Evaluation of an improved algorithm for producing realistic 3D breast software phantoms: application for mammography.

PURPOSE: This work presents an improved algorithm for the generation of 3D breast software phantoms and its evaluation for mammography. METHODS: The improved methodology has evolved from a previously presented 3D noncompressed breast modeling method used for the creation of breast models of different size, shape, and composition. The breast phantom is composed of breast surface, duct system and terminal ductal lobular units, Cooper's ligaments, lymphatic and blood vessel systems, pectoral muscle, skin, 3D mammographic background texture, and breast abnormalities. The key improvement is the development of a new algorithm for 3D mammographic texture generation. Simulated images of the enhanced 3D breast model without lesions were produced by simulating mammographic image acquisition and were evaluated subjectively and quantitatively. For evaluation purposes, a database with regions of interest taken from simulated and real mammograms was created. Four experienced radiologists participated in a visual subjective evaluation trial, as they judged the quality of the simulated mammograms, using the new algorithm compared to mammograms, obtained with the old modeling approach. In addition, extensive quantitative evaluation included power spectral analysis and calculation of fractal dimension, skewness, and kurtosis of simulated and real mammograms from the database. RESULTS: The results from the subjective evaluation strongly suggest that the new methodology for mammographic breast texture creates improved breast models compared to the old approach. Calculated parameters on simulated images such as beta exponent deducted from the power law spectral analysis and fractal dimension are similar to those calculated on real mammograms. The results for the kurtosis and skewness are also in good coincidence with those calculated from clinical images. Comparison with similar calculations published in the literature showed good agreement in the majority of cases. CONCLUSIONS: The improved methodology generated breast models with increased realism compared to the older model as shown in evaluations of simulated images by experienced radiologists. It is anticipated that the realism will be further improved using an advanced image simulator so that simulated images may be used in feasibility studies in mammography.

Motion correction of PET brain images through deconvolution: II. Practical implementation and algorithm optimization.

Image quality is significantly degraded even by small amounts of patient motion in very high-resolution PET scanners. When patient motion is known, deconvolution methods can be used to correct the reconstructed image and reduce motion blur. This paper describes the implementation and optimization of an iterative deconvolution method that uses an ordered subset approach to make it practical and clinically viable. We performed ten separate FDG PET scans using the Hoffman brain phantom and simultaneously measured its motion using the Polaris Vicra tracking system (Northern Digital Inc., Ontario, Canada). The feasibility and effectiveness of the technique was studied by performing scans with different motion and deconvolution parameters. Deconvolution resulted in visually better images and significant improvement as quantified by the Universal Quality Index (UQI) and contrast measures. Finally, the technique was applied to human studies to demonstrate marked improvement. Thus, the deconvolution technique presented here appears promising as a valid alternative to existing motion correction methods for PET. It has the potential for deblurring an image from any modality if the causative motion is known and its effect can be represented in a system matrix.

Hyperpolarized 129Xenon Magnetic Resonance Imaging to Quantify Regional Ventilation Differences in Mild to Moderate Asthma: A Prospective Comparison Between Semiautomated Ventilation Defect Percentage Calculation and Pulmonary Function Tests.

OBJECTIVES: The aim of this study was to investigate ventilation in mild to moderate asthmatic patients and age-matched controls using hyperpolarized (HP) Xenon magnetic resonance imaging (MRI) and correlate findings with pulmonary function tests (PFTs). MATERIALS AND METHODS: This single-center, Health Insurance Portability and Accountability Act-compliant prospective study was approved by our institutional review board. Thirty subjects (10 young asthmatic patients, 26 ± 6 years; 3 males, 7 females; 10 older asthmatic patients, 64 ± 6 years; 3 males, 7 females; 10 healthy controls) were enrolled. After repeated PFTs 1 week apart, the subjects underwent 2 MRI scans within 10 minutes, inhaling 1-L volumes containing 0.5 to 1 L of Xe. Xe ventilation signal was quantified by linear binning, from which the ventilation defect percentage (VDP) was derived. Differences in VDP among subgroups and variability with age were evaluated using 1-tailed t tests. Correlation of VDP with PFTs was tested using Pearson correlation coefficient. Reproducibility of VDP was assessed using Bland-Altman plots, linear regression (R), intraclass correlation coefficient, and concordance correlation coefficient. RESULTS: Ventilation defect percentage was significantly higher in young asthmatic patients versus young healthy subjects (8.4% ± 3.2% vs 5.6% ± 1.7%, P = 0.031), but not in older asthmatic patients versus age-matched controls (16.8% ± 10.3% vs 11.6% ± 6.6%, P = 0.13). Ventilation defect percentage was found to increase significantly with age (healthy, P = 0.05; asthmatic patients, P = 0.033). Ventilation defect percentage was highly reproducible (R = 0.976; intraclass correlation coefficient, 0.977; concordance correlation coefficient, 0.976) and significantly correlated with FEV1% (r = -0.42, P = 0.025), FEF25%-75% (r = -0.45, P = 0.019), FEV1/FVC (r = -0.71, P < 0.0001), FeNO (r = 0.69, P < 0.0001), and RV/TLC (r = 0.51, P = 0.0067). Bland-Altman analysis showed a bias for VDP of -0.88 ± 1.52 (FEV1%, -0.33 ± 7.18). CONCLUSIONS: Xenon MRI is able to depict airway obstructions in mild to moderate asthma and significantly correlates with PFTs.

Mammographic imaging with a small format CCD-based digital cassette: physical characteristics of a clinical system.

The physical characteristics of a clinical charge coupled device (CCD)-based imager (Senovision, GE Medical Systems, Milwaukee, WI) for small-field digital mammography have been investigated. The imager employs a MinR 2000 (Eastman Kodak Company, Rochester, NY) scintillator coupled by a 1:1 optical fiber to a front-illuminated 61 x 61 mm CCD operating at a pixel pitch of 30 microns. Objective criteria such as modulation transfer function (MTF), noise power spectrum (NPS), detective quantum efficiency (DQE), and noise equivalent quanta (NEQ) were employed for this evaluation. The results demonstrated a limiting spatial resolution (10% MTF) of 10 cy/mm. The measured DQE of the current prototype utilizing a 28 kVp, Mo-Mo spectrum beam hardened with 4.5 cm Lucite is approximately 40% at close to zero spatial frequency at an exposure of 8.2 mR, and decreases to approximately 28% at a low exposure of 1.1 mR. Detector element nonuniformity and electronic gain variations were not significant after appropriate calibration and software corrections. The response of the imager was linear and did not exhibit signal saturation under tested exposure conditions.

Full breast digital mammography with an amorphous silicon-based flat panel detector: physical characteristics of a clinical prototype.

The physical characteristics of a clinical prototype amorphous silicon-based flat panel imager for full-breast digital mammography have been investigated. The imager employs a thin thallium doped CsI scintillator on an amorphous silicon matrix of detector elements with a pixel pitch of 100 microm. Objective criteria such as modulation transfer function (MTF), noise power spectrum, detective quantum efficiency (DQE), and noise equivalent quanta were employed for this evaluation. The presampling MTF was found to be 0.73, 0.42, and 0.28 at 2, 4, and 5 cycles/mm, respectively. The measured DQE of the current prototype utilizing a 28 kVp, Mo-Mo spectrum beam hardened with 4.5 cm Lucite is approximately 55% at close to zero spatial frequency at an exposure of 32.8 mR, and decreases to approximately 40% at a low exposure of 1.3 mR. Detector element nonuniformity and electronic gain variations were not significant after appropriate calibration and software corrections. The response of the imager was linear and did not exhibit signal saturation under tested exposure conditions.

Architecture of the rectus abdominis, quadratus lumborum, and erector spinae.

Quantitative descriptions of muscle architecture are needed to characterize the force-generating capabilities of muscles. This study reports the architecture of three major trunk muscles: the rectus abdominis, quadratus lumborum, and three columns of the erector spinae (spinalis thoracis, longissimus thoracis and iliocostalis lumborum). Musculotendon lengths, muscle lengths, fascicle lengths, sarcomere lengths, pennation angles, and muscle masses were measured in five cadavers. Optimal fascicle lengths (the fascicle length at which the muscle generates maximum force) and physiologic cross-sectional areas (the ratio of muscle volume to optimal fascicle length) were computed from these measurements. The rectus abdominis had the longest fascicles of the muscles studied, with a mean (S.D.) optimal fascicle length of 28.3 (4.2)cm. The three columns of the erector spinae had mean optimal fascicle lengths that ranged from 6.4 (0.6)cm in the spinalis thoracis to 14.2 (2.1)cm in the iliocostalis lumborum. The proximal portion of the quadratus lumborum had a mean optimal fascicle length of 8.5 (1.5)cm and the distal segment of this muscle had a mean optimal fascicle length of 5.6 (0.9)cm. The physiologic cross-sectional area of the rectus abdominis was 2.6 (0.9)cm(2), the combined physiologic cross-sectional area of the erector spinae was 11.6 (1.8)cm(2), and the physiologic cross-sectional area of the quadratus lumborum was 2.8 (0.5)cm(2). These data provide the basis for estimation of the force-generating potential of these muscles.

Comparison of tomosynthesis methods used with digital mammography.

RATIONALE AND OBJECTIVES: The authors performed this study to investigate the potential applicability of tomosynthesis to digital mammography. Four methods of tomosynthesis-tuned aperture computed tomography (TACT)-backprojection, TACT-iterative restoration, iterative reconstruction with expectation maximization, and Bayesian smoothing-were compared to planar mammography and analyzed in terms of their contrast-detail characteristics. Specific comparisons between the tomosynthesis methods were not attempted in this study. MATERIALS AND METHODS: A full-field, amorphous, silicon-based, flat-panel digital mammographic system was used to obtain planar and tomosynthesis projection images. A composite tomosynthesis phantom with a centrally located contrast-detail insert was used as the object of interest. The total exposure for multiple views with tomosynthesis was always equal to or less than that for the planar technique. Algorithms were used to reconstruct the object from the acquired projections. RESULTS: Threshold contrast characteristics with all tomosynthesis reconstruction methods were significantly better than those with planar mammography, even when planar mammography was performed at more than twice the exposure level. Reduction of out-of-plane structural components was observed in all the tomosynthesis methods analyzed. CONCLUSION: The contrast-detail trends of all the tomosynthesis methods analyzed in this study were better than those of planar mammography. Further optimization of the algorithms could lead to better image reconstruction, which would improve visualization of valuable diagnostic information.

Evaluation of linear and nonlinear tomosynthetic reconstruction methods in digital mammography.

RATIONALE AND OBJECTIVES: The purpose of this study was to comparatively evaluate digital planar mammography and both linear and nonlinear tomosynthetic reconstruction methods. MATERIALS AND METHODS: A "disk" (ie, target) identification study was conducted to compare planar and reconstruction methods. Projective data using a composite phantom with circular disks were acquired in both planar and tomographic modes by using a full-field, digital mammographic system. Two-dimensional projections were reconstructed with both linear (ie, backprojection) and nonlinear (ie, maximization and minimization) tuned-aperture computed tomographic (TACT) methods to produce three-dimensional data sets. Four board-certified radiologists and one 4th-year radiology resident participated as observers. All images were compared by these observers in terms of the number of disks identified. RESULTS: Significant differences (P < .05, Bonferroni adjusted) were observed between all reconstruction and planar methods. No significant difference, however, was observed between the planar methods, and only a marginally significant difference (P < .054, Bonferroni adjusted) was observed between TACT-backprojection and TACT-minimization. CONCLUSION: A combination of linear and nonlinear reconstruction schemes may have potential implications in terms of enhancing image visualization to provide radiologists with valuable diagnostic information.

Fractal analysis of surface EMG signals from the biceps.

Nonlinear analysis techniques are necessary to understand the complexity of the EMG. The purpose of the present study was to determine the fractal dimension of surface EMG obtained from the biceps brachii of normal subjects during isokinetic flexion-extension of the arm. The measurements were obtained with different loading conditions on the arm and for various rates of flexion-extension. Fractal dimensions of the surface EMG signals were calculated for each of these conditions. ANOVA results showed statistically significant differences between the fractal dimensions calculated for different loading conditions and rates of flexion-extensin (P < or = 0.005). Linear regression analysis showed a correlation coefficient of 0.99 between the fractal dimension and the load, and a correlation coefficient of 0.98 between the fractal dimension and the rate of flexion-extension. The results of the study show that the fractal dimension can be used along with other parameters to characterize the EMG signal.

An intelligent system with EMG-based joint angle estimation for telemanipulation.

Bio-control of telemanipulators is being researched as an alternate control strategy. This study investigates the use of surface EMG from the biceps to predict joint angle during flexion of the arm that can be used to control an anthropomorphic telemanipulator. An intelligent system based on neural networks and fuzzy logic has been developed to use the processed surface EMG signal and predict the joint angle. The system has been tested on various angles of flexion-extension of the arm and at several speeds of flexion-extension. Preliminary results show the RMS error between the predicted angle and the actual angle to be less than 3% during training and less than 15% during testing. The technique of direct bio-control using EMG has the potential as an interface for telemanipulation applications.

Attenuation characteristics of fiberoptic plates for digital mammography and other X-ray imaging applications.

Spatially coherent fiberoptic plates are important components of some charge-coupled device (CCD)-based x-ray imaging systems. These plates efficiently transmit scintillations from the phosphor, and also filter out x-rays not absorbed by the phosphor, thus protecting the CCD from direct x-ray interaction. The thickness of the fiberoptic plate and the CCD package present a significant challenge in the design of a digital x-ray cassette capable of insertion into the existing film-screen cassette holders of digital mammography systems. This study was performed with an aim to optimize fiberoptic plate thickness. Attenuation measurements were performed on nine fiberoptic plates varying in material composition that exhibit desirable optical characteristics such as good coupling efficiency. Mammographic spectra from a clinical mammographic system and an Americium-241 (Am-241) source (59.54 KeV) were used. The spectra were recorded with a high-resolution cadmium zinc telluride (CZT)-based spectrometer and corrected for dead time and pile-up. The linear attenuation coefficients varied by a factor of 3 in the set of tested fiberoptic plates at both mammographic energies and 59.54 keV. Our results suggest that a 3-mm thick high-absorption plate might provide adequate for shielding at mammographic energies. A thickness of 2-mm is feasible for mammographic applications with further optimization of the fiberoptic plate composition by incorporating non-scintillating, high-atomic number material. This would allow more space for cooling components of the cassette and for a more compact device, which is critical for clinical implementation of the technology.

A fuzzy logic diagnosis system for classification of pharyngeal dysphagia.

Identification and classification of the dysphagic patient at risk of aspiration is important from a clinical point of view. Recently, we have developed techniques to quantify various biomechanical parameters that characterize the dysphagic patient, and have developed an expert system to classify patients based on these measurements. The purpose of the present investigation was to develop a fuzzy logic diagnosis system for classification of the patient with pharyngeal dysphagia into four categories of risk for aspiration. Non-invasive acceleration and swallow pressure measurements were obtained and five parameters were extracted from these measurements. A set of membership functions were defined for each parameter. The measured parameter values were fuzzified and fed to a rule base which provided a set of output membership values corresponding to each of the categories. The set of output values were defuzzified to obtain a continuous measure of classification. The fuzzy system was evaluated using the data obtained from 22 subjects. There was a complete agreement between the fuzzy system classification and the clinician's classification in 18 of the 22 patients. The fuzzy system overestimated the risk by half a category in two patients and underestimated by half a category in two patients. The fuzzy logic diagnosis system, together with the biomechanical measures, provides a tool for continued patient assessment on a daily basis to identify the patient who needs further videofluorography examination.

Hypertriglyceridaemia and NK cell lymphoma.

This case report describes a patient who presented with pyrexia of unknown origin allied with hypertriglyceridaemia (16.2 mmol/l) but not hypercholesterolaemia (4.1 mmol/l). Investigations identified the cause of the pyrexia as an adult T-cell lymphoma of natural killer cell phenotype (CD3[+], CD7[+], anti-TCR alpha/beta[+], CD8[+], CD56[+]). Hypertriglyceridaemia has been reported with non-Hodgkin s lymphoma, and an animal model suggests that antilipoprotein lipase antibodies may be made as an immunological response to the tumour. Lymphomas should be considered as part of the differential diagnosis in type IV-V hyperlipidaemia.

Breast imaging using an amorphous silicon-based full-field digital mammographic system: stability of a clinical prototype.

An amorphous silicon-based full-breast imager for digital mammography was evaluated for detector stability over a period of 1 year. This imager uses a structured CsI:TI scintillator coupled to an amorphous silicon layer with a 100-micron pixel pitch and read out by special purpose electronics. The stability of the system was characterized using the following quantifiable metrics: conversion factor (mean number of electrons generated per incident x-ray), presampling modulation transfer function (MTF), detector linearity and sensitivity, detector signal-to-noise ratio (SNR), and American College of Radiology (ACR) accreditation phantom scores. Qualitative metrics such as flat field uniformity, geometric distortion, and Society of Motion Picture and Television Engineers (SMPTE) test pattern image quality were also used to study the stability of the system. Observations made over this 1-year period indicated that the maximum variation from the average of the measurements were less than 0.5% for conversion factor, 3% for presampling MTF over all spatial frequencies, 5% for signal response, linearity and sensitivity, 12% for SNR over seven locations for all 3 target-filter combinations, and 0% for ACR accreditation phantom scores. ACR mammographic accreditation phantom images indicated the ability to resolve 5 fibers, 4 speck groups, and 5 masses at a mean glandular dose of 1.23 mGy. The SMPTE pattern image quality test for the display monitors used for image viewing indicated ability to discern all contrast steps and ability to distinguish line-pair images at the center and corners of the image. No bleeding effects were observed in the image. Flat field uniformity for all 3 target-filter combinations displayed no artifacts such as gridlines, bad detector rows or columns, horizontal or vertical streaks, or bad pixels. Wire mesh screen images indicated uniform resolution and no geometric distortion.

Noninvasive acceleration measurements to characterize knee arthritis and chondromalacia.

Devising techniques and instrumentation for early detection of knee arthritis and chondromalacia presents a challenge in the domain of biomedical engineering. The purpose of the present investigation was to characterize normal knees and knees affected by osteoarthritis, rheumatoid arthritis, and chondromalacia using a set of noninvasive acceleration measurements. Ultraminiature accelerometers were placed on the skin over the patella in four groups of subjects, and acceleration measurements were obtained during leg rotation. Acceleration measurements were significantly different in the four groups of subjects in the time and frequency domains. Power spectral analysis revealed that the average power was significantly different for these groups over a 100-500 Hz range. Noninvasive acceleration measurements can characterize the normal, arthritis, and chondromalacia knees. However, a study on a larger group of subjects is indicated.

Electric Field Dependence on Charge Collection of CdZnTe X-Ray Detectors.

In this study, the electric field dependence on the charge collection process of CdZnTe detectors, at different x-ray tube settings, within the x-ray diagnostic energy range, is investigated. In addition, the detector contrast at different applied bias voltages and x-ray tube settings have been experimentally determined. The experimental results suggest that an efficient charge collection process is obtained by increasing the applied bias voltage. Once the applied bias voltage is sufficiently high, charge collection becomes complete and the detector operates in the saturation region. This is a prerequisite for high contrast and spatial resolution. As a result, the detector contrast is enhanced significantly. Therefore, CdZnTe detectors appear to be potential candidates for digital radiographic applications.