An algorithm for mapping the catheter tip position on a fluorograph to the three-dimensional position in magnetic resonance angiography volume data.

This paper proposes an algorithm which maps the position of a catheter tip on a fluorograph to the 3D position in magnetic resonance angiography (MRA) data. This algorithm was assessed for its accuracy. We designed an algorithm consisting of a registration step and a recognition step. The registration step registers MRA and fluorography data using a digital subtraction angiography (DSA) image. The recognition step recognizes the position in the MRA data corresponding to the catheter tip position on a fluorograph. We checked the accuracy of the recognition step by employing an artificial data set consisting of 3D image data (64 x 64 x 64 matrix) and its projection image (92 x 92 matrix) and the accuracy of the registration step with the aid of three of the 3D time-of-flight MRA data sets (256 x 256 matrix and 60 slices) and their projection images in the form of DSA images. The accuracy of the recognition step depended upon that of the registration. When there was no misregistration, all of the mean errors were less than 0.2 mm. The mean errors of the registration step were 0.273 mm and 0.226 mm, respectively, for the longitudinal shift along the X and Y axes, 0.478 degrees, 1.203 degrees and 0.208 degrees, respectively, for the rotation angles around the X, Y and Z axes and 0.020 times for the magnification. The mean image error between the projection image of the registered MRA data and that of the MRA data which were employed as the DSA image was 0.034 mm.

Evaluation of imaging geometries calculated from biplane images.

A technique is developed that will calculate accurate and reliable imaging geometries and three-dimensional (3D) positions from biplane images of a calibration phantom. The calculated data provided by our technique will facilitate accurate 3D analysis in various clinical applications. Biplane images of a Lucite cube containing lead beads 1 mm in diameter were acquired. After identifying corresponding beads in both images and calculating their image positions, the 3D positions of the beads relative to each focal spot were determined. From these data, the transformation relating the 3D configurations were calculated to give the imaging geometry relating the biplane views. The 3D positions of objects were determined from the biplane images along with the corresponding imaging geometries. In addition, methods are developed to evaluate the quality of the calculated results on a case-by-case basis in the clinical setting. Methods are presented for evaluating the reproducibility of the calculated geometries and 3D positions, the accuracy of calculated object sizes, and the effects of errors due to time jitter, variation in user-indication, centering, and distortions on the calculated geometries and 3D reconstructions. The precision of the translation vectors and rotation matrices of the calculated geometries were within 1% and 1 degree, respectively, in phantom studies, with estimated accuracies of approximately 0.5% and 0.4 degree, respectively, in simulation studies. The precisions of the absolute 3D positions and orientations of the calculated 3D reconstructions were approximately 2 mm and 0.5 degree, respectively, in phantom studies, with estimated accuracies of approximately 1.5 mm and 0.4 degree, respectively, in simulation studies. This technique will provide accurate and precise imaging geometries as well as 3D positions from biplane images, thereby facilitating 3D analysis in various clinical applications. We believe that the study presented here is unique in that it represents the first steps toward understanding and evaluating the reliability of these 3D calculations in the clinical situation.

Consistency of variables in PCS and JASTRO great area database.

PURPOSE: To examine whether the Patterns of Care Study (PCS) reflects the data for the major areas in Japan, the consistency of variables in the PCS and in the major area database of the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) were compared. METHODS AND PATIENTS: Patients with esophageal or uterine cervical cancer were sampled from the PCS and JASTRO databases. From the JASTRO database, 147 patients with esophageal cancer and 95 patients with uterine cervical cancer were selected according to the eligibility criteria for the PCS. From the PCS, 455 esophageal and 432 uterine cervical cancer patients were surveyed. Six items for esophageal cancer and five items for uterine cervical cancer were selected for a comparative analysis of PCS and JASTRO databases. RESULTS: Esophageal cancer: Age (p=.0777), combination of radiation and surgery (p=.2136), and energy of the external beam (p=.6400) were consistent for PCS and JASTRO. However, the dose of the external beam for the non-surgery group showed inconsistency (p=.0467). Uterine cervical cancer: Age (p=.6301) and clinical stage (p=.8555) were consistent for the two sets of data. However, the energy of the external beam (p<.0001), dose rate of brachytherapy (p<.0001), and brachytherapy utilization by clinical stage (p<.0001) showed inconsistencies. CONCLUSION: It appears possible that the JASTRO major area database could not account for all patients' backgrounds and factors and that both surveys might have an imbalance in the stratification of institutions including differences in equipment and staffing patterns.

Time and flow study results before and after installation of a hospital information system and radiology information system and before clinical use of a picture archiving and communication system.

The effectiveness of a hospital information system (HIS) and a radiological information system (RIS) was evaluated to optimize preparation for the planned full clinical operation of a picture archiving and communication system (PACS), which is now linked experimentally to the HIS and the RIS. One thousand IC (integrated circuit) cards were used for time studies and flow studies in the hospital. Measurements were performed on image examination order entry, image examination, reporting, and image delivery times. Even though after the HIS and the RIS operation only a small amount of time savings were realized in each time fraction component, such as in the patient movement time, examination time, and film delivery time, the total turn-around time was shortened markedly, by more than 23 hours on average. It was verified that the HIS and the RIS was beneficial in the outpatient clinics of the orthopedic department. Our method of measurement employing IC cards before and after HIS and RIS operations can be applied in other hospitals.

Determination of 3D positions of pacemaker leads from biplane angiographic sequences.

In vitro and in vivo analyses of stress on pacemaker leads and their components during the heart cycle have become especially important because of incidences of failure of some of these mechanical components. For stress analyses, the three-dimensional (3D) position, shape, and motion of the pacemaker leads must be known accurately at each time point during the cardiac cycle. We have developed a method for determination of the in vivo 3D positions of pacemaker leads during the entire heart cycle. Sequences of biplane images of patients with pacemakers were obtained at 30 frames/s for each projection. The sequences usually included at least two heart cycles. After patient imaging, biplane images of a calibration object were obtained from which the biplane imaging geometry was determined. The centerlines of the leads and unique, identifiable points on the attached electrodes were indicated manually for all acquired images. Temporal interpolation of the lead and electrode data was performed so that the temporal nonsynchronicity of the image acquisition was overcome. Epipolar lines, generated from the calculated geometry, were employed to identify corresponding points along the leads in the pairs of biplane images for each time point. The 3D positions of the lead and electrodes were calculated from the known geometry and from the identified corresponding points in the images. Using multiple image sets obtained with the calibration object at various orientations, the precision of the calculated rotation matrix and of the translation vector defining the imaging geometry was found to be approximately 0.7 degree and 1%, respectively. The 3D positions were reproducible to within 2 mm, with the error lying primarily along the axis between the focal spot and the imaging plane. Using data obtained by temporally downsampling to 15 frames/s, the interpolated data were found to lie within approximately 2 mm of the true position for most of the heart cycle. These results indicate that, with this technique, one can reliably determine pacemaker lead positions throughout the heart cycle, and thereby it will provide the basis for stress analysis on pacemaker leads.