Assessment of water quality using entropy-weighted quality index, statistical methods and electrical resistivity tomography, Moti village, northern Pakistan.

In this study, twenty-two water samples were collected from boreholes (BH), and streams to evaluate drinking water quality, its distribution, identification of contamination sources and apportionment for Moti village, northern Pakistan. An atomic absorption spectrophotometer (AAS) is utilized to determine the level of heavy metals in water such as arsenic (As), zinc (Zn), lead (Pb), copper (Cu), cadmium (Cd), manganese (Mn), and ferrous (Fe). Groundwater chemistry and its quantitative driving factors were further explored using multivariate statistical methods, Principal Component Analysis (PCA) and Positive Matrix Factorization (PMF) models. Finally, a total of eight electrical resistivity tomographs (ERTs) were acquired across i) the highly contaminated streams; ii) the villages far away from contaminated streams; and iii) across the freshwater stream. In the Moti village, the mean levels (mg/l) of heavy metals in water samples were 7.2465 (As), 0.4971 (Zn), 0.5056 (Pb), 0.0422 (Cu), 0.0279 (Cd), 0.1579 (Mn), and 0.9253 (Fe) that exceeded the permissible limit for drinking water (such as 0.010 for As and Pb, 3.0 for Zn, 0.003 for Cd and 0.3 for Fe) established by the World Health Organization (WHO, 2008). The average entropy weighted water quality index (EWQI) of 200, heavy metal pollution index (HPI) of 175, heavy metal evaluation index (HEI) of 1.6 values reveal inferior water quality in the study area. Human health risk assessment, consisting of hazard quotient (HQ) and hazard index (HI), exceeded the risk threshold (>1),indicating prevention of groundwater usage. Results obtained from the PCA and PMF models indicated anthropogenic sources (i.e. industrial and solid waste) responsible for the high concentration of heavy metals in the surface and groundwater. The ERTs imaged the subsurface down to about 40 m depths and show the least resistivity values (<11 Ωm) for subsurface layers that are highly contaminated. However, the ERTs revealed relatively high resistivity values for subsurface layers containing fresh or less contaminated water. Filtering and continuous monitoring of the quality of drinking water in the village are highly recommended.

Comparative analysis of pulmonary ventilation distribution between low-cost and branded incentive spirometers using electrical impedance tomography in healthy adults: Study protocol.

BACKGROUND: The Incentive Spirometer (IS) increases lung volume and improves gas exchange by visually stimulating patients to take slow, deep breaths. It prevents respiratory complications and treats postoperative atelectasis in patients undergoing abdominal, thoracic, and neurosurgical procedures. Its effectiveness has been validated in studies that support improved lung capacities and volumes in individuals with respiratory complications, postoperative thoracic surgery, upper abdominal surgery, and bariatric surgery. The modified Pachón incentive spirometer (MPIS) is a cost-effective alternative to branded IS. It is crucial to validate whether the MPIS distributes ventilation as effectively as commercial devices do. Ventilation distribution will be measured using electrical impedance tomography. OBJECTIVE: The aim is to compare the distribution of pulmonary ventilation between the MPIS and another commercial IS in healthy adults using electrical impedance tomography. METHODS: A crossover clinical trial is proposed to evaluate the measurement of pulmonary ventilation distribution using EIT in a sample of healthy adults. All participants will use a commercial flow IS and the MPIS, with the order of assignment randomized. This research will use electrical impedance tomography to validate the operation of the MPIS. CONCLUSIONS: This study protocol will compare two incentive spirometers' impact on pulmonary ventilation, potentially endorsing the adoption of a cost-effective device to enhance accessibility for targeted populations. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov (NTC05532748).

A framework for risk assessment of groundwater contamination integrating hydrochemical, hydrogeological, and electrical resistivity tomography method.

Groundwater contamination have been widely concerned. To reliably conduct risk assessment, it is essential to accurately delineate the contaminant distribution and hydrogeological condition. Electrical resistivity tomography (ERT) has become a powerful tool because of its high sensitivity to hydrochemical parameters, as well as its advantages of non-invasiveness, spatial continuity, and cost-effectiveness. However, it is still difficult to integrate hydrochemical, hydrogeological, and ERT datasets for risk assessment. In this study, we develop a general framework for risk assessment by sequentially jointing hydrochemical, hydrogeological, and ERT surveys, while establishing petrophysical relationships among these data. This framework can be used in groundwater-contaminated site and help to delineate the distribution of contaminants. In this study, it was applied to a nitrogen-contaminated site where field ERT survey and borehole information provided valuable measurement data for validating the consistency of contamination and hydrogeological condition. Risk assessment was conducted based on the refined results by the establishment of relationship between conductivity and contaminants concentration with R 2 > 0.84 . The contamination source was identified and the transport direction was predicted with the good agreement of R 2 = 0.965 between simulated and observed groundwater head, which can help to propose measures for anti-seepage and monitoring. This study thus enhances the reliability of risk assessment and prediction through a thought-provoking innovation in the realm of groundwater environmental assessment.

Multispectral Optoacoustic Tomography Enables In Vivo Anatomical and Functional Assessment of Human Tendons.

Tendon injuries resulting from accidents and aging are increasing globally. However, key tendon functional parameters such as microvascularity and oxygen perfusion remain inaccessible via the currently available clinical diagnostic tools, resulting in disagreements on optimal treatment options. Here, a new noninvasive method for anatomical and functional characterization of human tendons based on multispectral optoacoustic tomography (MSOT) is reported. Healthy subjects are investigated using a hand-held scanner delivering real-time volumetric images. Tendons in the wrist, ankle, and lower leg are imaged in the near-infrared optical spectrum to utilize endogenous contrast from Type I collagen. Morphology of the flexor carpi ulnaris, carpi radialis, palmaris longus, and Achilles tendons are reconstructed in full. The functional roles of the flexor digitorium longus, hallicus longus, and the tibialis posterior tendons have been visualized by dynamic tracking during toe extension-flexion motion. Furthermore, major vessels and microvasculature near the Achilles tendon are localized, and the global increase in oxygen saturation in response to targeted exercise is confirmed by perfusion studies. MSOT is shown to be a versatile tool capable of anatomical and functional tendon assessments. Future studies including abnormal subjects can validate the method as a viable noninvasive clinical tool for tendinopathy management and healing monitoring.

Phantom evaluation of electrical conductivity mapping by MRI: Comparison to vector network analyzer measurements and spatial resolution assessment.

PURPOSE: To evaluate the performance of various MR electrical properties tomography (MR-EPT) methods at 3 T in terms of absolute quantification and spatial resolution limit for electrical conductivity. METHODS: Absolute quantification as well as spatial resolution performance were evaluated on homogeneous phantoms and a phantom with holes of different sizes, respectively. Ground-truth conductivities were measured with an open-ended coaxial probe connected to a vector network analyzer (VNA). Four widely used MR-EPT reconstruction methods were investigated: phase-based Helmholtz (PB), phase-based convection-reaction (PB-cr), image-based (IB), and generalized-image-based (GIB). These methods were compared using the same complex images from a 1 mm-isotropic UTE sequence. Alternative transceive phase acquisition sequences were also compared in PB and PB-cr. RESULTS: In large homogeneous phantoms, all methods showed a strong correlation with ground truth conductivities (r > 0.99); however, GIB was the best in terms of accuracy, spatial uniformity, and robustness to boundary artifacts. In the resolution phantom, the normalized root-mean-squared error of all methods grew rapidly (>0.40) when the hole size was below 10 mm, with simplified methods (PB and IB), or below 5 mm, with generalized methods (PB-cr and GIB). CONCLUSION: VNA measurements are essential to assess the accuracy of MR-EPT. In this study, all tested MR-EPT methods correlated strongly with the VNA measurements. The UTE sequence is recommended for MR-EPT, with the GIB method providing good accuracy for structures down to 5 mm. Structures below 5 mm may still be detected in the conductivity maps, but with significantly lower accuracy.

Global and regional lung function assessment using portable electrical impedance tomography (EIT) system: clinical study.

Recent development of affordable, portable and self-administrable electrical impedance tomography (EIT) system demonstrated the feasibility of using standalone EIT and subject's anthropometrics to predict the gold standard spirometry indicators for lung-function assessment. Compared to spirometry, the system showed the advantage of providing spatial mapping of the spirometry indicators. Nevertheless, the previous study was limited to healthy subjects. Here, we recruited (N=88): 47 lung disease patients and 41 healthy controls to perform simultaneous EIT and spirometry measurements to validate the capabilities of the system. Lung disease patients include 13 interstitial lung disease (ILD), 10 asthma, 8 chronic obstructive pulmonary disease (COPD), 8 bronchiectasis, and 8 with other diseases including left pneumonectomy, lung cancer, lung tumor, lymphangioleiomyomatosis, motor neuron disease, heart failure and bronchiolitis obliterans syndrome. The results showed significant correlation of the predicted global spirometry indicators (p<0.0001) and significant distinguishability between most disease groups and healthy subjects demonstrating the capability of the EIT system in diagnostic screening. Furthermore, the regional mapping of the spirometry indicators is evaluated and shown to be distinct for each disease group, providing an additional dimension for medical professionals to diagnose and monitor lung disease patients.Clinical Relevance- This establishes the significance of EIT-based global and regional indicators for assessing lung function on lung disease patients.

Deep learning based reconstruction enables high-resolution electrical impedance tomography for lung function assessment.

Recently, deep learning based methods have shown potential as alternative approaches for lung time difference electrical impedance tomography (tdEIT) reconstruction other than traditional regularized least square methods, that have inherent severe ill-posedness and low spatial resolution posing challenges for further interpretation. However, the validation of deep learning reconstruction quality is mainly focused on simulated data rather than in vivo human chest data, and on image quality rather than clinical indicator accuracy. In this study, a variational autoencoder is trained on high-resolution human chest simulations, and inference results on an EIT dataset collected from 22 healthy subjects performing various breathing paradigms are benchmarked with simultaneous spirometry measurements. The deep learning reconstructed global conductivity is significantly correlated with measured volume-time curves with correlation > 0.9. EIT lung function indicators from the reconstruction are also highly correlated with standard spirometry indicators with correlation > 0.75.Clinical Relevance- Our deep learning reconstruction method of lung tdEIT can predict lung volume and spirometry indicators while generating high-resolution EIT images, revealing potential of being a competitive approach in clinical settings.

Structure-fused deep 3D hierarchical network: A bioluminescence tomography scheme for different imaging objects.

Monte Carlo eXtreme (MCX) method has a unique advantage for deep neural network based bioluminescence tomography (BLT) reconstruction. However, this method ignores the distribution of sources energy and relies on the determined tissue structure. In this paper, a deep 3D hierarchical reconstruction network for BLT was proposed where the inputs were divided into two parts -- bioluminescence image (BLI) and anatomy of the imaged object by CT. Firstly, a parallel encoder is used to feature the original BLI & CT slices and integrate their features to distinguish the different tissue structure of imaging objects; Secondly, GRU is used to fit the spatial information of different slices and convert it into 3D features; Finally, the 3D features are decoded to the spacial and energy information of source by a symmetrical decoding structure. Our research suggested that this method can effectively compute the radiation intensity and the spatial distribution of the source for different imaging object.

Reconstruction of fluorophore absorption and fluorescence lifetime using early photon mesoscopic fluorescence molecular tomography: a phantom study.

Significance: Fluorescence molecular lifetime tomography (FMLT) plays an increasingly important role in experimental oncology. The article presents and experimentally verifies an original method of mesoscopic time domain FMLT, based on an asymptotic approximation to the fluorescence source function, which is valid for early arriving photons. Aim: The aim was to justify the efficiency of the method by experimental scanning and reconstruction of a phantom with a fluorophore. The experimental facility included the TCSPC system, the pulsed supercontinuum Fianium laser, and a three-channel fiber probe. Phantom scanning was done in mesoscopic regime for three-dimensional (3D) reflectance geometry. Approach: The sensitivity functions were simulated with a Monte Carlo method. A compressed-sensing-like reconstruction algorithm was used to solve the inverse problem for the fluorescence parameter distribution function, which included the fluorophore absorption coefficient and fluorescence lifetime distributions. The distributions were separated directly in the time domain with the QR-factorization least square method. Results: 3D tomograms of fluorescence parameters were obtained and analyzed using two strategies for the formation of measurement data arrays and sensitivity matrices. An algorithm is developed for the flexible choice of optimal strategy in view of attaining better reconstruction quality. Variants on how to improve the method are proposed, specifically, through stepped extraction and further use of a posteriori information about the object. Conclusions: Even if measurement data are limited, the proposed method is capable of giving adequate reconstructions but their quality depends on available a priori (or a posteriori) information. Further research aims to improve the method by implementing the variants proposed.

Image reconstruction in non-reciprocal broken-ray tomography.

Optical methods of biomedical tomographic imaging are of considerable interest due to their non-invasive nature and sensitivity to physiologically important markers. Similarly to other imaging modalities, optical methods can be enhanced by utilizing extrinsic contrast agents. Typically, these are fluorescent molecules, which can aggregate in regions of interest due to various mechanisms. In the current approaches to imaging, the intrinsic (related to the tissue) and extrinsic (related to the contrast agent) optical parameters are determined separately. This can result in errors, in particular, due to using simplified heuristic models for the spectral dependence of the optical parameters. Recently, we have developed the theory of non-reciprocal broken-ray tomography (NRBRT) for fluorescence imaging of weakly scattering systems. NRBRT enables simultaneous reconstruction of the fluorophore concentration as well as of the intrinsic optical attenuation coefficient at both the excitation and the emission wavelengths. Importantly, no assumption about the spectral dependence of the tissue optical properties is made in NRBRT. In this study, we perform numerical validation of NRBRT under realistic conditions using the Monte Carlo method to generate forward data. We demonstrate that NRBRT can be used for tomographic imaging of samples of up to four scattering lengths in size. The effects of physical characteristics of the detectors such as the area and the acceptance angle are also investigated.

3D k-space reflectance fluorescence tomography via deep learning.

We report on the potential to perform image reconstruction in 3D k-space reflectance fluorescence tomography (FT) using deep learning (DL). Herein, we adopt a modified AUTOMAP architecture and develop a training methodology that leverages an open-source Monte-Carlo-based simulator to generate a large dataset. Using an enhanced EMNIST (EEMNIST) dataset as an embedded contrast function allows us to train the network efficiently. The optical strategy utilizes k-space illumination in a reflectance configuration to probe tissue in the mesoscopic regime with high sensitivity and resolution. The proposed DL model training and validation is performed with both in silico data and a phantom experiment. Overall, our results indicate that the approach can correctly reconstruct both single and multiple fluorescent embedding(s) in a 3D volume. Furthermore, the presented technique is shown to outperform the traditional approaches [least-squares (LSQ) and total-variation minimization (TVAL)], especially at higher depths. We, therefore, expect the proposed computational technique to have future implications in preclinical studies.

Detection of subclinical keratoconus using a novel combined tomographic and biomechanical model based on an automated decision tree.

Early detection of keratoconus is a crucial factor in monitoring its progression and making the decision to perform refractive surgery. The aim of this study was to use the decision tree technique in the classification and prediction of subclinical keratoconus (SKC). A total of 194 eyes (including 105 normal eyes and 89 with SKC) were included in the double-center retrospective study. Data were separately used for training and validation databases. The baseline variables were derived from tomography and biomechanical imaging. The decision tree models were generated using Chi-square automatic interaction detection (CHAID) and classification and regression tree (CART) algorithms based on the training database. The discriminating rules of the CART model selected metrics of the Belin/Ambrósio deviation (BAD-D), stiffness parameter at first applanation (SPA1), back eccentricity (Becc), and maximum pachymetric progression index in that order; On the other hand, the CHAID model selected BAD-D, deformation amplitude ratio, SPA1, and Becc. Further, the CART model allowed for discrimination between normal and SKC eyes with 92.2% accuracy, which was higher than that of the CHAID model (88.3%), BAD-D (82.0%), Corvis biomechanical index (CBI, 77.3%), and tomographic and biomechanical index (TBI, 78.1%). The discriminating performance of the CART model was validated with 92.4% accuracy, while the CHAID model was validated with 86.4% accuracy in the validation database. Thus, the CART model using tomography and biomechanical imaging was an excellent model for SKC screening and provided easy-to-understand discriminating rules.

The role of Monte Carlo simulation in understanding the performance of proton computed tomography.

Proton computed tomography (pCT) is a promising tomographic imaging modality allowing direct reconstruction of proton relative stopping power (RSP) required for proton therapy dose calculation. In this review article, we aim at highlighting the role of Monte Carlo (MC) simulation in pCT studies. After describing the requirements for performing proton computed tomography and the various pCT scanners actively used in recent research projects, we present an overview of available MC simulation platforms. The use of MC simulations in the scope of investigations of image reconstruction, and for the evaluation of optimal RSP accuracy, precision and spatial resolution omitting detector effects is then described. In the final sections of the review article, we present specific applications of realistic MC simulations of an existing pCT scanner prototype, which we describe in detail.

Multi-Channel Trans-Impedance Leadforming for Cardiopulmonary Monitoring: Algorithm Development and Feasibility Assessment Using In Vivo Animal Data.

OBJECTIVE: The objectives of this study were to develop a multi-channel trans-impedance leadforming method for beat-to-beat stroke volume (SV) and breath-by-breath tidal volume (TV) measurements and assess its feasibility on an existing in vivo animal dataset. METHODS: A deterministic leadforming algorithm was developed to extract a cardiac volume signal (CVS) and a respiratory volume signal (RVS) from 208-channel trans-impedance data acquired every 20 ms by an electrical impedance tomography (EIT) device. SVEIT and TVEIT values were computed as a valley-to-peak value in the CVS and RVS, respectively. The method was applied to the existing dataset from five mechanically-ventilated pigs undergoing ten mini-fluid challenges. An invasive hemodynamic monitor was used in the arterial pressure-based cardiac output (APCO) mode to simultaneously measure SVAPCO values while a mechanical ventilator provided TVVent values. RESULTS: The leadforming method could reliably extract the CVS and RVS from the 208-channel trans-impedance data measured with the EIT device, from which SVEIT and TVEIT were computed. The SVEIT and TVEIT values were comparable to those from the invasive hemodynamic monitor and mechanical ventilator. Using the data from 5 pigs and a simple calibration method to remove bias, the error in SVEIT and TVEIT was 9.5% and 5.4%, respectively. CONCLUSION: We developed a new leadforming method for the EIT device to robustly extract both SV and TV values in a deterministic fashion. Future animal and clinical studies are needed to validate this leadforming method in various subject populations. SIGNIFICANCE: The leadforming method could be an integral component for a new cardiopulmonary monitor in the future to simultaneously measure SV and TV noninvasively, which would be beneficial to patients.

Uso de tomógrafo por impedancia eléctrica en pacientes con COVID-19 / Use of electrical impedance tomograph in COVID-19 patients

CONTEXTO: En los pacientes con COVID-19, la neumonía parece ser la manifestación grave más frecuente de esta infección, caracterizada por fiebre, tos, disnea e infiltrados bilaterales en las imágenes de tórax. El síndrome de dificultad respiratoria aguda (SDRA) con hipoxemia aguda profunda puede manifestarse poco después del inicio de la disnea. Se caracteriza por hipoxemia potencialmente mortal causada por hiperpermeabilidad de los capilares pulmonares resultantes de diversas enfermedades de fondo o condiciones. Aunque la neumonía COVID-19 cumple con el SDRA (Definición de Berlín), se puede considerar una enfermedad específica con características peculiares.8 Diferentes tipos de neumonitis por COVID-19 requieren diferentes estrategias de ventilación. La tomografía computarizada (TC) torácica es el estándar de oro para imágenes pulmonares en el diagnóstico y seguimiento, pero es caro, conlleva riesgo de radiación y requiere transporte de pacientes infecciosos críticamente enfermos con todos los riesgos asociados. La ecografía pulmonar es una herramienta de diagnóstico de cabecera para la evaluación de la patología pulmonar y pleural, pero la especificidad y la sensibilidad en pacientes con COVID-19 aún no se ha determinado, así como un protocolo estandarizado para su uso. DESCRIPCIÓN DE LA TECNOLOGÍA: La tomografía de impedancia eléctrica (TIE) utiliza el principio físico de la impedancia para evaluar diferentes propiedades tisulares. Se trata de una herramienta de diagnóstico que utiliza las características eléctricas del tejido para dar información de manera no invasiva, continua, a pie de cama y sin radiación. TECNOLOGÍAS ALTERNATIVAS: La tomografía computarizada funciona a través de una computadora conectada a una máquina de rayos X a fin de crear una serie de imágenes detalladas del interior del cuerpo. Las imágenes se toman desde diferentes ángulos y se usan para crear vistas tridimensionales (3D) de los tejidos y órganos. A veces se inyecta un tinte en una vena o se ingiere de modo que estos tejidos y órganos se destaquen de forma más clara. Una tomografía computarizada se usa para diagnosticar una enfermedad, planificar un tratamiento o determinar si el tratamiento es eficaz. También se llama exploración por TAC, TC, tomografía axial computarizada y tomografía computadorizada. METODOLOGÍA: Un equipo multidisciplinario e independiente de conflictos de interés con los proveedores de esta tecnología, y de tecnologías alternativas realizó una evaluación de tecnología sanitaria enfocada en responder las preguntas clínicas arriba mencionadas. Estrategia de Búsqueda Se realizó una búsqueda bibliográfica en las principales bases de datos, en buscadores genéricos de internet, y financiadores de salud. Se dio prioridad a las Revisiones Sistemáticas (RS), Evaluaciones de Tecnologías sanitarias (ETS), Evaluaciones Económicas (EE), Guías de Práctica Clínica (GPC), Políticas de Cobertura (PC) de diferentes sistemas de salud, Ensayos Clínicos Aleatorizados (ECA) y Estudios Observacionales. El rango de búsqueda fue desde Enero de 2020 hasta agosto 2021 sin ninguna restricción de idioma. La identificación de los distintos estudios se realizó mediante una búsqueda de la literatura científica en las siguientes bases de datos: en MEDLINE (PubMed), TRIP database (TRIP: Turning Research Into Practice), The Cochrane Library, Epistemonikos, BRISA (Base Regional de Informes de Evaluación de Tecnologías en Salud de las Américas), LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), PROSPERO (International prospective register of systematic reviews), IECS (Instituto de Efectividad Clínica Sanitaria). También se completó la búsqueda de literatura gris en buscadores genéricos de Internet como Google. Se priorizó la inclusión de revisiones sistemáticas y metaanálisis, ensayos controlados aleatorizados, evaluaciones de tecnologías sanitarias e informes de seguridad. RESULTADOS: No se encontraron metaanálisis, revisiones sistemáticas, ensayos controlados aleatorizados o evaluaciones de tecnologías sanitarias. Se encontraron tres documentos con reportes de casos. En el estudio de Zhao et al (2021) , se analizó el uso de la TIE en todo el manejo clínico de la ventilación en un paciente con SDRA con COVID-19. Los autores mencionan que hubo resultados positivos en las estrategias personalizadas basadas en TIE para la titulación de PEEP, posicionamiento, niveles de soporte de destete y en el uso de cánula nasal de alto flujo (HFNC) después de la extubación. CONCLUSIÓN: Para pacientes con COVID-19 moderado-severo, solo se encontraron reportes de casos, que arrojaron resultados positivos. Es importante mencionar que el diseño de este tipo de estudios presenta: subjetividad personal (generación de sesgos de medición y reporte), no permiten comparaciones, representan experiencia limitada a un investigador y la presencia de un factor de riesgo puede ser solo azar. Por lo tanto, no representan evidencia sólida para alterar la práctica clínica14. Hasta el momento, no existe evidencia para recomendar la incorporación del Tomógrafo de Impedancia Eléctrica. Es necesario el desarrollo de Ensayos Controlados Aleatorizados en pacientes con COVID-19 moderado-severo, utilizando la tecnología analizada.

Synergistic tomographic image reconstruction: part 1.

This special issue focuses on synergistic tomographic image reconstruction in a range of contributions in multiple disciplines and various application areas. The topic of image reconstruction covers substantial inverse problems (Mathematics) which are tackled with various methods including statistical approaches (e.g. Bayesian methods, Monte Carlo) and computational approaches (e.g. machine learning, computational modelling, simulations). The issue is separated in two volumes. This volume focuses mainly on algorithms and methods. Some of the articles will demonstrate their utility on real-world challenges, either medical applications (e.g. cardiovascular diseases, proton therapy planning) or applications in material sciences (e.g. material decomposition and characterization). One of the desired outcomes of the special issue is to bring together different scientific communities which do not usually interact as they do not share the same platforms (such as journals and conferences). This article is part of the theme issue 'Synergistic tomographic image reconstruction: part 1'.

The Interday Repeatability of Parameters for the Assessment of Progressive Disease in Subjects With Less Advanced Keratoconus.

PURPOSE: To evaluate the interday repeatability in the measurement of parameters used for the detection of progression of keratoconus by prediction limits (PL) for single measurements, and the repeatability coefficient (RC) for the mean of replicate measurements. DESIGN: Prospective reliability analysis for cases and control eyes. METHODS: Twenty-five eyes in 25 subjects with KC and 25 eyes in 25 healthy controls were included. Four consecutive measurements were made, 3 days apart, with a Pentacam HR tomographic instrument (denoted the Pentacam) and a Nidek ARK 560-A auto-keratometer (denoted the keratometer). Main outcome measures were the intra- and interday RC of parameters used in the detection of progression of keratoconus. RESULTS: The most repeatable parameter obtained with the Pentacam was the curvature power of the central flat meridian (K1, 0.44 D [RC], -0.55 to 0.60 diopter [D] [PL]), followed by the central steep meridian (K2, 0.72 D [RC], -0.90 to 0.94 D [PL]). The interday repeatability of K1 and K2 was similar when using the keratometer (K1, 0.32 D [RC], -0.66 to 0.57 D [PL], K2, 0.93 D [RC], -1.36 to 1.08 D [PL]). The interday repeatability of the curvature power of the steepest point (Kmax, 0.84 D [RC], -0.90 to 1.11 D [PL]) would benefit from being stratified: RC = 0.44 D and PL = -0.49 to 0.67 D for Kmax < 49.0 D, and RC = 1.08 D and PL = -1.19 to 1.42 D for Kmax ≥ 49.0 D. CONCLUSIONS: The interday repeatability of measurements, single or replicate, in subjects with keratoconus should be considered when diagnosing progressive disease. K1 exhibited the best intraday repeatability. Kmax benefits from being stratified according to disease severity.

Full wave 3D inverse scattering transmission ultrasound tomography in the presence of high contrast.

We present here a quantitative ultrasound tomographic method yielding a sub-mm resolution, quantitative 3D representation of tissue characteristics in the presence of high contrast media. This result is a generalization of previous work where high impedance contrast was not present and may provide a clinically and laboratory relevant, relatively inexpensive, high resolution imaging method for imaging in the presence of bone. This allows tumor, muscle, tendon, ligament or cartilage disease monitoring for therapy and general laboratory or clinical settings. The method has proven useful in breast imaging and is generalized here to high-resolution quantitative imaging in the presence of bone. The laboratory data are acquired in ~ 12 min and the reconstruction in ~ 24 min-approximately 200 times faster than previously reported simulations in the literature. Such fast reconstructions with real data require careful calibration, adequate data redundancy from a 2D array of 2048 elements and a paraxial approximation. The imaging results show that tissue surrounding the high impedance region is artifact free and has correct speed of sound at sub-mm resolution.