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1.
IEEE Trans Med Imaging ; 41(4): 895-902, 2022 04.
Article in English | MEDLINE | ID: mdl-34748485

ABSTRACT

Dark-field radiography of the human chest is a promising novel imaging technique with the potential of becoming a valuable tool for the early diagnosis of chronic obstructive pulmonary disease and other diseases of the lung. The large field-of-view needed for clinical purposes could recently be achieved by a scanning system. While this approach overcomes the limited availability of large area grating structures, it also results in a prolonged image acquisition time, leading to concomitant motion artifacts caused by intrathoracic movements (e.g. the heartbeat). Here we report on a motion artifact reduction algorithm for a dark-field X-ray scanning system, and its successful evaluation in a simulated chest phantom and human in vivo chest X-ray dark-field data. By partitioning the acquired data into virtual scans with shortened acquisition time, such motion artifacts may be reduced or even fully avoided. Our results demonstrate that motion artifacts (e.g. induced by cardiac motion or diaphragmatic movements) can effectively be reduced, thus significantly improving the image quality of dark-field chest radiographs.


Subject(s)
Algorithms , Artifacts , Humans , Motion , Phantoms, Imaging , Radiography
2.
PET Clin ; 16(4): 483-492, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34353746

ABSTRACT

Artificial intelligence (AI) has significant potential to positively impact and advance medical imaging, including positron emission tomography (PET) imaging applications. AI has the ability to enhance and optimize all aspects of the PET imaging chain from patient scheduling, patient setup, protocoling, data acquisition, detector signal processing, reconstruction, image processing, and interpretation. AI poses industry-specific challenges which will need to be addressed and overcome to maximize the future potentials of AI in PET. This article provides an overview of these industry-specific challenges for the development, standardization, commercialization, and clinical adoption of AI and explores the potential enhancements to PET imaging brought on by AI in the near future. In particular, the combination of on-demand image reconstruction, AI, and custom-designed data-processing workflows may open new possibilities for innovation which would positively impact the industry and ultimately patients.


Subject(s)
Artificial Intelligence , Positron-Emission Tomography , Humans , Image Processing, Computer-Assisted , Radiography
3.
Eur Radiol ; 30(3): 1823, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31897597

ABSTRACT

The article Towards clinical grating-interferometry mammography, written by Carolina Arboleda, Zhentian Wang, Konstantins Jefimovs, Thomas Koehler, Udo Van Stevendaal, Norbert Kuhn, Bernd David, Sven Prevrhal, Kristina Lång, Serafino Forte, Rahel Antonia Kubik-Huch, Cornelia Leo.

4.
Eur Radiol ; 30(3): 1419-1425, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31440834

ABSTRACT

OBJECTIVES: Grating-interferometry-based mammography (GIM) might facilitate breast cancer detection, as several research works have demonstrated in a pre-clinical setting, since it is able to provide attenuation, differential phase contrast, and scattering images simultaneously. In order to translate this technique to the clinics, it has to be adapted to cover a large field-of-view within a clinically acceptable exposure time and radiation dose. METHODS: We set up a grating interferometer that fits into a standard mammography system and fulfilled the aforementioned conditions. Here, we present the first mastectomy images acquired with this experimental device. RESULTS AND CONCLUSION: Our system performs at a mean glandular dose of 1.6 mGy for a 5-cm-thick, 18%-dense breast, and a field-of-view of 26 × 21 cm2. It seems to be well-suited as basis for a clinical-environment device. Further, dark-field signals seem to support an improved lesion visualization. Evidently, the effective impact of such indications must be evaluated and quantified within the context of a proper reader study. KEY POINTS: • Grating-interferometry-based mammography (GIM) might facilitate breast cancer detection, since it is sensitive to refraction and scattering and thus provides additional tissue information. • The most straightforward way to do grating-interferometry in the clinics is to modify a standard mammography device. • In a first approximation, the doses given with this technique seem to be similar to those of conventional mammography.


Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma, Ductal, Breast/diagnostic imaging , Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging , Mammography/methods , Neoplasms, Multiple Primary/diagnostic imaging , Breast Density , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/surgery , Carcinoma, Intraductal, Noninfiltrating/pathology , Carcinoma, Intraductal, Noninfiltrating/surgery , Female , Humans , Interferometry/methods , Mastectomy , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgery , Radiation Dosage , Tumor Burden
5.
Eur Radiol Exp ; 3(1): 19, 2019 05 21.
Article in English | MEDLINE | ID: mdl-31115796

ABSTRACT

Grating interferometry mammography (GIM) is an experimental breast imaging method at the edge of being clinically implemented. Besides attenuation, GIM can measure the refraction and scattering of x-rays resulting in differential phase contrast (DPC) and dark-field (DF) images. In this exploratory study, we assessed the feasibility of using microbubbles as a contrast agent in GIM. Two millilitres of microbubbles and iodine were respectively injected into ex vivo breast phantoms, consisting of fresh chicken breasts. Native and postcontrast images were acquired with a clinically compatible GIM setup, operated at 38 kVp, 14-s acquisition time, and with a dose of 1.3 mGy. The visibility of the contrast agents was analysed in a side-by-side comparison by three radiologists. The contrast-to-noise-ratio (CNR) was calculated for each contrast agent. We found that both contrast agents were judged to be visible by the readers. The mean CNR was 3.1 ± 1.9 for microbubbles in DF and 24.2 ± 6.5 for iodine in attenuation. In conclusion, this is a first proof-of-mechanism study that microbubbles could be used as a contrast agent in clinically compatible GIM, due to their scattering properties, which implies the potential use of a contrast agent with a high safety profile in x-ray-based breast imaging.


Subject(s)
Contrast Media , Interferometry , Mammography/methods , Microbubbles , Animals , Chickens , Feasibility Studies , Iodine
6.
Med Phys ; 44(3): 1040-1049, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28112409

ABSTRACT

PURPOSE: The goal of this study was to assess the potential added benefit of accounting for partial volume effects (PVE) in an automatic coronary lumen segmentation algorithm that is used to determine the hemodynamic significance of a coronary artery stenosis from coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: Two sets of data were used in our work: (a) multivendor CCTA datasets of 18 subjects from the MICCAI 2012 challenge with automatically generated centerlines and 3 reference segmentations of 78 coronary segments and (b) additional CCTA datasets of 97 subjects with 132 coronary lesions that had invasive reference standard FFR measurements. We extracted the coronary artery centerlines for the 97 datasets by an automated software program followed by manual correction if required. An automatic machine-learning-based algorithm segmented the coronary tree with and without accounting for the PVE. We obtained CCTA-based FFR measurements using a flow simulation in the coronary trees that were generated by the automatic algorithm with and without accounting for PVE. We assessed the potential added value of PVE integration as a part of the automatic coronary lumen segmentation algorithm by means of segmentation accuracy using the MICCAI 2012 challenge framework and by means of flow simulation overall accuracy, sensitivity, specificity, negative and positive predictive values, and the receiver operated characteristic (ROC) area under the curve. We also evaluated the potential benefit of accounting for PVE in automatic segmentation for flow simulation for lesions that were diagnosed as obstructive based on CCTA which could have indicated a need for an invasive exam and revascularization. RESULTS: Our segmentation algorithm improves the maximal surface distance error by ~39% compared to previously published method on the 18 datasets from the MICCAI 2012 challenge with comparable Dice and mean surface distance. Results with and without accounting for PVE were comparable. In contrast, integrating PVE analysis into an automatic coronary lumen segmentation algorithm improved the flow simulation specificity from 0.6 to 0.68 with the same sensitivity of 0.83. Also, accounting for PVE improved the area under the ROC curve for detecting hemodynamically significant CAD from 0.76 to 0.8 compared to automatic segmentation without PVE analysis with invasive FFR threshold of 0.8 as the reference standard. Accounting for PVE in flow simulation to support the detection of hemodynamic significant disease in CCTA-based obstructive lesions improved specificity from 0.51 to 0.73 with same sensitivity of 0.83 and the area under the curve from 0.69 to 0.79. The improvement in the AUC was statistically significant (N = 76, Delong's test, P = 0.012). CONCLUSION: Accounting for the partial volume effects in automatic coronary lumen segmentation algorithms has the potential to improve the accuracy of CCTA-based hemodynamic assessment of coronary artery lesions.


Subject(s)
Computed Tomography Angiography/methods , Coronary Angiography/methods , Coronary Stenosis/diagnostic imaging , Hemodynamics , Machine Learning , Pattern Recognition, Automated , Area Under Curve , Coronary Stenosis/physiopathology , Coronary Vessels/diagnostic imaging , Coronary Vessels/physiopathology , Datasets as Topic , Humans , Imaging, Three-Dimensional/methods , Models, Cardiovascular , ROC Curve , Retrospective Studies , Software
7.
Phys Med Biol ; 60(5): 1919-44, 2015 Mar 07.
Article in English | MEDLINE | ID: mdl-25668558

ABSTRACT

The origin ensemble (OE) algorithm is a novel statistical method for minimum-mean-square-error (MMSE) reconstruction of emission tomography data. This method allows one to perform reconstruction entirely in the image domain, i.e. without the use of forward and backprojection operations. We have investigated the OE algorithm in the context of list-mode (LM) time-of-flight (TOF) PET reconstruction. In this paper, we provide a general introduction to MMSE reconstruction, and a statistically rigorous derivation of the OE algorithm. We show how to efficiently incorporate TOF information into the reconstruction process, and how to correct for random coincidences and scattered events. To examine the feasibility of LM-TOF MMSE reconstruction with the OE algorithm, we applied MMSE-OE and standard maximum-likelihood expectation-maximization (ML-EM) reconstruction to LM-TOF phantom data with a count number typically registered in clinical PET examinations. We analyzed the convergence behavior of the OE algorithm, and compared reconstruction time and image quality to that of the EM algorithm. In summary, during the reconstruction process, MMSE-OE contrast recovery (CRV) remained approximately the same, while background variability (BV) gradually decreased with an increasing number of OE iterations. The final MMSE-OE images exhibited lower BV and a slightly lower CRV than the corresponding ML-EM images. The reconstruction time of the OE algorithm was approximately 1.3 times longer. At the same time, the OE algorithm can inherently provide a comprehensive statistical characterization of the acquired data. This characterization can be utilized for further data processing, e.g. in kinetic analysis and image registration, making the OE algorithm a promising approach in a variety of applications.


Subject(s)
Algorithms , Image Processing, Computer-Assisted/methods , Phantoms, Imaging , Positron-Emission Tomography/methods , Abdomen/diagnostic imaging , Feasibility Studies , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Kinetics , Radiopharmaceuticals/pharmacokinetics , Tissue Distribution
8.
J Nucl Med ; 55(10): 1643-9, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25168626

ABSTRACT

UNLABELLED: Fusion of information from PET and MR imaging can increase the diagnostic value of both modalities. This work sought to improve (18)F FDG PET image quality by using MR Dixon fat-constrained images to constrain PET image reconstruction to low-fat regions, with the working hypothesis that fatty tissue metabolism is low in glucose consumption. METHODS: A novel constrained PET reconstruction algorithm was implemented via a modification of the system matrix in list-mode time-of-flight ordered-subsets expectation maximization reconstruction, similar to the way time-of-flight weighting is incorporated. To demonstrate its use in PET/MR imaging, we modeled a constraint based on fat/water-separating Dixon MR images that shift activity away from regions of fat tissue during PET image reconstruction. PET and MR imaging scans of a modified National Electrical Manufacturers Association/International Electrotechnical Commission body phantom simulating body fat/water composition and in vivo experiments on 2 oncology patients were performed on a commercial time-of-flight PET/MR imaging system. RESULTS: Fat-constrained PET reconstruction visibly and quantitatively increased resolution and contrast between high-uptake and fatty-tissue regions without significantly affecting the images in nonfat regions. CONCLUSION: The incorporation of MR tissue information, such as fat, in image reconstruction can improve the quality of PET images. The combination of a variety of potential other MR tissue characteristics with PET represents a further justification for merging MR data with PET data in hybrid systems.


Subject(s)
Fluorodeoxyglucose F18 , Magnetic Resonance Imaging/methods , Positron-Emission Tomography/methods , Adipose Tissue/chemistry , Adipose Tissue/pathology , Adolescent , Adult , Algorithms , Female , Glucose/metabolism , Humans , Image Processing, Computer-Assisted/methods , Models, Statistical , Multimodal Imaging/methods , Phantoms, Imaging , Radiopharmaceuticals , Whole Body Imaging
9.
Ann Nucl Med ; 28(6): 540-50, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24710757

ABSTRACT

BACKGROUND: To determine if metal artefact reduction (MAR) combined with a priori knowledge of prosthesis material composition can be applied to obtain CT-based attenuation maps with sufficient accuracy for quantitative assessment of (18)F-fluorodeoxyglucose uptake in lesions near metallic prostheses. METHODS: A custom hip prosthesis phantom with a lesion-sized cavity filled with 0.2 ml (18)F-FDG solution having an activity of 3.367 MBq adjacent to a prosthesis bore was imaged twice with a chrome-cobalt steel hip prosthesis and a plastic replica, respectively. Scanning was performed on a clinical hybrid PET/CT system equipped with an additional external (137)Cs transmission source. PET emission images were reconstructed from both phantom configurations with CT-based attenuation correction (CTAC) and with CT-based attenuation correction using MAR (MARCTAC). To compare results with the attenuation-correction method extant prior to the advent of PET/CT, we also carried out attenuation correction with (137)Cs transmission-based attenuation correction (TXAC). CTAC and MARCTAC images were scaled to attenuation coefficients at 511 keV using a trilinear function that mapped the highest CT values to the prosthesis alloy attenuation coefficient. Accuracy and spatial distribution of the lesion activity was compared between the three reconstruction schemes. RESULTS: Compared to the reference activity of 3.37 MBq, the estimated activity quantified from the PET image corrected by TXAC was 3.41 MBq. The activity estimated from PET images corrected by MARCTAC was similar in accuracy at 3.32 MBq. CTAC corrected PET images resulted in nearly 40 % overestimation of lesion activity at 4.70 MBq. Comparison of PET images obtained with the plastic and metal prostheses in place showed that CTAC resulted in a marked distortion of the (18)F-FDG distribution within the lesion, whereas application of MARCTAC and TXAC resulted in lesion distributions similar to those observed with the plastic replica. CONCLUSIONS: MAR combined with a trilinear CT number mapping for PET attenuation correction resulted in estimates of lesion activity comparable in accuracy to that obtained with (137)Cs transmission-based attenuation correction, and far superior to estimates made without attenuation correction or with a standard CT attenuation map. The ability to use CT images for attenuation correction is a potentially important development because it obviates the need for a (137)Cs transmission source, which entails extra scan time, logistical complexity and expense.


Subject(s)
Artifacts , Hip Prosthesis , Metals , Positron-Emission Tomography/methods , Tomography, X-Ray Computed/methods , Cesium Radioisotopes , Cobalt , Fluorodeoxyglucose F18 , Phantoms, Imaging , Plastics
10.
Med Phys ; 38(12): 6775-86, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22149859

ABSTRACT

PURPOSE: List-mode processing is an efficient way of dealing with the sparse nature of positron emission tomography (PET) data sets and is the processing method of choice for time-of-flight (ToF) PET image reconstruction. However, the massive amount of computation involved in forward projection and backprojection limits the application of list-mode reconstruction in practice, and makes it challenging to incorporate accurate system modeling. METHODS: The authors present a novel formulation for computing line projection operations on graphics processing units (GPUs) using the compute unified device architecture (CUDA) framework, and apply the formulation to list-mode ordered-subsets expectation maximization (OSEM) image reconstruction. Our method overcomes well-known GPU challenges such as divergence of compute threads, limited bandwidth of global memory, and limited size of shared memory, while exploiting GPU capabilities such as fast access to shared memory and efficient linear interpolation of texture memory. Execution time comparison and image quality analysis of the GPU-CUDA method and the central processing unit (CPU) method are performed on several data sets acquired on a preclinical scanner and a clinical ToF scanner. RESULTS: When applied to line projection operations for non-ToF list-mode PET, this new GPU-CUDA method is >200 times faster than a single-threaded reference CPU implementation. For ToF reconstruction, we exploit a ToF-specific optimization to improve the efficiency of our parallel processing method, resulting in GPU reconstruction >300 times faster than the CPU counterpart. For a typical whole-body scan with 75 × 75 × 26 image matrix, 40.7 million LORs, 33 subsets, and 3 iterations, the overall processing time is 7.7 s for GPU and 42 min for a single-threaded CPU. Image quality and accuracy are preserved for multiple imaging configurations and reconstruction parameters, with normalized root mean squared (RMS) deviation less than 1% between CPU and GPU-generated images for all cases. CONCLUSIONS: A list-mode ToF OSEM library was developed on the GPU-CUDA platform. Our studies show that the GPU reformulation is considerably faster than a single-threaded reference CPU method especially for ToF processing, while producing virtually identical images. This new method can be easily adapted to enable more advanced algorithms for high resolution PET reconstruction based on additional information such as depth of interaction (DoI), photon energy, and point spread functions (PSFs).


Subject(s)
Algorithms , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Positron-Emission Tomography/methods , Reproducibility of Results , Sensitivity and Specificity
11.
Radiology ; 261(3): 923-9, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21969665

ABSTRACT

PURPOSE: To determine whether flow velocity can be measured by using projection data from computed tomographic (CT) scans obtained during contrast material injection in a phantom model. MATERIALS AND METHODS: The authors constructed a 12.7-mm-diameter single-channel flow phantom with constant water flow velocity settings of 25.3, 43.9, and 70.5 cm/sec. For each flow velocity, serial axial scans were obtained with 16-section multidetector CT while a 10-mL bolus of contrast material was injected upstream of the imaging plane. For each bolus injection, the CT projection data from the scan with the sharpest increase in magnitude of detected contrast material was used for flow velocity measurements. Flow velocity was calculated as the ratio of distance between CT detector rows and the corresponding time lag in the contrast enhancement curves and was correlated with the reference velocities. Five separate contrast material injections and CT measurements were made for each flow velocity setting. RESULTS: The correlation coefficient between the CT measurements of flow velocity and the reference measurements was 0.98 (P < .05). The mean CT measurements of flow velocity were 34.2, 53.9, and 80.8 cm/sec for slow, moderate, and fast velocity settings, respectively, overestimating the corresponding actual flow velocities by 26%, 18%, and 13% and showing precision values (coefficients of variation) of 5.2%, 3.7%, and 6.6%. CONCLUSION: Flow velocity can be measured from row-to-row multidetector CT projectional data obtained during a single gantry revolution as a bolus of contrast material flows through a vascular phantom. With further development, this novel technique could potentially provide physiologic information to complement the anatomic CT angiographic findings of vascular disease.


Subject(s)
Angiography/methods , Blood Flow Velocity , Contrast Media/pharmacokinetics , Iohexol/pharmacokinetics , Radiography, Dual-Energy Scanned Projection/methods , Tomography, X-Ray Computed/methods , Contrast Media/administration & dosage , Humans , Iohexol/administration & dosage , Phantoms, Imaging
12.
AJR Am J Roentgenol ; 193(1): 47-54, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19542394

ABSTRACT

OBJECTIVE: The purpose of this article is to discuss the influence of tube potential on CT images and explore the potential impact of dual-energy CT on imaging of the abdomen and pelvis. CONCLUSION: Low peak tube voltage (kVp) settings provide high conspicuity of contrast materials at CT but may result in high image noise, particularly in larger patients. Material decomposition at dual-energy CT can differentiate renal stones by their composition, quantify tissue iron stores, improve the detection of pathologic hyperenhancement, and reduce contrast material and radiation dose compared with conventional CT. Further clinical research and technique refinement will be needed as the usage of these exciting technologies spreads.


Subject(s)
Radiographic Image Enhancement/methods , Radiography, Abdominal/methods , Radiography, Dual-Energy Scanned Projection/methods , Tomography, X-Ray Computed/methods , Humans
13.
Curr Med Res Opin ; 25(4): 921-8, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19250060

ABSTRACT

OBJECTIVE: Most registration studies for new osteoporosis drugs have used a combination of quantitative morphometry (QM) and visual semiquantitative reading (SQ) to define vertebral fractures. However, in the pivotal teriparatide Fracture Prevention Trial (ClinicalTrials.gov Identifier: NCT00670501), vertebral fractures were previously defined only by the SQ methodology. The objective of this study was to define the effect of teriparatide on the incidence of vertebral fractures defined by QM plus SQ assessment. RESEARCH DESIGN AND METHODS: Radiographs from the Fracture Prevention Trial placebo- and teriparatide 20 microg/day groups were re-assessed in blinded fashion, defining incident vertebral fractures for vertebrae meeting all of the following requirements: (a) 20% decrease in height by QM, (b) a corresponding 4 mm decrease in height (c) an increase of at least one grade by visual SQ assessment by a radiologist. RESULTS: By this methodology, vertebral fracture risk was reduced in the teriparatide versus placebo group by 84% (RR = 0.16, p < 0.001). The risk of two or more vertebral fractures was also significantly reduced by 94% (RR = 0.06, p < 0.001). The fractures in the teriparatide group were of lesser severity than the fractures in the placebo group. The absolute benefit of teriparatide was greatest in those patients with the highest number and severity of prevalent vertebral fractures. CONCLUSIONS: As assessed by QM plus SQ, teriparatide reduced the incidence of vertebral fractures.


Subject(s)
Spinal Fractures/prevention & control , Spine/diagnostic imaging , Teriparatide/therapeutic use , Aged , Bone Density Conservation Agents/therapeutic use , Dose-Response Relationship, Drug , Double-Blind Method , Humans , Middle Aged , Osteoporosis/drug therapy , Osteoporosis/physiopathology , Placebos , Postmenopause , Radiography , Risk , Risk Reduction Behavior , Severity of Illness Index , Spinal Fractures/economics , Spinal Fractures/epidemiology
14.
J Orthop Trauma ; 22(8 Suppl): S83-90, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18753895

ABSTRACT

Fractures of the distal radius are one of the most common injuries presented to orthopaedic surgeons. A variety of treatment options are available for the vast array of fracture patterns. Research that explores bone fragility and fracture healing has led to new treatment modalities. As new products and methods are derived to aid in fracture healing it is essential to develop noninvasive and/or nondestructive techniques to assess structural information about bone. Quantitative assessment of macro-structural characteristics such as geometry, and microstructural features such as relative trabecular volume, trabecular spacing, and connectivity may improve our ability to estimate bone strength. Methods for quantitatively assessing macrostructure include (besides conventional radiographs) dual x-ray absorptiometry (DXA) and computed tomography (CT), particularly volumetric quantitative computed tomography (vQCT). Methods for assessing microstructure of trabecular bone include high resolution computed tomography (hrCT), micro computed tomography (microCT), high resolution magnetic resonance (hrMR), and micro magnetic resonance microMR. Volumetric QCT, hrCT and hrMR are generally applicable in vivo; microCT and microMR are principally applicable in vitro. Clinically, the challenges for bone imaging include balancing the advantages of simple bone densitometry versus the more complex architectural features of bone, or the deeper research requirements versus the broader clinical needs.


Subject(s)
Densitometry/methods , Diagnostic Imaging/methods , Fracture Healing , Fractures, Bone/diagnosis , Osteoporosis/diagnosis , Wrist Injuries/diagnosis , Fractures, Spontaneous/diagnosis , Humans , Image Interpretation, Computer-Assisted/methods
15.
J Comput Assist Tomogr ; 32(4): 621-9, 2008.
Article in English | MEDLINE | ID: mdl-18664852

ABSTRACT

Computed tomographic imaging of tissue surrounding metallic implants is often limited by metal artifacts. This paper compares 3 existing metal artifact reduction techniques that are based on segmentation of metal-affected regions in native images, followed by reprojection of segmented areas into original Radon space, removal of metal trace(s), and renewed reconstruction: Detector row-wise linear interpolation, 2-dimensional interpolation, and combination of row-wise linear interpolation and adaptive filtering. For each method, improvements of CT number accuracy and signal-noise as well as contrast-noise ratios near the prosthesis and in the image periphery over the values found for native images were evaluated in a phantom experiment simulating osteolytic bone lesions of different size and density around a Chrome-Cobalt hip prosthesis stem. Improvement in diagnostic usability was evaluated as lesion detectability by size. Quantitative and qualitative results showed that the linear interpolation and the combination method removed the artifacts most effectively. The mean accuracy error over different regions of interest placed in the direct vicinity of the metal and in the periphery of the object decreased 10-fold with linear interpolation. These methods increased contrast-noise ratio up to 68% of that measured on artifact-free images for the least dense lesion. Qualitatively, the linear interpolation and the combination method improved the lesion detectability and enabled differentiation of different lesion densities. However, in proximity to the stem, some artifacts remained for all methods. We conclude that published algorithms for metal artifact reduction substantially improve image quality for CT imaging of a metallic object and may be adequate for quantitative measurements except for the direct vicinity of the metallic object.


Subject(s)
Artifacts , Hip Prosthesis , Image Enhancement/methods , Image Processing, Computer-Assisted/methods , Metals , Phantoms, Imaging , Tomography, X-Ray Computed/methods , Algorithms , Reproducibility of Results
16.
Radiology ; 248(3): 910-6, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18632527

ABSTRACT

PURPOSE: To determine the effect of the number of detectors and peak tube voltage on renal cyst pseudoenhancement in a phantom model. MATERIALS AND METHODS: This study on computed tomographic (CT) phantoms did not require institutional review board approval. The renal compartments of a CT phantom were filled with iodinated contrast material diluted to attain attenuations of 40, 140, and 240 HU. Saline-filled cylinders simulating cysts of varying diameters (range, 0.7-3.0 cm) were serially suspended in the renal compartments and scanned at 80, 90, 100, 120, and 140 kVp in 16-detector (n = 3) and 64-detector (n = 2) CT scanners. Generalized estimating equations were used to determine predictors of cyst pseudoenhancement (defined as a >10 HU increase in cyst attenuation when the background renal attenuation increased from 40 to 140 or 240 HU). RESULTS: Pseudoenhancement was seen with higher frequency (59 [61%] of 96 cysts vs 52 [39%] of 132 cysts, P < .05) and magnitude (17 vs 13 HU, P < .005) with 64- rather than with 16-detector scanners. Pseudoenhancement was also seen with higher frequency (25 [42%] of 60 cysts vs 11 [18%] of 60 cysts, P < .005) and magnitude (18 vs 13 HU, P < .05) at 140 kVp than at 80 or 90 kVp. Cyst pseudoenhancement increased with higher background renal enhancement (P < .005) and smaller cyst diameter (P < .05). The number of detectors, peak tube voltage, renal parenchymal enhancement level, and cyst diameter were independent predictors of cyst pseudoenhancement. CONCLUSION: Lower tube voltage settings may be useful when accurate differentiation between small renal cysts and solid masses is critical, particularly for 64-detector CT scanners.


Subject(s)
Kidney Diseases, Cystic/diagnostic imaging , Kidney/diagnostic imaging , Radiographic Image Enhancement/instrumentation , Radiographic Image Enhancement/methods , Tomography, X-Ray Computed/instrumentation , Tomography, X-Ray Computed/methods , Humans , Phantoms, Imaging , Reproducibility of Results , Sensitivity and Specificity
17.
J Arthroplasty ; 23(6): 833-8, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18534519

ABSTRACT

There are currently no ideal quantitative measures assessing osteolysis after total joint arthroplasty. This study reports a new approach for quantification of osteolytic lesions on radiographs of total hip arthroplasty with the hypothesis that computer-assisted lesion quantification improves analysis precision over currently used qualitative visual assessment and thus improves progression monitoring. Duplicate exposure sets of anterior-posterior and frog-leg view radiographs of 15 volunteer total hip arthroplasty patients with radiographically evident periprosthetic lucencies were used. Two independent readers delineated the lesions using on-screen digital marker tools. Based on duplicate readings of the first exposure set only, intraoperator precision had a coefficient of variation (CV) from 1.5% to 3.4%, whereas interoperator precision CV ranged from 3.2% to 4.6%. The reproducibility of the x-ray technique as assessed by single readings of both sets of x-rays was CV 3.2% to 4.8%. The new technique compares favorably to precision of qualitative visual assessment and permits more accurate detection and quantitation of osteolytic lesions.


Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Femur/diagnostic imaging , Femur/pathology , Image Processing, Computer-Assisted/methods , Osteolysis/diagnostic imaging , Osteolysis/etiology , Adult , Aged , Aged, 80 and over , Diagnosis, Computer-Assisted/methods , Disease Progression , Female , Humans , Male , Middle Aged , Observer Variation , Radiography , Reproducibility of Results
18.
J Clin Densitom ; 11(1): 123-62, 2008.
Article in English | MEDLINE | ID: mdl-18442757

ABSTRACT

The International Society for Clinical Densitometry (ISCD) has developed Official Positions for the clinical use of dual-energy X-ray absorptiometry (DXA) and non-DXA technologies. While only DXA can be used for diagnostic classification according to criteria established by the World Health Organization, DXA and some other technologies may predict fracture risk and be used to monitor skeletal changes over time. ISCD task forces reviewed the evidence for clinical applications of non-DXA techniques and presented reports with recommendations at the 2007 ISCD Position Development Conference. Here we present the ISCD Official Positions for quantitative computed tomography (QCT) and peripheral QCT (pQCT), with supporting medical evidence, rationale, controversy, and suggestions for further study. QCT is available for bone mineral density measurements at the spine, hip, forearm, and tibia. The ISCD Official Positions presented here focus on QCT of the spine and pQCT of the forearm. Measurements at the hip may have clinical relevance, as this is an important fracture site; however, due to limited medical evidence, definitive advice on its use in clinical practice cannot be provided until more data emerge.


Subject(s)
Fractures, Bone/diagnostic imaging , Osteoporosis/diagnostic imaging , Tomography, X-Ray Computed/standards , Adult , Bone Density , Calibration , Femur/diagnostic imaging , Forearm/diagnostic imaging , Humans , Radiographic Image Interpretation, Computer-Assisted , Societies, Medical , Spinal Fractures/diagnostic imaging
19.
J Clin Densitom ; 11(2): 232-6, 2008.
Article in English | MEDLINE | ID: mdl-18280192

ABSTRACT

Hip structural analysis (HSA) estimates geometrical and mechanical properties from hip dual-energy X-ray absorptiometry (DXA) images and is widely used in osteoporosis trials. This study compares HSA to volumetric quantitative computed tomography (QCT) measurements in the same population. A total of 121 women (mean age 58 yr, mean body mass index 27 kg/m2) participated. Each woman received a volumetric QCT scan and DXA scan of the left hip. QCT scans were analyzed with in-house software that directly computed geometric and mechanical parameters at the neck and trochanteric regions. DXA HSA was performed with an implementation by GE/Lunar. Pair-wise linear regression of HSA variables was conducted by method to site matched QCT variables for bone density, cross-sectional area, and cross-sectional moment of inertia (CSMI) of the femur neck. HSA correlated well with QCT (r2=0.67 for neck bone mineral density [BMD] and 0.5 for CSMI) and standard DXA at the neck (r2=0.82 for BMD). HSA and volumetric QCT compared favorably, which supports the validity of a projective technique such as DXA to derive geometrical properties of the proximal hip.


Subject(s)
Absorptiometry, Photon , Femur/diagnostic imaging , Osteoporosis/diagnostic imaging , Tomography, X-Ray Computed , Female , Humans , Middle Aged
20.
Acad Radiol ; 15(3): 342-9, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18280932

ABSTRACT

RATIONALE AND OBJECTIVES: This study was performed to assess the imaging characteristics and pharmacokinetics of 1,3-Bis-[7-(3-amino-2,4,6-triiodophenyl)-heptanoyl]-2-oleoyl glycerol (DHOG, Fenestra LC), a hepatobiliary contrast agent for microCT. MATERIALS AND METHODS: We investigated the abdomen of 18 female C3H mice in a MicroCAT II microCT scanner before contrast agent injection and at multiple time points up to 48 hours after intravenous injection of DHOG (1 g I/kg body weight). The contrast agent effect was determined quantitatively and dynamically by measuring pre- and postcontrast Hounsfield units (HU) of the liver, aorta, spleen, and kidneys. Based on additional phantom measurements, the reproducibility of lesion detection was estimated for different lesion sizes. RESULTS: DHOG caused a marked early postcontrast enhancement of blood in the aorta and a very high enhancement of the spleen, both slowly declined after 90 minutes. The liver parenchyma showed a slow contrast agent accumulation and clearly increased HU data between 3 and 7 hours after injection. No significant renal parenchymal enhancement or excretion was noticed. At early time points after administration, DHOG exhibits characteristics of a macromolecular contrast agent by demonstrating a blood pool effect. At later time points, DHOG provides a prolonged, marked liver enhancement on microCT images due to its specific liver uptake. For a lesion size of 1 mm diameter, the variability in between two scans was 27.7 HU (P < .05) and the variability for different planes of one scan was 19.8 HU (P < .05). CONCLUSIONS: DHOG yields a very good visualization of the liver and delineation of the surrounding structures with a long plateau. It is a very suitable contrast agent for liver imaging in mice for microCT imaging. The presented protocol provides a high reproducibility for lesion detection with a relatively low radiation dose.


Subject(s)
Cholangiography/methods , Contrast Media , Iodine Isotopes , Liver/diagnostic imaging , Radiographic Image Enhancement/methods , Tomography, X-Ray Computed/methods , Triglycerides , Animals , Aortography , Contrast Media/administration & dosage , Female , Imaging, Three-Dimensional/methods , Injections, Intravenous , Iodine Isotopes/administration & dosage , Kidney/diagnostic imaging , Liver Diseases/diagnostic imaging , Mice , Mice, Inbred C3H , Phantoms, Imaging , Radiation Dosage , Reproducibility of Results , Spleen/diagnostic imaging , Time Factors , Tomography Scanners, X-Ray Computed , Triglycerides/administration & dosage
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