructions of MSCT (multislice computed tomography) scans acquired in the context of the Virtopsy project. To this end, four isolated and macerated skulls were examined by six examiners. First the skulls were conventionally (manually) measured using 32 internationally accepted linear measurements. Then the skulls were scanned by the use of MSCT with slice thicknesses of 1.25 mm and 0.63 mm, and the 33 measurements were virtually determined on the digital 3D reconstructions of the skulls. The results of the traditional and the digital measurements were compared for each examiner to figure out variations. Furthermore, several parameters were measured on the cranium and postcranium during an autopsy and compared to the values that had been measured on a 3D reconstruction from a previously acquired postmortem MSCT scan. The results indicate that equivalent osteometric values can be obtained from digital 3D reconstructions from MSCT scans using a slice thickness of 1.25 mm, and from conventional manual examinations. The measurements taken from a corpse during an autopsy could also be validated with the methods used for the digital 3D reconstructions in the context of the Virtopsy project. Future aims are the assessment and biostatistical evaluation in respect to sex, age and stature of all data sets stored in the Virtopsy project so far, as well as of future data sets. Furthermore, a definition of new parameters, only measurable with the aid of MSCT data would be conceivable.

[Quantitative analysis of emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT scan in smokers: correlation with pulmonary function test].

PubMed

Zhang, D; Guan, Y; Fan, L; Xia, Y; Liu, S Y

2018-05-22

Objective: To quantify emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT(MSCT) scanning in smokers without respiratory symptoms, and analyze the correlation between the CT quantifiable parameters and lung function parameters. Methods: A total of 72 smokers, who underwent medical examinations from September 2013 to September 2016 in Changzheng Hospital were enrolled in this research and were divided into two groups: 24 smokers with COPD and 48 smokers without COPD.Besides, thirty-nine non-smokers with normal pulmonary function were enrolled as the controls.All subjects underwent double phase MSCT scanning and pulmonary function tests.CT quantifiable parameters of emphysema included the low attenuation area below a threshold of -950 Hounsfield Units (HU)(LAA%(-950)), the lowest 15th percentile of the histogram of end-inspiratory attenuation values (P(15-IN)), the lowest 15th percentile of the histogram of end-expiratory attenuation values (P(15-EX)), relative volume change(RVC) and the expiratory to inspiratory ratio of mean lung density (E/I(MLD)). Pulmonary function parameters included forced expiratory volume in 1 second expressed as percent predicted (FEV(1)%), forced expiratory volume in one second to forced vital capacity ratio (FEV(1)/FVC), residual volume to total lung capacity ratio (RV/TLC) and carbon monoxide diffusion capacity corrected for alveolar volume (DLCO/VA). The differences of CT quantifiable parameters and pulmonary function parameters among the three groups were analyzed by using one-way analysis of variance or Kruskal - Wallis H test.The correlation between CT quantifiable parameters and pulmonary function parameters was analyzed by using Spearman ' s correlation analysis. Results: The differences of LAA%(-950)(the values for the controls, the group of smokers with out COPD and the group of smokers with COPD were 0.5%±0.7%, 0.7%±1.2% and 2.0%±2.4% respectively), P(15-IN)(the values of the three groups were (-892±33), (-905±15) and (-907±22) HU respectively), FEV(1)%(the values of the three groups were 88.4%±8.8%, 84.2%±7.5% and 82.1%±8.0% respectively), FEV(1)/FVC(the values of the three groups were 78.0%±3.8%, 76.6%±4.3% and 67.3%±5.5% respectively), DLCO/VA (the values of the three groups were (1.36±0.25), (1.30±0.22) and (1.21±0.22) mmol·min(-1)·kPa(-1)·L(-1) respectively) and RV/TLC (the values of the three groups were 49.5%±6.6%, 45.9%±6.0% and 53.0%±6.4% respectively) among the three groups were statistically significant (all P <0.05). In the control group, LAA%(-950) negatively correlated with FEV(1)/FVC and DLCO/VA( r =-0.32, P =0.04; r =-0.69, P =0.00) and neither did P(15-IN) with FEV(1)%( r =-0.14, P =0.02). Inversely, P(15-IN) positively correlated with DLCO/VA ( r =0.55, P =0.00). In the group of smokers without COPD, LAA%(-950) negatively correlated with FEV(1)/FVC and DLCO/VA( r =-0.31, P =0.04; r =-0.42, P =0.00), and P(15-IN) positively correlated with FEV(1)/FVC and DLCO/VA ( r =0.33, P =0.02; r =0.30, P =0.04). In the group of smokers with COPD, LAA%(-950) negatively correlated with DLCO/VA ( r =-0.62, P =0.00), but positively correlated with RV/TLC ( r =0.59, P =0.00). And P(15-IN) positively correlated with DLCO/VA( r =0.53, P =0.01). Conclusions: Smokers emphysema and air trapping can be effectively evaluated by double phase MSCT. Moreover, two of the CT quantifiable parameters, LAA%(-950) and P(15-IN), are highly sensitive to changes in pulmonary function.

Relationship between sclerostin and cardiovascular calcification in hemodialysis patients: a cross-sectional study

PubMed Central

2013-01-01

Background Sclerostin is a Wnt pathway antagonist regulating osteoblast activity and bone turnover. Here, we assessed the potential association of sclerostin with the development of coronary artery (CAC) and aortic valve calcifications (AVC) in haemodialysis (HD) patients. Methods We conducted a cross-sectional multi-slice computed tomography (MS-CT) scanning study in 67 chronic HD patients (59.4 ± 14.8 yrs) for measurement of CAC and AVC. We tested established biomarkers as well as serum sclerostin (ELISA) regarding their association to the presence of calcification. Fifty-four adults without relevant renal disease served as controls for serum sclerostin levels. Additionally, sclerostin expression in explanted aortic valves from 15 dialysis patients was analysed ex vivo by immunohistochemistry and mRNA quantification (Qt-RT-PCR). Results CAC (Agatston score > 100) and any AVC were present in 65% and in 40% of the MS-CT patient group, respectively. Serum sclerostin levels (1.53 ± 0.81 vs 0.76 ± 0.31 ng/mL, p < 0.001) were significantly elevated in HD compared to controls and more so in HD patients with AVC versus those without AVC (1.78 ± 0.84 vs 1.35 ± 0.73 ng/mL, p = 0.02). Multivariable regression analysis for AVC revealed significant associations with higher serum sclerostin. Ex vivo analysis of uraemic calcified aortic valves (n = 10) revealed a strong sclerostin expression very close to calcified regions (no sclerostin staining in non-calcified valves). Correspondingly, we observed a highly significant upregulation of sclerostin mRNA in calcified valves compared to non-calcified control valves. Conclusion We found a strong association of sclerostin with calcifying aortic heart valve disease in haemodialysis patients. Sclerostin is locally produced in aortic valve tissue adjacent to areas of calcification. PMID:24112318

Congenital intrahepatic arterioportal and portosystemic venous fistulae with jejunal arteriovenous malformation depicted on multislice spiral CT.

PubMed

Chae, Eun Jin; Goo, Hyun Woo; Kim, Seong-Chul; Yoon, Chong Hyun

2004-05-01

We report a symptomatic infant with very rare congenital arterioportal and portosystemic venous fistulae in the liver. Multislice CT after partial transcatheter embolisation revealed not only the complicated vascular architecture of the lesion, but also an incidental jejunal arteriovenous malformation which explained the patient's melena. The patient underwent ligation of the hepatic artery and resection of the jejunal arteriovenous malformation. Postoperative multislice CT clearly demonstrated the success of the treatment.

Detection of crestal radiolucencies around dental implants: an in vitro experimental study.

PubMed

Sirin, Yigit; Horasan, Sinan; Yaman, Duygu; Basegmez, Cansu; Tanyel, Cem; Aral, Ali; Guven, Koray

2012-07-01

The aim of this study was to compare the diagnostic potentials and practical advantages of different imaging modalities in detecting bone defects around dental implants. Crestal bone defects with sequentially larger diameters were randomly prepared around 100 implants that were inserted in bovine bone blocks. Conventional periapical radiography (PR), direct digital radiography (DDR), panoramic radiography (PANO), cone-beam computed tomography (CBCT), and multislice computed tomography (MSCT) were performed for all specimens. The diagnostic accuracies of the devices, confidence of the answers, subjective image quality, defect visibility in planar orientations, and duration of diagnosis were analyzed based on the interpretations of 7 calibrated observers. The agreement levels of intra- and interobserver scores were rated good. PR, DDR, and CBCT were mostly more accurate than PANO and MSCT (P < .05). Confidence levels were positively correlated with the defect size (ρ = 0.20, P < .01), and that of DDR was the highest (P < .05). The subjective image quality of PR and DDR was higher than that of CBCT, PANO, and MSCT (P < .05 for all comparisons). Axial-coronal-sagittal visibilities of the defects were higher for CBCT compared with MSCT (P < .05). The diagnostic time was shorter for DDR (P < .05) and longer for the tomographic systems (P < .05) than for the other devices. DDR may provide a faster and more confident diagnostic option that is as accurate as PR in detecting peri-implant radiolucencies. CBCT has a comparable potential to these intraoral systems but with slower decision making and lower image quality, whereas PANO and MSCT become more reliable when bone defects have a diameter that is at least 1.5 mm larger than that of the implant. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Heart imaging: the accuracy of the 64-MSCT in the detection of coronary artery disease.

PubMed

Alessandri, N; Di Matteo, A; Rondoni, G; Petrassi, M; Tufani, F; Ferrari, R; Laghi, A

2009-01-01

At present, coronary angiography represents the gold standard technique for the diagnosis of coronary artery disease. Our aim is to compare the conventional coronary angiography to the coronary 64-multislice spiral computed tomography (64-MSCT), a new and non-invasive cardiac imaging technique. The last generation of MSCT scanners show a better imaging quality, due to a greater spatial and temporal resolution. Four expert observers (two cardiologists and two radiologists) have compared the angiographic data with the accuracy of the 64-MSCT in the detection and evaluation of coronary vessels stenoses. From the data obtained, the sensibility, the specificity and the accuracy of the coronary 64-MSCT have been defined. We have enrolled 75 patients (57 male, 18 female, mean age 61.83 +/- 10.38; range 30-80 years) with known or suspected coronary artery disease. The above population has been divided into 3 groups: Group A (Gr. A) with 40 patients (mean age 60.7 +/- 12.5) affected by both non-significant and significant coronary artery disease; Group B (Gr. B) with 25 patients (mean age 60.3 +/- 14.6) who underwent to percutaneous coronary intervention (PCI); Group C (Gr. C) with 10 patients (mean age 54.20 +/- 13.7) without any coronary angiographic stenoses. All the patients underwent non-invasive exams, conventional coronary angiography and coronary 64-MSCT. The comparison of the data obtained has been carried out according to a per group analysis, per patient analysis and per segment analysis. Moreover, the accuracy of the 64-MSCT has been defined for the detection of >75%, 50-75% and <50% coronary stenoses. Coronary angiography has identified significant coronary artery disease in 75% of the patients in the Gr. A and in 73% of the patients in the Gr. B. No coronary stenoses have been detected in Gr. C. According to a per segment analysis, in Gr. A, 36% of the segments analysed have shown a coronary stenosis (37% stenoses >75%, 32% stenoses 50-75% and 31% stenoses <50%). In Gr. B, 32% of the segments have shown a coronary stenosis (33% stenoses >75%, 29% stenoses 50-75% and 38% stenoses <50%). In-stent disease has been shown in only 4 of the 29 coronary stents identified. In Gr. A, coronary 64-MSCT has confirmed the angiographic results in the 93% of cases (sensibility 93%, specificity 100%, positive predictive value 100% and negative predictive value 83%) while, in Gr. B, this confirm has been obtained only in 64% of cases (sensibility 64%, specificity 100%, positive predictive value 100% and negative predictive value 50%). In Gr. C, we have observed a complete agreement between angiographic and CT data (sensibility, specificity, positive predictive value and negative predictive value 100%). According to a per segment analysis, the angiographic results have been confirmed in 98% of cases in Gr. A (sensibility 98%, specificity 94%, positive predictive value 90% and negative predictive value 94%) but only in 55% of cases in Gr. B (sensibility 55%, specificity 90%, positive predictive value 71% and negative predictive value 81%). Moreover, only 1 of the 4 in-stent restenoses has been detected (sensibility 25%, specificity 100%, positive predictive value 100% and negative predictive value 77%). Coronary angiography has detected a greater number of coronary stenoses than the 64-MSCT. 64-MSCT has demonstrated better accuracy in the study of coronary vessels wider than 2 mm, while its accuracy is lower for smaller vessels (diameter < 2.5 mm) and for the identification of in-stent restenosis, because there is a reduced image quality for these vessels and therefore a lower accuracy in the coronary stenosis detection. Nevertheless, 64-MSCT shows high accuracy and it can be considered a comparative but not a substitutive exam of the coronary angiography. Several technical limitations of the 64-MSCT are responsible of its lower accuracy versus the conventional coronary angiography, but solving these technical problems could give us a new non-invasive imaging technique for the study of coronary stents.

Classification algorithm of lung lobe for lung disease cases based on multislice CT images

NASA Astrophysics Data System (ADS)

Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Mishima, M.; Ohmatsu, H.; Tsuchida, T.; Eguchi, K.; Kaneko, M.; Moriyama, N.

2011-03-01

With the development of multi-slice CT technology, to obtain an accurate 3D image of lung field in a short time is possible. To support that, a lot of image processing methods need to be developed. In clinical setting for diagnosis of lung cancer, it is important to study and analyse lung structure. Therefore, classification of lung lobe provides useful information for lung cancer analysis. In this report, we describe algorithm which classify lungs into lung lobes for lung disease cases from multi-slice CT images. The classification algorithm of lung lobes is efficiently carried out using information of lung blood vessel, bronchus, and interlobar fissure. Applying the classification algorithms to multi-slice CT images of 20 normal cases and 5 lung disease cases, we demonstrate the usefulness of the proposed algorithms.

An extraction algorithm of pulmonary fissures from multislice CT image

NASA Astrophysics Data System (ADS)

Tachibana, Hiroyuki; Saita, Shinsuke; Yasutomo, Motokatsu; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Sasagawa, Michizo; Eguchi, Kenji; Moriyama, Noriyuki

2005-04-01

Aging and smoking history increases number of pulmonary emphysema. Alveoli restoration destroyed by pulmonary emphysema is difficult and early direction is important. Multi-slice CT technology has been improving 3-D image analysis with higher body axis resolution and shorter scan time. And low-dose high accuracy scanning becomes available. Multi-slice CT image helps physicians with accurate measuring but huge volume of the image data takes time and cost. This paper is intended for computer added emphysema region analysis and proves effectiveness of proposed algorithm.

Comparison between multislice and cone-beam computerized tomography in the volumetric assessment of cleft palate.

PubMed

Albuquerque, Marco Antonio; Gaia, Bruno Felipe; Cavalcanti, Marcelo Gusmão Paraíso

2011-08-01

The aim of this study was to determine the applicability of multislice and cone-beam computerized tomography (CT) in the assessment of bone defects in patients with oral clefts. Bone defects were produced in 9 dry skulls to mimic oral clefts. All defects were modeled with wax. The skulls were submitted to multislice and cone-beam CT. Subsequently, physical measurements were obtained by the Archimedes principle of water displacement of wax models. The results demonstrated that multislice and cone-beam CT showed a high efficiency rate and were considered to be effective for volumetric assessment of bone defects. It was also observed that both CT modalities showed excellent results with high reliability in the study of the volume of bone defects, with no difference in performance between them. The clinical applicability of our research has shown these CT modalities to be immediate and direct, and they is important for the diagnosis and therapeutic process of patients with oral cleft. Copyright © 2011 Mosby, Inc. All rights reserved.

Restudy of malformations of the internal auditory meatus, cochlear nerve canal and cochlear nerve.

PubMed

Li, Youjin; Yang, Jun; Liu, Jinfen; Wu, Hao

2015-07-01

The present study aims to restudy the correlation between the internal auditory meatus (IAM), the cochlear nerve canal (CNC), the cochlear nerve (CN) and inner ear malformations. In this retrospective study design, the abnormal diameter of the IAM, CNC and CN in patients with any kind of inner ear malformations was evaluated using multi-slice spiral computed tomography (MSCT) (37 patients) and magnetic resonance imaging (MRI) (18 patients). Of 37 MSCT-diagnosed patients, 2 had IAM atresia, 11 IAM stenosis, 22 enlarged IAM, and 2 normal IAM with an abnormal CN. MRI diagnoses of 18 patients revealed 8 cases of aplastic CN, 6 hypoplastic CN, and 4 normal CN. CNC stenosis was associated with CN hypoplasia (P < 0.001). Patients with absent or stenotic IAM had less CN development than those with normal or enlarged IAM (P = 0.001). We propose a modification of the existing classification systems with a view to distinguishing malformations of the IAM, CNC and CN.

Diagnostic performance of multi-slice CT angiography combined with enterography for small bowel obstruction and intestinal ischaemia.

PubMed

He, Bosheng; Gu, Jinhua; Huang, Sheng; Gao, Xuesong; Fan, Jinhe; Sheng, Meihong; Wang, Lin; Gong, Shenchu

2017-02-01

This study was performed to evaluate the diagnostic performance of multi-slice CT angiography combined with enterography in determining the cause and location of obstruction as well as intestinal ischaemia in patients with small bowel obstruction (SBO). This study retrospectively summarized the image data of 57 SBO patients who received both multi-slice CT angiography and enterography examination between December 2012 and May 2013. The CT diagnoses of SBO and intestinal ischaemia were correlated with the findings at surgery or digital subtraction angiography, which were set as standard references. Multi-slice CT angiography and enterography indicated that the cause of SBO in three patients was misjudged, suggesting a diagnostic accuracy of 94.7%. In one patient the level of obstruction was incorrect, demonstrating a diagnostic accuracy of 98.2%. Based on the results of the receiver operating characteristic (ROC) curve analysis, the diagnostic criterion for ischaemic SBO was at least two of the four CT signs (circumferential bowel wall thickening, reduced enhancement of the intestinal wall, mesenteric oedema and mesenteric vascular engorgement). The criterion yielded a sensitivity of 94.4%, a specificity of 92.3%, a positive predicted value of 85.0% and a negative predicted value of 97.3%, and the area under curve (AUC) was 0.92 (95% CI, 0.85-0.99). Multi-slice CT angiography and enterography have high diagnostic value in identifying the cause and site of SBO. In addition, the suggested diagnostic criterion using CT signs is helpful for diagnosing intestinal ischaemia in SBO patients. © 2016 The Royal Australian and New Zealand College of Radiologists.

Inadequate increase in the volume of major epicardial coronary arteries compared with that in left ventricular mass. Novel concept for characterization of coronary arteries using 64-slice computed tomography.

PubMed

Ehara, Shoichi; Okuyama, Takuhiro; Shirai, Nobuyuki; Sugioka, Kenichi; Oe, Hiroki; Itoh, Toshihide; Matsuoka, Toshiyuki; Ikura, Yoshihiro; Ueda, Makiko; Naruko, Takahiko; Hozumi, Takeshi; Yoshiyama, Minoru

2009-08-01

Previous studies have shown a correlation between coronary artery cross-sectional diameter and left ventricular (LV) mass. However, no studies have examined the correlation between actual coronary artery volume (CAV) and LV mass. In the present study, measurements of CAV by 64-multislice computed tomography (MSCT) were validated and the relationship between CAV and LV mass was investigated. First, coronary artery phantoms consisting of syringes filled with solutions of contrast medium moving at simulated heart rates were scanned by 64-MSCT. Display window settings permitting accurate calculation of small volumes were optimized by evaluating volume-rendered images of the segmented contrast medium at different window settings. Next, 61 patients without significant coronary artery stenosis were scanned by 64-MSCT with the same protocol as for the phantoms. Coronary arteries were segmented on a workstation and the same window settings were applied to the volume-rendered images to calculate total CAV. Significant correlations between total CAV and LV mass (r=0.660, P<0.0001) were found, whereas an inverse relation was present between total CAV per 100 g of LV mass and LV mass. The novel concept of "CAV" for the characterization of coronary arteries may prove useful for future research, particularly on the causes of LV hypertrophy.

Chronic Contained Rupture of an Abdominal Aortic Aneurysm: From Diagnosis to Endovascular Resolution

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

Gandini, Roberto, E-mail: marcello.chiocchi@fastwebnet.it; Chiocchi, Marcello; Maresca, Luciano

2008-07-15

A male patient, 69 years old, presented with fever, leucocytosis, and persistent low back pain; he also had an abdominal aortic aneurysm (AAA), as previously diagnosed by Doppler UltraSound (US), and was admitted to our hospital. On multislice computed tomography (msCT), a large abdominal mass having no definite border and involving the aorta and both of the psoas muscles was seen. This mass involved the forth-lumbar vertebra with lysis, thus simulating AAA rupture into a paraspinal collection; it was initially considered a paraspinal abscess. After magnetic resonance imaging examination and culture of the fluid aspirated from the mass, no infectivemore » organisms were found; therefore, a diagnosisof chronically contained AAA rupture was made, and an aortic endoprosthesis was subsequently implanted. The patient was discharged with decreased lumbar pain. At 12-month follow-up, no evidence of leakage was observed. To our knowledge, this is the first case of endoprosthesis implantation in a patient, who was a poor candidate for surgical intervention due to renal failure, leucocytosis and high fever, having a chronically contained AAA ruptured simulatingspodilodiscitis abscess. Appropriate diagnosis and therapy resolved potentially crippling pathology and avoided surgical graft-related complications.« less

Multislice computed tomographic findings of the anomalous origins of the right coronary artery: evaluation of possible causes of myocardial ischemia.

PubMed

Ichikawa, Makoto; Sato, Yuichi; Komatsu, Sei; Hirayama, Atsushi; Kodama, Kazuhisa; Saito, Satoshi

2007-06-01

Anomalous right coronary arteries (RCA) arising from the left sinus of Valsalva may cause myocardial ischemia. We evaluated morphological features of anomalous RCA by using multislice computed tomography (MSCT) in relation to myocardial ischemia provoked by myocardial perfusion single-photon emission computed tomography. MSCT was performed in a total of 3, 212 patients by using an Aquillion 16 and a Light Speed Ultra. Retrospective ECG-gated image reconstruction was performed. Volume rendering, axial and curved multiplanar reformatted images were analyzed for the determination of the origin and course of the RCA, the take-off angle of the RCA from the aorta, and size of the RCA orifice. Furthermore, virtual angioscopic images were also used for the evaluation of the RCA orifice structure. Anomalous origins of the RCA were found in 15 patients. In 13 patients, the RCA arose from the left sinus of Valsalva, and in 2 patients it arose from the left main coronary artery as a single coronary artery. The RCA coursed anteriorly between the ascending aorta and pulmonary artery in 14 patients, whereas it had a retroaortic course in 1 patient. Acute angle take-off (<30 degrees ) of the RCA from the aorta and the left main coronary artery was observed in 8 patients, intramural course of the RCA within the aortic wall was observed in 6 patients and a small RCA orifice was observed in 4 patients. Exercise-induced myocardial ischemia was present in 5 patients. Coursing between the aorta and pulmonary artery, acute angle take-off and intramural course were thought to be major causes of exercise-induced ischemia in patients with anomalous origins of the RCA.

Measurement of aortic valve calcification using multislice computed tomography: correlation with haemodynamic severity of aortic stenosis and clinical implication for patients with low ejection fraction.

PubMed

Cueff, Caroline; Serfaty, Jean-Michel; Cimadevilla, Claire; Laissy, Jean-Pierre; Himbert, Dominique; Tubach, Florence; Duval, Xavier; Iung, Bernard; Enriquez-Sarano, Maurice; Vahanian, Alec; Messika-Zeitoun, David

2011-05-01

Measurement of the degree of aortic valve calcification (AVC) using electron beam computed tomography (EBCT) is an accurate and complementary method to transthoracic echocardiography (TTE) for assessment of the severity of aortic stenosis (AS). Whether threshold values of AVC obtained with EBCT could be extrapolated to multislice computed tomography (MSCT) was unclear and AVC diagnostic value in patients with low ejection fraction (EF) has never been specifically evaluated. Patients with mild to severe AS underwent prospectively within 1 week MSCT and TTE. Severe AS was defined as an aortic valve area (AVA) of less than 1 cm(2). In 179 patients with EF greater than 40% (validation set), the relationship between AVC and AVA was evaluated. The best threshold of AVC for the diagnosis of severe AS was then evaluated in a second subset (testing set) of 49 patients with low EF (≤40%). In this subgroup, AS severity was defined based on mean gradient, natural history or dobutamine stress echocardiography. Correlation between AVC and AVA was good (r=-0.63, p<0.0001). A threshold of 1651 arbitrary units (AU) provided 82% sensitivity, 80% specificity, 88% negative-predictive value and 70% positive-predictive value. In the testing set (patients with low EF), this threshold correctly differentiated patients with severe AS from non-severe AS in all but three cases. These three patients had an AVC score close to the threshold (1206, 1436 and 1797 AU). In this large series of patients with a wide range of AS, AVC was shown to be well correlated to AVA and may be a useful adjunct for the evaluation of AS severity especially in difficult cases such as patients with low EF.

[Significance and mechanism of MSCT perfusion scan on differentiation of NSCLC].

PubMed

Liu, Jin-Kang; Hu, Cheng-Ping; Zhou, Mo-Ling; Zhou, Hui; Xiong, Zeng; Xia, Yu; Chen, Wei

2009-06-01

To determine the significance of MSCT perfusion scan on differentiation of NSCLC and to investigate its possible mechanisms. Forty four NSCLC patients underwent CT perfusion scan by MSCT. Among them, 22 cases were selected to detected the two-dimensional tumor microvascular architecture phenotype (2D-TMAP), the relationships between CT perfusion parameters (BF, BV, PEI, TIP), and the differentiation of NSCLC were analysed by using the correlation analysis and trend test. Spearman correlation analysis was used to study the relationships between CT perfusion parameters, differentiation, and 2D-TMAP. The total BF, BV and PEI decreased with decreasing differentiation of NSCLC (P<0.05). The total PEI showed a positive correlation with the total MVD (P<0.05). There were negative correlations between the surrounding area BF, the total BF, BV, and PEI, the uncomplete lumen of the surrounding area MVD, and expression of PCNA, respectively (P<0.05). There were positive correlations between degree of differentiation and the uncomplete lumen of the surrounding area MVD (P<0.05). It was the same as degree of differentiation and expression of PCNA, VEGF, respectively. There were positive correlations between the uncomplete lumen of the surrounding area MVD and expression of VEGF, ephrinB2, EphB4, and PCNA, respectively (P<0.05). Perfusion parameters reflect the difference of density of vassels with mature functional lumen. Careful evaluation of the differences of blood flow pattern in pulmonary space-occupying lesions by MSCT perfusion scan can be used to identify the degree of NSCLC differentiation.

Correlation between a 2D Channelized Hotelling Observer and Human Observers in a Low-contrast Detection Task with Multi-slice Reading in CT

PubMed Central

Yu, Lifeng; Chen, Baiyu; Kofler, James M.; Favazza, Christopher P.; Leng, Shuai; Kupinski, Matthew A.; McCollough, Cynthia H.

2017-01-01

Purpose Model observers have been successfully developed and used to assess the quality of static 2D CT images. However, radiologists typically read images by paging through multiple 2D slices (i.e. multi-slice reading). The purpose of this study was to correlate human and model observer performance in a low-contrast detection task performed using both 2D and multi-slice reading, and to determine if the 2D model observer still correlate well with human observer performance in multi-slice reading. Methods A phantom containing 18 low-contrast spheres (6 sizes × 3 contrast levels) was scanned on a 192-slice CT scanner at 5 dose levels (CTDIvol = 27, 13.5, 6.8, 3.4, and 1.7 mGy), each repeated 100 times. Images were reconstructed using both filtered-backprojection (FBP) and an iterative reconstruction (IR) method (ADMIRE, Siemens). A 3D volume of interest (VOI) around each sphere was extracted and placed side-by-side with a signal-absent VOI to create a 2-alternative forced choice (2AFC) trial. Sixteen 2AFC studies were generated, each with 100 trials, to evaluate the impact of radiation dose, lesion size and contrast, and reconstruction methods on object detection. In total, 1600 trials were presented to both model and human observers. Three medical physicists acted as human observers and were allowed to page through the 3D volumes to make a decision for each 2AFC trial. The human observer performance was compared with the performance of a multi-slice channelized Hotelling observer (CHO_MS), which integrates multi-slice image data, and with the performance of previously validated CHO, which operates on static 2D images (CHO_2D). For comparison, the same 16 2AFC studies were also performed in a 2D viewing mode by the human observers and compared with the multi-slice viewing performance and the two CHO models. Results Human observer performance was well correlated with the CHO_2D performance in the 2D viewing mode (Pearson product-moment correlation coefficient R=0.972, 95% confidence interval (CI): 0.919 to 0.990) and with the CHO_MS performance in the multi-slice viewing mode (R=0.952, 95% CI: 0.865 to 0.984). The CHO_2D performance, calculated from the 2D viewing mode, also had a strong correlation with human observer performance in the multi-slice viewing mode (R=0.957, 95% CI: 879 to 0.985). Human observer performance varied between the multi-slice and 2D modes. One reader performed better in the multi-slice mode (p=0.013); whereas the other two readers showed no significant difference between the two viewing modes (p=0.057 and p=0.38). Conclusions A 2D CHO model is highly correlated with human observer performance in detecting spherical low contrast objects in multi-slice viewing of CT images. This finding provides some evidence for the use of a simpler, 2D CHO to assess image quality in clinically relevant CT tasks where multi-slice viewing is used. PMID:28555878

Correlation between a 2D channelized Hotelling observer and human observers in a low-contrast detection task with multislice reading in CT.

PubMed

Yu, Lifeng; Chen, Baiyu; Kofler, James M; Favazza, Christopher P; Leng, Shuai; Kupinski, Matthew A; McCollough, Cynthia H

2017-08-01

Model observers have been successfully developed and used to assess the quality of static 2D CT images. However, radiologists typically read images by paging through multiple 2D slices (i.e., multislice reading). The purpose of this study was to correlate human and model observer performance in a low-contrast detection task performed using both 2D and multislice reading, and to determine if the 2D model observer still correlate well with human observer performance in multislice reading. A phantom containing 18 low-contrast spheres (6 sizes × 3 contrast levels) was scanned on a 192-slice CT scanner at five dose levels (CTDI vol = 27, 13.5, 6.8, 3.4, and 1.7 mGy), each repeated 100 times. Images were reconstructed using both filtered-backprojection (FBP) and an iterative reconstruction (IR) method (ADMIRE, Siemens). A 3D volume of interest (VOI) around each sphere was extracted and placed side-by-side with a signal-absent VOI to create a 2-alternative forced choice (2AFC) trial. Sixteen 2AFC studies were generated, each with 100 trials, to evaluate the impact of radiation dose, lesion size and contrast, and reconstruction methods on object detection. In total, 1600 trials were presented to both model and human observers. Three medical physicists acted as human observers and were allowed to page through the 3D volumes to make a decision for each 2AFC trial. The human observer performance was compared with the performance of a multislice channelized Hotelling observer (CHO_MS), which integrates multislice image data, and with the performance of previously validated CHO, which operates on static 2D images (CHO_2D). For comparison, the same 16 2AFC studies were also performed in a 2D viewing mode by the human observers and compared with the multislice viewing performance and the two CHO models. Human observer performance was well correlated with the CHO_2D performance in the 2D viewing mode [Pearson product-moment correlation coefficient R = 0.972, 95% confidence interval (CI): 0.919 to 0.990] and with the CHO_MS performance in the multislice viewing mode (R = 0.952, 95% CI: 0.865 to 0.984). The CHO_2D performance, calculated from the 2D viewing mode, also had a strong correlation with human observer performance in the multislice viewing mode (R = 0.957, 95% CI: 879 to 0.985). Human observer performance varied between the multislice and 2D modes. One reader performed better in the multislice mode (P = 0.013); whereas the other two readers showed no significant difference between the two viewing modes (P = 0.057 and P = 0.38). A 2D CHO model is highly correlated with human observer performance in detecting spherical low contrast objects in multislice viewing of CT images. This finding provides some evidence for the use of a simpler, 2D CHO to assess image quality in clinically relevant CT tasks where multislice viewing is used. © 2017 American Association of Physicists in Medicine.

Correlation between model observers in uniform background and human observers in patient liver background for a low-contrast detection task in CT

NASA Astrophysics Data System (ADS)

Gong, Hao; Yu, Lifeng; Leng, Shuai; Dilger, Samantha; Zhou, Wei; Ren, Liqiang; McCollough, Cynthia H.

2018-03-01

Channelized Hotelling observer (CHO) has demonstrated strong correlation with human observer (HO) in both single-slice viewing mode and multi-slice viewing mode in low-contrast detection tasks with uniform background. However, it remains unknown if the simplest single-slice CHO in uniform background can be used to predict human observer performance in more realistic tasks that involve patient anatomical background and multi-slice viewing mode. In this study, we aim to investigate the correlation between CHO in a uniform water background and human observer performance at a multi-slice viewing mode on patient liver background for a low-contrast lesion detection task. The human observer study was performed on CT images from 7 abdominal CT exams. A noise insertion tool was employed to synthesize CT scans at two additional dose levels. A validated lesion insertion tool was used to numerically insert metastatic liver lesions of various sizes and contrasts into both phantom and patient images. We selected 12 conditions out of 72 possible experimental conditions to evaluate the correlation at various radiation doses, lesion sizes, lesion contrasts and reconstruction algorithms. CHO with both single and multi-slice viewing modes were strongly correlated with HO. The corresponding Pearson's correlation coefficient was 0.982 (with 95% confidence interval (CI) [0.936, 0.995]) and 0.989 (with 95% CI of [0.960, 0.997]) in multi-slice and single-slice viewing modes, respectively. Therefore, this study demonstrated the potential to use the simplest single-slice CHO to assess image quality for more realistic clinically relevant CT detection tasks.

Ontogeny of the spheno-occipital synchondrosis in a modern Queensland, Australian population using computed tomography.

PubMed

Lottering, Nicolene; MacGregor, Donna M; Alston, Clair L; Gregory, Laura S

2015-05-01

Due to disparity regarding the age at which skeletal maturation of the spheno-occipital synchondrosis occurs in forensic and biological literature, this study provides recalibrated multislice computed tomography (MSCT) age standards for the Australian (Queensland) population, using a Bayesian statistical approach. The sample comprises retrospective cranial/cervical MSCT scans obtained from 448 males and 416 females aged birth to 20 years from the Skeletal Biology and Forensic Anthropology Research Osteological Database. Fusion status of the synchondrosis was scored using a modified six-stage scoring tier on an MSCT platform, with negligible observer error (κ = 0.911 ± 0.04, intraclass correlation coefficient = 0.994). Bayesian transition analysis indicates that females are most likely to transition to complete fusion at 13.1 years and males at 15.6 years. Posterior densities were derived for each morphological stage, with complete fusion of the synchondrosis attained in all Queensland males over 16.3 years of age and females aged 13.8 years and older. The results demonstrate significant sexual dimorphism in synchondrosis fusion and are suggestive of intrapopulation variation between major geographic regions in Australia. This study contributes to the growing repository of contemporary anthropological standards calibrated for the Queensland milieu to improve the efficacy of the coronial process for medicolegal death investigation. As a stand-alone age indicator, the basicranial synchondrosis may be consulted as an exclusion criterion when determining the age of majority that constitutes 17 years in Queensland forensic practice. © 2014 Wiley Periodicals, Inc.

[Virtual otoscopy--technique, indications and initial experiences with multislice spiral CT].

PubMed

Klingebiel, R; Bauknecht, H C; Lehmann, R; Rogalla, P; Werbs, M; Behrbohm, H; Kaschke, O

2000-11-01

We report the standardized postprocessing of high-resolution CT data acquired by incremental CT and multi-slice CT in patients with suspected middle ear disorders to generate three-dimensional endoluminal views known as virtual otoscopy. Subsequent to the definition of a postprocessing protocol, standardized endoluminal views of the middle ear were generated according to their otological relevance. The HRCT data sets of 26 ENT patients were transferred to a workstation and postprocessed to 52 virtual otoscopies. Generation of predefined endoluminal views from the HRCT data sets was possible in all patients. Virtual endoscopic views added meaningful information to the primary cross-sectional data in patients suffering from ossicular pathology, having contraindications for invasive tympanic endoscopy or being assessed for surgery of the tympanic cavity. Multi slice CT improved the visualization of subtle anatomic details such as the stapes suprastructure and reduced the scanning time. Virtual endoscopy allows for the non invasive endoluminal visualization of various tympanic lesions. Use of the multi-slice CT technique reduces the scanning time and improves image quality in terms of detail resolution.

Multi-slice computed tomography-assisted endoscopic transsphenoidal surgery for pituitary macroadenoma: a comparison with conventional microscopic transsphenoidal surgery.

PubMed

Tosaka, Masahiko; Nagaki, Tomohito; Honda, Fumiaki; Takahashi, Katsumasa; Yoshimoto, Yuhei

2015-11-01

Intraoperative computed tomography (iCT) is a reliable method for the detection of residual tumour, but previous single-slice low-resolution computed tomography (CT) without coronal or sagittal reconstructions was not of adequate quality for clinical use. The present study evaluated the results of multi-slice iCT-assisted endoscopic transsphenoidal surgery for pituitary macroadenoma. This retrospective study included 30 consecutive patients with newly diagnosed or recurrent pituitary macroadenoma with supradiaphragmatic extension who underwent endoscopic transsphenoidal surgery using iCT (eTSS+iCT group), and control 30 consecutive patients who underwent conventional endoscope-assisted transsphenoidal surgery (cTSS group). The tumour volume was calculated by multiplying the tumour area by the slice thickness. Visual acuity and visual field were estimated by the visual impairment score (VIS). The resection extent, (preoperative tumour volume - postoperative residual tumour volume)/preoperative tumour volume, was 98.9% (median) in the eTSS+iCT group and 91.7% in the cTSS group, and had significant difference between the groups (P = 0.04). Greater than 95 and >90% removal rates were significantly higher in the eTSS+iCT group than in the cTSS group (P = 0.02 and P = 0.001, respectively). However, improvement in VIS showed no significant difference between the groups. The rate of complications also showed no significant difference. Multi-slice iCT-assisted endoscopic transsphenoidal surgery may improve the resection extent of pituitary macroadenoma. Multi-slice iCT may have advantages over intraoperative magnetic resonance imaging in less expensive, short acquisition time, and that special protection against magnetic fields is not needed.

Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation.

PubMed

Dos Santos, Denise Takehana; Costa e Silva, Adriana Paula Andrade; Vannier, Michael Walter; Cavalcanti, Marcelo Gusmão Paraiso

2004-12-01

The purpose of this study was to demonstrate the sensitivity and specificity of multislice computerized tomography (CT) for diagnosis of maxillofacial fractures following specific protocols using an independent workstation. The study population consisted of 56 patients with maxillofacial fractures who were submitted to a multislice CT. The original data were transferred to an independent workstation using volumetric imaging software to generate axial images and simultaneous multiplanar (MPR) and 3-dimensional (3D-CT) volume rendering reconstructed images. The images were then processed and interpreted by 2 examiners using the following protocols independently of each other: axial, MPR/axial, 3D-CT images, and the association of axial/MPR/3D images. The clinical/surgical findings were considered the gold standard corroborating the diagnosis of the fractures and their anatomic localization. The statistical analysis was carried out using validity and chi-squared tests. The association of axial/MPR/3D images indicated a higher sensitivity (range 95.8%) and specificity (range 99%) than the other methods regarding the analysis of all regions. CT imaging demonstrated high specificity and sensitivity for maxillofacial fractures. The association of axial/MPR/3D-CT images added important information in relationship to other CT protocols.

Low contrast detection in abdominal CT: comparing single-slice and multi-slice tasks

NASA Astrophysics Data System (ADS)

Ba, Alexandre; Racine, Damien; Viry, Anaïs.; Verdun, Francis R.; Schmidt, Sabine; Bochud, François O.

2017-03-01

Image quality assessment is crucial for the optimization of computed tomography (CT) protocols. Human and mathematical model observers are increasingly used for the detection of low contrast signal in abdominal CT, but are frequently limited to the use of a single image slice. Another limitation is that most of them only consider the detection of a signal embedded in a uniform background phantom. The purpose of this paper was to test if human observer performance is significantly different in CT images read in single or multiple slice modes and if these differences are the same for anatomical and uniform clinical images. We investigated detection performance and scrolling trends of human observers of a simulated liver lesion embedded in anatomical and uniform CT backgrounds. Results show that observers don't take significantly benefit of additional information provided in multi-slice reading mode. Regarding the background, performances are moderately higher for uniform than for anatomical images. Our results suggest that for low contrast detection in abdominal CT, the use of multi-slice model observers would probably only add a marginal benefit. On the other hand, the quality of a CT image is more accurately estimated with clinical anatomical backgrounds.

[Quantification of pulmonary emphysema in multislice-CT using different software tools].

PubMed

Heussel, C P; Achenbach, T; Buschsieweke, C; Kuhnigk, J; Weinheimer, O; Hammer, G; Düber, C; Kauczor, H-U

2006-10-01

The data records of thin-section MSCT of the lung with approx. 300 images are difficult to use in manual evaluation. A computer-assisted pre-diagnosis can help with reporting. Furthermore, post-processing techniques, for instance, for quantification of emphysema on the basis of three-dimensional anatomical information might be improved and the workflow might be further automated. The results of 4 programs (Pulmo, Volume, YACTA and PulmoFUNC) for the quantitative analysis of emphysema (lung and emphysema volume, mean lung density and emphysema index) of 30 consecutive thin-section MSCT datasets with different emphysema severity levels were compared. The classification result of the YACTA program for different types of emphysema was also analyzed. Pulmo and Volume have a median operating time of 105 and 59 minutes respectively due to the necessity for extensive manual correction of the lung segmentation. The programs PulmoFUNC and YACTA, which are automated to a large extent, have a median runtime of 26 and 16 minutes, respectively. The evaluation with Pulmo and Volume using 2 different datasets resulted in implausible values. PulmoFUNC crashed with 2 other datasets in a reproducible manner. Only with YACTA could all graphic datasets be evaluated. The lung volume, emphysema volume, emphysema index and mean lung density determined by YACTA and PulmoFUNC are significantly larger than the corresponding values of Volume and Pulmo (differences: Volume: 119 cm(3)/65 cm(3)/1 %/17 HU, Pulmo: 60 cm(3)/96 cm(3)/1 %/37 HU). Classification of the emphysema type was in agreement with that of the radiologist in 26 panlobular cases, in 22 paraseptalen cases and in 15 centrilobular emphysema cases. The substantial expenditure of time obstructs the employment of quantitative emphysema analysis in the clinical routine. The results of YACTA and PulmoFUNC are affected by the dedicated exclusion of the tracheobronchial system. These fully automatic tools enable not only fast quantification without manual interaction, but also a reproducible measurement without user dependence.

A next-generation bioresorbable coronary scaffold system: from bench to first clinical evaluation: 6- and 12-month clinical and multimodality imaging results.

PubMed

Verheye, Stefan; Ormiston, John A; Stewart, James; Webster, Mark; Sanidas, Elias; Costa, Ricardo; Costa, J Ribamar; Chamie, Daniel; Abizaid, Andrea S; Pinto, Ibraim; Morrison, Lynn; Toyloy, Sara; Bhat, Vinayak; Yan, John; Abizaid, Alexandre

2014-01-01

This study sought to perform clinical and imaging assessments of the DESolve Bioresorbable Coronary Scaffold (BCS). BCS, which is drug eluting, may have potential advantages compared with conventional metallic drug-eluting stents. The DESolve system, designed to provide vessel support and neointimal suppression, combines a poly-l-lactic acid-based scaffold with the antiproliferative myolimus. The DESolve First-in-Man (a non-randomized, consecutive enrollment evaluation of the DESolve myolimus eluting bioresorbable coronary stent in the treatment of patients with de novo native coronary artery lesions) trial was a prospective multicenter study enrolling 16 patients eligible for treatment. The principal safety endpoint was a composite of cardiac death, myocardial infarction, and clinically indicated target lesion revascularization. The principal imaging endpoint was in-scaffold late lumen loss (LLL) assessed by quantitative coronary angiography (QCA) at 6 months. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) imaging was performed at baseline and 6 months; multislice computed tomography (MSCT) was performed at 12 months. Acute procedural success was achieved in 15 of 15 patients receiving a study scaffold. At 12 months, there was no scaffold thrombosis and no major adverse cardiac events directly attributable to the scaffold. At 6 months, in-scaffold LLL (by QCA) was 0.19 ± 0.19 mm; neointimal volume (by IVUS) was 7.19 ± 3.56%, with no evidence of scaffold recoil or late malapposition. Findings were confirmed with OCT and showed uniform, thin neointimal coverage (0.12 ± 0.04 mm). At 12 months, MSCT demonstrated excellent vessel patency. This study demonstrated the feasibility and efficacy of the DESolve BCS. Results showing low in-scaffold LLL, low % neointimal volume at 6 months, no chronic recoil, and maintenance of lumen patency at 12 months prompt further study. (DESolve First-in-Man; EudraCT number 2011-000027-32). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Assessment of hemodynamics in a rat model of liver cirrhosis with precancerous lesions using multislice spiral CT perfusion imaging.

PubMed

Ma, Guolin; Bai, Rongjie; Jiang, Huijie; Hao, Xuejia; Ling, Zaisheng; Li, Kefeng

2013-01-01

To develop an optimal scanning protocol for multislice spiral CT perfusion (CTP) imaging to evaluate hemodynamic changes in liver cirrhosis with diethylnitrosamine- (DEN-) induced precancerous lesions. Male Wistar rats were randomly divided into the control group (n = 80) and the precancerous liver cirrhosis group (n = 40). The control group received saline injection and the liver cirrhosis group received 50 mg/kg DEN i.p. twice a week for 12 weeks. All animals underwent plain CT scanning, CTP, and contrast-enhanced CT scanning. Scanning parameters were optimized by adjusting the diatrizoate concentration, the flow rate, and the delivery time. The hemodynamics of both groups was further compared using optimized multislice spiral CTP imaging. High-quality CTP images were obtained with following parameters: 150 kV; 150 mAs; 5 mm thickness, 5 mm interval; pitch, 1; matrix, 512 × 512; and FOV, 9.6 cm. Compared to the control group, the liver cirrhosis group had a significantly increased value of the hepatic arterial fraction and the hepatic artery perfusion (P < 0.05) but significantly decreased hepatic portal perfusion and mean transit time (P < 0.05). Multislice spiral CTP imaging can be used to evaluate the hemodynamic changes in the rat model of liver cirrhosis with precancerous lesions.

Lesion detection performance of cone beam CT images with anatomical background noise: single-slice vs. multi-slice human and model observer study

NASA Astrophysics Data System (ADS)

Han, Minah; Jang, Hanjoo; Baek, Jongduk

2018-03-01

We investigate lesion detectability and its trends for different noise structures in single-slice and multislice CBCT images with anatomical background noise. Anatomical background noise is modeled using a power law spectrum of breast anatomy. Spherical signal with a 2 mm diameter is used for modeling a lesion. CT projection data are acquired by the forward projection and reconstructed by the Feldkamp-Davis-Kress algorithm. To generate different noise structures, two types of reconstruction filters (Hanning and Ram-Lak weighted ramp filters) are used in the reconstruction, and the transverse and longitudinal planes of reconstructed volume are used for detectability evaluation. To evaluate single-slice images, the central slice, which contains the maximum signal energy, is used. To evaluate multislice images, central nine slices are used. Detectability is evaluated using human and model observer studies. For model observer, channelized Hotelling observer (CHO) with dense difference-of-Gaussian (D-DOG) channels are used. For all noise structures, detectability by a human observer is higher for multislice images than single-slice images, and the degree of detectability increase in multislice images depends on the noise structure. Variation in detectability for different noise structures is reduced in multislice images, but detectability trends are not much different between single-slice and multislice images. The CHO with D-DOG channels predicts detectability by a human observer well for both single-slice and multislice images.

[Non-biological 3D printed simulator for training in percutaneous nephro- lithotripsy].

PubMed

Alyaev, Yu G; Sirota, E S; Bezrukov, E A; Ali, S Kh; Bukatov, M D; Letunovskiy, A V; Byadretdinov, I Sh

2018-03-01

To develop a non-biological 3D printed simulator for training and preoperative planning in percutaneous nephrolithotripsy (PCNL), which allows doctors to master and perform all stages of the operation under ultrasound and fluoroscopy guidance. The 3D model was constructed using multislice spiral computed tomography (MSCT) images of a patient with staghorn urolithiasis. The MSCT data were processed and used to print the model. The simulator consisted of two parts: a non-biological 3D printed soft model of a kidney with reproduced intra-renal vascular and collecting systems and a printed 3D model of a human body. Using this 3D printed simulator, PCNL was performed in the interventional radiology operating room under ultrasound and fluoroscopy guidance. The designed 3D printed model of the kidney completely reproduces the individual features of the intra-renal structures of the particular patient. During the training, all the main stages of PCNL were performed successfully: the puncture, dilation of the nephrostomy tract, endoscopic examination, intra-renal lithotripsy. Our proprietary 3D-printed simulator is a promising development in the field of endourologic training and preoperative planning in the treatment of complicated forms of urolithiasis.

Virtual autopsy using imaging: bridging radiologic and forensic sciences. A review of the Virtopsy and similar projects.

PubMed

Bolliger, Stephan A; Thali, Michael J; Ross, Steffen; Buck, Ursula; Naether, Silvio; Vock, Peter

2008-02-01

The transdisciplinary research project Virtopsy is dedicated to implementing modern imaging techniques into forensic medicine and pathology in order to augment current examination techniques or even to offer alternative methods. Our project relies on three pillars: three-dimensional (3D) surface scanning for the documentation of body surfaces, and both multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) to visualise the internal body. Three-dimensional surface scanning has delivered remarkable results in the past in the 3D documentation of patterned injuries and of objects of forensic interest as well as whole crime scenes. Imaging of the interior of corpses is performed using MSCT and/or MRI. MRI, in addition, is also well suited to the examination of surviving victims of assault, especially choking, and helps visualise internal injuries not seen at external examination of the victim. Apart from the accuracy and three-dimensionality that conventional documentations lack, these techniques allow for the re-examination of the corpse and the crime scene even decades later, after burial of the corpse and liberation of the crime scene. We believe that this virtual, non-invasive or minimally invasive approach will improve forensic medicine in the near future.

Comparative evaluation of physicians' pulmonary nodule detection with reduced slice thickness at CT screening

NASA Astrophysics Data System (ADS)

Sinsuat, Marodina; Shimamura, Ichiro; Saita, Shinsuke; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Eguchi, Kenji; Kaneko, Masahiro; Tominaga, Keigo; Moriyama, Noriyuki

2008-03-01

With thin and thick section Multi-slice CT images at lung cancer screening, we have statistically and quantitatively shown and evaluated the diagnostic capabilities of these slice thicknesses on physicians' pulmonary nodule diagnosis. To comparatively evaluate the 2 mm and 10 mm slice thicknesses, MSCT images of 360 people were read by six physicians. The reading criteria consisted of nodule for further examination (NFE), nodule for no further examination (NNFE) and no abnormality (NA) case. For reading results evaluation; firstly, cross-tabulation was carried out to roughly analyze the diagnoses based on whole lung field and each lung lobes. Secondly, from semi-automated extraction result of the nodule, detailed quantitative analysis was carried out to determine the diagnostic capabilities of two slice thicknesses. Finally, using the reading results of 2 mm thick image as the gold standard, the diagnostic capabilities were analyzed through the features and locations of pulmonary nodules. The study revealed that both slice thicknesses can depict lung cancer. Thin section may not be effective to diagnose nodules of <=3 mm in size and nodules of <= 5mm in size for thick section. Though thick section is less tiring for reading physicians, it is not good at depicting nodules located at the border of lung upper lobe and which have a pixel size distance of <=5 from the chest wall. The information presented may serve as a useful reference to determine in which particular pulmonary nodule condition the two slice thicknesses can be effectively used for early detection of lung cancer.

Intraoperative cone-beam computed tomography and multi-slice computed tomography in temporal bone imaging for surgical treatment.

PubMed

Erovic, Boban M; Chan, Harley H L; Daly, Michael J; Pothier, David D; Yu, Eugene; Coulson, Chris; Lai, Philip; Irish, Jonathan C

2014-01-01

Conventional computed tomography (CT) imaging is the standard imaging technique for temporal bone diseases, whereas cone-beam CT (CBCT) imaging is a very fast imaging tool with a significant less radiation dose compared with conventional CT. We hypothesize that a system for intraoperative cone-beam CT provides comparable image quality to diagnostic CT for identifying temporal bone anatomical landmarks in cadaveric specimens. Cross-sectional study. University tertiary care facility. Twenty cadaveric temporal bones were affixed into a head phantom and scanned with both a prototype cone-beam CT C-arm and multislice helical CT. Imaging performance was evaluated by 3 otologic surgeons and 1 head and neck radiologist. Participants were presented images in a randomized order and completed landmark identification questionnaires covering 21 structures. CBCT and multislice CT have comparable performance in identifying temporal structures. Three otologic surgeons indicated that CBCT provided statistically equivalent performance for 19 of 21 landmarks, with CBCT superior to CT for the chorda tympani and inferior for the crura of the stapes. Subgroup analysis showed that CBCT performed superiorly for temporal bone structures compared with CT. The radiologist rated CBCT and CT as statistically equivalent for 18 of 21 landmarks, with CT superior to CBCT for the crura of stapes, chorda tympani, and sigmoid sinus. CBCT provides comparable image quality to conventional CT for temporal bone anatomical sites in cadaveric specimens. Clinical applications of low-dose CBCT imaging in surgical planning, intraoperative guidance, and postoperative assessment are promising but require further investigation.

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

PubMed Central

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

2012-01-01

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

Computer-aided diagnosis workstation and network system for chest diagnosis based on multislice CT images

NASA Astrophysics Data System (ADS)

Satoh, Hitoshi; Niki, Noboru; Mori, Kiyoshi; Eguchi, Kenji; Kaneko, Masahiro; Kakinuma, Ryutarou; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru

2007-03-01

Multislice CT scanner advanced remarkably at the speed at which the chest CT images were acquired for mass screening. Mass screening based on multislice CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images and a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification. Moreover, we have provided diagnostic assistance methods to medical screening specialists by using a lung cancer screening algorithm built into mobile helical CT scanner for the lung cancer mass screening done in the region without the hospital. We also have developed electronic medical recording system and prototype internet system for the community health in two or more regions by using the Virtual Private Network router and Biometric fingerprint authentication system and Biometric face authentication system for safety of medical information. Based on these diagnostic assistance methods, we have now developed a new computer-aided workstation and database that can display suspected lesions three-dimensionally in a short time. This paper describes basic studies that have been conducted to evaluate this new system.

Response Evaluation of Malignant Liver Lesions After TACE/SIRT: Comparison of Manual and Semi-Automatic Measurement of Different Response Criteria in Multislice CT.

PubMed

Höink, Anna Janina; Schülke, Christoph; Koch, Raphael; Löhnert, Annika; Kammerer, Sara; Fortkamp, Rasmus; Heindel, Walter; Buerke, Boris

2017-11-01

Purpose  To compare measurement precision and interobserver variability in the evaluation of hepatocellular carcinoma (HCC) and liver metastases in MSCT before and after transarterial local ablative therapies. Materials and Methods  Retrospective study of 72 patients with malignant liver lesions (42 metastases; 30 HCCs) before and after therapy (43 SIRT procedures; 29 TACE procedures). Established (LAD; SAD; WHO) and vitality-based parameters (mRECIST; mLAD; mSAD; EASL) were assessed manually and semi-automatically by two readers. The relative interobserver difference (RID) and intraclass correlation coefficient (ICC) were calculated. Results  The median RID for vitality-based parameters was lower from semi-automatic than from manual measurement of mLAD (manual 12.5 %; semi-automatic 3.4 %), mSAD (manual 12.7 %; semi-automatic 5.7 %) and EASL (manual 10.4 %; semi-automatic 1.8 %). The difference in established parameters was not statistically noticeable (p > 0.05). The ICCs of LAD (manual 0.984; semi-automatic 0.982), SAD (manual 0.975; semi-automatic 0.958) and WHO (manual 0.984; semi-automatic 0.978) are high, both in manual and semi-automatic measurements. The ICCs of manual measurements of mLAD (0.897), mSAD (0.844) and EASL (0.875) are lower. This decrease cannot be found in semi-automatic measurements of mLAD (0.997), mSAD (0.992) and EASL (0.998). Conclusion  Vitality-based tumor measurements of HCC and metastases after transarterial local therapies should be performed semi-automatically due to greater measurement precision, thus increasing the reproducibility and in turn the reliability of therapeutic decisions. Key points   · Liver lesion measurements according to EASL and mRECIST are more precise when performed semi-automatically.. · The higher reproducibility may facilitate a more reliable classification of therapy response.. · Measurements according to RECIST and WHO offer equivalent precision semi-automatically and manually.. Citation Format · Höink AJ, Schülke C, Koch R et al. Response Evaluation of Malignant Liver Lesions After TACE/SIRT: Comparison of Manual and Semi-Automatic Measurement of Different Response Criteria in Multislice CT. Fortschr Röntgenstr 2017; 189: 1067 - 1075. © Georg Thieme Verlag KG Stuttgart · New York.

Multislice CT of the head and body routine scans: Are scanning protocols adjusted for paediatric patients?

PubMed Central

Sun, Z; Al Ghamdi, KS; Baroum, IH

2012-01-01

Purpose: To investigate whether the multislice CT scanning protocols of head, chest and abdomen are adjusted according to patient’s age in paediatric patients. Materials and Methods: Multislice CT examination records of paediatric patients undergoing head, chest and abdomen scans from three public hospitals during a one-year period were retrospectively reviewed. Patients were categorised into the following age groups: under 4 years, 5–8 years, 9–12 years and 13–16 years, while the tube current was classified into the following ranges: < 49 mA, 50–99 mA, 100–149 mA, 150–199 mA, > 200 mA and unknown. Results: A total of 4998 patient records, comprising a combination of head, chest and abdomen CT scans, were assessed, with head CT scans representing nearly half of the total scans. Age-based adjusted CT protocols were observed in most of the scans with higher tube current setting being used with increasing age. However, a high tube current (150–199 mA) was still used in younger patients (0–8 years) undergoing head CT scans. In one hospital, CT protocols remained constant across all age groups, indicating potential overexposure to the patients. Conclusion: This analysis shows that paediatric CT scans are adjusted according to the patient’s age in most of the routine CT examinations. This indicates increased awareness regarding radiation risks associated with CT. However, high tube current settings are still used in younger patient groups, thus, optimisation of paediatric CT protocols and implementation of current guidelines, such as age-and weight-based scanning, should be recommended in daily practice. PMID:22970059

Application of 3D documentation and geometric reconstruction methods in traffic accident analysis: with high resolution surface scanning, radiological MSCT/MRI scanning and real data based animation.

PubMed

Buck, Ursula; Naether, Silvio; Braun, Marcel; Bolliger, Stephan; Friederich, Hans; Jackowski, Christian; Aghayev, Emin; Christe, Andreas; Vock, Peter; Dirnhofer, Richard; Thali, Michael J

2007-07-20

The examination of traffic accidents is daily routine in forensic medicine. An important question in the analysis of the victims of traffic accidents, for example in collisions between motor vehicles and pedestrians or cyclists, is the situation of the impact. Apart from forensic medical examinations (external examination and autopsy), three-dimensional technologies and methods are gaining importance in forensic investigations. Besides the post-mortem multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) for the documentation and analysis of internal findings, highly precise 3D surface scanning is employed for the documentation of the external body findings and of injury-inflicting instruments. The correlation of injuries of the body to the injury-inflicting object and the accident mechanism are of great importance. The applied methods include documentation of the external and internal body and the involved vehicles and inflicting tools as well as the analysis of the acquired data. The body surface and the accident vehicles with their damages were digitized by 3D surface scanning. For the internal findings of the body, post-mortem MSCT and MRI were used. The analysis included the processing of the obtained data to 3D models, determination of the driving direction of the vehicle, correlation of injuries to the vehicle damages, geometric determination of the impact situation and evaluation of further findings of the accident. In the following article, the benefits of the 3D documentation and computer-assisted, drawn-to-scale 3D comparisons of the relevant injuries with the damages to the vehicle in the analysis of the course of accidents, especially with regard to the impact situation, are shown on two examined cases.

Comparison of helical and cine acquisitions for 4D-CT imaging with multislice CT.

PubMed

Pan, Tinsu

2005-02-01

We proposed a data sufficiency condition (DSC) for four-dimensional-CT (4D-CT) imaging on a multislice CT scanner, designed a pitch factor for a helical 4D-CT, and compared the acquisition time, slice sensitivity profile (SSP), effective dose, ability to cope with an irregular breathing cycle, and gating technique (retrospective or prospective) of the helical 4D-CT and the cine 4D-CT on the General Electric (GE) LightSpeed RT (4-slice), Plus (4-slice), Ultra (8-slice) and 16 (16-slice) multislice CT scanners. To satisfy the DSC, a helical or cine 4D-CT acquisition has to collect data at each location for the duration of a breathing cycle plus the duration of data acquisition for an image reconstruction. The conditions for the comparison were 20 cm coverage in the cranial-caudal direction, a 4 s breathing cycle, and half-scan reconstruction. We found that the helical 4D-CT has the advantage of a shorter scan time that is 10% shorter than that of the cine 4D-CT, and the disadvantages of 1.8 times broadening of SSP and requires an additional breathing cycle of scanning to ensure an adequate sampling at the start and end locations. The cine 4D-CT has the advantages of maintaining the same SSP as slice collimation (e.g., 8 x 2.5 mm slice collimation generates 2.5 mm SSP in the cine 4D-CT as opposed to 4.5 mm in the helical 4D-CT) and a lower dose by 4% on the 8- and 16-slice systems, and 8% on the 4-slice system. The advantage of faster scanning in the helical 4D-CT will diminish if a repeat scan at the location of a breathing irregularity becomes necessary. The cine 4D-CT performs better than the helical 4D-CT in the repeat scan because it can scan faster and is more dose efficient.

The pattern of renal vessels in live related potential donors pool. A multislice computed tomography angiography review.

PubMed

Mishra, Anuj; Ehtuish, Ehtuish F

2006-06-01

To assess the renal vessel anatomy, compare the findings with the perioperative findings, to determine the sensitivity of multislice computed tomography (CT) angiography in the work-up of live potential donors and to discuss and compare the results of the present study with the reported results using single slice CT, magnetic resonance (MRI) and conventional angiography (CA). Retrospective analysis of the angiographic data of 118 of prospective live related kidney donors was carried out from October 2004 to August 2005 at the National Organ Transplant Centre, Tripoli Central Hospital, Libya. All donors underwent renal angiography on multislice (16-slice) CT scan using 80 cc intravenous contrast with 1.25 mm slice thickness followed by maximum intensity projection (MIP) and volume rendering techniques (VRT) post-processing algorithms. The number of vessels, vessel bifurcation, vessel morphology and venous anatomy were analyzed and the findings were compared with the surgical findings. Multislice spiral CT angiography (MSCTA) showed clear delineation of the main renal arteries in all donors with detailed vessel morphology. The study revealed 100% sensitivity in detection of accessory renal vessels, with an overall incidence of 26.7%, which is the most common distribution in the parahilar region. The present study showed 100% sensitivity in the visualization and detection of main and accessory renal vessels. These results were comparable with conventional angiography which has so far been considered as the gold standard and were found superior in specificity and accuracy to the use of single slice CT (SSCT) and MR in the angiographic work-up of live renal donors. Due to improved detection of accessory vessels less than 2 mm in diameter, a higher incidence of aberrant vessels was seen on the right side as has been suggested so far.

Three-dimensional computed topography analysis of a patient with an unusual anatomy of the maxillary second and third molars.

PubMed

Zhao, Jin; Li, Yan; Yang, Zhi-Wei; Wang, Wei; Meng, Yan

2011-10-01

We present a case of a patient with rare anatomy of a maxillary second molar with three mesiobuccal root canals and a maxillary third molar with four separate roots, identified using multi-slice computed topography (CT) and three-dimensional reconstruction techniques. The described case enriched/might enrich our knowledge about possible anatomical aberrations of maxillary molars. In addition, we demonstrate the role of multi-slice CT as an objective tool for confirmatory diagnosis and successful endodontic management.

Dedicated dental volumetric and total body multislice computed tomography: a comparison of image quality and radiation dose

NASA Astrophysics Data System (ADS)

Strocchi, Sabina; Colli, Vittoria; Novario, Raffaele; Carrafiello, Gianpaolo; Giorgianni, Andrea; Macchi, Aldo; Fugazzola, Carlo; Conte, Leopoldo

2007-03-01

Aim of this work is to compare the performances of a Xoran Technologies i-CAT Cone Beam CT for dental applications with those of a standard total body multislice CT (Toshiba Aquilion 64 multislice) used for dental examinations. Image quality and doses to patients have been compared for the three main i-CAT protocols, the Toshiba standard protocol and a Toshiba modified protocol. Images of two phantoms have been acquired: a standard CT quality control phantom and an Alderson Rando ® anthropomorphic phantom. Image noise, Signal to Noise Ratio (SNR), Contrast to Noise Ratio (CNR) and geometric accuracy have been considered. Clinical image quality was assessed. Effective dose and doses to main head and neck organs were evaluated by means of thermo-luminescent dosimeters (TLD-100) placed in the anthropomorphic phantom. A Quality Index (QI), defined as the ratio of squared CNR to effective dose, has been evaluated. The evaluated effective doses range from 0.06 mSv (i-CAT 10 s protocol) to 2.37 mSv (Toshiba standard protocol). The Toshiba modified protocol (halved tube current, higher pitch value) imparts lower effective dose (0.99 mSv). The conventional CT device provides lower image noise and better SNR, but clinical effectiveness similar to that of dedicated dental CT (comparable CNR and clinical judgment). Consequently, QI values are much higher for this second CT scanner. No geometric distortion has been observed with both devices. As a conclusion, dental volumetric CT supplies adequate image quality to clinical purposes, at doses that are really lower than those imparted by a conventional CT device.

Rupture of splenic artery aneurysm in primipara five days after cesarean section: case report and review of the literature.

PubMed

Barišić, Tatjana; Šutalo, Nikica; Letica, Ludvig; Kordić, Andrea Vladimira

2015-11-01

Splenic artery aneurysm (SAA) is a rare and usually asymptomatic vascular anomaly which carries the risk of rupture and fatal hemorrhage. It is more common in women and is usually associated with pregnancy. We present the case of rupture of SAA, 5 days after giving birth by cesarean section, which was diagnosed with Multi-Slice Computed Tomografy (MSCT) angiography and was successfully operated in the second emergency laparotomy, with the final good outcome for the mother. This case indicates that in case of sudden bleeding in the abdomen, with the development of hypovolemic shock, especially in the peripartum period, should be suspected rupture of SAA. The paper presents a critical review of this case, with a review of the literature.

Multislice spiral CT simulator for dynamic cardiopulmonary studies

NASA Astrophysics Data System (ADS)

De Francesco, Silvia; Ferreira da Silva, Augusto M.

2002-04-01

We've developed a Multi-slice Spiral CT Simulator modeling the acquisition process of a real tomograph over a 4-dimensional phantom (4D MCAT) of the human thorax. The simulator allows us to visually characterize artifacts due to insufficient temporal sampling and a priori evaluate the quality of the images obtained in cardio-pulmonary studies (both with single-/multi-slice and ECG gated acquisition processes). The simulating environment allows both for conventional and spiral scanning modes and includes a model of noise in the acquisition process. In case of spiral scanning, reconstruction facilities include longitudinal interpolation methods (360LI and 180LI both for single and multi-slice). Then, the reconstruction of the section is performed through FBP. The reconstructed images/volumes are affected by distortion due to insufficient temporal sampling of the moving object. The developed simulating environment allows us to investigate the nature of the distortion characterizing it qualitatively and quantitatively (using, for example, Herman's measures). Much of our work is focused on the determination of adequate temporal sampling and sinogram regularization techniques. At the moment, the simulator model is limited to the case of multi-slice tomograph, being planned as a next step of development the extension to cone beam or area detectors.

Sinogram restoration for ultra-low-dose x-ray multi-slice helical CT by nonparametric regression

NASA Astrophysics Data System (ADS)

Jiang, Lu; Siddiqui, Khan; Zhu, Bin; Tao, Yang; Siegel, Eliot

2007-03-01

During the last decade, x-ray computed tomography (CT) has been applied to screen large asymptomatic smoking and nonsmoking populations for early lung cancer detection. Because a larger population will be involved in such screening exams, more and more attention has been paid to studying low-dose, even ultra-low-dose x-ray CT. However, reducing CT radiation exposure will increase noise level in the sinogram, thereby degrading the quality of reconstructed CT images as well as causing more streak artifacts near the apices of the lung. Thus, how to reduce the noise levels and streak artifacts in the low-dose CT images is becoming a meaningful topic. Since multi-slice helical CT has replaced conventional stop-and-shoot CT in many clinical applications, this research mainly focused on the noise reduction issue in multi-slice helical CT. The experiment data were provided by Siemens SOMATOM Sensation 16-Slice helical CT. It included both conventional CT data acquired under 120 kvp voltage and 119 mA current and ultra-low-dose CT data acquired under 120 kvp and 10 mA protocols. All other settings are the same as that of conventional CT. In this paper, a nonparametric smoothing method with thin plate smoothing splines and the roughness penalty was proposed to restore the ultra-low-dose CT raw data. Each projection frame was firstly divided into blocks, and then the 2D data in each block was fitted to a thin-plate smoothing splines' surface via minimizing a roughness-penalized least squares objective function. By doing so, the noise in each ultra-low-dose CT projection was reduced by leveraging the information contained not only within each individual projection profile, but also among nearby profiles. Finally the restored ultra-low-dose projection data were fed into standard filtered back projection (FBP) algorithm to reconstruct CT images. The rebuilt results as well as the comparison between proposed approach and traditional method were given in the results and discussions section, and showed effectiveness of proposed thin-plate based nonparametric regression method.

Analysis of dental injuries with clinical implications: A forensic case report.

PubMed

Tan, Si-Lei; Peng, Shu-Ya; Wan, Lei; Chen, Jie-Min; Xia, Wen-Tao

2018-01-01

Dental injuries, especially of the incisors, caused by punches in violent criminal attacks could be seen in daily forensic casework involving the identification of injuries to a living body. Sometimes, when there is neither circumstantial evidence nor information about the surrounding circumstances, it is difficult to discern the cause of these injuries and the manner in which they were inflicted. As an example of clinical forensic medicine, we present the case of a 58-year-old woman whose teeth were injured when fighting with her son-in-law over household affairs with no witnesses present. The two parties had conflicting stories about the cause of the woman's injury. The woman claimed that her teeth were lost while she was being beaten by her son-in-law, and the man argued that the damage to his mother-in-law's teeth was self-inflicted when she bit his fingers. The police attending the crime called for a forensic examination. Forensic practitioners analysed the mechanism of the tooth loss using multi-slice spiral computed tomography (MSCT) and imaging reconstruction technology. Local alveolar bone (medial alveolar) fracture and a small area of alveolar bone loss were found on MSCT. Thus, forensic medical experts speculated that the woman's lower central and lateral incisors were lost as a result of a violent attack and were not self-inflicted. Finally, forensic practitioners helped police in avoiding a miscarriage of justice and wrongful conviction.

Fast automatic delineation of cardiac volume of interest in MSCT images

NASA Astrophysics Data System (ADS)

Lorenz, Cristian; Lessick, Jonathan; Lavi, Guy; Bulow, Thomas; Renisch, Steffen

2004-05-01

Computed Tomography Angiography (CTA) is an emerging modality for assessing cardiac anatomy. The delineation of the cardiac volume of interest (VOI) is a pre-processing step for subsequent visualization or image processing. It serves the suppression of anatomic structures being not in the primary focus of the cardiac application, such as sternum, ribs, spinal column, descending aorta and pulmonary vasculature. These structures obliterate standard visualizations such as direct volume renderings or maximum intensity projections. In addition, outcome and performance of post-processing steps such as ventricle suppression, coronary artery segmentation or the detection of short and long axes of the heart can be improved. The structures being part of the cardiac VOI (coronary arteries and veins, myocardium, ventricles and atria) differ tremendously in appearance. In addition, there is no clear image feature associated with the contour (or better cut-surface) distinguishing between cardiac VOI and surrounding tissue making the automatic delineation of the cardiac VOI a difficult task. The presented approach locates in a first step chest wall and descending aorta in all image slices giving a rough estimate of the location of the heart. In a second step, a Fourier based active contour approach delineates slice-wise the border of the cardiac VOI. The algorithm has been evaluated on 41 multi-slice CT data-sets including cases with coronary stents and venous and arterial bypasses. The typical processing time amounts to 5-10s on a 1GHz P3 PC.

Aging adult skull remains through radiological density estimates: A comparison of different computed tomography systems and the use of computer simulations to judge the accuracy of results.

PubMed

Obert, Martin; Kubelt, Carolin; Schaaf, Thomas; Dassinger, Benjamin; Grams, Astrid; Gizewski, Elke R; Krombach, Gabriele A; Verhoff, Marcel A

2013-05-10

The objective of this article was to explore age-at-death estimates in forensic medicine, which were methodically based on age-dependent, radiologically defined bone-density (HC) decay and which were investigated with a standard clinical computed tomography (CT) system. Such density decay was formerly discovered with a high-resolution flat-panel CT in the skulls of adult females. The development of a standard CT methodology for age estimations--with thousands of installations--would have the advantage of being applicable everywhere, whereas only few flat-panel prototype CT systems are in use worldwide. A Multi-Slice CT scanner (MSCT) was used to obtain 22,773 images from 173 European human skulls (89 male, 84 female), taken from a population of patients from the Department of Neuroradiology at the University Hospital Giessen and Marburg during 2010 and 2011. An automated image analysis was carried out to evaluate HC of all images. The age dependence of HC was studied by correlation analysis. The prediction accuracy of age-at-death estimates was calculated. Computer simulations were carried out to explore the influence of noise on the accuracy of age predictions. Human skull HC values strongly scatter as a function of age for both sexes. Adult male skull bone-density remains constant during lifetime. Adult female HC decays during lifetime, as indicated by a correlation coefficient (CC) of -0.53. Prediction errors for age-at-death estimates for both of the used scanners are in the range of ±18 years at a 75% confidence interval (CI). Computer simulations indicate that this is the best that can be expected for such noisy data. Our results indicate that HC-decay is indeed present in adult females and that it can be demonstrated both by standard and by high-resolution CT methods, applied to different subject groups of an identical population. The weak correlation between HC and age found by both CT methods only enables a method to estimate age-at-death with limited practical relevance since the errors of the estimates are large. Computer simulations clearly indicate that data with less noise and CCs in the order of -0.97 or less would be necessary to enable age-at-death estimates with an accuracy of ±5 years at a 75% CI. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Computer-aided diagnosis for osteoporosis using chest 3D CT images

NASA Astrophysics Data System (ADS)

Yoneda, K.; Matsuhiro, M.; Suzuki, H.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.

2016-03-01

The patients of osteoporosis comprised of about 13 million people in Japan and it is one of the problems the aging society has. In order to prevent the osteoporosis, it is necessary to do early detection and treatment. Multi-slice CT technology has been improving the three dimensional (3-D) image analysis with higher body axis resolution and shorter scan time. The 3-D image analysis using multi-slice CT images of thoracic vertebra can be used as a support to diagnose osteoporosis and at the same time can be used for lung cancer diagnosis which may lead to early detection. We develop automatic extraction and partitioning algorithm for spinal column by analyzing vertebral body structure, and the analysis algorithm of the vertebral body using shape analysis and a bone density measurement for the diagnosis of osteoporosis. Osteoporosis diagnosis support system obtained high extraction rate of the thoracic vertebral in both normal and low doses.

Peripleural lung disease detection based on multi-slice CT images

NASA Astrophysics Data System (ADS)

Matsuhiro, M.; Suzuki, H.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, M.

2015-03-01

With the development of multi-slice CT technology, obtaining accurate 3D images of lung field in a short time become possible. To support that, a lot of image processing methods need to be developed. Detection peripleural lung disease is difficult due to its existence out of lung region, because lung extraction is often performed based on threshold processing. The proposed method uses thoracic inner region extracted by inner cavity of bone as well as air region, covers peripleural lung diseased cases such as lung nodule, calcification, pleural effusion and pleural plaque. We applied this method to 50 cases including 39 peripleural lung diseased cases. This method was able to detect 39 peripleural lung disease with 2.9 false positive per case.

Aorta-Left Renal Vein Fistula Complicating an Aortic Aneurysm: Preoperative and Postoperative Multislice CT Findings

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

Barrier, Pierre, E-mail: p.barrier@gmail.com; Otal, Philippe; Garcia, Olivier

Fistulas complicating an abdominal aortic aneurysm (AAA) are rare, and fistulas involving the left renal vein are particularly uncommon. We highlight here a fistula between an infrarenal aortic aneurysm and a retroaortic left renal vein, revealed by left flank pain associated with hematuria and acute renal failure. The multislice CT angiography performed in this 68-year-old patient revealed communication and equal enhancement between the aorta and the left gonadic vein, suggesting the presence of a fistula. The three-dimensional VRT reconstructions presented in this case were of great value in the preoperative planning, enabling immediate visualization of this unusual feature. Alternative diagnosesmore » to consider when encountering this clinical presentation are reviewed.« less

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.

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

PubMed

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

2013-12-01

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

Verbesserte Visualisierung der Koronararterien in MSCT-Daten mit direkter Vergleichbarkeit zur Angiographie

NASA Astrophysics Data System (ADS)

Lacalli, Christina; Jähne, Marion; Wesarg, Stefan

In diesem Beitrag stellen wir neue, automatisierte Verfahren zur Visualisierung der Koronararterien einerseits und für eine direkte Vergleichbarkeit mit konventionellen Angiogrammen andererseits vor. Unser Ansatz umfasst Methoden für die automatische Extraktion des Herzens aus kontrastverstärkten CT-Daten, sowie für die Maskierung grosser kontrastmittelgefüllter Kavitäten des Herzens, um die Sichtbarkeit der Koronararterien bei der Darstellung mittels Volumenrendering zu verbessern. Zum direkten Vergleich mit konventionellen Angiographien wurde ein Verfahren zur automatischen Generierung von Projektionsansichten aus den CT-Daten entwickelt.

Comparison between low (3:1) and high (6:1) pitch for routine abdominal/pelvic imaging with multislice computed tomography.

PubMed

Sahani, Dushyant; Saini, Sanjay; D'Souza, Roy V; O'Neill, Mary Jane; Prasad, Srinivasa R; Kalra, Mannudeep K; Halpern, Elkan F; Mueller, Peter

2003-01-01

The purpose of this study was to compare the performance of low helical pitch acquisition (3:1) and high helical pitch acquisition (6:1) for routine abdominal/pelvic imaging with multislice computed tomography (CT). Three hundred eighty-four patients referred for abdominal/pelvic CT were examined in a breath-hold on a multislice CT scanner (LightSpeed QX/I; General Electric Medical Systems, Milwaukee, WI). Patients were randomized and scanned with pitch of 3:1 or 6:1 using a constant 140 peak kV and 280-300 mA. Images were reconstructed at a 3.75-mm slice thickness. Direct comparison between the two pitches was possible in a subset of 40 patients who had a follow-up scan performed with the second pitch used in each patient. A comparison was also performed between standard dose CT using a pitch of 6:1 and 20% reduced radiation dose CT using a pitch of 3:1. Two readers performed a blind evaluation using a three-point scale for image quality, anatomic details, and motion artifacts. Statistical analysis was performed using a rank sum test and the Wilcoxon signed rank test. Overall image quality mean scores were 2.5 and 2.3 for a pitch of 3:1 and a pitch of 6:1, respectively (P = 0.134). Likewise, mean anatomic detail and motion artifact scores were 2.5 and 2.6 for a 3:1 pitch and 2.3 and 2.5 for a 6:1 pitch, respectively (P > 0.05). In patients with a direct comparison of the two pitches (with the standard radiation dose as well as with a 20% reduction in milliamperes), no statistically significant difference in the performance of the two pitches was observed (P > 0.05). Image quality with a high pitch (6:1) is acceptable for routine abdominal/pelvic CT.

Mixed stack charge transfer crystals: Crossing the neutral-ionic borderline by chemical substitution

NASA Astrophysics Data System (ADS)

Castagnetti, Nicola; Masino, Matteo; Rizzoli, Corrado; Girlando, Alberto; Rovira, Concepció

2018-02-01

We report extensive structural and spectroscopic characterization of four mixed stack charge-transfer (ms-CT) crystals formed by the electron donor 3,3',5 ,5' -tetramethylbenzidine (TMB) with Chloranil (CA), Bromanil (BA), 2,5-difluoro-tetracyanoquinodimethane (TCNQF2), and tetrafluoro-tetracyanoquinodimethane (TCNQF4). Together with the separately studied TMB-TCNQ [Phys. Rev. B 95, 024101 (2017), 10.1103/PhysRevB.95.024101] the TMB-acceptor series spans a wide range of degree of CT, from about 0.14 to 0.91, crossing the neutral-ionic interface, yet retaining similar packing and donor-acceptor CT integrals. First principle calculations of key phenomenological parameters allow us to get insight into the factors determining the degree of CT and other relevant physical properties.

Multislice computed tomography coronary angiography for risk stratification in patients with an intermediate pretest likelihood.

PubMed

van Werkhoven, J M; Gaemperli, O; Schuijf, J D; Jukema, J W; Kroft, L J; Leschka, S; Alkadhi, H; Valenta, I; Pundziute, G; de Roos, A; van der Wall, E E; Kaufmann, P A; Bax, J J

2009-10-01

To assess whether multislice computed tomography coronary angiography (MSCTA) may be useful for risk stratification of patients with suspected coronary artery disease (CAD) at intermediate pretest likelihood according to Diamond and Forrester. MSCTA images were evaluated for the presence of significant CAD in 316 patients with suspected CAD (60% male, average (SD) age 57 (11) years) and an intermediate pretest likelihood according to Diamond and Forrester. Patients were followed up to determine the occurrence of an event. A combined end point of all-cause mortality, non-fatal infarction and unstable angina requiring revascularisation. Significant CAD was seen in 89 patients (28%), whereas normal MSCTA or non-significant CAD was seen in the remaining 227 (72%) patients. During follow-up (median 621 days (25-75th centile 408-835) an event occurred in 13 patients (4.8%). The annualised event rate was 0.8% in patients with normal MSCT, 2.2% in patients with non-significant CAD and 6.5% in patients with significant CAD. Moreover, MSCTA remained a significant predictor (p<0.05) of events after multivariate correction (hazard ratio = 3.460 (95% CI 1.142 to 10.480). The results suggest that in patients with an intermediate pretest likelihood, MSCTA is highly effective in re-stratifying patients into either a low or high post-test risk group. These results further emphasise the usefulness of non-invasive imaging with MSCTA in this patient population.

Decapitation in reality and fine art: A review.

PubMed

Nikolić, Valentina; Savić, Slobodan; Antunović, Vaso; Marinković, Slobodan; Andrieux, Charlotte; Tomić, Irina

2017-11-01

The aim of our study was to examine all types of decapitation from forensic literature, including our own case, and to analyze the presentation of beheading in fine art, popular literature, and music. To do this, over 200 scientific articles in regard to decapitation were analyzed, as well as more than 10,000 artworks, and several hundreds of literary works and music pieces. In addition, a macroscopic examination of a decapitated victim was performed. Finally, a multislice computerized tomography (MSCT) examination of the cervical spine in two live volunteers was undertaken to present the osteological relationships. The forensic and criminal investigation revealed that a female victim was murdered by her jealous husband by applying several strikes with an axe, which resulted in an incomplete decapitation. All the main neck structures were transected, including the cervical spine, except a smaller part of the skin and soft tissue in the nuchal region. The mentioned MSCT examination in both the neutral position and flexion showed that the mandible can also be injured in a higher cervical location of the severance line. Various types of beheading were mentioned, including a homicidal, suicidal, accidental, judicial, internal, pathophysiological, and foetal ones. The status of consciousness and emotions in individuals just before and after decapitation was discussed. Finally, it was found that decapitation was the subject of many artists, and some writers and musicians. In conclusion, we presented a rare case of a homicide beheading performed with an axe. In addition, forensic importance of decapitation was discussed, as well as its great medical, social, anthropological, and artistic significance. Copyright © 2017 Elsevier B.V. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2007-03-01

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

Four-dimensional measurement of the displacement of internal fiducial and skin markers during 320-multislice computed tomography scanning of breast cancer.

PubMed

Yamashita, Hideomi; Okuma, Kae; Tada, Keiichiro; Shiraishi, Kenshiro; Takahashi, Wataru; Shibata-Mobayashi, Shino; Sakumi, Akira; Saotome, Naoya; Haga, Akihiro; Onoe, Tsuyoshi; Ino, Kenji; Akahane, Masaaki; Ohtomo, Kuni; Nakagawa, Keiichi

2012-10-01

To study the three-dimensional movement of internal tumor bed fiducial and breast skin markers, using 320-multislice computed tomography (CT); and to analyze intrafractional errors for breast cancer patients undergoing breast irradiation. This study examined 280 markers on the skin of the breast (200 markers) and on the primary tumor bed (80 markers) of 20 patients treated by external-beam photon radiotherapy. Motion assessment was analyzed in 41 respiratory phases during 20 s of cine CT in the radiotherapy position. To assess intrafractional errors resulting from respiratory motion, four-dimensional CT scans were acquired for 20 patients. Motion in the anterior-posterior (A/P) and superior-inferior (S/I) directions showed a strong correlation (|r| > 0.7) with the respiratory curve for most markers (79% and 70%, respectively). The average marker displacements between maximum and minimum value during 20 s for the 200 breast skin metal markers were 1.1 ± 0.3 mm, 2.1 ± 0.6 mm, and 1.6 ± 0.4 mm in the left-right, A/P, and S/I directions, respectively. For the 80 tumor bed clips, displacements were 0.9 ± 0.2 mm in left-right, 1.7 ± 0.5 mm in A/P, and 1.1 ± 0.3 mm in S/I. There was no significant difference in the motion between breast quadrant regions or between the primary site and the other regions. Motion in primary breast tumors was evaluated with 320-multislice CT. Very little change was detected during individual radiation treatment fractions. Copyright © 2012 Elsevier Inc. All rights reserved.

The role of multislice spiral computed tomography in the diagnosis and management of acute facial trauma in patients with multiple injuries.

PubMed

Nemsadze, G; Urushadze, O

2011-11-01

Using of mutislice spiral CT as first line examination for the diagnosis of Acute Facial trauma in the setting of Polytrauma reduces both: valuable time and cost of patient treatment. After a brief clinical examination, MDCT was performed depending on the area of injury, using a slice thickness of 0.65 mm. The obtained data were analyzed using 3D, MIP and Standard axial with Bone reconstruction protocols. 64 polytrauma patients were evaluated with both Anterior and Lateral craniography (plain skull X ray: AP and Lateral) and Multi Slice CT. Craniography detected only 18 cases of traumatic injuries of facial bones, but exact range of dislocation and accurate management plan could not be established. In the same 64 cases, Multislice CT revealed localization of all existed fractures, range of fragment dislocation, soft tissue damage and status of Paranasal sinus in 62 cases (96.8%). In two cases MS CT missed the facial fracture, in one case the examination was complicated because of bone thinness and numerous fracture fragments, in another multiple foreign body artifacts complicated the investigation. The study results show that, CT investigation based on our MDCT polytrauma protocol, detects all more or less serious facial bone injuries.

Flat-detector computed tomography evaluation in an experimental animal aneurysm model after endovascular treatment: A pilot study.

PubMed

Ott, Sabine; Gölitz, Philipp; Adamek, Edyta; Royalty, Kevin; Doerfler, Arnd; Struffert, Tobias

2015-08-01

We compared flat-detector computed tomography angiography (FD-CTA) to multislice computed tomography (MS-CTA) and digital subtracted angiography (DSA) for the visualization of experimental aneurysms treated with stents, coils or a combination of both.In 20 rabbits, aneurysms were created using the rabbit elastase aneurysm model. Seven aneurysms were treated with coils, seven with coils and stents, and six with self-expandable stents alone. Imaging was performed by DSA, MS-CTA and FD-CTA immediately after treatment. Multiplanar reconstruction (MPR) was performed and two experienced reviewers compared aneurysm/coil package size, aneurysm occlusion, stent diameters and artifacts for each modality.In aneurysms treated with stents alone, the visualization of the aneurysms was identical in all three imaging modalities. Residual aneurysm perfusion was present in two cases and visible in DSA and FD-CTA but not in MS-CTA. The diameter of coil-packages was overestimated in MS-CT by 56% and only by 16% in FD-CTA compared to DSA (p < 0.05). The diameter of stents was identical for DSA and FD-CTA and was significantly overestimated in MS-CTA (p < 0.05). Beam/metal hardening artifacts impaired image quality more severely in MS-CTA compared to FD-CTA.MS-CTA is impaired by blooming and beam/metal hardening artifacts in the visualization of implanted devices. There was no significant difference between measurements made with noninvasive FD-CTA compared to gold standard of DSA after stenting and after coiling/stent-assisted coiling of aneurysms. FD-CTA may be considered as a non-invasive alternative to the gold standard 2D DSA in selected patients that require follow up imaging after stenting. © The Author(s) 2015.

Intersecting fractures of the skull and gunshot wounds. Case report and literature review.

PubMed

Viel, Guido; Gehl, Axel; Sperhake, Jan P

2009-01-01

When two fracture lines of a solid surface (ice, glass, eggshell, etc.) intersect, it is always possible to tell which one has been made first. Indeed pre-existing damage of the surface arrests all the fracture lines produced by subsequent impacts. This well-known principle (established by Puppe in 1903) has been largely used in glass fracture analysis, but can be applied also to the examination of skull fractures. It can help sequencing blunt force or gunshot injuries determining the direction of fire and differentiating entrance from exit wounds in the absence of specific distinguishing features (i.e., internal/external beveling of the skull or overlying skin indicators). In this context, we report the case of a 76-year-old man who shot himself in the mouth with a Walther PPK 7.65 handgun and highlight the utility of the application of both Puppe's Rule and Multislice Computed Tomography (MSCT) in the examination of gunshot wounds to the skull.

Multislice spiral CT angiography for evaluation of acute aortic syndrome.

PubMed

Zhao, De-Li; Liu, Xin-Ding; Zhao, Cheng-Lei; Zhou, Hai-Ting; Wang, Guo-Kun; Liang, Hong-Wei; Zhang, Jin-Ling

2017-10-01

To discuss the diagnostic value of multislice CT angiography (MSCTA) in acute aortic syndrome (AAS). The clinical and imaging data of 36 cases diagnosed as AAS by MSCTA were collected. The manifestations of the MSCTA images were reviewed retrospectively, and the average x-ray dose was calculated. Among 36 AAS cases, 16 cases had aortic dissection (AD), 8 cases had penetrating atherosclerotic ulcer (PAU), 7 cases had intramural hematoma (IMH), and 5 cases had unstable thoracic aneurysm (UTA). Of 16 cases with AD, type A and type B accounted for 43.7% (7/16) and 56.3% (9/16), respectively. Of 7 cases with IMH, type A and type B accounted for 42.9% (3/7) and 57.1% (4/7), respectively. In spite of the x-ray radiation, MSCTA proves to be a rapid and noninvasive imaging technique for the diagnosis of AAS. © 2017, Wiley Periodicals, Inc.

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

PubMed

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

2013-12-01

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

Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage.

PubMed

Mennecke, Angelika; Svergun, Stanislav; Scholz, Bernhard; Royalty, Kevin; Dörfler, Arnd; Struffert, Tobias

2017-01-01

Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images. Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients. The algorithm was applied to post-treatment FD-CT. The effect of the algorithm was evaluated utilizing the pre-post concordance of a modified Fisher score, a subjective image quality assessment, the range of the Hounsfield units within three ROIs, and the pre-post slice-wise Pearson correlation. The pre-post concordance of the modified Fisher score, the subjective image quality, and the pre-post correlation of the ranges of the Hounsfield units were significantly higher for artefact-reduced than for non-artefact-reduced images. Within the metal-affected slices, the pre-post slice-wise Pearson correlation coefficient was higher for artefact-reduced than for non-artefact-reduced images. The overall diagnostic quality of the artefact-reduced images was improved and reached the level of the pre-interventional FD-CT images. The metal-unaffected parts of the image were not modified. • After coiling subarachnoid haemorrhage, metal artefacts seriously reduce FD-CT image quality. • This new metal artefact reduction algorithm is feasible for flat-detector CT. • After coiling, MAR is necessary for diagnostic quality of affected slices. • Slice-wise Pearson correlation is introduced to evaluate improvement of MAR in future studies. • Metal-unaffected parts of image are not modified by this MAR algorithm.

A generalized framework unifying image registration and respiratory motion models and incorporating image reconstruction, for partial image data or full images

NASA Astrophysics Data System (ADS)

McClelland, Jamie R.; Modat, Marc; Arridge, Simon; Grimes, Helen; D'Souza, Derek; Thomas, David; O' Connell, Dylan; Low, Daniel A.; Kaza, Evangelia; Collins, David J.; Leach, Martin O.; Hawkes, David J.

2017-06-01

Surrogate-driven respiratory motion models relate the motion of the internal anatomy to easily acquired respiratory surrogate signals, such as the motion of the skin surface. They are usually built by first using image registration to determine the motion from a number of dynamic images, and then fitting a correspondence model relating the motion to the surrogate signals. In this paper we present a generalized framework that unifies the image registration and correspondence model fitting into a single optimization. This allows the use of ‘partial’ imaging data, such as individual slices, projections, or k-space data, where it would not be possible to determine the motion from an individual frame of data. Motion compensated image reconstruction can also be incorporated using an iterative approach, so that both the motion and a motion-free image can be estimated from the partial image data. The framework has been applied to real 4DCT, Cine CT, multi-slice CT, and multi-slice MR data, as well as simulated datasets from a computer phantom. This includes the use of a super-resolution reconstruction method for the multi-slice MR data. Good results were obtained for all datasets, including quantitative results for the 4DCT and phantom datasets where the ground truth motion was known or could be estimated.

A generalized framework unifying image registration and respiratory motion models and incorporating image reconstruction, for partial image data or full images.

PubMed

McClelland, Jamie R; Modat, Marc; Arridge, Simon; Grimes, Helen; D'Souza, Derek; Thomas, David; Connell, Dylan O'; Low, Daniel A; Kaza, Evangelia; Collins, David J; Leach, Martin O; Hawkes, David J

2017-06-07

Surrogate-driven respiratory motion models relate the motion of the internal anatomy to easily acquired respiratory surrogate signals, such as the motion of the skin surface. They are usually built by first using image registration to determine the motion from a number of dynamic images, and then fitting a correspondence model relating the motion to the surrogate signals. In this paper we present a generalized framework that unifies the image registration and correspondence model fitting into a single optimization. This allows the use of 'partial' imaging data, such as individual slices, projections, or k-space data, where it would not be possible to determine the motion from an individual frame of data. Motion compensated image reconstruction can also be incorporated using an iterative approach, so that both the motion and a motion-free image can be estimated from the partial image data. The framework has been applied to real 4DCT, Cine CT, multi-slice CT, and multi-slice MR data, as well as simulated datasets from a computer phantom. This includes the use of a super-resolution reconstruction method for the multi-slice MR data. Good results were obtained for all datasets, including quantitative results for the 4DCT and phantom datasets where the ground truth motion was known or could be estimated.

A generalized framework unifying image registration and respiratory motion models and incorporating image reconstruction, for partial image data or full images

PubMed Central

McClelland, Jamie R; Modat, Marc; Arridge, Simon; Grimes, Helen; D’Souza, Derek; Thomas, David; Connell, Dylan O’; Low, Daniel A; Kaza, Evangelia; Collins, David J; Leach, Martin O; Hawkes, David J

2017-01-01

Abstract Surrogate-driven respiratory motion models relate the motion of the internal anatomy to easily acquired respiratory surrogate signals, such as the motion of the skin surface. They are usually built by first using image registration to determine the motion from a number of dynamic images, and then fitting a correspondence model relating the motion to the surrogate signals. In this paper we present a generalized framework that unifies the image registration and correspondence model fitting into a single optimization. This allows the use of ‘partial’ imaging data, such as individual slices, projections, or k-space data, where it would not be possible to determine the motion from an individual frame of data. Motion compensated image reconstruction can also be incorporated using an iterative approach, so that both the motion and a motion-free image can be estimated from the partial image data. The framework has been applied to real 4DCT, Cine CT, multi-slice CT, and multi-slice MR data, as well as simulated datasets from a computer phantom. This includes the use of a super-resolution reconstruction method for the multi-slice MR data. Good results were obtained for all datasets, including quantitative results for the 4DCT and phantom datasets where the ground truth motion was known or could be estimated. PMID:28195833

Bone suppression in CT angiography data by region-based multiresolution segmentation

NASA Astrophysics Data System (ADS)

Blaffert, Thomas; Wiemker, Rafael; Lin, Zhong Min

2003-05-01

Multi slice CT (MSCT) scanners have the advantage of high and isotropic image resolution, which broadens the range of examinations for CT angiography (CTA). A very important method to present the large amount of high-resolution 3D data is the visualization by maximum intensity projections (MIP). A problem with MIP projections in angiography is that bones often hide the vessels of interest, especially the scull and vertebral column. Software tools for a manual selection of bone regions and their suppression in the MIP are available, but processing is time-consuming and tedious. A highly computer-assisted of even fully automated suppression of bones would considerably speed up the examination and probably increase the number of examined cases. In this paper we investigate the suppression (or removal) of bone regions in 3D CT data sets for vascular examinations of the head with a visualization of the carotids and the circle of Willis.

Helical 4D CT and Comparison with Cine 4D CT

NASA Astrophysics Data System (ADS)

Pan, Tinsu

4D CT was one of the most important developments in radiation oncology in the last decade. Its early development in single slice CT and commercialization in multi-slice CT has radically changed our practice in radiation treatment of lung cancer, and has enabled the stereotactic radiosurgery of early stage lung cancer. In this chapter, we will document the history of 4D CT development, detail the data sufficiency condition governing the 4D CT data collection; present the design of the commercial helical 4D CTs from Philips and Siemens; compare the differences between the helical 4D CT and the GE cine 4D CT in data acquisition, slice thickness, acquisition time and work flow; review the respiratory monitoring devices; and understand the causes of image artifacts in 4D CT.

[Relationship between multi-slice spiral CT angiography imaging features and in-hospital death of patients with aortic dissection].

PubMed

Xiao, Z Y; Wang, H J; Yao, C L; Gu, G R; Xue, Y; Yin, J; Chen, J; Zhang, C; Tong, C Y; Song, Z J

2017-03-24

Objective: To explore the imaging manifestations of multi-slice spiral CT angiography (CTA) and relationship with in-hospital death in patients with aortic dissection (AD). Methods: The clinical data of 429 patients with AD who underwent CTA in Zhongshan Hospital of Fudan University between January 2009 and January 2016 were retrospectively analyzed. AD patients were divided into 2 groups, including operation group who underwent surgery or interventional therapy (370 cases) and non-operation group who underwent medical conservative treatment(59 cases). The multi-slice spiral CTA imaging features of AD were analyzed, and multivariate logistic regression analysis was used to investigate the relationship between imaging manifestations and in-hospital death in AD patients. Results: There were 12 cases (3.24%) of in-hospital death in operation group, and 28 cases (47.46%) of in-hospital death in non-operation group( P <0.001). AD involved different vascular branches. Multi-slice spiral CTA can clearly show the dissection of true and false lumen, and intimal tear was detected in 363 (84.62%) cases, outer wall calcification was revealed in 63 (14.69%) cases, and thrombus formation was present in 227 (52.91%) cases. The multivariate logistic regression analysis showed that the number of branch vessels involved ( OR =1.374, 95% CI 1.081-1.745, P =0.009) and tearing false lumen range( OR =2.059, 95% CI 1.252-3.385, P =0.004) were independent risk factors of in-hospital death in AD patients, and the number of branch vessels involved ( OR =1.600, 95% CI 1.062-2.411, P =0.025) was independent risk factor of in-hospital death in the operation group, while the tearing false lumen range ( OR =2.315, 95% CI 1.019-5.262, P =0.045) was independent risk factor of in-hospital death of non-operation group. Conclusions: Multi-slice spiral CTA can clearly show the entire AD, true and false lumen, intimal tear, wall calcification and thrombosis of AD patients. The number of branch vessels involved and tearing false lumen range are the independent risk factors of in-hospital death in AD patients.

X-ray imaging physics for nuclear medicine technologists. Part 2: X-ray interactions and image formation.

PubMed

Seibert, J Anthony; Boone, John M

2005-03-01

The purpose is to review in a 4-part series: (i) the basic principles of x-ray production, (ii) x-ray interactions and data capture/conversion, (iii) acquisition/creation of the CT image, and (iv) operational details of a modern multislice CT scanner integrated with a PET scanner. In part 1, the production and characteristics of x-rays were reviewed. In this article, the principles of x-ray interactions and image formation are discussed, in preparation for a general review of CT (part 3) and a more detailed investigation of PET/CT scanners in part 4.

Computed gray levels in multislice and cone-beam computed tomography.

PubMed

Azeredo, Fabiane; de Menezes, Luciane Macedo; Enciso, Reyes; Weissheimer, Andre; de Oliveira, Rogério Belle

2013-07-01

Gray level is the range of shades of gray in the pixels, representing the x-ray attenuation coefficient that allows for tissue density assessments in computed tomography (CT). An in-vitro study was performed to investigate the relationship between computed gray levels in 3 cone-beam CT (CBCT) scanners and 1 multislice spiral CT device using 5 software programs. Six materials (air, water, wax, acrylic, plaster, and gutta-percha) were scanned with the CBCT and CT scanners, and the computed gray levels for each material at predetermined points were measured with OsiriX Medical Imaging software (Geneva, Switzerland), OnDemand3D (CyberMed International, Seoul, Korea), E-Film (Merge Healthcare, Milwaukee, Wis), Dolphin Imaging (Dolphin Imaging & Management Solutions, Chatsworth, Calif), and InVivo Dental Software (Anatomage, San Jose, Calif). The repeatability of these measurements was calculated with intraclass correlation coefficients, and the gray levels were averaged to represent each material. Repeated analysis of variance tests were used to assess the differences in gray levels among scanners and materials. There were no differences in mean gray levels with the different software programs. There were significant differences in gray levels between scanners for each material evaluated (P <0.001). The software programs were reliable and had no influence on the CT and CBCT gray level measurements. However, the gray levels might have discrepancies when different CT and CBCT scanners are used. Therefore, caution is essential when interpreting or evaluating CBCT images because of the significant differences in gray levels between different CBCT scanners, and between CBCT and CT values. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

On-site Rapid Diagnosis of Intracranial Hematoma using Portable Multi-slice Microwave Imaging System.

PubMed

Mobashsher, Ahmed Toaha; Abbosh, A M

2016-11-29

Rapid, on-the-spot diagnostic and monitoring systems are vital for the survival of patients with intracranial hematoma, as their conditions drastically deteriorate with time. To address the limited accessibility, high costs and static structure of currently used MRI and CT scanners, a portable non-invasive multi-slice microwave imaging system is presented for accurate 3D localization of hematoma inside human head. This diagnostic system provides fast data acquisition and imaging compared to the existing systems by means of a compact array of low-profile, unidirectional antennas with wideband operation. The 3D printed low-cost and portable system can be installed in an ambulance for rapid on-site diagnosis by paramedics. In this paper, the multi-slice head imaging system's operating principle is numerically analysed and experimentally validated on realistic head phantoms. Quantitative analyses demonstrate that the multi-slice head imaging system is able to generate better quality reconstructed images providing 70% higher average signal to clutter ratio, 25% enhanced maximum signal to clutter ratio and with around 60% hematoma target localization compared to the previous head imaging systems. Nevertheless, numerical and experimental results demonstrate that previous reported 2D imaging systems are vulnerable to localization error, which is overcome in the presented multi-slice 3D imaging system. The non-ionizing system, which uses safe levels of very low microwave power, is also tested on human subjects. Results of realistic phantom and subjects demonstrate the feasibility of the system in future preclinical trials.

Automated airway evaluation system for multi-slice computed tomography using airway lumen diameter, airway wall thickness and broncho-arterial ratio

NASA Astrophysics Data System (ADS)

Odry, Benjamin L.; Kiraly, Atilla P.; Novak, Carol L.; Naidich, David P.; Lerallut, Jean-Francois

2006-03-01

Pulmonary diseases such as bronchiectasis, asthma, and emphysema are characterized by abnormalities in airway dimensions. Multi-slice computed tomography (MSCT) has become one of the primary means to depict these abnormalities, as the availability of high-resolution near-isotropic data makes it possible to evaluate airways at oblique angles to the scanner plane. However, currently, clinical evaluation of airways is typically limited to subjective visual inspection only: systematic evaluation of the airways to take advantage of high-resolution data has not proved practical without automation. We present an automated method to quantitatively evaluate airway lumen diameter, wall thickness and broncho-arterial ratios. In addition, our method provides 3D visualization of these values, graphically illustrating the location and extent of disease. Our algorithm begins by automatic airway segmentation to extract paths to the distal airways, and to create a map of airway diameters. Normally, airway diameters decrease as paths progress distally; failure to taper indicates abnormal dilatation. Our approach monitors airway lumen diameters along each airway path in order to detect abnormal profiles, allowing even subtle degrees of pathologic dilatation to be identified. Our method also systematically computes the broncho-arterial ratio at every terminal branch of the tree model, as a ratio above 1 indicates potentially abnormal bronchial dilatation. Finally, the airway wall thickness is computed at corresponding locations. These measurements are used to highlight abnormal branches for closer inspection, and can be summed to compute a quantitative global score for the entire airway tree, allowing reproducible longitudinal assessment of disease severity. Preliminary tests on patients diagnosed with bronchiectasis demonstrated rapid identification of lack of tapering, which also was confirmed by corresponding demonstration of elevated broncho-arterial ratios.

Diagnostic Imaging of the Hepatobiliary System: An Update.

PubMed

Marolf, Angela J

2017-05-01

Recent advances in diagnostic imaging of the hepatobiliary system include MRI, computed tomography (CT), contrast-enhanced ultrasound, and ultrasound elastography. With the advent of multislice CT scanners, sedated examinations in veterinary patients are feasible, increasing the utility of this imaging modality. CT and MRI provide additional information for dogs and cats with hepatobiliary diseases due to lack of superimposition of structures, operator dependence, and through intravenous contrast administration. Advanced ultrasound methods can offer complementary information to standard ultrasound imaging. These newer imaging modalities assist clinicians by aiding diagnosis, prognostication, and surgical planning. Copyright © 2016 Elsevier Inc. All rights reserved.

An evaluation of the Meditech M250 and a comparison with other CT scanners.

PubMed

Greensmith, R; Richardson, R B; Sargood, A J; Stevens, P H; Mackintosh, I P

1985-11-01

The Meditech M250 computerised tomography (CT) machine was evaluated during the first half of 1984. Measurements were made of noise, modulation transfer function, slice width, radiation dose profile, uniformity and linearity of CT number, effective photon energy and parameters relating to machine specification, such as pixel size and scan time. All breakdowns were logged to indicate machine reliability. A comparison with the established EMI CT1010 and CT5005 was made for noise, resolution and multislice radiation dose, as well as the dose efficiency or quality (Q) factor for both head and body modes of operation. The M250 was found to perform to its intended specification with an acceptable level of reliability.

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.

A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2)

PubMed Central

2012-01-01

Background Computed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. However, literature provides limited evidence whether immediate total-body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total-body CT scanning in trauma patients. Methods/design The REACT-2 trial is an international, multicenter randomized clinical trial. All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. Patients in whom direct scanning will hamper necessary cardiopulmonary resuscitation or who require an immediate operation because of imminent death (both as judged by the trauma team leader) are excluded. Randomization will be computer assisted. The intervention group will receive a contrast-enhanced total-body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness. Discussion The REACT-2 trial is a multicenter randomized clinical trial that will provide evidence on the value of immediate total-body CT scanning during the primary survey of severely injured trauma patients. If immediate total-body CT scanning is found to be the best imaging strategy in severely injured trauma patients it could replace conventional imaging supplemented with CT in this specific group. Trial Registration ClinicalTrials.gov: (NCT01523626). PMID:22458247

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.

[Establishment of a 3D finite element model of human skull using MSCT images and mimics software].

PubMed

Huang, Ping; Li, Zheng-dong; Shao, Yu; Zou, Dong-hua; Liu, Ning-guo; Li, Li; Chen, Yuan-yuan; Wan, Lei; Chen, Yi-jiu

2011-02-01

To establish a human 3D finite element skull model, and to explore its value in biomechanics analysis. The cadaveric head was scanned and then 3D skull model was created using Mimics software based on 2D CT axial images. The 3D skull model was optimized by preprocessor along with creation of the surface and volume meshes. The stress changes, after the head was struck by an object or the head hit the ground directly, were analyzed using ANSYS software. The original 3D skull model showed a large number of triangles with a poor quality and high similarity with the real head, while the optimized model showed high quality surface and volume meshes with a small number of triangles comparatively. The model could show the local and global stress changes effectively. The human 3D skull model can be established using MSCT and Mimics software and provides a good finite element model for biomechanics analysis. This model may also provide a base for the study of head stress changes following different forces.

Volumetric analysis of maxillary sinuses of Zulu and European crania by helical, multislice computed tomography.

PubMed

Fernandes, C L

2004-11-01

The volumes of the maxillary sinuses are of interest to surgeons operating endoscopically as variation in maxillary sinus volume may mean variation in anatomical landmarks. Other surgical disciplines, such as dentistry, maxillo-facial surgery and plastic surgery, may benefit from this information. To compare the maxillary sinus volumes of dried crania from cadavers of European and Zulu descent, with respect to ethnic group and gender. Helical, multislice computed tomography (CT) was performed using 1-mm coronal slices. The area for each slice was obtained by tracing the outline of each slice. The CT machine calculated a volume by totalling the slices for each sinus. Ethnic and gender variations were found in the different groups. It was found that European crania had significantly larger antral volumes than Zulu crania and men had larger volumes than women. Race and gender interaction was also assessed, as was maxillary sinus side. A variation in maxillary sinus volume between different ethnic groups and genders exists, and surgeons operating in this region should be aware of this.

[Myocardial infarction as cause of an accident. The role of multislice CT in polytrauma management, differential diagnosis and insurance aspects].

PubMed

Kleber, C; Oswald, B; Bail, H J; Haas, N P; Kandziora, F

2008-12-01

We present for the first time the use of contrast-enhanced multislice computed tomography in trauma care to detect acute myocardial infarction and verify it as the cause of a traffic accident. In addition to the case report, cardiac contusion, coronary dissection, and facets of insurance law are discussed. The determination of acute myocardial infarction, cardiac contusion, and coronary dissection can be challenging, but answers can be found in the medical history and accident details. The trauma surgeon in the emergency department must always be interested in clarifying the cause of trauma and keeping a secondary diagnosis in mind to strive for the goal of optimal and complete polytrauma care.

Initial experience in treating lung cancer with helical tomotherapy

PubMed Central

Yartsev, S; Dar, AR; Woodford, C; Wong, E; Bauman, G; Van Dyk, J

2007-01-01

Helical tomotherapy is a new form of image-guided radiation therapy that combines features of a linear accelerator and a helical computed tomography (CT) scanner. Megavoltage CT (MVCT) data allow the verification and correction of patient setup on the couch by comparison and image registration with the kilovoltage CT multi-slice images used for treatment planning. An 84-year-old male patient with Stage III bulky non-small cell lung cancer was treated on a Hi-ART II tomotherapy unit. Daily MVCT imaging was useful for setup corrections and signaled the need to adapt the delivery plan when the patient’s anatomy changed significantly. PMID:21614260

A fully automated multi-modal computer aided diagnosis approach to coronary calcium scoring of MSCT images

NASA Astrophysics Data System (ADS)

Wu, Jing; Ferns, Gordon; Giles, John; Lewis, Emma

2012-03-01

Inter- and intra- observer variability is a problem often faced when an expert or observer is tasked with assessing the severity of a disease. This issue is keenly felt in coronary calcium scoring of patients suffering from atherosclerosis where in clinical practice, the observer must identify firstly the presence, followed by the location of candidate calcified plaques found within the coronary arteries that may prevent oxygenated blood flow to the heart muscle. However, it can be difficult for a human observer to differentiate calcified plaques that are located in the coronary arteries from those found in surrounding anatomy such as the mitral valve or pericardium. In addition to the benefits to scoring accuracy, the use of fast, low dose multi-slice CT imaging to perform the cardiac scan is capable of acquiring the entire heart within a single breath hold. Thus exposing the patient to lower radiation dose, which for a progressive disease such as atherosclerosis where multiple scans may be required, is beneficial to their health. Presented here is a fully automated method for calcium scoring using both the traditional Agatston method, as well as the volume scoring method. Elimination of the unwanted regions of the cardiac image slices such as lungs, ribs, and vertebrae is carried out using adaptive heart isolation. Such regions cannot contain calcified plaques but can be of a similar intensity and their removal will aid detection. Removal of both the ascending and descending aortas, as they contain clinical insignificant plaques, is necessary before the final calcium scores are calculated and examined against ground truth scores of three averaged expert observer results. The results presented here are intended to show the feasibility and requirement for an automated scoring method to reduce the subjectivity and reproducibility error inherent with manual clinical calcium scoring.

Computed tomography angiography reveals the crime instrument – case report

PubMed Central

Banaszek, Anna; Guziński, Maciej; Sąsiadek, Marek

2010-01-01

Summary Background: The development of multislice CT technology enabled imaging of post-traumatic brain lesions with isotropic resolution, which led to unexpected results in the presented case Case Report: An unconscious, 49-year-old male with a suspected trauma underwent a routine CT examination of the head, which revealed an unusual intracerebral bleeding and therefore was followed by CT angiography (CTA). The thorough analysis of CTA source scans led to the detection of the bleeding cause. Conclusions: The presented case showed that a careful analysis of a CT scan allows not only to define the extent of pathological lesions in the intracranial space but it also helps to detect the crime instrument, which is of medico-legal significance. PMID:22802784

Radiation exposure in whole body CT screening.

PubMed

Suresh, Pamidighantam; Ratnam, S V; Rao, K V J

2011-04-01

Using a technology that "takes a look" at people's insides and promises early warnings of cancer, cardiac disease, and other abnormalities, clinics and medical imaging facilities nationwide are touting a new service for health conscious people: "Whole body CT screening" this typically involves scanning the body from the chin to below the hips with a form of x-ray imaging that produces cross-sectional images. In USA direct-to-consumer marketing of whole body CT is occurring today in many metropolitan areas. Free standing CT screening centres are being sited in shopping malls and other high density public areas, and these centres are being advertised in the electronic and print media. In this context the present article discussed the pros and cons of having such centres in India with the advent of multislice CT leading to fast scan times.

Complete genome of the cotton bacteria blight pathogen Xanthomonas citri pv. malvacearum strain MSCT

USDA-ARS?s Scientific Manuscript database

Xanthomonas citri pv. malvacearum (Xcm) is a major pathogen of Gossypium hirsutum. In this study we report the complete genome of the Xcm strain MSCT assembled from long read DNA sequencing technology. The MSCT genome is the first Xcm genome that has complete coding regions for Xcm transcriptional a...

Multislice CT imaging of ruptured left sinus of Valsalva aneurysm with fistulous track between left sinus and right atrium.

PubMed

Pampapati, Praveenkumar; Rao, Hejmadi Tati Gururaj; Radhesh, Srinivasan; Anand, Hejjaji Krishnamurthy; Praveen, Lokkur Srinivasamurthy

2011-01-01

Sinus of valsalva aneurysm is a rare condition arising from any of the three aortic sinuses. Among them, an aneurysm arising from the left coronary sinus is the rarest. Most of these cases were earlier diagnosed using echocardiography and conventional angiography. But with the availability of advanced imaging modalities like 64 slice cardiac CT and MR modalities, this condition can be accurately assessed noninvasively. We report a case of ruptured aneurysm originating from the left coronary sinus with a long windsock type of fistulous track between the aneurysm and right atrium evaluated by 64 slice cardiac CT imaging. This was later confirmed perioperatively.

[Localization of upper airway stricture by CT scan in patients with obstructive sleep apnea syndrome during drug-induced sleeping].

PubMed

Hu, Ji-bo; Hu, Hong-jie; Hou, Tie-ning; Gao, Hang-xiang; He, Jian

2010-03-01

To evaluate the feasibility of multi-slice spiral CT scan to localize upper airway stricture in patients with obstructive sleep apnea syndrome (OSAS) during drug-induced sleeping. One hundred and fourteen patients diagnosed as OSAS by polysomnography were included in the study. Multi-slice spiral CT scan covering upper airway was performed at the end of inspiration and clear upper airway images were obtained in waking. After injecting 5 mg of midazolam intravenously slowly in 109 patients, CT scan was performed at apnea and clear upper airway images were obtained in sleeping. Cross-section area and minimal diameter of airway were measured and the parameters were compared under those two states. Upper airway was displayed intuitionisticly by using post-processing techniques. One hundred and nine patients with OSAS finished the examination with a success rate of 100 %. Airway obstruction at retropalatal level was observed in 62 patients, among whom 26 were associated with airway obstruction at retroglossal level, 27 with narrower airway at retroglossal level in sleeping compared with that in waking, and 9 with no significant change of the airway at retroglossal level after sleeping. Narrower airway at retropalatal level in sleeping compared with that in waking was observed in 40 patients, among whom 20 were associated with narrower airway at retroglossal level in sleeping compared with that in waking, 10 with complete airway obstruction at retroglossal level in sleeping, and 7 with no significant change of the airway at both retropalatal and retroglossal levels before and after sleeping. Minimal mean cross-section area of airway at retropalatal level was (72.60 +/-45.15)mm(2) in waking and (8.26 +/-18.16)mm(2) in sleeping; and minimal mean cross-section area of airway at retroglossal level was (133.21 +/-120.36)mm(2)in waking and (16.73 +/-30.21)mm(2) in sleeping (P <0.01). Minimal mean diameter of airway at retropalatal level was (6.91 +/-2.23) mm in waking and (1.18 +/-2.14) mm in sleeping; and minimal mean diameter of airway at retroglossal level was (8.68 +/-4.32) mm in waking and (1.68 +/-2.22) mm in sleeping (P <0.01). Multi-slice spiral CT with post-processing techniques can display the shape of the upper airway in patients with OSAS in sleeping, and can localize the upper airway stricture and assess its range accurately.

Determination of dosimetric quantities in pediatric abdominal computed tomography scans*

PubMed Central

Jornada, Tiago da Silva; da Silva, Teógenes Augusto

2014-01-01

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

Computer aided detection system for Osteoporosis using low dose thoracic 3D CT images

NASA Astrophysics Data System (ADS)

Tsuji, Daisuke; Matsuhiro, Mikio; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Nakano, Yasutaka; Harada, Masafumi; Kusumoto, Masahiko; Tsuchida, Takaaki; Eguchi, Kenji; Kaneko, Masahiro

2018-02-01

The patient of osteoporosis is about 13 million people in Japan and it is one of healthy life problems in the aging society. It is necessary to do early stage detection and treatment in order to prevent the osteoporosis. Multi-slice CT technology has been improving the three dimensional (3D) image analysis with higher resolution and shorter scan time. The 3D image analysis of thoracic vertebra can be used for supporting to diagnosis of osteoporosis. This analysis can be used for lung cancer detection at the same time. We develop method of shape analysis and CT values of spongy bone for the detection osteoporosis. Osteoporosis and lung cancer screening show high extraction rate by the thoracic vertebral evaluation CT images. In addition, we created standard pattern of CT value per thoracic vertebra for male age group using 298 low dose data.

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.

Optimization of view weighting in tilted-plane-based reconstruction algorithms to minimize helical artifacts in multi-slice helical CT

NASA Astrophysics Data System (ADS)

Tang, Xiangyang

2003-05-01

In multi-slice helical CT, the single-tilted-plane-based reconstruction algorithm has been proposed to combat helical and cone beam artifacts by tilting a reconstruction plane to fit a helical source trajectory optimally. Furthermore, to improve the noise characteristics or dose efficiency of the single-tilted-plane-based reconstruction algorithm, the multi-tilted-plane-based reconstruction algorithm has been proposed, in which the reconstruction plane deviates from the pose globally optimized due to an extra rotation along the 3rd axis. As a result, the capability of suppressing helical and cone beam artifacts in the multi-tilted-plane-based reconstruction algorithm is compromised. An optomized tilted-plane-based reconstruction algorithm is proposed in this paper, in which a matched view weighting strategy is proposed to optimize the capability of suppressing helical and cone beam artifacts and noise characteristics. A helical body phantom is employed to quantitatively evaluate the imaging performance of the matched view weighting approach by tabulating artifact index and noise characteristics, showing that the matched view weighting improves both the helical artifact suppression and noise characteristics or dose efficiency significantly in comparison to the case in which non-matched view weighting is applied. Finally, it is believed that the matched view weighting approach is of practical importance in the development of multi-slive helical CT, because it maintains the computational structure of fan beam filtered backprojection and demands no extra computational services.

CT-guided robotically-assisted infiltration of foot and ankle joints.

PubMed

Wiewiorski, Martin; Valderrabano, Victor; Kretzschmar, Martin; Rasch, Helmut; Markus, Tanja; Dziergwa, Severine; Kos, Sebastian; Bilecen, Deniz; Jacob, Augustinus Ludwig

2009-01-01

It was our aim to describe a CT-guided robotically-assisted infiltration technique for diagnostic injections in foot and ankle orthopaedics. CT-guided mechatronically-assisted joint infiltration was performed on 16 patients referred to the orthopaedic department for diagnostic foot and ankle assessment. All interventions were performed using an INNOMOTION-assistance device on a multislice CT scanner in an image-guided therapy suite. Successful infiltration was defined as CT localization of contrast media in the target joint. Additionally, pre- and post-interventional VAS pain scores were assessed. All injections (16/16 joints) were technically successful. Contrast media deposit was documented in all targeted joints. Significant relief of pain was noted by all 16 patients (p<0.01). CT-guided robotically-assisted intervention is an exact, reliable and safe application method for diagnostic infiltration of midfoot and hindfoot joints. The high accuracy and feasibility in a clinical environment make it a viable alternative to the commonly used fluoroscopic-guided procedures.

Image Quality of 3rd Generation Spiral Cranial Dual-Source CT in Combination with an Advanced Model Iterative Reconstruction Technique: A Prospective Intra-Individual Comparison Study to Standard Sequential Cranial CT Using Identical Radiation Dose

PubMed Central

Wenz, Holger; Maros, Máté E.; Meyer, Mathias; Förster, Alex; Haubenreisser, Holger; Kurth, Stefan; Schoenberg, Stefan O.; Flohr, Thomas; Leidecker, Christianne; Groden, Christoph; Scharf, Johann; Henzler, Thomas

2015-01-01

Objectives To prospectively intra-individually compare image quality of a 3rd generation Dual-Source-CT (DSCT) spiral cranial CT (cCT) to a sequential 4-slice Multi-Slice-CT (MSCT) while maintaining identical intra-individual radiation dose levels. Methods 35 patients, who had a non-contrast enhanced sequential cCT examination on a 4-slice MDCT within the past 12 months, underwent a spiral cCT scan on a 3rd generation DSCT. CTDIvol identical to initial 4-slice MDCT was applied. Data was reconstructed using filtered backward projection (FBP) and 3rd-generation iterative reconstruction (IR) algorithm at 5 different IR strength levels. Two neuroradiologists independently evaluated subjective image quality using a 4-point Likert-scale and objective image quality was assessed in white matter and nucleus caudatus with signal-to-noise ratios (SNR) being subsequently calculated. Results Subjective image quality of all spiral cCT datasets was rated significantly higher compared to the 4-slice MDCT sequential acquisitions (p<0.05). Mean SNR was significantly higher in all spiral compared to sequential cCT datasets with mean SNR improvement of 61.65% (p*Bonferroni0.05<0.0024). Subjective image quality improved with increasing IR levels. Conclusion Combination of 3rd-generation DSCT spiral cCT with an advanced model IR technique significantly improves subjective and objective image quality compared to a standard sequential cCT acquisition acquired at identical dose levels. PMID:26288186

Image Quality of 3rd Generation Spiral Cranial Dual-Source CT in Combination with an Advanced Model Iterative Reconstruction Technique: A Prospective Intra-Individual Comparison Study to Standard Sequential Cranial CT Using Identical Radiation Dose.

PubMed

Wenz, Holger; Maros, Máté E; Meyer, Mathias; Förster, Alex; Haubenreisser, Holger; Kurth, Stefan; Schoenberg, Stefan O; Flohr, Thomas; Leidecker, Christianne; Groden, Christoph; Scharf, Johann; Henzler, Thomas

2015-01-01

To prospectively intra-individually compare image quality of a 3rd generation Dual-Source-CT (DSCT) spiral cranial CT (cCT) to a sequential 4-slice Multi-Slice-CT (MSCT) while maintaining identical intra-individual radiation dose levels. 35 patients, who had a non-contrast enhanced sequential cCT examination on a 4-slice MDCT within the past 12 months, underwent a spiral cCT scan on a 3rd generation DSCT. CTDIvol identical to initial 4-slice MDCT was applied. Data was reconstructed using filtered backward projection (FBP) and 3rd-generation iterative reconstruction (IR) algorithm at 5 different IR strength levels. Two neuroradiologists independently evaluated subjective image quality using a 4-point Likert-scale and objective image quality was assessed in white matter and nucleus caudatus with signal-to-noise ratios (SNR) being subsequently calculated. Subjective image quality of all spiral cCT datasets was rated significantly higher compared to the 4-slice MDCT sequential acquisitions (p<0.05). Mean SNR was significantly higher in all spiral compared to sequential cCT datasets with mean SNR improvement of 61.65% (p*Bonferroni0.05<0.0024). Subjective image quality improved with increasing IR levels. Combination of 3rd-generation DSCT spiral cCT with an advanced model IR technique significantly improves subjective and objective image quality compared to a standard sequential cCT acquisition acquired at identical dose levels.

Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

DTIC Science & Technology

2009-11-01

imaging using two distinct methods7-15: mathematically based models defined by geometric primitives and voxelized models derived from real human...trees to complete them. We also plan to add further detail by defining the Cooper’s ligaments using geometrical NURBS surfaces. Realistic...generated model for the coronary arterial tree based on multislice CT and morphometric data," Medical Imaging 2006: Physics of Medical Imaging 6142

Uncarboxylated matrix Gla protein (ucMGP) is associated with coronary artery calcification in haemodialysis patients.

PubMed

Cranenburg, Ellen C M; Brandenburg, Vincent M; Vermeer, Cees; Stenger, Melanie; Mühlenbruch, Georg; Mahnken, Andreas H; Gladziwa, Ulrich; Ketteler, Markus; Schurgers, Leon J

2009-02-01

Matrix gamma-carboxyglutamate (Gla) protein (MGP) is a potent local inhibitor of cardiovascular calcification and accumulates at areas of calcification in its uncarboxylated form (ucMGP). We previously found significantly lower circulating ucMGP levels in patients with a high vascular calcification burden. Here we report on the potential of circulating ucMGP to serve as a biomarker for vascular calcification in haemodialysis (HD) patients. Circulating ucMGP levels were measured with an ELISA-based assay in 40 HD patients who underwent multi-slice computed tomography (MSCT) scanning to quantify the extent of coronary artery calcification (CAC). The mean ucMGP level in HD patients (193 +/- 65 nM) was significantly lower as compared to apparently healthy subjects of the same age (441 +/- 97 nM; p < 0.001) and patients with rheumatoid arthritis (RA) without CAC (560 +/- 140 nM; p < 0.001). Additionally, ucMGP levels correlated inversely with CAC scores (r = -0.41; p = 0.009), and this correlation persisted after adjustment for age, dialysis vintage and high-sensitivity C-reactive protein (hs-CRP). Since circulating ucMGP levels are significantly and inversely correlated with the extent of CAC in HD patients, ucMGP may become a tool for identifying HD patients with a high probability of cardiovascular calcification.

Intraoperative computed tomography.

PubMed

Tonn, J C; Schichor, C; Schnell, O; Zausinger, S; Uhl, E; Morhard, D; Reiser, M

2011-01-01

Intraoperative computed tomography (iCT) has gained increasing impact among modern neurosurgical techniques. Multislice CT with a sliding gantry in the OR provides excellent diagnostic image quality in the visualization of vascular lesions as well as bony structures including skull base and spine. Due to short acquisition times and a high spatial and temporal resolution, various modalities such as iCT-angiography, iCT-cerebral perfusion and the integration of intraoperative navigation with automatic re-registration after scanning can be performed. This allows a variety of applications, e.g. intraoperative angiography, intraoperative cerebral perfusion studies, update of cerebral and spinal navigation, stereotactic procedures as well as resection control in tumour surgery. Its versatility promotes its use in a multidisciplinary setting. Radiation exposure is comparable to standard CT systems outside the OR. For neurosurgical purposes, however, new hardware components (e.g. a radiolucent headholder system) had to be developed. Having a different range of applications compared to intraoperative MRI, it is an attractive modality for intraoperative imaging being comparatively easy to install and cost efficient.

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

Segmentation algorithm of colon based on multi-slice CT colonography

NASA Astrophysics Data System (ADS)

Hu, Yizhong; Ahamed, Mohammed Shabbir; Takahashi, Eiji; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Suzuki, Masahiro; Iinuma, Gen; Moriyama, Noriyuki

2012-02-01

CT colonography is a radiology test that looks at people's large intestines(colon). CT colonography can screen many options of colon cancer. This test is used to detect polyps or cancers of the colon. CT colonography is safe and reliable. It can be used if people are too sick to undergo other forms of colon cancer screening. In our research, we proposed a method for automatic segmentation of the colon from abdominal computed Tomography (CT) images. Our multistage detection method extracted colon and spited colon into different parts according to the colon anatomy information. We found that among the five segmented parts of the colon, sigmoid (20%) and rectum (50%) are more sensitive toward polyps and masses than the other three parts. Our research focused on detecting the colon by the individual diagnosis of sigmoid and rectum. We think it would make the rapid and easy diagnosis of colon in its earlier stage and help doctors for analysis of correct position of each part and detect the colon rectal cancer much easier.

An automated multi-modal object analysis approach to coronary calcium scoring of adaptive heart isolated MSCT images

NASA Astrophysics Data System (ADS)

Wu, Jing; Ferns, Gordon; Giles, John; Lewis, Emma

2012-02-01

Inter- and intra- observer variability is a problem often faced when an expert or observer is tasked with assessing the severity of a disease. This issue is keenly felt in coronary calcium scoring of patients suffering from atherosclerosis where in clinical practice, the observer must identify firstly the presence, followed by the location of candidate calcified plaques found within the coronary arteries that may prevent oxygenated blood flow to the heart muscle. This can be challenging for a human observer as it is difficult to differentiate calcified plaques that are located in the coronary arteries from those found in surrounding anatomy such as the mitral valve or pericardium. The inclusion or exclusion of false positive or true positive calcified plaques respectively will alter the patient calcium score incorrectly, thus leading to the possibility of incorrect treatment prescription. In addition to the benefits to scoring accuracy, the use of fast, low dose multi-slice CT imaging to perform the cardiac scan is capable of acquiring the entire heart within a single breath hold. Thus exposing the patient to lower radiation dose, which for a progressive disease such as atherosclerosis where multiple scans may be required, is beneficial to their health. Presented here is a fully automated method for calcium scoring using both the traditional Agatston method, as well as the Volume scoring method. Elimination of the unwanted regions of the cardiac image slices such as lungs, ribs, and vertebrae is carried out using adaptive heart isolation. Such regions cannot contain calcified plaques but can be of a similar intensity and their removal will aid detection. Removal of both the ascending and descending aortas, as they contain clinical insignificant plaques, is necessary before the final calcium scores are calculated and examined against ground truth scores of three averaged expert observer results. The results presented here are intended to show the requirement and feasibility for an automated scoring method that reduces the subjectivity and reproducibility error inherent with manual clinical calcium scoring.

Radiologic evaluation after posterior instrumented surgery for thoracic ossification of the posterior longitudinal ligament: union between rostral and caudal ossifications.

PubMed

Ando, Kei; Imagama, Shiro; Ito, Zenya; Kobayashi, Kazuyoshi; Ukai, Junichi; Muramoto, Akio; Shinjo, Ryuichi; Matsumoto, Tomohiro; Nakashima, Hiroaki; Ishiguro, Naoki

2014-05-01

Retrospective clinical study. To investigate, using multislice CT images, how thoracic ossification of the posterior longitudinal ligament (OPLL) changes with time after thoracic posterior fusion surgery. Few studies have evaluated thoracic OPLL preoperatively and post using computed tomography (CT). The subjects included 19 patients (7 men and 12 women) with an average age at surgery of 52 years (38-66 y) who underwent indirect posterior decompression with corrective fusion and instrumentation at our institute. Minimum follow-up period was 1 year, and averaged 3 years 10 months (12-120 mo). Using CT images, we investigated fusion range, preoperative and postoperative Cobb angles of thoracic fusion levels, intraoperative and postoperative blood loss, operative time, hyperintense areas on preoperative MRI of thoracic spine and thickness of the OPLL on the reconstructed sagittal, multislice CT images taken before the operation and at 3 months, 6 months and 1 year after surgery. The basic fusion area was 3 vertebrae above and below the OPLL lesion. The mean operative time was 7 hours and 48 min (4 h 39 min-10 h 28 min), and blood loss was 1631 mL (160-11,731 mL). Intramedullary signal intensity change on magnetic resonance images was observed at the most severe ossification area in 18 patients. Interestingly, the rostral and caudal ossification regions of the OPLLs, as seen on sagittal CT images, were discontinuous across the disk space in all patients. Postoperatively, the discontinuous segments connected in all patients without progression of OPLL thickness by 5.1 months on average. All patients needing surgery had discontinuity across the disk space between the rostral and caudal ossified lesions as seen on CT. This discontinuity was considered to be the main reason for the myelopathy because a high-intensity area on magnetic resonance imaging was seen in 18 of 19 patients at the same level. Rigid fixation with instrumentation may allow the discontinuous segments to connect in patients without a concomitant thickening of the OPLL.

Application of a novel metal artifact correction algorithm in flat-panel CT after coil embolization of brain aneurysms: intraindividual comparison.

PubMed

Buhk, J-H; Groth, M; Sehner, S; Fiehler, J; Schmidt, N O; Grzyska, U

2013-09-01

To evaluate a novel algorithm for correcting beam hardening artifacts caused by metal implants in computed tomography performed on a C-arm angiography system equipped with a flat panel (FP-CT). 16 datasets of cerebral FP-CT acquisitions after coil embolization of brain aneurysms in the context of acute subarachnoid hemorrhage have been reconstructed by applying a soft tissue kernel with and without a novel reconstruction filter for metal artifact correction. Image reading was performed in multiplanar reformations (MPR) in average mode on a dedicated radiological workplace in comparison to the preinterventional native multisection CT (MS-CT) scan serving as the anatomic gold standard. Two independent radiologists performed image scoring following a defined scale in direct comparison of the image data with and without artifact correction. For statistical analysis, a random intercept model was calculated. The inter-rater agreement was very high (ICC = 86.3 %). The soft tissue image quality and visualization of the CSF spaces at the level of the implants was substantially improved. The additional metal artifact correction algorithm did not induce impairment of the subjective image quality in any other brain regions. Adding metal artifact correction to FP-CT in an acute postinterventional setting helps to visualize the close vicinity of the aneurysm at a generally consistent image quality. © Georg Thieme Verlag KG Stuttgart · New York.

[Impact of multi-layer spiral CT angiography of bronchial artery and pulmonary artery in assessment of the main blood supply to the primary lung cancer].

PubMed

Xiao, Xiang-sheng; Yu, Hong; Li, Hui-min; Liu, Shi-yuan; Li, Cheng-zhou; Liu, Jing

2006-04-01

To investigate the blood supply of primary lung cancer (PLC) using CT angiography for bronchial artery (BA) and pulmonary artery (PA). Thin-section enhanced multi-layer spiral CT (MSCT) were carried out in 147 primary lung cancer patients and 46 healthy subjects as control. Three-dimensional images of bronchial artery and pulmonary artery were obtained using volume render (VR) and multi-planar reconstruction (MPR) or maximum intensity projection (MIP) at the workstation, and their morphological findings and relationship with the mass were assessed. 136 primary lung cancer patients and 32 healthy controls were evaluated for at least one bronchial artery displayed clearly in VR. The detective rate of the bronchial artery was 92.5% and 69.6%, respectively. The bronchial artery caliber and the total section area of lesion side in lung cancer patients were significantly larger than that on the contralateral side and that of the control (P < 0.05). Bronchial artery on the lesion side in lung cancer was dilated and tortuous, directly penetrating into the mass with reticularly anastomosed branches. In the PLC patients, all PA were shown clearly with normal morphological image though crossing over the masses in 54 patients; In 25 PLC patients, the PA being essentially intact, was pushed around and surrounded the mass, giving the "hold ball" sign; In 40 other PLC patients, PA being also intact, the mass surrounded and buried the PA from the outside, crushing the PA flat resulting in an eccentric or centrifugal shrinkage, forming the "dead branch" sign; In the rest 28 patients, the PA was surrounded and even compressed, forming the "residual root" sign. Primary lung cancer patient shows dilated bronchial arteries and increased bronchial artery blood flow, whereas pulmonary arteries just pass through the mass or are compressed by the mass. It is further demonstrated that the bronchial artery, instead of the pulmonary artery, is the main vessel of blood supply to the primary lung cancer as shown by MSCT angiography of bronchial artery and pulmonary artery.

TU-EF-204-11: Impact of Using Multi-Slice Training Sets On the Performance of a Channelized Hotelling Observer in a Low-Contrast Detection Task in CT

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

Favazza, C; Yu, L; Leng, S

2015-06-15

Purpose: To investigate using multiple CT image slices from a single acquisition as independent training images for a channelized Hotelling observer (CHO) model to reduce the number of repeated scans for CHO-based CT image quality assessment. Methods: We applied a previously validated CHO model to detect low contrast disk objects formed from cross-sectional images of three epoxy-resin-based rods (diameters: 3, 5, and 9 mm; length: ∼5cm). The rods were submerged in a 35x 25 cm2 iodine-doped water filled phantom, yielding-15 HU object contrast. The phantom was scanned 100 times with and without the rods present. Scan and reconstruction parameters include:more » 5 mm slice thickness at 0.5 mm intervals, 120 kV, 480 Quality Reference mAs, and a 128-slice scanner. The CHO’s detectability index was evaluated as a function of factors related to incorporating multi-slice image data: object misalignment along the z-axis, inter-slice pixel correlation, and number of unique slice locations. In each case, the CHO training set was fixed to 100 images. Results: Artificially shifting the object’s center position by as much as 3 pixels in any direction relative to the Gabor channel filters had insignificant impact on object detectability. An inter-slice pixel correlation of >∼0.2 yielded positive bias in the model’s performance. Incorporating multi-slice image data yielded slight negative bias in detectability with increasing number of slices, likely due to physical variations in the objects. However, inclusion of image data from up to 5 slice locations yielded detectability indices within measurement error of the single slice value. Conclusion: For the investigated model and task, incorporating image data from 5 different slice locations of at least 5 mm intervals into the CHO model yielded detectability indices within measurement error of the single slice value. Consequently, this methodology would Result in a 5-fold reduction in number of image acquisitions. This project was supported by National Institutes of Health grants R01 EB017095 and U01 EB017185 from the National Institute of Biomedical Imaging and Bioengineering.« less

Temporal Subtraction of Digital Breast Tomosynthesis Images for Improved Mass Detection

DTIC Science & Technology

2008-10-01

K. Fishman and B. M. W. Tsui, "Development of a computer-generated model for the coronary arterial tree based on multislice CT and morphometric data...mathematical models based on geometric primitives8-22. Bakic et al created synthetic x-ray mammograms using a 3D simulated breast tissue model consisting of...utilized a combination of voxel matrices and geometric primitives to create a breast phantom that includes the breast surface, the duct system, and

Image quality and stability of image-guided radiotherapy (IGRT) devices: A comparative study.

PubMed

Stock, Markus; Pasler, Marlies; Birkfellner, Wolfgang; Homolka, Peter; Poetter, Richard; Georg, Dietmar

2009-10-01

Our aim was to implement standards for quality assurance of IGRT devices used in our department and to compare their performances with that of a CT simulator. We investigated image quality parameters for three devices over a period of 16months. A multislice CT was used as a benchmark and results related to noise, spatial resolution, low contrast visibility (LCV) and uniformity were compared with a cone beam CT (CBCT) at a linac and simulator. All devices performed well in terms of LCV and, in fact, exceeded vendor specifications. MTF was comparable between CT and linac CBCT. Integral nonuniformity was, on average, 0.002 for the CT and 0.006 for the linac CBCT. Uniformity, LCV and MTF varied depending on the protocols used for the linac CBCT. Contrast-to-noise ratio was an average of 51% higher for the CT than for the linac and simulator CBCT. No significant time trend was observed and tolerance limits were implemented. Reasonable differences in image quality between CT and CBCT were observed. Further research and development are necessary to increase image quality of commercially available CBCT devices in order for them to serve the needs for adaptive and/or online planning.

Assessment of multislice CT to quantify pulmonary emphysema function and physiology in a rat model

NASA Astrophysics Data System (ADS)

Cao, Minsong; Stantz, Keith M.; Liang, Yun; Krishnamurthi, Ganapathy; Presson, Robert G., Jr.

2005-04-01

Purpose: The purpose of this study is to evaluate multi-slice computed tomography technology to quantify functional and physiologic changes in rats with pulmonary emphysema. Method: Seven rats were scanned using a 16-slice CT (Philips MX8000 IDT) before and after artificial inducement of emphysema. Functional parameters i.e. lung volumes were measured by non-contrast spiral scan during forced breath-hold at inspiration and expiration followed by image segmentation based on attenuation threshold. Dynamic CT imaging was performed immediately following the contrast injection to estimate physiology changes. Pulmonary perfusion, fractional blood volume, and mean transit times (MTTs) were estimated by fitting the time-density curves of contrast material using a compartmental model. Results: The preliminary results indicated that the lung volumes of emphysema rats increased by 3.52+/-1.70mL (p<0.002) at expiration and 4.77+/-3.34mL (p<0.03) at inspiration. The mean lung densities of emphysema rats decreased by 91.76+/-68.11HU (p<0.01) at expiration and low attenuation areas increased by 5.21+/-3.88% (p<0.04) at inspiration compared with normal rats. The perfusion for normal and emphysema rats were 0.25+/-0.04ml/s/ml and 0.32+/-0.09ml/s/ml respectively. The fractional blood volumes for normal and emphysema rats were 0.21+/-0.04 and 0.15+/-0.02. There was a trend toward faster MTTs for emphysema rats (0.42+/-0.08s) than normal rats (0.89+/-0.19s) with p<0.006, suggesting that blood flow crossing the capillaries increases as the capillary volume decreases and which may cause the red blood cells to leave the capillaries incompletely saturated with oxygen if the MTTs become too short. Conclusion: Quantitative measurement using CT of structural and functional changes in pulmonary emphysema appears promising for small animals.

Effects of intrafractional motion on water equivalent pathlength in respiratory-gated heavy charged particle beam radiotherapy.

PubMed

Mori, Shinichiro; Chen, George T Y; Endo, Masahiro

2007-09-01

To analyze the water equivalent pathlength (WEL) fluctuations resulting from cardiac motion and display these variations on a beam's-eye-view image; the analysis provides insight into the accuracy of lung tumor irradiation with heavy charged particle beams. Volumetric cine computed tomography (CT) images were obtained on 7 lung cancer patients under free-breathing conditions with a 256-multislice CT scanner. Cardiac phase was determined by selecting systole and diastole. A WEL difference image (DeltaWEL) was calculated by subtracting the WEL image at end-systole from that at end-diastole at respiratory exhalation phase. Two calculation regions were defined: Region 1 was limited to the volume defined by planes bounding the heart; Region 2 included the entire body thickness for a given beam's-eye-view angle. The DeltaWEL values observed in Region 1 showed fluctuations at the periphery of the heart that varied from 20.4 (SD, 5.2) mm WEL to -15.6 (3.2) mm WEL. The areas over which these range perturbation values were observed were 36.8 (32.4) mm(2) and 6.0 (2.8) mm(2) for positive and negative WEL, respectively. The WEL fluctuations in Region 2 increased by approximately 3-4 mm WEL, whereas negative WEL fluctuations changed by approximately -4 to -5 mm WEL, compared with WEL for Region 1; areas over 20 mm WEL changes in Region 2 increased by 9 mm(2) for positive DeltaWEL and 2 mm(2) for negative DeltaWEL. Cine CT with a 256-multislice CT scanner captures both volumetric cardiac and respiratory motion with a temporal resolution sufficient to estimate range fluctuations by these motions. This information can be used to assess the range perturbations that charged particle beams may experience in irradiation of lung or esophageal tumors adjacent to the heart.

Expression of Wnt and Notch signaling pathways in inflammatory bowel disease treated with mesenchymal stem cell transplantation: evaluation in a rat model.

PubMed

Xing, Yanfen; Chen, Xiaojie; Cao, Yanwen; Huang, Jianyun; Xie, Xuhong; Wei, Yaming

2015-05-22

The purpose of this study was to investigate the expression of Wnt and Notch signaling pathway-related genes in inflammatory bowel disease (IBD) treated with mesenchymal stem cell transplantation (MSCT). TNBS (2,4,6-trinitrobenzene sulfonic acid) was used to establish IBD in a rat model. Mesenchymal stem cells (MSCs) were transplanted via tail vein transfusion. Saline water was used in a control group. The expression of Wnt and Notch main signaling molecules was screened by gene chips and verified by quantitative reverse transcription-polymerase chain reaction in the IBD rat model on day 14 and day 28 after transplantation. The IBD rat models were successfully established and MSCs were transplanted into those models. Genome-wide expression profile chips identified a total of 388 differentially expressive genes, of which 191 were upregulated and 197 were downregulated in the MSC-transplanted group in comparison with the IBD control group. Real-time quantitative polymerase chain reaction results showed that the level of Olfm4 mRNA expression in the IBD group (2.54±0.20) was significantly increased compared with the MSCT group (1.39±0.54) and the normal group (1.62±0.25) (P <0.05). The Wnt3a mRNA was more highly expressed in IBD rats (2.92±0.94) and decreased in MSCT rats (0.17±0.63, P <0.05). The expression of GSK-3β mRNA was decreased in the setting of inflammation (0.65±0.04 versus 1.00±0.01 in normal group, P <0.05) but returned to normal levels after MSCT (0.81±0.17). The expression of β-catenin was observed to increase in IBD tissues (1.76±0.44) compared with normal tissues (1.00±0.01, P <0.05), but no difference was found in the MSCT group (1.12±0.36). Wnt11 declined at 14 days and returned to normal levels at 28 days in the IBD group; in comparison, a significantly lower expression was found in MSCT rats. There were no differences in the expression of Fzd3, c-myc, TCF4, and Wnt5a in inflammation, but all of those genes declined after MSCT treatment. The canonical Wnt and Notch signaling pathways are activated in IBD and may be suppressed by stem cell transplantation to differentiate into intestinal epithelium after MSCT. Moreover, the non-canonical Wnt signaling may be inhibited by canonical Wnt signaling in the setting of inflammation and may also be suppressed by MSCT.

Deep multi-spectral ensemble learning for electronic cleansing in dual-energy CT colonography

NASA Astrophysics Data System (ADS)

Tachibana, Rie; Näppi, Janne J.; Hironaka, Toru; Kim, Se Hyung; Yoshida, Hiroyuki

2017-03-01

We developed a novel electronic cleansing (EC) method for dual-energy CT colonography (DE-CTC) based on an ensemble deep convolution neural network (DCNN) and multi-spectral multi-slice image patches. In the method, an ensemble DCNN is used to classify each voxel of a DE-CTC image volume into five classes: luminal air, soft tissue, tagged fecal materials, and partial-volume boundaries between air and tagging and those between soft tissue and tagging. Each DCNN acts as a voxel classifier, where an input image patch centered at the voxel is generated as input to the DCNNs. An image patch has three channels that are mapped from a region-of-interest containing the image plane of the voxel and the two adjacent image planes. Six different types of spectral input image datasets were derived using two dual-energy CT images, two virtual monochromatic images, and two material images. An ensemble DCNN was constructed by use of a meta-classifier that combines the output of multiple DCNNs, each of which was trained with a different type of multi-spectral image patches. The electronically cleansed CTC images were calculated by removal of regions classified as other than soft tissue, followed by a colon surface reconstruction. For pilot evaluation, 359 volumes of interest (VOIs) representing sources of subtraction artifacts observed in current EC schemes were sampled from 30 clinical CTC cases. Preliminary results showed that the ensemble DCNN can yield high accuracy in labeling of the VOIs, indicating that deep learning of multi-spectral EC with multi-slice imaging could accurately remove residual fecal materials from CTC images without generating major EC artifacts.

CT and MRI slice separation evaluation by LabView developed software.

PubMed

Acri, Giuseppe; Testagrossa, Barbara; Sestito, Angela; Bonanno, Lilla; Vermiglio, Giuseppe

2018-02-01

The efficient use of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) equipment necessitates establishing adequate quality-control (QC) procedures. In particular, the accuracy of slice separation, during multislices acquisition, requires scan exploration of phantoms containing test objects. To simplify such procedures, a novel phantom and a computerised LabView-based procedure have been devised, enabling determination the midpoint of full width at half maximum (FWHM) in real time while the distance from the profile midpoint of two progressive images is evaluated and measured. The results were compared with those obtained by processing the same phantom images with commercial software. To validate the proposed methodology the Fisher test was conducted on the resulting data sets. In all cases, there was no statistically significant variation between the commercial procedure and the LabView one, which can be used on any CT and MRI diagnostic devices. Copyright © 2017. Published by Elsevier GmbH.

Lung lobe modeling and segmentation with individualized surface meshes

NASA Astrophysics Data System (ADS)

Blaffert, Thomas; Barschdorf, Hans; von Berg, Jens; Dries, Sebastian; Franz, Astrid; Klinder, Tobias; Lorenz, Cristian; Renisch, Steffen; Wiemker, Rafael

2008-03-01

An automated segmentation of lung lobes in thoracic CT images is of interest for various diagnostic purposes like the quantification of emphysema or the localization of tumors within the lung. Although the separating lung fissures are visible in modern multi-slice CT-scanners, their contrast in the CT-image often does not separate the lobes completely. This makes it impossible to build a reliable segmentation algorithm without additional information. Our approach uses general anatomical knowledge represented in a geometrical mesh model to construct a robust lobe segmentation, which even gives reasonable estimates of lobe volumes if fissures are not visible at all. The paper describes the generation of the lung model mesh including lobes by an average volume model, its adaptation to individual patient data using a special fissure feature image, and a performance evaluation over a test data set showing an average segmentation accuracy of 1 to 3 mm.

The use of paleo-imaging and microbiological testing in the analysis of antique cultural material: multislice tomography, and microbial analysis of the Trogir Cathedral cope hood depicting St. Martin and a beggar.

PubMed

Cavka, Mislav; Petaros, Anja; Kavur, Lovro; Skrlin, Jasenka; Mlinaric Missoni, Emilija; Jankovic, Ivor; Brkljacic, Boris

2013-01-01

Paleoradiology is the study of biological and other materials from archeological settings through the use of various medical imaging techniques. Although it is most often used in the scientific study of ancient human remains, it can also be used to study metals, ceramics, paper, and clothes. The aim of this study was to test two paleoimaging techniques (MSCT and mammography) in the analysis of an important Croatian liturgical vestment: the hood of a bishop's cope from St. Lawrence's Treasury in Trogir depicting St. Martin and a beggar. To ensure a safe environment for scientists participating in the analysis, a preliminary microbiological analysis was performed, which contributed to the database of microbiological flora found on Croatian archeological remains and relics studied to date. Due to a great amount of metal filaments, the paleoradiological analysis did not produce satisfactory results. However, a digitally enhanced image clearly showed fine metal embroidery of the hood that was not so easily perceived by naked eye. This article argues in favor of expanding paleoradiological studies on materials other than human remains and also of publishing unsatisfactory results, as important lessons for future development of techniques and methods to analyze ancient remains and seek answers about human historical and cultural heritage.

Image quality and stability of image-guided radiotherapy (IGRT) devices: A comparative study

PubMed Central

Stock, Markus; Pasler, Marlies; Birkfellner, Wolfgang; Homolka, Peter; Poetter, Richard; Georg, Dietmar

2010-01-01

Introduction Our aim was to implement standards for quality assurance of IGRT devices used in our department and to compare their performances with that of a CT simulator. Materials and methods We investigated image quality parameters for three devices over a period of 16 months. A multislice CT was used as a benchmark and results related to noise, spatial resolution, low contrast visibility (LCV) and uniformity were compared with a cone beam CT (CBCT) at a linac and simulator. Results All devices performed well in terms of LCV and, in fact, exceeded vendor specifications. MTF was comparable between CT and linac CBCT. Integral nonuniformity was, on average, 0.002 for the CT and 0.006 for the linac CBCT. Uniformity, LCV and MTF varied depending on the protocols used for the linac CBCT. Contrast-to-noise ratio was an average of 51% higher for the CT than for the linac and simulator CBCT. No significant time trend was observed and tolerance limits were implemented. Discussion Reasonable differences in image quality between CT and CBCT were observed. Further research and development are necessary to increase image quality of commercially available CBCT devices in order for them to serve the needs for adaptive and/or online planning. PMID:19695725

[Multispiral computed tomographic semiotics of laryngeal cancer].

PubMed

Vasil'ev, P V; Iudin, A L; Sdvizhkov, A M; Kozhanov, L G

2007-01-01

Multispiral computed tomography (MSCT) with intravenous bolus contrasting is a currently available method for radiodiagnosis of laryngeal cancer. MSCT is of much higher informative value in estimating the extent of a tumorous lesion than the traditional radiodiagnostic techniques: linear tomography, lateral X-ray study, roentgenoscopy and roentgenography of the laryngopharynx and esophagus with barium meal.

Investigating different computed tomography techniques for internal target volume definition.

PubMed

Yoganathan, S A; Maria Das, K J; Subramanian, V Siva; Raj, D Gowtham; Agarwal, Arpita; Kumar, Shaleen

2017-01-01

The aim of this work was to evaluate the various computed tomography (CT) techniques such as fast CT, slow CT, breath-hold (BH) CT, full-fan cone beam CT (FF-CBCT), half-fan CBCT (HF-CBCT), and average CT for delineation of internal target volume (ITV). In addition, these ITVs were compared against four-dimensional CT (4DCT) ITVs. Three-dimensional target motion was simulated using dynamic thorax phantom with target insert of diameter 3 cm for ten respiration data. CT images were acquired using a commercially available multislice CT scanner, and the CBCT images were acquired using On-Board-Imager. Average CT was generated by averaging 10 phases of 4DCT. ITVs were delineated for each CT by contouring the volume of the target ball; 4DCT ITVs were generated by merging all 10 phases target volumes. Incase of BH-CT, ITV was derived by boolean of CT phases 0%, 50%, and fast CT target volumes. ITVs determined by all CT and CBCT scans were significantly smaller (P < 0.05) than the 4DCT ITV, whereas there was no significant difference between average CT and 4DCT ITVs (P = 0.17). Fast CT had the maximum deviation (-46.1% ± 20.9%) followed by slow CT (-34.3% ± 11.0%) and FF-CBCT scans (-26.3% ± 8.7%). However, HF-CBCT scans (-12.9% ± 4.4%) and BH-CT scans (-11.1% ± 8.5%) resulted in almost similar deviation. On the contrary, average CT had the least deviation (-4.7% ± 9.8%). When comparing with 4DCT, all the CT techniques underestimated ITV. In the absence of 4DCT, the HF-CBCT target volumes with appropriate margin may be a reasonable approach for defining the ITV.

SU-E-I-60: The Correct Selection of Pitch and Rotation Time for Optimal CT Scanning : The Big Misconception

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

Ranallo, F; Szczykutowicz, T

2014-06-01

Purpose: To provide correct guidance in the proper selection of pitch and rotation time for optimal CT imaging with multi-slice scanners. Methods: There exists a widespread misconception concerning the role of pitch in patient dose with modern multi-slice scanners, particularly with the use of mA modulation techniques. We investigated the relationship of pitch and rotation time to image quality, dose, and scan duration, with CT scanners from different manufacturers in a way that clarifies this misconception. This source of this misconception may concern the role of pitch in single slice CT scanners. Results: We found that the image noise andmore » dose are generally independent of the selected effective mAs (mA*time/ pitch) with manual mA technique settings and are generally independent of the selected pitch and /or rotation time with automatic mA modulation techniques. However we did find that on certain scanners the use of a pitch just above 0.5 provided images of equal image noise at a lower dose compared to the use of a pitch just below 1.0. Conclusion: The misconception that the use of a lower pitch over-irradiates patients by wasting dose is clearly false. The use of a lower pitch provides images of equal or better image quality at the same patient dose, whether using manual mA or automatic mA modulation techniques. By decreasing the pitch and the rotation times by equal amounts, both helical and patient motion artifacts can be reduced without affecting the exam time. The use of lower helical pitch also allows better scanning of larger patients by allowing a greater scan effective mAs, if the exam time can be extended. The one caution with the use of low pitch is not related to patient dose, but to the length of the scan time if the rotation time is not set short enough. Partial Research funding from GE HealthCare.« less

The influence of respiratory motion on CT image volume definition.

PubMed

Rodríguez-Romero, Ruth; Castro-Tejero, Pablo

2014-04-01

Radiotherapy treatments are based on geometric and density information acquired from patient CT scans. It is well established that breathing motion during scan acquisition induces motion artifacts in CT images, which can alter the size, shape, and density of a patient's anatomy. The aim of this work is to examine and evaluate the impact of breathing motion on multislice CT imaging with respiratory synchronization (4DCT) and without it (3DCT). A specific phantom with a movable insert was used. Static and dynamic phantom acquisitions were obtained with a multislice CT. Four sinusoidal breath patterns were simulated to move known geometric structures longitudinally. Respiratory synchronized acquisitions (4DCT) were performed to generate images during inhale, intermediate, and exhale phases using prospective and retrospective techniques. Static phantom data were acquired in helical and sequential mode to define a baseline for each type of respiratory 4DCT technique. Taking into account the fact that respiratory 4DCT is not always available, 3DCT helical image studies were also acquired for several CT rotation periods. To study breath and acquisition coupling when respiratory 4DCT was not performed, the beginning of the CT image acquisition was matched with inhale, intermediate, or exhale respiratory phases, for each breath pattern. Other coupling scenarios were evaluated by simulating different phantom and CT acquisition parameters. Motion induced variations in shape and density were quantified by automatic threshold volume generation and Dice similarity coefficient calculation. The structure mass center positions were also determined to make a comparison with their theoretical expected position. 4DCT acquisitions provided volume and position accuracies within ± 3% and ± 2 mm for structure dimensions >2 cm, breath amplitude ≤ 15 mm, and breath period ≥ 3 s. The smallest object (1 cm diameter) exceeded 5% volume variation for the breath patterns of higher frequency and amplitude motion. Larger volume differences (>10%) and inconsistencies between the relative positions of objects were detected in image studies acquired without respiratory control. Increasing the 3DCT rotation period caused a higher distortion in structures without obtaining their envelope. Simulated data showed that the slice acquisition time should be at least twice the breath period to average object movement. Respiratory 4DCT images provide accurate volume and position of organs affected by breath motion detecting higher volume discrepancies as amplitude length or breath frequency are increased. For 3DCT acquisitions, a CT should be considered slow enough to include lesion envelope as long as the slice acquisition time exceeds twice the breathing period. If this requirement cannot be satisfied, a fast CT (along with breath-hold inhale and exhale CTs to estimate roughly the ITV) is recommended in order to minimize structure distortion. Even with an awareness of a patient's respiratory cycle, its coupling with 3DCT acquisition cannot be predicted since patient anatomy is not accurately known. © 2014 American Association of Physicists in Medicine.

The influence of respiratory motion on CT image volume definition

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

Rodríguez-Romero, Ruth, E-mail: rrromero@salud.madrid.org; Castro-Tejero, Pablo, E-mail: pablo.castro@salud.madrid.org

Purpose: Radiotherapy treatments are based on geometric and density information acquired from patient CT scans. It is well established that breathing motion during scan acquisition induces motion artifacts in CT images, which can alter the size, shape, and density of a patient's anatomy. The aim of this work is to examine and evaluate the impact of breathing motion on multislice CT imaging with respiratory synchronization (4DCT) and without it (3DCT). Methods: A specific phantom with a movable insert was used. Static and dynamic phantom acquisitions were obtained with a multislice CT. Four sinusoidal breath patterns were simulated to move knownmore » geometric structures longitudinally. Respiratory synchronized acquisitions (4DCT) were performed to generate images during inhale, intermediate, and exhale phases using prospective and retrospective techniques. Static phantom data were acquired in helical and sequential mode to define a baseline for each type of respiratory 4DCT technique. Taking into account the fact that respiratory 4DCT is not always available, 3DCT helical image studies were also acquired for several CT rotation periods. To study breath and acquisition coupling when respiratory 4DCT was not performed, the beginning of the CT image acquisition was matched with inhale, intermediate, or exhale respiratory phases, for each breath pattern. Other coupling scenarios were evaluated by simulating different phantom and CT acquisition parameters. Motion induced variations in shape and density were quantified by automatic threshold volume generation and Dice similarity coefficient calculation. The structure mass center positions were also determined to make a comparison with their theoretical expected position. Results: 4DCT acquisitions provided volume and position accuracies within ±3% and ±2 mm for structure dimensions >2 cm, breath amplitude ≤15 mm, and breath period ≥3 s. The smallest object (1 cm diameter) exceeded 5% volume variation for the breath patterns of higher frequency and amplitude motion. Larger volume differences (>10%) and inconsistencies between the relative positions of objects were detected in image studies acquired without respiratory control. Increasing the 3DCT rotation period caused a higher distortion in structures without obtaining their envelope. Simulated data showed that the slice acquisition time should be at least twice the breath period to average object movement. Conclusions: Respiratory 4DCT images provide accurate volume and position of organs affected by breath motion detecting higher volume discrepancies as amplitude length or breath frequency are increased. For 3DCT acquisitions, a CT should be considered slow enough to include lesion envelope as long as the slice acquisition time exceeds twice the breathing period. If this requirement cannot be satisfied, a fast CT (along with breath-hold inhale and exhale CTs to estimate roughly the ITV) is recommended in order to minimize structure distortion. Even with an awareness of a patient's respiratory cycle, its coupling with 3DCT acquisition cannot be predicted since patient anatomy is not accurately known.« less

[Clinical implications of dual-energy computed tomography in the diagnosis and treatment of urolithiasis].

PubMed

Kapanadze, L B; Ternovoy, S K; Rudenko, V I; Serova, N S

2018-03-01

Urolithiasis (urolithiasis) is one of the most common urologic diseases with an estimated prevalence of no less than 3% in the population, usually affecting active working-age patients of 30-50 years. Taking into account major public health and economic significance of this problem, there is the need for the development of effective modern diagnostic techniques. Rapid medical-technological advances of the past two decades have led to the wide spread use of minimally invasive surgery the management of urolithiasis. Nevertheless, surgical intervention only removes the result of a long pathological process and does not change its course. Thus, there is a need for a detailed understanding of the etiology, epidemiology, and pathogenesis of urolithiasis. Diagnostic imaging plays a key role in the diagnosis of urolithiasis. Multislice spiral computed tomography (MSCT) is the gold standard for the diagnosis of urolithiasis. It provides information about the size, location, and density of the calculus. Over the past decade, the use of dual-energy computed tomography (DECT) in urological practice has been widely discussed in the international and domestic literature. One of the main advantages of DECT is the ability to determine the chemical composition of urinary stones. Previous studies have reported a high diagnostic value of the method, including the ability to predict treatment outcomes. However, the shortcomings of the method and the absence of standardized examination protocols leave a wide field for further research. This article reviews major distinctive features of using DECT in the diagnosis of urolithiasis.

FFT multislice method--the silver anniversary.

PubMed

Ishizuka, Kazuo

2004-02-01

The first paper on the FFT multislice method was published in 1977, a quarter of a century ago. The formula was extended in 1982 to include a large tilt of an incident beam relative to the specimen surface. Since then, with advances of computing power, the FFT multislice method has been successfully applied to coherent CBED and HAADF-STEM simulations. However, because the multislice formula is built on some physical approximations and approximations in numerical procedure, there seem to be controversial conclusions in the literature on the multislice method. In this report, the physical implication of the multislice method is reviewed based on the formula for the tilted illumination. Then, some results on the coherent CBED and the HAADF-STEM simulations are presented.

Advanced imaging programs: maximizing a multislice CT investment.

PubMed

Falk, Robert

2008-01-01

Advanced image processing has moved from a luxury to a necessity in the practice of medicine. A hospital's adoption of sophisticated 3D imaging entails several important steps with many factors to consider in order to be successful. Like any new hospital program, 3D post-processing should be introduced through a strategic planning process that includes administrators, physicians, and technologists to design, implement, and market a program that is scalable-one that minimizes up front costs while providing top level service. This article outlines the steps for planning, implementation, and growth of an advanced imaging program.

[State of the art and future trends in technology for computed tomography dose reduction].

PubMed

Calzado Cantera, A; Hernández-Girón, I; Salvadó Artells, M; Rodríguez González, R

2013-12-01

The introduction of helical and multislice acquisitions in CT scanners together with decreased image reconstruction times has had a tremendous impact on radiological practice. Technological developments in the last 10 to 12 years have enabled very high quality images to be obtained in a very short time. Improved image quality has led to an increase in the number of indications for CT. In parallel to this development, radiation exposure in patients has increased considerably. Concern about the potential health risks posed by CT imaging, reflected in diverse initiatives and actions by official organs and scientific societies, has prompted the search for ways to reduce radiation exposure in patients without compromising diagnostic efficacy. To this end, good practice guidelines have been established, special applications have been developed for scanners, and research has been undertaken to optimize the clinical use of CT. Noteworthy technical developments incorporated in scanners include the different modes of X-ray tube current modulation, automatic selection of voltage settings, selective organ protection, adaptive collimation, and iterative reconstruction. The appropriate use of these tools to reduce radiation doses requires thorough knowledge of how they work. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

Automated segmentations of skin, soft-tissue, and skeleton, from torso CT images

NASA Astrophysics Data System (ADS)

Zhou, Xiangrong; Hara, Takeshi; Fujita, Hiroshi; Yokoyama, Ryujiro; Kiryu, Takuji; Hoshi, Hiroaki

2004-05-01

We have been developing a computer-aided diagnosis (CAD) scheme for automatically recognizing human tissue and organ regions from high-resolution torso CT images. We show some initial results for extracting skin, soft-tissue and skeleton regions. 139 patient cases of torso CT images (male 92, female 47; age: 12-88) were used in this study. Each case was imaged with a common protocol (120kV/320mA) and covered the whole torso with isotopic spatial resolution of about 0.63 mm and density resolution of 12 bits. A gray-level thresholding based procedure was applied to separate the human body from background. The density and distance features to body surface were used to determine the skin, and separate soft-tissue from the others. A 3-D region growing based method was used to extract the skeleton. We applied this system to the 139 cases and found that the skin, soft-tissue and skeleton regions were recognized correctly for 93% of the patient cases. The accuracy of segmentation results was acceptable by evaluating the results slice by slice. This scheme will be included in CAD systems for detecting and diagnosing the abnormal lesions in multi-slice torso CT images.

Multislice CT Angiography in Renal Artery Stent Evaluation: Prospective Comparison with Intra-Arterial Digital Subtraction Angiography

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

Raza, Syed A.; Chughtai, Aamer R.; Wahba, Mona

2004-01-15

Purpose: To assess the role of multislice computed tomography angiography (MCTA) in the evaluation of renal artery stents, using intra-arterial digital subtraction angiography (DSA) as the gold standard. Methods: Twenty consecutive patients (15 men, 5 women) with 23 renal artery stents prospectively underwent both MCTA and DSA. Axial images, multiplanar reconstructions and maximum intensity projection images were used for diagnosis. The MCTA and DSA images were each interpreted without reference to the result of the other investigation. Results:The three cases of restenosis on DSA were detected correctly by MCTA; in 19 cases where MCTA showed a fully patent stent, themore » DSA was also negative. Sensitivity and negative predictive value (NPV) of MCTA were therefore 100%. In four cases, MCTA showed apparently minimal disease which was not shown on DSA. These cases are taken as false positive giving a specificity of 80% and a positive predictive value of 43%. Conclusion: The high sensitivity and NPV suggest MCTA may be useful as a noninvasive screen for renal artery stentrestenosis. MCTA detected mild disease in a few patients which was not confirmed on angiography.« less

Novel utilization of 3D technology and the hybrid operating theatre: Peri-operative assessment of posterior sterno-clavicular dislocation using cone beam CT

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

Crowhurst, James A; Campbell, Douglas; Whitby, Mark

A patient with a medial and posterior dislocation of the right sterno-clavicular (SC) joint and displacement of the trachea and brachiocephalic artery by the medial head of the clavicle underwent general anaesthetic in the operating theatre for an open reduction procedure. The surgeon initially attempted a closed reduction, but this required imaging to check SC alignment. The patient was transferred to an adjacent hybrid operating theatre for imaging. Cone beam computed tomography (CBCT) was performed, which successfully demonstrated a significant reduction in the dislocation of the SC joint. The trachea and brachiocephalic artery were no longer compressed or displaced. Thismore » case study demonstrates an alternative to the patient being transferred to the medical imaging department for multi-slice CT. It also describes a novel use of the hybrid operating theatre and its CBCT capabilities.« less

CT versus MR Techniques in the Detection of Cervical Artery Dissection.

PubMed

Hanning, Uta; Sporns, Peter B; Schmiedel, Meilin; Ringelstein, Erich B; Heindel, Walter; Wiendl, Heinz; Niederstadt, Thomas; Dittrich, Ralf

2017-11-01

Spontaneous cervical artery dissection (sCAD) is an important etiology of juvenile stroke. The gold standard for the diagnosis of sCAD is convential angiography. However, magnetic resonance imaging (MRI)/MR angiography (MRA) and computed tomography (CT)/CT angiography (CTA) are frequently used alternatives. New developments such as multislice CT/CTA have enabled routine acquisition of thinner sections with rapid imaging times. The goal of this study was to compare the capability of recent developed 128-slice CT/CTA to MRI/MRA to detect radiologic features of sCAD. Retrospective review of patients with suspected sCAD (n = 188) in a database of our Stroke center (2008-2014), who underwent CT/CTA and MRI/MRA on initial clinical work-up. A control group of 26 patients was added. All Images were evaluated concerning specific and sensitive radiological features for dissection by two experienced neuroradiologists. Imaging features were compared between the two modalities. Forty patients with 43 dissected arteries received both modalities (29 internal carotid arteries [ICAs] and 14 vertebral arteries [VAs]). All CADs were identified in CT/CTA and MRI/MRA. The features intimal flap, stenosis, and lumen irregularity appeared in both modalities. One high-grade stenosis was identified by CT/CTA that was expected occluded on MRI/MRA. Two MRI/MRA-confirmed pseudoaneurysms were missed by CT/CTA. None of the controls evidenced specific imaging signs for dissection. CT/CTA is a reliable and better available alternative to MRI/MRA for diagnosis of sCAD. CT/CTA should be used to complement MRI/MRA in cases where MRI/MRA suggests occlusion. Copyright © 2017 by the American Society of Neuroimaging.

Evaluation of treatment response after chemoembolisation (TACE) in hepatocellular carcinoma using real time image fusion of contrast-enhanced ultrasound (CEUS) and computed tomography (CT)--preliminary results.

PubMed

Wobser, Hella; Wiest, Reiner; Salzberger, Bernd; Wohlgemuth, Walter Alexander; Stroszczynski, Christian; Jung, Ernst-Michael

2014-01-01

To evaluate treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with a new real-time imaging fusion technique of contrast-enhanced ultrasound (CEUS) with multi-slice detection computed tomography (CT) in comparison to conventional post-interventional follow-up. 40 patients with HCC (26 male, ages 46-81 years) were evaluated 24 hours after TACE using CEUS with ultrasound volume navigation and image fusion with CT compared to non-enhanced CT and follow-up contrast-enhanced CT after 6-8 weeks. Reduction of tumor vascularization to less than 25% was regarded as "successful" treatment, whereas reduction to levels >25% was considered as "partial" treatment response. Homogenous lipiodol retention was regarded as successful treatment in non-enhanced CT. Post-interventional image fusion of CEUS with CT was feasible in all 40 patients. In 24 patients (24/40), post-interventional image fusion with CEUS revealed residual tumor vascularity, that was confirmed by contrast-enhanced CT 6-8 weeks later in 24/24 patients. In 16 patients (16/40), post-interventional image fusion with CEUS demonstrated successful treatment, but follow-up CT detected residual viable tumor (6/16). Non-enhanced CT did not identify any case of treatment failure. Image fusion with CEUS assessed treatment efficacy with a specificity of 100%, sensitivity of 80% and a positive predictive value of 1 (negative predictive value 0.63). Image fusion of CEUS with CT allows a reliable, highly specific post-interventional evaluation of embolization response with good sensitivity without any further radiation exposure. It can detect residual viable tumor at early state, resulting in a close patient monitoring or re-therapy.

Assessment of condylar morphology and position using MSCT in an Asian population.

PubMed

Liu, Qi; Wei, Xiaoer; Guan, Juanjuan; Wang, Ran; Zou, Derong; Yu, Lvfeng

2018-02-01

The purpose of the present study was to investigate the volume, surface, morphometric index (MI), and position of the condyle in a normal population by applying Mimics 17.0 software. Then, the difference between left and right sides, sex, and age can be explored, which will contribute to establish the reference value of condylar morphology and position in normal individuals, and help us to study characteristics of condylar morphology and position in abnormal individuals. Three-hundred subjects were enrolled in our study from the radiology department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. They were divided into three groups according to the age: group 1 (18-24 years old), group 2 (25-34 years old), and group 3 (35-44 years old). Each group included 100 subjects (with 50 males and 50 females). They were examined using multislice computed tomography (MSCT) after that. All images of condyle were reconstructed by Mimics 17.0 software, so as to measure the volume, surface, and MI of condyle, and to analyze the position of condyle in the articular fossa by means of joint spaces. The differences of condylar volume, surface, and MI between left and right sides were not obvious (P > 0.05). The condylar volume and surface were greater in males than females (P < 0.05), while their condylar MI existed no difference (P > 0.05). No statistical differences were found in volume and surface among three age groups. However, the MI of group 1 was statistically lower than that of group 3 (P < 0.05). On the other hand, no significant differences were found between left and right condylar position (P > 0.05). Nevertheless, there were significant differences of condylar position regarding the gender and age (P < 0.05). This study showed no significant differences in condylar morphology and position between left and right sides, but factors of gender and age were proven to have a certain influence on the morphology and position of the condyle. This information can be clinically useful in establishing the diagnostic criteria for condylar morphology and position in the normal Asian population. Examination of condylar morphology and position is important for evaluating the abnormalities and bony changes that affect the temporomandibular joint (TMJ). So, this will be conducive to the diagnosis and the evaluation of therapeutic effect of temporomandibular joint diseases. Also, it is important to evaluate these indexes prior to commencing orthodontic treatment, because TMJ abnormalities play a critical role in orthodontic treatment planning.

Computed tomographic anatomy of the nasal cavity, paranasal sinuses and tympanic cavity of the koala.

PubMed

Hemsley, S; Palmer, H; Canfield, R B; Stewart, M E B; Krockenberger, M B; Malik, R

2013-09-01

To use cross-sectional imaging (helical computed tomography (CT)) combined with conventional anatomical dissection to define the normal anatomy of the nasal cavity and bony cavitations of the koala skull. Helical CT scans of the heads of nine adult animals were obtained using a multislice scanner acquiring thin slices reconstructed in the transverse, sagittal and dorsal planes. Subsequent anatomical dissection permitted confirmation of correct identification and further delineation of bony and air-filled structures visible in axial and multiplanar reformatted CT images. The nasal cavity was relatively simple, with little scrolling of nasal conchae, but bony cavitations were complex and extensive. A rostral maxillary recess and ventral conchal, caudal maxillary, frontal and sphenoidal paranasal sinuses were identified and characterised. Extensive temporal bone cavitation was shown to be related to a large epitympanic recess. The detailed anatomical data provided are applicable to future functional and comparative anatomical studies, as well as providing a preliminary atlas for clinical investigation of conditions such as cryptococcal rhinosinusitis, a condition more common in the koala than in many other species. © 2013 Australian Veterinary Association.

Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know.

PubMed

Jaschke, Werner; Schmuth, Matthias; Trianni, Annalisa; Bartal, Gabriel

2017-08-01

For a long time, radiation-induced skin injuries were only encountered in patients undergoing radiation therapy. In diagnostic radiology, radiation exposures of patients causing skin injuries were extremely rare. The introduction of fast multislice CT scanners and fluoroscopically guided interventions (FGI) changed the situation. Both methods carry the risk of excessive high doses to the skin of patients resulting in skin injuries. In the early nineties, several reports of epilation and skin injuries following CT brain perfusion studies were published. During the same time, several papers reported skin injuries following FGI, especially after percutaneous coronary interventions and neuroembolisations. Thus, CT and FGI are of major concern regarding radiation safety since both methods can apply doses to patients exceeding 5 Gy (National Council on Radiation Protection and Measurements threshold for substantial radiation dose level). This paper reviews the problem of skin injuries observed after FGI. Also, some practical advices are given how to effectively avoid skin injuries. In addition, guidelines are discussed how to deal with patients who were exposed to a potentially dangerous radiation skin dose during medically justified interventional procedures.

Application of the LDM algorithm to identify small lung nodules on low-dose MSCT scans

NASA Astrophysics Data System (ADS)

Zhao, Binsheng; Ginsberg, Michelle S.; Lefkowitz, Robert A.; Jiang, Li; Cooper, Cathleen; Schwartz, Lawrence H.

2004-05-01

In this work, we present a computer-aided detection (CAD) algorithm for small lung nodules on low-dose MSCT images. With this technique, identification of potential lung nodules is carried out with a local density maximum (LDM) algorithm, followed by reduction of false positives from the nodule candidates using task-specific 2-D/3-D features along with a knowledge-based nodule inclusion/exclusion strategy. Twenty-eight MSCT scans (40/80mAs, 120kVp, 5mm collimation/2.5mm reconstruction) from our lung cancer screening program that included at least one lung nodule were selected for this study. Two radiologists independently interpreted these cases. Subsequently, a consensus reading by both radiologists and CAD was generated to define a "gold standard". In total, 165 nodules were considered as the "gold standard" (average: 5.9 nodules/case; range: 1-22 nodules/case). The two radiologists detected 146 nodules (88.5%) and CAD detected 100 nodules (60.6%) with 8.7 false-positives/case. CAD detected an additional 19 nodules (6 nodules > 3mm and 13 nodules < 3mm) that had been missed by both radiologists. Preliminary results show that the CAD is capable of detecting small lung nodules with acceptable number of false-positives on low-dose MSCT scans and it can detect nodules that are otherwise missed by radiologists, though a majority are small nodules (< 3mm).

Comparative effectiveness of using computed tomography alone to exclude cervical spine injuries in obtunded or intubated patients: meta-analysis of 14,327 patients with blunt trauma.

PubMed

Panczykowski, David M; Tomycz, Nestor D; Okonkwo, David O

2011-09-01

The current standard of practice for clearance of the cervical spine in obtunded patients suffering blunt trauma is to use CT and an adjuvant imaging modality (such as MR imaging). The objective of this study was to determine the comparative effectiveness of multislice helical CT alone to diagnose acute unstable cervical spine injury following blunt trauma. The authors performed a meta-analysis of studies comparing modern CT with adjunctive imaging modalities and required that studies present acute traumatic findings as well as treatment for unstable injuries. Study quality, population characteristics, diagnostic protocols, and outcome data were extracted. Positive disease status included all injuries necessitating surgical or orthotic stabilization identified on imaging and/or clinical follow-up. Seventeen studies encompassing 14,327 patients met the inclusion criteria. Overall, the sensitivity and specificity for modern CT were both > 99.9% (95% CI 0.99-1.00 and 0.99-1.00, respectively). The negative likelihood ratio of an unstable cervical injury after a CT scan negative for acute injury was < 0.001 (95% CI 0.00-0.01), while the negative predictive value of a normal CT scan was 100% (95% CI 0.96-1.00). Global severity of injury, CT slice thickness, and study quality did not significantly affect accuracy estimates. Modern CT alone is sufficient to detect unstable cervical spine injuries in trauma patients. Adjuvant imaging is unnecessary when the CT scan is negative for acute injury. Results of this meta-analysis strongly show that the cervical collar may be removed from obtunded or intubated trauma patients if a modern CT scan is negative for acute injury.

4D-CT motion estimation using deformable image registration and 5D respiratory motion modeling.

PubMed

Yang, Deshan; Lu, Wei; Low, Daniel A; Deasy, Joseph O; Hope, Andrew J; El Naqa, Issam

2008-10-01

Four-dimensional computed tomography (4D-CT) imaging technology has been developed for radiation therapy to provide tumor and organ images at the different breathing phases. In this work, a procedure is proposed for estimating and modeling the respiratory motion field from acquired 4D-CT imaging data and predicting tissue motion at the different breathing phases. The 4D-CT image data consist of series of multislice CT volume segments acquired in ciné mode. A modified optical flow deformable image registration algorithm is used to compute the image motion from the CT segments to a common full volume 3D-CT reference. This reference volume is reconstructed using the acquired 4D-CT data at the end-of-exhalation phase. The segments are optimally aligned to the reference volume according to a proposed a priori alignment procedure. The registration is applied using a multigrid approach and a feature-preserving image downsampling maxfilter to achieve better computational speed and higher registration accuracy. The registration accuracy is about 1.1 +/- 0.8 mm for the lung region according to our verification using manually selected landmarks and artificially deformed CT volumes. The estimated motion fields are fitted to two 5D (spatial 3D+tidal volume+airflow rate) motion models: forward model and inverse model. The forward model predicts tissue movements and the inverse model predicts CT density changes as a function of tidal volume and airflow rate. A leave-one-out procedure is used to validate these motion models. The estimated modeling prediction errors are about 0.3 mm for the forward model and 0.4 mm for the inverse model.

Correlation of Multislice CT and Histomorphology in HCC Following TACE: Predictors of Outcome

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

Herber, S., E-mail: herber@radiologie.klinik.uni-mainz.d; Biesterfeld, S.; Franz, U.

2008-07-15

The purpose of this study was to correlate histopathological with CT findings in patients suffering from hepatocellular carcinoma (HCC) eligible for orthotopic liver transplantation (OLT), with a special focus on the antitumoral effect of transarterial chemoembolization (TACE) therapy. A total of 42 consecutive patients suffering from HCC had been treated prior to OLT by means of TACE. TACE was carried out with a mixture of Lipiodol (10-20 ml) and mitomycin C (max. dosage, 10 mg). TACE was performed at 6- to 8-week intervals. Follow-up investigation included contrast-enhanced multislice CT controls and laboratory control. Liver explants were evaluated macroscopically and microscopicallymore » to determine the number and size of the tumor lesions as well as the degree of tumor necrosis. Necrosis was investigated in H and E-stained sections. The degree of necrosis was classified as follows: 0-25%, 26-50%, 51-75%, 75-99%, and complete necrosis. Two hundred thirty-one TACE procedures (5.5 {+-} 2.9; range, 1-14) were performed. Mean tumor size in CT before and after TACE was 4.1 {+-} 2.4 (range, 1.0-12.0 cm) and 2.7 {+-} 1.2 (range, 1.0-6.0 cm; p < 0.001). Mean tumor number before and after TACE in CT was 2.5 {+-} 1.5 (n = 105; range, 1-8) and 2.4 {+-} 2.0 (n = 103; range, 1-6; p = 0.99). In the surgical specimen tumor size and tumor number were 2.8 {+-} 1.6 (range, 1.0-7.0 cm; p = 0.78) and 1.9 {+-} 1.2 (range, 1-7; p = 0.003). Mean tumor necrosis was 67.8% {+-} 28.1%. Tumor necrosis was subtotal or complete in 17 of 42 (40.5%) patients. Tumor necrosis correlated significantly with the degree of arterial devascularization in CT (p = 0.001), the amount of Lipiodol washout (p = 0.002), and the number of tumor lesions (i.e., unifocal vs. multifocal). Furthermore, elevated serum levels of bilirubin (p = 0.005) and decreased albumin (p = 0.004) affected the local antitumoral effect. A poor necrosis rate (< 25%) significantly correlated with the number of TACE procedures accomplished (p = 0.023). In conclusion, TACE provided an acceptable local antitumoral effect in patients scheduled for liver transplantation. Tumor necrosis depended significantly on the degree of arterial devascularization and the accumulation of Lipiodol within the HCC lesions. Unifocal tumors and preserved liver function were positive predictors for a more favorable local antitumoral effect. Poor necrosis rates were found in patients with significant Lipiodol washout and who received a limited number of TACE procedures.« less

Large focal nodular hyperplasia and extrahepatic portosystemic shunt in a male patient: multi-modality imaging features.

PubMed

Kitzing, Yu Xuan; Gallagher, James; Waugh, Richard

2011-10-01

Congenital extrahepatic portocaval shunt is a rare condition that is described mostly in female patients. We report an unusual case of a young adult male patient with type 1 congenital extrahepatic portocaval shunt with associated development of a focal nodular hyperplasia on a background of regenerative nodules. With multi-slice CT utilisation, there is increased detection of portocaval malformation in asymptomatic patients. This congenital variant is clinically significant with associated development of hepatocellular lesions, hepatic dysfunction and/or encephalopathy. © 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.

Association of locally produced IL10 and TGFb1 with tumor size, histological type and presence of metastases in patients with lung carcinoma.

PubMed

Karlicic, Vukoica; Vukovic, Jelena; Stanojevic, Ivan; Sotirovic, Jelena; Peric, Aleksandar; Jovic, Milena; Cvijanovic, Vlado; Djukic, Mirjana; Banovic, Tatjana; Vojvodic, Danilo

2016-01-01

Advanced lung carcinoma is charasterized with fast disease progression. Interleukin (IL)10 and transforming growth factor (TGF)b1 are immunosuppressive mediators and their role in lung carcinoma pathogenesis and in the antitumor response has not yet been elucidated. The purpose of this study was to correlate IL10 and TGFb1 levels in the serum and lung tumor microcirculation with clinical stage, disease extent, histological features and TNM stage. The study included 41 lung cancer patients in clinical stage III and IV. Histological type was determined immunohistochemically, while tumor size, localization and dissemination were determined radiologically by multislice computerized tomography (MSCT). IL10 and TGFb1 levels were quantified with commercial flow cytometric test in serum and lung tumor microcirculation samples. Non small cell lung cancer (NSCLC) patients had significantly elevated TGFb1 while small cell lung cancer (SCLC) patients had significantly increased IL10 in tumor microcirculation. IL10 was significantly elevated in patients with the largest tumors, as well as in patients with III clinical stage and without metastases, both in the serum and tumor microcirculation. TGFb1 was significantly increased in serum and tumor microcirculation in patients with larger tumors. We found significant correlation between these two immunosuppressive cytokines, IL10 and TGFb1, in tumor microcirculation but not in patient serum samples. IL10 and TGFb1 in systemic and tumor microcirculation are significantly associated with particular histological type of lung cancer, tumor size and degree of disease extent.

Thrombelastographic haemostatic status and antiplatelet therapy after coronary artery bypass surgery (TEG-CABG trial): assessing and monitoring the antithrombotic effect of clopidogrel and aspirin versus aspirin alone in hypercoagulable patients: study protocol for a randomized controlled trial.

PubMed

Rafiq, Sulman; Johansson, Pär Ingemar; Zacho, Mette; Stissing, Trine; Kofoed, Klaus; Lilleør, Nikolaj Bang; Steinbrüchel, Daniel Andreas

2012-04-27

Hypercoagulability, assessed by the thrombelastography (TEG) assay, has in several observational studies been associated with an increased risk of post-procedural thromboembolic complications. We hypothesize that intensified antiplatelet therapy with clopidogrel and aspirin, as compared to aspirin alone, will improve saphenous vein graft patency in preoperatively TEG-Hypercoagulable coronary artery bypass surgery (CABG) patients and reduce their risk for thromboembolic complications and death postoperatively. This is a prospective randomized clinical trial, with an open-label design with blinded evaluation of graft patency. TEG-Hypercoagulability is defined as a TEG maximum amplitude above 69 mm. Two hundred and fifty TEG-Hypercoagulable patients will be randomized to either an interventional group receiving clopidogrel 75 mg daily for three months (after initial oral bolus of 300 mg) together with aspirin 75 mg or a control group receiving aspirin 75 mg daily alone. Monitoring of antiplatelet efficacy and on-treatment platelet reactivity to clopidogrel and aspirin will be conducted with Multiplate aggregometry. Graft patency will be assessed with Multislice computed tomography (MSCT) at three months after surgery. The present trial is the first randomized clinical trial to evaluate whether TEG-Hypercoagulable CABG patients will benefit from intensified antiplatelet therapy after surgery. Monitoring of platelet inhibition from instituted antithrombotic therapy will elucidate platelet resistance patterns after CABG surgery. The results could be helpful in redefining how clinicians can evaluate patients preoperatively for their postoperative thromboembolic risk and tailor individualized postoperative antiplatelet therapy. Clinicaltrials.gov Identifier NCT01046942.

Computed tomographic features of apical infection of equine maxillary cheek teeth: a retrospective study of 49 horses.

PubMed

Bühler, M; Fürst, A; Lewis, F I; Kummer, M; Ohlerth, S

2014-07-01

Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. Retrospective case-control study. Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality. © 2013 EVJ Ltd.

TH-CD-207B-06: Swank Factor of Segmented Scintillators in Multi-Slice CT Detectors: Pulse Height Spectra and Light Escape

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

Howansky, A; Peng, B; Lubinsky, A

Purpose: Pulse height spectra (PHS) have been used to determine the Swank factor of a scintillator by measuring fluctuations in its light output per x-ray interaction. The Swank factor and x-ray quantum efficiency of a scintillator define the upper limit to its imaging performance, i.e. DQE(0). The Swank factor below the K-edge is dominated by optical properties, i.e. variations in light escape efficiency from different depths of interaction, denoted e(z). These variations can be optimized to improve tradeoffs in x-ray absorption, light yield, and spatial resolution. This work develops a quantitative model for interpreting measured PHS, and estimating e(z) onmore » an absolute scale. The method is used to investigate segmented ceramic GOS scintillators used in multi-slice CT detectors. Methods: PHS of a ceramic GOS plate (1 mm thickness) and segmented GOS array (1.4 mm thick) were measured at 46 keV. Signal and noise propagation through x-ray conversion gain, light escape, detection by a photomultiplier tube and dynode amplification were modeled using a cascade of stochastic gain stages. PHS were calculated with these expressions and compared to measurements. Light escape parameters were varied until modeled PHS agreed with measurements. The resulting estimates of e(z) were used to calculate PHS without measurement noise to determine the inherent Swank factor. Results: The variation in e(z) was 67.2–89.7% in the plate and 40.2–70.8% in the segmented sample, corresponding to conversion gains of 28.6–38.1 keV{sup −1} and 17.1–30.1 keV{sup −1}, respectively. The inherent Swank factors of the plate and segmented sample were 0.99 and 0.95, respectively. Conclusion: The high light escape efficiency in the ceramic GOS samples yields high Swank factors and DQE(0) in CT applications. The PHS model allows the intrinsic optical properties of scintillators to be deduced from PHS measurements, thus it provides new insights for evaluating the imaging performance of segmented ceramic GOS scintillators.« less

Automated method for relating regional pulmonary structure and function: integration of dynamic multislice CT and thin-slice high-resolution CT

NASA Astrophysics Data System (ADS)

Tajik, Jehangir K.; Kugelmass, Steven D.; Hoffman, Eric A.

1993-07-01

We have developed a method utilizing x-ray CT for relating pulmonary perfusion to global and regional anatomy, allowing for detailed study of structure to function relationships. A thick slice, high temporal resolution mode is used to follow a bolus contrast agent for blood flow evaluation and is fused with a high spatial resolution, thin slice mode to obtain structure- function detail. To aid analysis of blood flow, we have developed a software module, for our image analysis package (VIDA), to produce the combined structure-function image. Color coded images representing blood flow, mean transit time, regional tissue content, regional blood volume, regional air content, etc. are generated and imbedded in the high resolution volume image. A text file containing these values along with a voxel's 3-D coordinates is also generated. User input can be minimized to identifying the location of the pulmonary artery from which the input function to a blood flow model is derived. Any flow model utilizing one input and one output function can be easily added to a user selectable list. We present examples from our physiologic based research findings to demonstrate the strengths of combining dynamic CT and HRCT relative to other scanning modalities to uniquely characterize pulmonary normal and pathophysiology.

Multislice Computed Tomography Accurately Detects Stenosis in Coronary Artery Bypass Conduits

PubMed Central

Duran, Cihan; Sagbas, Ertan; Caynak, Baris; Sanisoglu, Ilhan; Akpinar, Belhhan; Gulbaran, Murat

2007-01-01

The aim of this study was to evaluate the accuracy of multislice computed tomography in detecting graft stenosis or occlusion after coronary artery bypass grafting, using coronary angiography as the standard. From January 2005 through May 2006, 25 patients (19 men and 6 women; mean age, 54 ± 11.3 years) underwent diagnostic investigation of their bypass grafts by multislice computed tomography within 1 month of coronary angiography. The mean time elapsed after coronary artery bypass grafting was 6.2 years. In these 25 patients, we examined 65 bypass conduits (24 arterial and 41 venous) and 171 graft segments (the shaft, proximal anastomosis, and distal anastomosis). Compared with coronary angiography, the segment-based sensitivity, specificity, and positive and negative predictive values of multislice computed tomography in the evaluation of stenosis were 89%, 100%, 100%, and 99%, respectively. The patency rate for multislice compu-ted tomography was 85% (55/65: 3 arterial and 7 venous grafts were occluded), with 100% sensitivity and specificity. From these data, we conclude that multislice computed tomography can accurately evaluate the patency and stenosis of bypass grafts during outpatient follow-up. PMID:17948078

[Design and accuracy analysis of upper slicing system of MSCT].

PubMed

Jiang, Rongjian

2013-05-01

The upper slicing system is the main components of the optical system in MSCT. This paper focuses on the design of upper slicing system and its accuracy analysis to improve the accuracy of imaging. The error of slice thickness and ray center by bearings, screw and control system were analyzed and tested. In fact, the accumulated error measured is less than 1 microm, absolute error measured is less than 10 microm. Improving the accuracy of the upper slicing system contributes to the appropriate treatment methods and success rate of treatment.

Endovascular Exclusion of Visceral Artery Aneurysms with Stent-Grafts: Technique and Long-Term Follow-up

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

Rossi, Michele; Rebonato, Alberto, E-mail: albertorebonato@libero.it; Greco, Laura

This paper describes four cases of visceral artery aneurysms (VAAs) successfully treated with endovascular stent-grafts and discusses the endovascular approach to VAAs and the long-term results. Four balloon expandable stent-grafts were used to treat three splenic artery aneurysms and one bleeding common hepatic artery pseudoaneurysm. The percutaneous access site and the materials were chosen on the basis of CT angiography findings. In all cases the aneurysms were successfully excluded. In one case a splenic infarction occurred, with nonrelevant clinical findings. At 16- to 24-month follow-up three patients had patent stents and complete exclusion and shrinkage of the aneurysms. One patientmore » died due to pancreatitis and sepsis, 16 days after successful stenting and exclusion of a bleeding pseudoaneurysm. We conclude that endovascular treatment using covered stent-grafts is a valid therapeutic option for VAAs. Multislice CT preoperative study helps in planning stent-graft positioning.« less

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

Paschoal, Cinthia M. M.; Ferreira, Fernanda Carla L.; Santos, Luiz A. P.

The advance of multislice computed tomography (CT) has become inadequate the currently dosimetric protocol used in CT. Instead of dosimetry based on the measurement of CTDI using a pencil ion chamber of 100 m of length, it was proposed the use of a small ion chamber (IC) and the calculating the dose equilibrium (Deq) at the location of the chamber. The objective of this work was to compare the performance of a short IC and a commercial photodiode to measure the accumulated dose at the center of the scan length L, DL(0), and to obtain the equilibrium dose Deq usingmore » the two detectors. The result for L=100 mm was compared with the result of a pencil chamber. The results indicate that the commercial photodiode is suitable to measure the accumulated dose at the center of the scan length L as compared with the ion chambers. This methodology allows measurements of the accumulated dose for any desired scan length, allowing measuring the equilibrium dose Deq if the phantom is long enough to allow it. (authors)« less

A comparison of hepatic segmental anatomy as revealed by cross-sections and MPR CT imaging.

PubMed

Liu, Xue-Jing; Zhang, Jian-Fei; Sui, Hong-Jin; Yu, Sheng-Bo; Gong, Jin; Liu, Jie; Wu, Le-Bin; Liu, Cheng; Bai, Jian; Shi, Bing-Yi

2013-05-01

To compare the areas of human liver horizontal sections with computed tomography (CT) images and to evaluate whether the subsegments determined by CT are consistent with the actual anatomy. Six human cadaver livers were made into horizontal slices with multislice spiral CT three-dimensional (3D) reconstruction was used during infusion process. Each liver segment was displayed using different color, and 3D images of the portal and hepatic vein were reconstructed. Each segmental area was measured on CT-reconstructed images, which were compared with the actual area on the sections of the same liver. The measurements were performed at four key levels namely: (1) the three hepatic veins, (2) the left, and (3) the right branch of portal vein (PV), and (4) caudal to the bifurcation of the PV. By dividing the sum of these areas by the total area of the liver, the authors got the percentage of the incorrectly determined subsegmental areas. In addition to these percentage values, the maximum distances of the radiologically determined intersegmental boundaries from the true anatomic boundaries were measured. On the four key levels, an average of 28.64 ± 10.26% of the hepatic area of CT images was attributed to an incorrect segment. The mean-maximum error between artificial segments on images and actual anatomical segments was 3.81 ± 1.37 cm. The correlation between radiological segmenting method and actual anatomy was poor. The hepatic segments being divided strictly according to the branching point of the PV could be more informative during liver segmental resection. Copyright © 2012 Wiley Periodicals, Inc.

Analysis of metal artifact reduction tools for dental hardware in CT scans of the oral cavity: kVp, iterative reconstruction, dual-energy CT, metal artifact reduction software: does it make a difference?

PubMed

De Crop, An; Casselman, Jan; Van Hoof, Tom; Dierens, Melissa; Vereecke, Elke; Bossu, Nicolas; Pamplona, Jaime; D'Herde, Katharina; Thierens, Hubert; Bacher, Klaus

2015-08-01

Metal artifacts may negatively affect radiologic assessment in the oral cavity. The aim of this study was to evaluate different metal artifact reduction techniques for metal artifacts induced by dental hardware in CT scans of the oral cavity. Clinical image quality was assessed using a Thiel-embalmed cadaver. A Catphan phantom and a polymethylmethacrylate (PMMA) phantom were used to evaluate physical-technical image quality parameters such as artifact area, artifact index (AI), and contrast detail (IQFinv). Metal cylinders were inserted in each phantom to create metal artifacts. CT images of both phantoms and the Thiel-embalmed cadaver were acquired on a multislice CT scanner using 80, 100, 120, and 140 kVp; model-based iterative reconstruction (Veo); and synthesized monochromatic keV images with and without metal artifact reduction software (MARs). Four radiologists assessed the clinical image quality, using an image criteria score (ICS). Significant influence of increasing kVp and the use of Veo was found on clinical image quality (p = 0.007 and p = 0.014, respectively). Application of MARs resulted in a smaller artifact area (p < 0.05). However, MARs reconstructed images resulted in lower ICS. Of all investigated techniques, Veo shows to be most promising, with a significant improvement of both the clinical and physical-technical image quality without adversely affecting contrast detail. MARs reconstruction in CT images of the oral cavity to reduce dental hardware metallic artifacts is not sufficient and may even adversely influence the image quality.

Computer-aided diagnosis workstation and network system for chest diagnosis based on multislice CT images

NASA Astrophysics Data System (ADS)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru

2008-03-01

Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The function to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and Success in login" effective. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and security improvement of medical information.

Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

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

Wagner, Marlies, E-mail: marlies.wagner@kgu.de; Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com; Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de

2013-08-01

PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebralmore » PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.« less

Wide field of view CT and acromioclavicular joint instability: A technical innovation.

PubMed

Dyer, David R; Troupis, John M; Kamali Moaveni, Afshin

2015-06-01

A 21-year-old female with a traumatic shoulder injury is investigated and managed for symptoms relating to this injury. Pathology at the acromioclavicular joint is detected clinically; however, clinical examination and multiple imaging modalities do not reach a unified diagnosis on the grading of this acromioclavicular joint injury. When management appropriate to that suggested injury grading fail to help the patient's symptoms, further investigation methods were utilised. Wide field of view, dynamic CT (4D CT) is conducted on the patient's affected shoulder using a 320 × 0.5 mm detector multislice CT. Scans were conducted with a static table as the patient completed three movements of the affected shoulder. Capturing multiple data sets per second over a z-axis of 16 cm, measurements of the acromioclavicular joint were made, to show dynamic changes at the joint. Acromioclavicular (AC) joint translations were witnessed in three planes (a previously unrecognised pathology in the grading of acromioclavicular joint injuries). Translation in multiple planes was also not evident on careful clinical examination of this patient. AC joint width, anterior-posterior translation, superior-inferior translation and coracoclavicular width were measured with planar reconstructions while volume-rendered images and dynamic sequences aiding visual understanding of the pathology. Wide field of view dynamic CT (4D CT) is an accurate and quick modality to diagnose complex acromioclavicular joint injury. It provides dynamic information that no other modality can; 4D CT shows future benefits for clinical approach to diagnosis and management of acromioclavicular joint injury, and other musculoskeletal pathologies. © 2015 The Royal Australian and New Zealand College of Radiologists.

Improving the imaging of calcifications in CT by histogram-based selective deblurring

NASA Astrophysics Data System (ADS)

Rollano-Hijarrubia, Empar; van der Meer, Frits; van der Lugt, Add; Weinans, Harrie; Vrooman, Henry; Vossepoel, Albert; Stokking, Rik

2005-04-01

Imaging of small high-density structures, such as calcifications, with computed tomography (CT) is limited by the spatial resolution of the system. Blur causes small calcifications to be imaged with lower contrast and overestimated volume, thereby hampering the analysis of vessels. The aim of this work is to reduce the blur of calcifications by applying three-dimensional (3D) deconvolution. Unfortunately, the high-frequency amplification of the deconvolution produces edge-related ring artifacts and enhances noise and original artifacts, which degrades the imaging of low-density structures. A method, referred to as Histogram-based Selective Deblurring (HiSD), was implemented to avoid these negative effects. HiSD uses the histogram information to generate a restored image in which the low-intensity voxel information of the observed image is combined with the high-intensity voxel information of the deconvolved image. To evaluate HiSD we scanned four in-vitro atherosclerotic plaques of carotid arteries with a multislice spiral CT and with a microfocus CT (μCT), used as reference. Restored images were generated from the observed images, and qualitatively and quantitatively compared with their corresponding μCT images. Transverse views and maximum-intensity projections of restored images show the decrease of blur of the calcifications in 3D. Measurements of the areas of 27 calcifications and total volumes of calcification of 4 plaques show that the overestimation of calcification was smaller for restored images (mean-error: 90% for area; 92% for volume) than for observed images (143%; 213%, respectively). The qualitative and quantitative analyses show that the imaging of calcifications in CT can be improved considerably by applying HiSD.

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

Sun Zhonghua, E-mail: z.sun@curtin.edu.a; Chaichana, Thanapong

The purpose of the study was to investigate the hemodynamic effect of stent struts (wires) on renal arteries in patients with abdominal aortic aneurysms (AAAs) treated with suprarenal stent-grafts. Two sample patients with AAA undergoing multislice CT angiography pre- and postsuprarenal fixation of stent-grafts were selected for inclusion in the study. Eight juxtarenal models focusing on the renal arteries were generated from the multislice CT datasets. Four types of configurations of stent wires crossing the renal artery ostium were simulated in the segmented aorta models: a single wire crossing centrally, a single wire crossing peripherally, a V-shaped wire crossing centrally,more » and multiple wires crossing peripherally. The blood flow pattern, flow velocity, wall pressure, and wall shear stress at the renal arteries pre- and post-stent-grafting were analyzed and compared using a two-way fluid structure interaction analysis. The stent wire thickness was simulated with a diameter of 0.4, 1.0, and 2.0 mm, and hemodynamic analysis was performed at different cardiac cycles. The interference of stent wires with renal blood flow was mainly determined by the thickness of stent wires and the type of configuration of stent wires crossing the renal ostium. The flow velocity was reduced by 20-30% in most of the situations when the stent wire thickness increased to 1.0 and 2.0 mm. Of the four types of configuration, the single wire crossing centrally resulted in the highest reduction of flow velocity, ranging from 21% to 28.9% among three different wire thicknesses. Wall shear stress was also dependent on the wire thickness, which decreased significantly when the wire thickness reached 1.0 and 2.0 mm. In conclusion, our preliminary study showed that the hemodynamic effect of suprarenal stent wires in patients with AAA treated with suprarenal stent-grafts was determined by the thickness of suprarenal stent wires. Research findings in our study are useful for follow-up of patients treated with suprarenal stent-grafts to ensure long-term safety of the suprarenal fixation.« less

Endovascular Treatment of a Giant Superior Mesenteric Artery Pseudoaneurysm Using a Nitinol Stent-Graft

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

Gandini, Roberto; Pipitone, Vincenzo; Konda, Daniel, E-mail: danielkonda@yahoo.com

2005-01-15

A 68-year-old woman presenting with gastrointestinal bleeding (hematocrit 19.3%) and in a critical clinical condition (American Society of Anesthesiologists grade 4) from a giant superior mesenteric artery pseudoaneurysm (196.0 x 131.4 mm) underwent emergency endovascular treatment. The arterial tear supplying the pseudoaneurysm was excluded using a 5.0 mm diameter and 31 mm long monorail expanded polytetrafluoroethylene (ePTFE)-covered self-expanding nitinol stent. Within 6 days of the procedure, a gradual increase in hemoglobin levels and a prompt improvement in the clinical condition were observed. Multislice CT angiograms performed immediately, 5 days, 30 days and 3 months after the procedure confirmed the completemore » exclusion of the pseudoaneurysm.« less

[The use of an opect optic system in neurosurgical practice].

PubMed

Kalinovskiy, A V; Rzaev, D A; Yoshimitsu, K

2018-01-01

Modern neurosurgical practice is impossible without access to various information sources. The use of MRI and MSCT data during surgery is an integral part of the neurosurgeon's daily practice. Devices capable of managing an image viewer system without direct contact with equipment simplify working in the operating room. To test operation of a non-contact MRI and MSCT image viewer system in the operating room and to evaluate the system effectiveness. An Opect non-contact image management system developed at the Tokyo Women's Medical University was installed in one of the operating rooms of the Novosibirsk Federal Center of Neurosurgery in 2014. In 2015, the Opect system was used by operating surgeons in 73 surgeries performed in the same operating room. The system effectiveness was analyzed based on a survey of surgeons. The non-contact image viewer system occurred to be easy-to-learn for the personnel to operate this system, easy-to-manage it, and easy-to-present visual information during surgery. Application of the Opect system simplifies work with neuroimaging data during surgery. The surgeon can independently view series of relevant MRI and MSCT scans without any assistance.

CT attenuation measurements are valuable to discriminate pledgets used in prosthetic heart valve implantation from paravalvular leakage

PubMed Central

Habets, J; Meijer, T S; Meijer, R C A; Mali, W P Th M; Vonken, E-J P A; Budde, R P J

2012-01-01

Objectives Sutures with polytetrafluorethylene (PTFE) felt pledgets are commonly used in prosthetic heart valve (PHV) implantation. Paravalvular leakage can be difficult to distinguish from PTFE felt pledgets on multislice CT because both present as hyperdense structures. We assessed whether pledgets can be discriminated from contrast-enhanced solutions (blood/saline) on CT images based on attenuation difference in an ex vivo experiment and under in vivo conditions. Methods PTFE felt pledgets were sutured to the suture ring of a mechanical PHV and porcine aortic annulus, and immersed and scanned in four different contrast-enhanced (Ultravist®; 300 mg jopromide ml−1) saline concentrations (10.0, 12.0, 13.6 and 15.0 mg ml−1). Scanning was performed on a 256-slice scanner with eight different scan protocols with various tube voltage (100 kV, 120 kV) and tube current (400 mAs, 600 mAs, 800 mAs, 1000 mAs) settings. Attenuation of the pledgets and surrounding contrast-enhanced saline were measured. Additionally, the attenuation of pledgets and contrast-enhanced blood was measured on electrocardiography (ECG)-gated CTA scans of 19 patients with 22 PHVs. Results Ex vivo CT attenuation differences between the pledgets and contrast-enhanced solutions were larger by using higher tube voltages. CT attenuation values of the pledgets were higher than contrast-enhanced blood in patients: 420±26 Hounsfield units (mean±SD, range 383–494) and 288±41 Hounsfield units (range 202–367), respectively. Conclusions PTFE felt pledgets have consistently higher attenuation than surrounding contrast-enhanced blood. CT attenuation measurements therefore may help to differentiate pledgets from paravalvular leakage, and detect paravalvular leakage in patients with suspected PHV dysfunction. PMID:22919014

Performance of cone beam computed tomography in comparison to conventional imaging techniques for the detection of bone invasion in oral cancer.

PubMed

Linz, C; Müller-Richter, U D A; Buck, A K; Mottok, A; Ritter, C; Schneider, P; Metzen, D; Heuschmann, P; Malzahn, U; Kübler, A C; Herrmann, K; Bluemel, C

2015-01-01

Detecting bone invasion in oral cancer is crucial for therapy planning and the prognosis. The present study evaluated cone beam computed tomography (CBCT) for detecting bone invasion in comparison to standard imaging techniques. A total of 197 patients with diagnoses of oral cancer underwent CBCT as part of preoperative staging between January 2007 and April 2013. The sensitivity, specificity, and accuracy of CBCT were compared with panoramic radiography (PR), multi-slice computed tomography (CT) or magnetic resonance imaging (MRI), and bone scintigraphy (BS) using McNemar's test. Histopathology and clinical follow-up served as references for the presence of bone invasion. CBCT and BS (84.8% and 89.3%, respectively), as well as CBCT and CT/MRI (83.2%), showed comparable accuracy (P = 0.188 and P = 0.771). CBCT was significantly superior to PR, which was reconstructed based on a CBCT dataset (74.1%, P = 0.002). In detecting bone invasion, CBCT was significantly more accurate than PR and was comparable to BS and CT/MRI. However, each method has certain advantages, and the best combination of imaging methods must be evaluated in prospective clinic trials. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Dynamic three-dimensional model of the coronary circulation

NASA Astrophysics Data System (ADS)

Lehmann, Glen; Gobbi, David G.; Dick, Alexander J.; Starreveld, Yves P.; Quantz, M.; Holdsworth, David W.; Drangova, Maria

2001-05-01

A realistic numerical three-dimensional (3D) model of the dynamics of human coronary arteries has been developed. High- resolution 3D images of the coronary arteries of an excised human heart were obtained using a C-arm based computed tomography (CT) system. Cine bi-plane coronary angiograms were then acquired from a patient with similar coronary anatomy. These angiograms were used to determine the vessel motion, which was applied to the static 3D coronary tree. Corresponding arterial bifurcations were identified in the 3D CT image and in the 2D angiograms. The 3D positions of the angiographic landmarks, which were known throughout the cardiac cycle, were used to warp the 3D image via a non-linear thin-plate spline algorithm. The result was a set or 30 dynamic volumetric images sampling a complete cardiac cycle. To the best of our knowledge, the model presented here is the first dynamic 3D model that provides a true representation of both the geometry and motion of a human coronary artery tree. In the future, similar models can be generated to represent different coronary anatomy and motion. Such models are expected to become an invaluable tool during the development of dynamic imaging techniques such as MRI, multi-slice CT and 3D angiography.

SNR-weighted sinogram smoothing with improved noise-resolution properties for low-dose x-ray computed tomography

NASA Astrophysics Data System (ADS)

Li, Tianfang; Wang, Jing; Wen, Junhai; Li, Xiang; Lu, Hongbing; Hsieh, Jiang; Liang, Zhengrong

2004-05-01

To treat the noise in low-dose x-ray CT projection data more accurately, analysis of the noise properties of the data and development of a corresponding efficient noise treatment method are two major problems to be addressed. In order to obtain an accurate and realistic model to describe the x-ray CT system, we acquired thousands of repeated measurements on different phantoms at several fixed scan angles by a GE high-speed multi-slice spiral CT scanner. The collected data were calibrated and log-transformed by the sophisticated system software, which converts the detected photon energy into sinogram data that satisfies the Radon transform. From the analysis of these experimental data, a nonlinear relation between mean and variance for each datum of the sinogram was obtained. In this paper, we integrated this nonlinear relation into a penalized likelihood statistical framework for a SNR (signal-to-noise ratio) adaptive smoothing of noise in the sinogram. After the proposed preprocessing, the sinograms were reconstructed with unapodized FBP (filtered backprojection) method. The resulted images were evaluated quantitatively, in terms of noise uniformity and noise-resolution tradeoff, with comparison to other noise smoothing methods such as Hanning filter and Butterworth filter at different cutoff frequencies. Significant improvement on noise and resolution tradeoff and noise property was demonstrated.

In vitro comparative study of manual and mechanical rotary instrumentation of root canals using computed tomography.

PubMed

Limongi, Orlando; de Albuquerque, Diana Santana; Baratto Filho, Flares; Vanni, José Roberto; de Oliveira, Elias P Motcy; Barletta, Fernando Branco

2007-01-01

This in vitro study compared, using computed tomography (CT), the amount of dentin removed from root canal walls by manual and mechanical rotary instrumentation techniques. Forty mandibular incisors with dental crown and a single canal were selected. The teeth were randomly assigned to two groups, according to the technique used for root canal preparation: Group I - manual instrumentation with stainless steel files; Group II - mechanical instrumentation with RaCe rotary nickel-titanium instruments. In each tooth, root dentin thickness of the buccal, lingual, mesial and distal surfaces in the apical, middle and cervical thirds of the canal was measured (in mm) using a multislice CT scanner (Siemens Emotion, Duo). Data were stored in the SPSS v. 11.5 and SigmaPlot 2001 v. 7.101 softwares. After crown opening, working length was determined, root canals were instrumented and new CT scans were taken for assessment of root dentin thickness. Pre- and post-instrumentation data were compared and analyzed statistically by ANOVA and Tukey's post-hoc test for significant differences (p=0.05). Based on the findings of this study, it may be concluded that regarding dentin removal from root canal walls during instrumentation, neither of the techniques can be considered more effective than the other.

Simultaneous extraction of centerlines, stenosis, and thrombus detection in renal CT angiography

NASA Astrophysics Data System (ADS)

Subramanyan, Krishna; Durgan, Jacob; Hodgkiss, Thomas D.; Chandra, Shalabh

2004-05-01

The Renal Artery Stenosis (RAS) is the major cause of renovascular hypertension and CT angiography has shown tremendous promise as a noninvasive method for reliably detecting renal artery stenosis. The purpose of this study was to validate the semi-automated methods to assist in extraction of renal branches and characterizing the associated renal artery stenosis. Automatically computed diagnostic images such as straight MIP, curved MPR, cross-sections, and diameters from multi-slice CT are presented and evaluated for its acceptance. We used vessel-tracking image processing methods to extract the aortic-renal vessel tree in a CT data in axial slice images. Next, from the topology and anatomy of the aortic vessel tree, the stenosis, and thrombus section and branching of the renal arteries are extracted. The results are presented in curved MPR and continuously variable MIP images. In this study, 15 patients were scanned with contrast on Mx8000 CT scanner (Philips Medical Systems), with 1.0 mm thickness, 0.5mm slice spacing, and 120kVp and a stack of 512x512x150 volume sets were reconstructed. The automated image processing took less than 50 seconds to compute the centerline and borders of the aortic/renal vessel tree. The overall assessment of manual and automatically generated stenosis yielded a weighted kappa statistic of 0.97 at right renal arteries, 0.94 at the left renal branches. The thrombus region contoured manually and semi-automatically agreed upon at 0.93. The manual time to process each case is approximately 25 to 30 minutes.

X-ray imaging physics for nuclear medicine technologists. Part 1: Basic principles of x-ray production.

PubMed

Seibert, J Anthony

2004-09-01

The purpose is to review in a 4-part series: (i) the basic principles of x-ray production, (ii) x-ray interactions and data capture/conversion, (iii) acquisition/creation of the CT image, and (iv) operational details of a modern multislice CT scanner integrated with a PET scanner. Advances in PET technology have lead to widespread applications in diagnostic imaging and oncologic staging of disease. Combined PET/CT scanners provide the high-resolution anatomic imaging capability of CT with the metabolic and physiologic information by PET, to offer a significant increase in information content useful for the diagnostician and radiation oncologist, neurosurgeon, or other physician needing both anatomic detail and knowledge of disease extent. Nuclear medicine technologists at the forefront of PET should therefore have a good understanding of x-ray imaging physics and basic CT scanner operation, as covered by this 4-part series. After reading the first article on x-ray production, the nuclear medicine technologist will be familiar with (a) the physical characteristics of x-rays relative to other electromagnetic radiations, including gamma-rays in terms of energy, wavelength, and frequency; (b) methods of x-ray production and the characteristics of the output x-ray spectrum; (c) components necessary to produce x-rays, including the x-ray tube/x-ray generator and the parameters that control x-ray quality (energy) and quantity; (d) x-ray production limitations caused by heating and the impact on image acquisition and clinical throughput; and (e) a glossary of terms to assist in the understanding of this information.

Dose uniformity analysis among ten 16-slice same-model CT scanners.

PubMed

Erdi, Yusuf Emre

2012-01-01

With the introduction of multislice scanners, computed tomographic (CT) dose optimization has become important. The patient-absorbed dose may differ among the scanners although they are the same type and model. To investigate the dose output variation of the CT scanners, we designed the study to analyze dose outputs of 10 same-model CT scanners using 3 clinical protocols. Ten GE Lightspeed (GE Healthcare, Waukesha, Wis) 16-slice scanners located at main campus and various satellite locations of our institution have been included in this study. All dose measurements were performed using poly (methyl methacrylate) (PMMA) head (diameter, 16 cm) and body (diameter, 32 cm) phantoms manufactured by Radcal (RadCal Corp, Monrovia, Calif) using a 9095 multipurpose analyzer with 10 × 9-3CT ion chamber both from the same manufacturer. Ion chamber is inserted into the peripheral and central axis locations and volume CT dose index (CTDIvol) is calculated as weighted average of doses at those locations. Three clinical protocol settings for adult head, high-resolution chest, and adult abdomen are used for dose measurements. We have observed up to 9.4% CTDIvol variation for the adult head protocol in which the largest variation occurred among the protocols. However, head protocol uses higher milliampere second values than the other 2 protocols. Most of the measured values were less than the system-stored CTDIvol values. It is important to note that reduction in dose output from tubes as they age is expected in addition to the intrinsic radiation output fluctuations of the same scanner. Although the same model CT scanners were used in this study, it is possible to see CTDIvol variation in standard patient scanning protocols of head, chest, and abdomen. The compound effect of the dose variation may be larger with higher milliampere and multiphase and multilocation CT scans.

Can multi-slice or navigator-gated R2* MRI replace single-slice breath-hold acquisition for hepatic iron quantification?

PubMed

Loeffler, Ralf B; McCarville, M Beth; Wagstaff, Anne W; Smeltzer, Matthew P; Krafft, Axel J; Song, Ruitian; Hankins, Jane S; Hillenbrand, Claudia M

2017-01-01

Liver R2* values calculated from multi-gradient echo (mGRE) magnetic resonance images (MRI) are strongly correlated with hepatic iron concentration (HIC) as shown in several independently derived biopsy calibration studies. These calibrations were established for axial single-slice breath-hold imaging at the location of the portal vein. Scanning in multi-slice mode makes the exam more efficient, since whole-liver coverage can be achieved with two breath-holds and the optimal slice can be selected afterward. Navigator echoes remove the need for breath-holds and allow use in sedated patients. To evaluate if the existing biopsy calibrations can be applied to multi-slice and navigator-controlled mGRE imaging in children with hepatic iron overload, by testing if there is a bias-free correlation between single-slice R2* and multi-slice or multi-slice navigator controlled R2*. This study included MRI data from 71 patients with transfusional iron overload, who received an MRI exam to estimate HIC using gradient echo sequences. Patient scans contained 2 or 3 of the following imaging methods used for analysis: single-slice images (n = 71), multi-slice images (n = 69) and navigator-controlled images (n = 17). Small and large blood corrected region of interests were selected on axial images of the liver to obtain R2* values for all data sets. Bland-Altman and linear regression analysis were used to compare R2* values from single-slice images to those of multi-slice images and navigator-controlled images. Bland-Altman analysis showed that all imaging method comparisons were strongly associated with each other and had high correlation coefficients (0.98 ≤ r ≤ 1.00) with P-values ≤0.0001. Linear regression yielded slopes that were close to 1. We found that navigator-gated or breath-held multi-slice R2* MRI for HIC determination measures R2* values comparable to the biopsy-validated single-slice, single breath-hold scan. We conclude that these three R2* methods can be interchangeably used in existing R2*-HIC calibrations.

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.

Influence of Nitroglycerin on Coronary Artery CT Imaging in Cardiovascular Diseases.

PubMed

Zhang, PeiYing

2015-06-01

This study was designed to observe the influence of nitroglycerin on the quality of coronary artery imaging when CT is used for coronary heart disease. Data of 150 cardiology inpatients were collected from Department of Cardiology of our hospital from November 2013 to August 2014 for this study. All the subjects were diagnosed with multislice CT and coronary angiography after admission. The patients were then divided into two groups, the nitroglycerin group of 75 cases who took nitroglycerin and the control group of 75 cases who took no nitroglycerin. A total of 320 mixed plaques (pathological characteristics of calcified ingredients and non-calcified ingredients), including 290 calcified mixed plaques of type I, (mainly with calcified plaques and purely calcified plaques), and 30 non-calcified plaques of type II, (mainly with non-calcified ingredients or pure non-calcified plaques) were scanned. CT coronary angiography showed that the detection rate of type I plaque was 65.5 % in control group and 34.8 % in nitroglycerin group, whereas the detection rate of type II plaque was 30 % in control group and 70 % in nitroglycerin group. The difference for both type I and type II was statistically significant (p < 0.05). In Comparison with control group, the increase in diameter of 1-13 vascular segments in nitroglycerin group was statistically significant (p < 0.05). Taking nitroglycerin can improve the display resolution of coronary angiography, and shows better display for type I than type II plaques.

Comparison of the diagnostic quality of computed tomography images of normal ocular and orbital structures acquired with and without the use of general anesthesia in the cat.

PubMed

Collins, Sean P; Matheson, Jodi S; Hamor, Ralph E; Mitchell, Mark A; Labelle, Amber L; O'Brien, Robert T

2013-09-01

To compare the diagnostic quality of computed tomography (CT) images of normal ocular and orbital structures acquired with and without the use of general anesthesia in the cat. Eleven privately owned cats with nasal disease presenting to a single referral hospital. All cats received a complete ophthalmic examination. A 16 multislice helical CT system was utilized to acquire images of the skull and neck with and without the use of general anesthesia. Images were acquired before and after the administration of intravenous iodinated contrast. Images of normal ocular and orbital structures were evaluated via consensus by two board-certified radiologists. Visibility of ocular and orbital structures, degree of motion, and streak artifact were assessed and scored for each image set in the transverse, dorsal, and sagittal planes. The use of general anesthesia did not significantly affect the diagnostic quality of images. No motion artifact was observed in any CT image. Streak artifact was significantly increased in scans performed in the transverse orientation but not in the dorsal orientation or sagittal orientation and did not affect the diagnostic quality of the images. Contrast enhancement did not significantly enhance the visibility of any ocular or orbital structures. Diagnostic CT images of normal ocular and orbital structures can be acquired without the use of general anesthesia in the cat. © 2012 American College of Veterinary Ophthalmologists.

4D CT sorting based on patient internal anatomy

NASA Astrophysics Data System (ADS)

Li, Ruijiang; Lewis, John H.; Cerviño, Laura I.; Jiang, Steve B.

2009-08-01

Respiratory motion during free-breathing computed tomography (CT) scan may cause significant errors in target definition for tumors in the thorax and upper abdomen. A four-dimensional (4D) CT technique has been widely used for treatment simulation of thoracic and abdominal cancer radiotherapy. The current 4D CT techniques require retrospective sorting of the reconstructed CT slices oversampled at the same couch position. Most sorting methods depend on external surrogates of respiratory motion recorded by extra instruments. However, respiratory signals obtained from these external surrogates may not always accurately represent the internal target motion, especially when irregular breathing patterns occur. We have proposed a new sorting method based on multiple internal anatomical features for multi-slice CT scan acquired in the cine mode. Four features are analyzed in this study, including the air content, lung area, lung density and body area. We use a measure called spatial coherence to select the optimal internal feature at each couch position and to generate the respiratory signals for 4D CT sorting. The proposed method has been evaluated for ten cancer patients (eight with thoracic cancer and two with abdominal cancer). For nine patients, the respiratory signals generated from the combined internal features are well correlated to those from external surrogates recorded by the real-time position management (RPM) system (average correlation: 0.95 ± 0.02), which is better than any individual internal measures at 95% confidence level. For these nine patients, the 4D CT images sorted by the combined internal features are almost identical to those sorted by the RPM signal. For one patient with an irregular breathing pattern, the respiratory signals given by the combined internal features do not correlate well with those from RPM (correlation: 0.68 ± 0.42). In this case, the 4D CT image sorted by our method presents fewer artifacts than that from the RPM signal. Our 4D CT internal sorting method eliminates the need of externally recorded surrogates of respiratory motion. It is an automatic, accurate, robust, cost efficient and yet simple method and therefore can be readily implemented in clinical settings.

Implications of Artefacts Reduction in the Planning CT Originating from Implanted Fiducial Markers

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

Kassim, Iskandar, E-mail: i.binkassim@erasmusmc.n; Joosten, Hans; Barnhoorn, Jaco C.

The efficacy of metal artefact reduction (MAR) software to suppress artefacts in reconstructed computed tomography (CT) images originating from small metal objects, like tumor markers and surgical clips, was evaluated. In addition, possible implications of using digital reconstructed radiographs (DRRs), based on the MAR CT images, for setup verification were analyzed. A phantom and 15 patients with different tumor sites and implanted markers were imaged with a multislice CT scanner. The raw image data was reconstructed both with the clinically used filtered-backprojection (FBP) and with the MAR software. Using the MAR software, improvements in image quality were often observed inmore » CT slices with markers or clips. Especially when several markers were located near to each other, fewer streak artefacts were observed than with the FBP algorithm. In addition, the shape and size of markers could be identified more accurately, reducing the contoured marker volumes by a factor of 2. For the phantom study, the CT numbers measured near to the markers corresponded more closely to the expected values. However, the MAR images were slightly more smoothed compared with the images reconstructed with FBP. For 8 prostate cancer patients in this study, the interobserver variation in 3D marker definition was similar (<0.4 mm) when using DRRs based on either FBP or MAR CT scans. Automatic marker matches also showed a similar success rate. However, differences in automatic match results up to 1 mm, caused by differences in the marker definition, were observed, which turned out to be (borderline) statistically significant (p = 0.06) for 2 patients. In conclusion, the MAR software might improve image quality by suppressing metal artefacts, probably allowing for a more reliable delineation of structures. When implanted markers or clips are used for setup verification, the accuracy may slightly be improved as well, which is relevant when using very tight clinical target volume (CTV) to planning target volume (PTV) margins for planning.« less

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

SU-E-QI-21: Iodinated Contrast Agent Time Course In Human Brain Metastasis: A Study For Stereotactic Synchrotron Radiotherapy Clinical Trials

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

Obeid, L; Esteve, F; Adam, J

2014-06-15

Purpose: Synchrotron stereotactic radiotherapy (SSRT) is an innovative treatment combining the selective accumulation of heavy elements in tumors with stereotactic irradiations using monochromatic medium energy x-rays from a synchrotron source. Phase I/II clinical trials on brain metastasis are underway using venous infusion of iodinated contrast agents. The radiation dose enhancement depends on the amount of iodine in the tumor and its time course. In the present study, the reproducibility of iodine concentrations between the CT planning scan day (Day 0) and the treatment day (Day 10) was assessed in order to predict dose errors. Methods: For each of days 0more » and 10, three patients received a biphasic intravenous injection of iodinated contrast agent (40 ml, 4 ml/s, followed by 160 ml, 0.5 ml/s) in order to ensure stable intra-tumoral amounts of iodine during the treatment. Two volumetric CT scans (before and after iodine injection) and a multi-slice dynamic CT of the brain were performed using conventional radiotherapy CT (Day 0) or quantitative synchrotron radiation CT (Day 10). A 3D rigid registration was processed between images. The absolute and relative differences of absolute iodine concentrations and their corresponding dose errors were evaluated in the GTV and PTV used for treatment planning. Results: The differences in iodine concentrations remained within the standard deviation limits. The 3D absolute differences followed a normal distribution centered at zero mg/ml with a variance (∼1 mg/ml) which is related to the image noise. Conclusion: The results suggest that dose errors depend only on the image noise. This study shows that stable amounts of iodine are achievable in brain metastasis for SSRT treatment in a 10 days interval.« less

Comparison of tomographic and colonoscopic diagnoses in the presence of colonic wall thickening

PubMed Central

İnce, Ali Tüzün; Baysal, Birol; Kayar, Yusuf; Arabacı, Elif; Bilgin, Mehmet; Hamdard, Jamshid; Yay, Adnan; Şentürk, Hakan

2014-01-01

Introduction and objective: Colonic wall thickening is a common condition in a number of benignant and malignant diseases. This study investigated the accuracy of radiological diagnoses in patients diagnosed with colonic wall thickening using multislice CT (MDCT). Materials and Method: Files of patients with colonic wall thickening diagnosed with 64-slice MDCT were reviewed retrospectively. The colonoscopy results of these patients were grouped under neoplastic process (cancer and adenomatous polyp), inflammatory bowel disease (IBD), diverticulitis and other etiology (nonspecific events, ischemic colitis, solitary rectal ulcer, external compression, secondary to volvulus and radiotherapy), and the results were statistically evaluated. p values < 0.05 were considered statistically significant. Results: The study was performed on 505 files (290 males [57.4%], 215 females [42.6%], mean age: 49.15 ± 18.4 years). CT and colonoscopic diagnoses were reviewed and the following CT to colonoscopy ratios was observed: neoplastic process: 44.4% vs. 40.2%; IBD: 42.4% vs. 42.4%; diverticulitis: 4% vs. 4.2%; other etiology: 9.3% vs. 3.2%. Colonoscopy failed to identify pathology in 9.9% of the patients. The sensitivity, specificity, PPV, NPV and accuracy of CT were 95.6%, 90.4%, 87.1%, 96.8% and 92.4%, respectively, in detecting neoplastic processes; 97.2%, 97.9%, 97.2%, 97.9% and 97.6%, respectively, in detecting IBD; 90.5%, 99.8%, 95%, 99.6% and 99.4%, respectively, in detecting diverticulitis, and 50%, 96,7%, 62.5%, 94.6% and 92%, respectively, in detecting other etiology. Conclusion: While, accuracy of 64 slice-CT in diagnosing colonic wall thickenings secondary especially to neoplastic processes, IBD and diverticulitis was significantly higher, but differential diagnosis is challenging in pathologies due to other etiologies. PMID:25550962

SPECT/CT imaging in general orthopedic practice.

PubMed

Scharf, Stephen

2009-09-01

The availability of hybrid devices that combine the latest single-photon emission computed tomography (SPECT) imaging technology with multislice computed tomography (CT) scanning has allowed us to detect subtle, nonspecific abnormalities on bone scans and interpret them as specific focal areas of pathology. Abnormalities in the spine can be separated into those caused by pars fractures, facet joint arthritis, or osteophyte formation on vertebral bodies. Compression fractures can be distinguished from severe degenerative disease, both of which can cause intense activity across the spine on either planar or SPECT imaging. Localizing activity in patients who have had spinal fusion can provide tremendous insight into the causes of therapeutic failures. Infections of the spine now can be diagnosed with gallium SPECT/CT, despite the fact that gallium has long been abandoned because of its failure to detect spine infection on either planar or SPECT imaging. Small focal abnormalities in the feet and ankles can be localized well enough to make specific orthopedic diagnoses on the basis of their location. Moreover, when radiographic imaging provides equivocal or inadequate information, SPECT/CT can provide a road map for further diagnostic studies and has been invaluable in planning surgery. Our ability to localize activity within a bone or at an articular surface has allowed us to distinguish between fractures and joint disease. Increased activity associated with congenital anomalies, such as tarsal coalition and Bertolotti's syndrome have allowed us to understand the pathophysiology of these conditions, to confirm them as the cause of the patient's symptoms, and to provide information that is useful in determining appropriate clinical management. As our experience broadens, SPECT/CT will undoubtedly become an important tool in the evaluation and management of a wider variety of orthopedic patients.

Computer-aided diagnosis workstation and telemedicine network system for chest diagnosis based on multislice CT images

NASA Astrophysics Data System (ADS)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kakinuma, Ryutaru; Moriyama, Noriyuki

2009-02-01

Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. To overcome these problems, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The functions to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and "Success in login" effective. As a result, patients' private information is protected. We can share the screen of Web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with workstation. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and security improvement of medical information.

Explosive Detection in Aviation Applications Using CT

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

Martz, H E; Crawford, C R

2011-02-15

CT scanners are deployed world-wide to detect explosives in checked and carry-on baggage. Though very similar to single- and dual-energy multi-slice CT scanners used today in medical imaging, some recently developed explosives detection scanners employ multiple sources and detector arrays to eliminate mechanical rotation of a gantry, photon counting detectors for spectral imaging, and limited number of views to reduce cost. For each bag scanned, the resulting reconstructed images are first processed by automated threat recognition algorithms to screen for explosives and other threats. Human operators review the images only when these automated algorithms report the presence of possible threats.more » The US Department of Homeland Security (DHS) has requirements for future scanners that include dealing with a larger number of threats, higher probability of detection, lower false alarm rates and lower operating costs. One tactic that DHS is pursuing to achieve these requirements is to augment the capabilities of the established security vendors with third-party algorithm developers. A third-party in this context refers to academics and companies other than the established vendors. DHS is particularly interested in exploring the model that has been used very successfully by the medical imaging industry, in which university researchers develop algorithms that are eventually deployed in commercial medical imaging equipment. The purpose of this paper is to discuss opportunities for third-parties to develop advanced reconstruction and threat detection algorithms.« less

Short-term reproducibility of computed tomography-based lung density measurements in alpha-1 antitrypsin deficiency and smokers with emphysema.

PubMed

Shaker, S B; Dirksen, A; Laursen, L C; Maltbaek, N; Christensen, L; Sander, U; Seersholm, N; Skovgaard, L T; Nielsen, L; Kok-Jensen, A

2004-07-01

To study the short-term reproducibility of lung density measurements by multi-slice computed tomography (CT) using three different radiation doses and three reconstruction algorithms. Twenty-five patients with smoker's emphysema and 25 patients with alpha1-antitrypsin deficiency underwent 3 scans at 2-week intervals. Low-dose protocol was applied, and images were reconstructed with bone, detail, and soft algorithms. Total lung volume (TLV), 15th percentile density (PD-15), and relative area at -910 Hounsfield units (RA-910) were obtained from the images using Pulmo-CMS software. Reproducibility of PD-15 and RA-910 and the influence of radiation dose, reconstruction algorithm, and type of emphysema were then analysed. The overall coefficient of variation of volume adjusted PD-15 for all combinations of radiation dose and reconstruction algorithm was 3.7%. The overall standard deviation of volume-adjusted RA-910 was 1.7% (corresponding to a coefficient of variation of 6.8%). Radiation dose, reconstruction algorithm, and type of emphysema had no significant influence on the reproducibility of PD-15 and RA-910. However, bone algorithm and very low radiation dose result in overestimation of the extent of emphysema. Lung density measurement by CT is a sensitive marker for quantitating both subtypes of emphysema. A CT-protocol with radiation dose down to 16 mAs and soft or detail reconstruction algorithm is recommended.

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.

Ultralow-dose computed tomography imaging for surgery of midfacial and orbital fractures using ASIR and MBIR.

PubMed

Widmann, G; Dalla Torre, D; Hoermann, R; Schullian, P; Gassner, E M; Bale, R; Puelacher, W

2015-04-01

The influence of dose reductions on diagnostic quality using a series of high-resolution ultralow-dose computed tomography (CT) scans for computer-assisted planning and surgery including the most recent iterative reconstruction algorithms was evaluated and compared with the fracture detectability of a standard cranial emergency protocol. A human cadaver head including the mandible was artificially prepared with midfacial and orbital fractures and scanned using a 64-multislice CT scanner. The CT dose index volume (CTDIvol) and effective doses were calculated using application software. Noise was evaluated as the standard deviation in Hounsfield units within an identical region of interest in the posterior fossa. Diagnostic quality was assessed by consensus reading of a craniomaxillofacial surgeon and radiologist. Compared with the emergency protocol at CTDIvol 35.3 mGy and effective dose 3.6 mSv, low-dose protocols down to CTDIvol 1.0 mGy and 0.1 mSv (97% dose reduction) may be sufficient for the diagnosis of dislocated craniofacial fractures. Non-dislocated fractures may be detected at CTDIvol 2.6 mGy and 0.3 mSv (93% dose reduction). Adaptive statistical iterative reconstruction (ASIR) 50 and 100 reduced average noise by 30% and 56%, and model-based iterative reconstruction (MBIR) by 93%. However, the detection rate of fractures could not be improved due to smoothing effects. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Dental status of three Egyptian mummies: radiological investigation by multislice computerized tomography.

PubMed

Gerloni, Alessandro; Cavalli, Fabio; Costantinides, Fulvio; Costantinides, Fulvia; Bonetti, Stefano; Paganelli, Corrado

2009-06-01

The aim of the study was to provide a paleopathologic and radiologic overview of the jaws and teeth of 3 Egyptian mummies preserved in the Civic Museum of History and Art in Trieste. Computerized tomography (CT) imaging and postprocessing techniques were used to examine the oral structures. A 16-slice CT scanner was used (Aquilion 16; Toshiba Medical Systems Europe, Zoetermeer, The Netherlands). Scans were obtained at high resolution. Orthogonal-plane and 3-dimensional (3D) reconstructions were created along with curved reconstructions of the lower and upper jaws. Determination of decayed/missing teeth (DMT) and decayed/missing/tooth surfaces (DMTs) were made with 3D images. Analyses revealed differences in the embalming techniques and state of preservation of the bodies. Marked wear of the occlusal surfaces was a characteristic finding in all of the mummies. The DMT and DMTs were low compared with values for contemporary populations. Two mummies had fully erupted third molars. All mummies exhibited bone changes consistent with periodontitis. The CT evaluations of the oral structures of the mummies provided insight into the dental status and oral diseases of these ancient Egyptians. The low DMT and DMTs values and indications of periodontitis may be associated with the lifestyle of these Egyptians. The fully erupted and well aligned third molars may represent a morphologic adaptation of the arches to the muscular activity associated with grinding tough foods.

Tight-frame based iterative image reconstruction for spectral breast CT

PubMed Central

Zhao, Bo; Gao, Hao; Ding, Huanjun; Molloi, Sabee

2013-01-01

Purpose: To investigate tight-frame based iterative reconstruction (TFIR) technique for spectral breast computed tomography (CT) using fewer projections while achieving greater image quality. Methods: The experimental data were acquired with a fan-beam breast CT system based on a cadmium zinc telluride photon-counting detector. The images were reconstructed with a varying number of projections using the TFIR and filtered backprojection (FBP) techniques. The image quality between these two techniques was evaluated. The image's spatial resolution was evaluated using a high-resolution phantom, and the contrast to noise ratio (CNR) was evaluated using a postmortem breast sample. The postmortem breast samples were decomposed into water, lipid, and protein contents based on images reconstructed from TFIR with 204 projections and FBP with 614 projections. The volumetric fractions of water, lipid, and protein from the image-based measurements in both TFIR and FBP were compared to the chemical analysis. Results: The spatial resolution and CNR were comparable for the images reconstructed by TFIR with 204 projections and FBP with 614 projections. Both reconstruction techniques provided accurate quantification of water, lipid, and protein composition of the breast tissue when compared with data from the reference standard chemical analysis. Conclusions: Accurate breast tissue decomposition can be done with three fold fewer projection images by the TFIR technique without any reduction in image spatial resolution and CNR. This can result in a two-third reduction of the patient dose in a multislit and multislice spiral CT system in addition to the reduced scanning time in this system. PMID:23464320

CT diagnosis and differentiation of benign and malignant varieties of solitary fibrous tumor of the pleura

PubMed Central

You, Xiaofang; Sun, Xiwen; Yang, Chunyan; Fang, Yong

2017-01-01

Abstract To investigate computed tomography (CT) characteristics of benign and malignant solitary fibrous tumors of the pleura (SFTPs). Preoperative CTs for 60 SFTP cases (49 benign and 11 malignant) with subsequently confirmed diagnoses were retrospectively analyzed. Tumor morphologies included mounded or mushroom umbrella-shape (19 cases, 31.7%), quasi-circular or oval-shape (30 cases, 50%), and growth resembling a casting mould (12 cases, 20%). Maximum tumor diameters were 1.1 to 18.9 cm (average: 6.4 ± 4.8 cm). Fifty-seven cases had clear boundaries, and 3 had partially coarse boundaries. Twenty-seven cases showed homogeneous density; 33, “geographic”-patterned inhomogeneous density; 6, calcifications; 12, intratumor blood vessels; and 3, thick nourishing peritumoral blood vessels. Pleural thickening (regular and irregular) was found adjacent to tumors in 4, compression of adjacent ribs with absorption and cortical sclerosis in 2, and location adjacent to ribs with bony destruction in 1. Four cases had a small amount of lung tissue enfolded along the boundary, 2 had multiple peritumoral pulmonary bullae, and 9 had small ipsilateral pleural effusions. Compared with benign and malignant SFTPs were larger (P < .001), had inhomogeneous density, and were more commonly associated with intratumor blood vessels and pleural effusions (P < .01). CT revealed characteristic patterns in SFTPs, including casting mould-like growth, rich blood supply, and “geographic”-patterned enhancement. In addition, larger tumor size, inhomogeneous intensities, abundant intratumor blood vessels, and pleural effusions were more common with malignancy. Lastly, multislice CT angiography can reveal feeding arteries and help guide surgical management. PMID:29245313

CT diagnosis and differentiation of benign and malignant varieties of solitary fibrous tumor of the pleura.

PubMed

You, Xiaofang; Sun, Xiwen; Yang, Chunyan; Fang, Yong

2017-12-01

To investigate computed tomography (CT) characteristics of benign and malignant solitary fibrous tumors of the pleura (SFTPs).Preoperative CTs for 60 SFTP cases (49 benign and 11 malignant) with subsequently confirmed diagnoses were retrospectively analyzed.Tumor morphologies included mounded or mushroom umbrella-shape (19 cases, 31.7%), quasi-circular or oval-shape (30 cases, 50%), and growth resembling a casting mould (12 cases, 20%). Maximum tumor diameters were 1.1 to 18.9 cm (average: 6.4 ± 4.8 cm). Fifty-seven cases had clear boundaries, and 3 had partially coarse boundaries. Twenty-seven cases showed homogeneous density; 33, "geographic"-patterned inhomogeneous density; 6, calcifications; 12, intratumor blood vessels; and 3, thick nourishing peritumoral blood vessels. Pleural thickening (regular and irregular) was found adjacent to tumors in 4, compression of adjacent ribs with absorption and cortical sclerosis in 2, and location adjacent to ribs with bony destruction in 1. Four cases had a small amount of lung tissue enfolded along the boundary, 2 had multiple peritumoral pulmonary bullae, and 9 had small ipsilateral pleural effusions. Compared with benign and malignant SFTPs were larger (P < .001), had inhomogeneous density, and were more commonly associated with intratumor blood vessels and pleural effusions (P < .01).CT revealed characteristic patterns in SFTPs, including casting mould-like growth, rich blood supply, and "geographic"-patterned enhancement. In addition, larger tumor size, inhomogeneous intensities, abundant intratumor blood vessels, and pleural effusions were more common with malignancy. Lastly, multislice CT angiography can reveal feeding arteries and help guide surgical management.

[Application of second generation dual-source computed tomography dual-energy scan mode in detecting pancreatic adenocarcinoma].

PubMed

Xue, Hua-dan; Liu, Wei; Sun, Hao; Wang, Xuan; Chen, Yu; Su, Bai-yan; Sun, Zhao-yong; Chen, Fang; Jin, Zheng-yu

2010-12-01

To analyze the clinical value of multiple sequences derived from dual-source computed tomography (DSCT) dual-energy scan mode in detecting pancreatic adenocarcinoma. Totally 23 patients with clinically or pathologically diagnosed pancreatic cancer were enrolled in this retrospective study. DSCT (Definition Flash) was used and dual-energy scan mode was used in their pancreatic parenchyma phase scan (100kVp/230mAs and Sn140kVp/178mAs) . Mono-energetic 60kev, mono-energetic 80kev, mono-energetic 100kev, mono-energetic 120kev, linear blend image, non-linear blend image, and iodine map were acquired. pancreatic parenchyma-tumor CT value difference, ratio of tumor to pancreatic parenchyma, and pancreatic parenchyma-tumor contrast to noise ratio were calculated. One-way ANOVA was used for the comparison of diagnostic values of the above eight different dual-energy derived sequences for pancreatic cancer. The pancreatic parenchyma-tumor CT value difference, ratio of tumor to pancreatic parenchyma, and pancreatic parenchyma-tumor contrast to noise ratio were significantly different among eight sequences (P<0.05) . Mono-energetic 60kev image showed the largest parenchyma-tumor CT value [ (77.53 ± 23.42) HU] , and iodine map showed the lowest tumor/parenchyma enhancement ratio (0.39?0.12) and the largest contrast to noise ratio (4.08 ± 1.46) . Multiple sequences can be derived from dual-energy scan mode with DSCT via multiple post-processing methods. Integration of these sequences may further improve the sensitivity of the multislice spiral CT in the diagnosis of pancreatic cancer.

Small-animal CT: Its difference from, and impact on, clinical CT

NASA Astrophysics Data System (ADS)

Ritman, Erik L.

2007-10-01

For whole-body computed tomography (CT) images of small rodents, a voxel resolution of at least 10 -3 mm 3 is needed for scale-equivalence to that currently achieved in clinical CT scanners (˜1 mm 3) in adult humans. These "mini-CT" images generally require minutes rather than seconds to complete a scan. The radiation exposure resulting from these mini-CT scans, while higher than clinical CT scans, is below the level resulting in acute tissue damage. Hence, these scans are useful for performing clinical-type diagnostic and monitoring scans for animal models of disease and their response to treatment. "Micro-CT", with voxel size <10 -5 mm 3, has been useful for imaging isolated, intact organs at an almost cellular level of resolution. Micro-CT has the great advantage over traditional microscopic methods in that it generates detailed three-dimensional images in relatively large, opaque volumes such as an intact rodent heart or kidney. The radiation exposure needed in these scans results in acute tissue damage if used in living animals. Experience with micro-CT is contributing to exploration of new applications for clinical CT imaging by providing insights into different modes of X-ray image formation as follows: Spatial resolution should be sufficient to detect an individual Basic Functional Unit (BFU, the smallest collection of diverse cells, such as hepatic lobule, that behaves like the organ), which requires voxels ˜10 -3 mm 3 in volume, so that the BFUs can be counted. Contrast resolution sufficient to allow quantitation of: New microvascular growth, which manifests as increased tissue contrast due to X-ray contrast agent in those vessels' lumens during passage of injected contrast agent in blood. Impaired endothelial integrity which manifests as increased opacification and delayed washout of contrast from tissues. Discrimination of pathological accumulations of metals such as Fe and Ca, which occur in the arterial wall following hemorrhage or tissue damage. Micro-CT can also be used as a test bed for exploring the utility of several modes of X-ray image formation, such as the use of dual-energy X-ray subtraction, X-ray scatter, phase delay and refraction-based imaging for increasing the contrast amongst soft tissue components. With the recent commercial availability of high speed, multi-slice CT scanners which can be operated in dual-energy mode, some of these micro-CT scanner capabilities and insights are becoming implementable in those CT scanners. As a result, the potential diagnostic spectrum that can be addressed with those scanners is broadened considerably.

Robust lung identification in MSCT via controlled flooding and shape constraints: dealing with anatomical and pathological specificity

NASA Astrophysics Data System (ADS)

Fetita, Catalin; Tarando, Sebastian; Brillet, Pierre-Yves; Grenier, Philippe A.

2016-03-01

Correct segmentation and labeling of lungs in thorax MSCT is a requirement in pulmonary/respiratory disease analysis as a basis for further processing or direct quantitative measures: lung texture classification, respiratory functional simulations, intrapulmonary vascular remodeling evaluation, detection of pleural effusion or subpleural opacities, are only few clinical applications related to this requirement. Whereas lung segmentation appears trivial for normal anatomo-pathological conditions, the presence of disease may complicate this task for fully-automated algorithms. The challenges come either from regional changes of lung texture opacity or from complex anatomic configurations (e.g., thin septum between lungs making difficult proper lung separation). They make difficult or even impossible the use of classic algorithms based on adaptive thresholding, 3-D connected component analysis and shape regularization. The objective of this work is to provide a robust segmentation approach of the pulmonary field, with individualized labeling of the lungs, able to overcome the mentioned limitations. The proposed approach relies on 3-D mathematical morphology and exploits the concept of controlled relief flooding (to identify contrasted lung areas) together with patient-specific shape properties for peripheral dense tissue detection. Tested on a database of 40 MSCT of pathological lungs, the proposed approach showed correct identification of lung areas with high sensitivity and specificity in locating peripheral dense opacities.

Helical cone beam CT with an asymmetrical detector.

PubMed

Zamyatin, Alexander A; Taguchi, Katsuyuki; Silver, Michael D

2005-10-01

If a multislice or other area detector is shifted to one side to cover a larger field of view, then the data are truncated on one side. We propose a method to restore the missing data in helical cone-beam acquisitions that uses measured data on the longer side of the asymmetric detector array. The method is based on the idea of complementary rays, which is well known in fan beam geometry; in this paper we extend this concept to the cone-beam case. Different cases of complementary data coverage and dependence on the helical pitch are considered. The proposed method is used in our prototype 16-row CT scanner with an asymmetric detector and a 700 mm field of view. For evaluation we used scanned body phantom data and computer-simulated data. To simulate asymmetric truncation, the full, symmetric datasets were truncated by dropping either 22.5% or 45% from one side of the detector. Reconstructed images from the prototype scanner with the asymmetrical detector show excellent image quality in the extended field of view. The proposed method allows flexible helical pitch selection and can be used with overscan, short-scan, and super-short-scan reconstructions.

Feasibility of Pathology-Correlated Lung Imaging for Accurate Target Definition of Lung Tumors

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

Stroom, Joep; Blaauwgeers, Hans; Baardwijk, Angela van

2007-09-01

Purpose: To accurately define the gross tumor volume (GTV) and clinical target volume (GTV plus microscopic disease spread) for radiotherapy, the pretreatment imaging findings should be correlated with the histopathologic findings. In this pilot study, we investigated the feasibility of pathology-correlated imaging for lung tumors, taking into account lung deformations after surgery. Methods and Materials: High-resolution multislice computed tomography (CT) and positron emission tomography (PET) scans were obtained for 5 patients who had non-small-cell lung cancer (NSCLC) before lobectomy. At the pathologic examination, the involved lung lobes were inflated with formalin, sectioned in parallel slices, and photographed, and microscopic sectionsmore » were obtained. The GTVs were delineated for CT and autocontoured at the 42% PET level, and both were compared with the histopathologic volumes. The CT data were subsequently reformatted in the direction of the macroscopic sections, and the corresponding fiducial points in both images were compared. Hence, the lung deformations were determined to correct the distances of microscopic spread. Results: In 4 of 5 patients, the GTV{sub CT} was, on average, 4 cm{sup 3} ({approx}53%) too large. In contrast, for 1 patient (with lymphangitis carcinomatosa), the GTV{sub CT} was 16 cm{sup 3} ({approx}40%) too small. The GTV{sub PET} was too small for the same patient. Regarding deformations, the volume of the well-inflated lung lobes on pathologic examination was still, on average, only 50% of the lobe volume on CT. Consequently, the observed average maximal distance of microscopic spread (5 mm) might, in vivo, be as large as 9 mm. Conclusions: Our results have shown that pathology-correlated lung imaging is feasible and can be used to improve target definition. Ignoring deformations of the lung might result in underestimation of the microscopic spread.« less

Comparative performance analysis for computer aided lung nodule detection and segmentation on ultra-low-dose vs. standard-dose CT

NASA Astrophysics Data System (ADS)

Wiemker, Rafael; Rogalla, Patrik; Opfer, Roland; Ekin, Ahmet; Romano, Valentina; Bülow, Thomas

2006-03-01

The performance of computer aided lung nodule detection (CAD) and computer aided nodule volumetry is compared between standard-dose (70-100 mAs) and ultra-low-dose CT images (5-10 mAs). A direct quantitative performance comparison was possible, since for each patient both an ultra-low-dose and a standard-dose CT scan were acquired within the same examination session. The data sets were recorded with a multi-slice CT scanner at the Charite university hospital Berlin with 1 mm slice thickness. Our computer aided nodule detection and segmentation algorithms were deployed on both ultra-low-dose and standard-dose CT data without any dose-specific fine-tuning or preprocessing. As a reference standard 292 nodules from 20 patients were visually identified, each nodule both in ultra-low-dose and standard-dose data sets. The CAD performance was analyzed by virtue of multiple FROC curves for different lower thresholds of the nodule diameter. For nodules with a volume-equivalent diameter equal or larger than 4 mm (149 nodules pairs), we observed a detection rate of 88% at a median false positive rate of 2 per patient in standard-dose images, and 86% detection rate in ultra-low-dose images, also at 2 FPs per patient. Including even smaller nodules equal or larger than 2 mm (272 nodules pairs), we observed a detection rate of 86% in standard-dose images, and 84% detection rate in ultra-low-dose images, both at a rate of 5 FPs per patient. Moreover, we observed a correlation of 94% between the volume-equivalent nodule diameter as automatically measured on ultra-low-dose versus on standard-dose images, indicating that ultra-low-dose CT is also feasible for growth-rate assessment in follow-up examinations. The comparable performance of lung nodule CAD in ultra-low-dose and standard-dose images is of particular interest with respect to lung cancer screening of asymptomatic patients.

Investigation of relation between visceral and subcutaneous abdominal fat volumes and calcified aortic plaques via multislice computed tomography.

PubMed

Efe, Duran; Aygün, Fatih; Acar, Türker; Yildiz, Melda; Gemici, Kazım

2015-08-01

The present study investigated effect of subcutaneous fat volume and abdominal visceral fat volume on aortic atherosclerosis via multislice computed tomography. The present study comprised 424 subjects who underwent non-contrast-enhanced abdominal CT in our clinic between June 2012 and June 2013. Using dedicated software visceral fat volume was calculated for each individual and then subcutaneous fat volume was calculated by subtracting visceral fat volume from total fat volume. By dividing visceral fat volume/subcutaneous fat volume participants were assigned to three groups according to their mean visceral fat volume/subcutaneous fat volume: Group 1 consisted of subjects with visceral fat volume/subcutaneous fat volume lower than 0.48 (Group 1 < 0.48); Group 2 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.48 and lower than 0.69 (0.48 ≤ Group 2 < 0.69); and Group 3 consisted of subjects with visceral fat volume/subcutaneous fat volume equal to or higher than 0.69 (Group 3 ≥ 0.69). The mean abdominal aortic calcium scores according to Agatston scoring (au) were 136.8 ± 418.7 au in Group 1, 179.9 ± 463 au in Group 2 and 212.2 ± 486.9 in Group 3, respectively. We have demonstrated a significant correlation between visceral fat volume and abdominal aorta atherosclerosis, while there was absence of significant correlation between subcutaneous fat volume and abdominal atherosclerosis. © The Author(s) 2014.

Comparison of sequential left internal thoracic artery grafting and separate left internal thoracic artery and venous grafting : A 5-year follow-up.

PubMed

Wendt, D; Schmidt, D; Wasserfuhr, D; Osswald, B; Thielmann, M; Tossios, P; Kühl, H; Jakob, H; Massoudy, P

2010-09-01

The superiority of left internal thoracic artery (LITA) grafting to the left anterior descending artery (LAD) is well established. Patency rates of 80%-90% have been reported at 10-year follow-up. However, the superiority of sequential LITA grafting has not been proven. Our aim was to compare patency rates after sequential LITA grafting to a diagonal branch and the LAD with patency rates of LITA grafting to the LAD and separate vein grafting to a diagonal branch. A total of 58 coronary artery bypass graft (CABG) patients, operated on between 01/2000 and 12/2002, underwent multi-slice computed tomography (MSCT) between 2006 and 2008. Of these patients, 29 had undergone sequential LITA grafting to a diagonal branch and to the LAD ("Sequential" Group), while in 29 the LAD and a diagonal branch were separately grafted with LITA and vein ("Separate" Group). Patencies of all anastomoses were investigated. Mean follow-up was 1958±208 days. The patency rate of the LAD anastomosis was 100% in the Sequential Group and 93% in the Separate Group (p=0.04). The patency rate of the diagonal branch anastomosis was 100% in the Sequential Group and 89% in the Separate Group (p=0.04). Mean intraoperative flow on LITA graft was not different between groups (69±8ml/min in the Sequential Group and 68±9ml/min in the Separate Group, p=n.s.). Patency rates of both the LAD and the diagonal branch anastomoses were higher after sequential arterial grafting compared with separate arterial and venous grafting at 5-year follow-up. This indicates that, with regard to the antero-lateral wall of the left ventricle, there is an advantage to sequential arterial grafting compared with separate arterial and venous grafting.

The effect of width of facial canal in patients with idiopathic peripheral facial paralysis on the development of paralysis.

PubMed

Eksi, Guldem; Akbay, Ercan; Bayarogullari, Hanifi; Cevik, Cengiz; Yengil, Erhan; Ozler, Gul Soylu

2015-09-01

The aim of this prospective study is to investigate whether the possible stenosis due to anatomic variations of labyrinthine segment (LS), tympanic segment (TS) and mastoid segment (MS) of the facial canal in the temporal bone is a predisposing factor in the development of paralysis. 22 patients with idiopathic peripheral facial paralysis (IPFP) were included in the study. Multi-slice computed tomography (MSCT) with 64 detectors was used for temporal bone imaging of the patients. Reconstruction images in axial, coronal and sagittal planes were created in workstation computers from the captured images. The diameters and lengths of LS, TS and MS of the facial canal were measured. The mean values of LD, ND and SL of LS were 1.31 ± 0.39, 0.91 ± 0.27, 4.17 ± 0.48 in patient group and 1.26 ± 0.29, 0.95 ± 0.21, 4.60 ± 1.36 in control group, respectively. The mean values of LD, ND and SL of TS were 1.11 ± 0.22, 0.90 ± 0.14, 12.63 ± 1.47 in patient group and 1.17 ± 0.23, 0.85 ± 0.24, 12.10 ± 1.79 in control group, respectively. The mean values of LD, ND and SL of MS were 1.80 ± 0.30, 1.44 ± 0.29 vs. 14.3 ± 1.90 in patient group 1.74 ± 0.38, 1.40 ± 0.29, 14.15 ± 2.16 in control group, respectively. The measurements of the parameters of all three segments in patient group and control group were similar. Similar results between patient and control group were obtained in this study investigating the effect of stenosis in facial canal in the development of IPFP.

Virtopsy: postmortem imaging of laryngeal foreign bodies.

PubMed

Oesterhelweg, Lars; Bolliger, Stephan A; Thali, Michael J; Ross, Steffen

2009-05-01

Death from corpora aliena in the larynx is a well-known entity in forensic pathology. The correct diagnosis of this cause of death is difficult without an autopsy, and misdiagnoses by external examination alone are common. To determine the postmortem usefulness of modern imaging techniques in the diagnosis of foreign bodies in the larynx, multislice computed tomography, magnetic resonance imaging, and postmortem full-body computed tomography-angiography were performed. Three decedents with a suspected foreign body in the larynx underwent the 3 different imaging techniques before medicolegal autopsy. Multislice computed tomography has a high diagnostic value in the noninvasive localization of a foreign body and abnormalities in the larynx. The differentiation between neoplasm or soft foreign bodies (eg, food) is possible, but difficult, by unenhanced multislice computed tomography. By magnetic resonance imaging, the discrimination of the soft tissue structures and soft foreign bodies is much easier. In addition to the postmortem multislice computed tomography, the combination with postmortem angiography will increase the diagnostic value. Postmortem, cross-sectional imaging methods are highly valuable procedures for the noninvasive detection of corpora aliena in the larynx.

Cartwheel projections of segmented pulmonary vasculature for the detection of pulmonary embolism

NASA Astrophysics Data System (ADS)

Kiraly, Atilla P.; Naidich, David P.; Novak, Carol L.

2005-04-01

Pulmonary embolism (PE) detection via contrast-enhanced computed tomography (CT) images is an increasingly important topic of research. Accurate identification of PE is of critical importance in determining the need for further treatment. However, current multi-slice CT scanners provide datasets typically containing 600 or more images per patient, making it desirable to have a visualization method to help radiologists focus directly on potential candidates that might otherwise have been overlooked. This is especially important when assessing the ability of CT to identify smaller, sub-segmental emboli. We propose a cartwheel projection approach to PE visualization that computes slab projections of the original data aided by vessel segmentation. Previous research on slab visualization for PE has utilized the entire volumetric dataset, requiring thin slabs and necessitating the use of maximum intensity projection (MIP). Our use of segmentation within the projection computation allows the use of thicker slabs than previous methods, as well as the ability to employ visualization variations that are only possible with segmentation. Following automatic segmentation of the pulmonary vessels, slabs may be rotated around the X-, Y- or Z-axis. These slabs are rendered by preferentially using voxels within the lung vessels. This effectively eliminates distracting information not relevant to diagnosis, lessening both the chance of overlooking a subtle embolus and minimizing time on spent evaluating false positives. The ability to employ thicker slabs means fewer images need to be evaluated, yielding a more efficient workflow.

Is the corticomedullary index valid to distinguish human from nonhuman bones: a multislice computed tomography study.

PubMed

Rérolle, Camille; Saint-Martin, Pauline; Dedouit, Fabrice; Rousseau, Hervé; Telmon, Norbert

2013-09-10

The first step in the identification process of bone remains is to determine whether they are of human or nonhuman origin. This issue may arise when only a fragment of bone is available, as the species of origin is usually easily determined on a complete bone. The present study aims to assess the validity of a morphometric method used by French forensic anthropologists to determine the species of origin: the corticomedullary index (CMI), defined by the ratio of the diameter of the medullary cavity to the total diameter of the bone. We studied the constancy of the CMI from measurements made on computed tomography images (CT scans) of different human bones, and compared our measurements with reference values selected in the literature. The measurements obtained on CT scans at three different sites of 30 human femurs, 24 tibias, and 24 fibulas were compared between themselves and with the CMI reference values for humans, pigs, dogs and sheep. Our results differed significantly from these reference values, with three exceptions: the proximal quarter of the femur and mid-fibular measurements for the human CMI, and the proximal quarter of the tibia for the sheep CMI. Mid-tibial, mid-femoral, and mid-fibular measurements also differed significantly between themselves. Only 22.6% of CT scans of human bones were correctly identified as human. We concluded that the CMI is not an effective method for determining the human origin of bone remains. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Experimental verification of using nanostructured ceramic implants and osteograft

NASA Astrophysics Data System (ADS)

Rerikh, V. V.; Lastevskiy, A. D.; Sadovoy, M. A.; Zaidman, A. M.; Bataev, A. V.; Predein, Yu. A.; Avetisyan, A. R.; Romanenko, V. V.; Mamonova, E. V.; Nikulina, A. A.; Semantsova, E. S.; Smirnov, A. I.

2017-09-01

Ventral interbody fusion was carried out in 8 mini pigs in order to determine the effectiveness of anterior stabilization of the vertebral unit with implants made of nanostructured alumina ceramics using cellular technologies to form a bone block. A ceramic cage with a through cylindrical orifice in the center was implanted into the interbody gap; either cellular osteograft (group 1) or cellular autograft (group 2) was placed in it. The adjacent vertebrae were fixed anteriorly with a ceramic plate containing 4 screws. Bone block formation was studied radiographically, morphologically, and by MSCT. The signs of osteointegration of ceramic implants were observed in both groups after 90 days. MSCT and morphological analysis revealed the formation of the osteoceramic block and completed osteogenesis in the bone-graft contact region in group 1 compared to the control group (p < 0.05).

Calcium score of coronary artery stratifies the risk of obstructive coronary artery diseases.

PubMed

Ibrahim, O; Oteh, M; Anwar, I R; Che Hassan, H H; Choor, C K; Hamzaini, A H; Rahman, M M

2013-01-01

Coronary heart disease is a major health problem in Malaysia with high morbidity and mortality. Common primary screening tool of cardiovascular risk stratification is exercise treadmill test (ETT). This communication is to determine the performance of coronary artery calcium score a new method to stratify the presence of obstructive coronary artery disease (CAD) in comparison to traditional ETT in patients having coronary artery diseases. Patients between 30 to 60 years old attended the ETT to screen for ischemic heart disease were recruited for Agatston coronary artery calcium score (CACS) of multi-sliced computed tomography (MSCT). Subsequently all patients underwent a full MSCT coronary angiography. The major determinant was the state of CAD whether obstructive (50% stenosis or more) or non-obstructive (less than 50% stenosis). All patients diagnosed with obstructive CAD on MSCT coronary angiogram were subjected to invasive coronary angiogram (ICA) to confirm the findings and planned the need for revascularization. The CACS was 100% sensitivity and 97.5% specificity in detecting obstructive CAD at the optimal cut-off value of 106.5 and above. The positive predictive value (PPV) at CACS ≥ 106 was 71.4% and the negative predictive value (NPV) was consistent at 100%. Compare to ETT, the CACS discriminative value and diagnostic performance was much better (PPV 71.4% vs. 45.5%), respectively. CACS can be a good diagnostic screening tool in patients suspected of CAD, and particularly within the non-diagnostic ETT subgroup with low to moderate cardiovascular risks.

Estimation of the weighted CTDI{sub {infinity}} for multislice CT examinations

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

Li Xinhua; Zhang Da; Liu, Bob

2012-02-15

Purpose: The aim of this study was to examine the variations of CT dose index (CTDI) efficiencies, {epsilon}(CTDI{sub 100})=CTDI{sub 100}/CTDI{sub {infinity}}, with bowtie filters and CT scanner types. Methods: This was an extension of our previous study [Li, Zhang, and Liu, Phys. Med. Biol. 56, 5789-5803 (2011)]. A validated Monte Carlo program was used to calculate {epsilon}(CTDI{sub 100}) on a Siemens Somatom Definition scanner. The {epsilon}(CTDI{sub 100}) dependencies on tube voltages and beam widths were tested in previous studies. The influences of different bowtie filters and CT scanner types were examined in this work. The authors tested the variations ofmore » {epsilon}(CTDI{sub 100}) with bowtie filters on the Siemens Definition scanner. The authors also analyzed the published CTDI measurements of four independent studies on five scanners of four models from three manufacturers. Results: On the Siemens Definition scanner, the difference in {epsilon}(CTDI{sub W}) between using the head and body bowtie filters was 2.5% (maximum) in the CT scans of the 32-cm phantom, and 1.7% (maximum) in the CT scans of the 16-cm phantom. Compared with CTDI{sub W}, the weighted CTDI{sub {infinity}} increased by 30.5% (on average) in the 32-cm phantom, and by 20.0% (on average) in the 16-cm phantom. These results were approximately the same for 80-140 kV and 1-40 mm beam widths (4.2% maximum deviation). The differences in {epsilon}(CTDI{sub 100}) between the simulations and the direct measurements of four previous studies were 1.3%-5.0% at the center/periphery of the 16-cm/32-cm phantom (on average). Conclusions: Compared with CTDI{sub vol}, the equilibrium dose for large scan lengths is 30.5% higher in the 32-cm phantom, and is 20.0% higher in the 16-cm phantom. The relative increases are practically independent of tube voltages (80-140 kV), beam widths (up to 4 cm), and the CT scanners covered in this study.« less

Tracheal Self-Expandable Metallic Stents: A Comparative Study of Three Different Stents in a Rabbit Model.

PubMed

Serrano, Carolina; Lostalé, Fernando; Rodríguez-Panadero, Francisco; Blas, Ignacio de; Laborda, Alicia; de Gregorio, Miguel Angel

2016-03-01

The objective of this study was to assess tracheal reactivity after the deployment of different self-expandable metal stents (SEMS). Forty female New Zealand rabbits were divided into four groups. Three groups received three different SEMS: steel (ST), nitinol (NiTi), or nitinol drug-eluting stent (DES); the fourth group was the control group (no stent). Stents were deployed percutaneously under fluoroscopic guidance. Animals were assessed by multi-slice, computed tomography (CT) scans, and tracheas were collected for anatomical pathology (AP) study. Data from CT and AP were statistically analyzed and correlated. The DES group had the longest stenosis (20.51±14.08mm vs. 5.84±12.43 and 6.57±6.54mm in NiTi and ST, respectively, day 30; P<.05), and higher granuloma formation on CT (50% of cases). The NiTi group showed the lowest grade of stenosis (2.86±6.91% vs. 11.28±13.98 and 15.54±25.95% in DES and ST, respectively; P<.05). The AP study revealed that the ST group developed intense proliferative reactivity compared to the other groups. In the DES group, a destructive response was observed in 70% of the animals, while the NiTi was the least reactive stent. CT was more effective in detecting wall thickening (positive correlation of 68.9%; P<.001) than granuloma (not significant). The ST group developed granulomas and significant stenosis. NiTi was the least reactive stent, while DES caused significant lesions that may be related to drug dosage. This type of DES stent is therefore not recommended for the treatment of tracheobronchial stenosis. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

[Comparison of projection radiography and computed tomography for the detection of pulmonary nodules in the dog and cat].

PubMed

Niesterok, C; Köhler, C; Ludewig, E; Alef, M; Oechtering, G; Kiefer, I

2013-01-01

The aim of our study was to evaluate the value of projection radiography as a standard screening method for the detection of lung nodules compared to computed tomography (CT). Furthermore, we attempted to describe the reasons that might lead to a failed detection of pulmonary nodules in radiography. From dogs and cats which were diagnosed in CT (multislice CT) with nodular changes in the lung pattern we selected radiographs (projection radiography with soft copy reading) in at least two projection planes produced in the same timeframe as the CT images. Exclusion criteria were nodules > 3 cm and homogenously calcified nodules (osteomata). A total of 70 animals (50 dogs and 20 cats) met the inclusion criteria. In 43 animals (61%), nodular changes had already been detected using radiography and were then confirmed by the results of the computed tomography. In detail, 32 of 50 dogs (64%) and 11 of 20 cats (55%) showed nodular lesions in the radiographs. In cats, undetected nodules were often accompanied by highly changed lung opacities, resulting in a poor contrast of the lung. In dogs the reasons for a failed detection of lung nodules were relatively equally distributed to several causes. Interestingly, small nodule size itself was not the predominant reason for missing the nodules in radiographs. In general, radiography still plays an important role as a screening method for the detection of nodular lung lesions. However, one needs to be aware, that a quite high percentage of nodular lung changes can be missed in radiographs. The overall detection rate in this study was 61%. Furthermore, we showed that plane radiographs are of poor diagnostic value when concurrent problems exist which lead to increased lung opacity.

Electromagnetic navigation technology for more precise electrode placement in the foramen ovale: a technical report.

PubMed

Van Buyten, Jean-Pierre; Smet, Iris; Van de Kelft, Erik

2009-07-01

Introduction. Interventional pain management techniques require precise positioning of needles or electrodes, therefore fluoroscopic control is mandatory. This imaging technique does however not visualize soft tissues such as blood vessels. Moreover, patient and physician are exposed to a considerable dose of radiation. Computed tomography (CT)-scans give a better view of soft tissues, but there use requires presence of a radiologist and has proven to be laborious and time consuming. Objectives. This study is to develop a technique using electromagnetic (EM) navigation as a guidance technique for interventional pain management, using CT and/or magnetic resonance (MRI) images uploaded on the navigation station. Methods. One of the best documented interventional procedures for the management of trigeminal neuralgia is percutaneous radiofrequency treatment of the Gasserian ganglion. EM navigation software for intracranial applications already exists. We developed a technique using a stylet with two magnetic coils suitable for EM navigation. The procedure is followed in real time on a computer screen where the patient's multislice CT-scan images and three-dimensional reconstruction of his face are uploaded. Virtual landmarks on the screen are matched with those on the patient's face, calculating the precision of the needle placement. Discussion. The experience with EM navigation acquired with the radiofrequency technique can be transferred to other interventional pain management techniques, for instance, for the placement of a neuromodulation electrode close to the Gasserian ganglion. Currently, research is ongoing to extend the software of the navigation station for spinal application, and to adapt neurostimulation hardware to the EM navigation technology. This technology will allow neuromodulation techniques to be performed without x-ray exposure for the patient and the physician, and this with the precision of CT/MR imaging guidance. © 2009 International Neuromodulation Society.

Characterization of optically stimulated luminescence dosimeters and investigating their potential for estimating pediatric organ doses in multi-slice computed tomography

NASA Astrophysics Data System (ADS)

Al-Senan, Rani Mohammed

Recent epidemiologic studies have shown a strong association between the relatively high doses of pediatric CT and the risk of cancer. Quantifying organ doses, as a measure of the risk, is commonly based on either direct anthropomorphic phantom measurements or Monte Carlo simulation. The major disadvantage in the phantom approach is its high cost especially that, for pediatric CT dosimetry, various phantom sizes are required to represent different age groups of children. On the other hand, Monte Carlo simulation, although not considered costly, requires validation by anthropomorphic phantom measurements. The aim of this project was to develop two methods of organ dose estimation in pediatric CT: 1) from the measured surface dose using optically stimulated luminescence dosimeters (OSLDs) and 2) by measuring the circumference of the body part being scanned as well as knowing the scan parameters. The project was based on a study proposed by the surgery department to monitor radiation exposure to children during their CT examination in the ER. A total of 200 pediatric patients were enrolled in this study which used OSLDs to monitor the doses. Specific aim 1 of this project was to characterize the OSLDs in the diagnostic energy range. Specific aim 2(a) was to find relationships between the patients' doses from OSLDs and both scan CTDI and the measured circumference. In specific aim 2(b) we carried out measurements using CTDI phantoms to investigate the relationships studied in specific aim 2(a). Specific aim 3 was to come up with models to estimate select organ doses from measuring surface dose or by using the circumference of the body part. To do this, pediatric examinations were simulated using a set of pediatric anthropomorphic phantoms in which doses of select organs were measured.

Organ and effective doses in newborn patients during helical multislice computed tomography examination

NASA Astrophysics Data System (ADS)

Staton, Robert J.; Lee, Choonik; Lee, Choonsik; Williams, Matt D.; Hintenlang, David E.; Arreola, Manuel M.; Williams, Jonathon L.; Bolch, Wesley E.

2006-10-01

In this study, two computational phantoms of the newborn patient were used to assess individual organ doses and effective doses delivered during head, chest, abdomen, pelvis, and torso examinations using the Siemens SOMATOM Sensation 16 helical multi-slice computed tomography (MSCT) scanner. The stylized phantom used to model the patient anatomy was the revised ORNL newborn phantom by Han et al (2006 Health Phys.90 337). The tomographic phantom used in the study was that developed by Nipper et al (2002 Phys. Med. Biol. 47 3143) as recently revised by Staton et al (2006 Med. Phys. 33 3283). The stylized model was implemented within the MCNP5 radiation transport code, while the tomographic phantom was incorporated within the EGSnrc code. In both codes, the x-ray source was modelled as a fan beam originating from the focal spot at a fan angle of 52° and a focal-spot-to-axis distance of 57 cm. The helical path of the source was explicitly modelled based on variations in collimator setting (12 mm or 24 mm), detector pitch and scan length. Tube potentials of 80, 100 and 120 kVp were considered in this study. Beam profile data were acquired using radiological film measurements on a 16 cm PMMA phantom, which yielded effective beam widths of 14.7 mm and 26.8 mm for collimator settings of 12 mm and 24 mm, respectively. Values of absolute organ absorbed dose were determined via the use of normalization factors defined as the ratio of the CTDI100 measured in-phantom and that determined by Monte Carlo simulation of the PMMA phantom and ion chamber. Across various technique factors, effective dose differences between the stylized and tomographic phantoms ranged from +2% to +9% for head exams, -4% to -2% for chest exams, +8% to +24% for abdominal exams, -16% to -12% for pelvic exams and -7% to 0% for chest-abdomen-pelvis (CAP) exams. In many cases, however, relatively close agreement in effective dose was accomplished at the expense of compensating errors in individual organ dose. Per cent differences in organ dose between the stylized and tomographic phantoms at 120 kVp and 12 mm collimator setting ranged from -25% (skin) to +164% (muscle) for head exams, -92% (thyroid) to +98% (ovaries) for chest exams, -144% (uterus) to +112% (ovaries) for abdominal exams, -98% (SI wall) to +20% (thymus) for pelvic exams and -60% (extrathoracic airways) to +13% (ovaries) for CAP exams. Better agreement was seen between the two phantom types for organs entirely within the scan field. In these cases, corresponding per cent differences in organ absorbed dose did not vary more than 17%. For all scans, the effective dose was found to range approximately 1-13 mSv across the scan parameters and scan regions. The largest effective dose occurred for CAP scans at 120 kVp.

Multislice 1H magnetic resonance spectroscopic imaging: assessment of epilepsy, Alzheimer's disease, and amyotrophic lateral sclerosis

NASA Astrophysics Data System (ADS)

Weiner, Michael W.; Maudsley, Andrew A.; Schuff, Norbert; Soher, Brian J.; Vermathen, Peter P.; Fein, George; Laxer, Kenneth D.

1998-07-01

Proton magnetic resonance spectroscopic imaging (1H MRSI) with volume pre-selection (i.e. by PRESS) or multislice 1H MRSI was used to investigate changes in brain metabolites in Alzheimer's disease, epilepsy, and amyotrophic lateral sclerosis. Examples of results from several ongoing clinical studies are provided. Multislice 1H MRSI of the human brain, without volume pre-selection offers considerable advantages over previously available techniques. Furthermore, MRI tissue segmentation and completely automated spectra curve fitting greatly facilitate quantitative data analysis. Future efforts will be devoted to obtaining full brain coverage and data acquisition at short spin echo times (TE less than 30 ms) for the detection of metabolites with short T2 relaxation times.

Dysphagia lusorium in elderly: A case report

PubMed Central

Kantarceken, Bulent; Bulbuloglu, Ertan; Yuksel, Murvet; Cetinkaya, Ali

2004-01-01

AIM: Late unset of dysphagia due to vascular abnormalities is a rare condition. We aimed to present a case of right subclavian artery abnormalities caused dysphagia in the elderly. METHODS: A 68-year-old female was admitted with dysphagia seven months ago. Upper endoscopic procedures and routine examinations could not demonstrate any etiology. Multislice computed thorax tomography was performed for probable extra- esophagial lesions. RESULTS: Multislice computed thorax tomography showed right subclavian artery abnormality and esophagial compression with this aberrant artery. CONCLUSION: Causes of dysphagia in the elderly are commonly malignancies, strictures and/or motility disorders. If routine examinations and endoscopic procedures fail to show any etiology, rare vascular abnormalities can be considered in such patients. Multislice computed tomography is a usefull choice in such conditions. PMID:15285045

Estimating local noise power spectrum from a few FBP-reconstructed CT scans

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

Zeng, Rongping, E-mail: rongping.zeng@fda.hhs.gov; Gavrielides, Marios A.; Petrick, Nicholas

Purpose: Traditional ways to estimate 2D CT noise power spectrum (NPS) involve an ensemble average of the power spectrums of many noisy scans. When only a few scans are available, regions of interest are often extracted from different locations to obtain sufficient samples to estimate the NPS. Using image samples from different locations ignores the nonstationarity of CT noise and thus cannot accurately characterize its local properties. The purpose of this work is to develop a method to estimate local NPS using only a few fan-beam CT scans. Methods: As a result of FBP reconstruction, the CT NPS has themore » same radial profile shape for all projection angles, with the magnitude varying with the noise level in the raw data measurement. This allows a 2D CT NPS to be factored into products of a 1D angular and a 1D radial function in polar coordinates. The polar separability of CT NPS greatly reduces the data requirement for estimating the NPS. The authors use this property and derive a radial NPS estimation method: in brief, the radial profile shape is estimated from a traditional NPS based on image samples extracted at multiple locations. The amplitudes are estimated by fitting the traditional local NPS to the estimated radial profile shape. The estimated radial profile shape and amplitudes are then combined to form a final estimate of the local NPS. We evaluate the accuracy of the radial NPS method and compared it to traditional NPS methods in terms of normalized mean squared error (NMSE) and signal detectability index. Results: For both simulated and real CT data sets, the local NPS estimated with no more than six scans using the radial NPS method was very close to the reference NPS, according to the metrics of NMSE and detectability index. Even with only two scans, the radial NPS method was able to achieve a fairly good accuracy. Compared to those estimated using traditional NPS methods, the accuracy improvement was substantial when a few scans were available. Conclusions: The radial NPS method was shown to be accurate and efficient in estimating the local NPS of FBP-reconstructed 2D CT images. It presents strong advantages over traditional NPS methods when the number of scans is limited and can be extended to estimate the in-plane NPS of cone-beam CT and multislice helical CT scans.« less

Imaging of pediatric great vessel stents: Computed tomography or magnetic resonance imaging?

PubMed Central

van Hamersvelt, R. W.; Budde, R. P. J.; de Jong, P. A.; Schilham, A. M. R.; Bos, C.; Breur, J. M. P. J.; Leiner, T.

2017-01-01

Background Complications might occur after great vessel stent implantation in children. Therefore follow-up using imaging is warranted. Purpose To determine the optimal imaging modality for the assessment of stents used to treat great vessel obstructions in children. Material and methods Five different large vessel stents were evaluated in an in-vitro setting. All stents were expanded to the maximal vendor recommended diameter (20mm; n = 4 or 10mm; n = 1), placed in an anthropomorphic chest phantom and imaged with a 256-slice CT-scanner. MRI images were acquired at 1.5T using a multi-slice T2-weighted turbo spin echo, an RF-spoiled three-dimensional T1-weighted Fast Field Echo and a balanced turbo field echo 3D sequence. Two blinded observers assessed stent lumen visibility (measured diameter/true diameter *100%) in the center and at the outlets of the stent. Reproducibility of diameter measurements was evaluated using the intraclass correlation coefficient for reliability and 95% limits of agreement for agreement analysis. Results Median stent lumen visibility was 88 (IQR 86–90)% with CT for all stents at both the center and outlets. With MRI, the T2-weighted turbo spin echo sequence was preferred which resulted in 82 (78–84%) stent lumen visibility. Interobserver reliability and agreement was good for both CT (ICC 0.997, mean difference -0.51 [-1.07–0.05] mm) and MRI measurements (ICC 0.951, mean difference -0.05 [-2.52 –-2.41] mm). Conclusion Good in-stent lumen visibility was achievable in this in-vitro study with both CT and MRI in different great vessel stents. Overall reliability was good with clinical acceptable limits of agreement for both CT and MRI. However, common conditions such as in-stent stenosis and associated aneurysms were not tested in this in-vitro study, limiting the value of the in-vitro study. PMID:28141852

Body composition estimation from selected slices: equations computed from a new semi-automatic thresholding method developed on whole-body CT scans

PubMed Central

Villa, Chiara; Brůžek, Jaroslav

2017-01-01

Background Estimating volumes and masses of total body components is important for the study and treatment monitoring of nutrition and nutrition-related disorders, cancer, joint replacement, energy-expenditure and exercise physiology. While several equations have been offered for estimating total body components from MRI slices, no reliable and tested method exists for CT scans. For the first time, body composition data was derived from 41 high-resolution whole-body CT scans. From these data, we defined equations for estimating volumes and masses of total body AT and LT from corresponding tissue areas measured in selected CT scan slices. Methods We present a new semi-automatic approach to defining the density cutoff between adipose tissue (AT) and lean tissue (LT) in such material. An intra-class correlation coefficient (ICC) was used to validate the method. The equations for estimating the whole-body composition volume and mass from areas measured in selected slices were modeled with ordinary least squares (OLS) linear regressions and support vector machine regression (SVMR). Results and Discussion The best predictive equation for total body AT volume was based on the AT area of a single slice located between the 4th and 5th lumbar vertebrae (L4-L5) and produced lower prediction errors (|PE| = 1.86 liters, %PE = 8.77) than previous equations also based on CT scans. The LT area of the mid-thigh provided the lowest prediction errors (|PE| = 2.52 liters, %PE = 7.08) for estimating whole-body LT volume. We also present equations to predict total body AT and LT masses from a slice located at L4-L5 that resulted in reduced error compared with the previously published equations based on CT scans. The multislice SVMR predictor gave the theoretical upper limit for prediction precision of volumes and cross-validated the results. PMID:28533960

Imaging of pediatric great vessel stents: Computed tomography or magnetic resonance imaging?

PubMed

den Harder, A M; Suchá, D; van Hamersvelt, R W; Budde, R P J; de Jong, P A; Schilham, A M R; Bos, C; Breur, J M P J; Leiner, T

2017-01-01

Complications might occur after great vessel stent implantation in children. Therefore follow-up using imaging is warranted. To determine the optimal imaging modality for the assessment of stents used to treat great vessel obstructions in children. Five different large vessel stents were evaluated in an in-vitro setting. All stents were expanded to the maximal vendor recommended diameter (20mm; n = 4 or 10mm; n = 1), placed in an anthropomorphic chest phantom and imaged with a 256-slice CT-scanner. MRI images were acquired at 1.5T using a multi-slice T2-weighted turbo spin echo, an RF-spoiled three-dimensional T1-weighted Fast Field Echo and a balanced turbo field echo 3D sequence. Two blinded observers assessed stent lumen visibility (measured diameter/true diameter *100%) in the center and at the outlets of the stent. Reproducibility of diameter measurements was evaluated using the intraclass correlation coefficient for reliability and 95% limits of agreement for agreement analysis. Median stent lumen visibility was 88 (IQR 86-90)% with CT for all stents at both the center and outlets. With MRI, the T2-weighted turbo spin echo sequence was preferred which resulted in 82 (78-84%) stent lumen visibility. Interobserver reliability and agreement was good for both CT (ICC 0.997, mean difference -0.51 [-1.07-0.05] mm) and MRI measurements (ICC 0.951, mean difference -0.05 [-2.52 --2.41] mm). Good in-stent lumen visibility was achievable in this in-vitro study with both CT and MRI in different great vessel stents. Overall reliability was good with clinical acceptable limits of agreement for both CT and MRI. However, common conditions such as in-stent stenosis and associated aneurysms were not tested in this in-vitro study, limiting the value of the in-vitro study.

Evaluation of an X-Ray Dose Profile Derived from an Optically Stimulated Luminescent Dosimeter during Computed Tomographic Fluoroscopy.

PubMed

Hasegawa, Hiroaki; Sato, Masanori; Tanaka, Hiroshi

2015-01-01

The purpose of this study was to evaluate scatter radiation dose to the subject surface during X-ray computed tomography (CT) fluoroscopy using the integrated dose ratio (IDR) of an X-ray dose profile derived from an optically stimulated luminescent (OSL) dosimeter. We aimed to obtain quantitative evidence supporting the radiation protection methods used during previous CT fluoroscopy. A multislice CT scanner was used to perform this study. OSL dosimeters were placed on the top and the lateral side of the chest phantom so that the longitudinal direction of dosimeters was parallel to the orthogonal axis-to-slice plane for measurement of dose profiles in CT fluoroscopy. Measurement of fluoroscopic conditions was performed at 120 kVp and 80 kVp. Scatter radiation dose was evaluated by calculating the integrated dose determined by OSL dosimetry. The overall percent difference of the integrated doses between OSL dosimeters and ionization chamber was 5.92%. The ratio of the integrated dose of a 100-mm length area to its tails (-50 to -6 mm, 50 to 6 mm) was the lowest on the lateral side at 80 kVp and the highest on the top at 120 kVp. The IDRs for different measurement positions were larger at 120 kVp than at 80 kVp. Similarly, the IDRs for the tube voltage between the primary X-ray beam and scatter radiation was larger on the lateral side than on the top of the phantom. IDR evaluation suggested that the scatter radiation dose has a high dependence on the position and a low dependence on tube voltage relative to the primary X-ray beam for constant dose rate fluoroscopic conditions. These results provided quantitative evidence supporting the radiation protection methods used during CT fluoroscopy in previous studies.

Evaluation of an X-Ray Dose Profile Derived from an Optically Stimulated Luminescent Dosimeter during Computed Tomographic Fluoroscopy

PubMed Central

Hasegawa, Hiroaki; Sato, Masanori; Tanaka, Hiroshi

2015-01-01

The purpose of this study was to evaluate scatter radiation dose to the subject surface during X-ray computed tomography (CT) fluoroscopy using the integrated dose ratio (IDR) of an X-ray dose profile derived from an optically stimulated luminescent (OSL) dosimeter. We aimed to obtain quantitative evidence supporting the radiation protection methods used during previous CT fluoroscopy. A multislice CT scanner was used to perform this study. OSL dosimeters were placed on the top and the lateral side of the chest phantom so that the longitudinal direction of dosimeters was parallel to the orthogonal axis-to-slice plane for measurement of dose profiles in CT fluoroscopy. Measurement of fluoroscopic conditions was performed at 120 kVp and 80 kVp. Scatter radiation dose was evaluated by calculating the integrated dose determined by OSL dosimetry. The overall percent difference of the integrated doses between OSL dosimeters and ionization chamber was 5.92%. The ratio of the integrated dose of a 100-mm length area to its tails (−50 to −6 mm, 50 to 6 mm) was the lowest on the lateral side at 80 kVp and the highest on the top at 120 kVp. The IDRs for different measurement positions were larger at 120 kVp than at 80 kVp. Similarly, the IDRs for the tube voltage between the primary X-ray beam and scatter radiation was larger on the lateral side than on the top of the phantom. IDR evaluation suggested that the scatter radiation dose has a high dependence on the position and a low dependence on tube voltage relative to the primary X-ray beam for constant dose rate fluoroscopic conditions. These results provided quantitative evidence supporting the radiation protection methods used during CT fluoroscopy in previous studies. PMID:26151914

Evidence of neurofibromatosis type 1 in a multi-morbid Inca child mummy: A paleoradiological investigation using computed tomography

PubMed Central

Wittig, Holger; Zesch, Stephanie; Rosendahl, Wilfried; Blache, Sandra; Müller-Gerbl, Magdalena; Hotz, Gerhard

2017-01-01

Objective In this study, an Inca bundle was examined using computed tomography (CT). The primary aim was to determine the preservation status of bony and soft tissues, the sex, the age at the time of death, possible indicators for disease or even the cause of death, as well as the kind of mummification. A secondary aim was to obtain a brief overview of the wrapping in order to gain additional information on the cultural background. Materials and methods The bundle belongs to the Museum of Cultures in Basel, Switzerland, and was bought in Munich, Germany, in 1921. Radiocarbon dating of the superficial textile yielded a calibrated age between 1480 and 1650 AD. The mummy was investigated using multi-slice CT with slice thickness of 0.75 mm and 110 kilovolt. For standardized assessment of soft tissue preservation, a recently developed checklist was applied. Results CT revealed the mummy of a seven to nine year old boy with superior preservation of bony and soft tissues allowing detailed assessment. Indicators of neurofibromatosis type 1 (paravertebral and cutaneous neurofibromas, a breast neurofibroma, sphenoid wing dysplasia), Chagas disease (dilatation of the esophagus, stomach, rectum, and large amounts of feces), and lung infection (pleural adherence, calcifications), probably due to tuberculosis, were found. Furthermore, signs of peri-mortem violence (transection of the chest and a defect in the abdominal wall) were detected. CT images revealed a carefully performed wrapping. Conclusion CT examination of the Inca bundle proved to be an important non-destructive examination method. Standardized assessment, especially of the soft tissue structures, allowed for diagnoses of several diseases, indicating a multi-morbid child at the time of death. The careful wrapping pointed to a ceremonial burial. Within the cultural background, the signs of fatal violence were discussed as a possible result of war, murder, accident, or human sacrifice. PMID:28403237

Body composition estimation from selected slices: equations computed from a new semi-automatic thresholding method developed on whole-body CT scans.

PubMed

Lacoste Jeanson, Alizé; Dupej, Ján; Villa, Chiara; Brůžek, Jaroslav

2017-01-01

Estimating volumes and masses of total body components is important for the study and treatment monitoring of nutrition and nutrition-related disorders, cancer, joint replacement, energy-expenditure and exercise physiology. While several equations have been offered for estimating total body components from MRI slices, no reliable and tested method exists for CT scans. For the first time, body composition data was derived from 41 high-resolution whole-body CT scans. From these data, we defined equations for estimating volumes and masses of total body AT and LT from corresponding tissue areas measured in selected CT scan slices. We present a new semi-automatic approach to defining the density cutoff between adipose tissue (AT) and lean tissue (LT) in such material. An intra-class correlation coefficient (ICC) was used to validate the method. The equations for estimating the whole-body composition volume and mass from areas measured in selected slices were modeled with ordinary least squares (OLS) linear regressions and support vector machine regression (SVMR). The best predictive equation for total body AT volume was based on the AT area of a single slice located between the 4th and 5th lumbar vertebrae (L4-L5) and produced lower prediction errors (|PE| = 1.86 liters, %PE = 8.77) than previous equations also based on CT scans. The LT area of the mid-thigh provided the lowest prediction errors (|PE| = 2.52 liters, %PE = 7.08) for estimating whole-body LT volume. We also present equations to predict total body AT and LT masses from a slice located at L4-L5 that resulted in reduced error compared with the previously published equations based on CT scans. The multislice SVMR predictor gave the theoretical upper limit for prediction precision of volumes and cross-validated the results.

Multislice does it all—calculating the performance of nanofocusing X-ray optics

DOE PAGES

Li, Kenan; Wojcik, Michael; Jacobsen, Chris

2017-01-23

Here, we describe an approach to calculating the optical performance of a wide range of nanofocusing X-ray optics using multislice scalar wave propagation with a complex X-ray refractive index. This approach produces results indistinguishable from methods such as coupled wave theory, and it allows one to reproduce other X-ray optical phenomena such as grazing incidence reflectivity where the direction of energy flow is changed significantly. Just as finite element analysis methods allow engineers to compute the thermal and mechanical responses of arbitrary structures too complex to model by analytical approaches, multislice propagation can be used to understand the properties ofmore » the real-world optics of finite extent and with local imperfections, allowing one to better understand the limits to nanoscale X-ray imaging.« less

Multi-slice ultrasound image calibration of an intelligent skin-marker for soft tissue artefact compensation.

PubMed

Masum, M A; Pickering, M R; Lambert, A J; Scarvell, J M; Smith, P N

2017-09-06

In this paper, a novel multi-slice ultrasound (US) image calibration of an intelligent skin-marker used for soft tissue artefact compensation is proposed to align and orient image slices in an exact H-shaped pattern. Multi-slice calibration is complex, however, in the proposed method, a phantom based visual alignment followed by transform parameters estimation greatly reduces the complexity and provides sufficient accuracy. In this approach, the Hough Transform (HT) is used to further enhance the image features which originate from the image feature enhancing elements integrated into the physical phantom model, thus reducing feature detection uncertainty. In this framework, slice by slice image alignment and calibration are carried out and this provides manual ease and convenience. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of lung tumor motion management in radiation therapy with dynamic MRI

NASA Astrophysics Data System (ADS)

Park, Seyoun; Farah, Rana; Shea, Steven M.; Tryggestad, Erik; Hales, Russell; Lee, Junghoon

2017-03-01

Surrogate-based tumor motion estimation and tracing methods are commonly used in radiotherapy despite the lack of continuous real time 3D tumor and surrogate data. In this study, we propose a method to simultaneously track the tumor and external surrogates with dynamic MRI, which allows us to evaluate their reproducible correlation. Four MRIcompatible fiducials are placed on the patient's chest and upper abdomen, and multi-slice 2D cine MRIs are acquired to capture the lung and whole tumor, followed by two-slice 2D cine MRIs to simultaneously track the tumor and fiducials, all in sagittal orientation. A phase-binned 4D-MRI is first reconstructed from multi-slice MR images using body area as a respiratory surrogate and group-wise registration. The 4D-MRI provides 3D template volumes for different breathing phases. 3D tumor position is calculated by 3D-2D template matching in which 3D tumor templates in 4D-MRI reconstruction and the 2D cine MRIs from the two-slice tracking dataset are registered. 3D trajectories of the external surrogates are derived via matching a 3D geometrical model to the fiducial segmentations on the 2D cine MRIs. We tested our method on five lung cancer patients. Internal target volume from 4D-CT showed average sensitivity of 86.5% compared to the actual tumor motion for 5 min. 3D tumor motion correlated with the external surrogate signal, but showed a noticeable phase mismatch. The 3D tumor trajectory showed significant cycle-to-cycle variation, while the external surrogate was not sensitive enough to capture such variations. Additionally, there was significant phase mismatch between surrogate signals obtained from fiducials at different locations.

D Modelling and Rapid Prototyping for Cardiovascular Surgical Planning - Two Case Studies

NASA Astrophysics Data System (ADS)

Nocerino, E.; Remondino, F.; Uccheddu, F.; Gallo, M.; Gerosa, G.

2016-06-01

In the last years, cardiovascular diagnosis, surgical planning and intervention have taken advantages from 3D modelling and rapid prototyping techniques. The starting data for the whole process is represented by medical imagery, in particular, but not exclusively, computed tomography (CT) or multi-slice CT (MCT) and magnetic resonance imaging (MRI). On the medical imagery, regions of interest, i.e. heart chambers, valves, aorta, coronary vessels, etc., are segmented and converted into 3D models, which can be finally converted in physical replicas through 3D printing procedure. In this work, an overview on modern approaches for automatic and semiautomatic segmentation of medical imagery for 3D surface model generation is provided. The issue of accuracy check of surface models is also addressed, together with the critical aspects of converting digital models into physical replicas through 3D printing techniques. A patient-specific 3D modelling and printing procedure (Figure 1), for surgical planning in case of complex heart diseases was developed. The procedure was applied to two case studies, for which MCT scans of the chest are available. In the article, a detailed description on the implemented patient-specific modelling procedure is provided, along with a general discussion on the potentiality and future developments of personalized 3D modelling and printing for surgical planning and surgeons practice.

A high-resolution photon-counting breast CT system with tensor-framelet based iterative image reconstruction for radiation dose reduction

NASA Astrophysics Data System (ADS)

Ding, Huanjun; Gao, Hao; Zhao, Bo; Cho, Hyo-Min; Molloi, Sabee

2014-10-01

Both computer simulations and experimental phantom studies were carried out to investigate the radiation dose reduction with tensor framelet based iterative image reconstruction (TFIR) for a dedicated high-resolution spectral breast computed tomography (CT) based on a silicon strip photon-counting detector. The simulation was performed with a 10 cm-diameter water phantom including three contrast materials (polyethylene, 8 mg ml-1 iodine and B-100 bone-equivalent plastic). In the experimental study, the data were acquired with a 1.3 cm-diameter polymethylmethacrylate (PMMA) phantom containing iodine in three concentrations (8, 16 and 32 mg ml-1) at various radiation doses (1.2, 2.4 and 3.6 mGy) and then CT images were reconstructed using the filtered-back-projection (FBP) technique and the TFIR technique, respectively. The image quality between these two techniques was evaluated by the quantitative analysis on contrast-to-noise ratio (CNR) and spatial resolution that was evaluated using the task-based modulation transfer function (MTF). Both the simulation and experimental results indicated that the task-based MTF obtained from TFIR reconstruction with one-third of the radiation dose was comparable to that from the FBP reconstruction for low contrast target. For high contrast target, the TFIR was substantially superior to the FBP reconstruction in terms of spatial resolution. In addition, TFIR was able to achieve a factor of 1.6-1.8 increase in CNR, depending on the target contrast level. This study demonstrates that the TFIR can reduce the required radiation dose by a factor of two-thirds for a CT image reconstruction compared to the FBP technique. It achieves much better CNR and spatial resolution for high contrast target in addition to retaining similar spatial resolution for low contrast target. This TFIR technique has been implemented with a graphic processing unit system and it takes approximately 10 s to reconstruct a single-slice CT image, which can potentially be used in a future multi-slit multi-slice spiral CT system.

Intraoperative computed tomography with integrated navigation system in a multidisciplinary operating suite.

PubMed

Uhl, Eberhard; Zausinger, Stefan; Morhard, Dominik; Heigl, Thomas; Scheder, Benjamin; Rachinger, Walter; Schichor, Christian; Tonn, Jörg-Christian

2009-05-01

We report our preliminary experience in a prospective series of patients with regard to feasibility, work flow, and image quality using a multislice computed tomographic (CT) scanner combined with a frameless neuronavigation system (NNS). A sliding gantry 40-slice CT scanner was installed in a preexisting operating room. The scanner was connected to a frameless infrared-based NNS. Image data was transferred directly from the scanner into the navigation system. This allowed updating of the NNS during surgery by automated image registration based on the position of the gantry. Intraoperative CT angiography was possible. The patient was positioned on a radiolucent operating table that fits within the bore of the gantry. During image acquisition, the gantry moved over the patient. This table allowed all positions and movements like any normal operating table without compromising the positioning of the patient. For cranial surgery, a carbon-made radiolucent head clamp was fixed to the table. Experience with the first 230 patients confirms the feasibility of intraoperative CT scanning (136 patients with intracranial pathology, 94 patients with spinal lesions). After a specific work flow, interruption of surgery for intraoperative scanning can be limited to 10 to 15 minutes in cranial surgery and to 9 minutes in spinal surgery. Intraoperative imaging changed the course of surgery in 16 of the 230 cases either because control CT scans showed suboptimal screw position (17 of 307 screws, with 9 in 7 patients requiring correction) or that tumor resection was insufficient (9 cases). Intraoperative CT angiography has been performed in 7 cases so far with good image quality to determine residual flow in an aneurysm. Image quality was excellent in spinal and cranial base surgery. The system can be installed in a preexisting operating environment without the need for special surgical instruments. It increases the safety of the patient and the surgeon without necessitating a change in the existing surgical protocol and work flow. Imaging and updating of the NNS can be performed at any time during surgery with very limited time and modification of the surgical setup. Multidisciplinary use increases utilization of the system and thus improves the cost-efficiency relationship.

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.

Multi-slice ptychography with large numerical aperture multilayer Laue lenses

DOE PAGES

Ozturk, Hande; Yan, Hanfei; He, Yan; ...

2018-05-09

Here, the highly convergent x-ray beam focused by multilayer Laue lenses with large numerical apertures is used as a three-dimensional (3D) probe to image layered structures with an axial separation larger than the depth of focus. Instead of collecting weakly scattered high-spatial-frequency signals, the depth-resolving power is provided purely by the intense central cone diverged from the focused beam. Using the multi-slice ptychography method combined with the on-the-fly scan scheme, two layers of nanoparticles separated by 10 μm are successfully reconstructed with 8.1 nm lateral resolution and with a dwell time as low as 0.05 s per scan point. Thismore » approach obtains high-resolution images with extended depth of field, which paves the way for multi-slice ptychography as a high throughput technique for high-resolution 3D imaging of thick samples.« less

Comparison of effects of ProTaper, HeroShaper, and Gates Glidden Burs on cervical dentin thickness and root canal volume by using multislice computed tomography.

PubMed

Mahran, Abeer H; AboEl-Fotouh, Mona M

2008-10-01

The purpose of this study was to compare the effects of 3 different instruments used to prepare curved root canals on the remaining cervical dentin thickness and total amount of dentin removed from root canals during instrumentation by using multislice computed tomography. Mesiobuccal canals of 45 mandibular first molars with curvature between 30-40 degrees were divided into 3 equal groups: ProTaper, Hero Shaper, and Gates Glidden Bur with Flex-R hand file. Cervical dentin thickness and canal volume were measured before and after instrumentation by using multislice computed tomography and image analysis software. The results indicated that ProTaper removed significantly less cervical dentin from distal wall of the root (dangerous zone) than HeroShaper and Gates Glidden Bur (P < .05). The total dentin removed during canal instrumentation was significantly more with ProTaper system (P < .05).

Whole-body multislice computed tomography as the primary and sole diagnostic tool in patients with blunt trauma: searching for its appropriate indication.

PubMed

Wurmb, Thomas Erik; Frühwald, Peter; Hopfner, Wittiko; Roewer, Norbert; Brederlau, Jörg

2007-11-01

In our hospital, whole-body multislice computed tomography is used as the primary diagnostic tool in patients with suspected multiple trauma. A triage rule is used for its indication. We have retrospectively analyzed data of sedated, intubated and ventilated patients consecutively admitted to our trauma center to assess whether the triage rule can help identify patients with severe trauma (injury severity score > or = 16). We have found that overtriage (injury severity score < 16) occurs in 30%, and undertriage occurs in 6% of patients. Although we have found the triage rule to be highly sensitive, this results in a high rate of overtriage. Until we know more about the most relevant and independent predictive factors, sole reliance upon multislice computed tomography in triaging suspected polytrauma victims will imply the risk to overscan many patients.

Multi-slice ptychography with large numerical aperture multilayer Laue lenses

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

Ozturk, Hande; Yan, Hanfei; He, Yan

Here, the highly convergent x-ray beam focused by multilayer Laue lenses with large numerical apertures is used as a three-dimensional (3D) probe to image layered structures with an axial separation larger than the depth of focus. Instead of collecting weakly scattered high-spatial-frequency signals, the depth-resolving power is provided purely by the intense central cone diverged from the focused beam. Using the multi-slice ptychography method combined with the on-the-fly scan scheme, two layers of nanoparticles separated by 10 μm are successfully reconstructed with 8.1 nm lateral resolution and with a dwell time as low as 0.05 s per scan point. Thismore » approach obtains high-resolution images with extended depth of field, which paves the way for multi-slice ptychography as a high throughput technique for high-resolution 3D imaging of thick samples.« less

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

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

Yadava, G; Imai, Y; Hsieh, J

2014-06-15

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

What are the potential advantages and disadvantages of volumetric CT scanning?

PubMed

Voros, Szilard

2009-01-01

After the introduction and dissemination of 64-slice multislice computed tomography systems, cardiovascular CT has arrived at a crossroad, and different philosophies lead down different paths of technologic development. Increased number of detector rows in the z-axis led to the introduction of dynamic, volumetric scanning of the heart and allows for whole-organ imaging. Dynamic, volumetric "whole-organ" scanning significantly reduces image acquisition time; "single-beat whole-heart imaging" results in improved image quality and reduced radiation exposure and reduced contrast dose. It eliminates helical and pitch artifacts and allows for simultaneous imaging of the base and apex of the heart. Beyond coronary arterial luminal imaging, such innovations open up the opportunity for myocardial perfusion and viability imaging and coronary arterial plaque imaging. Dual-source technology with 2 x-ray tubes placed at 90-degree angles provides heart rate-independent temporal resolution and has the potential for tissue characterization on the basis of different attenuation values at different energy levels. Refined detector technology allows for improved low-contrast resolution and may be beneficial for more detailed evaluation of coronary arterial plaque composition. The clinical benefit of each of these technologies will have to be evaluated in carefully designed clinical trials and in everyday clinical practice. Such combined experience will probably show the relative benefit of each of these philosophies in different patient populations and in different clinical scenarios.

Non-homogeneous updates for the iterative coordinate descent algorithm

NASA Astrophysics Data System (ADS)

Yu, Zhou; Thibault, Jean-Baptiste; Bouman, Charles A.; Sauer, Ken D.; Hsieh, Jiang

2007-02-01

Statistical reconstruction methods show great promise for improving resolution, and reducing noise and artifacts in helical X-ray CT. In fact, statistical reconstruction seems to be particularly valuable in maintaining reconstructed image quality when the dosage is low and the noise is therefore high. However, high computational cost and long reconstruction times remain as a barrier to the use of statistical reconstruction in practical applications. Among the various iterative methods that have been studied for statistical reconstruction, iterative coordinate descent (ICD) has been found to have relatively low overall computational requirements due to its fast convergence. This paper presents a novel method for further speeding the convergence of the ICD algorithm, and therefore reducing the overall reconstruction time for statistical reconstruction. The method, which we call nonhomogeneous iterative coordinate descent (NH-ICD) uses spatially non-homogeneous updates to speed convergence by focusing computation where it is most needed. Experimental results with real data indicate that the method speeds reconstruction by roughly a factor of two for typical 3D multi-slice geometries.

Gallium-68 EDTA PET/CT for Renal Imaging.

PubMed

Hofman, Michael S; Hicks, Rodney J

2016-09-01

Nuclear medicine renal imaging provides important functional data to assist in the diagnosis and management of patients with a variety of renal disorders. Physiologically stable metal chelates like ethylenediaminetetraacetic acid (EDTA) and diethylenetriamine penta-acetate (DTPA) are excreted by glomerular filtration and have been radiolabelled with a variety of isotopes for imaging glomerular filtration and quantitative assessment of glomerular filtration rate. Gallium-68 ((68)Ga) EDTA PET usage predates Technetium-99m ((99m)Tc) renal imaging, but virtually disappeared with the widespread adoption of gamma camera technology that was not optimal for imaging positron decay. There is now a reemergence of interest in (68)Ga owing to the greater availability of PET technology and use of (68)Ga to label other radiotracers. (68)Ga EDTA can be used a substitute for (99m)Tc DTPA for wide variety of clinical indications. A key advantage of PET for renal imaging over conventional scintigraphy is 3-dimensional dynamic imaging, which is particularly helpful in patients with complex anatomy in whom planar imaging may be nondiagnostic or difficult to interpret owing to overlying structures containing radioactive urine that cannot be differentiated. Other advantages include accurate and absolute (rather than relative) camera-based quantification, superior spatial and temporal resolution and integrated multislice CT providing anatomical correlation. Furthermore, the (68)Ga generator enables on-demand production at low cost, with no additional patient radiation exposure compared with conventional scintigraphy. Over the past decade, we have employed (68)Ga EDTA PET/CT primarily to answer difficult clinical questions in patients in whom other modalities have failed, particularly when it was envisaged that dynamic 3D imaging would be of assistance. We have also used it as a substitute for (99m)Tc DTPA if unavailable owing to supply issues, and have additionally examined the role of (68)Ga EDTA PET/CT for measuring glomerular filtration rate and split renal function. Copyright © 2016 Elsevier Inc. All rights reserved.

Role of Spiral and Multislice Computed Tomography in the evaluation of traumatic and spontaneous oesophageal perforation. Our experience.

PubMed

De Lutio di Castelguidone, Elisabetta; Pinto, Antonio; Merola, Stefanella; Stavolo, Ciro; Romano, Luigia

2005-03-01

To assess the role CT in the evaluation of traumatic and spontaneous oesophageal perforation. From March 2001 to May 2003, we studied 12 patients (7 males and 5 females; age range: 25-66 years, mean age: 43.5 years) with suspected oesophageal perforation due to motor-vehicle accidents (4 cases), stab wound (one case), post-intubation (2 cases), foreign body ingestion (2 cases) and spontaneous (3 cases). Five patients underwent standard chest and cervical radiography; two patients with suspected foreign body ingestion also underwent a gastrografin swallow study; all of the 12 patients underwent CT of the neck, chest and abdomen before and after intravenous, and in four cases oral, administration of contrast material. In 5 patients with cervical, thoracic and abdominal trauma, the CT examination showed the presence of pleuroparenchymal injury (pneumothorax, pleural effusion and subcutaneous emphysema) as well as findings suggestive of oesophageal perforation: peri-oesophageal air (5 cases), peri-oesophageal fluid (4 cases), oesophageal wall thickening (3 cases), oesophageal wall laceration (2 cases) with abnormal course of the nasogastric tube in one of them and extraluminal extravasation of oral contrast material (2 cases). In 2 patients with post-intubation complications, CT showed the presence of a small peri-oesophageal fluid collection containing small gas bubbles in one case, and a gross perioesophageal abscess-like collection in the second case. In the 2 patients with foreign body ingestion, the plain radiography associated with CT showed the presence of a thin metal object in the cervical region (fragment of a dental plate) and a small extraluminal extravasation of gastrografin in one case, whereas in the other case CT showed the presence of a foreign body (chicken bone) in the hypopharynx with oesophageal wall thickening and peri-oesophageal oedema. In the remaining three patients with suspected spontaneous oesophageal perforation, CT showed the presence of a intramural haematoma in one case, oesophageal fluid distension with gas and a small peri-oesophageal fluid effusion (Mallory-Weiss syndrome) in another, and oesophageal rupture (Boerhaave syndrome) in the last case. Our experience shows that in patients with suspected traumatic and spontaneous oesophageal perforation, standard cervical and chest radiography may suggest a suspected oesophageal perforation in only a small proportion of cases, whereas oral contrast oesophagography has a higher sensitivity. Through the careful analysis of suggestive and specific signs of oesophageal perforation, a correct CT examination enables an accurate and timely diagnosis which significantly affects prognosis and provides valuable indications for treatment.

Imaging of Pericardiophrenic Bundles Using Multislice Spiral Computed Tomography for Phrenic Nerve Anatomy.

PubMed

Wang, Yan-Jing; Liu, Lin; Zhang, Meng-Chao; Sun, Huan; Zeng, Hong; Yang, Ping

2016-08-01

Phrenic nerve injury and diaphragmatic stimulation are common complications following arrhythmia ablation and pacing therapies. Preoperative comprehension of phrenic nerve anatomy via non-invasive CT imaging may help to minimize the electrophysiological procedure-related complications. Coronary CT angiography data of 121 consecutive patients were collected. Imaging of left and right pericardiophrenic bundles was performed with volume rendering and multi-planar reformation techniques. The shortest spatial distances between phrenic nerves and key electrophysiology-related structures were determined. The frequencies of the shortest distances ≤5 mm, >5 mm and direct contact between phrenic nerves and adjacent structures were calculated. Left and right pericardiophrenic bundles were identified in 86.8% and 51.2% of the patients, respectively. The right phrenic nerve was <5 mm from right superior and inferior pulmonary veins in 92.0% and 3.2% of the patients, respectively. The percentage of right phrenic nerve, <5 mm from right atrium, superior caval vein, and superior caval vein-right atrium junction was 87.1%, 100%, and 62.9%, respectively. Left phrenic nerve was <5 mm from left atrial appendage, great cardiac vein, anterior and posterior interventricular veins, and left ventricular posterior veins in 81.9%, 1.0%, 39.1%, 28.6%, and 91.4% of the patients, respectively. Merely 0.06% left phrenic nerve had a distance <5 mm with left superior pulmonary vein, and none left phrenic nerve showed a distance <5 mm with left inferior pulmonary vein. One-stop enhanced CT scanning enabled detection of phrenic nerve anatomy, which might facilitate avoidance of the phrenic nerve-related complications in interventional electrophysiology. © 2016 Wiley Periodicals, Inc.

[Significance of three-dimensional reconstruction as a method of preoperative planning of laparoscopic radiofrequency ablation].

PubMed

Zhang, W W; Wang, H G; Shi, X J; Chen, M Y; Lu, S C

2016-09-01

To discuss the significance of three-dimensional reconstruction as a method of preoperative planning of laparoscopic radiofrequency ablation(LRFA). Thirty-two cases of LRFA admitted from January 2014 to December 2015 in Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital were analyzed(3D-LRFA group). Three-dimensional(3D) reconstruction were taken as a method of preoperative planning in 3D-LRFA group.Other 64 LRFA cases were paired over the same period without three-dimensional reconstruction before the operation (LRFA group). Hepatobiliary system contrast enhanced CT scan of 3D-RFA patients were taken by multi-slice spiral computed tomography(MSCT), and the DICOM data were processed by IQQA(®)-Liver and IQQA(®)-guide to make 3D reconstruction.Using 3D reconstruction model, diameter and scope of tumor were measured, suitable size (length and radiofrequency length) and number of RFA electrode were chosen, scope and effect of radiofrequency were simulated, reasonable needle track(s) was planed, position and angle of laparoscopic ultrasound (LUS) probe was designed and LUS image was simulated.Data of operation and recovery were collected and analyzed. Data between two sets of measurement data were compared with t test or rank sum test, and count data with χ(2) test or Fisher exact probability test.Tumor recurrence rate was analyzed with the Kaplan-Meier survival curve and Log-rank (Mantel-Cox) test. Compared with LRFA group ((216.8±66.2) minutes, (389.1±183.4) s), 3D-LRFA group ((173.3±59.4) minutes, (242.2±90.8) s) has shorter operation time(t=-3.138, P=0.002) and shorter mean puncture time(t=-2.340, P=0.021). There was no significant difference of blood loss(P=0.170), ablation rate (P=0.871) and incidence of complications(P=1.000). Compared with LRFA group ((6.3±3.9)days, (330±102)U/L, (167±64)ng/L), 3D-LRFA group ((4.3±3.1) days, (285±102) U/L, (139±43) ng/L) had shorter post-operative stay(t=-2.527, P=0.016), less post-operation ALT changes (t=-2.038, P=0.048) and post-operative TNF-α changes(t=-2.233, P=0.027). Disease-free survival between two groups was significantly different (χ(2)=4.049, P=0.046). Disease-free survival of 12 months survival rates were 77.6% and 65.7% in 3D-LRFA group and LRFA group, respectively.The median disease-free survival was 16.0 months in LRFA group and over 24.0 months in 3D-LRFA group. Three-dimensional model of liver reconstruction based on image information is a powerful tool in liver surgery planning.It helps to simulate tumor location and vital tubular structure, make plan for interventional treatment, and therefore mean puncture time and operation time is shortened, influence on liver function is reduced, hospital stay is decreased and DFS is prolonged.

A streaming multi-GPU implementation of image simulation algorithms for scanning transmission electron microscopy

DOE PAGES

Pryor, Alan; Ophus, Colin; Miao, Jianwei

2017-10-25

Simulation of atomic-resolution image formation in scanning transmission electron microscopy can require significant computation times using traditional methods. A recently developed method, termed plane-wave reciprocal-space interpolated scattering matrix (PRISM), demonstrates potential for significant acceleration of such simulations with negligible loss of accuracy. In this paper, we present a software package called Prismatic for parallelized simulation of image formation in scanning transmission electron microscopy (STEM) using both the PRISM and multislice methods. By distributing the workload between multiple CUDA-enabled GPUs and multicore processors, accelerations as high as 1000 × for PRISM and 15 × for multislice are achieved relative to traditionalmore » multislice implementations using a single 4-GPU machine. We demonstrate a potentially important application of Prismatic, using it to compute images for atomic electron tomography at sufficient speeds to include in the reconstruction pipeline. Prismatic is freely available both as an open-source CUDA/C++ package with a graphical user interface and as a Python package, PyPrismatic.« less

Optimization of Brain T2 Mapping Using Standard CPMG Sequence In A Clinical Scanner

NASA Astrophysics Data System (ADS)

Hnilicová, P.; Bittšanský, M.; Dobrota, D.

2014-04-01

In magnetic resonance imaging, transverse relaxation time (T2) mapping is a useful quantitative tool enabling enhanced diagnostics of many brain pathologies. The aim of our study was to test the influence of different sequence parameters on calculated T2 values, including multi-slice measurements, slice position, interslice gap, echo spacing, and pulse duration. Measurements were performed using standard multi-slice multi-echo CPMG imaging sequence on a 1.5 Tesla routine whole body MR scanner. We used multiple phantoms with different agarose concentrations (0 % to 4 %) and verified the results on a healthy volunteer. It appeared that neither the pulse duration, the size of interslice gap nor the slice shift had any impact on the T2. The measurement accuracy was increased with shorter echo spacing. Standard multi-slice multi-echo CPMG protocol with the shortest echo spacing, also the smallest available interslice gap (100 % of slice thickness) and shorter pulse duration was found to be optimal and reliable for calculating T2 maps in the human brain.

Detecting anomalous traders using multi-slice network analysis

NASA Astrophysics Data System (ADS)

Sun, Xiao-Qian; Shen, Hua-Wei; Cheng, Xue-Qi; Zhang, Yuqing

2017-05-01

Manipulation is an important issue for both developed and emerging stock markets. Many efforts have been made to detect manipulation in stock market. However, it is still an open problem to identify the fraudulent traders, especially when they collude with each other. In this paper, we focus on the problem of identifying anomalous traders using the transaction data of 8 manipulated stocks and 42 non-manipulated stocks during a one-year period. For each stock, we construct a multi-slice trading network to characterize the daily trading behavior and the cross-day participation of each trader. Comparing the multi-slice trading network of manipulated stocks and non-manipulated stocks with their randomized version, we find that manipulated stocks exhibit high number of trader pairs that trade with each other in multiple days and high deviation from randomized network at correlation between trading frequency and trading activity. These findings are effective at distinguishing manipulated stocks from non-manipulated ones and at identifying anomalous traders.

A streaming multi-GPU implementation of image simulation algorithms for scanning transmission electron microscopy.

PubMed

Pryor, Alan; Ophus, Colin; Miao, Jianwei

2017-01-01

Simulation of atomic-resolution image formation in scanning transmission electron microscopy can require significant computation times using traditional methods. A recently developed method, termed plane-wave reciprocal-space interpolated scattering matrix (PRISM), demonstrates potential for significant acceleration of such simulations with negligible loss of accuracy. Here, we present a software package called Prismatic for parallelized simulation of image formation in scanning transmission electron microscopy (STEM) using both the PRISM and multislice methods. By distributing the workload between multiple CUDA-enabled GPUs and multicore processors, accelerations as high as 1000 × for PRISM and 15 × for multislice are achieved relative to traditional multislice implementations using a single 4-GPU machine. We demonstrate a potentially important application of Prismatic , using it to compute images for atomic electron tomography at sufficient speeds to include in the reconstruction pipeline. Prismatic is freely available both as an open-source CUDA/C++ package with a graphical user interface and as a Python package, PyPrismatic .

A streaming multi-GPU implementation of image simulation algorithms for scanning transmission electron microscopy

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

Pryor, Alan; Ophus, Colin; Miao, Jianwei

Simulation of atomic-resolution image formation in scanning transmission electron microscopy can require significant computation times using traditional methods. A recently developed method, termed plane-wave reciprocal-space interpolated scattering matrix (PRISM), demonstrates potential for significant acceleration of such simulations with negligible loss of accuracy. In this paper, we present a software package called Prismatic for parallelized simulation of image formation in scanning transmission electron microscopy (STEM) using both the PRISM and multislice methods. By distributing the workload between multiple CUDA-enabled GPUs and multicore processors, accelerations as high as 1000 × for PRISM and 15 × for multislice are achieved relative to traditionalmore » multislice implementations using a single 4-GPU machine. We demonstrate a potentially important application of Prismatic, using it to compute images for atomic electron tomography at sufficient speeds to include in the reconstruction pipeline. Prismatic is freely available both as an open-source CUDA/C++ package with a graphical user interface and as a Python package, PyPrismatic.« less

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.

Quality and Dose Optimized CT Trauma Protocol - Recommendation from a University Level-I Trauma Center.

PubMed

Kahn, Johannes; Kaul, David; Böning, Georg; Rotzinger, Roman; Freyhardt, Patrick; Schwabe, Philipp; Maurer, Martin H; Renz, Diane Miriam; Streitparth, Florian

2017-09-01

Purpose  As a supra-regional level-I trauma center, we evaluated computed tomography (CT) acquisitions of polytraumatized patients for quality and dose optimization purposes. Adapted statistical iterative reconstruction [(AS)IR] levels, tube voltage reduction as well as a split-bolus contrast agent (CA) protocol were applied. Materials and Methods  61 patients were split into 3 different groups that differed with respect to tube voltage (120 - 140 kVp) and level of applied ASIR reconstruction (ASIR 20 - 50 %). The CT protocol included a native acquisition of the head followed by a single contrast-enhanced acquisition of the whole body (64-MSCT). CA (350 mg/ml iodine) was administered as a split bolus injection of 100 ml (2 ml/s), 20 ml NaCl (1 ml/s), 60 ml (4 ml/s), 40 ml NaCl (4 ml/s) with a scan delay of 85 s to detect injuries of both the arterial system and parenchymal organs in a single acquisition. Both the quantitative (SNR/CNR) and qualitative (5-point Likert scale) image quality was evaluated in parenchymal organs that are often injured in trauma patients. Radiation exposure was assessed. Results  The use of IR combined with a reduction of tube voltage resulted in good qualitative and quantitative image quality and a significant reduction in radiation exposure of more than 40 % (DLP 1087 vs. 647 mGyxcm). Image quality could be improved due to a dedicated protocol that included different levels of IR adapted to different slice thicknesses, kernels and the examined area for the evaluation of head, lung, body and bone injury patterns. In synopsis of our results, we recommend the implementation of a polytrauma protocol with a tube voltage of 120 kVp and the following IR levels: cCT 5mm: ASIR 20; cCT 0.625 mm: ASIR 40; lung 2.5 mm: ASIR 30, body 5 mm: ASIR 40; body 1.25 mm: ASIR 50; body 0.625 mm: ASIR 0. Conclusion  A dedicated adaptation of the CT trauma protocol (level of reduction of tube voltage and of IR) according to the examined body region (head, lung, body, bone) combined with a split bolus CA injection protocol allows for a high-quality CT examination and a relevant reduction of radiation exposure in the examination of polytraumatized patients Key Points   · Dedicated adaption of the CT trauma protocol allows for an optimized examination.. · Different levels of iterative reconstruction, tube voltage and the CA injection protocol are crucial.. · A reduction of radiation exposure of more than 40 % with good image quality is possible.. Citation Format · Kahn J, Kaul D, Böning G et al. Quality and Dose Optimized CT Trauma Protocol - Recommendation from a University Level-I Trauma Center. Fortschr Röntgenstr 2017; 189: 844 - 854. © Georg Thieme Verlag KG Stuttgart · New York.

Internal respiratory surrogate in multislice 4D CT using a combination of Fourier transform and anatomical features

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

Hui, Cheukkai; Suh, Yelin; Robertson, Daniel

Purpose: The purpose of this study was to develop a novel algorithm to create a robust internal respiratory signal (IRS) for retrospective sorting of four-dimensional (4D) computed tomography (CT) images. Methods: The proposed algorithm combines information from the Fourier transform of the CT images and from internal anatomical features to form the IRS. The algorithm first extracts potential respiratory signals from low-frequency components in the Fourier space and selected anatomical features in the image space. A clustering algorithm then constructs groups of potential respiratory signals with similar temporal oscillation patterns. The clustered group with the largest number of similar signalsmore » is chosen to form the final IRS. To evaluate the performance of the proposed algorithm, the IRS was computed and compared with the external respiratory signal from the real-time position management (RPM) system on 80 patients. Results: In 72 (90%) of the 4D CT data sets tested, the IRS computed by the authors’ proposed algorithm matched with the RPM signal based on their normalized cross correlation. For these data sets with matching respiratory signals, the average difference between the end inspiration times (Δt{sub ins}) in the IRS and RPM signal was 0.11 s, and only 2.1% of Δt{sub ins} were more than 0.5 s apart. In the eight (10%) 4D CT data sets in which the IRS and the RPM signal did not match, the average Δt{sub ins} was 0.73 s in the nonmatching couch positions, and 35.4% of them had a Δt{sub ins} greater than 0.5 s. At couch positions in which IRS did not match the RPM signal, a correlation-based metric indicated poorer matching of neighboring couch positions in the RPM-sorted images. This implied that, when IRS did not match the RPM signal, the images sorted using the IRS showed fewer artifacts than the clinical images sorted using the RPM signal. Conclusions: The authors’ proposed algorithm can generate robust IRSs that can be used for retrospective sorting of 4D CT data. The algorithm is completely automatic and requires very little processing time. The algorithm is cost efficient and can be easily adopted for everyday clinical use.« less

[18F]FDG imaging of head and neck tumours: comparison of hybrid PET and morphological methods.

PubMed

Dresel, S; Grammerstorff, J; Schwenzer, K; Brinkbäumer, K; Schmid, R; Pfluger, T; Hahn, K

2003-07-01

The aim of this study was to evaluate fluorine-18 fluorodeoxyglucose ([(18)F]FDG) imaging of head and neck tumours using a second- or third-generation hybrid PET device. Results were compared with the findings of spiral computed tomography (CT) and magnetic resonance imaging (MRI), and, as regards lymph node metastasis, the ultrasound findings. A total of 116 patients with head and neck tumours (83 males and 33 females aged 27-88 years) were examined using a hybrid PET scanner after injection of 185-350 MBq of [(18)F]FDG (Picker Prism 2000 XP-PCD, Marconi Axis gamma-PET(2) AZ). Hybrid PET examinations were performed in list mode using an axial filter. Reconstruction of data was performed iteratively. Ninety-six patients underwent CT using a multislice technique (Siemens Somatom Plus 4, Marconi MX 8000), 18 patients underwent MRI and 100 patients were examined by ultrasound. All findings were verified by histology, which was considered the gold standard, or, in the event of negative histology, by follow-up. Correct diagnosis of the primary or recurrent lesion was made in 73 of 85 patients using the hybrid PET scanner, in 50 of 76 patients on CT and in 7 of 10 patients on MRI. Hybrid PET successfully visualised metastatic disease in cervical lymph nodes in 28 of 34 patients, while 23 of 31 were correctly diagnosed with CT, 3 of 4 with MRI and 30 of 33 with ultrasound. False positive results regarding lymph node metastasis were seen in three patients with hybrid PET, in 14 patients with CT and in 13 patients with ultrasound. MRI yielded no false positive results concerning lymph node metastasis. In one patient, unrecognised metastatic lesions were seen on hybrid PET elsewhere in the body (lung: n=1; bone: n=1). Additional malignant lesions at sites other than the head and neck tumour were found in three patients (one patient with lung cancer, one patient with pelvic metastasis due to a carcinoma of the prostate and one patient with pulmonary metastasis due to breast cancer). It is concluded that [(18)F]FDG PET with hybrid PET scanners is superior to CT and MRI in the diagnosis of primary or recurrent lesions as well as in the assessment of lymph node involvement, whereas it is inferior to ultrasound in the detection of cervical lymph node metastasis.

[Comparative analysis of the semiotics of disseminated pulmonary tuberculosis and exogenous allergic alveolitis in accordance with the data of computed tomography].

PubMed

Amansakhedov, R B; Limarova, I V; Perfiliev, A V; Abdullaev, R Yu; Sigaev, A T; Ergeshov, A E

2016-01-01

to improve the differential diagnosis of disseminated pulmonary tuberculosis (DPT) and exogenous allergic alveolitis (EAA) via comparative investigation of their computed tomography (CT) semiotics and identification of the most informative diagnostic criteria. 70 patients, including 40 patients with DPT in a phase of infiltration and 30 patients with acute EAA, were studied using a Somatom Emotion 16 multi-slice spiral CT scanner (Siemens). All the patients underwent spiral scanning from the upper chest aperture to the costodiaphragmatic recesses with a high CT algorithm at 0.8-mm slice thickness and a 1.5-mm step. Analysis of the spread of dissemination foci established that pathological changes were peribronchovascularly located in both nosological entities and characterized by a preponderance of septal and intrabronchial locations in DPT and by a centrilobular distribution in EAA. Centrilobular foci were more commonly poorly defined in EAA and mixed foci were observed in DPT. In the latter, peribronchovascular, centrilobular foci were revealed at a distance from the visceral pleura (the boundary of the deep and superficial lymphatic network, respectively) in 38% and more than half of the cases (62%) with the involvement of the visceral and parietal pleura; in EAA, the centrilobular foci were more often combined with the involvement of the visceral pleura in more than 92% of cases. The tree-in-bud sign was significantly more common in DPT. The latter was mostly characterized by apicocaudal regression of dissemination. In EAA, the foci were more frequently located asymmetrically. Monomorphic foci with destruction, as well as their polymorphism were seen in DPT; those without destruction were predominantly observed in EAA. CT ground glass and mosaic perfusion syndromes were significantly more often in EAA. In DPT, the visceral and parietal pleuras were involved in the process in 62% of cases and changes were also more common in the extrapleural fat. In addition to the peribronchovascular location of foci, the characteristic CT signs for DPT are a preponderance of intrabronchial and septal locations of foci, their apicocaudal regression, the presence of the CT tree-in-bud sign, and thickened extrapleural fat. EAA showed a prevalence of asymmetrical foci with centrilobular location with the involvement of the visceral pleura into the process, with the presence of CT ground glass and mosaic perfusion syndromes, as well as the bronchial lumen visualized in the peripheral segments of the lung.

Value of C-Arm Cone Beam Computed Tomography Image Fusion in Maximizing the Versatility of Endovascular Robotics.

PubMed

Chinnadurai, Ponraj; Duran, Cassidy; Al-Jabbari, Odeaa; Abu Saleh, Walid K; Lumsden, Alan; Bismuth, Jean

2016-01-01

To report our initial experience and highlight the value of using intraoperative C-arm cone beam computed tomography (CT; DynaCT(®)) image fusion guidance along with steerable robotic endovascular catheter navigation to optimize vessel cannulation. Between May 2013 and January 2015, all patients who underwent endovascular procedures using DynaCT image fusion technique along with Hansen Magellan vascular robotic catheter were included in this study. As a part of preoperative planning, relevant vessel landmarks were electronically marked in contrast-enhanced multi-slice computed tomography images and stored. At the beginning of procedure, an intraoperative noncontrast C-arm cone beam CT (syngo DynaCT(®), Siemens Medical Solutions USA Inc.) was acquired in the hybrid suite. Preoperative images were then coregistered to intraoperative DynaCT images using aortic wall calcifications and bone landmarks. Stored landmarks were then overlaid on 2-dimensional (2D) live fluoroscopic images as virtual markers that are updated in real-time with C-arm, table movements and image zoom. Vascular access and robotic catheter (Magellan(®), Hansen Medical) was setup per standard. Vessel cannulation was performed based on electronic virtual markers on live fluoroscopy using robotic catheter. The impact of 3-dimensional (3D) image fusion guidance on robotic vessel cannulation was evaluated retrospectively, by assessing quantitative parameters like number of angiograms acquired before vessel cannulation and qualitative parameters like accuracy of vessel ostium and centerline markers. All 17 vessels were cannulated successfully in 14 patients' attempted using robotic catheter and image fusion guidance. Median vessel diameter at origin was 5.4 mm (range, 2.3-13 mm), whereas 12 of 17 (70.6%) vessels had either calcified and/or stenosed origin from parent vessel. Nine of 17 vessels (52.9 %) were cannulated without any contrast injection. Median number of angiograms required before cannulation was 0 (range, 0-2). On qualitative assessment, 14 of 15 vessels (93.3%) had grade = 1 accuracy (guidewire inside virtual ostial marker). Fourteen of 14 vessels had grade = 1 accuracy (virtual centerlines that matched with the actual vessel trajectory during cannulation). In this small series, the experience of using DynaCT image fusion guidance together with a steerable endovascular robotic catheter indicates that such image fusion strategies can enhance intraoperative 2D fluoroscopy by bringing preoperative 3D information about vascular stenosis and/or calcification, angulation, and take off from main vessel thereby facilitating ultimate vessel cannulation. Copyright © 2016 Elsevier Inc. All rights reserved.

Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients☆

PubMed Central

Canella, Richard Prazeres; Adam, Guilherme Pradi; de Castillo, Roberto André Ulhôa; Codonho, Daniel; Ganev, Gerson Gandhi; de Vicenzi, Luiz Fernando

2016-01-01

Objective To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). Methods We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. Results There were inverse correlations between the following angles: (1) acetabular coverage versus alpha angle (p = 0.019); (2) acetabular version (supraequatorial) versus alpha angle (p = 0.049). For patients with femoral anteversion lower than 15 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.026); (2) acetabular version (middle third) versus alpha angle (p = 0.02). For patients with acetabular version (supraequatorial) lower than 10 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.004); (2) acetabular version (middle third) versus alpha angle (p = 0.009). Conclusion There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was) in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases. PMID:27069890

Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients.

PubMed

Canella, Richard Prazeres; Adam, Guilherme Pradi; de Castillo, Roberto André Ulhôa; Codonho, Daniel; Ganev, Gerson Gandhi; de Vicenzi, Luiz Fernando

2016-01-01

To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. There were inverse correlations between the following angles: (1) acetabular coverage versus alpha angle (p = 0.019); (2) acetabular version (supraequatorial) versus alpha angle (p = 0.049). For patients with femoral anteversion lower than 15 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.026); (2) acetabular version (middle third) versus alpha angle (p = 0.02). For patients with acetabular version (supraequatorial) lower than 10 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.004); (2) acetabular version (middle third) versus alpha angle (p = 0.009). There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was) in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases.

Condyle fossa relationship associated with functional posterior crossbite, before and after rapid maxillary expansion.

PubMed

Leonardi, Rosalia; Caltabiano, Mario; Cavallini, Costanza; Sicurezza, Edoardo; Barbato, Ersilia; Spampinato, Concetto; Giordano, Daniela

2012-11-01

To investigate condylar symmetry and condyle fossa relationships in subjects with functional posterior crossbite comparing findings before and after rapid maxillary expansion (RME) treatment through low-dose computed tomography (CT). Twenty-six patients (14 girls and 12 boys, mean age 9.6 ± 1.4 years) with functional posterior crossbite (FPXB) diagnosis underwent rapid palatal expansion with a Hyrax appliance. Patients' temporomandibular joints (TMJ) underwent multislice CT scans before rapid palatal expansion (T0) and after (T1). Joint spaces were compared with those of a control sample of 13 subjects (7 girls and 5 boys, mean age 11 ± 0.6 years). Anterior space (AS), superior space (SS), and posterior space (PS) joint space measurements at T0 between the FPXB side and contralateral side demonstrated no statistically significant differences. After RME treatment (T1), all three joint spaces increased on both the FPXB side and the non-crossbite side. However, differences were statistically significant only for the SS when comparing the two sides at T1. SS increased more than AS and PS in the non-crossbite condyle (0.28 mm) and FPXB condyle (0.37 mm), and PS increased only on the FPXB side (0.34 mm). There were no statistically significant differences in condyle position within the glenoid fossa between the FPXB and non-crossbite side before treatment. Increases in joint spaces were observed after treatment with RME on both sides. These changes were, however, of small amounts.

Exact consideration of data redundancies for spiral cone-beam CT

NASA Astrophysics Data System (ADS)

Lauritsch, Guenter; Katsevich, Alexander; Hirsch, Michael

2004-05-01

In multi-slice spiral computed tomography (CT) there is an obvious trend in adding more and more detector rows. The goals are numerous: volume coverage, isotropic spatial resolution, and speed. Consequently, there will be a variety of scan protocols optimizing clinical applications. Flexibility in table feed requires consideration of data redundancies to ensure efficient detector usage. Until recently this was achieved by approximate reconstruction algorithms only. However, due to the increasing cone angles there is a need of exact treatment of the cone beam geometry. A new, exact and efficient 3-PI algorithm for considering three-fold data redundancies was derived from a general, theoretical framework based on 3D Radon inversion using Grangeat's formula. The 3-PI algorithm possesses a simple and efficient structure as the 1-PI method for non-redundant data previously proposed. Filtering is one-dimensional, performed along lines with variable tilt on the detector. This talk deals with a thorough evaluation of the performance of the 3-PI algorithm in comparison to the 1-PI method. Image quality of the 3-PI algorithm is superior. The prominent spiral artifacts and other discretization artifacts are significantly reduced due to averaging effects when taking into account redundant data. Certainly signal-to-noise ratio is increased. The computational expense is comparable even to that of approximate algorithms. The 3-PI algorithm proves its practicability for applications in medical imaging. Other exact n-PI methods for n-fold data redundancies (n odd) can be deduced from the general, theoretical framework.

Visualisation of the temporary cavity by computed tomography using contrast material.

PubMed

Schyma, Christian; Hagemeier, Lars; Greschus, Susanne; Schild, Hans; Madea, Burkhard

2012-01-01

The temporary cavity of a missile produces radial tears in ordnance gelatine, which correlate to the energy transfer. Computed tomography is a useful and non-destructive method to examine gelatine blocks. However, the tears give only few radiocontrast by air filling, which decreases with the time past shooting. Therefore, systematically, a radiocontrast material was searched to enhance the contrast. Different contrast materials were amalgamated to acryl paint, and about 7 g was sealed in a foil bag, which was integrated in the front of a standard 10% gelatine cylinder. Shots with Action-5 expanding bullets were performed from a 5-m distance. Gelatine was scanned by multi-slice computed tomography. The multiplanar reconstructed images were compared to mechanically cut slices of 1 cm thickness. It was shown experimentally that iodine containing water-soluble contrast material did not give sufficient contrast and caused diffusion artefacts. Best results were obtained by barium sulphate emulsion. The amount of acryl paint was sufficient to colour the tears for optical scanning. The radiocontrast of barium leads to satisfying imaging of tears and allowed the creation of a three-dimensional reconstruction of the temporary cavity. Comparison of optical and radiological results showed an excellent correlation, but absolute measures in computed tomographic (CT) images remained lower compared with optically gathered values in the gelatine slices. Combination of paint and contrast material for CT examination will facilitate the evaluation of complex ballistic models and increase accuracy.

Sex determination of a Tunisian population by CT scan analysis of the skull.

PubMed

Zaafrane, Malek; Ben Khelil, Mehdi; Naccache, Ines; Ezzedine, Ekbel; Savall, Frédéric; Telmon, Norbert; Mnif, Najla; Hamdoun, Moncef

2018-05-01

It is widely accepted that the estimation of biological attributes in the human skeleton is more accurate when population-specific standards are applied. With the shortage of such data for contemporary North African populations, it is duly required to establish population-specific standards. We present here the first craniometric standards for sex determination of a contemporary Tunisian population. The aim of this study was to analyze the correlation between sex and metric parameters of the skull in this population using CT scan analysis and to generate proper reliable standards for sex determination of a complete or fragmented skull. The study sample comprised cranial multislice computed tomography scans of 510 individuals equally distributed by sex. ASIR TM software in a General Electric TM workstation was used to position 37 landmarks along the volume-rendered images and the multiplanar slices, defining 27 inter-landmark distances. Frontal and parietal bone thickness was also measured for each case. The data were analyzed using basic descriptive statistics and logistic regression with cross-validation of classification results. All of the measurements were sexually dimorphic with male values being higher than female values. A nine-variable model achieved the maximum classification accuracy of 90% with -2.9% sex bias and a six-variable model yielded 85.9% sexing accuracy with -0.97% sex bias. We conclude that the skull is highly dimorphic and represents a reliable bone for sex determination in contemporary Tunisian individuals.

Investigation of practical approaches to evaluating cumulative dose for cone beam computed tomography (CBCT) from standard CT dosimetry measurements: a Monte Carlo study.

PubMed

Abuhaimed, Abdullah; Martin, Colin J; Sankaralingam, Marimuthu; Gentle, David J

2015-07-21

A function called Gx(L) was introduced by the International Commission on Radiation Units and Measurements (ICRU) Report-87 to facilitate measurement of cumulative dose for CT scans within long phantoms as recommended by the American Association of Physicists in Medicine (AAPM) TG-111. The Gx(L) function is equal to the ratio of the cumulative dose at the middle of a CT scan to the volume weighted CTDI (CTDIvol), and was investigated for conventional multi-slice CT scanners operating with a moving table. As the stationary table mode, which is the basis for cone beam CT (CBCT) scans, differs from that used for conventional CT scans, the aim of this study was to investigate the extension of the Gx(L) function to CBCT scans. An On-Board Imager (OBI) system integrated with a TrueBeam linac was simulated with Monte Carlo EGSnrc/BEAMnrc, and the absorbed dose was calculated within PMMA, polyethylene (PE), and water head and body phantoms using EGSnrc/DOSXYZnrc, where the body PE body phantom emulated the ICRU/AAPM phantom. Beams of width 40-500 mm and beam qualities at tube potentials of 80-140 kV were studied. Application of a modified function of beam width (W) termed Gx(W), for which the cumulative dose for CBCT scans f (0) is normalized to the weighted CTDI (CTDIw) for a reference beam of width 40 mm, was investigated as a possible option. However, differences were found in Gx(W) with tube potential, especially for body phantoms, and these were considered to be due to differences in geometry between wide beams used for CBCT scans and those for conventional CT. Therefore, a modified function Gx(W)100 has been proposed, taking the form of values of f (0) at each position in a long phantom, normalized with respect to dose indices f 100(150)x measured with a 100 mm pencil ionization chamber within standard 150 mm PMMA phantoms, using the same scanning parameters, beam widths and positions within the phantom. f 100(150)x averages the dose resulting from a CBCT scan over the 100 mm length. Like the Gx(L) function, the Gx(W)100 function showed only a weak dependency on tube potential at most positions for the phantoms studied. The results were fitted to polynomial equations from which f (0) within the longer PMMA, PE, or water phantoms can be evaluated from measurements of f 100(150)x. Comparisons with other studies, suggest that these functions may be suitable for application to any CT or CBCT scan acquired with stationary table mode.

Rich internet application system for patient-centric healthcare data management using handheld devices.

PubMed

Constantinescu, L; Pradana, R; Kim, J; Gong, P; Fulham, Michael; Feng, D

2009-01-01

Rich Internet Applications (RIAs) are an emerging software platform that blurs the line between web service and native application, and is a powerful tool for handheld device deployment. By democratizing health data management and widening its availability, this software platform has the potential to revolutionize telemedicine, clinical practice, medical education and information distribution, particularly in rural areas, and to make patient-centric medical computing a reality. In this paper, we propose a telemedicine application that leverages the ability of a mobile RIA platform to transcode, organise and present textual and multimedia data, which are sourced from medical database software. We adopted a web-based approach to communicate, in real-time, with an established hospital information system via a custom RIA. The proposed solution allows communication between handheld devices and a hospital information system for media streaming with support for real-time encryption, on any RIA enabled platform. We demonstrate our prototype's ability to securely and rapidly access, without installation requirements, medical data ranging from simple textual records to multi-slice PET-CT images and maximum intensity (MIP) projections.

Magnetic resonance imaging of the nose and paranasal sinuses.

PubMed Central

Lloyd, G A

1989-01-01

Seventy-five patients with a wide range of sinus disease have been investigated by magnetic resonance (MR): these included congenital conditions, allergic and inflammatory sinus disease, fungus infections, and the necrotizing granulomata. In addition, a variety of benign and malignant tumours have been examined, and in the more recent sinus malignancies the paramagnetic contrast agent, Gadolinium (Gd) DTPA (Schering Health Care) has been used. This experience of magnetic resonance scanning has shown that it is superior to computed tomography in demonstrating the extent of malignant disease in the nose and sinuses; most especially when Gd DTPA is used, reaching an accuracy of over 96% by biopsy correlation. An additional advantage of this technique is the wide coverage of the head and neck for the assessment of malignant disease, provided by direct 3 plane imaging and the multislice facility. The main disadvantage of magnetic resonance of the sinuses is the poor demonstration of calcification and bone. For this reason the MR scans may need to be augmented by high resolution CT performed specifically to show bone detail. Images Figure 2. Figure 3. PMID:2926770

The “dirty chest”—correlations between chest radiography, multislice CT and tobacco burden

PubMed Central

Kirchner, J; Goltz, J P; Lorenz, F; Obermann, A; Kirchner, E M; Kickuth, R

2012-01-01

Objectives Cigarette smoking-induced airway disease commonly results in an overall increase of non-specific lung markings on chest radiography. This has been described as “dirty chest”. As the morphological substrate of this condition is similar to the anthracosilicosis of coal workers, we hypothesised that it is possible to quantify the radiological changes using the International Labour Organization (ILO) classification of pneumoconiosis. The aims of this study were to evaluate whether there is a correlation between the extent of cigarette smoking and increased lung markings on chest radiography and to correlate the chest radiographic scores with findings on CT studies. Methods In a prospective analysis a cohort of 85 smokers was examined. The cigarette consumption was evaluated in pack years (defined as 20 cigarettes per day over 1 year). Film reading was performed by two board-certified radiologists. Chest radiographs were evaluated for the presence of thickening of bronchial walls, the presence of linear or nodular opacities, and emphysema. To correlate the smoking habits with the increase of overall lung markings in chest radiography, the ILO profusion score was converted to numbers ranging from zero to nine. Chest radiographs were rated according to the complete set of standard films of the revised ILO classification. Results 63/85 (74%) of the smokers showed an increase in overall lung markings on chest radiography; 32 (37%) had an ILO profusion score of <1/1, 29 (34%) had an ILO profusion score of <2/2 and 2 (2%) had an ILO score of ≥2/2. There was a significant positive linear correlation between the increase of overall lung markings on chest radiography and the cigarette consumption quantified as pack years (r=0.68). The majority of the heavy smokers (>40 pack years) showed emphysema; there was no significant difference between the prevalence of emphysema as diagnosed by CT (62%) or chest radiography (71%) (p<0.05).The most common findings in CT were thickening of bronchial walls (64%) and the presence of emphysema (62%) and of intralobular opacities (61%). Ground-glass opacities were seen in only 7% of our patients. Conclusion Bronchial wall thickening and intralobular opacities as seen in CT showed a positive linear correlation with the increase of overall lung markings on chest radiography. PMID:21937617

4D XCAT phantom for multimodality imaging research

PubMed Central

Segars, W. P.; Sturgeon, G.; Mendonca, S.; Grimes, Jason; Tsui, B. M. W.

2010-01-01

Purpose: The authors develop the 4D extended cardiac-torso (XCAT) phantom for multimodality imaging research. Methods: Highly detailed whole-body anatomies for the adult male and female were defined in the XCAT using nonuniform rational B-spline (NURBS) and subdivision surfaces based on segmentation of the Visible Male and Female anatomical datasets from the National Library of Medicine as well as patient datasets. Using the flexibility of these surfaces, the Visible Human anatomies were transformed to match body measurements and organ volumes for a 50th percentile (height and weight) male and female. The desired body measurements for the models were obtained using the PEOPLESIZE program that contains anthropometric dimensions categorized from 1st to the 99th percentile for US adults. The desired organ volumes were determined from ICRP Publication 89 [ICRP, ‘‘Basic anatomical and physiological data for use in radiological protection: reference values,” ICRP Publication 89 (International Commission on Radiological Protection, New York, NY, 2002)]. The male and female anatomies serve as standard templates upon which anatomical variations may be modeled in the XCAT through user-defined parameters. Parametrized models for the cardiac and respiratory motions were also incorporated into the XCAT based on high-resolution cardiac- and respiratory-gated multislice CT data. To demonstrate the usefulness of the phantom, the authors show example simulation studies in PET, SPECT, and CT using publicly available simulation packages. Results: As demonstrated in the pilot studies, the 4D XCAT (which includes thousands of anatomical structures) can produce realistic imaging data when combined with accurate models of the imaging process. With the flexibility of the NURBS surface primitives, any number of different anatomies, cardiac or respiratory motions or patterns, and spatial resolutions can be simulated to perform imaging research. Conclusions: With the ability to produce realistic, predictive 3D and 4D imaging data from populations of normal and abnormal patients under various imaging parameters, the authors conclude that the XCAT provides an important tool in imaging research to evaluate and improve imaging devices and techniques. In the field of x-ray CT, the phantom may also provide the necessary foundation with which to optimize clinical CT applications in terms of image quality versus radiation dose, an area of research that is becoming more significant with the growing use of CT. PMID:20964209

Prevalence of sacral dysmorphia in a prospective trauma population: Implications for a "safe" surgical corridor for sacro-iliac screw placement

PubMed Central

2011-01-01

Background Percutaneous sacro-iliac (SI) screw fixation represents a widely used technique in the management of unstable posterior pelvic ring injuries and sacral fractures. The misplacement of SI-screws under fluoroscopic guidance represents a critical complication for these patients. This study was designed to determine the prevalence of sacral dysmorphia and the radiographic anatomy of surgical S1 and S2 corridors in a representative trauma population. Methods Prospective observational cohort study on a consecutive series of 344 skeletally mature trauma patients of both genders enrolled between January 1, 2007, to September 30, 2007, at a single academic level 1 trauma center. Inclusion criteria included a pelvic CT scan as part of the initial diagnostic trauma work-up. The prevalence of sacral dysmorphia was determined by plain radiographic pelvic films and CT scan analysis. The anatomy of sacral corridors was analyzed on 3 mm reconstruction sections derived from multislice CT scan, in the axial, coronal, and sagittal plane. "Safe" potential surgical corridors at S1 and S2 were calculated based on these measurements. Results Radiographic evidence of sacral dysmorphia was detected in 49 patients (14.5%). The prevalence of sacral dysmorphia was not significantly different between male and female patients (12.2% vs. 19.2%; P = 0.069). In contrast, significant gender-related differences were detected with regard to radiographic analysis of surgical corridors for SI-screw placement, with female trauma patients (n = 99) having significantly narrower corridors at S1 and S2 in all evaluated planes (axial, coronal, sagittal), compared to male counterparts (n = 245; P < 0.01). In addition, the mean S2 body height was higher in dysmorphic compared to normal sacra, albeit without statistical significance (P = 0.06), implying S2 as a safe surgical corridor of choice in patients with sacral dysmorphia. Conclusions These findings emphasize a high prevalence of sacral dysmorphia in a representative trauma population and imply a higher risk of SI-screw misplacement in female patients. Preoperative planning for percutaneous SI-screw fixation for unstable pelvic and sacral fractures must include a detailed CT scan analysis to determine the safety of surgical corridors. PMID:21569232

Prevalence of sacral dysmorphia in a prospective trauma population: Implications for a "safe" surgical corridor for sacro-iliac screw placement.

PubMed

Hasenboehler, Erik A; Stahel, Philip F; Williams, Allison; Smith, Wade R; Newman, Justin T; Symonds, David L; Morgan, Steven J

2011-05-10

Percutaneous sacro-iliac (SI) screw fixation represents a widely used technique in the management of unstable posterior pelvic ring injuries and sacral fractures. The misplacement of SI-screws under fluoroscopic guidance represents a critical complication for these patients. This study was designed to determine the prevalence of sacral dysmorphia and the radiographic anatomy of surgical S1 and S2 corridors in a representative trauma population. Prospective observational cohort study on a consecutive series of 344 skeletally mature trauma patients of both genders enrolled between January 1, 2007, to September 30, 2007, at a single academic level 1 trauma center. Inclusion criteria included a pelvic CT scan as part of the initial diagnostic trauma work-up. The prevalence of sacral dysmorphia was determined by plain radiographic pelvic films and CT scan analysis. The anatomy of sacral corridors was analyzed on 3 mm reconstruction sections derived from multislice CT scan, in the axial, coronal, and sagittal plane. "Safe" potential surgical corridors at S1 and S2 were calculated based on these measurements. Radiographic evidence of sacral dysmorphia was detected in 49 patients (14.5%). The prevalence of sacral dysmorphia was not significantly different between male and female patients (12.2% vs. 19.2%; P = 0.069). In contrast, significant gender-related differences were detected with regard to radiographic analysis of surgical corridors for SI-screw placement, with female trauma patients (n = 99) having significantly narrower corridors at S1 and S2 in all evaluated planes (axial, coronal, sagittal), compared to male counterparts (n = 245; P < 0.01). In addition, the mean S2 body height was higher in dysmorphic compared to normal sacra, albeit without statistical significance (P = 0.06), implying S2 as a safe surgical corridor of choice in patients with sacral dysmorphia. These findings emphasize a high prevalence of sacral dysmorphia in a representative trauma population and imply a higher risk of SI-screw misplacement in female patients. Preoperative planning for percutaneous SI-screw fixation for unstable pelvic and sacral fractures must include a detailed CT scan analysis to determine the safety of surgical corridors.

Radiation dose and image conspicuity comparison between conventional 120 kVp and 150 kVp with spectral beam shaping for temporal bone CT.

PubMed

Kim, Chang Rae; Jeon, Ji Young

2018-05-01

The purpose of this article is to compare radiation doses and conspicuity of anatomic landmarks of the temporal bone between the CT technique using spectral beam shaping at 150 kVp with a dedicated tin filter (150 kVp-Sn) and the conventional protocol at 120 kVp. 25 patients (mean age, 46.8 ± 21.2 years) were examined using the 150-kVp Sn protocol (200 reference mAs using automated tube current modulation, 64 × 0.6 mm collimation, 0.6 mm slice thickness, pitch 0.8), whereas 30 patients (mean age, 54.5 ± 17.8 years) underwent the 120-kVp protocol (180 mAs, 128 × 0.6 mm collimation, 0.6 mm slice thickness, pitch 0.8). Radiation doses were compared between the two acquisition techniques, and dosimetric data from the literature were reviewed for comparison of radiation dose reduction. Subjective conspicuity of 23 anatomic landmarks of the temporal bone, expressed by 5-point rating scale and objective conspicuity by signal-to-noise ratio (SNR) which measured in 4 different regions of interest (ROI), were compared between 150-kVp Sn and 120-kVp acquisitions. The mean dose-length-product (DLP) and effective dose were significantly lower for the 150-kVp Sn scans (0.26 ± 0.26 mSv) compared with the 120-kVp scans (0.92 ± 0.10 mSv, p < 0.001). The lowest effective dose from the literature-based protocols was 0.31 ± 0.12 mSv, which proposed as a low-dose protocol in the setting of spiral multislice temporal bone CT. SNR was slightly superior for 120-kVp images, however analyzability of the 23 anatomic structures did not differ significantly between 150-kVp Sn and 120-kVp scans. Temporal bone CT performed at 150 kVp with an additional tin filter for spectral shaping markedly reduced radiation exposure when compared with conventional temporal bone CT at 120 kVp while maintaining anatomic conspicuity. The decreased radiation dose of the 150-kVp Sn was also lower in comparison to the previous literature-based low-dose temporal bone CT protocol. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinical application of three-dimensional reconstruction and rapid prototyping technology of multislice spiral computed tomography angiography for the repair of ventricular septal defect of tetralogy of Fallot.

PubMed

Ma, X J; Tao, L; Chen, X; Li, W; Peng, Z Y; Chen, Y; Jin, J; Zhang, X L; Xiong, Q F; Zhong, Z L; Chen, X F

2015-02-13

Three-dimensional (3D) reconstruction and rapid prototyping technology (RPT) of multislice spiral computed tomography angiography (CTA) was applied to prepare physical models of the heart and ventricular septal defects of tetralogy of Fallot (ToF) patients in order to explore their applications in the diagnosis and treatment of this complex heart disease. CTA data of 35 ToF patients were collected to prepare l:l 3D solid models using digital 3D reconstruction and RPT, and the resultant models were used intraoperatively as reference. The operations of all 35 patients were completed under the guidance of the 3D solid model, without difficulty. Intraoperative findings of the patients were consistent with the morphological and size changes of the 3D solid model, and no significant differences were found between the patches obtained from the 3D solid model and the actual intraoperative measurements (t = 0.83, P = 0.412). 3D reconstruction and RPT of multislice spiral CTA can accurately and intuitively reflect the anatomy of ventricular septal defects in ToF patients, providing the foundation for a solid model of the complex congenital heart.

Chest Wall Constriction after the Nuss Procedure Identified from Chest Radiograph and Multislice Computed Tomography Shortly after Removal of the Bar.

PubMed

Chang, Pei-Yeh; Zeng, Qi; Wong, Kin-Sun; Wang, Chao-Jan; Chang, Chee-Jen

2016-01-01

This study radiographically examined the changes in the chest walls of patients with pectus excavatum (PE) after Nuss bar removal, to define the deformation caused by the bar and stabilizer. In the first part of the study, we compared the changes in chest radiographs of patients with PE to a preoperation PE control group. In the second part, we used multislice computed tomography (CT) scans to provide three-dimensional reconstructions with which to evaluate the changes to the thoracic wall. Part 1 From June 2006 to August 2011, 1,125 patients with PE who had posteroanterior chest radiographs taken before undergoing the Nuss procedure at four hospitals were enrolled as a preoperative control group. At the same time, 203 patients who had the bar removed were enrolled as the study group. The maximum dimensions of the outer boundary of the first to ninth rib pairs (R1-R9, rib pair width), chest height, and chest width were measured. Part 2 Thirty-one consecutive patients with PE (20 males and 11 females) who underwent Nuss bar removal were evaluated 7 to 30 days after operation. During this period, a further 34 patients with PE who had undergone CT imaging before bar insertion were evaluated and compared with the postoperative group. Part 1 The width of the lower ribs (R4-R9) after bar removal was significantly less than in the age-matched controls. The ribs adjacent to the bar (R5-R7) showed the greatest restriction. The width of the upper ribs (R1-R3) 2 to 3 years after bar placement did not differ significantly from the controls. Patients who were operated on after 10 years of age had less of a restrictive effect. Three years of bar placement resulted in more restriction than a 2-year period, particularly in patients younger than 10 years old. Part 2: A significant constriction of the chest wall was observed in 13 patients after removal of the Nuss bar. Constriction at ribs 5 to 8 was found to be present adjacent to the site of bar insertion. However, constriction of the chest wall was found in only 3 of the 34 patients in the preoperative group. The severity of constriction (as graded by the spline model) also increased in the postoperative group. The growth of the chest wall was restricted after placement of the Nuss bar for PE correction. Long-term follow-up of chest wall growth is needed to clarify whether such constriction resolves with time. Georg Thieme Verlag KG Stuttgart · New York.

SU-E-T-599: The Variation of Hounsfield Unit and Relative Electron Density Determination as a Function of KVp and Its Effect On Dose Calculation Accuracy

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

Ohl, A; Boer, S De

Purpose: To investigate the differences in relative electron density for different energy (kVp) settings and the effect that these differences have on dose calculations. Methods: A Nuclear Associates 76-430 Mini CT QC Phantom with materials of known relative electron densities was imaged by one multi-slice (16) and one single-slice computed tomography (CT) scanner. The Hounsfield unit (HU) was recorded for each material with energies ranging from 80 to 140 kVp and a representative relative electron density (RED) curve was created. A 5 cm thick inhomogeneity was created in the treatment planning system (TPS) image at a depth of 5 cm.more » The inhomogeneity was assigned HU for various materials for each kVp calibration curve. The dose was then calculated with the analytical anisotropic algorithm (AAA) at points within and below the inhomogeneity and compared using the 80 kVp beam as a baseline. Results: The differences in RED values as a function of kVp showed the largest variations of 580 and 547 HU for the Aluminum and Bone materials; the smallest differences of 0.6 and 3.0 HU were observed for the air and lung inhomogeneities. The corresponding dose calculations for the different RED values assigned to the 5 cm thick slab revealed the largest differences inside the aluminum and bone inhomogeneities of 2.2 to 6.4% and 4.3 to 7.0% respectively. The dose differences beyond these two inhomogeneities were between 0.4 to 1.6% for aluminum and 1.9 to 2.2 % for bone. For materials with lower HU the calculated dose differences were less than 1.0%. Conclusion: For high CT number materials the dose differences in the phantom calculation as high as 7.0% are significant. This result may indicate that implementing energy specific RED curves can increase dose calculation accuracy.« less

Novel detector design for reducing intercell x-ray cross-talk in the variable resolution x-ray CT scanner: a Monte Carlo study.

PubMed

Arabi, Hosein; Asl, Ali Reza Kamali; Ay, Mohammad Reza; Zaidi, Habib

2011-03-01

The variable resolution x-ray (VRX) CT scanner provides substantial improvement in the spatial resolution by matching the scanner's field of view (FOV) to the size of the object being imaged. Intercell x-ray cross-talk is one of the most important factors limiting the spatial resolution of the VRX detector. In this work, a new cell arrangement in the VRX detector is suggested to decrease the intercell x-ray cross-talk. The idea is to orient the detector cells toward the opening end of the detector. Monte Carlo simulations were used for performance assessment of the oriented cell detector design. Previously published design parameters and simulation results of x-ray cross-talk for the VRX detector were used for model validation using the GATE Monte Carlo package. In the first step, the intercell x-ray cross-talk of the actual VRX detector model was calculated as a function of the FOV. The obtained results indicated an optimum cell orientation angle of 28 degrees to minimize the x-ray cross-talk in the VRX detector. Thereafter, the intercell x-ray cross-talk in the oriented cell detector was modeled and quantified. The intercell x-ray cross-talk in the actual detector model was considerably high, reaching up to 12% at FOVs from 24 to 38 cm. The x-ray cross-talk in the oriented cell detector was less than 5% for all possible FOVs, except 40 cm (maximum FOV). The oriented cell detector could provide considerable decrease in the intercell x-ray cross-talk for the VRX detector, thus leading to significant improvement in the spatial resolution and reduction in the spatial resolution nonuniformity across the detector length. The proposed oriented cell detector is the first dedicated detector design for the VRX CT scanners. Application of this concept to multislice and flat-panel VRX detectors would also result in higher spatial resolution.

[Role of multislice computed tomography in the diagnosis of acute rupture of the thoracic aorta and hepatic artery in a patient with severe concomitant injury].

PubMed

Muslimov, R Sh; Sharifullin, F A; Chernaia, N R; Novruzbekov, M S; Kokov, L S

2015-01-01

Acute traumatic aortic rupture is associated with extremely high mortality rates and requires emergency diagnosis and treatment. This clinical example shows the role of multislice spiral computed tomography in the emergency diagnosis of rupture of two large arterial vessels in severe concomitant injury. It presents the benefits of this rapid and noninvasive imaging technique, an algorithm of the study and the semiotics of injuries in patients with suspected traumatic aortic rupture. The paper also shows the importance of this method in defining treatment policy and then in the assessment of the results of the performed correction.

Multislice imaging of integrated circuits by precession X-ray ptychography.

PubMed

Shimomura, Kei; Hirose, Makoto; Takahashi, Yukio

2018-01-01

A method for nondestructively visualizing multisection nanostructures of integrated circuits by X-ray ptychography with a multislice approach is proposed. In this study, tilt-series ptychographic diffraction data sets of a two-layered circuit with a ∼1.4 µm gap at nine incident angles are collected in a wide Q range and then artifact-reduced phase images of each layer are successfully reconstructed at ∼10 nm resolution. The present method has great potential for the three-dimensional observation of flat specimens with thickness on the order of 100 µm, such as three-dimensional stacked integrated circuits based on through-silicon vias, without laborious sample preparation.

Is fetal-type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

PubMed

He, Zhen; Wan, Yeda

2018-01-01

Fetal-type posterior cerebral artery (FTP) is a common anatomic variation that is closely associated with intracranial aneurysm. In the present study, multislice computed tomography angiography (CTA) was performed to assess whether FTP is a risk factor for intracranial aneurysm. CTA data of 364 consecutive cases of patients who were suspected with cerebrovascular disease or intracranial aneurysm of intracranial artery from 2013 to 2016 were reviewed and the incidence rates of FTP, other variations of the circle of Willis, intracranial aneurysm and FTP with intracranial aneurysm were evaluated. The χ 2 test was used to assess the influence of FTP and gender on the incidence rates of other variations of the circle of Willis, intracranial aneurysm and internal carotid artery-posterior communicating artery (ICA-PComA) aneurysm. Binary logistic regression analysis was performed to assess the associations of FTP and gender with intracranial aneurysm and ICA-PComA aneurysm. Compared with non-FTP patients, FTP cases exhibited significantly higher rates of other variations of the circle of Willis (χ 2 =80.173, P<0.001) and ICA-PComA aneurysm (χ 2 =4.437, P=0.035). Among patients with FTP and bilateral FTP, more female than male patients with intracranial aneurysm were identified. However, among all patients with intracranial aneurysm, no statistically significant differences in the prevalence of FTP (χ 2 =2.577, P=0.108) and bilateral FTP (χ 2 =2.199, P=0.159) between males and females were identified. Binary logistic regression analysis revealed that FTP and gender were risk factors for intracranial aneurysm and ICA-PComA aneurysm. A moderate association between FTP and ICA-PComA aneurysm (OR=2.762) were identified, although there was a weak association between FTP and intracranial aneurysm [odds ratio (OR)=1.365]. Furthermore, a strong association was identified between gender and intracranial aneurysm (OR=0.328), and a moderate association existed between gender and ICA-PComA aneurysm (OR=0.357). In conclusion, female gender is an independent risk factor for intracranial aneurysm, and FTP and female gender are independent risk factors for ICA-PComA aneurysm.

Is fetal-type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

PubMed Central

He, Zhen; Wan, Yeda

2018-01-01

Fetal-type posterior cerebral artery (FTP) is a common anatomic variation that is closely associated with intracranial aneurysm. In the present study, multislice computed tomography angiography (CTA) was performed to assess whether FTP is a risk factor for intracranial aneurysm. CTA data of 364 consecutive cases of patients who were suspected with cerebrovascular disease or intracranial aneurysm of intracranial artery from 2013 to 2016 were reviewed and the incidence rates of FTP, other variations of the circle of Willis, intracranial aneurysm and FTP with intracranial aneurysm were evaluated. The χ2 test was used to assess the influence of FTP and gender on the incidence rates of other variations of the circle of Willis, intracranial aneurysm and internal carotid artery-posterior communicating artery (ICA-PComA) aneurysm. Binary logistic regression analysis was performed to assess the associations of FTP and gender with intracranial aneurysm and ICA-PComA aneurysm. Compared with non-FTP patients, FTP cases exhibited significantly higher rates of other variations of the circle of Willis (χ2=80.173, P<0.001) and ICA-PComA aneurysm (χ2=4.437, P=0.035). Among patients with FTP and bilateral FTP, more female than male patients with intracranial aneurysm were identified. However, among all patients with intracranial aneurysm, no statistically significant differences in the prevalence of FTP (χ2=2.577, P=0.108) and bilateral FTP (χ2=2.199, P=0.159) between males and females were identified. Binary logistic regression analysis revealed that FTP and gender were risk factors for intracranial aneurysm and ICA-PComA aneurysm. A moderate association between FTP and ICA-PComA aneurysm (OR=2.762) were identified, although there was a weak association between FTP and intracranial aneurysm [odds ratio (OR)=1.365]. Furthermore, a strong association was identified between gender and intracranial aneurysm (OR=0.328), and a moderate association existed between gender and ICA-PComA aneurysm (OR=0.357). In conclusion, female gender is an independent risk factor for intracranial aneurysm, and FTP and female gender are independent risk factors for ICA-PComA aneurysm. PMID:29434687

Prospective study comparing three-dimensional computed tomography and magnetic resonance imaging for evaluating the renal vascular anatomy in potential living renal donors.

PubMed

Bhatti, Aftab A; Chugtai, Aamir; Haslam, Philip; Talbot, David; Rix, David A; Soomro, Naeem A

2005-11-01

To prospectively compare the accuracy of multislice spiral computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) in evaluating the renal vascular anatomy in potential living renal donors. Thirty-one donors underwent multislice spiral CTA and gadolinium-enhanced MRA. In addition to axial images, multiplanar reconstruction and maximum intensity projections were used to display the renal vascular anatomy. Twenty-four donors had a left laparoscopic donor nephrectomy (LDN), whereas seven had right open donor nephrectomy (ODN); LDN was only considered if the renal vascular anatomy was favourable on the left. CTA and MRA images were analysed by two radiologists independently. The radiological and surgical findings were correlated after the surgery. CTA showed 33 arteries and 32 veins (100% sensitivity) whereas MRA showed 32 arteries and 31 veins (97% sensitivity). CTA detected all five accessory renal arteries whereas MRA only detected one. CTA also identified all three accessory renal veins whereas MRA identified two. CTA had a sensitivity of 97% and 47% for left lumbar and left gonadal veins, whereas MRA had a sensitivity of 74% and 46%, respectively. Multislice spiral CTA with three-dimensional reconstruction was more accurate than MRA for both renal arterial and venous anatomy.

A z-gradient array for simultaneous multi-slice excitation with a single-band RF pulse.

PubMed

Ertan, Koray; Taraghinia, Soheil; Sadeghi, Alireza; Atalar, Ergin

2018-07-01

Multi-slice radiofrequency (RF) pulses have higher specific absorption rates, more peak RF power, and longer pulse durations than single-slice RF pulses. Gradient field design techniques using a z-gradient array are investigated for exciting multiple slices with a single-band RF pulse. Two different field design methods are formulated to solve for the required current values of the gradient array elements for the given slice locations. The method requirements are specified, optimization problems are formulated for the minimum current norm and an analytical solution is provided. A 9-channel z-gradient coil array driven by independent, custom-designed gradient amplifiers is used to validate the theory. Performance measures such as normalized slice thickness error, gradient strength per unit norm current, power dissipation, and maximum amplitude of the magnetic field are provided for various slice locations and numbers of slices. Two and 3 slices are excited by a single-band RF pulse in simulations and phantom experiments. The possibility of multi-slice excitation with a single-band RF pulse using a z-gradient array is validated in simulations and phantom experiments. Magn Reson Med 80:400-412, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Development of Multi-slice Analytical Tool to Support BIM-based Design Process

NASA Astrophysics Data System (ADS)

Atmodiwirjo, P.; Johanes, M.; Yatmo, Y. A.

2017-03-01

This paper describes the on-going development of computational tool to analyse architecture and interior space based on multi-slice representation approach that is integrated with Building Information Modelling (BIM). Architecture and interior space is experienced as a dynamic entity, which have the spatial properties that might be variable from one part of space to another, therefore the representation of space through standard architectural drawings is sometimes not sufficient. The representation of space as a series of slices with certain properties in each slice becomes important, so that the different characteristics in each part of space could inform the design process. The analytical tool is developed for use as a stand-alone application that utilises the data exported from generic BIM modelling tool. The tool would be useful to assist design development process that applies BIM, particularly for the design of architecture and interior spaces that are experienced as continuous spaces. The tool allows the identification of how the spatial properties change dynamically throughout the space and allows the prediction of the potential design problems. Integrating the multi-slice analytical tool in BIM-based design process thereby could assist the architects to generate better design and to avoid unnecessary costs that are often caused by failure to identify problems during design development stages.

Phase-sensitive dual-inversion recovery for accelerated carotid vessel wall imaging.

PubMed

Bonanno, Gabriele; Brotman, David; Stuber, Matthias

2015-03-01

Dual-inversion recovery (DIR) is widely used for magnetic resonance vessel wall imaging. However, optimal contrast may be difficult to obtain and is subject to RR variability. Furthermore, DIR imaging is time-inefficient and multislice acquisitions may lead to prolonged scanning times. Therefore, an extension of phase-sensitive (PS) DIR is proposed for carotid vessel wall imaging. The statistical distribution of the phase signal after DIR is probed to segment carotid lumens and suppress their residual blood signal. The proposed PS-DIR technique was characterized over a broad range of inversion times. Multislice imaging was then implemented by interleaving the acquisition of 3 slices after DIR. Quantitative evaluation was then performed in healthy adult subjects and compared with conventional DIR imaging. Single-slice PS-DIR provided effective blood-signal suppression over a wide range of inversion times, enhancing wall-lumen contrast and vessel wall conspicuity for carotid arteries. Multislice PS-DIR imaging with effective blood-signal suppression is enabled. A variant of the PS-DIR method has successfully been implemented and tested for carotid vessel wall imaging. This technique removes timing constraints related to inversion recovery, enhances wall-lumen contrast, and enables a 3-fold increase in volumetric coverage at no extra cost in scanning time.

The development of hematopoietic and mesenchymal stem cell transplantation as an effective treatment for multiple sclerosis

PubMed Central

Holloman, Jameson P; Ho, Calvin C; Hukki, Arushi; Huntley, Jennifer L; Gallicano, G Ian

2013-01-01

This article examines the current use and future implications of stem cell therapy in treating Multiple Sclerosis (MS). MS is the most common neurological disease in young adults, affecting approximately two million people worldwide. Currently there is no cure for MS. The standard treatment of MS involves disease-modifying drugs, which work to alleviate the symptoms of MS. However, these drugs carry adverse side effects and are ineffective in preventing disease progression in many MS patients. Hematopoietic stem cell transplantation (HSCT) was first used in 1995 to treat patients with severe rapidly progressing MS. The HSCT treatment protocol has evolved into a less intense conditioning regimen that is currently demonstrating efficacy in treating patients with variable disease severity—with best results in early-stage rapidly progressing MS patients with active CNS inflammation. Mesenchymal stem cell therapy (MSCT) is an experimental stem cell therapy currently undergoing clinical trials. Animal models and early clinical trials have shown promise that MSCT might be a low risk treatment to precipitate neuroregeneration and immunomodulation in MS patients. Specifically, neuroprogenitor and placental-derived mesenchymal stem cells offer the best hope for a practical treatment for MS. Stem cell therapy, and perhaps a combinatorial therapeutic approach, holds promise for a better treatment for MS. PMID:23862098

High-speed multislice T1 mapping using inversion-recovery echo-planar imaging.

PubMed

Ordidge, R J; Gibbs, P; Chapman, B; Stehling, M K; Mansfield, P

1990-11-01

Tissue contrast in MR images is a strong function of spin-lattice (T1) and spin-spin (T2) relaxation times. However, the T1 relaxation time is rarely quantified because of the long scan time required to produce an accurate T1 map of the subject. In a standard 2D FT technique, this procedure may take up to 30 min. Modifications of the echo-planar imaging (EPI) technique which incorporate the principle of inversion recovery (IR) enable multislice T1 maps to be produced in total scan times varying from a few seconds up to a minute. Using IR-EPI, rapid quantification of T1 values may thus lead to better discrimination between tissue types in an acceptable scan time.

A fast image simulation algorithm for scanning transmission electron microscopy.

PubMed

Ophus, Colin

2017-01-01

Image simulation for scanning transmission electron microscopy at atomic resolution for samples with realistic dimensions can require very large computation times using existing simulation algorithms. We present a new algorithm named PRISM that combines features of the two most commonly used algorithms, namely the Bloch wave and multislice methods. PRISM uses a Fourier interpolation factor f that has typical values of 4-20 for atomic resolution simulations. We show that in many cases PRISM can provide a speedup that scales with f 4 compared to multislice simulations, with a negligible loss of accuracy. We demonstrate the usefulness of this method with large-scale scanning transmission electron microscopy image simulations of a crystalline nanoparticle on an amorphous carbon substrate.

A fast image simulation algorithm for scanning transmission electron microscopy

DOE PAGES

Ophus, Colin

2017-05-10

Image simulation for scanning transmission electron microscopy at atomic resolution for samples with realistic dimensions can require very large computation times using existing simulation algorithms. Here, we present a new algorithm named PRISM that combines features of the two most commonly used algorithms, namely the Bloch wave and multislice methods. PRISM uses a Fourier interpolation factor f that has typical values of 4-20 for atomic resolution simulations. We show that in many cases PRISM can provide a speedup that scales with f 4 compared to multislice simulations, with a negligible loss of accuracy. We demonstrate the usefulness of this methodmore » with large-scale scanning transmission electron microscopy image simulations of a crystalline nanoparticle on an amorphous carbon substrate.« less

A model-based scatter artifacts correction for cone beam CT

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

Zhao, Wei; Zhu, Jun; Wang, Luyao

2016-04-15

Purpose: Due to the increased axial coverage of multislice computed tomography (CT) and the introduction of flat detectors, the size of x-ray illumination fields has grown dramatically, causing an increase in scatter radiation. For CT imaging, scatter is a significant issue that introduces shading artifact, streaks, as well as reduced contrast and Hounsfield Units (HU) accuracy. The purpose of this work is to provide a fast and accurate scatter artifacts correction algorithm for cone beam CT (CBCT) imaging. Methods: The method starts with an estimation of coarse scatter profiles for a set of CBCT data in either image domain ormore » projection domain. A denoising algorithm designed specifically for Poisson signals is then applied to derive the final scatter distribution. Qualitative and quantitative evaluations using thorax and abdomen phantoms with Monte Carlo (MC) simulations, experimental Catphan phantom data, and in vivo human data acquired for a clinical image guided radiation therapy were performed. Scatter correction in both projection domain and image domain was conducted and the influences of segmentation method, mismatched attenuation coefficients, and spectrum model as well as parameter selection were also investigated. Results: Results show that the proposed algorithm can significantly reduce scatter artifacts and recover the correct HU in either projection domain or image domain. For the MC thorax phantom study, four-components segmentation yields the best results, while the results of three-components segmentation are still acceptable. The parameters (iteration number K and weight β) affect the accuracy of the scatter correction and the results get improved as K and β increase. It was found that variations in attenuation coefficient accuracies only slightly impact the performance of the proposed processing. For the Catphan phantom data, the mean value over all pixels in the residual image is reduced from −21.8 to −0.2 HU and 0.7 HU for projection domain and image domain, respectively. The contrast of the in vivo human images is greatly improved after correction. Conclusions: The software-based technique has a number of advantages, such as high computational efficiency and accuracy, and the capability of performing scatter correction without modifying the clinical workflow (i.e., no extra scan/measurement data are needed) or modifying the imaging hardware. When implemented practically, this should improve the accuracy of CBCT image quantitation and significantly impact CBCT-based interventional procedures and adaptive radiation therapy.« less

Dynamic multi-coil tailored excitation for transmit B1 correction at 7 Tesla.

PubMed

Umesh Rudrapatna, S; Juchem, Christoph; Nixon, Terence W; de Graaf, Robin A

2016-07-01

Tailored excitation (TEx) based on interspersing multiple radio frequency pulses with linear gradient and higher-order shim pulses can be used to obtain uniform flip angle in the presence of large radio frequency transmission (B 1+) inhomogeneity. Here, an implementation of dynamic, multislice tailored excitation using the recently developed multi-coil nonlinear shim hardware (MC-DTEx) is reported. MC-DTEx was developed and tested both in a phantom and in vivo at 7 T, and its efficacy was quantitatively assessed. Predicted outcomes of MC-DTEx and DTEx based on spherical harmonic shims (SH-DTEx) were also compared. For a planned 30 ° flip angle, in a phantom, the standard deviation in excitation improved from 28% (regular excitation) to 12% with MC-DTEx. The SD in in vivo excitation improved from 22 to 12%. The improvements achieved with experimental MC-DTEx closely matched the theoretical predictions. Simulations further showed that MC-DTEx outperforms SH-DTEx for both scenarios. Successful implementation of multislice MC-DTEx is presented and is shown to be capable of homogenizing excitation over more than twofold B 1+ variations. Its benefits over SH-DTEx are also demonstrated. A distinct advantage of MC hardware over SH shim hardware is the absence of significant eddy current effects, which allows for a straightforward, multislice implementation of MC-DTEx. Magn Reson Med 76:83-93, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Rapid multislice T1 mapping of mouse myocardium: Application to quantification of manganese uptake in α-Dystrobrevin knockout mice.

PubMed

Jiang, Kai; Li, Wen; Li, Wei; Jiao, Sen; Castel, Laurie; Van Wagoner, David R; Yu, Xin

2015-11-01

The aim of this study was to develop a rapid, multislice cardiac T1 mapping method in mice and to apply the method to quantify manganese (Mn(2+)) uptake in a mouse model with altered Ca(2+) channel activity. An electrocardiography-triggered multislice saturation-recovery Look-Locker method was developed and validated both in vitro and in vivo. A two-dose study was performed to investigate the kinetics of T1 shortening, Mn(2+) relaxivity in myocardium, and the impact of Mn(2+) on cardiac function. The sensitivity of Mn(2+)-enhanced MRI in detecting subtle changes in altered Ca(2+) channel activity was evaluated in a mouse model with α-dystrobrevin knockout. Validation studies showed strong agreement between the current method and an established method. High Mn(2+) dose led to significantly accelerated T1 shortening. Heart rate decreased during Mn(2+) infusion, while ejection ratio increased slightly at the end of imaging protocol. No statistical difference in cardiac function was detected between the two dose groups. Mice with α-dystrobrevin knockout showed enhanced Mn(2+) uptake in vivo. In vitro patch-clamp study showed increased Ca(2+) channel activity. The saturation recovery method provides rapid T1 mapping in mouse hearts, which allowed sensitive detection of subtle changes in Mn(2+) uptake in α-dystrobrevin knockout mice. © 2014 Wiley Periodicals, Inc.

Software compensation of eddy current fields in multislice high order dynamic shimming.

PubMed

Sengupta, Saikat; Avison, Malcolm J; Gore, John C; Brian Welch, E

2011-06-01

Dynamic B(0) shimming (DS) can produce better field homogeneity than static global shimming by dynamically updating slicewise shim values in a multislice acquisition. The performance of DS however is limited by eddy current fields produced by the switching of 2nd and 3rd order unshielded shims. In this work, we present a novel method of eddy field compensation (EFC) applied to higher order shim induced eddy current fields in multislice DS. This method does not require shim shielding, extra hardware for eddy current compensation or subject specific prescanning. The interactions between shim harmonics are modeled assuming steady state of the medium and long time constant, cross and self term eddy fields in a DS experiment and 'correction factors' characterizing the entire set of shim interactions are derived. The correction factors for a given time between shim switches are shown to be invariable with object scanned, shim switching pattern and actual shim values, allowing for their generalized prospective use. Phantom and human head, 2nd and 3rd order DS experiments performed without any hardware eddy current compensation using the technique show large reductions in field gradients and offsets leading to significant improvements in image quality. This method holds promise as an alternative to expensive hardware based eddy current compensation required in 2nd and 3rd order DS. Copyright © 2011 Elsevier Inc. All rights reserved.

Ejection fraction in myocardial perfusion imaging assessed with a dynamic phantom: comparison between IQ-SPECT and LEHR.

PubMed

Hippeläinen, Eero; Mäkelä, Teemu; Kaasalainen, Touko; Kaleva, Erna

2017-12-01

Developments in single photon emission tomography instrumentation and reconstruction methods present a potential for decreasing acquisition times. One of such recent options for myocardial perfusion imaging (MPI) is IQ-SPECT. This study was motivated by the inconsistency in the reported ejection fraction (EF) and left ventricular (LV) volume results between IQ-SPECT and more conventional low-energy high-resolution (LEHR) collimation protocols. IQ-SPECT and LEHR quantitative results were compared while the equivalent number of iterations (EI) was varied. The end-diastolic (EDV) and end-systolic volumes (ESV) and the derived EF values were investigated. A dynamic heart phantom was used to produce repeatable ESVs, EDVs and EFs. Phantom performance was verified by comparing the set EF values to those measured from a gated multi-slice X-ray computed tomography (CT) scan (EF True ). The phantom with an EF setting of 45, 55, 65 and 70% was imaged with both IQ-SPECT and LEHR protocols. The data were reconstructed with different EI, and two commonly used clinical myocardium delineation software were used to evaluate the LV volumes. The CT verification showed that the phantom EF settings were repeatable and accurate with the EF True being within 1% point from the manufacture's nominal value. Depending on EI both MPI protocols can be made to produce correct EF estimates, but IQ-SPECT protocol produced on average 41 and 42% smaller EDV and ESV when compared to the phantom's volumes, while LEHR protocol underestimated volumes by 24 and 21%, respectively. The volume results were largely similar between the delineation methods used. The reconstruction parameters can greatly affect the volume estimates obtained from perfusion studies. IQ-SPECT produces systematically smaller LV volumes than the conventional LEHR MPI protocol. The volume estimates are also software dependent.

Consistent interactive segmentation of pulmonary ground glass nodules identified in CT studies

NASA Astrophysics Data System (ADS)

Zhang, Li; Fang, Ming; Naidich, David P.; Novak, Carol L.

2004-05-01

Ground glass nodules (GGNs) have proved especially problematic in lung cancer diagnosis, as despite frequently being malignant they characteristically have extremely slow rates of growth. This problem is further magnified by the small size of many of these lesions now being routinely detected following the introduction of multislice CT scanners capable of acquiring contiguous high resolution 1 to 1.25 mm sections throughout the thorax in a single breathhold period. Although segmentation of solid nodules can be used clinically to determine volume doubling times quantitatively, reliable methods for segmentation of pure ground glass nodules have yet to be introduced. Our purpose is to evaluate a newly developed computer-based segmentation method for rapid and reproducible measurements of pure ground glass nodules. 23 pure or mixed ground glass nodules were identified in a total of 8 patients by a radiologist and subsequently segmented by our computer-based method using Markov random field and shape analysis. The computer-based segmentation was initialized by a click point. Methodological consistency was assessed using the overlap ratio between 3 segmentations initialized by 3 different click points for each nodule. The 95% confidence interval on the mean of the overlap ratios proved to be [0.984, 0.998]. The computer-based method failed on two nodules that were difficult to segment even manually either due to especially low contrast or markedly irregular margins. While achieving consistent manual segmentation of ground glass nodules has proven problematic most often due to indistinct boundaries and interobserver variability, our proposed method introduces a powerful new tool for obtaining reproducible quantitative measurements of these lesions. It is our intention to further document the value of this approach with a still larger set of ground glass nodules.

Pyelocaliceal Distribution of Kidney Stones Used as an Outcome Predictor in Percutaneous Nephrolithotomy After Being Evaluated with Preoperative and Postoperative CT Scan.

PubMed

Tirapegui, Federico Ignacio; González, Mariano Sebastian; González, Ignacio Pablo Tobía; Daels, Francisco P

2015-06-01

To identify kidney stone characteristics that will determine either success or failure of a percutaneous nephrolithotomy (PCNL) and design a classification system to predict results according to these characteristics. One hundred thirty-eight patients were assessed with multislice abdominal and pelvic CT before and after PCNL. With regard to pyelocaliceal stone distribution, we classified our patients in two groups that we called "no extra stone in middle calix" (NESMC) and "extra stone in middle calix" (ESMC), according to the difficulty in reaching the stones. We did a univariate and a multivariate analysis, as well as a receiving operating curve (ROC) of the proposed classification, based on the foreseen probabilities, to determine the diagnostic yield. Global residual lithiasis (RL) was 26.08%. The proportion of patients with RL according to classification was NESMC 11.5% and ESMC 59.5%. In the univariate logistic regression analysis of the distribution, number, total volumetry, side, type, radio-opacity of stones, and the presence or not of preoperatory urinary tract infection, the variables related to RL were the distribution (11.3; 95% confidence interval [95% CI] 4.7, 27.4), volumetry (odds ratio [OR] 1.01; 95% CI 1.004, 1.014), and the presence of staghorn stones (OR 6.64; 95% CI 2.463, 17.905). In the multivariate analysis, distribution was statistically significant (OR 8.687; 95% CI 2.69, 28.06), whereas total volumetry and the presence of staghorn stones were not (OR 1; 95% CI 1.000, 1.000 and OR 2.7; 95% CI 0.35, 20.57, respectively). The ROC showed an area under the curve of 0.77. In our experience, the distribution of kidney stones is the most important predictor of RL after PCNL. The results also suggest that the presence of stones in the middle calix has a direct impact on the stone-free rate. We put forward a simple and reproducible classification, easy to apply, and useful to estimate the chances of success of the procedure using preoperatory CT scans.

A simultaneous multi-slice selective J-resolved experiment for fully resolved scalar coupling information

NASA Astrophysics Data System (ADS)

Zeng, Qing; Lin, Liangjie; Chen, Jinyong; Lin, Yanqin; Barker, Peter B.; Chen, Zhong

2017-09-01

Proton-proton scalar coupling plays an important role in molecular structure elucidation. Many methods have been proposed for revealing scalar coupling networks involving chosen protons. However, determining all JHH values within a fully coupled network remains as a tedious process. Here, we propose a method termed as simultaneous multi-slice selective J-resolved spectroscopy (SMS-SEJRES) for simultaneously measuring JHH values out of all coupling networks in a sample within one experiment. In this work, gradient-encoded selective refocusing, PSYCHE decoupling and echo planar spectroscopic imaging (EPSI) detection module are adopted, resulting in different selective J-edited spectra extracted from different spatial positions. The proposed pulse sequence can facilitate the analysis of molecular structures. Therefore, it will interest scientists who would like to efficiently address the structural analysis of molecules.

Metabolomics of Therapy Response in Preclinical Glioblastoma: A Multi-Slice MRSI-Based Volumetric Analysis for Noninvasive Assessment of Temozolomide Treatment

PubMed Central

Arias-Ramos, Nuria; Ferrer-Font, Laura; Lope-Piedrafita, Silvia; Mocioiu, Victor; Julià-Sapé, Margarida; Pumarola, Martí; Arús, Carles; Candiota, Ana Paula

2017-01-01

Glioblastoma (GBM) is the most common aggressive primary brain tumor in adults, with a short survival time even after aggressive therapy. Non-invasive surrogate biomarkers of therapy response may be relevant for improving patient survival. Previous work produced such biomarkers in preclinical GBM using semi-supervised source extraction and single-slice Magnetic Resonance Spectroscopic Imaging (MRSI). Nevertheless, GBMs are heterogeneous and single-slice studies could prevent obtaining relevant information. The purpose of this work was to evaluate whether a multi-slice MRSI approach, acquiring consecutive grids across the tumor, is feasible for preclinical models and may produce additional insight into therapy response. Nosological images were analyzed pixel-by-pixel and a relative responding volume, the Tumor Responding Index (TRI), was defined to quantify response. Heterogeneous response levels were observed and treated animals were ascribed to three arbitrary predefined groups: high response (HR, n = 2), TRI = 68.2 ± 2.8%, intermediate response (IR, n = 6), TRI = 41.1 ± 4.2% and low response (LR, n = 2), TRI = 13.4 ± 14.3%, producing therapy response categorization which had not been fully registered in single-slice studies. Results agreed with the multi-slice approach being feasible and producing an inverse correlation between TRI and Ki67 immunostaining. Additionally, ca. 7-day oscillations of TRI were observed, suggesting that host immune system activation in response to treatment could contribute to the responding patterns detected. PMID:28524099

Use of pattern recognition for unaliasing simultaneously acquired slices in simultaneous multislice MR fingerprinting.

PubMed

Jiang, Yun; Ma, Dan; Bhat, Himanshu; Ye, Huihui; Cauley, Stephen F; Wald, Lawrence L; Setsompop, Kawin; Griswold, Mark A

2017-11-01

The purpose of this study is to accelerate an MR fingerprinting (MRF) acquisition by using a simultaneous multislice method. A multiband radiofrequency (RF) pulse was designed to excite two slices with different flip angles and phases. The signals of two slices were driven to be as orthogonal as possible. The mixed and undersampled MRF signal was matched to two dictionaries to retrieve T 1 and T 2 maps of each slice. Quantitative results from the proposed method were validated with the gold-standard spin echo methods in a phantom. T 1 and T 2 maps of in vivo human brain from two simultaneously acquired slices were also compared to the results of fast imaging with steady-state precession based MRF method (MRF-FISP) with a single-band RF excitation. The phantom results showed that the simultaneous multislice imaging MRF-FISP method quantified the relaxation properties accurately compared to the gold-standard spin echo methods. T 1 and T 2 values of in vivo brain from the proposed method also matched the results from the normal MRF-FISP acquisition. T 1 and T 2 values can be quantified at a multiband acceleration factor of two using our proposed acquisition even in a single-channel receive coil. Further acceleration could be achieved by combining this method with parallel imaging or iterative reconstruction. Magn Reson Med 78:1870-1876, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Optimization of flow-sensitive alternating inversion recovery (FAIR) for perfusion functional MRI of rodent brain.

PubMed

Nasrallah, Fatima A; Lee, Eugene L Q; Chuang, Kai-Hsiang

2012-11-01

Arterial spin labeling (ASL) MRI provides a noninvasive method to image perfusion, and has been applied to map neural activation in the brain. Although pulsed labeling methods have been widely used in humans, continuous ASL with a dedicated neck labeling coil is still the preferred method in rodent brain functional MRI (fMRI) to maximize the sensitivity and allow multislice acquisition. However, the additional hardware is not readily available and hence its application is limited. In this study, flow-sensitive alternating inversion recovery (FAIR) pulsed ASL was optimized for fMRI of rat brain. A practical challenge of FAIR is the suboptimal global inversion by the transmit coil of limited dimensions, which results in low effective labeling. By using a large volume transmit coil and proper positioning to optimize the body coverage, the perfusion signal was increased by 38.3% compared with positioning the brain at the isocenter. An additional 53.3% gain in signal was achieved using optimized repetition and inversion times compared with a long TR. Under electrical stimulation to the forepaws, a perfusion activation signal change of 63.7 ± 6.3% can be reliably detected in the primary somatosensory cortices using single slice or multislice echo planar imaging at 9.4 T. This demonstrates the potential of using pulsed ASL for multislice perfusion fMRI in functional and pharmacological applications in rat brain. Copyright © 2012 John Wiley & Sons, Ltd.

Multislice CT perfusion imaging of the lung in detection of pulmonary embolism

NASA Astrophysics Data System (ADS)

Hong, Helen; Lee, Jeongjin

2006-03-01

We propose a new subtraction technique for accurately imaging lung perfusion and efficiently detecting pulmonary embolism in chest MDCT angiography. Our method is composed of five stages. First, optimal segmentation technique is performed for extracting same volume of the lungs, major airway and vascular structures from pre- and post-contrast images with different lung density. Second, initial registration based on apex, hilar point and center of inertia (COI) of each unilateral lung is proposed to correct the gross translational mismatch. Third, initial alignment is refined by iterative surface registration. For fast and robust convergence of the distance measure to the optimal value, a 3D distance map is generated by the narrow-band distance propagation. Fourth, 3D nonlinear filter is applied to the lung parenchyma to compensate for residual spiral artifacts and artifacts caused by heart motion. Fifth, enhanced vessels are visualized by subtracting registered pre-contrast images from post-contrast images. To facilitate visualization of parenchyma enhancement, color-coded mapping and image fusion is used. Our method has been successfully applied to ten patients of pre- and post-contrast images in chest MDCT angiography. Experimental results show that the performance of our method is very promising compared with conventional methods with the aspects of its visual inspection, accuracy and processing time.

A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation

PubMed Central

2011-01-01

Introduction The extent of wound contamination in gunshot injuries is still a topic of controversial debate. The purpose of the present study is to develop a model that illustrates the contamination of wounds with exogenous particles along the bullet path. Material and methods To simulate bacteria, radio-opaque barium titanate (3-6 μm in diameter) was atomized in a dust chamber. Full metal jacket or soft point bullets caliber .222 (n = 12, v0 = 1096 m/s) were fired through the chamber into a gelatin block directly behind it. After that, the gelatin block underwent multi-slice CT in order to analyze the permanent and temporary wound cavity. Results The permanent cavity caused by both types of projectiles showed deposits of barium titanate distributed over the entire bullet path. Full metal jacket bullets left only few traces of barium titanate in the temporary cavity. In contrast, the soft point bullets disintegrated completely, and barium titanate covered the entire wound cavity. Discussion Deep penetration of potential exogenous bacteria can be simulated easily and reproducibly with barium titanate particles shot into a gelatin block. Additionally, this procedure permits conclusions to be drawn about the distribution of possible contaminants and thus can yield essential findings in terms of necessary therapeutic procedures. PMID:22032229

Conservative orthodontic treatment of mandibular bilateral condyle fracture.

PubMed

Gašpar, Goran; Brakus, Ivan; Kovačić, Ivan

2014-09-01

Maxillofacial trauma is rare in children younger than the age of 5 years (range 0.6%-1.2%), and they can require different clinical treatment strategies compared with fractures in the adult population because of concerns regarding mandibular growth and development of dentition. A 5-year-old girl with a history of falling from a bicycle 7 hours earlier was referred to the department of oral and maxillofacial surgery. Multislice computed tomographic examination demonstrated a bilateral fracture of the mandibular condyle neck associated with minimal fracture of the alveolar ridge of the maxilla. The multislice computed tomographic scan also demonstrated dislocation on the right condyle neck and, on the left side, a medial inclination of approximately 45 degrees associated with greenstick fracture of the right parasymphysis region. In this particular case, orthodontic rubber elastics in combination with fixed orthodontic brackets provided good results in the treatment of bilateral condyle neck fractures associated with greenstick fracture of parasymphysis.

New horizons in forensic radiology: the 60-second digital autopsy-full-body examination of a gunshot victim by multislice computed tomography.

PubMed

Thali, Michael J; Schweitzer, Wolf; Yen, Kathrin; Vock, Peter; Ozdoba, Christoph; Spielvogel, Elke; Dirnhofer, Richard

2003-03-01

The goal of this study was the full-body documentation of a gunshot wound victim with multislice helical computed tomography for subsequent comparison with the findings of the standard forensic autopsy. Complete volume data of the head, neck, and trunk were acquired by use of two acquisitions of less than 1 minute of total scanning time. Subsequent two-dimensional multiplanar reformations and three-dimensional shaded surface display reconstructions helped document the gunshot-created skull fractures and brain injuries, including the wound track, and the intracerebral bone fragments. Computed tomography also demonstrated intracardiac air embolism and pulmonary aspiration of blood resulting from bullet wound-related trauma. The "digital autopsy," even when postprocessing time was added, was more rapid than the classic forensic autopsy and, based on the nondestructive approach, offered certain advantages in comparison with the forensic autopsy.

Quantitative multi-modality imaging analysis of a bioabsorbable poly-L-lactic acid stent design in the acute phase: a comparison between 2- and 3D-QCA, QCU and QMSCT-CA.

PubMed

Bruining, Nico; Tanimoto, Shuzou; Otsuka, Masato; Weustink, Annick; Ligthart, Jurgen; de Winter, Sebastiaan; van Mieghem, Carlos; Nieman, Koen; de Feyter, Pim J; van Domburg, Ron T; Serruys, Patrick W

2008-08-01

To investigate if three-dimensional (3D) based quantitative techniques are comparable to each other and to explore possible differences with respect to the reference method of 2D-QCA in the acute phase and to study whether non-invasive MSCT could potentially be applied to quantify luminal dimensions of a stented coronary segment with a novel bioabsorable drug-eluting stent made of poly-l-lactic-acid (PLLA). Quantitative imaging data derived from 16 patients enrolled at our institution in a first-in-man trial (ABSORB) receiving a biodegradable stent and who were imaged with standard coronary angiography and intravascular ultrasound were compared. Shortly, after stenting the patients also underwent a MSCT procedure. Standard 2D-QCA showed significant smaller stent lengths (p < 0.01). Although, the absolute measured stent diameters and areas by 2D-QCA tend to be smaller, the differences failed to be statistically different when compared to the 3D based quantitative modalities. Measurements made by non-invasive QMSCT-CA of implanted PLLA stents appeared to be comparable to the other 3D modalities without significant differences. Three-dimensional based quantitative analyses showed similar results quantifying luminal dimensions as compared to 2D-QCA during an evaluation of a new bioabsorbable coronary stent design in the acute phase. Furthermore, in biodegradable stents made of PLLA, non-invasive QMSCT-CA can be used to quantify luminal dimensions.

Multi-slice MRI reveals heterogeneity in disease distribution along the length of muscle in Duchenne muscular dystrophy.

PubMed

Chrzanowski, Stephen M; Baligand, Celine; Willcocks, Rebecca J; Deol, Jasjit; Schmalfuss, Ilona; Lott, Donovan J; Daniels, Michael J; Senesac, Claudia; Walter, Glenn A; Vandenborne, Krista

2017-09-01

Duchenne muscular dystrophy (DMD) causes progressive pathologic changes to muscle secondary to a cascade of inflammation, lipid deposition, and fibrosis. Clinically, this manifests as progressive weakness, functional loss, and premature mortality. Though insult to whole muscle groups is well established, less is known about the relationship between intramuscular pathology and function. Differences of intramuscular heterogeneity across muscle length were assessed using an ordinal MRI grading scale in lower leg muscles of boys with DMD and correlated to patient's functional status. Cross sectional T 1 weighted MRI images with fat suppression were obtained from ambulatory boys with DMD. Six muscles (tibialis anterior, extensor digitorum longus, peroneus, soleus, medial and lateral gastrocnemii) were graded using an ordinal grading scale over 5 slice sections along the lower leg length. The scores from each slice were combined and results were compared to global motor function and age. Statistically greater differences of involvement were observed at the proximal ends of muscle compared to the midbellies. Multi-slice assessment correlated significantly to age and the Vignos functional scale, whereas single-slice assessment correlated to the Vignos functional scale only. Lastly, differential disease involvement of whole muscle groups and intramuscular heterogeneity were observed amongst similar age subjects. A multi-slice ordinal MRI grading scale revealed that muscles are not uniformly affected, with more advanced disease visible near the tendons in a primarily ambulatory population with DMD. A geographically comprehensive evaluation of the heterogeneously affected muscle in boys with DMD may more accurately assess disease involvement.

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

Arabi, Hosein; Asl, Ali Reza Kamali; Ay, Mohammad Reza

Purpose: The variable resolution x-ray (VRX) CT scanner provides substantial improvement in the spatial resolution by matching the scanner's field of view (FOV) to the size of the object being imaged. Intercell x-ray cross-talk is one of the most important factors limiting the spatial resolution of the VRX detector. In this work, a new cell arrangement in the VRX detector is suggested to decrease the intercell x-ray cross-talk. The idea is to orient the detector cells toward the opening end of the detector. Methods: Monte Carlo simulations were used for performance assessment of the oriented cell detector design. Previously publishedmore » design parameters and simulation results of x-ray cross-talk for the VRX detector were used for model validation using the GATE Monte Carlo package. In the first step, the intercell x-ray cross-talk of the actual VRX detector model was calculated as a function of the FOV. The obtained results indicated an optimum cell orientation angle of 28 deg. to minimize the x-ray cross-talk in the VRX detector. Thereafter, the intercell x-ray cross-talk in the oriented cell detector was modeled and quantified. Results: The intercell x-ray cross-talk in the actual detector model was considerably high, reaching up to 12% at FOVs from 24 to 38 cm. The x-ray cross-talk in the oriented cell detector was less than 5% for all possible FOVs, except 40 cm (maximum FOV). The oriented cell detector could provide considerable decrease in the intercell x-ray cross-talk for the VRX detector, thus leading to significant improvement in the spatial resolution and reduction in the spatial resolution nonuniformity across the detector length. Conclusions: The proposed oriented cell detector is the first dedicated detector design for the VRX CT scanners. Application of this concept to multislice and flat-panel VRX detectors would also result in higher spatial resolution.« less

A methodology for direct quantification of over-ranging length in helical computed tomography with real-time dosimetry.

PubMed

Tien, Christopher J; Winslow, James F; Hintenlang, David E

2011-01-31

In helical computed tomography (CT), reconstruction information from volumes adjacent to the clinical volume of interest (VOI) is required for proper reconstruction. Previous studies have relied upon either operator console readings or indirect extrapolation of measurements in order to determine the over-ranging length of a scan. This paper presents a methodology for the direct quantification of over-ranging dose contributions using real-time dosimetry. A Siemens SOMATOM Sensation 16 multislice helical CT scanner is used with a novel real-time "point" fiber-optic dosimeter system with 10 ms temporal resolution to measure over-ranging length, which is also expressed in dose-length-product (DLP). Film was used to benchmark the exact length of over-ranging. Over-ranging length varied from 4.38 cm at pitch of 0.5 to 6.72 cm at a pitch of 1.5, which corresponds to DLP of 131 to 202 mGy-cm. The dose-extrapolation method of Van der Molen et al. yielded results within 3%, while the console reading method of Tzedakis et al. yielded consistently larger over-ranging lengths. From film measurements, it was determined that Tzedakis et al. overestimated over-ranging lengths by one-half of beam collimation width. Over-ranging length measured as a function of reconstruction slice thicknesses produced two linear regions similar to previous publications. Over-ranging is quantified with both absolute length and DLP, which contributes about 60 mGy-cm or about 10% of DLP for a routine abdominal scan. This paper presents a direct physical measurement of over-ranging length within 10% of previous methodologies. Current uncertainties are less than 1%, in comparison with 5% in other methodologies. Clinical implantation can be increased by using only one dosimeter if codependence with console readings is acceptable, with an uncertainty of 1.1% This methodology will be applied to different vendors, models, and postprocessing methods--which have been shown to produce over-ranging lengths differing by 125%.

Review on the characteristics of radiation detectors for dosimetry and imaging

NASA Astrophysics Data System (ADS)

Seco, Joao; Clasie, Ben; Partridge, Mike

2014-10-01

The enormous advances in the understanding of human anatomy, physiology and pathology in recent decades have led to ever-improving methods of disease prevention, diagnosis and treatment. Many of these achievements have been enabled, at least in part, by advances in ionizing radiation detectors. Radiology has been transformed by the implementation of multi-slice CT and digital x-ray imaging systems, with silver halide films now largely obsolete for many applications. Nuclear medicine has benefited from more sensitive, faster and higher-resolution detectors delivering ever-higher SPECT and PET image quality. PET/MR systems have been enabled by the development of gamma ray detectors that can operate in high magnetic fields. These huge advances in imaging have enabled equally impressive steps forward in radiotherapy delivery accuracy, with 4DCT, PET and MRI routinely used in treatment planning and online image guidance provided by cone-beam CT. The challenge of ensuring safe, accurate and precise delivery of highly complex radiation fields has also both driven and benefited from advances in radiation detectors. Detector systems have been developed for the measurement of electron, intensity-modulated and modulated arc x-ray, proton and ion beams, and around brachytherapy sources based on a very wide range of technologies. The types of measurement performed are equally wide, encompassing commissioning and quality assurance, reference dosimetry, in vivo dosimetry and personal and environmental monitoring. In this article, we briefly introduce the general physical characteristics and properties that are commonly used to describe the behaviour and performance of both discrete and imaging detectors. The physical principles of operation of calorimeters; ionization and charge detectors; semiconductor, luminescent, scintillating and chemical detectors; and radiochromic and radiographic films are then reviewed and their principle applications discussed. Finally, a general discussion of the application of detectors for x-ray nuclear medicine and ion beam imaging and dosimetry is presented.

Comparison of ring artifact removal methods using flat panel detector based CT images

PubMed Central

2011-01-01

Background Ring artifacts are the concentric rings superimposed on the tomographic images often caused by the defective and insufficient calibrated detector elements as well as by the damaged scintillator crystals of the flat panel detector. It may be also generated by objects attenuating X-rays very differently in different projection direction. Ring artifact reduction techniques so far reported in the literature can be broadly classified into two groups. One category of the approaches is based on the sinogram processing also known as the pre-processing techniques and the other category of techniques perform processing on the 2-D reconstructed images, recognized as the post-processing techniques in the literature. The strength and weakness of these categories of approaches are yet to be explored from a common platform. Method In this paper, a comparative study of the two categories of ring artifact reduction techniques basically designed for the multi-slice CT instruments is presented from a common platform. For comparison, two representative algorithms from each of the two categories are selected from the published literature. A very recently reported state-of-the-art sinogram domain ring artifact correction method that classifies the ring artifacts according to their strength and then corrects the artifacts using class adaptive correction schemes is also included in this comparative study. The first sinogram domain correction method uses a wavelet based technique to detect the corrupted pixels and then using a simple linear interpolation technique estimates the responses of the bad pixels. The second sinogram based correction method performs all the filtering operations in the transform domain, i.e., in the wavelet and Fourier domain. On the other hand, the two post-processing based correction techniques actually operate on the polar transform domain of the reconstructed CT images. The first method extracts the ring artifact template vector using a homogeneity test and then corrects the CT images by subtracting the artifact template vector from the uncorrected images. The second post-processing based correction technique performs median and mean filtering on the reconstructed images to produce the corrected images. Results The performances of the comparing algorithms have been tested by using both quantitative and perceptual measures. For quantitative analysis, two different numerical performance indices are chosen. On the other hand, different types of artifact patterns, e.g., single/band ring, artifacts from defective and mis-calibrated detector elements, rings in highly structural object and also in hard object, rings from different flat-panel detectors are analyzed to perceptually investigate the strength and weakness of the five methods. An investigation has been also carried out to compare the efficacy of these algorithms in correcting the volume images from a cone beam CT with the parameters determined from one particular slice. Finally, the capability of each correction technique in retaining the image information (e.g., small object at the iso-center) accurately in the corrected CT image has been also tested. Conclusions The results show that the performances of the algorithms are limited and none is fully suitable for correcting different types of ring artifacts without introducing processing distortion to the image structure. To achieve the diagnostic quality of the corrected slices a combination of the two approaches (sinogram- and post-processing) can be used. Also the comparing methods are not suitable for correcting the volume images from a cone beam flat-panel detector based CT. PMID:21846411

Hybrid computational phantoms of the 15-year male and female adolescent: Applications to CT organ dosimetry for patients of variable morphometry

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

Lee, Choonsik; Lodwick, Daniel; Williams, Jonathan L.

Currently, two classes of the computational phantoms have been developed for dosimetry calculation: (1) stylized (or mathematical) and (2) voxel (or tomographic) phantoms describing human anatomy through mathematical surface equations and three-dimensional labeled voxel matrices, respectively. Mathematical surface equations in stylized phantoms provide flexibility in phantom design and alteration, but the resulting anatomical description is, in many cases, not very realistic. Voxel phantoms display far better anatomical realism, but they are limited in terms of their ability to alter organ shape, position, and depth, as well as body posture. A new class of computational phantoms - called hybrid phantoms -more » takes advantage of the best features of stylized and voxel phantoms - flexibility and anatomical realism, respectively. In the current study, hybrid computational phantoms representing reference 15-year male and female body anatomy and anthropometry are presented. For the male phantom, organ contours were extracted from the University of Florida (UF) 14-year series B male voxel phantom, while for the female phantom, original computed tomography (CT) data from two 14-year female patients were used. Polygon mesh models for the major organs and tissues were reconstructed for nonuniform rational B-spline (NURBS) surface modeling. The resulting NURBS/polygon mesh models representing body contour and internal anatomy were matched to anthropometric data and reference organ mass data provided by the Centers for Disease Control and Prevention (CDC) and the International Commission on Radiation Protection (ICRP), respectively. Finally, two hybrid 15-year male and female phantoms were completed where a total of eight anthropometric data categories were matched to standard values within 4% and organ masses matched to ICRP data within 1% with the exception of total skin. To highlight the flexibility of the hybrid phantoms, 10th and 90th weight percentile 15-year male and female phantoms were further developed from the 50th percentile phantoms through adjustments in the body contour to match the total body masses given in CDC pediatric growth curves. The resulting six NURBS phantoms, male and female phantoms representing their 10th, 50th, and 90th weight percentiles, were used to investigate the influence of body fat distributions on internal organ doses following CT imaging. The phantoms were exposed to multislice chest and abdomen helical CT scans, and in-field organ absorbed doses were calculated. The results demonstrated that the use of traditional stylized phantoms yielded organ dose estimates that deviate from those given by the UF reference hybrid phantoms by up to a factor of 2. The study also showed that use of reference, or 50th percentile, phantoms to assess organ doses in underweight 15-year-old children would not lead to significant organ dose errors (typically less than 10%). However, more significant errors were noted (up to {approx}30%) when reference phantoms are used to represent overweight children in CT imaging dosimetry. These errors are expected to only further increase as one considers CT organ doses in overweight and obese individuals of the adult patient population, thus emphasizing the advantages of patient-sculptable phantom technology.« less

3D mapping of airway wall thickening in asthma with MSCT: a level set approach

NASA Astrophysics Data System (ADS)

Fetita, Catalin; Brillet, Pierre-Yves; Hartley, Ruth; Grenier, Philippe A.; Brightling, Christopher

2014-03-01

Assessing the airway wall thickness in multi slice computed tomography (MSCT) as image marker for airway disease phenotyping such asthma and COPD is a current trend and challenge for the scientific community working in lung imaging. This paper addresses the same problem from a different point of view: considering the expected wall thickness-to-lumen-radius ratio for a normal subject as known and constant throughout the whole airway tree, the aim is to build up a 3D map of airway wall regions of larger thickness and to define an overall score able to highlight a pathological status. In this respect, the local dimension (caliber) of the previously segmented airway lumen is obtained on each point by exploiting the granulometry morphological operator. A level set function is defined based on this caliber information and on the expected wall thickness ratio, which allows obtaining a good estimate of the airway wall throughout all segmented lumen generations. Next, the vascular (or mediastinal dense tissue) contact regions are automatically detected and excluded from analysis. For the remaining airway wall border points, the real wall thickness is estimated based on the tissue density analysis in the airway radial direction; thick wall points are highlighted on a 3D representation of the airways and several quantification scores are defined. The proposed approach is fully automatic and was evaluated (proof of concept) on a patient selection coming from different databases including mild, severe asthmatics and normal cases. This preliminary evaluation confirms the discriminative power of the proposed approach regarding different phenotypes and is currently extending to larger cohorts.

Virtobot--a multi-functional robotic system for 3D surface scanning and automatic post mortem biopsy.

PubMed

Ebert, Lars Christian; Ptacek, Wolfgang; Naether, Silvio; Fürst, Martin; Ross, Steffen; Buck, Ursula; Weber, Stefan; Thali, Michael

2010-03-01

The Virtopsy project, a multi-disciplinary project that involves forensic science, diagnostic imaging, computer science, automation technology, telematics and biomechanics, aims to develop new techniques to improve the outcome of forensic investigations. This paper presents a new approach in the field of minimally invasive virtual autopsy for a versatile robotic system that is able to perform three-dimensional (3D) surface scans as well as post mortem image-guided soft tissue biopsies. The system consists of an industrial six-axis robot with additional extensions (i.e. a linear axis to increase working space, a tool-changing system and a dedicated safety system), a multi-slice CT scanner with equipment for angiography, a digital photogrammetry and 3D optical surface-scanning system, a 3D tracking system, and a biopsy end effector for automatic needle placement. A wax phantom was developed for biopsy accuracy tests. Surface scanning times were significantly reduced (scanning times cut in half, calibration three times faster). The biopsy module worked with an accuracy of 3.2 mm. Using the Virtobot, the surface-scanning procedure could be standardized and accelerated. The biopsy module is accurate enough for use in biopsies in a forensic setting. The Virtobot can be utilized for several independent tasks in the field of forensic medicine, and is sufficiently versatile to be adapted to different tasks in the future. (c) 2009 John Wiley & Sons, Ltd.

Comparison of analysis methods for airway quantification

NASA Astrophysics Data System (ADS)

Odry, Benjamin L.; Kiraly, Atilla P.; Novak, Carol L.; Naidich, David P.

2012-03-01

Diseased airways have been known for several years as a possible contributing factor to airflow limitation in Chronic Obstructive Pulmonary Diseases (COPD). Quantification of disease severity through the evaluation of airway dimensions - wall thickness and lumen diameter - has gained increased attention, thanks to the availability of multi-slice computed tomography (CT). Novel approaches have focused on automated methods of measurement as a faster and more objective means that the visual assessment routinely employed in the clinic. Since the Full-Width Half-Maximum (FWHM) method of airway measurement was introduced two decades ago [1], several new techniques for quantifying airways have been detailed in the literature, but no approach has truly become a standard for such analysis. Our own research group has presented two alternative approaches for determining airway dimensions, one involving a minimum path and the other active contours [2, 3]. With an increasing number of techniques dedicated to the same goal, we decided to take a step back and analyze the differences of these methods. We consequently put to the test our two methods of analysis and the FWHM approach. We first measured a set of 5 airways from a phantom of known dimensions. Then we compared measurements from the three methods to those of two independent readers, performed on 35 airways in 5 patients. We elaborate on the differences of each approach and suggest conclusions on which could be defined as the best one.

Imaging Characteristics and Prevalence of Pancreatic Carcinoma in Kosovo During 2011-2015 - Diagnostic Method as Choice.

PubMed

Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Hasbahta, Gazmed; Ramadani, Naser; Hoxhaj, Astrit

2016-06-01

Pancreatic cancer is the 10(th)most common malignancy and the 4(th)largest cancer killer in adults. The purpose of this paper is to evaluate the number of cases presented with pancreatic carcinoma during the years 2011-2015, our experience of the imaging characteristics of pancreatic carcinoma. We evaluated prevalence of the pancreatic cancers, distant metastases and other local infiltration signs among the total cases of the pancreatic cancers diagnosed in the University Clinical Center of Kosovo, with the aim to compare these research findings to similar studies made in the developed countries. This is a retrospective research study done during the period of 2011-2015. This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, examined in the period of 2011-2015 at the University Clinical Center of Kosovo. The imaging diagnostics are performed with MSCT Sensation 64 Siemens, MSCT Emotion 6 Siemens, and 1.5T MRI Symphony Siemens, biopsy guide with MSCT Sensation 64 Siemens in the Radiologic Clinic of UCCK; while the histopathology diagnostics has been performed in Clinic of Pathology at UCCK and prevalence is taken from the number of cases Reported at the Institute of Oncology Institute of Statistics and NIPH (National Institute of Public Health of Kosovo). Out of a total of the 362 patients diagnosed with pancreas cancer, results is female 39.5% (n=143) and male 61.5% (n=219), report M: F (1: 1.6), 286 cases resulted in head and neck 79 % (n=286), 76 cases resulted in body and tail cancers (21%), distant metastases in first imaging modality were found in(n=155) patients 43 %, local infiltration was found in patients: gastric infiltration 15 % (n=54), duodenal and papilla infiltration 26% (n=94), local infiltration spleen 16% (n=57), local infiltration mesentery 43 % (n= 155), dilated biliary tree 34 % (n=123), regional lymph node infiltration 83 % (n= 300). Out of a total of the 362 patients diagnosed with pancreas cancer, 346 cases resulted > 2 cm and 16 cases resulted < 2 cm and with component cystic was 41.2 % (n = 149), solid with component cystic - necrotic 33% (n= 119), solid 25.7% (n= 93). The prevalence is 19.9: 100,000 inhabitants. Prevalence of carcinoma of the pancreas for 5 years in Kosovo has proved to be prevalence is 19.9: 100,000 inhabitants. Seventy-four percent (74 %, n= 268) of all cancers are found in Stage III and IV. From an imaging point of view, these cancers were presented in an advanced stage, mainly due to their late clinical symptoms and limited access to imaging methods in our country.

Imaging Characteristics and Prevalence of Pancreatic Carcinoma in Kosovo During 2011-2015 - Diagnostic Method as Choice

PubMed Central

Dedushi, Kreshnike; Kabashi, Serbeze; Mucaj, Sefedin; Hasbahta, Gazmed; Ramadani, Naser; Hoxhaj, Astrit

2016-01-01

Introduction: Pancreatic cancer is the 10thmost common malignancy and the 4thlargest cancer killer in adults. Aim: The purpose of this paper is to evaluate the number of cases presented with pancreatic carcinoma during the years 2011-2015, our experience of the imaging characteristics of pancreatic carcinoma. We evaluated prevalence of the pancreatic cancers, distant metastases and other local infiltration signs among the total cases of the pancreatic cancers diagnosed in the University Clinical Center of Kosovo, with the aim to compare these research findings to similar studies made in the developed countries. This is a retrospective research study done during the period of 2011-2015. Materials and Methodology: This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, examined in the period of 2011-2015 at the University Clinical Center of Kosovo. The imaging diagnostics are performed with MSCT Sensation 64 Siemens, MSCT Emotion 6 Siemens, and 1.5T MRI Symphony Siemens, biopsy guide with MSCT Sensation 64 Siemens in the Radiologic Clinic of UCCK; while the histopathology diagnostics has been performed in Clinic of Pathology at UCCK and prevalence is taken from the number of cases Reported at the Institute of Oncology Institute of Statistics and NIPH (National Institute of Public Health of Kosovo). Results: Out of a total of the 362 patients diagnosed with pancreas cancer, results is female 39.5% (n=143) and male 61.5% (n=219), report M: F (1: 1.6), 286 cases resulted in head and neck 79 % (n=286), 76 cases resulted in body and tail cancers (21%), distant metastases in first imaging modality were found in(n=155) patients 43 %, local infiltration was found in patients: gastric infiltration 15 % (n=54), duodenal and papilla infiltration 26% (n=94), local infiltration spleen 16% (n=57), local infiltration mesentery 43 % (n= 155), dilated biliary tree 34 % (n=123), regional lymph node infiltration 83 % (n= 300). Out of a total of the 362 patients diagnosed with pancreas cancer, 346 cases resulted > 2 cm and 16 cases resulted < 2 cm and with component cystic was 41.2 % (n = 149), solid with component cystic – necrotic 33% (n= 119), solid 25.7% (n= 93). The prevalence is 19.9: 100,000 inhabitants. Conclusions: Prevalence of carcinoma of the pancreas for 5 years in Kosovo has proved to be prevalence is 19.9: 100,000 inhabitants. Seventy-four percent (74 %, n= 268) of all cancers are found in Stage III and IV. From an imaging point of view, these cancers were presented in an advanced stage, mainly due to their late clinical symptoms and limited access to imaging methods in our country. PMID:27482128

Multiple myeloma invasion of the central nervous system.

PubMed

Marjanović, Slobodan; Mijusković, Zoran; Stamatović, Dragana; Madjaru, Lavinika; Ralić, Tijana; Trimcev, Jovana; Stojanović, Jelica; Radović, Vesna

2012-02-01

Multiple myeloma (MM) is characterized by the presence of neoplastic proliferating plasma cells. The tumor is generally restricted to the bone marrow. The most common complications include renal insufficiency, hypercalcemia, anemia and reccurent infections. The spectrum of MM neurological complications is diverse, however, involvement of MM in the cerebrospinal fluid (CSF) and leptomeningeal infiltration are rare considered. In about 1% of the cases, the disease affects the central nervous system (CNS) and presents itself in the form of localized intraparenchymal lesions, solitary cerebral plasmocytoma or CNS myelomatosis (LMM). We presented the clinical course of a 55-year-old man with MM and LMM proven by malignant plasma cells in the CSF, hospitalized with the pain in the thoracic spine. His medical history was uneventful. There had been no evidence of mental or neurological impairment prior to the seizures. Physical examination showed no abnormalities. After a complete staging, the diagnosis of MM type biclonal gammopathia IgG lambda and free lambda light chains in the stage III was confirmed. The treatment started with systemic chemotherapy (with vincristine, doxorubicin plus high-dose dexamethasone--VAD protocol), radiotherapy and bisphosphonate. The patient developed weakness, nausea, febrility, dispnea, bilateral bronchopneumonia, acute renal insufficiency, confusions, headaches and soon thereafter sensomotor aphasias and right hemiparesis. The patient was treated with the adequate therapy including one hemodyalisis. His neurological status was deteriorated, so Multislice Computed Tomography (MSCT) of the head was performed and the findings were normal. Analysis of CSF showed pleocytosis, 26 elements/mL and increased concentrations of proteins. Cytological analysis revealed an increased number of plasma cells (29%). Electrophoretic analysis of proteins disclosed the existance of monoclonal components in the serum, urine and CSF. Immunofixation electrophoretic and quantitative nephelometric tests confirmed Biclonal multiple myeloma of IgG lambda and light chain lambda isotypes. Analysis of neurothropic viruses with ELISA methods was negative. Once the presence of LMM was confirmed, the patient received intrathecal chemotherapy with methotrexate, cytosine arabinoside, dexamethasone three times a week, and systemic high doses of dexamethasone iv like a single agent without craniospinale irradiations. Despite the treatment, the patient died one month after the diagnosis. Autopsy was not performed. Presented patient, as well as most other patients with MM progressing to CN Sinfiltration was in the stage III. In addition to the detailed clinical examination, and all investigations required for MM diagnosis and staging of the disease, we introduced the additional CSF examination and calculation of kappa lambda ratio, that helped us make an early diagnosis and prognosis of MM with LMM. Although LMM had a low prevalence, it could be more frequent than expected especially in patients with high risk. CSF examination with positive plasma cells and abnormal morphology remains the hallmark for diag nosing CNS infiltration.

Comprehensive long-term efficacy and safety of recombinant human alpha-mannosidase (velmanase alfa) treatment in patients with alpha-mannosidosis.

PubMed

Lund, Allan M; Borgwardt, Line; Cattaneo, Federica; Ardigò, Diego; Geraci, Silvia; Gil-Campos, Mercedes; De Meirleir, Linda; Laroche, Cécile; Dolhem, Philippe; Cole, Duncan; Tylki-Szymanska, Anna; Lopez-Rodriguez, Monica; Guillén-Navarro, Encarna; Dali, Christine I; Héron, Bénédicte; Fogh, Jens; Muschol, Nicole; Phillips, Dawn; Van den Hout, J M Hannerieke; Jones, Simon A; Amraoui, Yasmina; Harmatz, Paul; Guffon, Nathalie

2018-05-03

Long-term outcome data provide important insights into the clinical utility of enzyme replacement therapies. Such data are presented for velmanase alfa in the treatment of alpha-mannosidosis (AM). Patient data (n = 33; 14 adults, 19 paediatric) from the clinical development programme for velmanase alfa were integrated in this prospectively-designed analysis of long-term efficacy and safety. Patients who participated in the phase I/II or phase III trials and were continuing to receive treatment after completion of the trials were invited to participate in a comprehensive evaluation visit to assess long-term outcomes. Primary endpoints were changes in serum oligosaccharide and the 3-minute stair climb test (3MSCT). Mean (SD) treatment exposure was 29.3 (15.2) months. Serum oligosaccharide levels were significantly reduced in the overall population at 12 months (mean change: -72.7%, P < 0.001) and remained statistically significant at last observation (-62.8%, P < 0.001). A mean improvement of +9.3% in 3MSCT was observed at 12 months (P = 0.013), which also remained statistically significant at last observation (+13.8%, P = 0.004), with a more pronounced improvement detected in the paediatric subgroup. No treatment-emergent adverse events were reported leading to permanent treatment discontinuation. Patients treated with velmanase alfa experienced improvements in biochemical and functional measures that were maintained for up to 4 years. Long term follow-up is important and further supports the use of velmanase alfa as an effective and well-tolerated treatment for AM. Based on the currently available data set, no baseline characteristic can be predictive of treatment outcome. Early treatment during paediatric age showed better outcome in functional endpoints.

SIMULTANEOUS MULTISLICE MAGNETIC RESONANCE FINGERPRINTING WITH LOW-RANK AND SUBSPACE MODELING

PubMed Central

Zhao, Bo; Bilgic, Berkin; Adalsteinsson, Elfar; Griswold, Mark A.; Wald, Lawrence L.; Setsompop, Kawin

2018-01-01

Magnetic resonance fingerprinting (MRF) is a new quantitative imaging paradigm that enables simultaneous acquisition of multiple magnetic resonance tissue parameters (e.g., T1, T2, and spin density). Recently, MRF has been integrated with simultaneous multislice (SMS) acquisitions to enable volumetric imaging with faster scan time. In this paper, we present a new image reconstruction method based on low-rank and subspace modeling for improved SMS-MRF. Here the low-rank model exploits strong spatiotemporal correlation among contrast-weighted images, while the subspace model captures the temporal evolution of magnetization dynamics. With the proposed model, the image reconstruction problem is formulated as a convex optimization problem, for which we develop an algorithm based on variable splitting and the alternating direction method of multipliers. The performance of the proposed method has been evaluated by numerical experiments, and the results demonstrate that the proposed method leads to improved accuracy over the conventional approach. Practically, the proposed method has a potential to allow for a 3x speedup with minimal reconstruction error, resulting in less than 5 sec imaging time per slice. PMID:29060594

BlochSolver: A GPU-optimized fast 3D MRI simulator for experimentally compatible pulse sequences

NASA Astrophysics Data System (ADS)

Kose, Ryoichi; Kose, Katsumi

2017-08-01

A magnetic resonance imaging (MRI) simulator, which reproduces MRI experiments using computers, has been developed using two graphic-processor-unit (GPU) boards (GTX 1080). The MRI simulator was developed to run according to pulse sequences used in experiments. Experiments and simulations were performed to demonstrate the usefulness of the MRI simulator for three types of pulse sequences, namely, three-dimensional (3D) gradient-echo, 3D radio-frequency spoiled gradient-echo, and gradient-echo multislice with practical matrix sizes. The results demonstrated that the calculation speed using two GPU boards was typically about 7 TFLOPS and about 14 times faster than the calculation speed using CPUs (two 18-core Xeons). We also found that MR images acquired by experiment could be reproduced using an appropriate number of subvoxels, and that 3D isotropic and two-dimensional multislice imaging experiments for practical matrix sizes could be simulated using the MRI simulator. Therefore, we concluded that such powerful MRI simulators are expected to become an indispensable tool for MRI research and development.

A multislice gradient echo pulse sequence for CEST imaging.

PubMed

Dixon, W Thomas; Hancu, Ileana; Ratnakar, S James; Sherry, A Dean; Lenkinski, Robert E; Alsop, David C

2010-01-01

Chemical exchange-dependent saturation transfer and paramagnetic chemical exchange-dependent saturation transfer are agent-mediated contrast mechanisms that depend on saturating spins at the resonant frequency of the exchangeable protons on the agent, thereby indirectly saturating the bulk water. In general, longer saturating pulses produce stronger chemical and paramagnetic exchange-dependent saturation transfer effects, with returns diminishing for pulses longer than T1. This could make imaging slow, so one approach to chemical exchange-dependent saturation transfer imaging has been to follow a long, frequency-selective saturation period by a fast imaging method. A new approach is to insert a short frequency-selective saturation pulse before each spatially selective observation pulse in a standard, two-dimensional, gradient-echo pulse sequence. Being much less than T1 apart, the saturation pulses have a cumulative effect. Interleaved, multislice imaging is straightforward. Observation pulses directed at one slice did not produce observable, unintended chemical exchange-dependent saturation transfer effects in another slice. Pulse repetition time and signal-to noise ratio increase in the normal way as more slices are imaged simultaneously. Copyright (c) 2009 Wiley-Liss, Inc.

Simultaneous multislice magnetic resonance fingerprinting with low-rank and subspace modeling.

PubMed

Bo Zhao; Bilgic, Berkin; Adalsteinsson, Elfar; Griswold, Mark A; Wald, Lawrence L; Setsompop, Kawin

2017-07-01

Magnetic resonance fingerprinting (MRF) is a new quantitative imaging paradigm that enables simultaneous acquisition of multiple magnetic resonance tissue parameters (e.g., T 1 , T 2 , and spin density). Recently, MRF has been integrated with simultaneous multislice (SMS) acquisitions to enable volumetric imaging with faster scan time. In this paper, we present a new image reconstruction method based on low-rank and subspace modeling for improved SMS-MRF. Here the low-rank model exploits strong spatiotemporal correlation among contrast-weighted images, while the subspace model captures the temporal evolution of magnetization dynamics. With the proposed model, the image reconstruction problem is formulated as a convex optimization problem, for which we develop an algorithm based on variable splitting and the alternating direction method of multipliers. The performance of the proposed method has been evaluated by numerical experiments, and the results demonstrate that the proposed method leads to improved accuracy over the conventional approach. Practically, the proposed method has a potential to allow for a 3× speedup with minimal reconstruction error, resulting in less than 5 sec imaging time per slice.

Development and first validation of a simplified CT-based classification system of soft tissue changes in large-head metal-on-metal total hip replacement: intra- and interrater reliability and association with revision rates in a uniform cohort of 664 arthroplasties.

PubMed

Boomsma, Martijn F; Edens, Mireille A; Van Lingen, Christiaan P; Warringa, Niek; Ettema, Harmen B; Verheyen, Cees C P M; Maas, Mario

2015-08-01

After implantation of a metal-on-metal total hip arthroplasty (MoM THA), a large incidence of pseudotumor formation has been described recently. Several centers have invited patients for follow-up in order to screen for pseudotumor formation. The spectrum of abnormalities found by CT in MoM THA patients can be unfamiliar to radiologists and orthopedic surgeons. Previously, a CT five-point grading scale has been published. In this paper, a simplification into a three-point classification system gives insight in the morphological distinction of abnormalities of the postoperative hip capsule in MoM implants in relation to the decision for revision. The reliability of this simplified classification regarding intra- and interrater reliability and its association with revision rate is investigated and discussed. All patients who underwent MoM THA in our hospital were invited for screening. Various clinical measures and CT scan were obtained in a cross-sectional fashion. A decision on revision surgery was made shortly after screening. CT scans were read in 582 patients, of which 82 patients were treated bilaterally. CT scans were independently single read by two board-certified radiologists and classified into categories I-V. In a second meeting, consensus was obtained. Categories were subsequently rubricated in class A (categories I and II), B (category III), and C (categories IV and V). Intra- and inter-radiologist agreement on MoM pathology was assessed by means of the weighted Cohen's kappa. Categorical data were presented as n (%), and tested by means of Fisher's exact test. Continuous data were presented as median (min-max) and tested by means of Mann-Whitney U test (two group comparison) or Kruskal-Wallis test (three group comparison). Logistic regression analysis was performed in order to study independence of CT class for association with revision surgery. Univariate statistically significant variables were entered in a multiple model. All statistical analysis was performed two-tailed using alpha 5% as the significance level. In total, 664 scores from 664 MoM hips obtained by two observers were available for analyses. Interobserver reliability for the non-simplified version (I-V) was κw = 0.71 (95% CI: 0.62-0.79), which indicates good agreement between the two musculoskeletal radiologists. Intra- and interobserver reliability for the simplified version (A-C) were respectively κw 0.78 (95% CI: 0.68-0.87), and κw = 0.71 (95% CI: 0.65-0.76). This indicates good agreement within and between the two observers. The simplified A-C version is significantly associated with revision exclusively due to MoM pathology, in both patients with unilateral MoM THA (p < 0.001) and patients with bilateral MoM THA (p < 0.044). The simplified A-C version is associated with several clinical measures. In patients with unilateral MoM THA, with or without contralateral THA, in situ time (p < 0.008), cobalt and chromium (p < 0.001) were statistically significant. In patients with bilateral MoM, cobalt (p < 0.001) and chromium (p < 0.027) were statistically significant. Revision is significantly associated with cup size (p < 0.001), anteversion of the cup (p < 0.004), serum ion levels of cobalt and chromium (p < 0.001) and the adapted classification system (p < 0.001). In univariate logistic regression analysis on revision, cup, anteversion of the cup, cobalt-chromium ion serum levels, and the simplified (A-C) CT category system were statistically significant. The simplified (A-C) CT category system was an independent associate of revision, in several multiple logistic regression models. The presented simplified CT grading system (A-C) in its first clinical validation on 48- and 64-multislice systems is reliable, showing good intra- and interrater reliability and is independently associated with revision surgery.

Simultaneous Multislice Echo Planar Imaging With Blipped Controlled Aliasing in Parallel Imaging Results in Higher Acceleration: A Promising Technique for Accelerated Diffusion Tensor Imaging of Skeletal Muscle.

PubMed

Filli, Lukas; Piccirelli, Marco; Kenkel, David; Guggenberger, Roman; Andreisek, Gustav; Beck, Thomas; Runge, Val M; Boss, Andreas

2015-07-01

The aim of this study was to investigate the feasibility of accelerated diffusion tensor imaging (DTI) of skeletal muscle using echo planar imaging (EPI) applying simultaneous multislice excitation with a blipped controlled aliasing in parallel imaging results in higher acceleration unaliasing technique. After federal ethics board approval, the lower leg muscles of 8 healthy volunteers (mean [SD] age, 29.4 [2.9] years) were examined in a clinical 3-T magnetic resonance scanner using a 15-channel knee coil. The EPI was performed at a b value of 500 s/mm2 without slice acceleration (conventional DTI) as well as with 2-fold and 3-fold acceleration. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in all 3 acquisitions. Fiber tracking performance was compared between the acquisitions regarding the number of tracks, average track length, and anatomical precision using multivariate analysis of variance and Mann-Whitney U tests. Acquisition time was 7:24 minutes for conventional DTI, 3:53 minutes for 2-fold acceleration, and 2:38 minutes for 3-fold acceleration. Overall FA and MD values ranged from 0.220 to 0.378 and 1.595 to 1.829 mm2/s, respectively. Two-fold acceleration yielded similar FA and MD values (P ≥ 0.901) and similar fiber tracking performance compared with conventional DTI. Three-fold acceleration resulted in comparable MD (P = 0.199) but higher FA values (P = 0.006) and significantly impaired fiber tracking in the soleus and tibialis anterior muscles (number of tracks, P < 0.001; anatomical precision, P ≤ 0.005). Simultaneous multislice EPI with blipped controlled aliasing in parallel imaging results in higher acceleration can remarkably reduce acquisition time in DTI of skeletal muscle with similar image quality and quantification accuracy of diffusion parameters. This may increase the clinical applicability of muscle anisotropy measurements.

Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA.

PubMed

Filli, Lukas; Piccirelli, Marco; Kenkel, David; Boss, Andreas; Manoliu, Andrei; Andreisek, Gustav; Bhat, Himanshu; Runge, Val M; Guggenberger, Roman

2016-06-01

To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA. After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil. An EPI sequence (b-value, 1,000 s/mm(2); 20 gradient directions) was acquired without acceleration as well as with twofold and threefold slice acceleration. Fractional anisotropy (FA), mean diffusivity (MD) and quality of nerve tractography (number of tracks, average track length, track homogeneity, anatomical accuracy) were compared between the acquisitions using multivariate ANOVA and the Kruskal-Wallis test. Acquisition time was 6:08 min for standard DTI, 3:38 min for twofold and 2:31 min for threefold acceleration. No differences were found regarding FA (standard DTI: 0.620 ± 0.058; twofold acceleration: 0.642 ± 0.058; threefold acceleration: 0.644 ± 0.061; p ≥ 0.217) and MD (standard DTI: 1.076 ± 0.080 mm(2)/s; twofold acceleration: 1.016 ± 0.123 mm(2)/s; threefold acceleration: 0.979 ± 0.153 mm(2)/s; p ≥ 0.074). Twofold acceleration yielded similar tractography quality compared to standard DTI (p > 0.05). With threefold acceleration, however, average track length and track homogeneity decreased (p = 0.004-0.021). Accelerated DTI of the median nerve is feasible. Twofold acceleration yields similar results to standard DTI. • Standard DTI of the median nerve is limited by its long acquisition time. • Simultaneous multi-slice acquisition is a new technique for accelerated DTI. • Accelerated DTI of the median nerve yields similar results to standard DTI.

Localized Spatio-Temporal Constraints for Accelerated CMR Perfusion

PubMed Central

Akçakaya, Mehmet; Basha, Tamer A.; Pflugi, Silvio; Foppa, Murilo; Kissinger, Kraig V.; Hauser, Thomas H.; Nezafat, Reza

2013-01-01

Purpose To develop and evaluate an image reconstruction technique for cardiac MRI (CMR)perfusion that utilizes localized spatio-temporal constraints. Methods CMR perfusion plays an important role in detecting myocardial ischemia in patients with coronary artery disease. Breath-hold k-t based image acceleration techniques are typically used in CMR perfusion for superior spatial/temporal resolution, and improved coverage. In this study, we propose a novel compressed sensing based image reconstruction technique for CMR perfusion, with applicability to free-breathing examinations. This technique uses local spatio-temporal constraints by regularizing image patches across a small number of dynamics. The technique is compared to conventional dynamic-by-dynamic reconstruction, and sparsity regularization using a temporal principal-component (pc) basis, as well as zerofilled data in multi-slice 2D and 3D CMR perfusion. Qualitative image scores are used (1=poor, 4=excellent) to evaluate the technique in 3D perfusion in 10 patients and 5 healthy subjects. On 4 healthy subjects, the proposed technique was also compared to a breath-hold multi-slice 2D acquisition with parallel imaging in terms of signal intensity curves. Results The proposed technique results in images that are superior in terms of spatial and temporal blurring compared to the other techniques, even in free-breathing datasets. The image scores indicate a significant improvement compared to other techniques in 3D perfusion (2.8±0.5 vs. 2.3±0.5 for x-pc regularization, 1.7±0.5 for dynamic-by-dynamic, 1.1±0.2 for zerofilled). Signal intensity curves indicate similar dynamics of uptake between the proposed method with a 3D acquisition and the breath-hold multi-slice 2D acquisition with parallel imaging. Conclusion The proposed reconstruction utilizes sparsity regularization based on localized information in both spatial and temporal domains for highly-accelerated CMR perfusion with potential utility in free-breathing 3D acquisitions. PMID:24123058

TH-EF-BRA-08: A Novel Technique for Estimating Volumetric Cine MRI (VC-MRI) From Multi-Slice Sparsely Sampled Cine Images Using Motion Modeling and Free Form Deformation

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

Harris, W; Yin, F; Wang, C

Purpose: To develop a technique to estimate on-board VC-MRI using multi-slice sparsely-sampled cine images, patient prior 4D-MRI, motion-modeling and free-form deformation for real-time 3D target verification of lung radiotherapy. Methods: A previous method has been developed to generate on-board VC-MRI by deforming prior MRI images based on a motion model(MM) extracted from prior 4D-MRI and a single-slice on-board 2D-cine image. In this study, free-form deformation(FD) was introduced to correct for errors in the MM when large anatomical changes exist. Multiple-slice sparsely-sampled on-board 2D-cine images located within the target are used to improve both the estimation accuracy and temporal resolution ofmore » VC-MRI. The on-board 2D-cine MRIs are acquired at 20–30frames/s by sampling only 10% of the k-space on Cartesian grid, with 85% of that taken at the central k-space. The method was evaluated using XCAT(computerized patient model) simulation of lung cancer patients with various anatomical and respirational changes from prior 4D-MRI to onboard volume. The accuracy was evaluated using Volume-Percent-Difference(VPD) and Center-of-Mass-Shift(COMS) of the estimated tumor volume. Effects of region-of-interest(ROI) selection, 2D-cine slice orientation, slice number and slice location on the estimation accuracy were evaluated. Results: VCMRI estimated using 10 sparsely-sampled sagittal 2D-cine MRIs achieved VPD/COMS of 9.07±3.54%/0.45±0.53mm among all scenarios based on estimation with ROI-MM-ROI-FD. The FD optimization improved estimation significantly for scenarios with anatomical changes. Using ROI-FD achieved better estimation than global-FD. Changing the multi-slice orientation to axial, coronal, and axial/sagittal orthogonal reduced the accuracy of VCMRI to VPD/COMS of 19.47±15.74%/1.57±2.54mm, 20.70±9.97%/2.34±0.92mm, and 16.02±13.79%/0.60±0.82mm, respectively. Reducing the number of cines to 8 enhanced temporal resolution of VC-MRI by 25% while maintaining the estimation accuracy. Estimation using slices sampled uniformly through the tumor achieved better accuracy than slices sampled non-uniformly. Conclusions: Preliminary studies showed that it is feasible to generate VC-MRI from multi-slice sparsely-sampled 2D-cine images for real-time 3D-target verification. This work was supported by the National Institutes of Health under Grant No. R01-CA184173 and a research grant from Varian Medical Systems.« less

Emerging imaging tools for use with traumatic brain injury research.

PubMed

Hunter, Jill V; Wilde, Elisabeth A; Tong, Karen A; Holshouser, Barbara A

2012-03-01

This article identifies emerging neuroimaging measures considered by the inter-agency Pediatric Traumatic Brain Injury (TBI) Neuroimaging Workgroup. This article attempts to address some of the potential uses of more advanced forms of imaging in TBI as well as highlight some of the current considerations and unresolved challenges of using them. We summarize emerging elements likely to gain more widespread use in the coming years, because of 1) their utility in diagnosis, prognosis, and understanding the natural course of degeneration or recovery following TBI, and potential for evaluating treatment strategies; 2) the ability of many centers to acquire these data with scanners and equipment that are readily available in existing clinical and research settings; and 3) advances in software that provide more automated, readily available, and cost-effective analysis methods for large scale data image analysis. These include multi-slice CT, volumetric MRI analysis, susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), arterial spin tag labeling (ASL), functional MRI (fMRI), including resting state and connectivity MRI, MR spectroscopy (MRS), and hyperpolarization scanning. However, we also include brief introductions to other specialized forms of advanced imaging that currently do require specialized equipment, for example, single photon emission computed tomography (SPECT), positron emission tomography (PET), encephalography (EEG), and magnetoencephalography (MEG)/magnetic source imaging (MSI). Finally, we identify some of the challenges that users of the emerging imaging CDEs may wish to consider, including quality control, performing multi-site and longitudinal imaging studies, and MR scanning in infants and children.

Numerical simulation of humidification and heating during inspiration within an adult nose.

PubMed

Sommer, F; Kroger, R; Lindemann, J

2012-06-01

The temperature of inhaled air is highly relevant for the humidification process. Narrow anatomical conditions limit possibilities for in vivo measurements. Numerical simulations offer a great potential to examine the function of the human nose. In the present study, the nasal humidification of inhaled air was simulated simultaneously with temperature distribution during a respiratory cycle. A realistic nose model based on a multislice CT scan was created. The simulation was performed by the Software Fluent(r). Boundary conditions were based on previous in vivo measurements. Inhaled air had a temperature of 20(deg)C and relative humidity of 30%. The wall temperature was assumed to be variable from 34(deg)C to 30(deg)C with constant humidity saturation of 100% during the respiratory cycle. A substantial increase in temperature and humidity can be observed after passing the nasal valve area. Areas with high speed air flow, e.g. the space around the turbinates, show an intensive humidification and heating potential. Inspired air reaches 95% humidity and 28(deg)C within the nasopharynx. The human nose features an enormous humidification and heating capability. Warming and humidification are dependent on each other and show a similar spacial pattern. Concerning the climatisation function, the middle turbinate is of high importance. In contrast to in vivo measurements, numerical simulations can explore the impact of airflow distribution on nasal air conditioning. They are an effective method to investigate nasal pathologies and impacts of surgical procedures.

Pulsed arterial spin labeling using TurboFLASH with suppression of intravascular signal.

PubMed

Pell, Gaby S; Lewis, David P; Branch, Craig A

2003-02-01

Accurate quantification of perfusion with the ADC techniques requires the suppression of the majority of the intravascular signal. This is normally achieved with the use of diffusion gradients. The TurboFLASH sequence with its ultrashort repetition times is not readily amenable to this scheme. This report demonstrates the implementation of a modified TurboFLASH sequence for FAIR imaging. Intravascular suppression is achieved with a modified preparation period that includes a driven equilibrium Fourier transform (DEFT) combination of 90 degrees-180 degrees-90 degrees hard RF pulses subsequent to the inversion delay. These pulses rotate the perfusion-prepared magnetization into the transverse plane where it can experience the suitably placed diffusion gradients before being returned to the longitudinal direction by the second 90 degrees pulse. A value of b = 20-30 s/mm(2) was thereby found to suppress the majority of the intravascular signal. For single-slice perfusion imaging, quantification is only slightly modified. The technique can be readily extended to multislice acquisition if the evolving flow signal after the DEFT preparation is considered. An advantage of the modified preparation scheme is evident in the multislice FAIR images by the preservation of the sign of the magnetization difference. Copyright 2003 Wiley-Liss, Inc.

Bias Field Inconsistency Correction of Motion-Scattered Multislice MRI for Improved 3D Image Reconstruction

PubMed Central

Kim, Kio; Habas, Piotr A.; Rajagopalan, Vidya; Scott, Julia A.; Corbett-Detig, James M.; Rousseau, Francois; Barkovich, A. James; Glenn, Orit A.; Studholme, Colin

2012-01-01

A common solution to clinical MR imaging in the presence of large anatomical motion is to use fast multi-slice 2D studies to reduce slice acquisition time and provide clinically usable slice data. Recently, techniques have been developed which retrospectively correct large scale 3D motion between individual slices allowing the formation of a geometrically correct 3D volume from the multiple slice stacks. One challenge, however, in the final reconstruction process is the possibility of varying intensity bias in the slice data, typically due to the motion of the anatomy relative to imaging coils. As a result, slices which cover the same region of anatomy at different times may exhibit different sensitivity. This bias field inconsistency can induce artifacts in the final 3D reconstruction that can impact both clinical interpretation of key tissue boundaries and the automated analysis of the data. Here we describe a framework to estimate and correct the bias field inconsistency in each slice collectively across all motion corrupted image slices. Experiments using synthetic and clinical data show that the proposed method reduces intensity variability in tissues and improves the distinction between key tissue types. PMID:21511561

Bias field inconsistency correction of motion-scattered multislice MRI for improved 3D image reconstruction.

PubMed

Kim, Kio; Habas, Piotr A; Rajagopalan, Vidya; Scott, Julia A; Corbett-Detig, James M; Rousseau, Francois; Barkovich, A James; Glenn, Orit A; Studholme, Colin

2011-09-01

A common solution to clinical MR imaging in the presence of large anatomical motion is to use fast multislice 2D studies to reduce slice acquisition time and provide clinically usable slice data. Recently, techniques have been developed which retrospectively correct large scale 3D motion between individual slices allowing the formation of a geometrically correct 3D volume from the multiple slice stacks. One challenge, however, in the final reconstruction process is the possibility of varying intensity bias in the slice data, typically due to the motion of the anatomy relative to imaging coils. As a result, slices which cover the same region of anatomy at different times may exhibit different sensitivity. This bias field inconsistency can induce artifacts in the final 3D reconstruction that can impact both clinical interpretation of key tissue boundaries and the automated analysis of the data. Here we describe a framework to estimate and correct the bias field inconsistency in each slice collectively across all motion corrupted image slices. Experiments using synthetic and clinical data show that the proposed method reduces intensity variability in tissues and improves the distinction between key tissue types.

Simultaneous multislice refocusing via time optimal control.

PubMed

Rund, Armin; Aigner, Christoph Stefan; Kunisch, Karl; Stollberger, Rudolf

2018-02-09

Joint design of minimum duration RF pulses and slice-selective gradient shapes for MRI via time optimal control with strict physical constraints, and its application to simultaneous multislice imaging. The minimization of the pulse duration is cast as a time optimal control problem with inequality constraints describing the refocusing quality and physical constraints. It is solved with a bilevel method, where the pulse length is minimized in the upper level, and the constraints are satisfied in the lower level. To address the inherent nonconvexity of the optimization problem, the upper level is enhanced with new heuristics for finding a near global optimizer based on a second optimization problem. A large set of optimized examples shows an average temporal reduction of 87.1% for double diffusion and 74% for turbo spin echo pulses compared to power independent number of slices pulses. The optimized results are validated on a 3T scanner with phantom measurements. The presented design method computes minimum duration RF pulse and slice-selective gradient shapes subject to physical constraints. The shorter pulse duration can be used to decrease the effective echo time in existing echo-planar imaging or echo spacing in turbo spin echo sequences. © 2018 International Society for Magnetic Resonance in Medicine.

Whole left ventricular functional assessment from two minutes free breathing multi-slice CINE acquisition

NASA Astrophysics Data System (ADS)

Usman, M.; Atkinson, D.; Heathfield, E.; Greil, G.; Schaeffter, T.; Prieto, C.

2015-04-01

Two major challenges in cardiovascular MRI are long scan times due to slow MR acquisition and motion artefacts due to respiratory motion. Recently, a Motion Corrected-Compressed Sensing (MC-CS) technique has been proposed for free breathing 2D dynamic cardiac MRI that addresses these challenges by simultaneously accelerating MR acquisition and correcting for any arbitrary motion in a compressed sensing reconstruction. In this work, the MC-CS framework is combined with parallel imaging for further acceleration, and is termed Motion Corrected Sparse SENSE (MC-SS). Validation of the MC-SS framework is demonstrated in eight volunteers and three patients for left ventricular functional assessment and results are compared with the breath-hold acquisitions as reference. A non-significant difference (P > 0.05) was observed in the volumetric functional measurements (end diastolic volume, end systolic volume, ejection fraction) and myocardial border sharpness values obtained with the proposed and gold standard methods. The proposed method achieves whole heart multi-slice coverage in 2 min under free breathing acquisition eliminating the time needed between breath-holds for instructions and recovery. This results in two-fold speed up of the total acquisition time in comparison to the breath-hold acquisition.

Computer Aided Detection of Breast Masses in Digital Tomosynthesis

DTIC Science & Technology

2008-06-01

the suspicious CAD location were extracted. For the second set, 256x256 ROIs representing the - 8 - summed slab of 5 slices (5 mm) were extracted...region hotelling observer, digital tomosynthesis, multi-slice CAD algorithms, biopsy 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...developing computer-aided detection ( CAD ) tools for mammography. Although these tools have shown promise in identifying calcifications, detecting

Longitudinal analysis of endurance and respiratory function from a natural history study of Morquio A syndrome.

PubMed

Harmatz, Paul R; Mengel, Karl Eugen; Giugliani, Roberto; Valayannopoulos, Vassili; Lin, Shuan-Pei; Parini, Rossella; Guffon, Nathalie; Burton, Barbara K; Hendriksz, Christian J; Mitchell, John J; Martins, Ana Maria; Jones, Simon A; Guelbert, Norberto; Vellodi, Ashok; Wijburg, Frits A; Yang, Ke; Slasor, Peter; Decker, Celeste

2015-02-01

Baseline data from the Morquio A Clinical Assessment Program (MorCAP) revealed that individuals with Morquio A syndrome show substantial impairment in multiple domains including endurance and respiratory function (Harmatz et al., Mol Genet Metab, 2013). Here, 1- and 2-year longitudinal endurance and respiratory function data are presented. Endurance was assessed using the 6-minute walk test (6MWT) and the 3-minute stair climb test (3MSCT). Respiratory function was evaluated by measuring forced vital capacity (FVC) and maximum voluntary ventilation (MVV). Data were analyzed using repeated measures ANCOVA models. Annualized estimates of change were determined using model estimates and interpolation. 353, 184, and 78 subjects were assessed at Year 0 (baseline), Year 1, and Year 2, respectively. The overall annualized estimate of change (SE) in 6MWT distance was -4.86±3.25m; a larger decline of -6.84±5.38m was observed in the subset of subjects meeting the inclusion/exclusion criteria of the Phase 3 clinical trial of elosulfase alfa (≥5years of age with baseline 6MWT distance ≥30 and ≤325m). In contrast, little change (-0.14±0.60stairs/min) was observed in 3MSCT. Annualized changes (SE) in FVC and MVV were 2.44±0.68% and 1.01±2.38%, respectively. FVC and MVV increased in patients aged ≤14years, but decreased in older patients. The natural history of Morquio A syndrome is characterized by progressive impairment of endurance as measured by the 6MWT. Longitudinal trends in FVC and MVV showing increase in younger patients, but decrease in older patients, are likely to be influenced by growth. Changes in 6MWT may represent a sensitive measure of disease progression in ambulatory Morquio A patients. Copyright © 2014. Published by Elsevier Inc.

On-demand rendering of an oblique slice through 3D volumetric data using JPEG2000 client-server framework

NASA Astrophysics Data System (ADS)

Joshi, Rajan L.

2006-03-01

In medical imaging, the popularity of image capture modalities such as multislice CT and MRI is resulting in an exponential increase in the amount of volumetric data that needs to be archived and transmitted. At the same time, the increased data is taxing the interpretation capabilities of radiologists. One of the workflow strategies recommended for radiologists to overcome the data overload is the use of volumetric navigation. This allows the radiologist to seek a series of oblique slices through the data. However, it might be inconvenient for a radiologist to wait until all the slices are transferred from the PACS server to a client, such as a diagnostic workstation. To overcome this problem, we propose a client-server architecture based on JPEG2000 and JPEG2000 Interactive Protocol (JPIP) for rendering oblique slices through 3D volumetric data stored remotely at a server. The client uses the JPIP protocol for obtaining JPEG2000 compressed data from the server on an as needed basis. In JPEG2000, the image pixels are wavelet-transformed and the wavelet coefficients are grouped into precincts. Based on the positioning of the oblique slice, compressed data from only certain precincts is needed to render the slice. The client communicates this information to the server so that the server can transmit only relevant compressed data. We also discuss the use of caching on the client side for further reduction in bandwidth requirements. Finally, we present simulation results to quantify the bandwidth savings for rendering a series of oblique slices.

Platelet and leukocyte activation, atherosclerosis and inflammation in European and South Asian men.

PubMed

Dotsenko, O; Chaturvedi, N; Thom, S A McG; Wright, A R; Mayet, J; Shore, A; Schalkwijk, C; Hughes, A D

2007-10-01

Increased platelet activation occurs in ischemic heart disease (IHD), but increased platelet activation is also seen in cerebrovascular atherosclerosis and peripheral artery disease. It is not clear therefore whether platelet activation is an indicator of IHD or a marker of generalized atherosclerosis and inflammation. South Asian subjects are at high risk of IHD, but little is known regarding differences in platelet and leukocyte function between European and South Asian subjects. Fifty-four male subjects (age 49-79 years) had coronary artery calcification measured by multislice computed tomography (CT), aortic atherosclerosis assessed by measurement of carotid-femoral pulse wave velocity (aortic PWV), and femoral and carotid atherosclerosis measured by B-mode ultrasound. Platelet and leukocyte activation was assessed by flow cytometry of platelet-monocyte complexes (PMC), platelet expression of PAC-1 binding site and CD62P, and expression of L-selectin on leukocytes. Elevated circulating PMC correlated significantly with elevated aortic PWV and PMC were higher in subjects with femoral plaques. In contrast PMC did not differ by increasing coronary artery calcification category or presence of carotid plaques. Higher numbers of PMC were independently related to elevated levels of C-reactive protein (CRP), higher aortic PWV, hypertension and smoking in a multivariate model. Markers of platelet and leukocyte activation did not differ significantly by ethnicity. Increased PMC are related to the extent of aortic and femoral atherosclerosis rather than coronary or carotid atherosclerosis. The association between elevated CRP and increased PMC suggests that inflammation in relation to generalized atherosclerosis may play an important role in PMC activation.

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

PubMed Central

Wilde, Elisabeth A.; Tong, Karen A.; Holshouser, Barbara A.

2012-01-01

Abstract This article identifies emerging neuroimaging measures considered by the inter-agency Pediatric Traumatic Brain Injury (TBI) Neuroimaging Workgroup. This article attempts to address some of the potential uses of more advanced forms of imaging in TBI as well as highlight some of the current considerations and unresolved challenges of using them. We summarize emerging elements likely to gain more widespread use in the coming years, because of 1) their utility in diagnosis, prognosis, and understanding the natural course of degeneration or recovery following TBI, and potential for evaluating treatment strategies; 2) the ability of many centers to acquire these data with scanners and equipment that are readily available in existing clinical and research settings; and 3) advances in software that provide more automated, readily available, and cost-effective analysis methods for large scale data image analysis. These include multi-slice CT, volumetric MRI analysis, susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), arterial spin tag labeling (ASL), functional MRI (fMRI), including resting state and connectivity MRI, MR spectroscopy (MRS), and hyperpolarization scanning. However, we also include brief introductions to other specialized forms of advanced imaging that currently do require specialized equipment, for example, single photon emission computed tomography (SPECT), positron emission tomography (PET), encephalography (EEG), and magnetoencephalography (MEG)/magnetic source imaging (MSI). Finally, we identify some of the challenges that users of the emerging imaging CDEs may wish to consider, including quality control, performing multi-site and longitudinal imaging studies, and MR scanning in infants and children. PMID:21787167

Computer-assisted surgery planning in children with complex liver tumors identifies variability of the classical Couinaud classification.

PubMed

Warmann, Steven W; Schenk, Andrea; Schaefer, Juergen F; Ebinger, Martin; Blumenstock, Gunnar; Tsiflikas, Ilias; Fuchs, Joerg

2016-11-01

In complex malignant pediatric liver tumors there is an ongoing discussion regarding surgical strategy; for example, primary organ transplantation versus extended resection in hepatoblastoma involving 3 or 4 sectors of the liver. We evaluated the possible role of computer-assisted surgery planning in children with complex hepatic tumors. Between May 2004 and March 2016, 24 Children with complex liver tumors underwent standard multislice helical CT scan or MRI scan at our institution. Imaging data were processed using the software assistant LiverAnalyzer (Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany). Results were provided as Portable Document Format (PDF) with embedded interactive 3-dimensional surface mesh models. Median age of patients was 33months. Diagnoses were hepatoblastoma (n=14), sarcoma (n=3), benign parenchyma alteration (n=2), as well as hepatocellular carcinoma, rhabdoid tumor, focal nodular hyperplasia, hemangioendothelioma, or multiple hepatic metastases of a pancreas carcinoma (each n=1). Volumetry of liver segments identified remarkable variations and substantial aberrances from the Couinaud classification. Computer-assisted surgery planning was used to determine surgical strategies in 20/24 children; this was especially relevant in tumors affecting 3 or 4 liver sectors. Primary liver transplantation could be avoided in 12 of 14 hepaoblastoma patients who theoretically were candidates for this approach. Computer-assisted surgery planning substantially contributed to the decision for surgical strategies in children with complex hepatic tumors. This tool possibly allows determination of specific surgical procedures such as extended surgical resection instead of primary transplantation in certain conditions. Copyright © 2016. Published by Elsevier Inc.

Numerical simulation of humidification and heating during inspiration in nose models with three different located septal perforations.

PubMed

Lindemann, Jörg; Reichert, Michael; Kröger, Ralf; Schuler, Patrick; Hoffmann, Thomas; Sommer, Fabian

2016-07-01

Nasal septum perforations (SP) are characterized by nasal obstruction, bleeding and crusting. The disturbed heating and humidification of the inhaled air are important factors, which cause these symptoms due to a disturbed airflow. Numerical simulations offer a great potential to avoid these limitations and to provide valid data. The aim of the study was to simulate the humidification and heating of the inhaled air in digital nose models with three different SPs and without SP. Four realistic bilateral nose models based on a multi-slice CT scan were created. The SP were located anterior caudal, anterior cranial and posterior caudal. One model was without SP. A numerical simulation was performed. Boundary conditions were based on previous in vivo measurements. Heating and humidification of the inhaled air were displayed, analyzed in each model and compared to each other. Anterior caudal SPs cause a disturbed decrease of temperature and humidity of the inhaled air. The reduced temperature and humidity values can still be shown in the posterior nose. The anterior cranial and the posterior caudal perforation have only a minor influence on heating and humidification. A reduced humidification and heating of the air can be shown by numerical simulations due to SP depending on their localization. The anterior caudal SP representing a typical localization after previous surgery has the biggest influence on heating and humidification. The results explain the typical symptoms such as crusting by drying-out the nasal mucosa. The size and the localization of the SP are essential for the symptoms.

Right cervical aortic arch with aberrant left subclavian artery.

PubMed

Tjang, Yanto S; Aramendi, José I; Crespo, Alejandro; Hamzeh, Gadah; Voces, Roberto; Rodríguez, Miguel A

2008-08-01

The combination of right cervical aortic arch, aberrant retroesophageal left subclavian artery originating from a Kommerell's diverticulum, and a ligamentum arteriosum, constitutes a rare form of vascular ring. Two patients aged 21 days and 54 years, who were diagnosed by multislice 3-dimensional computed tomography and magnetic resonance imaging, underwent surgical division of a vascular ring. The adult required resection of a Kommerell's aneurysm and subclavian artery reimplantation.

A low power radiofrequency pulse for simultaneous multislice excitation and refocusing.

PubMed

Eichner, Cornelius; Wald, Lawrence L; Setsompop, Kawin

2014-10-01

Simultaneous multislice (SMS) acquisition enables increased temporal efficiency of MRI. Nonetheless, MultiBand (MB) radiofrequency (RF) pulses used for SMS can cause large energy deposition. Power independent of number of slices (PINS) pulses reduce RF power at cost of reduced bandwidth and increased off-resonance dependency. This work improves PINS design to further reduce energy deposition, off-resonance dependency and peak power. Modifying the shape of MB RF-pulses allows for mixing with PINS excitation, creating a new pulse type with reduced energy deposition and SMS excitation characteristics. Bloch Simulations were used to evaluate excitation and off-resonance behavior of this "MultiPINS" pulse. In this work, MultiPINS was used for whole-brain MB = 3 acquisition of high angular and spatial resolution diffusion MRI at 7 Tesla in 3 min. By using MultiPINS, energy transmission and peak power for SMS imaging can be significantly reduced compared with PINS and MB pulses. For MB = 3 acquisition in this work, MultiPINS reduces energy transmission by up to ∼50% compared with PINS pulses. The energy reduction was traded off to shorten the MultiPINS pulse, yielding higher signal at off-resonances for spin-echo acquisitions. MB and PINS pulses can be combined to enable low energy and peak power SMS acquisition. Copyright © 2014 Wiley Periodicals, Inc.

Materials characterisation by angle-resolved scanning transmission electron microscopy.

PubMed

Müller-Caspary, Knut; Oppermann, Oliver; Grieb, Tim; Krause, Florian F; Rosenauer, Andreas; Schowalter, Marco; Mehrtens, Thorsten; Beyer, Andreas; Volz, Kerstin; Potapov, Pavel

2016-11-16

Solid-state properties such as strain or chemical composition often leave characteristic fingerprints in the angular dependence of electron scattering. Scanning transmission electron microscopy (STEM) is dedicated to probe scattered intensity with atomic resolution, but it drastically lacks angular resolution. Here we report both a setup to exploit the explicit angular dependence of scattered intensity and applications of angle-resolved STEM to semiconductor nanostructures. Our method is applied to measure nitrogen content and specimen thickness in a GaN x As 1-x layer independently at atomic resolution by evaluating two dedicated angular intervals. We demonstrate contrast formation due to strain and composition in a Si- based metal-oxide semiconductor field effect transistor (MOSFET) with Ge x Si 1-x stressors as a function of the angles used for imaging. To shed light on the validity of current theoretical approaches this data is compared with theory, namely the Rutherford approach and contemporary multislice simulations. Inconsistency is found for the Rutherford model in the whole angular range of 16-255 mrad. Contrary, the multislice simulations are applicable for angles larger than 35 mrad whereas a significant mismatch is observed at lower angles. This limitation of established simulations is discussed particularly on the basis of inelastic scattering.

Imaging anatomy of the vestibular and visual systems.

PubMed

Gunny, Roxana; Yousry, Tarek A

2007-02-01

This review will outline the imaging anatomy of the vestibular and visual pathways, using computed tomography and magnetic resonance imaging, with emphasis on the more recent developments in neuroimaging. Technical advances in computed tomography and magnetic resonance imaging, such as the advent of multislice computed tomography and newer magnetic resonance imaging techniques such as T2-weighted magnetic resonance cisternography, have improved the imaging of the vestibular and visual pathways, allowing better visualization of the end organs and peripheral nerves. Higher field strength magnetic resonance imaging is a promising tool, which has been used to evaluate and resolve fine anatomic detail in vitro, as in the labyrinth. Advanced magnetic resonance imaging techniques such as functional magnetic resonance imaging and diffusion tractography have been used to identify cortical areas of activation and associated white matter pathways, and show potential for the future identification of complex neuronal relays involved in integrating these pathways. The assessment of the various components of the vestibular and the visual systems has improved with more detailed research on the imaging anatomy of these systems, the advent of high field magnetic resonance scanners and multislice computerized tomography, and the wider use of specific techniques such as tractography which displays white matter tracts not directly accessible until now.

Design of parallel transmission pulses for simultaneous multislice with explicit control for peak power and local specific absorption rate.

PubMed

Guérin, Bastien; Setsompop, Kawin; Ye, Huihui; Poser, Benedikt A; Stenger, Andrew V; Wald, Lawrence L

2015-05-01

To design parallel transmit (pTx) simultaneous multislice (SMS) spokes pulses with explicit control for peak power and local and global specific absorption rate (SAR). We design SMS pTx least-squares and magnitude least squares spokes pulses while constraining local SAR using the virtual observation points (VOPs) compression of SAR matrices. We evaluate our approach in simulations of a head (7T) and a body (3T) coil with eight channels arranged in two z-rows. For many of our simulations, control of average power by Tikhonov regularization of the SMS pTx spokes pulse design yielded pulses that violated hardware and SAR safety limits. On the other hand, control of peak power alone yielded pulses that violated local SAR limits. Pulses optimized with control of both local SAR and peak power satisfied all constraints and therefore had the best excitation performance under limited power and SAR constraints. These results extend our previous results for single slice pTx excitations but are more pronounced because of the large power demands and SAR of SMS pulses. Explicit control of local SAR and peak power is required to generate optimal SMS pTx excitations satisfying both the system's hardware limits and regulatory safety limits. © 2014 Wiley Periodicals, Inc.

Application of 3D printing in the surgical planning of hypertrophic obstructive cardiomyopathy and physician-patient communication: a preliminary study.

PubMed

Guo, Hong-Chang; Wang, Yang; Dai, Jiang; Ren, Chang-Wei; Li, Jin-Hua; Lai, Yong-Qiang

2018-02-01

The aim of this study was to evaluate the effect of 3-dimensional (3D) printing in treatment of hypertrophic obstructive cardiomyopathy (HOCM) and its roles in doctor-patient communication. 3D-printed models were constructed preoperatively and postoperatively in seven HOCM patients received surgical treatment. Based on multi-slice computed tomography (CT) images, regions of disorder were segmented using the Mimics 19.0 software (Materialise, Leuven, Belgium). After generating an STL-file (StereoLithography file) with patients' data, the 3D printer (Objet350 Connex3, Stratasys Ltd., USA) created a 3D model. The pre- and post-operative 3D-printed models were used to make the surgical plan preoperatively and evaluate the outcome postoperatively. Meanwhile, a questionnaire was designed for patients and their relatives to learn the effectiveness of the 3D-printed prototypes in the preoperative conversations. The heart anatomies were accurately printed with 3D technology. The 3D-printed prototypes were useful for preoperative evaluation, surgical planning, and practice. Preoperative and postoperative echocardiographic evaluation showed left ventricular outflow tract (LVOT) obstruction was adequately relieved (82.71±31.63 to 14.91±6.89 mmHg, P<0.001), the septal thickness was reduced from 21.57±4.65 to 17.42±5.88 mm (P<0.001), and the SAM disappeared completely after the operation. Patients highly appreciated the role of 3D model in preoperative conversations and the communication score was 9.11±0.38 points. A 3D-printed model is a useful tool in individualized planning for myectomies and represent a useful tool for physician-patient communication.

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

Mast, Mirjam E., E-mail: m.mast@mchaaglanden.nl; Heijenbrok, Mark W.; Petoukhova, Anna L.

Purpose: Breast cancer radiotherapy has been associated with an increased risk of cardiac toxicity. However, no data are available on the probability of developing coronary artery disease (CAD) in breast cancer patients when compared with healthy women. Therefore, baseline coronary artery calcium (CAC) scores, as an accepted tool to predict CAD, were determined and compared with the CAC scores of a healthy, asymptomatic cohort, the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Methods and Materials: Eighty consecutive patients with ductal carcinoma in situ or infiltrative breast cancer referred for radiotherapy after breast-conserving surgery were included in our study. Their cardiovascular riskmore » profile was registered, and a 64 multislice CT scan was performed. The CAC scores of an unselected (Caucasian only) Radiotherapy Centre West (RCWEST) cohort, as well as of those of a selected (comorbidity and race adjusted) RCWEST cohort, were determined. The scores of both cohorts were compared with those of the female (Caucasian only) MESA cohort. Results: For the unselected RCWEST cohort (n = 62) we found significant (p < .01) higher scores for women in the 55-64 age category compared with those of the MESA cohort. In the selected cohort (n = 55) the CAC scores of the women in the age category 55-64 were significantly (p = .02) higher compared with the MESA cohort. No significant differences were noted in the other age categories. Conclusion: Both cohorts revealed that CAC scores in the 55-64 age category were significantly higher than the CAC scores in the asymptomatic (female) MESA population. These data suggest that breast cancer patients bear a higher risk of developing coronary heart disease before the start of radiotherapy. Therefore, measures to decrease cardiac dose further in breast cancer radiotherapy are even more important.« less

Image quality and artefact generation post-cerebral aneurysm clipping using a 64-row multislice computer tomography angiography (MSCTA) technology: A retrospective study and review of the literature.

PubMed

Zachenhofer, Iris; Cejna, Manfred; Schuster, Antonius; Donat, Markus; Roessler, Karl

2010-06-01

Computed tomography angiography (CTA) is a time and cost saving investigation for postoperative evaluation of clipped cerebral aneurysm patients. A retrospective study was conducted to analyse image quality and artefact generation due to implanted aneurysm clips using a new technology. MSCTA was performed pre- and postoperatively using a Philips Brilliance 64-detector-row CT scanner. Altogether, 32 clipping sites were analysed in 27 patients (11 female and 16 male, mean ages 52a, from 24 to 72 years). Clip number per aneurysm was 2.3 mean (from 1 to 4), 54 clips were made of titanium alloy and 5 of cobalt alloy. Altogether, image quality was rated 1.8 mean, using a scale from 1 (very good) to 5 (unserviceable) and clip artefacts were rated 2.4 mean, using a 5 point rating scale (1 no artefacts, 5 unserviceable due to artefacts). A significant loss of image quality and rise of artefacts was found when using cobalt alloy clips (1.4 versus 4.2 and 2.1 versus 4.0). In 72% of all investigations, an excellent image quality was found. Excluding the cobalt clip group, 85% of scans showed excellent image quality. Artefacts were absent or minimal (grade 1 or 2) in 69% of all investigations and in 81% in the pure titanium clip group. In 64-row MSCTA of good image quality with low artefacts, it was possible to detect small aneurysm remnants of 2mm size in individual patients. By using titanium alloy clips, in our study up to 85% of postoperative CTA images were of excellent quality with absent or minimal artefacts in 81% and seem adequate to detect small aneurysm remnants. Copyright 2010 Elsevier B.V. All rights reserved.

Characterizing probe performance in the aberration corrected STEM.

PubMed

Batson, P E

2006-01-01

Sub-Angstrom imaging using the 120 kV IBM STEM is now routine if the probe optics is carefully controlled and fully characterized. However, multislice simulation using at least a frozen phonon approximation is required to understand the Annular Dark Field image contrast. Analysis of silicon dumbbell structures in the [110] and [211] projections illustrate this finding. Using fast image acquisition, atomic movement appears ubiquitous under the electron beam, and may be useful to illuminate atomic level processes.

Advances in the Study of the Middle Cranial Fossa through Cutting Edge Neuroimaging Techniques.

PubMed

Juanes Méndez, Juan A; Ruisoto, Pablo; Paniagua, Juan C; Prats, Alberto

2018-01-16

The objective of this paper is to present a morphometric study of the middle cranial fossa from the study of 87 patients using cutting edge multislice computed tomography scans (32 detectors) and Magnetic Resonance Imaging. The study presents a detailed anatomical-radiological and morphometric analysis of the middle cranial fossa as well as its neurovascular elements in normal conditions. The implications of this investigation in training and clinical contexts are discussed.

Simultaneous Multi-Slice fMRI using Spiral Trajectories

PubMed Central

Zahneisen, Benjamin; Poser, Benedikt A.; Ernst, Thomas; Stenger, V. Andrew

2014-01-01

Parallel imaging methods using multi-coil receiver arrays have been shown to be effective for increasing MRI acquisition speed. However parallel imaging methods for fMRI with 2D sequences show only limited improvements in temporal resolution because of the long echo times needed for BOLD contrast. Recently, Simultaneous Multi-Slice (SMS) imaging techniques have been shown to increase fMRI temporal resolution by factors of four and higher. In SMS fMRI multiple slices can be acquired simultaneously using Echo Planar Imaging (EPI) and the overlapping slices are un-aliased using a parallel imaging reconstruction with multiple receivers. The slice separation can be further improved using the “blipped-CAIPI” EPI sequence that provides a more efficient sampling of the SMS 3D k-space. In this paper a blipped-spiral SMS sequence for ultra-fast fMRI is presented. The blipped-spiral sequence combines the sampling efficiency of spiral trajectories with the SMS encoding concept used in blipped-CAIPI EPI. We show that blipped spiral acquisition can achieve almost whole brain coverage at 3 mm isotropic resolution in 168 ms. It is also demonstrated that the high temporal resolution allows for dynamic BOLD lag time measurement using visual/motor and retinotopic mapping paradigms. The local BOLD lag time within the visual cortex following the retinotopic mapping stimulation of expanding flickering rings is directly measured and easily translated into an eccentricity map of the cortex. PMID:24518259

Advancing RF pulse design using an open-competition format: Report from the 2015 ISMRM challenge.

PubMed

Grissom, William A; Setsompop, Kawin; Hurley, Samuel A; Tsao, Jeffrey; Velikina, Julia V; Samsonov, Alexey A

2017-10-01

To advance the best solutions to two important RF pulse design problems with an open head-to-head competition. Two sub-challenges were formulated in which contestants competed to design the shortest simultaneous multislice (SMS) refocusing pulses and slice-selective parallel transmission (pTx) excitation pulses, subject to realistic hardware and safety constraints. Short refocusing pulses are needed for spin echo SMS imaging at high multiband factors, and short slice-selective pTx pulses are needed for multislice imaging in ultra-high field MRI. Each sub-challenge comprised two phases, in which the first phase posed problems with a low barrier of entry, and the second phase encouraged solutions that performed well in general. The Challenge ran from October 2015 to May 2016. The pTx Challenge winners developed a spokes pulse design method that combined variable-rate selective excitation with an efficient method to enforce SAR constraints, which achieved 10.6 times shorter pulse durations than conventional approaches. The SMS Challenge winners developed a time-optimal control multiband pulse design algorithm that achieved 5.1 times shorter pulse durations than conventional approaches. The Challenge led to rapid step improvements in solutions to significant problems in RF excitation for SMS imaging and ultra-high field MRI. Magn Reson Med 78:1352-1361, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Impacts of simultaneous multislice acquisition on sensitivity and specificity in fMRI.

PubMed

Risk, Benjamin B; Kociuba, Mary C; Rowe, Daniel B

2018-05-15

Simultaneous multislice (SMS) imaging can be used to decrease the time between acquisition of fMRI volumes, which can increase sensitivity by facilitating the removal of higher-frequency artifacts and boosting effective sample size. The technique requires an additional processing step in which the slices are separated, or unaliased, to recover the whole brain volume. However, this may result in signal "leakage" between aliased locations, i.e., slice "leakage," and lead to spurious activation (decreased specificity). SMS can also lead to noise amplification, which can reduce the benefits of decreased repetition time. In this study, we evaluate the original slice-GRAPPA (no leak block) reconstruction algorithm and acceleration factor (AF = 8) used in the fMRI data in the young adult Human Connectome Project (HCP). We also evaluate split slice-GRAPPA (leak block), which can reduce slice leakage. We use simulations to disentangle higher test statistics into true positives (sensitivity) and false positives (decreased specificity). Slice leakage was greatly decreased by split slice-GRAPPA. Noise amplification was decreased by using moderate acceleration factors (AF = 4). We examined slice leakage in unprocessed fMRI motor task data from the HCP. When data were smoothed, we found evidence of slice leakage in some, but not all, subjects. We also found evidence of SMS noise amplification in unprocessed task and processed resting-state HCP data. Copyright © 2018 Elsevier Inc. All rights reserved.

Accelerating Magnetic Resonance Fingerprinting (MRF) using t-Blipped Simultaneous Multi-Slice (SMS) acquisition

PubMed Central

Ye, Huihui; Ma, Dan; Jiang, Yun; Cauley, Stephen F.; Du, Yiping; Wald, Lawrence L.; Griswold, Mark A.; Setsompop, Kawin

2015-01-01

Purpose We incorporate Simultaneous Multi-Slice (SMS) acquisition into MR Fingerprinting (MRF) to accelerate the MRF acquisition. Methods The t-Blipped SMS-MRF method is achieved by adding a Gz blip before each data acquisition window and balancing it with a Gz blip of opposing polarity at the end of each TR. Thus the signal from different simultaneously excited slices are encoded with different phases without disturbing the signal evolution. Further, by varying the Gz blip area and/or polarity as a function of TR, the slices’ differential phase can also be made to vary as a function of time. For reconstruction of t-Blipped SMS-MRF data, we demonstrate a combined slice-direction SENSE and modified dictionary matching method. Results In Monte Carlo simulation, the parameter mapping from Multi-band factor (MB)=2 t-Blipped SMS-MRF shows good accuracy and precision when compared to results from reference conventional MRF data with concordance correlation coefficients (CCC) of 0.96 for T1 estimates and 0.90 for T2 estimates. For in vivo experiments, T1 and T2 maps from MB=2 t-Blipped SMS-MRF have a high agreement with ones from conventional MRF. Conclusions The MB=2 t-Blipped SMS-MRF acquisition/reconstruction method has been demonstrated and validated to provide more rapid parameter mapping in the MRF framework. PMID:26059430

Accelerating magnetic resonance fingerprinting (MRF) using t-blipped simultaneous multislice (SMS) acquisition.

PubMed

Ye, Huihui; Ma, Dan; Jiang, Yun; Cauley, Stephen F; Du, Yiping; Wald, Lawrence L; Griswold, Mark A; Setsompop, Kawin

2016-05-01

We incorporate simultaneous multislice (SMS) acquisition into MR fingerprinting (MRF) to accelerate the MRF acquisition. The t-Blipped SMS-MRF method is achieved by adding a Gz blip before each data acquisition window and balancing it with a Gz blip of opposing polarity at the end of each TR. Thus the signal from different simultaneously excited slices are encoded with different phases without disturbing the signal evolution. Furthermore, by varying the Gz blip area and/or polarity as a function of repetition time, the slices' differential phase can also be made to vary as a function of time. For reconstruction of t-Blipped SMS-MRF data, we demonstrate a combined slice-direction SENSE and modified dictionary matching method. In Monte Carlo simulation, the parameter mapping from multiband factor (MB) = 2 t-Blipped SMS-MRF shows good accuracy and precision when compared with results from reference conventional MRF data with concordance correlation coefficients (CCC) of 0.96 for T1 estimates and 0.90 for T2 estimates. For in vivo experiments, T1 and T2 maps from MB=2 t-Blipped SMS-MRF have a high agreement with ones from conventional MRF. The MB=2 t-Blipped SMS-MRF acquisition/reconstruction method has been demonstrated and validated to provide more rapid parameter mapping in the MRF framework. © 2015 Wiley Periodicals, Inc.

Effect of low refocusing angle in T1-weighted spin echo and fast spin echo MRI on low-contrast detectability: a comparative phantom study at 1.5 and 3 Tesla.

PubMed

Sarkar, Subhendra N; Mangosing, Jason L; Sarkar, Pooja R

2013-01-01

MRI tissue contrast is not well preserved at high field. In this work, we used a phantom with known, intrinsic contrast (3.6%) for model tissue pairs to test the effects of low angle refocusing pulses and magnetization transfer from adjacent slices on intrinsic contrast at 1.5 and 3 Tesla. Only T1-weighted spin echo sequences were tested since for such sequences the contrast loss, tissue heating, and image quality degradation at high fields seem to present significant diagnostic and quality issues. We hypothesized that the sources of contrast loss could be attributed to low refocusing angles that do not fulfill the Hahn spin echo conditions or to magnetization transfer effects from adjacent slices in multislice imaging. At 1.5 T the measured contrast was 3.6% for 180° refocusing pulses and 2% for 120° pulses, while at 3 T, it was 4% for 180° and only 1% for 120° refocusing pulses. There was no significant difference between single slice and multislice imaging suggesting little or no role played by magnetization transfer in the phantom chosen. Hence, one may conclude that low angle refocusing pulses not fulfilling the Hahn spin echo conditions are primarily responsible for significant deterioration of T1-weighted spin echo image contrast in high-field MRI.

[Application of 3D soft print models of the kidney for treatment of patients with localized cancer of the kidney (a pilot study)].

PubMed

Alyaev, Yu G; Sirota, E S; Bezrukov, E A; Fiev, D N; Bukatov, M D; Letunovskii, A V; Byadretdinov, I Sh

2017-12-01

To evaluate the possibility of using 3D-printing in the management of patients with localized kidney cancer. The study comprised five patients with localized kidney cancer who were treated at the Urology Clinic of the I.M. Sechenov First Moscow State Medical University from January 2016 to April 2017. Along with the standard examination, the patients underwent multispiral computed tomography (MSCT) to produce patient-specific 3D-printed models of the kidney tumors using 3D modeling and 3D printing. To evaluate the effectiveness of using 3D-printed models, two-stage preoperative planning was conducted, and five surgeons were surveyed using a four-question multiple choice questionnaire. At the first stage, the planning of operations was carried out based on MSCT findings. At the second stage, the surgeons were given patient-specific soft 3D models of the kidney with a tumor for preoperative training. After preoperative training, patients underwent laparoscopic resection of the kidney with a tumor. According to the survey results, each of the participating surgeons at least once changed surgical plan based on data obtained with 3D printed models of the kidney with the tumor. The implementation of preoperative training using 3D printed models of the kidney turned out to be effective. All patients underwent laparoscopic surgery performed by a single surgeon with extensive experience in this type of surgery. The mean operative time was 187 minutes. All operations were performed with main renal artery occlusion. The men warm ischemia time was 19.5 minutes and the mean blood loss was 170 ml. There were no conversions to open surgery and organ-removing operations. There were no postoperative complications or deaths. All surgical margins were negative. Morphological examination showed that four patients had renal cell carcinoma one patient had the oncocytoma. The study demonstrated the promise of using 3D printing for preoperative planning and surgical performance due to a high-precision three-dimensional soft patient-specific model of the localized kidney.

The diagnostic performance of coronary artery angiography with 64-MSCT and post 64-MSCT: systematic review and meta-analysis.

PubMed

Li, Min; Du, Xiang-Min; Jin, Zhi-Tao; Peng, Zhao-Hui; Ding, Juan; Li, Li

2014-01-01

To comprehensively investigate the diagnostic performance of coronary artery angiography with 64-MDCT and post 64-MDCT. PubMed was searched for all published studies that evaluated coronary arteries with 64-MDCT and post 64-MDCT. The clinical diagnostic role was evaluated by applying the likelihood ratios (LRs) to calculate the post-test probability based on Bayes' theorem. 91 studies that met our inclusion criteria were ultimately included in the analysis. The pooled positive and negative LRs at patient level were 8.91 (95% CI, 7.53, 10.54) and 0.02 (CI, 0.01, 0.03), respectively. For studies that did not claim that non-evaluable segments were included, the pooled positive and negative LRs were 11.16 (CI, 8.90, 14.00) and 0.01 (CI, 0.01, 0.03), respectively. For studies including uninterruptable results, the diagnostic performance decreased, with the pooled positive LR 7.40 (CI, 6.00, 9.13) and negative LR 0.02 (CI, 0.01, 0.03). The areas under the summary ROC curve were 0.98 (CI, 0.97 to 0.99) for 64-MDCT and 0.96 (CI, 0.94 to 0.98) for post 64-MDCT, respectively. For references explicitly stating that the non-assessable segments were included during analysis, a post-test probability of negative results >95% and a positive post-test probability <95% could be obtained for patients with a pre-test probability of <73% for coronary artery disease (CAD). On the other hand, when the pre-test probability of CAD was >73%, the diagnostic role was reversed, with a positive post-test probability of CAD >95% and a negative post-test probability of CAD <95%. The diagnostic performance of post 64-MDCT does not increase as compared with 64-MDCT. CTA, overall, is a test of exclusion for patients with a pre-test probability of CAD<73%, while for patients with a pre-test probability of CAD>73%, CTA is a test used to confirm the presence of CAD.

Normal and Pathological NCAT Image and PhantomData Based onPhysiologically Realistic Left Ventricle Finite-Element Models

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

Veress, Alexander I.; Segars, W. Paul; Weiss, Jeffrey A.

2006-08-02

The 4D NURBS-based Cardiac-Torso (NCAT) phantom, whichprovides a realistic model of the normal human anatomy and cardiac andrespiratory motions, is used in medical imaging research to evaluate andimprove imaging devices and techniques, especially dynamic cardiacapplications. One limitation of the phantom is that it lacks the abilityto accurately simulate altered functions of the heart that result fromcardiac pathologies such as coronary artery disease (CAD). The goal ofthis work was to enhance the 4D NCAT phantom by incorporating aphysiologically based, finite-element (FE) mechanical model of the leftventricle (LV) to simulate both normal and abnormal cardiac motions. Thegeometry of the FE mechanical modelmore » was based on gated high-resolutionx-ray multi-slice computed tomography (MSCT) data of a healthy malesubject. The myocardial wall was represented as transversely isotropichyperelastic material, with the fiber angle varying from -90 degrees atthe epicardial surface, through 0 degreesat the mid-wall, to 90 degreesat the endocardial surface. A time varying elastance model was used tosimulate fiber contraction, and physiological intraventricular systolicpressure-time curves were applied to simulate the cardiac motion over theentire cardiac cycle. To demonstrate the ability of the FE mechanicalmodel to accurately simulate the normal cardiac motion as well abnormalmotions indicative of CAD, a normal case and two pathologic cases weresimulated and analyzed. In the first pathologic model, a subendocardialanterior ischemic region was defined. A second model was created with atransmural ischemic region defined in the same location. The FE baseddeformations were incorporated into the 4D NCAT cardiac model through thecontrol points that define the cardiac structures in the phantom whichwere set to move according to the predictions of the mechanical model. Asimulation study was performed using the FE-NCAT combination toinvestigate how the differences in contractile function between thesubendocardial and transmural infarcts manifest themselves in myocardialSPECT images. The normal FE model produced strain distributions that wereconsistent with those reported in the literature and a motion consistentwith that defined in the normal 4D NCAT beating heart model based ontagged MRI data. The addition of a subendocardial ischemic region changedthe average transmural circumferential strain from a contractile value of0.19 to a tensile value of 0.03. The addition of a transmural ischemicregion changed average circumferential strain to a value of 0.16, whichis consistent with data reported in the literature. Model resultsdemonstrated differences in contractile function between subendocardialand transmural infarcts and how these differences in function aredocumented in simulated myocardial SPECT images produced using the 4DNCAT phantom. In comparison to the original NCAT beating heart model, theFE mechanical model produced a more accurate simulation for the cardiacmotion abnormalities. Such a model, when incorporated into the 4D NCATphantom, has great potential for use in cardiac imaging research. Withits enhanced physiologically-based cardiac model, the 4D NCAT phantom canbe used to simulate realistic, predictive imaging data of a patientpopulation with varying whole-body anatomy and with varying healthy anddiseased states of the heart that will provide a known truth from whichto evaluate and improve existing and emerging 4D imaging techniques usedin the diagnosis of cardiac disease.« less

Transmission Electron Microscopy of Single Wall Carbon Nanotube/Polymer Nanocomposites: A First-Principles Study

NASA Technical Reports Server (NTRS)

Sola, Francisco; Xia, Zhenhai; Lebrion-Colon, Marisabel; Meador, Michael A.

2012-01-01

The physics of HRTEM image formation and electron diffraction of SWCNT in a polymer matrix were investigated theoretically on the basis of the multislice method, and the optics of a FEG Super TWIN Philips CM 200 TEM operated at 80 kV. The effect of nanocomposite thickness on both image contrast and typical electron diffraction reflections of nanofillers were explored. The implications of the results on the experimental applicability to study dispersion, chirality and diameter of nanofillers are discussed.

Reciprocity relations in transmission electron microscopy: A rigorous derivation.

PubMed

Krause, Florian F; Rosenauer, Andreas

2017-01-01

A concise derivation of the principle of reciprocity applied to realistic transmission electron microscopy setups is presented making use of the multislice formalism. The equivalence of images acquired in conventional and scanning mode is thereby rigorously shown. The conditions for the applicability of the found reciprocity relations is discussed. Furthermore the positions of apertures in relation to the corresponding lenses are considered, a subject which scarcely has been addressed in previous publications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of low-contrast detectability between two CT reconstruction algorithms using voxel-based 3D printed textured phantoms.

PubMed

Solomon, Justin; Ba, Alexandre; Bochud, François; Samei, Ehsan

2016-12-01

To use novel voxel-based 3D printed textured phantoms in order to compare low-contrast detectability between two reconstruction algorithms, FBP (filtered-backprojection) and SAFIRE (sinogram affirmed iterative reconstruction) and determine what impact background texture (i.e., anatomical noise) has on estimating the dose reduction potential of SAFIRE. Liver volumes were segmented from 23 abdominal CT cases. The volumes were characterized in terms of texture features from gray-level co-occurrence and run-length matrices. Using a 3D clustered lumpy background (CLB) model, a fitting technique based on a genetic optimization algorithm was used to find CLB textures that were reflective of the liver textures, accounting for CT system factors of spatial blurring and noise. With the modeled background texture as a guide, four cylindrical phantoms (Textures A-C and uniform, 165 mm in diameter, and 30 mm height) were designed, each containing 20 low-contrast spherical signals (6 mm diameter at nominal contrast levels of ∼3.2, 5.2, 7.2, 10, and 14 HU with four repeats per signal). The phantoms were voxelized and input into a commercial multimaterial 3D printer (Object Connex 350), with custom software for voxel-based printing (using principles of digital dithering). Images of the textured phantoms and a corresponding uniform phantom were acquired at six radiation dose levels (SOMATOM Flash, Siemens Healthcare) and observer model detection performance (detectability index of a multislice channelized Hotelling observer) was estimated for each condition (5 contrasts × 6 doses × 2 reconstructions × 4 backgrounds = 240 total conditions). A multivariate generalized regression analysis was performed (linear terms, no interactions, random error term, log link function) to assess whether dose, reconstruction algorithm, signal contrast, and background type have statistically significant effects on detectability. Also, fitted curves of detectability (averaged across contrast levels) as a function of dose were constructed for each reconstruction algorithm and background texture. FBP and SAFIRE were compared for each background type to determine the improvement in detectability at a given dose, and the reduced dose at which SAFIRE had equivalent performance compared to FBP at 100% dose. Detectability increased with increasing radiation dose (P = 2.7 × 10 -59 ) and contrast level (P = 2.2 × 10 -86 ) and was higher in the uniform phantom compared to the textured phantoms (P = 6.9 × 10 -51 ). Overall, SAFIRE had higher d' compared to FBP (P = 0.02). The estimated dose reduction potential of SAFIRE was found to be 8%, 10%, 27%, and 8% for Texture-A, Texture-B, Texture-C and uniform phantoms. In all background types, detectability was higher with SAFIRE compared to FBP. However, the relative improvement observed from SAFIRE was highly dependent on the complexity of the background texture. Iterative algorithms such as SAFIRE should be assessed in the most realistic context possible.

Tracking lung tissue motion and expansion/compression with inverse consistent image registration and spirometry

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

Christensen, Gary E.; Song, Joo Hyun; Lu, Wei

2007-06-15

Breathing motion is one of the major limiting factors for reducing dose and irradiation of normal tissue for conventional conformal radiotherapy. This paper describes a relationship between tracking lung motion using spirometry data and image registration of consecutive CT image volumes collected from a multislice CT scanner over multiple breathing periods. Temporal CT sequences from 5 individuals were analyzed in this study. The couch was moved from 11 to 14 different positions to image the entire lung. At each couch position, 15 image volumes were collected over approximately 3 breathing periods. It is assumed that the expansion and contraction ofmore » lung tissue can be modeled as an elastic material. Furthermore, it is assumed that the deformation of the lung is small over one-fifth of a breathing period and therefore the motion of the lung can be adequately modeled using a small deformation linear elastic model. The small deformation inverse consistent linear elastic image registration algorithm is therefore well suited for this problem and was used to register consecutive image scans. The pointwise expansion and compression of lung tissue was measured by computing the Jacobian of the transformations used to register the images. The logarithm of the Jacobian was computed so that expansion and compression of the lung were scaled equally. The log-Jacobian was computed at each voxel in the volume to produce a map of the local expansion and compression of the lung during the breathing period. These log-Jacobian images demonstrate that the lung does not expand uniformly during the breathing period, but rather expands and contracts locally at different rates during inhalation and exhalation. The log-Jacobian numbers were averaged over a cross section of the lung to produce an estimate of the average expansion or compression from one time point to the next and compared to the air flow rate measured by spirometry. In four out of five individuals, the average log-Jacobian value and the air flow rate correlated well (R{sup 2}=0.858 on average for the entire lung). The correlation for the fifth individual was not as good (R{sup 2}=0.377 on average for the entire lung) and can be explained by the small variation in tidal volume for this individual. The correlation of the average log-Jacobian value and the air flow rate for images near the diaphragm correlated well in all five individuals (R{sup 2}=0.943 on average). These preliminary results indicate a strong correlation between the expansion/compression of the lung measured by image registration and the air flow rate measured by spirometry. Predicting the location, motion, and compression/expansion of the tumor and normal tissue using image registration and spirometry could have many important benefits for radiotherapy treatment. These benefits include reducing radiation dose to normal tissue, maximizing dose to the tumor, improving patient care, reducing treatment cost, and increasing patient throughput.« less

Tracking lung tissue motion and expansion/compression with inverse consistent image registration and spirometry.

PubMed

Christensen, Gary E; Song, Joo Hyun; Lu, Wei; El Naqa, Issam; Low, Daniel A

2007-06-01

Breathing motion is one of the major limiting factors for reducing dose and irradiation of normal tissue for conventional conformal radiotherapy. This paper describes a relationship between tracking lung motion using spirometry data and image registration of consecutive CT image volumes collected from a multislice CT scanner over multiple breathing periods. Temporal CT sequences from 5 individuals were analyzed in this study. The couch was moved from 11 to 14 different positions to image the entire lung. At each couch position, 15 image volumes were collected over approximately 3 breathing periods. It is assumed that the expansion and contraction of lung tissue can be modeled as an elastic material. Furthermore, it is assumed that the deformation of the lung is small over one-fifth of a breathing period and therefore the motion of the lung can be adequately modeled using a small deformation linear elastic model. The small deformation inverse consistent linear elastic image registration algorithm is therefore well suited for this problem and was used to register consecutive image scans. The pointwise expansion and compression of lung tissue was measured by computing the Jacobian of the transformations used to register the images. The logarithm of the Jacobian was computed so that expansion and compression of the lung were scaled equally. The log-Jacobian was computed at each voxel in the volume to produce a map of the local expansion and compression of the lung during the breathing period. These log-Jacobian images demonstrate that the lung does not expand uniformly during the breathing period, but rather expands and contracts locally at different rates during inhalation and exhalation. The log-Jacobian numbers were averaged over a cross section of the lung to produce an estimate of the average expansion or compression from one time point to the next and compared to the air flow rate measured by spirometry. In four out of five individuals, the average log-Jacobian value and the air flow rate correlated well (R2 = 0.858 on average for the entire lung). The correlation for the fifth individual was not as good (R2 = 0.377 on average for the entire lung) and can be explained by the small variation in tidal volume for this individual. The correlation of the average log-Jacobian value and the air flow rate for images near the diaphragm correlated well in all five individuals (R2 = 0.943 on average). These preliminary results indicate a strong correlation between the expansion/compression of the lung measured by image registration and the air flow rate measured by spirometry. Predicting the location, motion, and compression/expansion of the tumor and normal tissue using image registration and spirometry could have many important benefits for radiotherapy treatment. These benefits include reducing radiation dose to normal tissue, maximizing dose to the tumor, improving patient care, reducing treatment cost, and increasing patient throughput.

RARE/Turbo Spin Echo Imaging with Simultaneous MultiSlice Wave-CAIPI

PubMed Central

Eichner, Cornelius; Bhat, Himanshu; Grant, P. Ellen; Wald, Lawrence L.; Setsompop, Kawin

2014-01-01

Purpose To enable highly accelerated RARE/Turbo Spin Echo (TSE) imaging using Simultaneous MultiSlice (SMS) Wave-CAIPI acquisition with reduced g-factor penalty. Methods SMS Wave-CAIPI incurs slice shifts across simultaneously excited slices while playing sinusoidal gradient waveforms during the readout of each encoding line. This results in an efficient k-space coverage that spreads aliasing in all three dimensions to fully harness the encoding power of coil sensitivities. The novel MultiPINS radiofrequency (RF) pulses dramatically reduce the power deposition of multiband (MB) refocusing pulse, thus allowing high MB factors within the Specific Absorption Rate (SAR) limit. Results Wave-CAIPI acquisition with MultiPINS permits whole brain coverage with 1 mm isotropic resolution in 70 seconds at effective MB factor 13, with maximum and average g-factor penalties of gmax=1.34 and gavg=1.12, and without √R penalty. With blipped-CAIPI, the g-factor performance was degraded to gmax=3.24 and gavg=1.42; a 2.4-fold increase in gmax relative to Wave-CAIPI. At this MB factor, the SAR of the MultiBand and PINS pulses are 4.2 and 1.9 times that of the MultiPINS pulse, while the peak RF power are 19.4 and 3.9 times higher. Conclusion Combination of the two technologies, Wave-CAIPI and MultiPINS pulse, enables highly accelerated RARE/TSE imaging with low SNR penalty at reduced SAR. PMID:25640187

Quantitative HAADF STEM of SiGe in presence of amorphous surface layers from FIB preparation.

PubMed

Grieb, Tim; Tewes, Moritz; Schowalter, Marco; Müller-Caspary, Knut; Krause, Florian F; Mehrtens, Thorsten; Hartmann, Jean-Michel; Rosenauer, Andreas

2018-01-01

The chemical composition of four Si 1-x Ge x layers grown on silicon was determined from quantitative scanning transmission electron microscopy (STEM). The chemical analysis was performed by a comparison of the high-angle annular dark field (HAADF) intensity with multislice simulations. It could be shown that amorphous surface layers originating from the preparation process by focused-ion beam (FIB) at 30 kV have a strong influence on the quantification: the local specimen thickness is overestimated by approximately a factor of two, and the germanium concentration is substantially underestimated. By means of simulations, the effect of amorphous surface layers on the HAADF intensity of crystalline silicon and germanium is investigated. Based on these simulations, a method is developed to analyze the experimental HAADF-STEM images by taking the influence of the amorphous layers into account which is done by a reduction of the intensities by multiplication with a constant factor. This suggested modified HAADF analysis gives germanium concentrations which are in agreement with the nominal values. The same TEM lamella was treated with low-voltage ion milling which removed the amorphous surface layers completely. The results from subsequent quantitative HAADF analyses are in agreement with the nominal concentrations which validates the applicability of the used frozen-lattice based multislice simulations to describe the HAADF scattering of Si 1-x Ge x in STEM. Copyright © 2017 Elsevier B.V. All rights reserved.

In vivo single-shot 13C spectroscopic imaging of hyperpolarized metabolites by spatiotemporal encoding

NASA Astrophysics Data System (ADS)

Schmidt, Rita; Laustsen, Christoffer; Dumez, Jean-Nicolas; Kettunen, Mikko I.; Serrao, Eva M.; Marco-Rius, Irene; Brindle, Kevin M.; Ardenkjaer-Larsen, Jan Henrik; Frydman, Lucio

2014-03-01

Hyperpolarized metabolic imaging is a growing field that has provided a new tool for analyzing metabolism, particularly in cancer. Given the short life times of the hyperpolarized signal, fast and effective spectroscopic imaging methods compatible with dynamic metabolic characterizations are necessary. Several approaches have been customized for hyperpolarized 13C MRI, including CSI with a center-out k-space encoding, EPSI, and spectrally selective pulses in combination with spiral EPI acquisitions. Recent studies have described the potential of single-shot alternatives based on spatiotemporal encoding (SPEN) principles, to derive chemical-shift images within a sub-second period. By contrast to EPSI, SPEN does not require oscillating acquisition gradients to deliver chemical-shift information: its signal encodes both spatial as well as chemical shift information, at no extra cost in experimental complexity. SPEN MRI sequences with slice-selection and arbitrary excitation pulses can also be devised, endowing SPEN with the potential to deliver single-shot multi-slice chemical shift images, with a temporal resolution required for hyperpolarized dynamic metabolic imaging. The present work demonstrates this with initial in vivo results obtained from SPEN-based imaging of pyruvate and its metabolic products, after injection of hyperpolarized [1-13C]pyruvate. Multi-slice chemical-shift images of healthy rats were obtained at 4.7 T in the region of the kidney, and 4D (2D spatial, 1D spectral, 1D temporal) data sets were obtained at 7 T from a murine lymphoma tumor model.

Coil compression in simultaneous multislice functional MRI with concentric ring slice-GRAPPA and SENSE.

PubMed

Chu, Alan; Noll, Douglas C

2016-10-01

Simultaneous multislice (SMS) imaging is a useful way to accelerate functional magnetic resonance imaging (fMRI). As acceleration becomes more aggressive, an increasingly larger number of receive coils are required to separate the slices, which significantly increases the computational burden. We propose a coil compression method that works with concentric ring non-Cartesian SMS imaging and should work with Cartesian SMS as well. We evaluate the method on fMRI scans of several subjects and compare it to standard coil compression methods. The proposed method uses a slice-separation k-space kernel to simultaneously compress coil data into a set of virtual coils. Five subjects were scanned using both non-SMS fMRI and SMS fMRI with three simultaneous slices. The SMS fMRI scans were processed using the proposed method, along with other conventional methods. Code is available at https://github.com/alcu/sms. The proposed method maintained functional activation with a fewer number of virtual coils than standard SMS coil compression methods. Compression of non-SMS fMRI maintained activation with a slightly lower number of virtual coils than the proposed method, but does not have the acceleration advantages of SMS fMRI. The proposed method is a practical way to compress and reconstruct concentric ring SMS data and improves the preservation of functional activation over standard coil compression methods in fMRI. Magn Reson Med 76:1196-1209, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

In vivo single-shot 13C spectroscopic imaging of hyperpolarized metabolites by spatiotemporal encoding

PubMed Central

Schmidt, Rita; Laustsen, Christoffer; Dumez, Jean-Nicolas; Kettunen, Mikko I.; Serrao, Eva M.; Marco-Rius, Irene; Brindle, Kevin M.; Ardenkjaer-Larsen, Jan Henrik; Frydman, Lucio

2016-01-01

Hyperpolarized metabolic imaging is a growing field that has provided a tool for analyzing metabolism, particularly in cancer. Given the short life times of the hyperpolarized signal, fast and effective spectroscopic imaging methods compatible with dynamic metabolic characterizations are necessary. Several approaches have been customized for hyperpolarized 13C MRI, including CSI with a center-out k-space encoding, EPSI, and spectrally selective pulses in combination with spiral EPI acquisitions. Recent studies have described the potential of single-shot alternatives based on spatiotemporal encoding (SPEN) principles, to derive chemical-shift images within a sub-second period. By contrast to EPSI, SPEN does not require oscillating acquisition gradients to deliver chemical-shift information: its signal encodes both spatial as well as chemical shift information, at no extra cost in experimental complexity. SPEN MRI sequences with slice-selection and arbitrary excitation pulses can also be devised, endowing SPEN with the potential to deliver single-shot multi-slice chemical shift images, with a temporal resolution required for hyperpolarized dynamic metabolic imaging. The present work demonstrates this with initial in vivo results obtained from SPEN-based imaging of pyruvate and its metabolic products, after injection of hyperpolarized [1-13C]pyruvate. Multi-slice chemical-shift images of healthy rats were obtained at 4.7 T in the region of the kidney, and 4D (2D spatial, 1D spectral, 1D temporal) data sets were obtained at 7 T from a murine lymphoma tumor model. PMID:24486720

Prostate Dose Escalation by Innovative Inverse Planning-Driven IMRT

DTIC Science & Technology

2006-11-01

fLJ and at each step, we find the minimizer u,\\ of J’. The Euler-Lagrange equation for the regularized J’ functional is u- div ( 1 Vu )= f E S1,2A...GD, Agazaryan N, Solberg TD . 2003. The effects of tumor motion on planning and delivery of respiratory-gated IMRT. Med Phys 30:1052-1066. Jaffray DA...modulated) radiation therapy: a review. Phys Med Biol 51 :R403-425. Wink NM, McNitt-Gray MF, Solberg TD . 2005. Optimization of multi-slice helical

STEMsalabim: A high-performance computing cluster friendly code for scanning transmission electron microscopy image simulations of thin specimens.

PubMed

Oelerich, Jan Oliver; Duschek, Lennart; Belz, Jürgen; Beyer, Andreas; Baranovskii, Sergei D; Volz, Kerstin

2017-06-01

We present a new multislice code for the computer simulation of scanning transmission electron microscope (STEM) images based on the frozen lattice approximation. Unlike existing software packages, the code is optimized to perform well on highly parallelized computing clusters, combining distributed and shared memory architectures. This enables efficient calculation of large lateral scanning areas of the specimen within the frozen lattice approximation and fine-grained sweeps of parameter space. Copyright © 2017 Elsevier B.V. All rights reserved.

A Novel Multivoxel-Based Quantitation of Metabolites and Lipids Noninvasively Combined with Diffusion-Weighted Imaging in Breast Cancer

DTIC Science & Technology

2012-09-01

scanner. Report of the Progress: Multi-slice DWI-MRI and 4D EP-COSI was tested in 2 malignant and 3 benign breast cancer patients and 6 healthy...for improving the overall specificity. • We are currently testing retrospective Maximum Entropy and Compressed Sensing of the 4D EP-COSI data so that...MRS. NMR in Biomed. 2008;22(1):77-91. 2 Kobus T, Vos PC, Hambrock T, De Rooij M, Hulsbergen-Van de Kaa CA, Barentsz JO, Heerschap A, Scheenen TW

[Breast cancer metastases to the stomach and colon: two case reports].

PubMed

Pulanić, Roland; Jelavić, Marko; Premuzić, Marina; Opacić, Milorad; Jakic-Razumović, Jasminka; Padovan-Stern, Ranka; Vrbanec, Damir

2012-01-01

Summary. Breast cancer has a high potential for metastasis, usually to the lungs, bones, liver and lymph nodes. Metastases in the holow organs of the digestive system are rare and mainly affectes the stomach and colon. They are characterized by very different clinical and radiological manifestations. We have warned that the initial unrecognized breast cancer can appear as a primary tumor of the stomach and colon, and onlya histopathological analysis reveales that it is a metastatic breast cancer. Metastases to the stomach or intestine involve deep layer of the mucosa and pathohistological findings of standard biopsy sample can be falsely negative, despite positive imaging technique (abdominal ultrasound and MSCT, endoscopic ultrasound) that indicate the tumor process. That's,why we emphasize the importance of endoscopic mucosal resection in the detection of malignant process of deeper layers of the gastric mucosa and deep intestinal mucosal biopsies with postoperative analysis of its walls.

Fallon, Nevada FORGE Well 21-31 Wireline Logs

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

Blankenship, Doug

Included are the following wireline logs from the Fallon FORGE Well 21-31. Ormat_Forge 21-31_8.5 inch section: FMI data in PDF and DLIS formats; MSCT data in PDF format; Pressure and Temperature data in PDF, LAS, and DLIS formats; Sonic Scanner data in PDF, DLIS, and LAS formats (LAS format contains Stoneley Slowness, Shear Slowness, and Compressional Slowness logs); Triple Combo in PDF, DLIS, and LAS formats; and USIT data in DLIS and PDF formats. Ormat_Forge_21-31_12.25 inch section: Resistivity data in PDF and LAS formats; Sonic Scanner data in PDF, DLIS, and LAS formats (LAS format contains Stoneley Slowness, Shear Slowness,more » and Compressional Slowness logs); Triple Combo in PDF and LAS formats; and Caliper data in PDF format (DLIS format for caliper data is included in the Sonic Scanner DLIS).« less

Vascularization of liver tumors - preliminary results with Coded Harmonic Angio (CHA), phase inversion imaging, 3D power Doppler and contrast medium-enhanced B-flow with second generation contrast agent (Optison).

PubMed

Jung, E M; Kubale, R; Jungius, K-P; Jung, W; Lenhart, M; Clevert, D-A

2006-01-01

To investigate the dynamic value of contrast medium-enhanced ultrasonography with Optison for appraisal of the vascularization of hepatic tumors using harmonic imaging, 3D-/power Doppler and B-flow. 60 patients with a mean age of 56 years (range 35-76 years) with 93 liver tumors, including histopathologically proven hepatocellular carcinoma (HCC) [15 cases with 20 lesions], liver metastases of colorectal tumors [17 cases with 33 lesions], metastases of breast cancer [10 cases with 21 lesions] and hemangiomas [10 cases with 19 lesions] were prospectively investigated by means of multislice CT as well as native and contrast medium-enhanced ultrasound using a multifrequency transducer (2.5-4 MHz, Logig 9, GE). B scan was performed with additional color and power Doppler, followed by a bolus injection of 0.5 ml Optison. Tumor vascularization was evaluated with coded harmonic angio (CHA), pulse inversion imaging with power Doppler, 3D power Doppler and in the late phase (>5 min) with B-flow. In 15 cases with HCC, i.a. DSA was performed in addition. The results were also correlated with MRT and histological findings. Compared to spiral-CT/MRT, only 72/93 (77%) of the lesions could be detected in the B scan, 75/93 (81%) with CHA and 93/93 (100%) in the pulse inversion mode. Tumor vascularization was detectable in 43/93 (46%) of lesions with native power Doppler, in 75/93 (81%) of lesions after administering contrast medium in the CHA mode, in 81/93 (87%) of lesions in the pulse inversion mode with power Doppler and in 77/93 (83%) of lesions with contrast-enhanced B-flow. Early arterial and capillary perfusion was best detected with CHA, particularly in 20/20 (100%) of the HCC lesions, allowing a 3D reconstruction. 3D power Doppler was especially useful in investigating the tumor margins. Up to 20 min after contrast medium injection, B-flow was capable of detecting increased metastatic tumor vascularization in 42/54 (78%) of cases and intratumoral perfusion in 17/20 (85%) of HCC cases. All 19 hemangiomas were correctly classified by phase inversion imaging. Contrast medium-enhanced ultrasound investigation of liver tumors with Optison allowed reliable detection of tumor foci and, in most cases, appraisal of tumor vascularization. The time available for evaluation of tumor margin vascularization was substantially longer in B-flow.

Using channelized Hotelling observers to quantify temporal effects of medical liquid crystal displays on detection performance

NASA Astrophysics Data System (ADS)

Platiša, Ljiljana; Goossens, Bart; Vansteenkiste, Ewout; Badano, Aldo; Philips, Wilfried

2010-02-01

Clinical practice is rapidly moving in the direction of volumetric imaging. Often, radiologists interpret these images in liquid crystal displays at browsing rates of 30 frames per second or higher. However, recent studies suggest that the slow response of the display can compromise image quality. In order to quantify the temporal effect of medical displays on detection performance, we investigate two designs of a multi-slice channelized Hotelling observer (msCHO) model in the task of detecting a single-slice signal in multi-slice simulated images. The design of msCHO models is inspired by simplifying assumptions about how humans observe while viewing in the stack-browsing mode. For comparison, we consider a standard CHO applied only on the slice where the signal is located, recently used in a similar study. We refer to it as a single-slice CHO (ssCHO). Overall, our results confirm previous findings that the slow response of displays degrades the detection performance of the observers. More specifically, the observed performance range of msCHO designs is higher compared to the ssCHO suggesting that the extent and rate of degradation, though significant, may be less drastic than previously estimated by the ssCHO. Especially, the difference between msCHO and ssCHO is more significant for higher browsing speeds than for slow image sequences or static images. This, together with their design criteria driven by the assumptions about humans, makes the msCHO models promising candidates for further studies aimed at building anthropomorphic observer models for the stack-mode image presentation.

Clinical application of Half Fourier Acquisition Single Shot Turbo Spin Echo (HASTE) imaging accelerated by simultaneous multi-slice acquisition.

PubMed

Schulz, Jenni; P Marques, José; Ter Telgte, Annemieke; van Dorst, Anouk; de Leeuw, Frank-Erik; Meijer, Frederick J A; Norris, David G

2018-01-01

As a single-shot sequence with a long train of refocusing pulses, Half-Fourier Acquisition Single-Shot Turbo-Spin-Echo (HASTE) suffers from high power deposition limiting use at high resolutions and high field strengths, particularly if combined with acceleration techniques such as simultaneous multi-slice (SMS) imaging. Using a combination of multiband (MB)-excitation and PINS-refocusing pulses will effectively accelerate the acquisition time while staying within the SAR limitations. In particular, uncooperative and young patients will profit from the speed of the MB-PINS HASTE sequence, as clinical diagnosis can be possible without sedation. Materials and MethodsMB-excitation and PINS-refocusing pulses were incorporated into a HASTE-sequence with blipped CAIPIRINHA and TRAPS including an internal FLASH reference scan for online reconstruction. Whole brain MB-PINS HASTE data were acquired on a Siemens 3T-Prisma system from 10 individuals and compared to a clinical HASTE protocol. ResultsThe proposed MB-PINS HASTE protocol accelerates the acquisition by about a factor 2 compared to the clinical HASTE. The diagnostic image quality proved to be comparable for both sequences for the evaluation of the overall aspect of the brain, the detection of white matter changes and areas of tissue loss, and for the evaluation of the CSF spaces although artifacts were more frequently encountered with MB-PINS HASTE. ConclusionsMB-PINS HASTE enables acquisition of slice accelerated highly T2-weighted images and provides good diagnostic image quality while reducing acquisition time. Copyright © 2017 Elsevier B.V. All rights reserved.

Dynamic 2D self-phase-map Nyquist ghost correction for simultaneous multi-slice echo planar imaging.

PubMed

Yarach, Uten; Tung, Yi-Hang; Setsompop, Kawin; In, Myung-Ho; Chatnuntawech, Itthi; Yakupov, Renat; Godenschweger, Frank; Speck, Oliver

2018-02-09

To develop a reconstruction pipeline that intrinsically accounts for both simultaneous multislice echo planar imaging (SMS-EPI) reconstruction and dynamic slice-specific Nyquist ghosting correction in time-series data. After 1D slice-group average phase correction, the separate polarity (i.e., even and odd echoes) SMS-EPI data were unaliased by slice GeneRalized Autocalibrating Partial Parallel Acquisition. Both the slice-unaliased even and odd echoes were jointly reconstructed using a model-based framework, extended for SMS-EPI reconstruction that estimates a 2D self-phase map, corrects dynamic slice-specific phase errors, and combines data from all coils and echoes to obtain the final images. The percentage ghost-to-signal ratios (%GSRs) and its temporal variations for MB3R y 2 with a field of view/4 shift in a human brain obtained by the proposed dynamic 2D and standard 1D phase corrections were 1.37 ± 0.11 and 2.66 ± 0.16, respectively. Even with a large regularization parameter λ applied in the proposed reconstruction, the smoothing effect in fMRI activation maps was comparable to a very small Gaussian kernel size 1 × 1 × 1 mm 3 . The proposed reconstruction pipeline reduced slice-specific phase errors in SMS-EPI, resulting in reduction of GSR. It is applicable for functional MRI studies because the smoothing effect caused by the regularization parameter selection can be minimal in a blood-oxygen-level-dependent activation map. © 2018 International Society for Magnetic Resonance in Medicine.

Multislice frozen phonon high angle annular dark-field image simulation study of Mo-V-Nb-Te-O complex oxidation catalyst "M1".

PubMed

Blom, Douglas A

2012-01-01

Multislice frozen phonon calculations were performed on a model structure of a complex oxide which has potential use as an ammoxidation catalyst. The structure has 11 cation sites in the framework, several of which exhibit mixed Mo/V substitution. In this paper the sensitivity of high-angle annular dark-field (HAADF) imaging to partial substitution of V for Mo in this structure is reported. While the relationship between the average V content in an atom column and the HAADF image intensity is not independent of thickness, it is a fairly weak function of thickness suggesting that HAADF STEM imaging in certain cases can provide a useful starting point for Rietveld refinements of mixed occupancy in complex materials. The thermal parameters of the various cations and oxygen anions in the model affect the amount of thermal diffuse scattering and therefore the intensity in the HAADF images. For complex materials where the structure has been derived via powder Rietveld refinement, the uncertainty in the thermal parameters may limit the accuracy of HAADF image simulations. With the current interest in quantitative microscopy, simulations need to accurately describe the electron scattering to the very high angles often subtended by a HAADF detector. For this system approximately 15% of the scattering occurs above 200 mrad at 200 kV. To simulate scattering to such high angles, very fine sampling of the projected potential is necessary which increases the computational cost of the simulation. Copyright © 2011 Elsevier B.V. All rights reserved.

Multi-domain impact of elosufase alfa in Morquio A syndrome in the pivotal phase III trial.

PubMed

Hendriksz, Christian J; Giugliani, Roberto; Harmatz, Paul; Mengel, Eugen; Guffon, Nathalie; Valayannopoulos, Vassili; Parini, Rossella; Hughes, Derralynn; Pastores, Gregory M; Lau, Heather A; Al-Sayed, Moeenaldeen D; Raiman, Julian; Yang, Ke; Mealiffe, Matthew; Haller, Christine

2015-02-01

To report and discuss the multi-domain impact of elosulfase alfa, with focus on tertiary and composite endpoints, in the 24-week, randomized, double-blind, placebo-controlled phase 3 trial in patients with Morquio A syndrome (mucopolysaccharidosis IVA). Patients with Morquio A syndrome aged ≥5 years were randomized 1:1:1 to elosulfase alfa 2.0mg/kg/week (qw; N=58), elosulfase alfa 2.0mg/kg/every other week (qow; N=59), or placebo (N=59) for 24 weeks. Primary and secondary efficacy measures were 6-minute walk test (6MWT; primary), 3-minute stair climb test (3-MSCT) and urinary keratan sulfate (KS). Safety was also evaluated. Tertiary efficacy measures included respiratory function measures, activities of daily living (MPS Health Assessment Questionnaire [MPS-HAQ]), anthropometric, echocardiographic and radiographic measures, hearing and corneal clouding assessment. In order to fully characterize treatment impact in this heterogeneous disorder, the effect of elosulfase alfa on composite efficacy measures was evaluated as well. The study was not designed to have sufficient power for any of the tertiary outcomes. For most tertiary endpoints, subjects treated with the weekly dose of elosulfase alfa improved more than those receiving placebo. The largest treatment effects were seen in maximal voluntary ventilation (MVV), MPS-HAQ, height, and growth rate. The qow group appeared similar to placebo. The analysis of a pre-specified composite endpoint (combining changes from baseline in 6MWT, 3MSCT and MVV z-scores equally weighted) showed a modest positive impact of elosulfase alfa qw versus placebo group (P=0.053). As a pre-specified supportive analysis, the O'Brien Rank Sum composite endpoint (changes from baseline in 6MWT, 3MSC, and MVV), analysis also showed that the qw group performed better than the placebo group (P=0.011). In post-hoc analyses, combinations of other endpoints were also explored using the O'Brien Rank Sum test and showed statistically significant differences between elosulfase alfa qw and placebo favoring elosulfase alfa qw. Differences between elosulfase alfa qow and placebo were not statistically significant. Positive changes were observed in most tertiary variables, demonstrating the efficacy of weekly treatment with elosulfase alfa. Treatment with weekly elosulfase alfa led to improvements across most efficacy measures, resulting in clinically meaningful benefits in a heterogeneous study population. Copyright © 2014. Published by Elsevier Inc.

Ultrafast electron diffraction pattern simulations using GPU technology. Applications to lattice vibrations.

PubMed

Eggeman, A S; London, A; Midgley, P A

2013-11-01

Graphical processing units (GPUs) offer a cost-effective and powerful means to enhance the processing power of computers. Here we show how GPUs can greatly increase the speed of electron diffraction pattern simulations by the implementation of a novel method to generate the phase grating used in multislice calculations. The increase in speed is especially apparent when using large supercell arrays and we illustrate the benefits of fast encoding the transmission function representing the atomic potentials through the simulation of thermal diffuse scattering in silicon brought about by specific vibrational modes. © 2013 Elsevier B.V. All rights reserved.

Giant floating thrombus localized in the ascending aorta.

PubMed

Akyildiz, Mahmut; Zorman, Yilmaz; Aksoy, Tamer; Yilmazer, Mustafa S; Erturk, Esra; Onar, Cagatay L; Midi, Ahmet

2010-06-01

We report the case of a 32-year-old male patient with symptoms of cerebrovascular accident manifesting with dysarthria. A transesophageal echocardiogram showed a floating mass localized in the ascending aorta, and a multislice computed tomography evaluation confirmed the diagnosis. With a comprehensive assessment of the mass, we decided on surgical intervention. A pedunculated and fragile mass was seen just near the right coronary ostium. The measured dimensions were 7.7 x 1.0 x 1.5 cm. The removed mass has been analyzed histopathologically and found to be the cause of the neurologic findings with an uncertain underlying etiology.

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

Herber, S.; Otto, G.; Schneider, J.

The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control.more » Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 {+-} 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 {+-} 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was diagnosed in eight patients, and multifocal disease in seven. Mean survival was 21.1 months (95% CI, 9.4-32.5 months). At the end of the investigation period 3 patients are still alive, and 12 patients have died. The 1-, 2-, and 3-year survival rate was 51.3%, 27.5%, and 27.5% respectively. According to RECIST criteria interim best response to therapy was stable disease in 9 of 15 patients, a partial response in 1 of 15 patients, and tumor progression in 4 of 15 patients. No deaths and no acute liver failure occurred under TACE therapy. Major complications were observed in two patients, comprising anaphylactic shock owing to contrast medium administration in one and gastric ulceration due to lipiodol displacement in the second patient. These results demonstrate that TACE is a safe procedure with a moderate number of complications for patients suffering from inoperable CCA. According to recently published data on i.v. chemotherapy we suggest that TACE might be able to prolong survival in selected patients who would succumb under other palliative treatment modalities.« less

Evaluation of the morphological characteristic and sex differences of sternum by multi-detector computed tomography.

PubMed

Ateşoğlu, Sibel; Deniz, Mustafa; Uslu, Ayşe İmge

2018-01-18

Sternum is one of the skeleton parts which have frequently congenital anomalies and variations are commonly used by researchers in determining sex. We evaluated the morphological characteristics and sex-related changes of the sternum in adult individuals using multidetector CT in our study. 200 adults (103 female and 97 male) aged between 18-87 years were evaluated. Utilizing the morphological characteristics of the sternum based on the multi-slice images; length, width and the thickness of Manubrium, length, width and the thickness of Corpus Sterni, total length of Sternum, Sternal angle, Sternal index, length of the xiphoid process, the thickness of xiphoid process, the number of indents of xiphoid process were measured and a total of 20 parameters were evaluated by adding age, height and weight to these variables. The mean length of the manubrium, the length of corpus sterni, the length of total sternum, sternal index, sternal angle were found in females 46.7±5.1,86.6±9.7, 133.1±1.1, 54.47±10.0 and 163.75±5.79; in males 51.2±6, 102.4±13.3, 154.1±13.1, 50.11±10.02 and 162.21±6.17, respectively. We found that Hyrtl's law and Sternal index did not provide adequate accuracy for sex determination in our patients. It has been detected that the length of the Manubrium alone is not helpful for individual samples. Total length of the sternum was found to be more reliable than the length of the Manubrium and the length of corpus Sterni. We determined Sternal cleft and Sternal foramen as 0.5% and 3.5%, respectively. We suggest that the Morphometric standards cannot be universally applied and can demonstrate individual differences. The standard rules must be implemented for every population.

Using irreversible compression in digital radiology: a preliminary study of the opinions of radiologists

NASA Astrophysics Data System (ADS)

Seeram, Euclid

2006-03-01

The large volumes of digital images produced by digital imaging modalities in Radiology have provided the motivation for the development of picture archiving and communication systems (PACS) in an effort to provide an organized mechanism for digital image management. The development of more sophisticated methods of digital image acquisition (Multislice CT and Digital Mammography, for example), as well as the implementation and performance of PACS and Teleradiology systems in a health care environment, have created challenges in the area of image compression with respect to storing and transmitting digital images. Image compression can be reversible (lossless) or irreversible (lossy). While in the former, there is no loss of information, the latter presents concerns since there is a loss of information. This loss of information from diagnostic medical images is of primary concern not only to radiologists, but also to patients and their physicians. In 1997, Goldberg pointed out that "there is growing evidence that lossy compression can be applied without significantly affecting the diagnostic content of images... there is growing consensus in the radiologic community that some forms of lossy compression are acceptable". The purpose of this study was to explore the opinions of expert radiologists, and related professional organizations on the use of irreversible compression in routine practice The opinions of notable radiologists in the US and Canada are varied indicating no consensus of opinion on the use of irreversible compression in primary diagnosis, however, they are generally positive on the notion of the image storage and transmission advantages. Almost all radiologists are concerned with the litigation potential of an incorrect diagnosis based on irreversible compressed images. The survey of several radiology professional and related organizations reveals that no professional practice standards exist for the use of irreversible compression. Currently, the only standard for image compression is stated in the ACR's Technical Standards for Teleradiology and Digital Image Management.

Numerical and experimental analysis of factors leading to suture dehiscence after Billroth II gastric resection.

PubMed

Cvetkovic, Aleksandar M; Milasinovic, Danko Z; Peulic, Aleksandar S; Mijailovic, Nikola V; Filipovic, Nenad D; Zdravkovic, Nebojsa D

2014-11-01

The main goal of this study was to numerically quantify risk of duodenal stump blowout after Billroth II (BII) gastric resection. Our hypothesis was that the geometry of the reconstructed tract after BII resection is one of the key factors that can lead to duodenal dehiscence. We used computational fluid dynamics (CFD) with finite element (FE) simulations of various models of BII reconstructed gastrointestinal (GI) tract, as well as non-perfused, ex vivo, porcine experimental models. As main geometrical parameters for FE postoperative models we have used duodenal stump length and inclination between gastric remnant and duodenal stump. Virtual gastric resection was performed on each of 3D FE models based on multislice Computer Tomography (CT) DICOM. According to our computer simulation the difference between maximal duodenal stump pressures for models with most and least preferable geometry of reconstructed GI tract is about 30%. We compared the resulting postoperative duodenal pressure from computer simulations with duodenal stump dehiscence pressure from the experiment. Pressure at duodenal stump after BII resection obtained by computer simulation is 4-5 times lower than the dehiscence pressure according to our experiment on isolated bowel segment. Our conclusion is that if the surgery is performed technically correct, geometry variations of the reconstructed GI tract by themselves are not sufficient to cause duodenal stump blowout. Pressure that develops in the duodenal stump after BII resection using omega loop, only in the conjunction with other risk factors can cause duodenal dehiscence. Increased duodenal pressure after BII resection is risk factor. Hence we recommend the routine use of Roux en Y anastomosis as a safer solution in terms of resulting intraluminal pressure. However, if the surgeon decides to perform BII reconstruction, results obtained with this methodology can be valuable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Two-dimensional speckle-tracking strain echocardiography in long-term heart transplant patients: a study comparing deformation parameters and ejection fraction derived from echocardiography and multislice computed tomography.

PubMed

Syeda, Bonni; Höfer, Peter; Pichler, Philipp; Vertesich, Markus; Bergler-Klein, Jutta; Roedler, Susanne; Mahr, Stephane; Goliasch, Georg; Zuckermann, Andreas; Binder, Thomas

2011-07-01

Longitudinal strain determined by speckle tracking is a sensitive parameter to detect systolic left ventricular dysfunction. In this study, we assessed regional and global longitudinal strain values in long-term heart transplants and compared deformation indices with ejection fraction as determined by transthoracic echocardiography (TTE) and multislice computed tomographic coronary angiography (MSCTA). TTE and MSCTA were prospectively performed in 31 transplant patients (10.6 years post-transplantation) and in 42 control subjects. Grey-scale apical views were recorded for speckle tracking (EchoPAC 7.0, GE) of the 16 segments of the left ventricle. The presence of coronary artery disease (CAD) was assessed by MSCTA. Strain analysis was performed in 1168 segments [496 in transplant patients (42.5%), 672 in control subjects (57.7%)]. Global longitudinal peak systolic strain was significantly lower in the transplant recipients than in the healthy population (-13.9 ± 4.2 vs. -17.4 ± 5.8%, P< 0.01). This was still the case after exclusion of the nine transplant patients with CAD (-14.1 ± 4.4 vs. -17.4 ± 5.8%, P=0.03). Transplant patients exhibited significantly lower regional strain values in 9 of the 16 segments. Left ventricular ejection fraction (%) (MSCTA/Simpsons method) was 60.7 ± 10.1%/60.2 ± 6.7% in transplant recipients vs. 64.7 ± 6.4%/63.0 ± 6.2% in the healthy population, P=ns. Even though 'healthy' heart transplants without CAD exhibit normal ejection fraction, deformation indices are reduced in this population when compared with control subjects. Our findings suggests that strain analysis is more sensitive than assessment of ejection fraction for the detection of abnormalities of systolic function.

Towards real-time thermometry using simultaneous multislice MRI

NASA Astrophysics Data System (ADS)

Borman, P. T. S.; Bos, C.; de Boorder, T.; Raaymakers, B. W.; Moonen, C. T. W.; Crijns, S. P. M.

2016-09-01

MR-guided thermal therapies, such as high-intensity focused ultrasound (MRgHIFU) and laser-induced thermal therapy (MRgLITT) are increasingly being applied in oncology and neurology. MRI is used for guidance since it can measure temperature noninvasively based on the proton resonance frequency shift (PRFS). For therapy guidance using PRFS thermometry, high temporal resolution and large spatial coverage are desirable. We propose to use the parallel imaging technique simultaneous multislice (SMS) in combination with controlled aliasing (CAIPIRINHA) to accelerate the acquisition. We compare this with the sensitivity encoding (SENSE) acceleration technique. Two experiments were performed to validate that SMS can be used to increase the spatial coverage or the temporal resolution. The first was performed in agar gel using LITT heating and a gradient-echo sequence with echo-planar imaging (EPI), and the second was performed in bovine muscle using HIFU heating and a gradient-echo sequence without EPI. In both experiments temperature curves from an unaccelerated scan and from SMS, SENSE, and SENSE/SMS accelerated scans were compared. The precision was quantified by a standard deviation analysis of scans without heating. Both experiments showed a good agreement between the temperature curves obtained from the unaccelerated, and SMS accelerated scans, confirming that accuracy was maintained during SMS acceleration. The standard deviations of the temperature measurements obtained with SMS were significantly smaller than when SENSE was used, implying that SMS allows for higher acceleration. In the LITT and HIFU experiments SMS factors up to 4 and 3 were reached, respectively, with a loss of precision of less than a factor of 3. Based on these results we conclude that SMS acceleration of PRFS thermometry is a valuable addition to SENSE, because it allows for a higher temporal resolution or bigger spatial coverage, with a higher precision.

Clinical feasibility of simultaneous multi-slice imaging with blipped-CAIPI for diffusion-weighted imaging and diffusion-tensor imaging of the brain.

PubMed

Yokota, Hajime; Sakai, Koji; Tazoe, Jun; Goto, Mariko; Imai, Hiroshi; Teramukai, Satoshi; Yamada, Kei

2017-12-01

Background Simultaneous multi-slice (SMS) imaging is starting to be used in clinical situation, although evidence of clinical feasibility is scanty. Purpose To prospectively assess the clinical feasibility of SMS diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI) with blipped-controlled aliasing in parallel imaging for brain lesions. Material and Methods The institutional review board approved this study. This study included 156 hyperintense lesions on DWI from 32 patients. A slice acceleration factor of 2 was applied for SMS scans, which allowed shortening of the scan time by 41.3%. The signal-to-noise ratio (SNR) was calculated for brain tissue of a selected slice. The contrast-to-noise ratio (CNR), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were calculated in 36 hyperintense lesions with a diameter of three pixels or more. Visual assessment was performed for all 156 lesions. Tractography of the corticospinal tract of 29 patients was evaluated. The number of tracts and averaged tract length were used for quantitative analysis, and visual assessment was evaluated by grading. Results The SMS scan showed no bias and acceptable 95% limits of agreement compared to conventional scans in SNR, CNR, and ADC on Bland-Altman analyses. Only FA of the lesions was higher in the SMS scan by 9% ( P = 0.016), whereas FA of the surrounding tissues was similar. Quantitative analysis of tractography showed similar values. Visual assessment of DWI hyperintense lesions and tractography also resulted in comparable evaluation. Conclusion SMS imaging was clinically feasible for imaging quality and quantitative values compared with conventional DWI and DTI.

Simultaneous multi-slice combined with PROPELLER.

PubMed

Norbeck, Ola; Avventi, Enrico; Engström, Mathias; Rydén, Henric; Skare, Stefan

2018-08-01

Simultaneous multi-slice (SMS) imaging is an advantageous method for accelerating MRI scans, allowing reduced scan time, increased slice coverage, or high temporal resolution with limited image quality penalties. In this work we combine the advantages of SMS acceleration with the motion correction and artifact reduction capabilities of the PROPELLER technique. A PROPELLER sequence was developed with support for CAIPIRINHA and phase optimized multiband radio frequency pulses. To minimize the time spent on acquiring calibration data, both in-plane-generalized autocalibrating partial parallel acquisition (GRAPPA) and slice-GRAPPA weights for all PROPELLER blade angles were calibrated on a single fully sampled PROPELLER blade volume. Therefore, the proposed acquisition included a single fully sampled blade volume, with the remaining blades accelerated in both the phase and slice encoding directions without additional auto calibrating signal lines. Comparison to 3D RARE was performed as well as demonstration of 3D motion correction performance on the SMS PROPELLER data. We show that PROPELLER acquisitions can be efficiently accelerated with SMS using a short embedded calibration. The potential in combining these two techniques was demonstrated with a high quality 1.0 × 1.0 × 1.0 mm 3 resolution T 2 -weighted volume, free from banding artifacts, and capable of 3D retrospective motion correction, with higher effective resolution compared to 3D RARE. With the combination of SMS acceleration and PROPELLER imaging, thin-sliced reformattable T 2 -weighted image volumes with 3D retrospective motion correction capabilities can be rapidly acquired with low sensitivity to flow and head motion. Magn Reson Med 80:496-506, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Automated multi-slice extracellular and patch-clamp experiments using the WinLTP data acquisition system with automated perfusion control

PubMed Central

Anderson, William W.; Fitzjohn, Stephen M.; Collingridge, Graham L.

2012-01-01

WinLTP is a data acquisition program for studying long-term potentiation (LTP) and other aspects of synaptic function. Earlier versions of WinLTP (J. Neurosci. Methods, 162:346–356, 2007) provided automated electrical stimulation and data acquisition capable of running nearly an entire synaptic plasticity experiment, with the primary exception that perfusion solutions had to be changed manually. This automated stimulation and acquisition was done by using ‘Sweep’, ‘Loop’ and ‘Delay’ events to build scripts using the ‘Protocol Builder’. However, this did not allow automatic changing of many solutions while running multiple slice experiments, or solution changing when this had to be performed rapidly and with accurate timing during patch-clamp experiments. We report here the addition of automated perfusion control to WinLTP. First, perfusion change between sweeps is enabled by adding the ‘Perfuse’ event to Protocol Builder scripting and is used in slice experiments. Second, fast perfusion changes during as well as between sweeps is enabled by using the Perfuse event in the protocol scripts to control changes between sweeps, and also by changing digital or analog output during a sweep and is used for single cell single-line perfusion patch-clamp experiments. The addition of stepper control of tube placement allows dual- or triple-line perfusion patch-clamp experiments for up to 48 solutions. The ability to automate perfusion changes and fully integrate them with the already automated stimulation and data acquisition goes a long way toward complete automation of multi-slice extracellularly recorded and single cell patch-clamp experiments. PMID:22524994

Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta

PubMed Central

Abdel Moniem, Alaa M.; Ibrahim, Ahmed; Akl, Sherif A.; Aboul-Enen, Loay; Abdelazim, Ibrahim A.

2015-01-01

Objective To detect the accuracy of the three-dimensional multislice view (3D MSV) Doppler in the diagnosis of morbid adherent placenta (MAP). Material and Methods Fifty pregnant women at ≥28 weeks gestation with suspected MAP were included in this prospective study. Two dimensional (2D) trans-abdominal gray-scale ultrasound scan was performed for the subjects to confirm the gestational age, placental location, and findings suggestive of MAP, followed by the 3D power Doppler and then the 3D MSV Doppler to confirm the diagnosis of MAP. Intraoperative findings and histopathology results of removed uteri in cases managed by emergency hysterectomy were compared with preoperative sonographic findings to detect the accuracy of the 3D MSV Doppler in the diagnosis of MAP. Results The 3D MSV Doppler increased the accuracy and predictive values of the diagnostic criteria of MAP compared with the 3D power Doppler. The sensitivity and negative predictive value (NPV) (79.6% and 82.2%, respectively) of crowded vessels over the peripheral sub-placental zone to detect difficult placental separation and considerable intraoperative blood loss in cases of MAP using the 3D power Doppler was increased to 82.6% and 84%, respectively, using the 3D MSV Doppler. In addition, the sensitivity, specificity, and positive predictive value (PPV) (90.9%, 68.8%, and 47%, respectively) of the disruption of the uterine serosa-bladder interface for the detection of emergency hysterectomy in cases of MAP using the 3D power Doppler was increased to 100%, 71.8%, and 50%, respectively, using the 3D MSV Doppler. Conclusion The 3D MSV Doppler is a useful adjunctive tool to the 3D power Doppler or color Doppler to refine the diagnosis of MAP. PMID:26401104

Simultaneous multislice magnetic resonance fingerprinting (SMS-MRF) with direct-spiral slice-GRAPPA (ds-SG) reconstruction.

PubMed

Ye, Huihui; Cauley, Stephen F; Gagoski, Borjan; Bilgic, Berkin; Ma, Dan; Jiang, Yun; Du, Yiping P; Griswold, Mark A; Wald, Lawrence L; Setsompop, Kawin

2017-05-01

To develop a reconstruction method to improve SMS-MRF, in which slice acceleration is used in conjunction with highly undersampled in-plane acceleration to speed up MRF acquisition. In this work two methods are employed to efficiently perform the simultaneous multislice magnetic resonance fingerprinting (SMS-MRF) data acquisition and the direct-spiral slice-GRAPPA (ds-SG) reconstruction. First, the lengthy training data acquisition is shortened by employing the through-time/through-k-space approach, in which similar k-space locations within and across spiral interleaves are grouped and are associated with a single set of kernel. Second, inversion recovery preparation (IR prepped), variable flip angle (FA), and repetition time (TR) are used for the acquisition of the training data, to increase signal variation and to improve the conditioning of the kernel fitting. The grouping of k-space locations enables a large reduction in the number of kernels required, and the IR-prepped training data with variable FA and TR provide improved ds-SG kernels and reconstruction performance. With direct-spiral slice-GRAPPA, tissue parameter maps comparable to that of conventional MRF were obtained at multiband (MB) = 3 acceleration using t-blipped SMS-MRF acquisition with 32-channel head coil at 3 Tesla (T). The proposed reconstruction scheme allows MB = 3 accelerated SMS-MRF imaging with high-quality T 1 , T 2 , and off-resonance maps, and can be used to significantly shorten MRF acquisition and aid in its adoption in neuro-scientific and clinical settings. Magn Reson Med 77:1966-1974, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Changes in Left Atrial Transport Function in Patients Who Maintained Sinus Rhythm After Successful Radiofrequency Catheter Ablation for Atrial Fibrillation: A 1-Year Follow-Up Multislice Computed Tomography Study.

PubMed

Kim, Jin-Seok; Im, Sung Il; Shin, Seung Yong; Kang, Jun Hyuk; Na, Jin Oh; Choi, Cheol Ung; Kim, Seong Hwan; Kim, Eung Ju; Rha, Seung-Woon; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo; Hwang, Chun; Kim, Young-Hoon; Yong, Hwan Seok; Lim, Hong Euy

2017-02-01

Functional remodeling of left atrium (LA) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has not been fully elucidated. This study aimed to determine the impact of RFCA on LA transport function in patients who maintained sinus rhythm (SR) after AF ablation. A total of 96 patients (paroxysmal AF [PAF] = 52) who maintained SR during 1 year after AF ablation were enrolled. Multislice computed tomography was performed to determine LA volume (LAV) and LA emptying fraction (LAEF) at pre-RFCA and 1-year post-RFCA. Creatine kinase-MB (CK-MB) and troponin-T levels were analyzed 1-day post-RFCA. At 1-year post-RFCA, mean LAV and LAEF decreased in overall patients. Based on LAEF change (ΔLAEF) cutoff of 5.0%, LAEF reduced in 41 patients (worsened group) and improved or showed no change in 55 patients (preserved group). Compared with preserved group, worsened group had a higher proportion of PAF, higher levels of CK-MB and troponin-T, and additional LA ablation. ΔLAEF was inversely correlated with CK-MB and troponin-T levels. Subgroup analysis showed that LAEF significantly decreased in PAF patients who underwent additional LA ablation. Multivariate analysis revealed that high baseline LAEF and additional LA ablation were independent predictors for worsened LAEF. Although SR was maintained for 1 year after AF ablation, LAEF as well as LAV decreased. The extent of LAEF deterioration was significantly associated with the amount of iatrogenic myocardial damage. Our data indicate that extensive atrial ablation may lead to LA functional deterioration, especially in patients with PAF. © 2016 Wiley Periodicals, Inc.

A multislice single breath-hold scheme for imaging alveolar oxygen tension in humans.

PubMed

Hamedani, Hooman; Kadlecek, Stephen J; Emami, Kiarash; Kuzma, Nicholas N; Xu, Yinan; Xin, Yi; Mongkolwisetwara, Puttisarn; Rajaei, Jennia; Barulic, Amy; Wilson Miller, G; Rossman, Milton; Ishii, Masaru; Rizi, Rahim R

2012-05-01

Reliable, noninvasive, and high-resolution imaging of alveolar partial pressure of oxygen (p(A)O(2)) is a potentially valuable tool in the early diagnosis of pulmonary diseases. Several techniques have been proposed for regional measurement of p(A)O(2) based on the increased depolarization rate of hyperpolarized (3) He. In this study, we explore one such technique by applying a multislice p(A)O(2) -imaging scheme that uses interleaved-slice ordering to utilize interslice time-delays more efficiently. This approach addresses the low spatial resolution and long breath-hold requirements of earlier techniques, allowing p(A)O(2) measurements to be made over the entire human lung in 10-15 s with a typical resolution of 8.3 × 8.3 × 15.6 mm(3). PO(2) measurements in a glass syringe phantom were in agreement with independent gas analysis within 4.7 ± 4.1% (R = 0.9993). The technique is demonstrated in four human subjects (healthy nonsmoker, healthy former smoker, healthy smoker, and patient with COPD), each imaged six times on 3 different days during a 2-week span. Two independent measurements were performed in each session, consisting of 12 coronal slices. The overall p(A)O(2) mean across all subjects was 95.9 ± 12.2 Torr and correlated well with end-tidal O(2) (R = 0.805, P < 0.0001). The alveolar O(2) uptake rate was consistent with the expected range of 1-2 Torr/s. Repeatable visual features were observed in p(A)O(2) maps over different days, as were characteristic differences among the subjects and gravity-dependent effects. Copyright © 2011 Wiley Periodicals, Inc.

An artificial bee colony algorithm for locating the critical slip surface in slope stability analysis

NASA Astrophysics Data System (ADS)

Kang, Fei; Li, Junjie; Ma, Zhenyue

2013-02-01

Determination of the critical slip surface with the minimum factor of safety of a slope is a difficult constrained global optimization problem. In this article, an artificial bee colony algorithm with a multi-slice adjustment method is proposed for locating the critical slip surfaces of soil slopes, and the Spencer method is employed to calculate the factor of safety. Six benchmark examples are presented to illustrate the reliability and efficiency of the proposed technique, and it is also compared with some well-known or recent algorithms for the problem. The results show that the new algorithm is promising in terms of accuracy and efficiency.

Rare extraskeletal Ewing's sarcoma mimicking as adenocarcinoma of the sigmoid.

PubMed

Mertens, Michelle; Haenen, Filip W N; Siozopoulou, Vasiliki; Van Cleemput, Marc

2017-06-01

Extraskeletal Ewing's sarcoma (EES) is a rare finding in comparison with Ewing's sarcoma of bone and usually manifests in young patients. However, even in older patients, one must consider the diagnosis. In this case, we describe a 52-year-old woman diagnosed with EES, mimicking as adenocarcinoma of the sigmoid. The tumor was not visualized by a multi-slice spiral computed tomography of the abdomen and pelvis with intravenous contrast, and eventually the diagnosis was made by positive immunohistochemical staining for CD99 and by molecular testing for EWSR1 translocation. This combination of the patient's age and the localization of the tumor mimicking an adenocarcinoma of the sigmoid has never been described before.

Atomic bonding effects in annular dark field scanning transmission electron microscopy. II. Experiments

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

Odlyzko, Michael L.; Held, Jacob T.; Mkhoyan, K. Andre, E-mail: mkhoyan@umn.edu

2016-07-15

Quantitatively calibrated annular dark field scanning transmission electron microscopy (ADF-STEM) imaging experiments were compared to frozen phonon multislice simulations adapted to include chemical bonding effects. Having carefully matched simulation parameters to experimental conditions, a depth-dependent bonding effect was observed for high-angle ADF-STEM imaging of aluminum nitride. This result is explained by computational predictions, systematically examined in the preceding portion of this study, showing the propagation of the converged STEM beam to be highly sensitive to net interatomic charge transfer. Thus, although uncertainties in experimental conditions and simulation accuracy remain, the computationally predicted experimental bonding effect withstands the experimental testing reportedmore » here.« less

Postmortem whole-body computed tomography angiography visualizing vascular rupture in a case of fatal car crash.

PubMed

Flach, Patricia M; Ross, Steffen G; Bolliger, Stephan A; Preiss, Ulrich S; Thali, Michael J; Spendlove, Danny

2010-01-01

In addition to the increasingly significant role of multislice computed tomography in forensic pathology, the performance of whole-body computed tomography angiography provides outstanding results. In this case, we were able to detect multiple injuries of the parenchymal organs in the upper abdomen as well as lesions of the brain parenchyma and vasculature of the neck. The radiologic findings showed complete concordance with the autopsy and even supplemented the autopsy findings in areas that are difficult to access via a manual dissection (such as the vasculature of the neck). This case shows how minimally invasive computed tomography angiography can serve as an invaluable adjunct to the classic autopsy procedure.

Characterization of LiBC by phase-contrast scanning transmission electron microscopy.

PubMed

Krumeich, Frank; Wörle, Michael; Reibisch, Philipp; Nesper, Reinhard

2014-08-01

LiBC was used as a model compound for probing the applicability of phase-contrast (PC) imaging in an aberration-corrected scanning transmission electron microscope (STEM) to visualize lithium distributions. In the LiBC structure, boron and carbon are arranged to hetero graphite layers between which lithium is incorporated. The crystal structure is reflected in the PC-STEM images recorded perpendicular to the layers. The experimental images and their defocus dependence match with multi-slice simulations calculated utilizing the reciprocity principle. The observation that a part of the Li positions is not occupied is likely an effect of the intense electron beam triggering Li displacement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Multi-slice Fractional Ventilation Imaging in Large Animals with Hyperpolarized Gas MRI

PubMed Central

Emami, Kiarash; Xu, Yinan; Hamedani, Hooman; Xin, Yi; Profka, Harrilla; Rajaei, Jennia; Kadlecek, Stephen; Ishii, Masaru; Rizi, Rahim R.

2012-01-01

Noninvasive assessment of regional lung ventilation is of critical importance in quantifying the severity of disease and evaluating response to therapy in many pulmonary diseases. This work presents for the first time the implementation of a hyperpolarized (HP) gas MRI technique for measuring whole-lung regional fractional ventilation (r) in Yorkshire pigs (n = 5) through the use of a gas mixing and delivery device in supine position. The proposed technique utilizes a series of back-to-back HP gas breaths with images acquired during short end-inspiratory breath-holds. In order to decouple the RF pulse decay effect from ventilatory signal build-up in the airways, regional distribution of flip angle (α) was estimated in the imaged slices by acquiring a series of back-to-back images with no inter-scan time delay during a breath-hold at the tail-end of the ventilation sequence. Analysis was performed to assess the multi-slice ventilation model sensitivity to noise, oxygen and number of flip angle images. The optimal α value was determined based on minimizing the error in r estimation; αopt = 5–6° for the set of acquisition parameters in pigs. The mean r values for the group of pigs were 0.27±0.09, 0.35±0.06, 0.40±0.04 for ventral, middle and dorsal slices, respectively, (excluding conductive airways r > 0.9). A positive gravitational (ventral-dorsal) ventilation gradient effect was present in all animals. The trachea and major conductive airways showed a uniform near-unity r value, with progressively smaller values corresponding to smaller diameter airways, and ultimately leading to lung parenchyma. Results demonstrate the feasibility of measurements of fractional ventilation in large species, and provides a platform to address technical challenges associated with long breathing time scales through the optimization of acquisition parameters in species with a pulmonary physiology very similar to that of human beings. PMID:22290603

Simultaneous tumor and surrogate motion tracking with dynamic MRI for radiation therapy planning

NASA Astrophysics Data System (ADS)

Park, Seyoun; Farah, Rana; Shea, Steven M.; Tryggestad, Erik; Hales, Russell; Lee, Junghoon

2018-01-01

Respiration-induced tumor motion is a major obstacle for achieving high-precision radiotherapy of cancers in the thoracic and abdominal regions. Surrogate-based estimation and tracking methods are commonly used in radiotherapy, but with limited understanding of quantified correlation to tumor motion. In this study, we propose a method to simultaneously track the lung tumor and external surrogates to evaluate their spatial correlation in a quantitative way using dynamic MRI, which allows real-time acquisition without ionizing radiation exposure. To capture the lung and whole tumor, four MRI-compatible fiducials are placed on the patient’s chest and upper abdomen. Two different types of acquisitions are performed in the sagittal orientation including multi-slice 2D cine MRIs to reconstruct 4D-MRI and two-slice 2D cine MRIs to simultaneously track the tumor and fiducials. A phase-binned 4D-MRI is first reconstructed from multi-slice MR images using body area as a respiratory surrogate and groupwise registration. The 4D-MRI provides 3D template volumes for different breathing phases. 3D tumor position is calculated by 3D-2D template matching in which 3D tumor templates in the 4D-MRI reconstruction and the 2D cine MRIs from the two-slice tracking dataset are registered. 3D trajectories of the external surrogates are derived via matching a 3D geometrical model of the fiducials to their segmentations on the 2D cine MRIs. We tested our method on ten lung cancer patients. Using a correlation analysis, the 3D tumor trajectory demonstrates a noticeable phase mismatch and significant cycle-to-cycle motion variation, while the external surrogate was not sensitive enough to capture such variations. Additionally, there was significant phase mismatch between surrogate signals obtained from the fiducials at different locations.

Wave-CAIPI ViSTa: highly accelerated whole-brain direct myelin water imaging with zero-padding reconstruction.

PubMed

Wu, Zhe; Bilgic, Berkin; He, Hongjian; Tong, Qiqi; Sun, Yi; Du, Yiping; Setsompop, Kawin; Zhong, Jianhui

2018-09-01

This study introduces a highly accelerated whole-brain direct visualization of short transverse relaxation time component (ViSTa) imaging using a wave controlled aliasing in parallel imaging (CAIPI) technique, for acquisition within a clinically acceptable scan time, with the preservation of high image quality and sufficient spatial resolution, and reduced residual point spread function artifacts. Double inversion RF pulses were applied to preserve the signal from short T 1 components for directly extracting myelin water signal in ViSTa imaging. A 2D simultaneous multislice and a 3D acquisition of ViSTa images incorporating wave-encoding were used for data acquisition. Improvements brought by a zero-padding method in wave-CAIPI reconstruction were also investigated. The zero-padding method in wave-CAIPI reconstruction reduced the root-mean-square errors between the wave-encoded and Cartesian gradient echoes for all wave gradient configurations in simulation, and reduced the side-main lobe intensity ratio from 34.5 to 16% in the thin-slab in vivo ViSTa images. In a 4 × acceleration simultaneous-multislice scenario, wave-CAIPI ViSTa achieved negligible g-factors (g mean /g max  = 1.03/1.10), while retaining minimal interslice artifacts. An 8 × accelerated acquisition of 3D wave-CAIPI ViSTa imaging covering the whole brain with 1.1 × 1.1 × 3 mm 3 voxel size was achieved within 15 minutes, and only incurred a small g-factor penalty (g mean /g max  = 1.05/1.16). Whole-brain ViSTa images were obtained within 15 minutes with negligible g-factor penalty by using wave-CAIPI acquisition and zero-padding reconstruction. The proposed zero-padding method was shown to be effective in reducing residual point spread function for wave-encoded images, particularly for ViSTa. © 2018 International Society for Magnetic Resonance in Medicine.

Simultaneous multislice diffusion-weighted MRI of the liver: Analysis of different breathing schemes in comparison to standard sequences.

PubMed

Taron, Jana; Martirosian, Petros; Erb, Michael; Kuestner, Thomas; Schwenzer, Nina F; Schmidt, Holger; Honndorf, Valerie S; Weiβ, Jakob; Notohamiprodjo, Mike; Nikolaou, Konstantin; Schraml, Christina

2016-10-01

To systematically evaluate image characteristics of simultaneous-multislice (SMS)-accelerated diffusion-weighted imaging (DWI) of the liver using different breathing schemes in comparison to standard sequences. DWI of the liver was performed in 10 healthy volunteers and 12 patients at 1.5T using an SMS-accelerated echo planar imaging sequence performed with respiratory-triggering and free breathing (SMS-RT, SMS-FB). Standard DWI sequences served as reference (STD-RT, STD-FB). Reduction of scan time by SMS-acceleration was measured. Image characteristics of SMS-DWI and STD-DWI with both breathing schemes were analyzed quantitatively (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR]) and qualitatively (5-point Likert scale, 5 = excellent). Qualitative and quantitative parameters were compared using Friedman test and Dunn-Bonferroni post-hoc method with P-values < 0.05 considered statistically significant. SMS-DWI provided diagnostic image quality in volunteers and patients both with RT and FB with a reduction of scan time of 70% (0:56 vs. 3:20 min in FB). Overall image quality did not significantly differ between FB and RT acquisition in both STD and SMS sequences (median STD-RT 5.0, STD-FB 4.5, SMS-RT: 4.75; SMS-FB: 4.5; P = 0.294). SNR in the right hepatic lobe was comparable between the four tested sequences. ADC values were significantly lower in SMS-DWI compared to STD-DWI irrespective of the breathing scheme (1.2 ± 0.2 × 10(-3) mm(2) /s vs. 1.0 ± 0.2 × 10(-3) mm(2) /s; P < 0.001). SMS-acceleration provides considerable scan time reduction for hepatic DWI with equivalent image quality compared to the STD technique both using RT and FB. Discrepancies in ADC between STD-DWI and SMS-DWI need to be considered when transferring the SMS technique to clinical routine reading. J. MAGN. RESON. IMAGING 2016;44:865-879. © 2016 International Society for Magnetic Resonance in Medicine.

Increased fMRI Sensitivity at Equal Data Burden Using Averaged Shifted Echo Acquisition

PubMed Central

Witt, Suzanne T.; Warntjes, Marcel; Engström, Maria

2016-01-01

There is growing evidence as to the benefits of collecting BOLD fMRI data with increased sampling rates. However, many of the newly developed acquisition techniques developed to collect BOLD data with ultra-short TRs require hardware, software, and non-standard analytic pipelines that may not be accessible to all researchers. We propose to incorporate the method of shifted echo into a standard multi-slice, gradient echo EPI sequence to achieve a higher sampling rate with a TR of <1 s with acceptable spatial resolution. We further propose to incorporate temporal averaging of consecutively acquired EPI volumes to both ameliorate the reduced temporal signal-to-noise inherent in ultra-fast EPI sequences and reduce the data burden. BOLD data were collected from 11 healthy subjects performing a simple, event-related visual-motor task with four different EPI sequences: (1) reference EPI sequence with TR = 1440 ms, (2) shifted echo EPI sequence with TR = 700 ms, (3) shifted echo EPI sequence with every two consecutively acquired EPI volumes averaged and effective TR = 1400 ms, and (4) shifted echo EPI sequence with every four consecutively acquired EPI volumes averaged and effective TR = 2800 ms. Both the temporally averaged sequences exhibited increased temporal signal-to-noise over the shifted echo EPI sequence. The shifted echo sequence with every two EPI volumes averaged also had significantly increased BOLD signal change compared with the other three sequences, while the shifted echo sequence with every four EPI volumes averaged had significantly decreased BOLD signal change compared with the other three sequences. The results indicated that incorporating the method of shifted echo into a standard multi-slice EPI sequence is a viable method for achieving increased sampling rate for collecting event-related BOLD data. Further, consecutively averaging every two consecutively acquired EPI volumes significantly increased the measured BOLD signal change and the subsequently calculated activation map statistics. PMID:27932947

Corticosteroid therapy in patients with non-arteritic anterior ischemic optic neuropathy.

PubMed

Vidović, Tomislav; Cerovski, Branimir; Perić, Sanja; Kordić, Rajko; Mrazovac, Danijela

2015-03-01

Non-arteritic anterior ischemic optic neuropathy is one of the most common conditions affecting the optic nerve in the elderly. It may lead to severe visual loss. Typical symptoms are painless impairment of visual function accompanied by relative afferent pupillary defect, edema of the optic disc and visual field defects. Aim is to present 38 patients with nonarteritic anterior ischemic optic neuropathy who were treated with corticosteroid therapy. This prospective study involved 38 patients, 20 men and 18 women aged 60-75 years who were treated with corticosteroid therapy. The study included patients with visual acuity in the affected eye from 0.1 to 0.8 according to Snellen. Every patient underwent clinical examination, the Octopus 900 perimetry in G program, laboratory testing, while the compressive optic neuropathy was rule out with MSCT of the brain and orbits. The most common forms of visual field defect are altitudinal defect and diffuse depression. Corticosteroid therapy led to recovery in 65% of patient, in 30% of patients did not change, while the deterioration occurred in 5% of patients.

PACS archive upgrade and data migration: clinical experiences

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Documet, Luis; Sarti, Dennis A.; Huang, H. K.; Donnelly, John

2002-05-01

Saint John's Health Center PACS data volumes have increased dramatically since the hospital became filmless in April of 1999. This is due in part of continuous image accumulation, and the integration of a new multi-slice detector CT scanner into PACS. The original PACS archive would not be able to handle the distribution and archiving load and capacity in the near future. Furthermore, there is no secondary copy backup of all the archived PACS image data for disaster recovery purposes. The purpose of this paper is to present a clinical and technical process template to upgrade and expand the PACS archive, migrate existing PACs image data to the new archive, and provide a back-up and disaster recovery function not currently available. Discussion of the technical and clinical pitfalls and challenges involved in this process will be presented as well. The server hardware configuration was upgraded and a secondary backup implemented for disaster recovery. The upgrade includes new software versions, database reconfiguration, and installation of a new tape jukebox to replace the current MOD jukebox. Upon completion, all PACS image data from the original MOD jukebox was migrated to the new tape jukebox and verified. The migration was performed during clinical operation continuously in the background. Once the data migration was completed the MOD jukebox was removed. All newly acquired PACS exams are now archived to the new tape jukebox. All PACs image data residing on the original MOD jukebox have been successfully migrated into the new archive. In addition, a secondary backup of all PACS image data has been implemented for disaster recovery and has been verified using disaster scenario testing. No PACS image data was lost during the entire process and there was very little clinical impact during the entire upgrade and data migration. Some of the pitfalls and challenges during this upgrade process included hardware reconfiguration for the original archive server, clinical downtime involved with the upgrade, and data migration planning to minimize impact on clinical workflow. The impact was minimized with a downtime contingency plan.

SU-E-J-110: Dosimetric Analysis of Respiratory Motion Based On Four-Dimensional Dose Accumulation in Liver Stereotactic Body Radiotherapy

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

Kang, S; Kim, D; Kim, T

2015-06-15

Purpose: Respiratory motion in thoracic and abdominal region could lead to significant underdosing of target and increased dose to healthy tissues. The aim of this study is to evaluate the dosimetric effect of respiratory motion in conventional 3D dose by comparing 4D deformable dose in liver stereotactic body radiotherapy (SBRT). Methods: Five patients who had previously treated liver SBRT were included in this study. Four-dimensional computed tomography (4DCT) images with 10 phases for all patients were acquired on multi-slice CT scanner (Siemens, Somatom definition). Conventional 3D planning was performed using the average intensity projection (AIP) images. 4D dose accumulation wasmore » calculated by summation of dose distribution for all phase images of 4DCT using deformable image registration (DIR) . The target volume and normal organs dose were evaluated with the 4D dose and compared with those from 3D dose. And also, Index of achievement (IOA) which assesses the consistency between planned dose and prescription dose was used to compare target dose distribution between 3D and 4D dose. Results: Although the 3D dose calculation considered the moving target coverage, significant differences of various dosimetric parameters between 4D and 3D dose were observed in normal organs and PTV. The conventional 3D dose overestimated dose to PTV, however, there was no significant difference for GTV. The average difference of IOA which become ‘1’ in an ideal case was 3.2% in PTV. The average difference of liver and duodenum was 5% and 16% respectively. Conclusion: 4D dose accumulation which can provide dosimetric effect of respiratory motion has a possibility to predict the more accurate delivered dose to target and normal organs and improve treatment accuracy. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning (MSIP) of Korea.« less

Myocardial blood flow reserve is impaired in patients with aortic valve calcification and unobstructed epicardial coronary arteries.

PubMed

Nel, Karen; Nam, Michael C Y; Anstey, Chris; Boos, Christopher J; Carlton, Edward; Senior, Roxy; Kaski, Juan Carlos; Khattab, Ahmed; Shamley, Delva; Byrne, Christopher D; Stanton, Tony; Greaves, Kim

2017-12-01

Although calcific aortic valve disease (CAVD) is associated with coronary atherosclerosis, it is not known whether early CAVD is associated with coronary microcirculatory dysfunction (CMD). We sought to investigate the relationship between myocardial blood flow reserve (MBFR) - a measure of CMD, and early CAVD in the absence of obstructive epicardial coronary artery disease. We also determined whether this relationship was independent of coronary artery disease (CAD) and hs-CRP, a marker of systemic inflammation. 183 patients with chest pain and unobstructed coronary arteries were studied. Aortic valve calcification score (AVCS), coronary total plaque length (TPL), and coronary calcium score were quantified from multislice CT. MBFR was assessed using vasodilator myocardial contrast echocardiography. Hs-CRP was measured from venous blood using a particle-enhanced immunoassay. Mean (±SD) participant age was 59.8 (9.6) years. Mean AVCS was 68 (258) AU, TPL was 15.6 (22.2) mm, and median coronary calcification score was 43.5AU. Mean MBFR was 2.20 (0.52). Mean hs-CRP was 2.52 (3.86) mg/l. Multivariable linear regression modelling incorporating demographics, coronary plaque characteristics, MBFR, and inflammatory markers, demonstrated that age (β=0.05, 95% CI: 0.02, 0.08, P=0.007), hs-CRP (β=0.09, CI: 0.02, 0.16, P=0.010) and diabetes (β=1.03, CI: 0.08, 1.98, P=0.033), were positively associated with AVCS. MBFR (β=-0.87, CI: -1.44, -0.30, P=0.003), BMI (β=-0.11, CI: -0.21, -0.01, P=0.033), and LDL (β=-0.32, CI: -0.61, -0.03, P=0.029) were negatively associated with AVCS. TPL and coronary calcium score were not independently associated with AVCS when included in the regression model. Coronary microvascular function as determined by measurement of myocardial blood flow reserve is independently associated with early CAVD. This effect is independent of the presence of coronary artery disease and also systemic inflammation. Copyright © 2017 Elsevier B.V. All rights reserved.

[The clinical and X-ray classification of osteonecrosis of the low jaw].

PubMed

Medvedev, Iu A; Basin, E M; Sokolina, I A

2013-01-01

To elaborate a clinical and X-ray classification of osteonecrosis of the low jaw in people with desomorphine or pervitin addiction. Ninety-two patients with drug addiction who had undergone orthopantomography, direct frontal X-ray of the skull, and multislice computed tomography, followed by multiplanar and three-dimensional imaging reconstruction were examined. One hundred thirty four X-ray films and 74 computed tomographic images were analyzed. The authors proposed a clinical and X-ray classification of osteonecrosis of the low jaw in people with desomorphine or pervitin addiction and elaborated recommendations for surgical interventions on the basis of the developed classification. The developed clinical and X-ray classification and recommendations for surgical interventions may be used to treat osteonecroses of various etiology.

Investigation of sagittal image acquisition for 4D-MRI with body area as respiratory surrogate.

PubMed

Liu, Yilin; Yin, Fang-Fang; Chang, Zheng; Czito, Brian G; Palta, Manisha; Bashir, Mustafa R; Qin, Yujiao; Cai, Jing

2014-10-01

The authors have recently developed a novel 4D-MRI technique for imaging organ respiratory motion employing cine acquisition in the axial plane and using body area (BA) as a respiratory surrogate. A potential disadvantage associated with axial image acquisition is the space-dependent phase shift in the superior-inferior (SI) direction, i.e., different axial slice positions reach the respiratory peak at different respiratory phases. Since respiratory motion occurs mostly in the SI and anterior-posterior (AP) directions, sagittal image acquisition, which embeds motion information in these two directions, is expected to be more robust and less affected by phase-shift than axial image acquisition. This study aims to develop and evaluate a 4D-MRI technique using sagittal image acquisition. The authors evaluated axial BA and sagittal BA using both 4D-CT images (11 cancer patients) and cine MR images (6 healthy volunteers and 1 cancer patient) by comparing their corresponding space-dependent phase-shift in the SI direction (δSPS (SI)) and in the lateral direction (δSPS (LAT)), respectively. To evaluate sagittal BA 4D-MRI method, a motion phantom study and a digital phantom study were performed. Additionally, six patients who had cancer(s) in the liver were prospectively enrolled in this study. For each patient, multislice sagittal MR images were acquired for 4D-MRI reconstruction. 4D retrospective sorting was performed based on respiratory phases. Single-slice cine MRI was also acquired in the axial, coronal, and sagittal planes across the tumor center from which tumor motion trajectories in the SI, AP, and medial-lateral (ML) directions were extracted and used as references from comparison. All MR images were acquired in a 1.5 T scanner using a steady-state precession sequence (frame rate ∼ 3 frames/s). 4D-CT scans showed that δSPS (SI) was significantly greater than δSPS (LAT) (p-value: 0.012); the median phase-shift was 16.9% and 7.7%, respectively. Body surface motion measurement from axial and sagittal MR cines also showed δSPS (SI) was significantly greater than δSPS (LAT). The median δSPS (SI) and δSPS (LAT) was 11.0% and 9.2% (p-value = 0.008), respectively. Tumor motion trajectories from 4D-MRI matched with those from single-slice cine MRI: the mean (±SD) absolute differences in tumor motion amplitude between the two were 1.5 ± 1.6 mm, 2.1 ± 1.9 mm, and 1.1 ± 1.0 mm in the SI, ML, and AP directions from this patient study. Space-dependent phase shift is less problematic for sagittal acquisition than for axial acquisition. 4D-MRI using sagittal acquisition was successfully carried out in patients with hepatic tumors.

The metaplastic variant of Warthin tumor of the parotid gland: dynamic multislice computerized tomography and magnetic resonance imaging findings with histopathologic correlation in a case.

PubMed

Yerli, Hasan; Avci, Suat; Aydin, Erdinc; Arikan, Unser

2010-03-01

Metaplastic Warthin tumor is a rarely seen subtype of Warthin tumor. It can resemble squamous carcinomas histopathologically, because it contains atypical squamous cells on the necrotic surface. Making a diagnosis can become easier by knowing this entity of Warthin tumor well and by correlating the radiologic findings with pathology. In this case presentation, imaging features of a metaplastic Warthin tumor are presented together with its histopathologic findings. When a solid mass with peripheral enhancing cystic-necrotic component and well defined contour and capsule that shows early enhancement and washout is identified with imaging methods in parotid gland, metaplastic Warthin tumor should be indicated in the differential diagnosis before the histopathologic evaluation. Copyright 2010 Mosby, Inc. All rights reserved.

Image correction during large and rapid B(0) variations in an open MRI system with permanent magnets using navigator echoes and phase compensation.

PubMed

Li, Jianqi; Wang, Yi; Jiang, Yu; Xie, Haibin; Li, Gengying

2009-09-01

An open permanent magnet system with vertical B(0) field and without self-shielding can be quite susceptible to perturbations from external magnetic sources. B(0) variation in such a system located close to a subway station was measured to be greater than 0.7 microT by both MRI and a fluxgate magnetometer. This B(0) variation caused image artifacts. A navigator echo approach that monitored and compensated the view-to-view variation in magnetic resonance signal phase was developed to correct for image artifacts. Human brain imaging experiments using a multislice gradient-echo sequence demonstrated that the ghosting and blurring artifacts associated with B(0) variations were effectively removed using the navigator method.

Volumetric segmentation of ADC maps and utility of standard deviation as measure of tumor heterogeneity in soft tissue tumors.

PubMed

Singer, Adam D; Pattany, Pradip M; Fayad, Laura M; Tresley, Jonathan; Subhawong, Ty K

2016-01-01

Determine interobserver concordance of semiautomated three-dimensional volumetric and two-dimensional manual measurements of apparent diffusion coefficient (ADC) values in soft tissue masses (STMs) and explore standard deviation (SD) as a measure of tumor ADC heterogeneity. Concordance correlation coefficients for mean ADC increased with more extensive sampling. Agreement on the SD of tumor ADC values was better for large regions of interest and multislice methods. Correlation between mean and SD ADC was low, suggesting that these parameters are relatively independent. Mean ADC of STMs can be determined by volumetric quantification with high interobserver agreement. STM heterogeneity merits further investigation as a potential imaging biomarker that complements other functional magnetic resonance imaging parameters. Copyright © 2016 Elsevier Inc. All rights reserved.

Single coronary artery originating from the right sinus Valsalva and ability to work.

PubMed

De Rosa, Roberto; Ratti, Gennaro; Gerardi, Donato; Tedeschi, Carlo; Lamberti, Monica

2015-01-01

We present a case of a 56-year-old male electrician who was admitted to the hospital with atrial fibrillation, atypical chest pain and dyspnea. He gave a history that on the morning he had working for almost 4 hours carrying out various activities with considerable physical effort. After cardioversion, conventional coronary angiography revealed a suspect of single coronary vessel (SCA) arising from the right sinus of Valsalva. The patient underwent multislice computed tomography that showed a SCA arising from the right sinus Valsalva and dividing in Right Coronary Artery (RCA) and Left Main coronary artery (LM). The finding of posterior course of the LM without atherosclerotic has proved crucial for the expression of an opinion of working capacity even with limitation.

[Case report of rare co-occurrence of renal cell carcinoma and crossed renal dystopia (L-shaped kidney)].

PubMed

Bakov, V N; Los, M S

2017-10-01

L-shaped kidney refers to a rare anomaly of the relative kidney positioning. Due to low prevalence, the literature on the co-occurrence of this anomaly with malignancy is lacking. And, if the diagnosis of a renal anomaly does not present difficulties, if a tumor is detected in such a kidney, even MSCT does not always help differentiate a pelvic tumor from a tumor of the renal parenchyma spreading to the pelvicalyceal system. This has important implications for choosing an appropriate surgical strategy. A feature of the presented clinical observation is the co-occurrence of the rare anomaly of kidney position and locally advanced renal cell carcinoma spreading to the renal pelvis. Due to the massive spread of the tumor, an organ-sparing surgery was not feasible. Due to the suspicion of tumor spread to the renal pelvis, the patient underwent nephrureterectomy of the L-shaped kidney. Introduction to renoprival state with transfer to chronic hemodialysis became the only option to maintain homeostasis and extend the patients life. Histological examination revealed clear cell renal cell carcinoma with invasion of the pelvis and renal capsule, with no clear demarcation between the fused kidneys.

SU-F-J-156: The Feasibility of MR-Only IMRT Planning for Prostate Anatomy

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

Vaitheeswaran, R; Sivaramakrishnan, KR; Kumar, Prashant

Purpose: For prostate anatomy, previous investigations have shown that simulated CT (sCT) generated from MR images can be used for accurate dose computation. In this study, we demonstrate the feasibility of MR-only IMRT planning for prostate case. Methods: Regular CT (rCT) and MR images of the same patient were acquired for prostate anatomy. Regions-of-interest (ROIs) i.e. target and risk structures are delineated on the rCT. A simulated CT (sCT) is generated from the MR image using the method described by Schadewaldt N et al. Their work establishes the clinical acceptability of dose calculation results on the sCT when compared tomore » rCT. rCT and sCT are rigidly registered to ensure proper alignment between the two images. rCT and sCT are overlaid on each other and slice-wise visual inspection confirms excellent agreement between the two images. ROIs on the rCT are copied over to sCT. Philips AutoPlanning solution is used for generating treatment plans. The same treatment technique protocol (plan parameters and clinical goals) is used to generate AutoPlan-rCT and AutoPlan-sCT respectively for rCT and and sCT. DVH comparison on ROIs and slice-wise evaluation of dose is performed between AutoPlan-rCT and AutoPlan-sCT. Delivery parameters i.e. beam and corresponding segments from the AutoPlan-sCT are copied over to rCT and dose is computed to get AutoPlan-sCT-on-rCT. Results: Plan evaluation is done based on Dose Volume Histogram (DVH) of ROIs and manual slice-wise inspection of dose distribution. Both AutoPlan-rCT and AutoPlan-sCT provide a clinically acceptable plan. Also, AutoPlan-sCT-on-rCT shows excellent agreement with AutoPlan-sCT. Conclusion: The study demonstrates that it is feasible to do IMRT planning on the simulated CT image obtained from MR image for prostate anatomy. The research is supported by Philips India Ltd.« less

Diagnostic value of CT, PET and combined PET/CT performed with low-dose unenhanced CT and full-dose enhanced CT in the initial staging of lymphoma.

PubMed

Pinilla, I; Gómez-León, N; Del Campo-Del Val, L; Hernandez-Maraver, D; Rodríguez-Vigil, B; Jover-Díaz, R; Coya, J

2011-10-01

The aim of this paper was to compare the accuracy of contrast-enhanced computed tomography (CT), positron emission tomography (PET), unenhanced low-dose PET/CT (LD-PET/CT) and full-dose enhanced PET/CT (FD-PET/CT) for the initial staging of lymphoma. One hundred and one lymphoma patients were examined by [18F]FDG-PET/CT including unenhanced low-dose CT and enhanced full-dose CT. Each modality of PET/CT was evaluated by a nuclear medicine physician and a radiologist unaware of the other modality, while the CT and PET images were interpreted separately by another independent radiologist and nuclear medicine physician respectively. The nodal and extranodal lesions detected by each technique were compared with a reference standard. For nodal assessment, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative LR (LR-) of LD-PET/CT were 97%, 96%, 98%, 95%, 26 and 0.02 respectively, and those of FD-PET/CT were 97%, 97%, 98%, 95%, 36 and 0.02. These results were significantly better than those of PET (sensitivity 82%, specificity 81%, PPV 88%, NPV 72%, LR+ 4.3, LR- 0.21). Likewise, both PET/CT displayed a higher sensitivity, NPV and LR- than CT (91%, 84%, 0.1 respectively). For organ evaluation, both modalities of PET/CT also had significantly better sensitivity and NPV than that of PET (LD-PET/CT: sensitivity 92%, NPV 90%; FD-PET/CT sensitivity 94%, NPV 92%; PET: sensitivity 70%, NPV 69%). The sensitivity, specificity, PPV and NPV for bone marrow involvement were 29%, 84%, 45% and 72% respectively for PET, and 29%, 90%, 56%, and 74% for both, LD-PET/CT, and FD-PET/CT. No significant differences were found between LD-PET/CT and FD-PET/CT, but FD-PET/CT detected important incidental findings in 5.9% of patients. PET/CT is an accurate technique for the initial staging of lymphomas without significant differences between LD-PET/CT and FD-PET/CT. FD-PET/CT detects relevant incidental findings that are missed on LD-PET/CT.

Extended phase graph formalism for systems with magnetization transfer and exchange

PubMed Central

Teixeira, Rui Pedro A.G.; Hajnal, Joseph V.

2017-01-01

Purpose An extended phase graph framework (EPG‐X) for modeling systems with exchange or magnetization transfer (MT) is proposed. Theory EPG‐X models coupled two‐compartment systems by describing each compartment with separate phase graphs that exchange during evolution periods. There are two variants: EPG‐X(BM) for systems governed by the Bloch‐McConnell equations, and EPG‐X(MT) for the pulsed MT formalism. For the MT case, the “bound” protons have no transverse components, so their phase graph consists of only longitudinal states. Methods The EPG‐X model was validated against steady‐state solutions and isochromat‐based simulation of gradient‐echo sequences. Three additional test cases were investigated: (i) MT effects in multislice turbo spin‐echo; (ii) variable flip angle gradient‐echo imaging of the type used for MR fingerprinting; and (iii) water exchange in multi‐echo spin‐echo T2 relaxometry. Results EPG‐X was validated successfully against isochromat based transient simulations and known steady‐state solutions. EPG‐X(MT) simulations matched in‐vivo measurements of signal attenuation in white matter in multislice turbo spin‐echo images. Magnetic resonance fingerprinting–style experiments with a bovine serum albumin (MT) phantom showed that the data were not consistent with a single‐pool model, but EPG‐X(MT) could be used to fit the data well. The EPG‐X(BM) simulations of multi‐echo spin‐echo T2 relaxometry suggest that exchange could lead to an underestimation of the myelin‐water fraction. Conclusions The EPG‐X framework can be used for modeling both steady‐state and transient signal response of systems exhibiting exchange or MT. This may be particularly beneficial for relaxometry approaches that rely on characterizing transient rather than steady‐state sequences. Magn Reson Med 80:767–779, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. PMID:29243295

Short-scan-time multi-slice diffusion MRI of the mouse cervical spinal cord using echo planar imaging.

PubMed

Callot, Virginie; Duhamel, Guillaume; Cozzone, Patrick J; Kober, Frank

2008-10-01

Mouse spinal cord (SC) diffusion-weighted imaging (DWI) provides important information on tissue morphology and structural changes that may occur during pathologies such as multiple sclerosis or SC injury. The acquisition scheme of the commonly used DWI techniques is based on conventional spin-echo encoding, which is time-consuming. The purpose of this work was to investigate whether the use of echo planar imaging (EPI) would provide good-quality diffusion MR images of mouse SC, as well as accurate measurements of diffusion-derived metrics, and thus enable diffusion tensor imaging (DTI) and highly resolved DWI within reasonable scan times. A four-shot diffusion-weighted spin-echo EPI (SE-EPI) sequence was evaluated at 11.75 T on a group of healthy mice (n = 10). SE-EPI-derived apparent diffusion coefficients of gray and white matter were compared with those obtained using a conventional spin-echo sequence (c-SE) to validate the accuracy of the method. To take advantage of the reduction in acquisition time offered by the EPI sequence, multi-slice DTI acquisitions were performed covering the cervical segments (six slices, six diffusion-encoding directions, three b values) within 30 min (vs 2 h for c-SE). From these measurements, fractional anisotropy and mean diffusivities were calculated, and fiber tracking along the C1 to C6 cervical segments was performed. In addition, high-resolution images (74 x 94 microm(2)) were acquired within 5 min per direction. Clear delineation of gray and white matter and identical apparent diffusion coefficient values were obtained, with a threefold reduction in acquisition time compared with c-SE. While overcoming the difficulties associated with high spatially and temporally resolved DTI measurements, the present SE-EPI approach permitted identification of reliable quantitative parameters with a reproducibility compatible with the detection of pathologies. The SE-EPI method may be particularly valuable when multiple sets of images from the SC are needed, in cases of rapidly evolving conditions, to decrease the duration of anesthesia or to improve MR exploration by including additional MR measurements. Copyright (c) 2008 John Wiley & Sons, Ltd.

Breath-hold imaging of the coronary arteries using Quiescent-Interval Slice-Selective (QISS) magnetic resonance angiography: pilot study at 1.5 Tesla and 3 Tesla.

PubMed

Edelman, Robert R; Giri, S; Pursnani, A; Botelho, M P F; Li, W; Koktzoglou, I

2015-11-23

Coronary magnetic resonance angiography (MRA) is usually obtained with a free-breathing navigator-gated 3D acquisition. Our aim was to develop an alternative breath-hold approach that would allow the coronary arteries to be evaluated in a much shorter time and without risk of degradation by respiratory motion artifacts. For this purpose, we implemented a breath-hold, non-contrast-enhanced, quiescent-interval slice-selective (QISS) 2D technique. Sequence performance was compared at 1.5 and 3 Tesla using both radial and Cartesian k-space trajectories. The left coronary circulation was imaged in six healthy subjects and two patients with coronary artery disease. Breath-hold QISS was compared with T2-prepared 2D balanced steady-state free-precession (bSSFP) and free-breathing, navigator-gated 3D bSSFP. Approximately 10 2.1-mm thick slices were acquired in a single ~20-s breath-hold using two-shot QISS. QISS contrast-to-noise ratio (CNR) was 1.5-fold higher at 3 Tesla than at 1.5 Tesla. Cartesian QISS provided the best coronary-to-myocardium CNR, whereas radial QISS provided the sharpest coronary images. QISS image quality exceeded that of free-breathing 3D coronary MRA with few artifacts at either field strength. Compared with T2-prepared 2D bSSFP, multi-slice capability was not restricted by the specific absorption rate at 3 Tesla and pericardial fluid signal was better suppressed. In addition to depicting the coronary arteries, QISS could image intra-cardiac structures, pericardium, and the aortic root in arbitrary slice orientations. Breath-hold QISS is a simple, versatile, and time-efficient method for coronary MRA that provides excellent image quality at both 1.5 and 3 Tesla. Image quality exceeded that of free-breathing, navigator-gated 3D MRA in a much shorter scan time. QISS also allowed rapid multi-slice bright-blood, diastolic phase imaging of the heart, which may have complementary value to multi-phase cine imaging. We conclude that, with further clinical validation, QISS might provide an efficient alternative to commonly used free-breathing coronary MRA techniques.

Using 3D spatial correlations to improve the noise robustness of multi component analysis of 3D multi echo quantitative T2 relaxometry data.

PubMed

Kumar, Dushyant; Hariharan, Hari; Faizy, Tobias D; Borchert, Patrick; Siemonsen, Susanne; Fiehler, Jens; Reddy, Ravinder; Sedlacik, Jan

2018-05-12

We present a computationally feasible and iterative multi-voxel spatially regularized algorithm for myelin water fraction (MWF) reconstruction. This method utilizes 3D spatial correlations present in anatomical/pathological tissues and underlying B1 + -inhomogeneity or flip angle inhomogeneity to enhance the noise robustness of the reconstruction while intrinsically accounting for stimulated echo contributions using T2-distribution data alone. Simulated data and in vivo data acquired using 3D non-selective multi-echo spin echo (3DNS-MESE) were used to compare the reconstruction quality of the proposed approach against those of the popular algorithm (the method by Prasloski et al.) and our previously proposed 2D multi-slice spatial regularization spatial regularization approach. We also investigated whether the inter-sequence correlations and agreements improved as a result of the proposed approach. MWF-quantifications from two sequences, 3DNS-MESE vs 3DNS-gradient and spin echo (3DNS-GRASE), were compared for both reconstruction approaches to assess correlations and agreements between inter-sequence MWF-value pairs. MWF values from whole-brain data of six volunteers and two multiple sclerosis patients are being reported as well. In comparison with competing approaches such as Prasloski's method or our previously proposed 2D multi-slice spatial regularization method, the proposed method showed better agreements with simulated truths using regression analyses and Bland-Altman analyses. For 3DNS-MESE data, MWF-maps reconstructed using the proposed algorithm provided better depictions of white matter structures in subcortical areas adjoining gray matter which agreed more closely with corresponding contrasts on T2-weighted images than MWF-maps reconstructed with the method by Prasloski et al. We also achieved a higher level of correlations and agreements between inter-sequence (3DNS-MESE vs 3DNS-GRASE) MWF-value pairs. The proposed algorithm provides more noise-robust fits to T2-decay data and improves MWF-quantifications in white matter structures especially in the sub-cortical white matter and major white matter tract regions. Copyright © 2018 Elsevier Inc. All rights reserved.

Exploiting sparsity and low-rank structure for the recovery of multi-slice breast MRIs with reduced sampling error.

PubMed

Yin, X X; Ng, B W-H; Ramamohanarao, K; Baghai-Wadji, A; Abbott, D

2012-09-01

It has been shown that, magnetic resonance images (MRIs) with sparsity representation in a transformed domain, e.g. spatial finite-differences (FD), or discrete cosine transform (DCT), can be restored from undersampled k-space via applying current compressive sampling theory. The paper presents a model-based method for the restoration of MRIs. The reduced-order model, in which a full-system-response is projected onto a subspace of lower dimensionality, has been used to accelerate image reconstruction by reducing the size of the involved linear system. In this paper, the singular value threshold (SVT) technique is applied as a denoising scheme to reduce and select the model order of the inverse Fourier transform image, and to restore multi-slice breast MRIs that have been compressively sampled in k-space. The restored MRIs with SVT for denoising show reduced sampling errors compared to the direct MRI restoration methods via spatial FD, or DCT. Compressive sampling is a technique for finding sparse solutions to underdetermined linear systems. The sparsity that is implicit in MRIs is to explore the solution to MRI reconstruction after transformation from significantly undersampled k-space. The challenge, however, is that, since some incoherent artifacts result from the random undersampling, noise-like interference is added to the image with sparse representation. These recovery algorithms in the literature are not capable of fully removing the artifacts. It is necessary to introduce a denoising procedure to improve the quality of image recovery. This paper applies a singular value threshold algorithm to reduce the model order of image basis functions, which allows further improvement of the quality of image reconstruction with removal of noise artifacts. The principle of the denoising scheme is to reconstruct the sparse MRI matrices optimally with a lower rank via selecting smaller number of dominant singular values. The singular value threshold algorithm is performed by minimizing the nuclear norm of difference between the sampled image and the recovered image. It has been illustrated that this algorithm improves the ability of previous image reconstruction algorithms to remove noise artifacts while significantly improving the quality of MRI recovery.

(2 + 1)D-CAIPIRINHA accelerated MR spectroscopic imaging of the brain at 7T.

PubMed

Strasser, B; Považan, M; Hangel, G; Hingerl, L; Chmelik, M; Gruber, S; Trattnig, S; Bogner, W

2017-08-01

To compare a new parallel imaging (PI) method for multislice proton magnetic resonance spectroscopic imaging ( 1 H-MRSI), termed (2 + 1)D-CAIPIRINHA, with two standard PI methods: 2D-GRAPPA and 2D-CAIPIRINHA at 7 Tesla (T). (2 + 1)D-CAIPIRINHA is a combination of 2D-CAIPIRINHA and slice-CAIPIRINHA. Eight healthy volunteers were measured on a 7T MR scanner using a 32-channel head coil. The best undersampling patterns were estimated for all three PI methods. The artifact powers, g-factors, Cramér-Rao lower bounds (CRLB), and root mean square errors (RMSE) were compared quantitatively among the three PI methods. Metabolic maps and spectra were compared qualitatively. (2 + 1)D-CAIPIRINHA allows acceleration in three spatial dimensions in contrast to 2D-GRAPPA and 2D-CAIPIRINHA. Thus, this sequence significantly decreased the RMSE of the metabolic maps by 12.1 and 6.9%, on average, for 4 < R < 11, compared with 2D-GRAPPA and 2D-CAIPIRINHA, respectively. The artifact power was 22.6 and 8.4% lower, and the CRLB were 3.4 and 0.6% lower, respectively. (2 + 1)-CAIPIRINHA can be implemented for multislice MRSI in the brain, enabling higher accelerations than possible with two-dimensional (2D) parallel imaging methods. An eight-fold acceleration was still feasible in vivo with negligible PI artifacts with lipid decontamination, thus decreasing the measurement time from 120 to 15 min for a 64 × 64 × 4 matrix. Magn Reson Med 78:429-440, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

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

De Ornelas-Couto, M; Bossart, E; Elsayyad, N

Purpose: To determine the sensitivity of dose-mass-histogram (DMH) due to anatomical changes of head-and-neck squamous cell carcinoma (HNSCC) radiotherapy (RT). Methods: Eight patients undergoing RT treatment for HNSCC were scanned during the third and sixth week of RT. These second (CT2) and third (CT3) CTs were co-registered to the planning CT (CT1). Contours were propagated via deformable registration from CT1 and doses were re-calculated. DMHs were extracted for each CT set. DMH sensitivity was assessed by dose-mass indices (DMIs), which represent the dose delivered to a certain mass of and anatomical structure. DMIs included: dose to 98%, 95% and 2%more » of the target masses (PTV1, PTV2, and PTV3) and organs-at-risk (OARs): cord DMI2%, brainstem DMI2%, left- and right-parotid DMI2% and DMI50%, and mandible DMI2%. A two-tailed paired t-test was used to compare changes to DMIs in CT2 and CT3 with respect to CT1 (CT2/CT1 and CT3/CT1). Results: Changes to DMHs were found for all OARs and PTVs, but they were significant only for the PTVs. Maximum dose to PTVs increased significantly for CT2/CT1 in all three PTVs, but CT3/CT1 changes were only significantly different for PTV1 and PTV2. Dose coverage to the three PTVs was also significantly different, DMI98% was lower for both CT2/CT1 and CT3/CT1. DMI95% was significantly lower for PTV1 for CT2/CT1, PTV2 for CT2/CT1 and CT3/CT1, and PTV3 for CT3/CT1. Conclusion: Changes in anatomy significantly change dose-mass coverage for the planning targets, making it necessary to re-plan in order to maintain the therapeutic goals. Maximum dose to the PTVs increase significantly as RT progresses, which may not be problematic as long as the high dose remains in the gross tumor volume. Doses to OARs were minimally affected and the differences were not significant.« less

Investigating CT to CBCT image registration for head and neck proton therapy as a tool for daily dose recalculation

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

Landry, Guillaume, E-mail: g.landry@lmu.de; Nijhuis, Reinoud; Thieke, Christian

2015-03-15

Purpose: Intensity modulated proton therapy (IMPT) of head and neck (H and N) cancer patients may be improved by plan adaptation. The decision to adapt the treatment plan based on a dose recalculation on the current anatomy requires a diagnostic quality computed tomography (CT) scan of the patient. As gantry-mounted cone beam CT (CBCT) scanners are currently being offered by vendors, they may offer daily or weekly updates of patient anatomy. CBCT image quality may not be sufficient for accurate proton dose calculation and it is likely necessary to perform CBCT CT number correction. In this work, the authors investigatedmore » deformable image registration (DIR) of the planning CT (pCT) to the CBCT to generate a virtual CT (vCT) to be used for proton dose recalculation. Methods: Datasets of six H and N cancer patients undergoing photon intensity modulated radiation therapy were used in this study to validate the vCT approach. Each dataset contained a CBCT acquired within 3 days of a replanning CT (rpCT), in addition to a pCT. The pCT and rpCT were delineated by a physician. A Morphons algorithm was employed in this work to perform DIR of the pCT to CBCT following a rigid registration of the two images. The contours from the pCT were deformed using the vector field resulting from DIR to yield a contoured vCT. The DIR accuracy was evaluated with a scale invariant feature transform (SIFT) algorithm comparing automatically identified matching features between vCT and CBCT. The rpCT was used as reference for evaluation of the vCT. The vCT and rpCT CT numbers were converted to stopping power ratio and the water equivalent thickness (WET) was calculated. IMPT dose distributions from treatment plans optimized on the pCT were recalculated with a Monte Carlo algorithm on the rpCT and vCT for comparison in terms of gamma index, dose volume histogram (DVH) statistics as well as proton range. The DIR generated contours on the vCT were compared to physician-drawn contours on the rpCT. Results: The DIR accuracy was better than 1.4 mm according to the SIFT evaluation. The mean WET differences between vCT (pCT) and rpCT were below 1 mm (2.6 mm). The amount of voxels passing 3%/3 mm gamma criteria were above 95% for the vCT vs rpCT. When using the rpCT contour set to derive DVH statistics from dose distributions calculated on the rpCT and vCT the differences, expressed in terms of 30 fractions of 2 Gy, were within [−4, 2 Gy] for parotid glands (D{sub mean}), spinal cord (D{sub 2%}), brainstem (D{sub 2%}), and CTV (D{sub 95%}). When using DIR generated contours for the vCT, those differences ranged within [−8, 11 Gy]. Conclusions: In this work, the authors generated CBCT based stopping power distributions using DIR of the pCT to a CBCT scan. DIR accuracy was below 1.4 mm as evaluated by the SIFT algorithm. Dose distributions calculated on the vCT agreed well to those calculated on the rpCT when using gamma index evaluation as well as DVH statistics based on the same contours. The use of DIR generated contours introduced variability in DVH statistics.« less

Xenon-enhanced CT using subtraction CT: Basic and preliminary clinical studies for comparison of its efficacy with that of dual-energy CT and ventilation SPECT/CT to assess regional ventilation and pulmonary functional loss in smokers.

PubMed

Ohno, Yoshiharu; Yoshikawa, Takeshi; Takenaka, Daisuke; Fujisawa, Yasuko; Sugihara, Naoki; Kishida, Yuji; Seki, Shinichiro; Koyama, Hisanobu; Sugimura, Kazuro

2017-01-01

To prospectively and directly compare the capability for assessments of regional ventilation and pulmonary functional loss in smokers of xenon-ventilation CT obtained with the dual-energy CT (DE-CT) and subtraction CT (Sub-CT) MATERIALS AND METHODS: Twenty-three consecutive smokers (15 men and 8 women, mean age: 69.7±8.7years) underwent prospective unenhanced and xenon-enhanced CTs, the latter by Sub-CT and DE-CT methods, ventilation SPECT and pulmonary function tests. Sub-CT was generated from unenhanced and xenon-enhanced CT, and all co-registered SPECT/CT data were produced from SPECT and unenhanced CT data. For each method, regional ventilation was assessed by using a 11-point scoring system on a per-lobe basis. To determine the functional lung volume by each method, it was also calculated for individual sublets with a previously reported method. To determine inter-observer agreement for each method, ventilation defect assessment was evaluated by using the χ2 test with weighted kappa statistics. For evaluation of the efficacy of each method for pulmonary functional loss assessment, functional lung volume was correlated with%FEV 1 . Each inter-observer agreement was rated as substantial (Sub-CT: κ=0.69, p<0.0001; DE-CT: κ=0.64, p<0.0001; SPECT/CT: κ=0.64, p<0.0001). Functional lung volume for each method showed significant to good correlation with%FEV 1 (Sub-CT: r=0.72, p=0.0001; DE-CT: r=0.74, p<0.0001; SPECT/CT: r=0.66, p=0.0006). Xenon-enhanced CT obtained by Sub-CT can be considered at least as efficacious as that obtained by DE-CT and SPECT/CT for assessment of ventilation abnormality and pulmonary functional loss in smokers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Head CT scan

MedlinePlus

Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial; CAT scan - brain ... conditions: Birth (congenital) defect of the head or brain Brain infection Brain tumor Buildup of fluid inside ...

Individually optimized contrast-enhanced 4D-CT for radiotherapy simulation in pancreatic ductal adenocarcinoma

PubMed Central

Xue, Ming; Lane, Barton F.; Kang, Min Kyu; Patel, Kruti; Regine, William F.; Klahr, Paul; Wang, Jiahui; Chen, Shifeng; D’Souza, Warren; Lu, Wei

2016-01-01

Purpose: To develop an individually optimized contrast-enhanced (CE) 4D-computed tomography (CT) for radiotherapy simulation in pancreatic ductal adenocarcinomas (PDA). Methods: Ten PDA patients were enrolled. Each underwent three CT scans: a 4D-CT immediately following a CE 3D-CT and an individually optimized CE 4D-CT using test injection. Three physicians contoured the tumor and pancreatic tissues. Image quality scores, tumor volume, motion, tumor-to-pancreas contrast, and contrast-to-noise ratio (CNR) were compared in the three CTs. Interobserver variations were also evaluated in contouring the tumor using simultaneous truth and performance level estimation. Results: Average image quality scores for CE 3D-CT and CE 4D-CT were comparable (4.0 and 3.8, respectively; P = 0.082), and both were significantly better than that for 4D-CT (2.6, P < 0.001). Tumor-to-pancreas contrast results were comparable in CE 3D-CT and CE 4D-CT (15.5 and 16.7 Hounsfield units (HU), respectively; P = 0.21), and the latter was significantly higher than in 4D-CT (9.2 HU, P = 0.001). Image noise in CE 3D-CT (12.5 HU) was significantly lower than in CE 4D-CT (22.1 HU, P = 0.013) and 4D-CT (19.4 HU, P = 0.009). CNRs were comparable in CE 3D-CT and CE 4D-CT (1.4 and 0.8, respectively; P = 0.42), and both were significantly better in 4D-CT (0.6, P = 0.008 and 0.014). Mean tumor volumes were significantly smaller in CE 3D-CT (29.8 cm3, P = 0.03) and CE 4D-CT (22.8 cm3, P = 0.01) than in 4D-CT (42.0 cm3). Mean tumor motion was comparable in 4D-CT and CE 4D-CT (7.2 and 6.2 mm, P = 0.17). Interobserver variations were comparable in CE 3D-CT and CE 4D-CT (Jaccard index 66.0% and 61.9%, respectively) and were worse for 4D-CT (55.6%) than CE 3D-CT. Conclusions: CE 4D-CT demonstrated characteristics comparable to CE 3D-CT, with high potential for simultaneously delineating the tumor and quantifying tumor motion with a single scan. PMID:27782710

Differences between postmortem computed tomography and conventional autopsy in a stabbing murder case

PubMed Central

Zerbini, Talita; da Silva, Luiz Fernando Ferraz; Ferro, Antonio Carlos Gonçalves; Kay, Fernando Uliana; Junior, Edson Amaro; Pasqualucci, Carlos Augusto Gonçalves; do Nascimento Saldiva, Paulo Hilario

2014-01-01

OBJECTIVE: The aim of the present work is to analyze the differences and similarities between the elements of a conventional autopsy and images obtained from postmortem computed tomography in a case of a homicide stab wound. METHOD: Comparison between the findings of different methods: autopsy and postmortem computed tomography. RESULTS: In some aspects, autopsy is still superior to imaging, especially in relation to external examination and the description of lesion vitality. However, the findings of gas embolism, pneumothorax and pulmonary emphysema and the relationship between the internal path of the instrument of aggression and the entry wound are better demonstrated by postmortem computed tomography. CONCLUSIONS: Although multislice computed tomography has greater accuracy than autopsy, we believe that the conventional autopsy method is fundamental for providing evidence in criminal investigations. PMID:25518020

A powerful graphical pulse sequence programming tool for magnetic resonance imaging.

PubMed

Jie, Shen; Ying, Liu; Jianqi, Li; Gengying, Li

2005-12-01

A powerful graphical pulse sequence programming tool has been designed for creating magnetic resonance imaging (MRI) applications. It allows rapid development of pulse sequences in graphical mode (allowing for the visualization of sequences), and consists of three modules which include a graphical sequence editor, a parameter management module and a sequence compiler. Its key features are ease to use, flexibility and hardware independence. When graphic elements are combined with a certain text expressions, the graphical pulse sequence programming is as flexible as text-based programming tool. In addition, a hardware-independent design is implemented by using the strategy of two step compilations. To demonstrate the flexibility and the capability of this graphical sequence programming tool, a multi-slice fast spin echo experiment is performed on our home-made 0.3 T permanent magnet MRI system.

SU-E-J-187: Individually Optimized Contrast-Enhancement 4D-CT for Pancreatic Adenocarcinoma in Radiotherapy Simulation

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

Xue, M; Patel, K; Regine, W

2014-06-01

Purpose: To study the feasibility of individually optimized contrastenhancement (CE) 4D-CT for pancreatic adenocarcinoma (PDA) in radiotherapy simulation. To evaluate the image quality and contrast enhancement of tumor in the CE 4D-CT, compared to the clinical standard of CE 3D-CT and 4D-CT. Methods: In this IRB-approved study, each of the 7 PDA patients enrolled underwent 3 CT scans: a free-breathing 3D-CT with contrast (CE 3D-CT) followed by a 4D-CT without contrast (4D-CT) in the first study session, and a 4D-CT with individually synchronized contrast injection (CE 4D-CT) in the second study session. In CE 4D-CT, the time of full contrastmore » injection was determined based on the time of peak enhancement for the test injection, injection rate, table speed, and longitudinal location and span of the pancreatic region. Physicians contoured both the tumor (T) and the normal pancreatic parenchyma (P) on the three CTs (end-of-exhalation for 4D-CT). The contrast between the tumor and normal pancreatic tissue was computed as the difference of the mean enhancement level of three 1 cm3 regions of interests in T and P, respectively. Wilcoxon rank sum test was used to statistically compare the scores and contrasts. Results: In qualitative evaluations, both CE 3D-CT and CE 4D-CT scored significantly better than 4D-CT (4.0 and 3.6 vs. 2.6). There was no significant difference between CE 3D-CT and CE 4D-CT. In quantitative evaluations, the contrasts between the tumor and the normal pancreatic parenchyma were 0.6±23.4, −2.1±8.0, and −19.6±28.8 HU, in CE 3D-CT, 4D-CT, and CE 4D-CT, respectively. Although not statistically significant, CE 4D-CT achieved better contrast enhancement between the tumor and the normal pancreatic parenchyma than both CE 3D-CT and 4DCT. Conclusion: CE 4D-CT achieved equivalent image quality and better contrast enhancement between tumor and normal pancreatic parenchyma than the clinical standard of CE 3D-CT and 4D-CT. This study was supported in part by Philips Healthcare.« less

SU-F-T-427: Utilization and Evaluation of Diagnostic CT Imaging with MAR Technique for Radiation Therapy Treatment Planning

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

Xu, M; Foster, R; Parks, H

Purpose: The objective was to utilize and evaluate diagnostic CT-MAR technique for radiation therapy treatment planning. Methods: A Toshiba-diagnostic-CT acquisition with SEMAR(Single-energy-MAR)-algorism was performed to make the metal-artifact-reduction (MAR) for patient treatment planning. CT-imaging datasets with and without SEMAR were taken on a Catphan-phantom. Two sets of CT-numbers were calibrated with the relative electron densities (RED). A tissue characterization phantom with Gammex various simulating material rods was used to establish the relationship between known REDs and corresponding CT-numbers. A GE-CT-sim acquisition was taken on the Catphan for comparison. A patient with bilateral hip arthroplasty was scanned in the radiotherapy CT-simmore » and the diagnostic SEMAR-CT on a flat panel. The derived SEMAR images were used as a primary CT dataset to create contours for the target, critical-structures, and for planning. A deformable registration was performed with VelocityAI to track voxel changes between SEMAR and CT-sim images. The SEMAR-CT images with minimal artifacts and high quality of geometrical and spatial integrity were employed for a treatment plan. Treatment-plans were evaluated based on deformable registration of SEMAR-CT and CT-sim dataset with assigned CT-numbers in the metal artifact regions in Eclipse v11 TPS. Results: The RED and CT-number relationships were consistent for the datasets in CT-sim and CT’s with and without SEMAR. SEMAR datasets with high image quality were used for PTV and organ delineation in the treatment planning process. For dose distribution to the PTV through the DVH analysis, the plan using CT-sim with the assigned CT-number showed a good agreement to those on deformable CT-SEMAR. Conclusion: A diagnostic-CT with MAR-algorithm can be utilized for radiotherapy treatment planning with CT-number calibrated to the RED. Treatment planning comparison and DVH shows a good agreement in the PTV and critical organs between the plans on CT-sim with assigned CT-number and the deformable SEMAR CT datasets.« less

Structure and Protein-Protein Interaction Studies on Chlamydia trachomatis Protein CT670 (YscO Homolog)

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

Lorenzini, Emily; Singer, Alexander; Singh, Bhag

2010-07-28

Comparative genomic studies have identified many proteins that are found only in various Chlamydiae species and exhibit no significant sequence similarity to any protein in organisms that do not belong to this group. The CT670 protein of Chlamydia trachomatis is one of the proteins whose genes are in one of the type III secretion gene clusters but whose cellular functions are not known. CT670 shares several characteristics with the YscO protein of Yersinia pestis, including the neighboring genes, size, charge, and secondary structure, but the structures and/or functions of these proteins remain to be determined. Although a BLAST search withmore » CT670 did not identify YscO as a related protein, our analysis indicated that these two proteins exhibit significant sequence similarity. In this paper, we report that the CT670 crystal, solved at a resolution of 2 {angstrom}, consists of a single coiled coil containing just two long helices. Gel filtration and analytical ultracentrifugation studies showed that in solution CT670 exists in both monomeric and dimeric forms and that the monomer predominates at lower protein concentrations. We examined the interaction of CT670 with many type III secretion system-related proteins (viz., CT091, CT665, CT666, CT667, CT668, CT669, CT671, CT672, and CT673) by performing bacterial two-hybrid assays. In these experiments, CT670 was found to interact only with the CT671 protein (YscP homolog), whose gene is immediately downstream of ct670. A specific interaction between CT670 and CT671 was also observed when affinity chromatography pull-down experiments were performed. These results suggest that CT670 and CT671 are putative homologs of the YcoO and YscP proteins, respectively, and that they likely form a chaperone-effector pair.« less

PET/CT vs. non-contrast CT alone for surveillance 1-year post lobectomy for stage I non-small-cell lung cancer

PubMed Central

Dane, Bari; Grechushkin, Vadim; Plank, April; Moore, William; Bilfinger, Thomas

2013-01-01

18F-FDG PET/CT was compared with non-contrast chest CT in monitoring for recurrence 1-year after lobectomy of stage 1 non-small-cell lung cancer (NSCLC). For surveillance after treatment with curative intent, current (April 2012) National Comprehensive Cancer network guidelines recommend chest CT with or without contrast every 6-12 months for 2 years, then non-contrast chest CT annually. PET/CT is not currently indicated for routine follow-up. One hundred patients receiving surveillance PET/CT 1-year after lobectomy for the treatment of stage 1a or 1b NSCLC were included in the study. Exclusion criteria included the presence or interval diagnosis of a second malignancy, or surgical treatment more radical than single lobectomy. The non-contrast CT obtained from the 1-year PET/CT was interpreted by an experienced chest radiologist blinded to the PET/CT for evidence of recurrence using the following findings: pulmonary nodule, pleural effusion, pleural mass, adenopathy, and extrathoracic mass. The ecision about recurrence was made solely from the non-contrast CT without PET/CT findings. This was compared with the determination made with PET/CT. The reference standard for determination of recurrence was the multi-disciplinary tumor board who had access to all imaging and clinical data. Recurrence at 1 year was documented in 16 of 90 patients. All 16 recurrences were documented with PET/CT and 9 were found with non-contrast CT. Five of the 7 recurrences missed with non-contrast CT were extrathoracic metastases. Sensitivity of CT and PET/CT for recurrence was 56.3% and 100%, respectively (p = 0.015). Specificity of CT and PET/CT for recurrence was 95.9% and 93.2%, respectively (p = 0.62). PMID:24116349

Clinical validation of FDG-PET/CT in the radiation treatment planning for patients with oesophageal cancer.

PubMed

Muijs, Christina T; Beukema, Jannet C; Woutersen, Dankert; Mul, Veronique E; Berveling, Maaike J; Pruim, Jan; van der Jagt, Eric J; Hospers, Geke A P; Groen, Henk; Plukker, John Th; Langendijk, Johannes A

2014-11-01

The aim of this prospective study was to determine the proportion of locoregional recurrences (LRRs) that could have been prevented if radiotherapy treatment planning for oesophageal cancer was based on PET/CT instead of CT. Ninety oesophageal cancer patients, eligible for high dose (neo-adjuvant) (chemo)radiotherapy, were included. All patients underwent a planning FDG-PET/CT-scan. Radiotherapy target volumes (TVs) were delineated on CT and patients were treated according to the CT-based treatment plans. The PET images remained blinded. After treatment, TVs were adjusted based on PET/CT, when appropriate. Follow up included CT-thorax/abdomen every 6months. If LRR was suspected, a PET/CT was conducted and the site of recurrence was compared to the original TVs. If the LRR was located outside the CT-based clinical TV (CTV) and inside the PET/CT-based CTV, we considered this LRR possibly preventable. Based on PET/CT, the gross tumour volume (GTV) was larger in 23% and smaller in 27% of the cases. In 32 patients (36%), >5% of the PET/CT-based GTV would be missed if the treatment planning was based on CT. The median follow up was 29months. LRRs were seen in 10 patients (11%). There were 3 in-field recurrences, 4 regional recurrences outside both CT-based and PET/CT-based CTV and 3 recurrences at the anastomosis without changes in TV by PET/CT; none of these recurrences were considered preventable by PET/CT. No LRR was found after CT-based radiotherapy that could have been prevented by PET/CT. The value of PET/CT for radiotherapy seems limited. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.