Speckle Suppression by Decoherence in Fluctuation Electron Microscopy.

We compare experimental fluctuation electron microscopy (FEM) speckle data with electron diffraction simulations for thin amorphous carbon and silicon samples. We find that the experimental speckle intensity variance is generally more than an order of magnitude lower than kinematical scattering theory predicts for spatially coherent illumination. We hypothesize that decoherence, which randomizes the phase relationship between scattered waves, is responsible for the anomaly. Specifically, displacement decoherence can contribute strongly to speckle suppression, particularly at higher beam energies. Displacement decoherence arises when the local structure is rearranged significantly by interactions with the beam during the exposure. Such motions cause diffraction speckle to twinkle, some of it at observable time scales. We also find that the continuous random network model of amorphous silicon can explain the experimental variance data if displacement decoherence and multiple scattering is included in the modeling. This may resolve the longstanding discrepancy between X-ray and electron diffraction studies of radial distribution functions, and conclusions reached from previous FEM studies. Decoherence likely affects all quantitative electron imaging and diffraction studies. It likely contributes to the so-called Stobbs factor, where high-resolution atomic-column image intensities are anomalously lower than predicted by a similar factor to that observed here.

Standardized accuracy assessment of the calypso wireless transponder tracking system.

Electromagnetic (EM) tracking allows localization of small EM sensors in a magnetic field of known geometry without line-of-sight. However, this technique requires a cable connection to the tracked object. A wireless alternative based on magnetic fields, referred to as transponder tracking, has been proposed by several authors. Although most of the transponder tracking systems are still in an early stage of development and not ready for clinical use yet, Varian Medical Systems Inc. (Palo Alto, California, USA) presented the Calypso system for tumor tracking in radiation therapy which includes transponder technology. But it has not been used for computer-assisted interventions (CAI) in general or been assessed for accuracy in a standardized manner, so far. In this study, we apply a standardized assessment protocol presented by Hummel et al (2005 Med. Phys. 32 2371-9) to the Calypso system for the first time. The results show that transponder tracking with the Calypso system provides a precision and accuracy below 1 mm in ideal clinical environments, which is comparable with other EM tracking systems. Similar to other systems the tracking accuracy was affected by metallic distortion, which led to errors of up to 3.2 mm. The potential of the wireless transponder tracking technology for use in many future CAI applications can be regarded as extremely high.

Interventional real-time ultrasound imaging with an integrated electromagnetic field generator.

PURPOSE: Ultrasound (US) guided procedures are frequently performed for diagnosis and treatment of many diseases. However, there are safety and procedure duration limitations in US-guided interventions due to poor image quality and inadequate visibility of medical instruments in the field of view. To address this issue, we propose an interventional imaging system based on a mobile electromagnetic (EM) field generator (FG) attached to a US probe. METHODS: A standard US probe was integrated with an EM FG to allow combined movement of the FG with real-time imaging to achieve (1) increased tracking accuracy for medical instruments are located near the center of the tracking volume, (2) increased robustness because the FG is distant to large metallic objects, and (3) reduced setup complexity since time-consuming placement of the FG is not required. The new integrated US-FG imaging system was evaluated by assessing tracking and calibration accuracy in a clinical setting. To demonstrate clinical applicability, the prototype US-EMFG probe was tested in needle puncture procedures. RESULTS: The mobile EMFG attached to a US probe yielded sub-millimeter tracking accuracy despite the presence of metal close to the FG. Calibration errors were in the range of 1-2 mm. In an initial phantom study on US-guided needle punctures, targeting errors of about 3 mm were achieved. CONCLUSION: A combined US-EMFG probe is feasible and effective for tracking medical instruments relative to US images with high accuracy and robustness while keeping hardware complexity low.

MITK-US: real-time ultrasound support within MITK.

PURPOSE: Intra-procedural acquisition of the patient anatomy is a key technique in the context of computer-assisted interventions (CAI). Ultrasound (US) offers major advantages as an interventional imaging modality because it is real time and low cost and does not expose the patient or physician to harmful radiation. To advance US-related research, the purpose of this paper was to develop and evaluate an open-source framework for US-based CAI applications. MATERIALS AND METHODS: We developed the open-source software module MITK-US for acquiring and processing US data as part of the well-known medical imaging interaction toolkit (MITK). To demonstrate its utility, we applied the module to implement a new concept for US-guided needle insertion. Performance of the US module was assessed by determining frame rate and latency for both a simple sample application and a more complex needle guidance system. RESULTS: MITK-US has successfully been used to implement both sample applications. Modern laptops achieve frame rates above 24 frames per second. Latency is measured to be approximately 250 ms or less. CONCLUSION: MITK-US can be considered a viable rapid prototyping environment for US-based CAI applications.

Standardized assessment of new electromagnetic field generators in an interventional radiology setting.

PURPOSE: Two of the main challenges associated with electromagnetic (EM) tracking in computer-assisted interventions (CAIs) are (1) the compensation of systematic distance errors arising from the influence of metal near the field generator (FG) or the tracked sensor and (2) the optimized setup of the FG to maximize tracking accuracy in the area of interest. Recently, two new FGs addressing these issues were proposed for the well-established Aurora(®) tracking system [Northern Digital, Inc. (NDI), Waterloo, Canada]: the Tabletop 50-70 FG, a planar transmitter with a built-in shield that compensates for metal distortions emanating from treatment tables, and the prototypical Compact FG 7-10, a mobile generator designed to be attached to mobile imaging devices. The purpose of this paper was to assess the accuracy and precision of these new FGs in an interventional radiology setting. METHODS: A standardized assessment protocol, which uses a precisely machined base plate to measure relative error in position and orientation, was applied to the two new FGs as well as to the well-established standard Aurora(®) Planar FG. The experiments were performed in two different settings: a reference laboratory environment and a computed tomography (CT) scanning room. In each setting, the protocol was applied to three different poses of the measurement plate within the tracking volume of the three FGs. RESULTS: The two new FGs provided higher precision and accuracy within their respective measurement volumes as well as higher robustness with respect to the CT scanner compared to the established FG. Considering all possible 5 cm distances on the grid, the error of the Planar FG was increased by a factor of 5.94 in the clinical environment (4.4 mm) in comparison to the error in the laboratory environment (0.8 mm). In contrast, the mean values for the two new FGs were all below 1 mm with an increase in the error by factors of only 2.94 (Reference: 0.3 mm; CT: 0.9 mm) and 1.04 (both: 0.5 mm) in the case of the Tabletop FG and the Compact FG, respectively. CONCLUSIONS: Due to their high accuracy and robustness, the Tabletop FG and the Compact FG could eliminate the need for compensation of EM field distortions in certain CT-guided interventions.

Electromagnetic tracking for US-guided interventions: standardized assessment of a new compact field generator.

PURPOSE: One of the main challenges related to electromagnetic tracking in the clinical setting is a placement of the field generator (FG) that optimizes the reliability and accuracy of sensor localization. Recently, a new mobile FG for the NDI Aurora(®) tracking system has been presented. This Compact FG is the first FG that can be attached directly to an ultrasound (US) probe. The purpose of this study was to assess the precision and accuracy of the Compact FG in the presence of nearby mounted US probes. MATERIALS AND METHODS: Six different US probes were mounted onto the Compact FG by means of a custom-designed mounting adapter. To assess precision and accuracy of the Compact FG, we employed a standardized assessment protocol. Utilizing a specifically manufactured plate, we measured positional data on three levels of distances from the FG as well as rotational data. RESULTS: While some probes had negligible influence on tracking accuracy two probes increased the mean distance error up to 1.5 mm compared with a reference measurement of 0.5 mm. The jitter error consistently stayed below 0.2 mm in all cases. The mean relative error in orientation was found to be smaller than 3°. CONCLUSION: Attachment of an US probe to the Compact FG does not have a critical influence on tracking accuracy in most cases. Clinical benefit of this promising mobile FG must be shown in future studies.

Accounting for anisotropic noise in fine registration of time-of-flight range data with high-resolution surface data.

Time-of-Flight (ToF) sensors have become a considerable alternative to conventional surface acquisition techniques such as laser range scanning and stereo vision. Application of ToF cameras for the purpose of intra-operative registration requires matching of the noisy surfaces generated from ToF range data onto pre-interventionally acquired high-resolution surfaces. The contribution of this paper is twofold: Firstly, we present a novel method for fine rigid registration of noisy ToF data with high-resolution surface meshes taking into account both, the noise characteristics of ToF cameras and the resolution of the target mesh. Secondly, we introduce an evaluation framework for assessing the performance of ToF registration methods based on physically realistic ToF range data generated from a virtual scence. According to experiments within the presented evaluation framework, the proposed method outperforms the standard ICP algorithm with respect to correspondence search and transformation computation, leading to a decrease in the target registration error (TRE) of more than 70%.

Focal adhesion kinase regulates beta1 integrin-dependent T cell migration through an HEF1 effector pathway.

Although beta1 integrin-dependent T cell migration is required for immune function, little is known of the signaling pathways regulating this migration. We now show that the cytoplasmic tyrosine kinase, focal adhesion kinase (FAK) plays an essential role in the beta1 integrin-stimulated migration of T cells through regulation of the unique Crk-associated substrate (Cas) family docking protein, human enhancer of filamentation 1 (HEF1) and effects on "outside-in" beta1 integrin signaling. Overexpression of wild-type FAK promoted beta1 integrin-dependent Jurkat T cell migration, whereas FAK mutated in either its autophosphorylation site or proline rich region 1 (PR1)/HEF1 SH3 domain-binding site had a dominant negative effect on migration. In contrast, neither wild-type nor mutant FAK affected Jurkat cell adhesion to fibronectin, a beta1 integrin ligand. The migration of FAK-overexpressing cells directly correlated with the beta1 integrin-inducible tyrosine phosphorylation of endogenous plus wild-type exogenous FAK, and not with phosphorylation of the FAK-related kinase, Pyk2. FAK was also found to regulate both HEF1-promoted migration, and HEF1 tyrosine phosphorylation in beta1 integrin-stimulated cells, in a manner dependent upon the FAK autophosphorylation and PR1 sites, and HEF1 SH3 domain. Together, our results indicate that beta1 integrin-stimulated T cell migration requires a linear beta1 integrin-FAK-HEF1 effector pathway.

Mediastinal lymph node enlargement and splenomegaly in primary hypogammaglobulinaemia.

The computed tomography (CT) scans of 37 patients with primary hypogammaglobulinaemia were reviewed to determine the frequency of enlarged mediastinal lymph nodes and splenomegaly in this group. None of the 10 X-linked Agammaglobulinaemia (XLA) patients had enlarged nodes and only one had splenomegaly. Eleven of the 27 Common Variable Immunodeficiency (CVID) group had enlarged nodes (41%) and 13 had splenomegaly (48%). There was no significant correlation between the presence of enlarged nodes and splenic enlargement. Twenty-two patients had bronchiectasis but the presence of bronchiectasis did not correlate with the presence of either splenomegaly or lymphadenopathy. Three to 6 years follow-up is available for 36 of the 37 patients and none of this group have developed lymphoma or other malignancy. Enlarged mediastinal nodes and/or splenomegaly are frequently found in patients with CVID and are usually due to a benign, non-neoplastic, process. Mediastinal lymph node enlargement is not a feature of XLA and splenomegaly is unusual in this condition.