Feasibility of differential geometry-based features in detection of anatomical feature points on patient surfaces in range image-guided radiation therapy.

PURPOSE: To investigate the feasibility of differential geometry features in the detection of anatomical feature points on a patient surface in infrared-ray-based range images in image-guided radiation therapy. METHODS: The key technology was to reconstruct the patient surface in the range image, i.e., point distribution with three-dimensional coordinates, and characterize the geometrical shape at every point based on curvature features. The region of interest on the range image was extracted by using a template matching technique, and the range image was processed for reducing temporal and spatial noise. Next, a mathematical smooth surface of the patient was reconstructed from the range image by using a non-uniform rational B-splines model. The feature points were detected based on curvature features computed on the reconstructed surface. The framework was tested on range images acquired by a time-of-flight (TOF) camera and a Kinect sensor for two surface (texture) types of head phantoms A and B that had different anatomical geometries. The detection accuracy was evaluated by measuring the residual error, i.e., the mean of minimum Euclidean distances (MMED) between reference (ground truth) and detected feature points on convex and concave regions. RESULTS: The MMEDs obtained using convex feature points for range images of the translated and rotated phantom A were [Formula: see text] and [Formula: see text], respectively, using the TOF camera. For the phantom B, the MMEDs of the convex and concave feature points were [Formula: see text] and [Formula: see text] mm, respectively, using the Kinect sensor. There was a statistically significant difference in the decreased MMED for convex feature points compared with concave feature points [Formula: see text]. CONCLUSIONS: The proposed framework has demonstrated the feasibility of differential geometry features for the detection of anatomical feature points on a patient surface in range image-guided radiation therapy.

Automated measurement of cerebral cortical thickness based on fuzzy membership map derived from MR images for evaluation of Alzheimer's disease.

We have proposed an automated method for three-dimensional (3D) measurement of cerebral cortical thicknesses based on fuzzy membership maps derived from magnetic resonance (MR) images for evaluation of Alzheimer's disease (AD). The cerebral cortical thickness was three-dimensionally measured on each cortical surface voxel by using a localized gradient vector trajectory in a fuzzy membership map. The proposed method could be useful for the 3D measurement of the cerebral cortical thickness on individual cortical surface voxels as an atrophy feature in AD.

Improvement of partial volume segmentation for brain tissue on diffusion tensor images using multiple-tensor estimation.

To improve evaluations of cortical and subcortical diffusivity in neurological diseases, it is necessary to improve the accuracy of brain diffusion tensor imaging (DTI) data segmentation. The conventional partial volume segmentation method fails to classify voxels with multiple white matter (WM) fiber orientations such as fiber-crossing regions. Our purpose was to improve the performance of segmentation by taking into account the partial volume effects due to both multiple tissue types and multiple WM fiber orientations. We quantitatively evaluated the overall performance of the proposed method using digital DTI phantom data. Moreover, we applied our method to human DTI data, and compared our results with those of a conventional method. In the phantom experiments, the conventional method and proposed method yielded almost the same root mean square error (RMSE) for gray matter (GM) and cerebrospinal fluid (CSF), while the RMSE in the proposed method was smaller than that in the conventional method for WM. The volume overlap measures between our segmentation results and the ground truth of the digital phantom were more than 0.8 in all three tissue types, and were greater than those in the conventional method. In visual comparisons for human data, the WM/GM/CSF regions obtained using our method were in better agreement with the corresponding regions depicted in the structural image than those obtained using the conventional method. The results of the digital phantom experiment and human data demonstrated that our method improved accuracy in the segmentation of brain tissue data on DTI compared to the conventional method.

Investigation of optimum anti-scatter grid selection for digital radiography: physical imaging properties and detectability of low-contrast signals.

Our aim in this study was to evaluate the effect of the grid variations on the imaging performance for a computed radiographic system under identical exposure condition. Digital radiographies using a 20-cm Lucite phantom were performed without grid and with grid ratios of 5:1, 8:1, 10:1, 12:1, and 14:1. The scatter fraction, the incident dose to the image receptor, the Wiener spectrum (WS), and the noise-equivalent quanta (NEQ) were measured. Visibility of low-contrast signals was evaluated using a contrast-detail phantom. The scatter fractions decreased considerably with an increase in the grid ratio. On the other hand, the WSs were increased (the noise property deteriorated) as the grid ratio increased due to a decreased incident dose to the image receptor under the identical exposure condition. The NEQs were improved as the grid ratio increased. The high grid ratios provided higher low-contrast detectability compared to the low grid ratios. Our results indicated that the removal of scattered radiation was very effective in improvement of the NEQ in the digital system under the identical exposure condition.

Computer-aided beam arrangement based on similar cases in radiation treatment-planning databases for stereotactic lung radiation therapy.

The purpose of this study was to develop a computer-aided method for determination of beam arrangements based on similar cases in a radiotherapy treatment-planning database for stereotactic lung radiation therapy. Similar-case-based beam arrangements were automatically determined based on the following two steps. First, the five most similar cases were searched, based on geometrical features related to the location, size and shape of the planning target volume, lung and spinal cord. Second, five beam arrangements of an objective case were automatically determined by registering five similar cases with the objective case, with respect to lung regions, by means of a linear registration technique. For evaluation of the beam arrangements five treatment plans were manually created by applying the beam arrangements determined in the second step to the objective case. The most usable beam arrangement was selected by sorting the five treatment plans based on eight plan evaluation indices, including the D95, mean lung dose and spinal cord maximum dose. We applied the proposed method to 10 test cases, by using an RTP database of 81 cases with lung cancer, and compared the eight plan evaluation indices between the original treatment plan and the corresponding most usable similar-case-based treatment plan. As a result, the proposed method may provide usable beam arrangements, which have no statistically significant differences from the original beam arrangements (P > 0.05) in terms of the eight plan evaluation indices. Therefore, the proposed method could be employed as an educational tool for less experienced treatment planners.

Chromaticity and correlated color temperature of the white point in medical liquid-crystal display.

PURPOSE: The color characteristics of medical liquid-crystal displays (LCDs) have become one of the main interests in quality assurance and quality control of medical display devices. It is necessary to evaluate variations of the color characteristics in medical LCDs in order to provide consistent color characteristics for image reading. In this study, we characterize the color characteristics in grayscale images displayed on medical LCDs. METHODS: Eight medical color LCDs and eight medical monochrome LCDs were used in this study with operating times ranging from 800 to 25 000 h. Default settings of correlated color temperature (CCT) of white points for all color LCDs were set at 7500 K. We measured chromaticity in the Commission Internationale de l'Éclairage (CIE) u'v' color space and CCT of the white point at 18 luminance levels. A colorimeter and grayscale test patterns with various luminance levels were used for the measurements. First, we examined differences in chromaticity and CCT at 18 luminance levels for each LCD. Second, we compared chromaticities of the different LCDs. Then, chromaticity and CCT of LCDs were measured at different ambient light conditions (30 and 560 lux) and compared to those measured in a dark room. Finally, the relationship between operating times and CCT was evaluated. RESULTS: The chromaticities of monochrome LCDs changed toward the blue and CCT increased as luminance decreased. In color LCDs, the chromaticity and CCT of the white point except at the minimum luminance were nearly constant to those measured at the maximum luminance. We observed differences in chromaticity between color and monochrome LCDs because of the nonadjustable white point of monochrome LCDs. When the ambient light increased, chromaticity varied, and CCT decreased on every LCD. Ambient light had a much greater impact on chromaticity and CCT at lower luminance levels. The CCT of LCDs decreased in longer operating times. The grayscale of LCDs with longer operating times was measured to be more yellowish due to the degradation of cold cathode fluorescent lamps. CONCLUSIONS: Our results clearly indicate that the white point in grayscale images displayed on medical LCDs changes depending on luminance levels, color or monochrome LCDs, ambient light conditions, and operating times. These data provide useful information to understand color characteristics of LCD for image reading, especially for quality assurance and quality control of LCDs.

Computerized estimation of patient setup errors in portal images based on localized pelvic templates for prostate cancer radiotherapy.

We have developed a computerized method for estimating patient setup errors in portal images based on localized pelvic templates for prostate cancer radiotherapy. The patient setup errors were estimated based on a template-matching technique that compared the portal image and a localized pelvic template image with a clinical target volume produced from a digitally reconstructed radiography (DRR) image of each patient. We evaluated the proposed method by calculating the residual error between the patient setup error obtained by the proposed method and the gold standard setup error determined by consensus between two radiation oncologists. Eleven training cases with prostate cancer were used for development of the proposed method, and then we applied the method to 10 test cases as a validation test. As a result, the residual errors in the anterior-posterior, superior-inferior and left-right directions were smaller than 2 mm for the validation test. The mean residual error was 2.65 ± 1.21 mm in the Euclidean distance for training cases, and 3.10 ± 1.49 mm for the validation test. There was no statistically significant difference in the residual error between the test for training cases and the validation test (P = 0.438). The proposed method appears to be robust for detecting patient setup error in the treatment of prostate cancer radiotherapy.

Automated detection of multiple sclerosis candidate regions in MR images: false-positive removal with use of an ANN-controlled level-set method.

Our purpose in this study was to develop an automated segmentation scheme for multiple sclerosis (MS) lesions in magnetic resonance images using an artificial neural network (ANN)-controlled level-set method. Forty-nine slices with T1-weighted, T2-weighted, and fluid-attenuated inversion recovery images were selected from six examinations of three MS patients including 168 MS lesions for this study. First, MS lesions were enhanced by background subtraction. Initial regions of MS candidates were detected based on a multiple-gray-level thresholding technique and a region-growing technique on the subtraction image. Then, final regions of MS candidates were determined by application of a proposed segmentation method using an ANN-controlled level-set method, which was used for reduction of false positives (FPs) as well as more accurate segmentation. Finally, all candidate regions were classified into true positive and FP candidate regions by use of a support vector machine. As the result of a leave-one-candidate-out test method, the detection sensitivity for MS lesions increased from 64.9 to 75.0% while decreasing the number of FPs per slice from 19.9 to 4.4 compared with a previous study. The proposed scheme improved the sensitivity and the number of FPs in the detection of MS lesions.

Digital magnification mammography with matched incident exposure: physical imaging properties and detectability of simulated microcalcifications.

Our purpose was to evaluate the usefulness of digital magnification mammography with matched incident exposure by investigating the physical imaging properties and doing an observer performance test. A computed radiography system and a mammographic unit were used in this study. Contact and magnification radiographies of 1.2-1.8 in combination with focal spot sizes of 0.1 mm without grid and 0.3 mm with grid were performed. Physical imaging properties, namely, scatter fraction, total modulation transfer function (MTF) including the presampled MTF and the MTF of focal spot size, and Wiener spectrum (WS), were measured. Detail visibility was evaluated by use of free-response receiver operating characteristic analysis of the detectability of simulated microcalcifications. Scatter fractions decreased considerably as the magnification factor increased without grid technique. In the grid technique, scatter fractions for all magnification techniques were comparable. The total MTFs of magnification techniques with a focal spot size of 0.1 mm improved significantly compared with the conventional contact technique. However, the improvement of the total MTFs of magnification techniques with the combination of 0.3 mm focal spot size was small. The WSs degraded with an increase of the magnification factor compared with the contact technique due to the maintained exposure incident on the object. The observer performance test indicated that the 1.8 magnification technique with the 0.1 mm focal spot size provided higher detectability than did the contact technique. Digital magnification mammography under the same incident exposure conditions improved the detectability of microcalcifications.

Automated segmentation method of white matter and gray matter regions with multiple sclerosis lesions in MR images.

Our purpose in this study was to develop an automated method for segmentation of white matter (WM) and gray matter (GM) regions with multiple sclerosis (MS) lesions in magnetic resonance (MR) images. The brain parenchymal (BP) region was derived from a histogram analysis for a T1-weighted image. The WM regions were segmented by addition of MS candidate regions, which were detected by our computer-aided detection system for the MS lesions, and subtraction of a basal ganglia and thalamus template from "tentative" WM regions. The GM regions were obtained by subtraction of the WM regions from the BP region. We applied our proposed method to T1-weighted, T2-weighted, and fluid-attenuated inversion-recovery images acquired from 7 MS patients and 7 control subjects on a 3.0 T MRI system. The average similarity indices between the specific regions obtained by our method and by neuroradiologists for the BP and WM regions were 95.5 ± 1.2 and 85.2 ± 4.3%, respectively, for MS patients. Moreover, they were 95.0 ± 2.0 and 85.9 ± 3.4%, respectively, for the control subjects. The proposed method might be feasible for segmentation of WM and GM regions in MS patients.

Comparison of detectability of a simple object with low contrast displayed on a high-brightness color LCD and a monochrome LCD.

The goal of this study was to investigate the effect of the different luminance settings of a high-brightness color liquid-crystal display (LCD) on the detectability of a simple grayscale object with low contrast by use of receiver operating characteristic (ROC) analysis. The detectability of a high-brightness color LCD with two maximum-luminance settings (500 and 170 cd/m(2)) was compared with the detectability of a monochrome LCD (500 cd/m(2)). The two LCDs used in this study were calibrated to the grayscale standard display function. The average areas under the ROC curve (AUCs) and the standard deviations for all thirteen observers for the 500 cd/m(2) color LCD, 500 cd/m(2) monochrome LCD, and 170 cd/m(2) color LCD were 0.937 +/- 0.040, 0.924 +/- 0.056, and 0.915 +/- 0.068, respectively. There were no statistically significant differences in the average AUCs among the three LCD monitor conditions. On the other hand, the total observation time for the 170 cd/m(2) color LCD was significantly shorter than that for the 500 cd/m(2) color and monochrome LCDs (p < 0.05). Irrespective of the maximum luminance settings (500 and 170 cd/m(2)), the color LCD provided a performance comparable to the monochrome LCD for detection of a simple grayscale object with low contrast.

Effects of ambient-light correction in luminance measurements of liquid-crystal display monitors by use of a telescopic-type luminance meter.

The quality control of liquid-crystal display (LCD) monitors has become one of the important topics for maintaining reliable soft-copy readings in the interpretation of diagnostic images. In this paper, the effects of correction in the luminance measurement of an LCD monitor by use of a telescopic-type luminance meter were investigated. The luminance of the LCD monitor in different ambient-lighting conditions was measured and compared to the results obtained with no ambient lighting (0 lux). The reproducibility of luminance measurements and luminance ratios without a baffled tube was lower than those measured with the baffled tube due to the effect of ambient light. These tendencies were obvious at a relatively low luminance. The correction method by subtraction of the reflected ambient light on the surface of the LCD monitor and the stray light of the telescopic-type luminance meter from the measured luminance was examined. We found that the correction was able to bring the luminance close to that measured with the baffled tube.

Partial volume estimation and segmentation of brain tissue based on diffusion tensor MRI.

PURPOSE: Brain tissue segmentation based on diffusion tensor magnetic resonance imaging (DT-MRI) data has been attempted by previous researchers. Due to inherent low spatial resolution of DT-MRI data, conventional methods suffered from partial volume averaging among the different types of tissues, which may result in inaccurate segmentation results. The purpose was to develop a new brain tissue segmentation method for DT-MRI data in which effect of the partial volume averaging is taken into account. METHODS: The method estimates the partial volume fractions of white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) within each voxel using a maximum a posteriori probability principle, based on five DT parameters (three eigenvalues, apparent diffusion coefficient, and fractional anisotropy). The authors evaluated the performance of the proposed method quantitatively by using digital phantom data. Moreover, the authors applied the method to real DT-MRI data of the human brain, and compared the results with those of a conventional segmentation method. RESULTS: In the digital phantom experiments, the root mean square error in term of partial volume fraction with the method for WM, GM, and CSF were 0.137, 0.049, and 0.085, respectively. The volume overlap measures between the segmentation results and the ground truth of the digital phantom were more than 0.9 in all three tissue types, while those between the results by the conventional method and the ground truth ranged between 0.550 and 0.854. In visual comparisons for real DT-MRI, WM/GM/CSF regions estimated by the method were more similar to the corresponding regions depicted in the structural image than those estimated by the conventional method. CONCLUSIONS: The results of the digital phantom experiment and real DT-MRI data demonstrated that the method improved accuracy in estimation and segmentation of brain tissue on DT-MRI data over the conventional method. This method may be useful in evaluating the cortical and subcortical diffusivity in neurological diseases.

Computer-aided detection of multiple sclerosis lesions in brain magnetic resonance images: False positive reduction scheme consisted of rule-based, level set method, and support vector machine.

The purpose of this study was to develop a computerized method for detection of multiple sclerosis (MS) lesions in brain magnetic resonance (MR) images. We have proposed a new false positive reduction scheme, which consisted of a rule-based method, a level set method, and a support vector machine. We applied the proposed method to 49 slices selected from 6 studies of three MS cases including 168 MS lesions. As a result, the sensitivity for detection of MS lesions was 81.5% with 2.9 false positives per slice based on a leave-one-candidate-out test, and the similarity index between MS regions determined by the proposed method and neuroradiologists was 0.768 on average. These results indicate the proposed method would be useful for assisting neuroradiologists in assessing the MS in clinical practice.

Computer-aided evaluation method of white matter hyperintensities related to subcortical vascular dementia based on magnetic resonance imaging.

It has been reported that the severity of subcortical vascular dementia (VaD) correlated with an area ratio of white matter hyperintensity (WMH) regions to the brain parenchyma (WMH area ratio). The purpose of this study was to develop a computer-aided evaluation method of WMH regions for diagnosis of subcortical VaD based on magnetic resonance (MR) images. A brain parenchymal region was segmented based on the histogram analysis of a T1-weigthed image. The WMH regions were segmented on the subtraction image between a T1-weighted and fluid-attenuated inversion-recovery (FLAIR) images using two segmentation methods, i.e., a region-growing technique and a level-set method, which were automatically and adaptively selected on each WMH region based on its image features by using a support vector machine. We applied the proposed method to 33 slices of the three types of MR images with 245 lesions, which were acquired from 10 patients (age range: 64-90 years, mean: 78) with a diagnosis of VaD on a 1.5-T MR imaging scanner. The average similarity index between regions determined by a manual method and the proposed method was 93.5+/-2.0% for brain parenchymal regions and 78.2+/-11.0% for WMH regions. The WMH area ratio obtained by the proposed method correlated with that determined by two neuroradiologists with a correlation coefficient of 0.992. The results presented in this study suggest that the proposed method could assist neuroradiologists in the evaluation of WMH regions related to the subcortical VaD.

Need for liquid-crystal display monitors having the capability of rendering higher than 8 bits in display-bit depth.

Our purpose in this study was to examine the potential usefulness of liquid-crystal display (LCD) monitors having the capability of rendering higher than 8 bits in display-bit depth. An LCD monitor having the capability of rendering 8, 10, and 12 bits was used. It was calibrated to the grayscale standard display function with a maximum luminance of 450 cd/m(2) and a minimum of 0.75 cd/m(2). For examining the grayscale resolution reported by ten observers, various simple test patterns having two different combinations of luminance in 8, 10, and 12 bits were randomly displayed on the LCD monitor. These patterns were placed on different uniform background luminance levels, such as 0, 50, and 100%, for maximum luminance. All observers participating in this study distinguished a smaller difference in luminance than one gray level in 8 bits irrespective of background luminance levels. As a result of the adaptation processes of the human visual system, observers distinguished a smaller difference in luminance as the luminance level of the test pattern was closer to the background. The smallest difference in luminance that observers distinguished was four gray levels in 12 bits, i.e., one gray level in 10 bits. Considering the results obtained by use of simple test patterns, medical images should ideally be displayed on LCD monitors having 10 bits or greater so that low-contrast objects with small differences in luminance can be detected and for providing a smooth gradation of grayscale.

Comparison of viewing angle and observer performances in different types of liquid-crystal display monitors.

It is known that the performance of liquid-crystal display (LCD) monitors, such as the luminance and contrast ratio, is dependent on the viewing angle. Our purpose in this study was to compare the angular performance and the effect on observer performance of different types of LCD monitors. The luminance performance and contrast ratio as a function of viewing angle (-60 degrees to 60 degrees) in each direction for two types of LCD monitors, namely, a general-purpose LCD monitor and one especially designed for medical use, were measured in this study. Furthermore, the observer performance at various viewing angles in the horizontal direction for a medical-grade LCD monitor was investigated by eight observers based on a contrast-detail diagram. The two types of LCD monitors showed notable variations in luminance and contrast ratio as a function of the viewing angle. Acceptable viewing angles in terms of the contrast ratio were much smaller in each direction than those for nominal viewing angles in the specifications provided by the manufacturers, and those for the medical-grade LCD monitor in the horizontal and vertical directions were broader than those of the general-purpose LCD monitor. There was no significant difference in observer performance between 0 degrees and 40 degrees. On the other hand, our results showed a statistically significant difference in observer performance between 0 degrees and 60 degrees.

Automated method for identification of patients with Alzheimer's disease based on three-dimensional MR images.

RATIONALE AND OBJECTIVES: An automated method for identification of patients with cerebral atrophy due to Alzheimer's disease (AD) was developed based on three-dimensional (3D) T1-weighted magnetic resonance (MR) images. MATERIALS AND METHODS: Our proposed method consisted of determination of atrophic image features and identification of AD patients. The atrophic image features included white matter and gray matter volumes, cerebrospinal fluid (CSF) volume, and cerebral cortical thickness determined based on a level set method. The cortical thickness was measured with normal vectors on a voxel-by-voxel basis, which were determined by differentiating a level set function. The CSF spaces within cerebral sulci and lateral ventricles (LVs) were extracted by wrapping the brain tightly in a propagating surface determined with a level set method. Identification of AD cases was performed using a support vector machine (SVM) classifier, which was trained by the atrophic image features of AD and non-AD cases, and then an unknown case was classified into either AD or non-AD group based on an SVM model. We applied our proposed method to MR images of the whole brains obtained from 54 cases, including 29 clinically diagnosed AD cases (age range, 52-82 years; mean age, 70 years) and 25 non-AD cases (age range, 49-78 years; mean age, 62 years). RESULTS: As a result, the area under a receiver operating characteristic (ROC) curve (Az value) obtained by our computerized method was 0.909 based on a leave-one-out test in identification of AD cases among 54 cases. CONCLUSION: This preliminary result showed that our method may be promising for detecting AD patients.

MR tractography based on directional diffusion function validation in somatotopic organization of the pyramidal tract.

RATIONALE AND OBJECTIVES: Conventional tractography based on the "streamline" method only partially visualizes the pyramidal tract because of fiber crossing with other white matter tracts. Recently a new tractography method based on directional diffusion function (DDF) has been proposed. This method was reported to visualize the pyramidal tract to a larger extent than conventional techniques do. To validate the DDF-based tractography method, we studied the somatotopic organization of the pyramidal tract in the posterior limb of the internal capsule (PLIC). MATERIALS AND METHODS: Pyramidal tracts in the intact hemispheres of 14 brain tumor patients were drawn using the directional diffusion function-based tractography method. Each pyramidal tract was divided into four fiber bundles according to the cephalocaudal positions of their termination in the precentral gyrus. The cephalocaudal positions in the precentral gyrus of the four fiber bundles were correlated with their positional relationships in the PLIC along the mediolateral and anteroposterior axes. RESULTS: Fiber bundles terminating more caudally in the precentral gyrus were located significantly more anteriorly in the PLIC (r = 0.59, Spearman's correlation coefficient, P < .0001). On the other hand, no significant correlation was shown between the cephalocaudal positions in the precentral gyrus of the four fiber bundles and their relative positions in the PLIC along the mediolateral axis. CONCLUSIONS: Estimated organization of the fiber bundles of the pyramidal tract in the PLIC was consistent with anatomically known somatotopic organization, which supported the validity of the DDF-based tractography method.

Effect of test patterns on measurement of the luminance of LCD devices by use of a telescopic-type luminance meter.

Quality assurance of electronic display devices is important for maintaining reliable soft-copy image interpretations. This paper presents effects of test patterns on measurement of the luminance of liquid-crystal display (LCD) devices by use of a telescopic-type luminance meter. The luminance for different types of test patterns having different backgrounds and measurement areas was measured and compared with the results obtained with AAPM task group-18 (TG-18) LN test patterns. The luminance measured for the test patterns with a black background was lower than that measured for TG-18 LN test patterns due to the light emitted from the outside the focused area of the telescopic-type luminance meter. Also, the luminance obtained with smaller measurement areas indicated lower luminance. These tendencies were particularly obvious at low luminance. The luminance of the LCD device by use of a telescopic-type luminance meter should be measured with test patterns that have a black background and a smaller measurement area than that for the TG-18 LN test patterns.