Visualization of stent lumen in MR imaging: relationship with stent design and RF direction.

Magnetic resonance imaging (MRI) visualization of metallic stent lumens is possible if the stent structure counteracts eddy currents in the lumen induced by the radio frequency magnetic field, B(1). To examine the effectiveness of various stent designs in counteracting eddy currents, we anchored eight copper stent models and 2 commercially available nickel-titanium alloy (Nitinol) stents in a gel phantom, perpendicular or parallel to the direction of B(1). A mesh stent lumen showed hypointensity irrespective of its alignment relative to B(1). A solenoid stent lumen showed hypointensity with the stent axis parallel to B(1), but it had the same signal intensity as outside the lumen when perpendicular to B(1). A Moebius stent lumen showed no signal reduction, irrespective of alignment relative to B(1). Lumens of the commercially available stents showed hypointensity regardless of alignment relative to B(1). Computer simulation revealed that the signal intensities of the stents corresponded to magnetic flux densities of B(1) in the stents, which are modified by the structure of the stent. While in vivo MRI viewing of a Moebius stent lumen is likely possible regardless of axis alignment, inherent structural weakness may be problematic. As a more practical choice, the solenoid stent is easier to manufacture and generates no hypointensive signal when the axis is parallel to B(0).

Comparison of daily prostate positions during conformal radiation therapy of prostate cancer using an integrated CT-linear accelerator system: in-room CT image versus digitally reconstructed radiograph.

PURPOSE: The purpose of this study is to quantify the magnitudes of the position shifts of internal structures together with the correlation between the day-to-day positioning of the prostate and the bony anatomy using an integrated CT-linear accelerator system for external beam radiation therapy for prostate cancer. MATERIALS AND METHODS: A total of 1176 pretreatment in-room CT images and their digitally reconstructed radio-graph (DRR) pairs from 33 patients were acquired over the course of the study. The differences between the isocenter of the prostate on in-room CT and the isocenter of the bony anatomy on DRR were analyzed. The agreement between positions in each direction was compared using Bland-Altman limits of agreement. RESULTS: The 95% limits of agreement in lateral (LR), superoinferior (SI), and anteroposterior (AP) directions were -2.98 to 2.49 mm, -4.69 to 5.75 mm, and -8.23 to 7.30 mm, respectively. The isocenter was localized to within 3.0 mm on in-room CT images and DRR 99.0% in LR, 85.1% in SI, and 85.9% in AP. CONCLUSIONS: Considerable differences between in-room CT images and DRR exist. These data demonstrate that there is a significantly greater shift in the SI and AP directions than in the lateral direction for the entire patient group. Applications such as our image guide system will, with routine clinical use, continue to improve the precision of external beam radiation therapy for prostate cancer.

Infant hip joint diagnostic support system based on clinical manifestations in X-ray images.

Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH). The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images:the outward displacement rate, upward displacement rate, OE angle, and alpha angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

A new phantom using polyethylene glycol as an apparent diffusion coefficient standard for MR imaging.

In recent years, magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) has seen wide clinical use, such as for early detection of cerebrovascular diseases and whole body screening for tumors. The apparent diffusion coefficient (ADC) standard phantom, which mimics the ADC values of several lesions in the body, is indispensable for the development of new pulse sequences for DWI, such as diffusion-weighted whole-body imaging with background body-signal suppression (DWIBS). However, information on the ADC values of the previously reported ADC standard phantoms is limited, because these phantoms were made using only a few different materials at a limited range of concentrations, and the ADC values were measured only at certain temperatures. It has been considered difficult, if not impossible, to create a phantom that provides arbitrary ADC values, because it is difficult to calculate the concentrations of the materials and the temperature at ADC measurement. In this study, we used polyethylene glycol (PEG) as a phantom material, and developed an empirical formula to calculate the PEG concentration at any measurement temperature to obtain arbitrary ADC values of the phantom. DWI images of phantoms made using seven different PEG concentrations were taken under heating from 17 to 46 degrees C at 1 degrees C intervals. Using ADC values calculated from these DWI images, we developed two empirical formulas: i) an empirical formula to calculate the ADC values of phantoms made using any PEG concentration at any measurement temperature; and ii) an empirical formula to calculate PEG concentrations to obtain arbitrary ADC values at any measurement temperature. We inspected the accuracy of these empirical formulas by newly made PEG phantoms. A comparison between the ADC values calculated with the empirical formulas and the measured ADC values confirmed the high accuracy of these formulas. PEG phantoms are safe, inexpensive and easy to make, compared with the previously reported ADC standard phantoms. Our empirical formulas enable us to calculate PEG concentrations that provide arbitrary ADC values at any measurement temperature. The empirical formulas could be used within a range of ADC values from 0.37x10(-3) to 3.67x10(-3) mm(2)/s, PEG concentrations from 0 to 120 mM, and measurement temperatures from 18 to 45 degrees C. Using these formulas, it would be possible to make standard phantoms that mimic the ADC values of any clinical lesions. The PEG phantom might thus be an excellent new ADC standard phantom for MRI with DWI.

In vitro experimental study of the relationship between the apparent diffusion coefficient and changes in cellularity and cell morphology.

Diffusion-weighted magnetic resonance imaging (MRI) is frequently used clinically, and is available for the whole-body screening for tumors. The exact mechanism by which the apparent diffusion coefficient (ADC) value decreases in tumorous tissue remains unclear, although various theories have been proposed, including intracellular and extracellular factor theories. It is impossible to distinguish each factor in the intracellular and extracellular spaces as the source of MR signal generation by means of conventional comparison between MR images and pathological specimens. Other factors which have been reported to affect ADC include cellularity and cellular edema of human tissues, and temperature of phantoms at the time of measurement. We employed a new technique that enables cellular MR imaging using a newly developed bio-phantom containing a living culture tumor cell line, Jurkat-N1. We investigated possible reasons for observed decreases in ADC values for tumors, and we considered the contribution of both the intracellular and extracellular space to such a decrease. The ADC values of the bio-phantom increased with increasing heat exposure from 27 to 45 degrees C. ADC values also increased after the destruction by sonication of tumor cell membranes. ADC values decreased as cellularity increased in the bio-phantom. ADC values decreased due to cellular edema caused by a low salt concentration in the bio-phantom. Changes in pressure in the bio-phantom had no effect on the observed ADC values. We calculated both the intracellular ADC and extracellular ADC values using the ADC values, cellularity, and cellular volume of Jurkat-N1 cells in the bio-phantom. The extracellular ADC values in the bio-phantom were estimated to be lower than the ADC value of distilled water. These results indicate that not only intracellular ADC values, but also extracellular ADC values contribute to the determination of the ADC values of bio-phantoms. This is the first report to have examined the contribution of intracellular and extracellular space on the ADC values of bio-phantoms containing cultured tumor cells.

[Accuracy of measurement of radiochromic film density for high-energy X-rays].

Radiochromic film (RC-film) is of great interest as a film-type dosimeter for radiation oncology applications. We present a two-dimensional image-based evaluation of the measurement accuracy of a commercial RC-film product (Gafchromic MD-55-2 film, ISP TECHNOLOGIES, Inc.) by using a commercial Laser Densitometer (Model 1710, Computerized Medical Systems, Inc.) as an optical density imaging system. The coefficient of variation of the density (pixel-value) in one sample was approximately 3% to 11% at 3 Gy or less, and 3% or less at 4 to 60 Gy. Although the coefficient of variation between three samples at the same dose was about 14% at 1 Gy, it decreased as the dose increased, reaching several percent. In 1 to 6 Gy samples, geometric imaging artifacts [interference (moire) patterns] were observed, and it was found that scan-sampling pitch influenced the accuracy of measurement of the density of the sample. To improve the accuracy of density measurement, sufficient knowledge about characteristic features of the density measuring system is essential.