Effects of bolus injection duration on perfusion estimates in dynamic CT and dynamic susceptibility contrast MRI.

Estimates of cerebral blood flow (CBF) and tissue mean transit time (MTT) have been shown to differ between dynamic CT perfusion (CTP) and dynamic susceptibility contrast MRI (DSC-MRI). This study investigates whether these discrepancies regarding CBF and MTT between CTP and DSC-MRI can be attributed to the different injection durations of these techniques. Five subjects were scanned using CTP and DSC-MRI. Region-wise estimates of CBF, MTT, and cerebral blood volume (CBV) were derived based on oscillatory index regularized singular value decomposition. A parametric model that reproduced the shape of measured time curves and characteristics of resulting perfusion parameter estimates was developed and used to simulate data with injection durations typical for CTP and DSC-MRI for a clinically relevant set of perfusion scenarios and noise levels. In simulations, estimates of CBF/MTT showed larger negative/positive bias and increasing variability for CTP when compared to DSC-MRI, especially for high CBF levels. While noise also affected estimates, at clinically relevant levels, the injection duration effect was larger. There are several methodological differences between CTP and DSC-MRI. The results of this study suggest that the injection duration is among those that can explain differences in estimates of CBF and MTT between these bolus tracking techniques.

Brain structural and functional correlates to defense-related inhibition of muscle sympathetic nerve activity in man.

An individual's blood pressure (BP) reactivity to stress is linked to increased risk of hypertension and cardiovascular disease. However, inter- and intra-individual BP variability makes understanding the coupling between stress, BP reactivity, and long-term outcomes challenging. Previous microneurographic studies of sympathetic signaling to muscle vasculature (i.e. muscle sympathetic nerve activity, MSNA) have established a neural predictor for an individual's BP reactivity during short-lasting stress. Unfortunately, this method is invasive, technically demanding, and time-consuming and thus not optimal for widespread use. Potential central nervous system correlates have not been investigated. We used MagnetoEncephaloGraphy and Magnetic Resonance Imaging to search for neural correlates to sympathetic response profiles within the central autonomic network and sensorimotor (Rolandic) regions in 20 healthy young males. The main correlates include (a) Rolandic beta rebound and an anterior cingulate cortex (ACC) response elicited by sudden stimulation and (b) cortical thickness in the ACC. Our findings highlight the involvement of the ACC in reactions to stress entailing peripheral sympathetic responses to environmental stimuli. The Rolandic response furthermore indicates a surprisingly strong link between somatosensory and autonomic processes. Our results thus demonstrate the potential in using non-invasive neuroimaging-based measures of stress-related MSNA reactions, previously assessed only using invasive microneurography.

A Longitudinal Study of Medial Temporal Lobe Volumes in Graves Disease.

CONTEXT: Neuropsychiatric symptoms are common features of Graves disease (GD) in hyperthyroidism and after treatment. The mechanism behind these symptoms is unknown, but reduced hippocampal volumes have been observed in association with increased thyroid hormone levels. OBJECTIVE: This work aimed at investigating GD influence on regional medial temporal lobe (MTL) volumes. METHODS: Sixty-two women with newly diagnosed GD underwent assessment including magnetic resonance (MR) imaging in hyperthyroidism and 48 of them were followed up after a mean of 16.4 ±â€…4.2 SD months of treatment. Matched thyroid-healthy controls were also assessed twice at a 15-month interval. MR images were automatically segmented using multiatlas propagation with enhanced registration. Regional medial temporal lobe (MTL) volumes for amygdalae and hippocampi were compared with clinical data and data from symptom questionnaires and neuropsychological tests. RESULTS: Patients had smaller MTL regions than controls at inclusion. At follow-up, all 4 MTL regions had increased volumes and only the volume of the left amygdala remained reduced compared to controls. There were significant correlations between the level of thyrotropin receptor antibodies (TRAb) and MTL volumes at inclusion and also between the longitudinal difference in the levels of free 3,5,3'-triiodothyronine and TRAb and the difference in MTL volumes. There were no significant correlations between symptoms or test scores and any of the 4 MTL volumes. CONCLUSION: Dynamic alterations in the amygdalae and hippocampi in GD reflect a previously unknown level of brain involvement both in the hyperthyroid state of the condition and after treatment. The clinical significance, as well as the mechanisms behind these novel findings, warrant further study of the neurological consequences of GD.

Erratum: Reliable phase-contrast flow volume magnetic resonance measurements are feasible without adjustment of the velocity encoding parameter.

[This corrects the article DOI: 10.1117/1.JMI.7.6.063502.].

Neurochemical properties measured by 1H magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study.

To identify neurochemical factors measured pre-treatment that may predict cognitive behavioural treatment (CBT) outcome, aiming at understanding possible causes of poor CBT response. 1H magnetic resonance spectroscopy was used before treatment with CBT in treatment naïve 11-18 year-old patients with moderate-severe OCD. Diagnoses and assessment of OCD severity were based on semi-structured interviews. Linear mixed effects models were used to analyse the association between metabolite level and treatment outcome. Worse CBT outcome was associated with higher concentration of glutamine and glutamate combined (Glx) in middle cingulate cortex (MCC) (F = + 3.35, p = 0.004) and of N-acetylaspartate and N-acetylaspartylglutamate combined (tNAA) (F = + 2.59, p = 0.019). Also, we noted a tendency towards higher thalamic Glx concentration (F = + 1.91, p = 0.077) to be associated with worse CBT outcome. In general, the findings of the current pilot study are compatible with the hypothesis of an overweight of excitatory to inhibitory factors in brain circuits driving goal-directed behaviours (GDB). Higher MCC Glx and tNAA may be involved in the selection of GDB. A more detailed understanding of how these brain areas function in health and illness is needed.

Reliable phase-contrast flow volume magnetic resonance measurements are feasible without adjustment of the velocity encoding parameter.

Purpose: To show that adjustment of velocity encoding (VENC) for phase-contrast (PC) flow volume measurements is not necessary in modern MR scanners with effective background velocity offset corrections. Approach: The independence on VENC was demonstrated theoretically, but also experimentally on dedicated phantoms and on patients with chronic aortic regurgitation ( n = 17 ) and one healthy volunteer. All PC measurements were performed using a modern MR scanner, where the pre-emphasis circuit but also a subsequent post-processing filter were used for effective correction of background velocity offset errors. Results: The VENC level strongly affected the velocity noise level in the PC images and, hence, the estimated peak flow velocity. However, neither the regurgitant blood flow volume nor the mean flow velocity displayed any clinically relevant dependency on the VENC level. Also, the background velocity offset was shown to be close to zero ( < 0.6 cm / s ) for a VENC range of 150 to 500 cm / s , adding no significant errors to the PC flow volume measurement. Conclusions: Our study shows that reliable PC flow volume measurements are feasible without adjustment of the VENC parameter. Without the need for VENC adjustments, the scan time can be reduced for the benefit of the patient.

MRI diffusion and perfusion alterations in the mesencephalon and pons as markers of disease and symptom reversibility in idiopathic normal pressure hydrocephalus.

INTRODUCTION: Core symptomatology in idiopathic normal pressure hydrocephalus (iNPH) points at dysfunction in the mesencephalon and pons indicating pathological changes in these regions, but only a few studies have addressed the issue. The aim of this study was to investigate diffusion (ADC) and perfusion patterns pre- and postoperatively in these areas in iNPH. METHODS: Twenty iNPH patients and 15 healthy controls were included. Patients underwent a clinical examination and brain MRI pre- and 3-6 months postoperatively. The MRI-scan included diffusion and dynamic susceptibility contrast perfusion weighted sequences. Regions of interest in the mesencephalon and pons were drawn on a FLAIR sequence and co-registered to ADC maps and perfusion data. RESULTS: There were no significant differences in pre or postoperative ADC compared to the control group, however postoperative ADC increased by 10% (p = 0.026) in the mesencephalon and 6% (p = 0.016) in the pons in all patients and also in the subgroup of shunt responders by 11% (p = 0.021) and 4% (p = 0.020), respectively. Preoperative relative cerebral blood flow (rCBF) was similar in iNPH patients and controls. Postoperatively, rCBF increased in shunt responders by 6% (p = 0.02) in the mesencephalon and 11% (p = 0.004) in the pons. This increase correlated with the degree of clinical improvement (rs = 0.80, p = 0.031 and rs = 0.66, p = 0.021, respectively). CONCLUSION: The postoperative increase in ADC and the correlation between postoperative increase in rCBF and clinical improvement in the mesencephalon and pons shown in this study point at an involvement of these areas in the core pathophysiology and its reversibility in iNPH.

Optimization of b-value schemes for estimation of the diffusion coefficient and the perfusion fraction with segmented intravoxel incoherent motion model fitting.

PURPOSE: Intravoxel incoherent motion (IVIM) modeling for estimation of the diffusion coefficient (D) and perfusion fraction (f) is increasingly popular, but no consensus on standard protocols exists. This study provides a framework for optimization of b-value schemes for reduced estimation uncertainty of D and f from segmented model fitting. THEORY: Analytical expressions for uncertainties of D and f from segmented model fitting were derived as Cramer-Rao lower bounds (CRLBs). METHODS: Optimized b-value schemes were obtained for 3 to 12 acquisitions and in the limit of infinitely many acquisitions through constrained minimization of the CRLBs, with b-values constrained to be 0 or 200 to 800 s/mm2 . The optimized b-value scheme with eight acquisitions was compared with b-values linearly distributed in the allowed range using simulations and in vivo liver data from seven healthy volunteers. RESULTS: All optimized b-value schemes contained exactly three unique b-values regardless of the total number of acquisitions (0, 200, and 800 s/mm2 ) with repeated acquisitions distributed approximately as 1:2:2. Compared with linearly distributed b-values, the variability of estimates of D and f was reduced by approximately 30% as seen both in simulations and in repeated in vivo measurements. CONCLUSION: The uncertainty of IVIM D and f estimates can be reduced by the use of optimized b-value schemes.

Data-driven identification of tumor subregions based on intravoxel incoherent motion reveals association with proliferative activity.

PURPOSE: Intravoxel incoherent motion (IVIM) analysis gives information on tissue diffusion and perfusion and may thus have a potential for e.g. tumor tissue characterization. This work aims to study if clustering based on IVIM parameter maps can identify tumor subregions, and to assess the relevance of obtained subregions by histological analysis. METHODS: Fourteen mice with human neuroendocrine tumors were examined with diffusion-weighted imaging to obtain IVIM parameter maps. Gaussian mixture models with IVIM maps from all tumors as input were used to partition voxels into k clusters, where k = 2 was chosen for further analysis based on goodness of fit. Clustering was performed with and without the perfusion-related IVIM parameter D* , and with and without including spatial information. The validity of the clustering was assessed by comparison with corresponding histologically stained tumor sections. A Ki-67-based index quantifying the degree of tumor proliferation was considered appropriate for the comparison based on the obtained cluster characteristics. RESULTS: The clustering resulted in one class with low diffusion and high perfusion and another with slightly higher diffusion and low perfusion. Strong agreement was found between tumor subregions identified by clustering and subregions identified by histological analysis, both regarding size and spatial agreement. Neither D* nor spatial information had substantial effects on the clustering results. CONCLUSIONS: The results of this study show that IVIM parameter maps can be used to identify tumor subregions using a data-driven framework based on Gaussian mixture models. In the studied tumor model, the obtained subregions showed agreement with proliferative activity.

Processing of affective and emotionally neutral tactile stimuli in the insular cortex.

The insula is important for the processing of pleasant aspects of touch whereas its role in the processing of emotionally neutral touch has been less explored. Here, we used a network approach to investigate the insular processing of pleasant stroking touch and emotionally neutral vibratory touch, analysing functional magnetic resonance imaging data from 23 healthy adult participants. Vibration and skin stroking activated areas in the posterior, middle and anterior insula. Psychophysiological interaction analyses suggested that skin stroking increased functional connectivity between the posterior and ventral anterior insula. Vibration instead increased functional connectivity between the posterior and dorsal anterior insula, and induced a stronger decrease of the default mode network activity compared to stroking. These results confirmed findings from previous studies showing that the posterior insula processes affective touch information. We suggest that this is accomplished by relaying tactile information from the posterior insula to ventral anterior insula, an area tightly connected to the emotional parts of the brain. However, our results also suggested that the insula processes tactile information with less emotional valence. A central hub in this processing seemed to be the right dorsal anterior insula.

Abnormal brain processing of gentle touch in anorexia nervosa.

Body image disturbance is a core symptom in anorexia nervosa (AN). Recent research suggests that abnormalities in touch perception may contribute to the disease mechanisms in AN. Here, we used functional magnetic resonance imaging (fMRI) to study possible abnormalities in cortical processing of affective touch in AN. Gentle skin strokes were applied to the right forearm during fMRI scanning in women diagnosed with AN (n = 25) and in matched healthy controls (HC; n = 25). Blocks of skin stroking were alternated with blocks of static skin indentation. Participants provided ratings of the pleasantness of skin stroking stimulation. AN participants perceived skin stroking as significantly less pleasant than HC. We observed no group differences for the contrast between skin stroking and skin indentation in primary tactile regions. We did find, however, significantly less activity in the AN group in areas including left caudate nucleus. Also, we found less activity in the AN group in bilateral lateral occipital cortex for the main effect of skin stroking. Our results suggest that abnormal functioning of the dorsal striatum could affect evaluation of pleasant tactile stimuli, and that abnormal functioning of the lateral occipital cortex might be related to disturbed body image perception.

Comparison of methods for estimation of the intravoxel incoherent motion (IVIM) diffusion coefficient (D) and perfusion fraction (f).

OBJECTIVE: Intravoxel incoherent motion (IVIM) shows great potential in many applications, e.g., tumor tissue characterization. To reduce image-quality demands, various IVIM analysis approaches restricted to the diffusion coefficient (D) and the perfusion fraction (f) are increasingly being employed. In this work, the impact of estimation approach for D and f is studied. MATERIALS AND METHODS: Four approaches for estimating D and f were studied: segmented IVIM fitting, least-squares fitting of a simplified IVIM model (sIVIM), and Bayesian fitting of the sIVIM model using marginal posterior modes or posterior means. The estimation approaches were evaluated in terms of bias and variability as well as ability for differentiation between tumor and healthy liver tissue using simulated and in vivo data. RESULTS: All estimation approaches had similar variability and ability for differentiation and negligible bias, except for the Bayesian posterior mean of f, which was substantially biased. Combined use of D and f improved tumor-to-liver tissue differentiation compared with using D or f separately. DISCUSSION: The similar performance between estimation approaches renders the segmented one preferable due to lower numerical complexity and shorter computational time. Superior tissue differentiation when combining D and f suggests complementary biologically relevant information.

Grey matter correlates of autistic traits in women with anorexia nervosa.

BACKGROUND: Patients with anorexia nervosa exhibit higher levels of behaviours typically associated with autism-spectrum disorder (ASD), but the neural basis is unclear. We sought to determine whether elevated autistic traits in women with anorexia nervosa may be reflected in cortical morphology. METHODS: We used voxel-based morphometry (VBM) to examine regional grey matter volumes in high-resolution MRI structural brain scans in women with anorexia nervosa and matched healthy controls. The Autism-spectrum Quotient (AQ) scale was used to assess autistic traits. RESULTS: Women with anorexia nervosa (n = 25) had higher AQ scores and lower bilateral superior temporal sulcus (STS) grey matter volumes than the control group (n = 25). The AQ scores correlated negatively with average left STS grey matter volume in women with anorexia nervosa. LIMITATIONS: We did not control for cognitive ability and examined only women with ongoing anorexia nervosa. CONCLUSION: Elevated autistic traits in women with anorexia nervosa are associated with morphometric alterations of brain areas linked to social cognition. This finding provides neurobiological support for the behavioural link between anorexia nervosa and ASD and emphasizes the importance of recognizing autistic traits in preventing and treating anorexia nervosa.

Impact of prior distributions and central tendency measures on Bayesian intravoxel incoherent motion model fitting.

PURPOSE: Bayesian model fitting has been proposed as a robust alternative for intravoxel incoherent motion (IVIM) model-fitting parameter estimation. However, consensus regarding choice of prior distribution and posterior distribution central tendency measure is needed. The aim of this study was to compare the quality of IVIM parameter estimates produced by different prior distributions and central tendency measures, and to gain knowledge about the effect of these choices. METHODS: Three prior distributions (uniform, reciprocal, and lognormal) and two measures of central tendency (mean and mode) found in the literature were studied using simulations and in vivo data from a tumor mouse model. RESULTS: Simulations showed that the uniform and lognormal priors were superior to the reciprocal prior, especially for the parameters D and f and clinically relevant SNR levels. The choice of central tendency measure had less effect on the results, but had some effects on estimation bias. Results based on simulations and in vivo data agreed well, indicating high validity of the simulations. CONCLUSIONS: Choice of prior distribution and central tendency measure affects the results of Bayesian IVIM parameter estimates. This must be considered when comparing results from different studies. The best overall quality of IVIM parameter estimates was obtained using the lognormal prior. Magn Reson Med 79:1674-1683, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Grey matter correlates of autistic traits in women with anorexia nervosa

Background: Patients with anorexia nervosa exhibit higher levels of behaviours typically associated with autism-spectrum disorder (ASD), but the neural basis is unclear. We sought to determine whether elevated autistic traits in women with anorexia nervosa may be reflected in cortical morphology. Methods: We used voxel-based morphometry (VBM) to examine regional grey matter volumes in high-resolution MRI structural brain scans in women with anorexia nervosa and matched healthy controls. The Autism-spectrum Quotient (AQ) scale was used to assess autistic traits. Results: Women with anorexia nervosa (n = 25) had higher AQ scores and lower bilateral superior temporal sulcus (STS) grey matter volumes than the control group (n = 25). The AQ scores correlated negatively with average left STS grey matter volume in women with anorexia nervosa. Limitations: We did not control for cognitive ability and examined only women with ongoing anorexia nervosa. Conclusion: Elevated autistic traits in women with anorexia nervosa are associated with morphometric alterations of brain areas linked to social cognition. This finding provides neurobiological support for the behavioural link between anorexia nervosa and ASD and emphasizes the importance of recognizing autistic traits in preventing and treating ­anorexia nervosa.

Visual pathway impairment by pituitary adenomas: quantitative diagnostics by diffusion tensor imaging.

OBJECTIVE Despite ample experience in surgical treatment of pituitary adenomas, little is known about objective indices that may reveal risk of visual impairment caused by tumor growth that leads to compression of the anterior visual pathways. This study aimed to explore diffusion tensor imaging (DTI) as a means for objective assessment of injury to the anterior visual pathways caused by pituitary adenomas. METHODS Twenty-three patients with pituitary adenomas, scheduled for transsphenoidal tumor resection, and 20 healthy control subjects were included in the study. A minimum suprasellar tumor extension of Grade 2-4, according to the SIPAP (suprasellar, infrasellar, parasellar, anterior, and posterior) scale, was required for inclusion. Neuroophthalmological examinations, conventional MRI, and DTI were completed in all subjects and were repeated 6 months after surgery. Quantitative assessment of chiasmal lift, visual field defect (VFD), and DTI parameters from the optic tracts was performed. Linear correlations, group comparisons, and prediction models were done in controls and patients. RESULTS Both the degree of VFD and chiasmal lift were significantly correlated with the radial diffusivity (r = 0.55, p < 0.05 and r = 0.48, p < 0.05, respectively) and the fractional anisotropy (r = -0.58, p < 0.05 and r = -0.47, p < 0.05, respectively) but not with the axial diffusivity. The axial diffusivity differed significantly between controls and patients with VFD, both before and after surgery (p < 0.05); however, no difference was found between patients with and without VFD. Based on the axial diffusivity and fractional anisotropy, a prediction model classified all patients with VFD correctly (sensitivity 1.0), 9 of 12 patients without VFD correctly (sensitivity 0.75), and 17 of 20 controls as controls (specificity 0.85). CONCLUSIONS DTI could detect pathology and degree of injury in the anterior visual pathways that were compressed by pituitary adenomas. The correlation between radial diffusivity and visual impairment may reflect a gradual demyelination in the visual pathways caused by an increased tumor effect. The low level of axial diffusivity found in the patient group may represent early atrophy in the visual pathways, detectable on DTI but not by conventional methods. DTI may provide objective data, detect early signs of injury, and be an additional diagnostic tool for determining indication for surgery in cases of pituitary adenomas.

1H magnetic resonance spectroscopy evidence for occipital involvement in treatment-naive paediatric obsessive-compulsive disorder.

OBJECTIVE: Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder leading to considerable distress and disability. Therapies are effective in a majority of paediatric patients, however, many only get partial response. It is therefore important to study the underlying pathophysiology of the disorder. METHODS: 1H magnetic resonance spectroscopy (MRS) was used to study the concentration of brain metabolites in four different locations (cingulate gyrus and sulcus, occipital cortex, thalamus and right caudate nucleus). Treatment-naive children and adolescents with OCD (13 subjects) were compared with a group of healthy age- and gender-matched subjects (11 subjects). Multivariate analyses were performed on the concentration values. RESULTS: No separation between controls and patients was found. However, a correlation between metabolite concentrations and symptom severity as measured with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was found. Strongest was the correlation with the CY-BOCS obsession subscore and aspartate and choline in the caudate nucleus (positively correlated with obsessions), lipids at 2 and 0.9 ppm in thalamus, and occipital glutamate+glutamine, N-acetylaspartate and myo-inosytol (negatively correlated with obsessions). CONCLUSIONS: The observed correlations between 1H MRS and CY-BOCS in treatment-naive patients further supports an occipital involvement in OCD. The results are consistent with our previous study on adult OCD patients. The 1H MRS data were not supportive of a separation between the patient and control groups.

Impact of region-of-interest method on quantitative analysis of DTI data in the optic tracts.

BACKGROUND: To extract DTI parameters from a specific structure, a region of interest (ROI) must be defined. ROI selection in small structures is challenging; the final measurement results could be affected due to the significant impact of small geometrical errors. In this study the optic tracts were analyzed with the aim to assess differences in DTI parameters due to ROI method and to identify the most reliable method. METHODS: Images of 20 healthy subjects were acquired. Fractional anisotropy (FA) was extracted from the optic tracts by four different ROI methods. Manual tracing was performed in 1) the b0 image and 2) a T1-weighted image registered to the FA image. Semi-automatic segmentation was performed based on 3) tractography and 4) the FA-skeleton algorithm in the tract-based spatial statistics (TBSS) framework. Results were analyzed with regard to ROI method as well as to inter-scan, intra-rater and inter-rater reliability. RESULTS: The resulting FA values divided the ROI methods into two groups that differed significantly: 1) the FA-skeleton and the b0 methods showed higher FA values compared to 2) the tractography and the T1-weighted methods. The intra- and inter-rater variabilities were similar for all methods, except for the tractography method where the inter-rater variability was higher. The FA-skeleton method had a better reproducibility than the other methods. CONCLUSION: Choice of ROI method was found to be highly influential on FA values when the optic tracts were analyzed. The FA-skeleton method performed the best, yielding low variability and high repeatability.

Pre-and postoperative cerebral blood flow changes in patients with idiopathic normal pressure hydrocephalus measured by computed tomography (CT)-perfusion.

In idiopathic normal pressure hydrocephalus (iNPH), the cerebral blood flow (CBF) is of pathophysiological interest and a potential biomarker. Computed tomography perfusion (CTP), an established technique with high spatial resolution and quantitative measurements, has not yet been used in the iNPH context. If CTP were sensitive to the CBF levels and changes in iNPH, this technique might provide diagnostic and prognostic absolute perfusion thresholds. The aim of this work was to determine the applicability of CTP to iNPH. CBF measurements of 18 patients pre- and 17 three months postoperatively, and six healthy individuals (HI) were evaluated in 12 cortical and subcortical regions of interest. Correlations between CBF and symptomatology were analyzed in shunt-responders. Compared to HI, the preoperative CBF in iNPH was significantly reduced in normal appearing and periventricular white matter (PVWM), the lentiform nucleus and the global parenchyma. No CBF differences were shown between responders and non-responders. In responders, the CBF recovered postoperatively by 2.5-32% to approximately the level of HI, but remained significantly decreased in the PVWM of non-responders. The pre- and postoperative CBF of cortical and subcortical regions correlated with the intensity of symptoms. In spite of limited spatial coverage, CTP can measure CBF changes in iNPH.

IMAGE FUSION OF RECONSTRUCTED DIGITAL TOMOSYNTHESIS VOLUMES FROM A FRONTAL AND A LATERAL ACQUISITION.

Digital tomosynthesis (DTS) has been used in chest imaging as a low radiation dose alternative to computed tomography (CT). Traditional DTS shows limitations in the spatial resolution in the out-of-plane dimension. As a first indication of whether a dual-plane dual-view (DPDV) DTS data acquisition can yield a fair resolution in all three spatial dimensions, a manual registration between a frontal and a lateral image volume was performed. An anthropomorphic chest phantom was scanned frontally and laterally using a linear DTS acquisition, at 120 kVp. The reconstructed image volumes were resampled and manually co-registered. Expert radiologist delineations of the mediastinal soft tissues enabled calculation of similarity metrics in regard to delineations in a reference CT volume. The fused volume produced the highest total overlap, implying that the fused volume was a more isotropic 3D representation of the examined object than the traditional chest DTS volumes.